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https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#1
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3(-)) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29149953/myocardial-perfusion-scans-and-mortality-in-asymptomatic-patients-awaiting-renal-transplantation
#2
A Jauhal, S Harenberg, J J Crawford, I Bare, B Prasad, L Zahorski, G Ollenberger, V Trivedi, V Chopra, A Shoker, A Lavoie, P Dehghani
Cardiac risk assessment for asymptomatic patients awaiting renal transplantation is controversial. Patients awaiting renal transplantation in Southern Saskatchewan from 2005 to 2015 were retrospectively reviewed. Patients underwent cardiac risk stratification with stress myocardial perfusion scan. Baseline clinical characteristics, nuclear scan results, all-cause mortality, and cardiovascular events were analyzed. Abnormal scans were defined as studies with reversible defects, wall motion abnormalities, lung uptake, or transient ischemic dilation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149952/financial-impact-of-incidental-radiologic-findings-during-living-kidney-donor-evaluation
#3
A Mutneja, L Saling, M Yano, A Vijayan
Living kidney donor (LKD) transplantation is an important alternative for the end-stage renal disease population and is preferred due to superior outcomes when compared with dialysis or deceased donor transplantation. LKD evaluation includes a computed tomography angiogram (CTA) for assessment of renal and renovascular anatomy. Incidental nonrenal findings are frequently noted during the CTAs, and these may have variable clinical significance. These incidental findings lead to further testing, procedures, and referrals, which incur additional cost...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149950/structural-and-functional-adaptation-of-the-remnant-kidney-after-living-kidney-donation-long-term-follow-up
#4
M Meier, J Winterhoff, L Fricke, H Lehnert, M Nitschke
OBJECTIVE: Several adjustments occur after nephrectomy (NT) in the donor's remnant kidney. We investigated kidney donors 10 years after NT and compared several parameters before and after transplantation. METHODS: A total of 42 kidney donors of the University of Luebeck's Transplant Center were scheduled for a 10-year follow-up and were offered several investigations: laboratory tests, urinalysis and kidney ultrasound examination including determination of kidney volume (KV), resistive index (RI) and pulsatility index (PI)...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149834/cystatin-c-in-cerebrovascular-disorders
#5
Yaru Zhang, Li Sun
Cystatin C (CysC), a cysteine protease inhibitor, has been widely proven to be a highly sensitive biomarker to predict the kidney function. The similarity of the renal and cerebral small vessels has awakened a surge of studies suggesting that CysC plays a key role in various cerebrovascular disorders. This review focuses on four major mechanisms of CysC in a variety of cerebrovascular diseases. (1)The property of the CysC Leu-68-Gln (L68Q) variant to aggregate and the property of the wild type CysC protein to co-aggregate with Amyloid-β (Aβ); (2)The disruption of equilibrium between CysC and related cysteine proteases; (3)The function of CysC as an inflammatory inducing factor; (4)The ability of CysC to induce autophagy...
November 15, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/29149818/renal-dysfunction-following-elective-endovascular-aortic-aneurysm-repair
#6
Esma Isenovic, Djodje Radak, Mihailo Neskovic, Petar Otasevic
Abdominal aortic aneurysm (AAA) is a degenerative disease of the aortic wall with potentially fatal complications. Open repair (OR) was considered the gold standard, until the emergence of endovascular aneurysm repair (EVAR), which is less invasive and equally (if not more) effective. As the popularity of endovascular procedures grows, related complications become more evident, with kidney damage being one of them. Although acute kidney injury (AKI) following EVAR is relatively common, its true incidence is still uncertain...
November 16, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#7
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29147917/recommendations-for-perioperative-management-of-lung-cancer-patients-with-comorbidities
#8
REVIEW
Hiroyoshi Tsubochi, Tomoki Shibano, Shunsuke Endo
OBJECTIVES: To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. METHODS: We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29147470/retrospective-analysis-of-inferior-vena-cava-collapsibility-with-point-of-care-ultrasound-and-urine-sodium-and-fena-in-patients-with-early-stage-acute-kidney-injury
#9
Faizan Babar, Gurkeerat Singh, Mustafa Noor, Bruce Sabath
Early stage acute kidney injury (AKI) is an independent risk factor for an increase in mortality. Accurate assessment of volume status is a major challenge during the early stages of acute renal injury. Determining volume status based on the history and physical exam lacks accuracy. Urine sodium and free excretion of sodium (FENa) provide objective evidence of intravascular volume status when interpreted carefully and is helpful to delineate prerenal from intrinsic renal failure. In recent years point of care ultrasound has been used to assess volume status...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#10
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146618/management-of-adverse-events-associated-with-cabozantinib-therapy-in-renal-cell-carcinoma
#11
REVIEW
Manuela Schmidinger, Romano Danesi
Cabozantinib was recently approved for the treatment of advanced renal cell carcinoma (RCC) after treatment with vascular endothelial growth factor (VEGF)-targeted therapy. Cabozantinib is a multikinase inhibitor targeting VEGF receptor (VEGFR) 2, mesenchymal-epithelial transition receptor, and "anexelekto" receptor tyrosine kinase. A 60-mg daily dose led to improved overall survival and progression-free survival (PFS) versus everolimus in advanced RCC patients as a second- or later-line treatment in the METEOR trial...
November 16, 2017: Oncologist
https://www.readbyqxmd.com/read/29146617/cure-in-advanced-renal-cell-cancer-is-it-an-achievable-goal
#12
Dhanusha Sabanathan, John J Park, Manuel Marquez, Louise Francisco, Natalie Byrne, Howard Gurney
BACKGROUND: Immunotherapy has historically been of interest in the management of metastatic renal cell cancer (mRCC) because of its relative chemoresistance and the reproducible but low incidence of spontaneous remission in metastatic disease. Recently, targeted immunotherapies in the form of checkpoint inhibitors have shown durable responses in approximately 20%-30% of patients with solid tumors, with a much more acceptable side-effect profile. Anti-programmed death receptor 1 (PD-1)/programmed death receptor ligand 1 antibodies rely on the presence of host T cells in the tumor microenvironment to be stimulated in order to activate an antitumor response...
November 16, 2017: Oncologist
https://www.readbyqxmd.com/read/29146282/-measurement-and-estimation-of-glomerular-filtration-rate
#13
Emmanuelle Vidal-Petiot, Martin Flamant
Glomerular filtration rate is the best quantitative marker of renal function. It allows diagnosis and classification of severe chronic kidney disease into five stages. Theoretically, the measurement of glomerular filtration rate is based on the calculation of urinary clearance of exogenous substances such as chromium 51-labeled inulin or ethylenediaminetetraacetic acid ([(51)Cr]-EDTA). In practice, glomerular filtration rate is most often estimated from equations derived from plasma creatinine. This article reviews the range of methods used to measure or approximate glomerular filtration rate and attempts to describe recent developments in this area, including those related to plasma creatinine assay methods, creatinine and cystatin C concentration-derived estimations...
November 13, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29146035/renal-outcomes-with-dipeptidyl-peptidase-4-inhibitors
#14
REVIEW
A J Scheen, P Delanaye
Dipeptidyl peptidase-4 inhibitors (DPP-4is) are increasingly being used in the management of type 2 diabetes (T2D). The present review summarizes the current knowledge of the effects of DPP-4is on renal outcomes by analyzing the experimental preclinical data, the effects of DPP-4is on urinary albumin-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) from observational studies and clinical trials, and renal events (including kidney failure requiring renal replacement therapy) in recent large prospective cardiovascular outcome trials...
November 13, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29145743/novel-avenues-for-drug-discovery-in-diabetic-kidney-disease
#15
Matthew D Breyer, Matthias Kretzler
Diabetic kidney disease (DKD) has emerged as major cause of morbidity and mortality. After progressing to renal failure, over 70% of DKD patients are dead with five years. New treatments to slow this progression are desperately needed. Areas covered: This review highlights the current treatment options for people with DKD with a particular focus on angiotensin pathway blockade and the potential use of sodium glucose linked transporter 2 (SGLT2) inhibitors. These treatments are associated with an initial decrease in glomerular filtration rate (GFR) and albuminuria; there is also attention on renal hyperfiltration as therapeutic target...
November 16, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/29145295/extrarenal-teratoma-with-nephroblastoma-in-the-retroperitoneum-case-report-and-literature-review
#16
Yanan Li, Chuanfen Lei, Bo Xiang, Fuyu Li, Chuan Wang, Qi Wang, Siyuan Chen, Yi Ji
RATIONALE: Teratoma with nephroblastoma is a rare disease. The most common site at which teratoma with nephroblastoma occurs is the kidney. The mechanisms underlying the development of teratoma with nephroblastoma have not been fully elucidated. PATIENT CONCERNS: In the current report, we describe the clinical characteristics of a 3-year-old girl with a complaint of a painless abdominal mass in the upper right side of the body. Ultrasonography and computed tomography revealed a cystic-solid mass with a clear boundary...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145282/autosomal-dominant-polycystic-kidney-disease-combined-with-hypertrophic-cardiomyopathy-a-case-report
#17
Yingjing Shen, Chenggang Xu
INTRODUCTION: This report describes the novel sampling of autosomal dominant polycystic kidney disease (ADPKD) combined with hypertrophic cardiomyopathy (HCM). SYMPTOMS AND CLINICAL FINDINGS: A 48-year-old Chinese man presented with anasarca, hypourocrinia, gross hematuria, and weight gain by 10 kg subsequently developed acute kidney injury after struck by acute respiratory distress syndrome, really a threat to his heart. DIAGNOSES: Abdominal ultrasound revealed multiple small cysts in both kidneys, with the right kidney measuring 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144938/re-partial-nephrectomy-versus-radical-nephrectomy-for-clinical-t1b-and-t2-renal-tumors-a-systematic-review-and-meta-analysis-of-comparative-studies
#18
https://www.readbyqxmd.com/read/29144835/modern-systemic-therapy-for-metastatic-renal-cell-carcinoma-of-the-clear-cell-type
#19
Mamta Parikh, Primo N Lara
In the last 30 years, there have been many advances in the treatment of metastatic renal cell carcinoma of the clear cell type. Renal cell carcinoma has long been understood to have a component of immune mediation and has been responsive to immune-based therapies; in addition to early cytokine therapy, newer checkpoint inhibition therapies have also demonstrated activity. Molecular characterization of the genome of clear cell renal cell carcinoma enabled identification of the roles of angiogenesis and hypoxic stress...
November 16, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29144825/salt-hypertension-and-immunity
#20
A Justin Rucker, Nathan P Rudemiller, Steven D Crowley
The link between inappropriate salt retention in the kidney and hypertension is well recognized. However, growing evidence suggests that the immune system can play surprising roles in sodium homeostasis, such that the study of inflammatory cells and their secreted effectors has provided important insights into salt sensitivity. As part of the innate immune system, myeloid cells have diverse roles in blood pressure regulation, ranging from prohypertensive actions in the kidney, vasculature, and brain, to effects in the skin that attenuate blood pressure elevation...
November 16, 2017: Annual Review of Physiology
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