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Acute kidney injury on chronic kidney disease

E Corden, E Higgins, C Smith
A 55-year-old man with severe plaque psoriasis presented with a 2-week history of feeling generally unwell with lethargy and thirst. His symptoms had developed 6 weeks after commencement of the topical vitamin D3 analogue calcitriol. Investigations revealed hypercalcaemia and acute-on-chronic kidney injury, probably directly induced by systemic absorption of vitamin D3 following extensive topical use. Topical calcitriol had been started as a steroid-sparing agent to reduce the patient's liberal potent corticosteroid usage during anti-tumour necrosis factor-alfa therapy...
October 20, 2016: Clinical and Experimental Dermatology
Olga Ruiz-Andres, Maria Dolores Sanchez-Niño, Juan Antonio Moreno, Marta Ruiz-Ortega, Adrian Mario Ramos, Ana Belén Sanz, Alberto Ortiz
Chronic kidney disease (CKD) is associated to an increased risk of death, CKD progression and acute kidney injury (AKI) even from early stages, when glomerular filtration rate (GFR) is preserved. The link between early CKD and these risks is unclear, since there is no accumulation of uremic toxins. However, pathological albuminuria and kidney inflammation are frequent features of early CKD and the production of kidney protective factors may be decreased. Indeed, Klotho expression is already decreased in CKD category G1 (normal GFR)...
October 19, 2016: American Journal of Physiology. Renal Physiology
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
David Legouis, Pierre Galichon, Aurélien Bataille, Sylvie Chevret, Sophie Provenchère, Anne Boutten, Dimitrios Buklas, Jean-Luc Fellahi, Jean-Luc Hanouz, Alexandre Hertig
BACKGROUND: There is recent evidence to show that patients suffering from acute kidney injury are at increased risk of developing chronic kidney disease despite the fact that surviving tubular epithelial cells have the capacity to fully regenerate renal tubules and restore renal function within days or weeks. The aim of the study was to investigate the impact of acute kidney injury on de novo chronic kidney disease. METHODS: The authors conducted a retrospective population-based cohort study of patients initially free from chronic kidney disease who were scheduled for elective cardiac surgery with cardiopulmonary bypass and who developed an episode of acute kidney injury from which they recovered...
October 17, 2016: Anesthesiology
Jeremiah R Brown, Richard J Solomon, R Brooks Robey, Meg E Plomondon, Thomas M Maddox, Emily J Marshall, Elizabeth L Nichols, Michael E Matheny, Thomas T Tsai, John S Rumsfeld, Richard E Lee, Mark J Sarnak
BACKGROUND: Studies of kidney disease associated with cardiac catheterization typically rely on billing records rather than laboratory data. We examined the associations between percutaneous coronary interventions, acute kidney injury, and chronic kidney disease progression using comprehensive Veterans Affairs clinical and laboratory databases. METHODS AND RESULTS: Patients undergoing percutaneous coronary interventions between 2005 and 2010 (N=24 405) were identified in the Veterans Affairs Clinical Assessment, Reporting, and Tracking registry and examined for associated acute kidney injury and chronic kidney disease development or progression relative to 24 405 matched population controls...
October 14, 2016: Journal of the American Heart Association
Yuta Matsukuma, Kosuke Masutani, Shigeru Tanaka, Akihiro Tsuchimoto, Kiichiro Fujisaki, Kumiko Torisu, Ritsuko Katafuchi, Hideki Hirakata, Kazuhiko Tsuruya, Takanari Kitazono
Recently, low serum uric acid (SUA) levels and high SUA levels, have emerged as risk factors for cardiovascular disease, as well as for the incidence of acute kidney injury and chronic kidney disease (CKD). However, the effect of low SUA on the progression of CKD remains unclear. To evaluate the association between SUA and renal prognosis in patients with immunoglobulin A nephropathy (IgAN), one of the most common causes of CKD, we retrospectively followed 1218 patients who were diagnosed with primary IgAN by kidney biopsy between October 1979 and December 2010...
October 13, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Ryoichi Sugisawa, Emiri Hiramoto, Shigeru Matsuoka, Satomi Iwai, Ryosuke Takai, Tomoko Yamazaki, Nobuko Mori, Yuki Okada, Naoki Takeda, Ken-Ichi Yamamura, Toshiro Arai, Satoko Arai, Toru Miyazaki
Renal failure is one of the most important social problems for its incurability and high costs for patients' health care. Through clarification of the underlying mechanism for the high susceptibility of cats to renal disease, we here demonstrates that the effective dissociation of serum AIM protein from IgM is necessary for the recovery from acute kidney injury (AKI). In cats, the AIM-IgM binding affinity is 1000-fold higher than that in mice, which is caused by the unique positively-charged amino-acid cluster present in feline AIM...
October 12, 2016: Scientific Reports
Anna Julie Peired, Alessandro Sisti, Paola Romagnani
Mesenchymal stem cells form a population of self-renewing, multipotent cells that can be isolated from several tissues. Multiple preclinical studies have demonstrated that the administration of exogenous MSC could prevent renal injury and could promote renal recovery through a series of complex mechanisms, in particular via immunomodulation of the immune system and release of paracrine factors and microvesicles. Due to their therapeutic potentials, MSC are being evaluated as a possible player in treatment of human kidney disease, and an increasing number of clinical trials to assess the safety, feasibility, and efficacy of MSC-based therapy in various kidney diseases have been proposed...
2016: Stem Cells International
Patricia Huelin, Salvatore Piano, Elsa Solà, Marialuisa Stanco, Cristina Solé, Rebeca Moreira, Elisa Pose, Silvano Fasolato, Nuria Fabrellas, Glòria de Prada, Chiara Pilutti, Isabel Graupera, Xavier Ariza, Antonietta Romano, Chiara Elia, Andrés Cárdenas, Javier Fernández, Paolo Angeli, Pere Ginès
BACKGROUND & AIMS: In patients with cirrhosis of the liver, acute kidney injury (AKI) is classified into 3 stages. Recent studies indicate that there are 2 subgroups of stage 1 disease, associated with different outcomes and serum levels of creatinine (sCr): stage 1A (sCr <1.5 mg/dL) and stage 1B (SCr ≥1.5 mg/dL). We performed a prospective study to validate, in a large series of patients with cirrhosis, the association between this new description and patient outcomes, as well as assess the relationship between AKI stage and the presence of acute-on-chronic liver failure (ACLF)...
October 5, 2016: Clinical Gastroenterology and Hepatology
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
Muzafar Wani, Imtiaz Wani, Khurshid Banday, Mohd Ashraf
BACKGROUND: Vitamin D deficiency is highly prevalent in Indian Kashmir. Many people get injectable vitamin D (600,000 IU/injection). At times, the dose prescribed is far above the permissible limit. We report 62 patients with malpractice-related vitamin D intoxication, presenting with hypercalcemia and acute kidney injury (AKI). METHODS: The diagnosis was made on basis of (1) history of multiple intramuscular vitamin D injections (2) toxic serum levels of 25-OH vitamin D and (3) exclusion of common causes of hypercalcemia (malignancy and hyperparathyroidism)...
November 2016: Clinical Nephrology
Matthias Heringlake, Efstratios I Charitos, Kira Erber, Astrid Ellen Berggreen, Hermann Heinze, Hauke Paarmann
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is an emerging humoral marker for risk stratification in cardiovascular disease. Cardiac-surgery-associated acute kidney injury (CSA-AKI), an important complication in patients undergoing cardiac surgery, is associated with poor prognosis. The present secondary analysis of an observational cohort study aimed to determine the role of GDF-15 in predicting CSA-AKI compared with the Cleveland-Clinic Acute Renal Failure (CC-ARF) score and a logistic regression model including variables associated with renal dysfunction...
October 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Erik W Holy, Alexander Akhmedov, Thimoteus Speer, Giovanni G Camici, Stephen Zewinger, Nicole Bonetti, Jürg H Beer, Thomas F Lüscher, Felix C Tanner
BACKGROUND: Carbamylation alters low-density lipoprotein (LDL) structure and is thought to promote vascular inflammation and dysfunction in patients with chronic kidney disease (CKD). OBJECTIVES: This study sought to determine whether carbamylated LDL (cLDL) exerts prothrombotic effects in vascular cells and platelets and whether cLDL enhances arterial thrombus formation in vivo. METHODS: LDL was isolated from healthy subjects or patients with CKD by sequential ultracentrifugation...
October 11, 2016: Journal of the American College of Cardiology
Henrique Palomba, Isac Castro, Luis Yu, Emmanuel A Burdmann
BACKGROUND: Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. METHODS: A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up...
October 4, 2016: Journal of Nephrology
Sahir Kalim, Eugene P Rhee
The high-throughput, high-resolution phenotyping enabled by metabolomics has been applied increasingly to a variety of questions in nephrology research. This article provides an overview of current metabolomics methodologies and nomenclature, citing specific considerations in sample preparation, metabolite measurement, and data analysis that investigators should understand when examining the literature or designing a study. Furthermore, we review several notable findings that have emerged in the literature that both highlight some of the limitations of current profiling approaches, as well as outline specific strengths unique to metabolomics...
September 28, 2016: Kidney International
Heng-Chih Pan, Pei-Chen Wu, Vin-Cent Wu, Ya-Fei Yang, Tao-Min Huang, Chih-Chung Shiao, Te-Chuan Chen, Der-Cherng Tarng, Jui-Hsiang Lin, Wei-Shun Yang, Chiao-Yin Sun, Chan-Yu Lin, Tzong-Shinn Chu, Mai-Szu Wu, Kwan-Dun Wu, Yung-Chang Chen, Chiu-Ching Huang
Acute kidney injury (AKI) is a common complication in hospitalized patients. The International Society of Nephrology implemented the "0 by 25" initiative aimed at preventing deaths from treatable AKI worldwide by 2025 and conducted a global snapshot survey in 2014. We joined in the project and conducted this study to compare the epidemiology, risk factors, and prognosis between patients with pure AKI and those with acute-on-chronic kidney disease (ACKD). In this study, we prospectively collected demographic parameters and data on clinical characteristics, baseline comorbidities, management, and outcomes of 201 AKI patients in 18 hospitals in Taiwan from September 2014 to November 2014...
September 2016: Medicine (Baltimore)
Shun-Yang Cheng, Yu-Hsiang Chou, Fang-Ling Liao, Chi-Chun Lin, Fan-Chi Chang, Chia-Hao Liu, Tao-Min Huang, Chun-Fu Lai, Yu-Feng Lin, Vin-Cent Wu, Tzong-Shinn Chu, Ming-Shiou Wu, Shuei-Liong Lin
Acute kidney injury (AKI) is an important risk factor for incident chronic kidney disease (CKD). Clinical studies disclose that ensuing CKD progresses after functional recovery from AKI, but the underlying mechanisms remain illusive. Using a murine model representing AKI-CKD continuum, we show angiotensin II type 1a (AT1a) receptor signaling as one of the underlying mechanisms. Male adult CD-1 mice presented severe AKI with 20% mortality within 2 weeks after right nephrectomy and left renal ischemia-reperfusion injury...
September 28, 2016: Scientific Reports
M Esrefoglu, O E Tok, M S Aydin, M Iraz, O F Ozer, S Selek, M Iraz
BACKGROUND: Ischemia-reperfusion injury is one of the leading causes of acute renal failure which is a common clinical event leading to development of chronic kidney disease and a high mortality; especially in elderly people. β-glucans are glucose polymer groups with free-radical scavenger, macrophage activator, and immune defense inducer functions. We designed this study to determine the possible protective effects of β-glucan against renal ischemia-reperfusion injury comparatively in young and aged rats...
2016: Bratislavské Lekárske Listy
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
Francesca Saccon, Mariele Gatto, Anna Ghirardello, Luca Iaccarino, Leonardo Punzi, Andrea Doria
Galectins are evolutionary conserved β-galactoside binding proteins with a carbohydrate-recognition domain (CRD) of approximately 130 amino acids. In mammals, 15 members of the galectin family have been identified and classified into three subtypes according to CRD organization: prototype, tandem repeat-type and chimera-type galectins. Galectin-3 (gal-3) is the only chimera type galectin in vertebrates containing one CRD linked to an unusual long N-terminal domain which displays non-lectin dependent activities...
September 23, 2016: Autoimmunity Reviews
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