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Renal Function Recovery

Hassan Izzedine
Drug-induced nephrotoxicity (DIN) remains a current problem with economic and medical consequences. It affects all nephron segments. Recovery of renal function is based on the identification of risk factors, early diagnosis of renal disease, rapid (if possible) cessation of the causative agent and, in some cases, adjunctive therapy. Prevention is based on identification of early markers of DIN, correction of risk factors, initial assessment of renal function for adequate dosage adjustment and exclusion of other nephrotoxic factors...
March 11, 2018: Néphrologie & Thérapeutique
Jeehoon Kang, Jin Joo Park, Young-Jin Cho, Il-Young Oh, Hyun-Ah Park, Sang Eun Lee, Min-Seok Kim, Hyun-Jai Cho, Hae-Young Lee, Jin Oh Choi, Kyung-Kuk Hwang, Kye Hun Kim, Byung-Su Yoo, Seok-Min Kang, Sang Hong Baek, Eun-Seok Jeon, Jae-Joong Kim, Myeong-Chan Cho, Shung Chull Chae, Byung-Hee Oh, Dong-Ju Choi
BACKGROUND: Worsening renal function (WRF) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction (HFpEF) versus those with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0...
March 13, 2018: Journal of the American Heart Association
Shouzhe Lin, Dameng Lian, Weihua Liu, Aaron Haig, Ian Lobb, Ahmed Hijazi, Hassan Razvi, Jeremy Burton, Matthew Whiteman, Alp Sener
OBJECTIVES: To assess the effects of slow-releasing H2 S donor GYY4137 on post-obstructive renal function and injury following unilateral ureteral obstruction (UUO) by using the UUO and reimplantation (UUO-R) model in rats and to elucidate potential mechanisms by using an in vitro model of epithelial-mesenchymal transition (EMT). METHODS: Male Lewis rats underwent UUO at the left ureterovesical junction. From post-obstructive day (POD) 1-13, rats received daily intraperitoneal (IP) injection of phosphate buffered saline (PBS, 1 mL) or GYY4137 (200 μmol/kg/day in 1 mL PBS, IP)...
March 6, 2018: Nitric Oxide: Biology and Chemistry
Lu-Ping Li, Jon Thacker, Wei Li, Huan Tan, Chi Wang, Orly Kohn, Stuart Sprague, Pottumarthi Prasad
BACKGROUND: Identification of patients with progressive chronic kidney disease (CKD) and those likely to respond to candidate therapeutics is urgently needed. Functional MRI measurements have shown promise. However, knowledge about the consistency of the measurements is essential to conduct longitudinal studies. PURPOSE/HYPOTHESIS: To investigate the consistency of repeated functional MRI measurements in healthy subjects. STUDY TYPE: Prospective, longitudinal study...
March 8, 2018: Journal of Magnetic Resonance Imaging: JMRI
James A Tumlin, Raghavan Murugan, Adam M Deane, Marlies Ostermann, Laurence W Busse, Kealy R Ham, Kianoush Kashani, Harold M Szerlip, John R Prowle, Azra Bihorac, Kevin W Finkel, Alexander Zarbock, Lui G Forni, Shannan J Lynch, Jeff Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Rinaldo Bellomo
OBJECTIVE: Acute kidney injury requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function without decreasing intrarenal oxygenation. We analyzed the impact of angiotensin II on the outcomes of acute kidney injury requiring renal replacement therapy. DESIGN: Post hoc analysis of the Angiotensin II for the Treatment of High-Output Shock 3 trial...
March 3, 2018: Critical Care Medicine
Eduardo C Gomes, Diego R Falci, Pedro Bergo, Alexandre P Zavascki, Maria Helena Rigatto
OBJECTIVES: To evaluate the impact of polymyxin B (PMB)- associated Acute Kidney Injury (AKI) in 1-year mortality and renal function recovery. METHODS: Patients >18 years old who survived the first 30-days after PMB therapy were followed for 1-year. The impact of AKI and Renal Failure (using RIFLE score) in 1-year mortality was analyzed, along with other confounding variables. Variables with a P value ≤0.2 were included in a forward stepwise Cox regression model...
March 1, 2018: International Journal of Antimicrobial Agents
Neil J Glassford, Rinaldo Bellomo
Acute kidney injury (AKI) is common, although commonly used clinical diagnostic markers are imperfect. Intravenous fluid administration remains a cornerstone of therapy worldwide, but there is minimal evidence of efficacy for the use of fluid bolus therapy outside of specific circumstances, and emerging evidence associates fluid accumulation with worse renal outcomes and even increased mortality among critically ill patients. Artificial colloid solutions have been associated with harm, and chloride-rich solutions may adversely affect renal function...
April 2018: Critical Care Clinics
Tauqeer Hussain Mallhi, Amer Hayat Khan, Azreen Syazril Adnan, Azmi Sarriff, Yusra Habib Khan, Siew Hua Gan
BACKGROUND: Despite myriad improvements in the care of dengue patients, acute kidney injury (AKI) remained least appreciated intricacy of dengue infection. Exiting literature does not provide any information on renal outcomes among dengue patients surviving an episode of AKI. METHODS: Dengue patients who developed AKI were followed up for post-discharge period of three months and renal recovery was assessed by using recovery criteria based on different thresholds of serum creatinine (SCr) and estimated glomerular filtration rates (eGFR)...
2018: PloS One
Wen-Yi Zhang, Cui-Juan Niu, Bo-Jian Chen, Kenneth B Storey
Turtles are well known for their stress tolerance, including an ability to deal with temperature extremes or rapid thermal change. To know more about the comprehensive molecular basis of thermal stress responses in turtles, we assessed differentially expressed genes (DEGs) in the brain, liver and kidney of juvenile soft-shelled turtles, Pelodiscus sinensis, after acute cold stress (28 °C-8 °C acute transfer and held for 12 h) and following recovery (back to 28 °C and held for 24 h) by digital gene expression profiling...
February 20, 2018: Cryobiology
Theis S Itenov, Rasmus Ehrenfried Berthelsen, Jens-Ulrik Jensen, Thomas A Gerds, Lars M Pedersen, Ditte Strange, Katrin Thormar, Jesper Løken, Mads H Andersen, Hamid Tousi, Nanna Reiter, Jens D Lundgren, Morten H Bestle
OBJECTIVE: Intensive care unit (ICU) patients with acute kidney injury (AKI) who recover kidney function within 28 days experience less severe chronic kidney impairment and have increased long term survival. The aims of this study were to develop and validate a risk prediction model to identify these patients. DESIGN: Observational study with development and validation of a risk prediction model. SETTING: Nine academic ICUs in Denmark. PARTICIPANTS: Development cohort of critically ill patients with AKI at ICU admission from the Procalcitonin and Survival Study cohort (n = 568), validation cohort of adult patients with AKI admitted to two university hospitals in Denmark in 2012-13 (n = 766)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Zohra Ghlissi, Ahmed Hakim, Hela Mnif, Rim Kallel, Khaled Zeghal, Tahiya Boudawara, Zouheir Sahnoun
This study was carried out to evaluate spontaneous renal regeneration after stopping colistin methanesulfonate (CMS), which induces tubular damage, and the curative effect of Vitamin E (vit E) in rats. Animals were given the following: sterile saline (n = 6), 300,000 IU/kg/ day of CMS (n = 24), or 450,000 IU/kg/day of CMS (n = 24) for seven days. Each CMS group was subdivided into four subgroups (n = 6) and sacrificed as follows: (i) 12 h after stopping CMS, (ii) two weeks after stopping CMS, (iii) two weeks after stopping treatment with vit E, and (iv) two weeks after stopping treatment with olive oil...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Cátia Pereira, Patrícia Costa-Reis, José Esteves da Silva, Rosário Stone
Tubulointerstitial nephritis and uveitis syndrome is an uncommon disease, probably underdiagnosed in clinical practice. Its aetiology and pathogenesis remain unknown. This syndrome is defined by an association of uveitis and tubulointerstitial nephritis, with no evidence of systemic disease or infection that might cause both ocular and renal inflammation. Renal and ocular manifestations may not occur simultaneously, making the diagnosis even more challenging. Treatment includes topical and oral corticosteroids...
February 17, 2018: BMJ Case Reports
Hongbo Xu, Cheng Chen, Linkun Hu, Jianquan Hou
Acute kidney injury (AKI) is a common syndrome in the clinic and has become a worldwide public health problem. Renal ischemia-reperfusion injury (IRI) is the most common cause of AKI. So far, effective treatment is still lacking for renal IRI, resulting in a high mortality rate of AKI. Mesenchymal stem cells (MSCs), considered as a promising candidate for tissue repair and regenerative medicine have aroused an increasing concern in recent years for the capacity of self-renewal and multi-lineage differentiation...
February 13, 2018: Current Gene Therapy
Ina Maria Schiessl, Alexandra Grill, Katharina Fremter, Dominik Steppan, Maj-Kristina Hellmuth, Hayo Castrop
BACKGROUND: The kidney is considered to be a structurally stable organ with limited baseline cellular turnover. Nevertheless, single cells must be constantly replaced to conserve the functional integrity of the organ. PDGF chain B (PDGF-BB) signaling through fibroblast PDGF receptor- β (PDGFR β ) contributes to interstitial-epithelial cell communication and facilitates regenerative functions in several organs. However, the potential role of interstitial cells in renal tubular regeneration has not been examined...
February 14, 2018: Journal of the American Society of Nephrology: JASN
Shantelle Bartra
Transcatheter pulmonary valve replacement is now a feasible alternative to surgical pulmonary valve replacement in children and adults with dysfunctional right ventricular outflow conduits. Currently, 2 types of valves can be used for this application. This article provides an overview of the procedure and how it is performed, indications and contraindications for transcatheter pulmonary valve replacement, and short- and long-term outcomes. Nursing considerations mainly focus on educating patients, preventing bleeding and infection, monitoring renal function, and preventing injury to the catheter insertion site...
February 2018: Critical Care Nurse
Sandhya Manohar, Abdurrahman Hamadah, Sandra M Herrmann, Stephen C Textor
Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Adrien Joseph, Stephanie Harel, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Lara Zafrani, Elie Azoulay, Emmanuel Canet
Background: Despite substantial improvements in the management of multiple myeloma, renal failure remains an important burden that tremendously impairs prognosis. The purpose of this study was to describe the characteristics and to establish prognostic factors of renal recovery in myeloma patients admitted to the intensive care unit (ICU) for acute kidney injury (AKI) Stage 3 treated with renal replacement therapy (RRT). Methods: A retrospective single-centre cohort study was performed, including consecutive myeloma patients admitted to one medical ICU between 1 January 2007 and 1 September 2015 and treated with RRT...
February 2018: Clinical Kidney Journal
Jochen G Raimann, Miguel C Riella, Nathan W Levin
In developing countries with limited medical infrastructure, preservation and recovery of renal function following acute kidney injury (AKI) is difficult. In conjunction with clinical presentation, rapid measurement of renal function is essential for early diagnosis and management. Especially in low- and middle-income countries, simple interventions such as hydration and avoidance of toxins have the highest probability of recovery. In such contexts, measurement of urine volume and osmolality and serum creatinine with point-of-care devices and saliva urea nitrogen dipsticks can be valuable...
February 2018: Clinical Kidney Journal
Judith Kooiman, Jean-Paul P M de Vries, Jan Van der Heyden, Yvo W J Sijpkens, Paul R M van Dijkman, Jan J Wever, Hans van Overhagen, Antonie C Vahl, Nico Aarts, Iris J A M Verberk-Jonkers, Harald F H Brulez, Jaap F Hamming, Aart J van der Molen, Suzanne C Cannegieter, Hein Putter, Wilbert B van den Hout, Inci Kilicsoy, Ton J Rabelink, Menno V Huisman
BACKGROUND: Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures. METHODS: We performed an open-label multicentre non-inferiority trial between 2011-2014...
2018: PloS One
Wei Zhang, Feng Xue, Cui Wang, Leping Shao
IgG4-related retroperitoneal fibrosis (IgG4-RPF) is a newly recognized entity which often mimics cancer. We aimed to investigate the clinical features and the causes of renal failure, as well as to explore the factors affecting the prognosis of renal function by analysis of the clinical data of patients with IgG4-RPF. We reviewed clinical features of 10 patients with renal failure caused by IgG4-RPF, which was confirmed by pathology review and clinic-pathologic correlations. All patients were male, and the mean age at onset was 64...
January 5, 2018: Oncotarget
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