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Acute Kidney Insufficiency

Mark E Lowe, Marc T Goodman, Gregory A Coté, Marshall J Glesby, Mark Haupt, Nicholas J Schork, Vikesh K Singh, Dana K Andersen, Stephen J Pandol, Aliye Uc, David C Whitcomb
Recurrent acute pancreatitis (RAP) is a complex clinical syndrome with significant morbidity, unpredictable outcomes, and limited treatment options. The National Institute of Diabetes and Digestive and Kidney Disease sponsored a workshop on July 25, 2018, in Pittsburgh, Pennsylvania, to address research gaps impeding development of effective therapies for pancreatitis. The RAP working group identified challenges to clinical progress using existing definitions, risk assessment, diagnostic and severity criteria, disease trajectories, outcomes, and research methods...
November 2018: Pancreas
Channabasappa Shivaprasad, Yalamanchi Aiswarya, Atluri Sridevi, Biswas Anupam, Goel Amit, Boppana Rakesh, Pulikkal A Annie, Kolly Anish
PURPOSE: Hypopituitarism (HP) is an uncommon consequence of Russell's viper envenomation (RVE). Delayed hypopituitarism (DHP) presents months to years after recovering from snake bites (SB). The clinical presentation, manifestations, and outcomes of DHP following RVE have not been systematically studied. Here, we present a case series of HP following RVE with delayed diagnosis and conduct a literature review. METHODS: We retrospectively reviewed data of eight DHP cases and literature to outline the presentation, manifestations, hormonal profiles, and radiological features of DHP following RVE...
October 13, 2018: Pituitary
Chung Hee Baek, Hyosang Kim, Hoon Yu, Won Seok Yang, Duck Jong Han, Su-Kil Park
BACKGROUND BK nephropathy (BKN) affects graft function and increases the risk of graft failure. The reduction of immunosuppression is the main treatment for BKN. However, acute rejection may develop following immunosuppression reduction, and data regarding the risk factors of acute rejection during the post-reduction period are insufficient. MATERIAL AND METHODS Of 758 patients who received a kidney transplantation (KT) between 2008 and 2011, 79 who underwent immunosuppression reduction as BKN treatment were enrolled...
October 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Jonathan Maurice Chemouny, Aurélie Sannier, Guillaume Hanouna, Laure Champion, Francois Vrtovsnik, Eric Daugas
RATIONALE: Malakoplakia is a rare disease characterized by the presence of nongranulomatous macrophage infiltration. In most cases, it affects the urinary tract. Malakoplakia can cause acute kidney injury when it is localized in the kidneys. PATIENT CONCERNS: Here, we report the case of a 65-year-old female patient with renal malakoplakia responsible for hypercalcemia. During her initial assessment, she was also diagnosed 25-OH vitamin D insufficiency, for which she was prescribed oral cholecalciferol...
October 2018: Medicine (Baltimore)
Laura K Young, Shona Z Matthew, J Graeme Houston
OBJECTIVES: Recent safety concerns regarding gadolinium-based contrast agents (GdCAs) concluded with the suspension of some agents from the European market, yet a clinical consequence remains unknown. We used electronic health records to investigate the incidence of potential toxicity to gadoteric acid (Dotarem®) within our local population, including those with renal insufficiency (RI). METHODS: Data for patients who underwent contrast-enhanced MRI were identified, stratified by renal function at time of scan and retrospectively followed using routinely collected health data...
October 1, 2018: European Radiology
Fabrice Barlesi, Johan Vansteenkiste, David Spigel, Hidenobu Ishii, Marina Garassino, Filippo de Marinis, Mustafa Özgüroğlu, Aleksandra Szczesna, Andreas Polychronis, Ruchan Uslu, Maciej Krzakowski, Jong-Seok Lee, Luana Calabrò, Osvaldo Arén Frontera, Barbara Ellers-Lenz, Marcis Bajars, Mary Ruisi, Keunchil Park
BACKGROUND: Antibodies targeting the immune checkpoint molecules PD-1 or PD-L1 have demonstrated clinical efficacy in patients with metastatic non-small-cell lung cancer (NSCLC). In this trial we investigated the efficacy and safety of avelumab, an anti-PD-L1 antibody, in patients with NSCLC who had already received platinum-based therapy. METHODS: JAVELIN Lung 200 was a multicentre, open-label, randomised, phase 3 trial at 173 hospitals and cancer treatment centres in 31 countries...
September 21, 2018: Lancet Oncology
B Nagaraju Naik, Ashish Bhalla, Navneet Sharma, Jitender Mokta, Surjit Singh, Prakamya Gupta, Ashutosh Rai, Sridhar Subbiah, Anil Bhansali, Pinaki Dutta
Purpose: Endocrinal insufficiency caused by vasculotoxic snake envenomation is under-recognized and is mostly confined to a specific geographic area. We conducted a prospective study to determine the prevalence and pattern of pituitary-target gland insufficiencies caused by snake envenomation. Materials and Methods: The hormonal evaluation of patients who had suffered from vasculotoxic snake envenomation was done at baseline and at 6 months of follow-up. Those patients with a documented hormonal insufficiency underwent magnetic resonance imaging (MRI) of the hypothalamo-pituitary area...
September 2018: Neurology India
Siu-Hin Wan, Joshua P Slusser, David O Hodge, Horng H Chen
Objective: To determine the risks of acute kidney injury development and long-term clinical outcomes of patients with hypertensive crisis. Patients and Methods: This was a population study of Olmsted County residents with hypertensive crisis between January 1, 2000, and December 31, 2008, with follow-up until June 30, 2016. Results: The results demonstrated that those with underlying chronic kidney disease upon admission for hypertensive crisis, defined as a systolic blood pressure above 180 mm Hg or diastolic blood pressure above 120 mm Hg, were more likely to develop acute kidney injury during hospitalization (odds ratio, 6...
June 2018: Mayo Clinic proceedings. Innovations, quality & outcomes
Chun Zhang, Ting Lin, Jingyao Zhang, Huan Liang, Ying Di, Na Li, Jie Gao, Wenjing Wang, Sinan Liu, Zheng Wang, Hongli Jiang, Chang Liu
OBJECTIVE: To evaluate the clinical effect and safety of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) after hepatectomy. METHODS: A retrospective analysis of the clinical data of all patients with AKI after hepatectomy for CRRT admitted to surgical intensive care unit (ICU) of the First Affiliated Hospital of Xi'an Jiaotong University from January 19th, 2013 to January 19th, 2018 was performed...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Ramy M Hanna, Umut Selamet, Patrick Bui, Shih-Fan Sun, Olivia Shenouda, Niloofar Nobakht, Marina Barsoum, Farid Arman, Anjay Rastogi
Pembrolizumab is an immune checkpoint inhibitor that targets the programmed cell death protein 1 (PD-1) antigen and induces an immune response against tumor tissues. It has been successful in inducing remission in patients with severe metastatic disease, often refractory to other chemotherapeutic agents. The risk of injury of other organ systems has been noted with reported cases of glomerular disease and endocrine disease. In addition, hypophysitis as well as dermatological and gastroenterological side effects have been reported...
May 2018: Case Reports in Nephrology and Dialysis
Nathan M Lee, Lev Deriy, Timothy R Petersen, Vallabh O Shah, Michael P Hutchens, Neal S Gerstein
OBJECTIVE: Administration of excess chloride in 0.9% normal saline (NS) decreases renal perfusion and glomerular filtration rate, thereby increasing the risk for acute kidney injury (AKI). In this study, the effect of NS versus Isolyte use during cardiac surgery on urinary levels of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor-binding protein 7 [TIMP-2] × [IGFBP7] and postoperative risk of AKI were examined. DESIGN: Prospective, randomized, and single-blinded trial...
August 1, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Ulf Nyman, Joanna Ahlkvist, Peter Aspelin, Torkel Brismar, Anders Frid, Mikael Hellström, Per Liss, Gunnar Sterner, Peter Leander
A side-by-side comparison of updated guidelines regarding contrast medium-induced acute kidney injury (CI-AKI) from the Swedish Society of Uroradiology (SSUR) and the European Society of Urogenital Radiology (ESUR) is presented. The major discrepancies include a higher glomerular filtration rate (GFR) threshold as a risk factor for CI-AKI and for discontinuation of metformin by SSUR, i.e., < 45 ml/min versus < 30 ml/min/1.73 m2 by ESUR, when intravenous or intra-arterial contrast media (CM) with second-pass renal exposure is administered...
August 21, 2018: European Radiology
Zachary Tyerman, Robert B Hawkins, James Hunter Mehaffey, Mohammed Quader, Alan Speir, Leora T Yarboro, Gorav Ailawadi
Statins have potent pleiotropic effects that have been correlated with improved perioperative cardiovascular surgery outcomes. We hypothesize that statins may improve morbidity and mortality after ascending aortic surgery. Within a statewide database consisting of 19 centers a total of 1804 patients had ascending aortic repair with or without aortic valve replacement (2004-2016). Patients were stratified by preoperative statin therapy for analysis. To account for baseline differences, patients were propensity matched in a 1:1 fashion by baseline characteristics...
August 10, 2018: Seminars in Thoracic and Cardiovascular Surgery
Carlos G Musso, Alejandrina Castañeda, María Giordani, Cesar Mombelli, Silvia Groppa, Nora Imperiali, Guillermo Rosa Diez
Kidney transplant patients (KTPs), and particularly those with advanced chronic kidney rejection, may be affected by opportunistic infections, metabolic alterations and vascular and oncologic diseases that promote clinical conditions that require a variety of treatments, the combinations of which may predispose them to hyponatremia. Salt and water imbalance can induce abnormalities in volemia and/or serum sodium depending on the nature of this alteration (increase or decrease), its absolute magnitude (mild or severe) and its relative magnitude (body sodium:water ratio)...
August 2018: Clinical Kidney Journal
Guiming Cheng, Xun Tang, Jun Zhang
Type II diabetes is associated with a low quality of life and inflammation, and is often accompanied by varying degrees of chronic renal failure. Chronic renal failure is considered one of the most important factors that aggravates diabetes and contributes to renal insufficiency in patients with diabetes though cellular fibrosis. It has previously been reported that hepatocyte growth factor (HGF) serves extensive biological roles, and is a multifunctional antifibrotic factor that is involved in kidney development, acute injury and regeneration...
September 2018: Molecular Medicine Reports
Jun-Li Tsai, Shang-Feng Tsai
Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes...
July 31, 2018: Experimental and Clinical Transplantation
Geng Qian, Chang-Fu Liu, Jun Guo, Wei Dong, Jin Wang, Yun-Dai Chen
OBJECTIVES: This study aimed to explore the adequate hydration with nitrates for patients with chronic kidney disease (CKD) and congestive heart failure (CHF) to reduce the risk of contrast-induced nephropathy (CIN) and at the same time avoid the acute heart failure. METHODS: 394 consecutive patients with CKD and CHF undergoing coronary procedures were randomized to either adequate hydration with nitrates (n=196) or to routine hydration (control group; n=198). The adequate hydration group received continuous intravenous infusion of isosorbide dinitrate combined with intravenous infusion of isotonic saline at a rate of 1...
July 27, 2018: Clinical Cardiology
Ioannis Bellos, Georgia Fitrou, Georgios Daskalakis, Despina N Perrea, Vasilios Pergialiotis
There is growing evidence that neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury. The objective of this meta-analysis is to determine the accuracy of serum and urinary NGAL in the detection of acute kidney injury in neonates with perinatal asphyxia. Medline (1966-2018), Scopus (2004-2018), EMBASE (1980-2018), (2008-2018), and Google Scholar (2004-2018) databases, along with the reference lists of the electronically retrieved articles, were systematically searched...
October 2018: European Journal of Pediatrics
Anne C van Erp, Leon F A van Dullemen, Rutger J Ploeg, Henri G D Leuvenink
BACKGROUND: Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation. METHODS: Pubmed, Embase, Cochrane, and were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment...
October 2018: Transplantation Reviews
Shiyong Zeng, Jinle Lin, Wenwu Zhang
Acute kidney injury (AKI) is a common complication in patients with sepsis, with poor prognosis and high mortality. The pathogenesis of sepsis-induced acute kidney injury (SAKI) is closely related to renal hemodynamic abnormalities, inflammatory injury and adaptive mechanism. It is insufficient for previous criteria based on urine output and creatinine to the early diagnosis of SAKI. The emergence of new biomarkers may make up for deficiencies in early diagnosis. And significant progress has also been made in the treatment of SAKI...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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