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Janesh Lakhoo, Senthil S Gunasekaran, R Peter Lokken, Andrew J Lipnik, Charles E Ray, James T Bui, Ron C Gaba
BACKGROUND AND STUDY AIMS: There are currently limited data available summarizing the clinical outcomes and safety of transjugular intrahepatic portosystemic shunts (TIPS) in cases of advanced chronic kidney disease (CKD). The study aimed to assess efficacy and safety of TIPS in patients with advanced CKD. PATIENTS AND METHODS: Seventeen patients (M :F 8 :9, age 55 years, MELD 24) with grade 4-5 CKD who underwent TIPS for ascites (n = 7) or varices (n = 10) were analyzed...
April 2017: Acta Gastro-enterologica Belgica
Agnes Bosch, Johannes B Scheppach, Joanna M Harazny, Ulrike Raff, Kai-Uwe Eckardt, Roland E Schmieder, Markus P Schneider
RATIONALE: Premature cardiovascular disease is a leading cause of death in patients with chronic kidney disease (CKD). In animal models CKD has been shown to cause renal and extrarenal vascular remodeling and capillary rarefaction, but data in humans with CKD are sparse. Retinal arteriolar wall-to-lumen ratio (WLR) is an established marker of early end-organ damage and there is evidence that arteriolar and capillary changes in the retinal circulation mirror those in the general and in particular the cerebrovascular microcirculation...
March 17, 2018: Microvascular Research
Chalairat Suk-Ouichai, Jitao Wu, Wen Dong, Hajime Tanaka, Yanbo Wang, J J H Zhang, Elvis Caraballo, Erick Remer, Jianbo Li, Sudhir Isharwal, Steven C Campbell
OBJECTIVES: To evaluate contact surface area (CSA) between the tumor and parenchyma as a predictor of ipsilateral parenchyma and function preserved after partial nephrectomy (PN). Previous studies suggested that CSA is a strong predictor of functional outcomes but the limitations of CSA have not been adequately explored. PATIENTS/METHODS: 419 patients managed with standard PN for solitary tumor with necessary studies to evaluate ipsilateral preoperative/postoperative parenchymal mass/function were analyzed...
March 6, 2018: Urology
Ayman S Samman Tahhan, Muhammad Hammadah, Mohamad Raad, Zakaria Almuwaqqat, Ayman Alkhoder, Pratik B Sandesara, Heval Kelli, Salim S Hayek, Jeong H Kim, Wesley T O'Neal, Matthew L Topel, Aubrey J Grant, Nabil Sabbak, Robert E Heinl, Mohamad M Gafeer, Malik Obideen, Belal Kaseer, Naser Abdelhadi, Yi-An Ko, Chang Liu, Iraj Ghaini, Ernestine A Mahar, Viola Vaccarino, Edmund K Waller, Arshed A Quyyumi
<u>Rationale:</u> Circulating progenitor cells (CPCs) mobilize in response to ischemic injury, but their predictive value remains unknown in acute coronary syndrome (ACS). <u>Objective:</u> We aimed to investigate the number of CPCs in ACS compared to those with stable coronary artery disease (CAD), relationship between bone marrow PCs and CPCs, and whether CPC counts predict mortality in patients with ACS. <u>Methods and Results:</u> In 2028 patients, 346 had unstable angina, 183 had an acute myocardial infarction (AMI) and the remaining 1499 patients had stable CAD...
March 7, 2018: Circulation Research
Verônica Torres da Costa E Silva, Elerson C Costalonga, Fernanda O Coelho, Renato A Caires, Emmanuel A Burdmann
Cancer patients are living longer. The sequelae of cancer treatment and the role of comorbid conditions present before the diagnosis, such as CKD, have been increasingly recognized. The interface between CKD and cancer is multifaceted. CKD is frequently observed in patients with cancer, and cancer treatment contributes to CKD development and progression. In addition, CKD has been recognized as an important risk factor for cancer development and reduced specific cancer survival. In this context, an accurate evaluation of the glomerular filtration rate (GFR) during oncologic treatment is pivotal and is used to define surgery strategies, program prophylactic management of contrasted examinations, make decisions on cisplatin eligibility, and adjust drug prescriptions, particularly chemotherapy agents...
January 2018: Advances in Chronic Kidney Disease
Alex R Chang, Waleed Zafar, Morgan E Grams
As the prevalence of obesity continues to increase worldwide, an increasing number of people are at risk for kidney disease. Thus, there is a critical need to understand how best to assess kidney function in this population, and several challenges exist. The convention of indexing glomerular filtration rate (GFR) to body surface area (BSA) attempts to normalize exposure to metabolic wastes across populations of differing body size. In obese individuals, this convention results in a significantly lower indexed GFR than unindexed GFR, which has practical implications for drug dosing...
January 2018: Advances in Chronic Kidney Disease
M S Ansari, Sandeep Kumar Nunia, Ankur Bansal, Prempal Singh, Virender Sekhon, Dharmveer Singh, Rahul Soni, Priyank Yadav
INTRODUCTION: Posterior urethral valve (PUV) is the most common cause of pediatric end stage renal disease (ESRD), imposing a major health burden on medical community caregivers and adversely affecting the quality of life of patients. Chronic kidney disease (CKD) stage III or estimated GFR of <60 mL/min/1.73 m2 is known to be associated with more adverse renal, cardiovascular, and clinical outcomes. Thus, it is desirable to identify factors predicting the rapid and early progression of disease...
November 22, 2017: Journal of Pediatric Urology
Kristin E Follman, Marilyn E Morris
Renal Impairment (RI) is a major health concern with a growing prevalence. RI leads to various physiological changes, in addition to a decrease in GFR, that impact the pharmacokinetics (PK) and specifically the renal clearance (CLR) of compounds, including alterations of drug transporter (DT)/drug metabolizing enzyme expression and activity, as well as protein binding. The objectives of this study were to utilize the physiologically based pharmacokinetic (PBPK) modeling platform, Simcyp® to (1) assess the impact of alterations in DT expression, toxin-drug interactions (TDIs) and free fraction (fu) on PK predictions for the OCT2/MATE1 substrate metformin in RI populations, and (2) utilize available in vitro data to improve predictions of ClR for two actively secreted substrates, metformin and ranitidine...
February 28, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
George Thomas, Paul E Drawz
Patients with CKD typically have hypertension. Manual BP measurement in the office setting was used to define hypertension, establish eligibility, and assess BP targets in the epidemiologic studies and early randomized, controlled trials that inform current management of hypertension. Use of automated oscillometric devices has largely replaced manual BP measurement in the office and clinical trials. These newer devices may reduce the white coat effect and facilitate guideline-adherent measurement protocols...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Olamide O Omidele, Natan Davoudzadeh, Michael Palese
Background and Objectives: The learning curve for achieving desirable perioperative outcomes in robot-assisted partial nephrectomy (RAPN) has not been well studied. Information is available regarding "trifecta" outcomes of no complications, no positive margins, warm ischemia time (WIT) of ≤25 minutes, and a ≤15% decrease in postoperative glomerular filtration rate (GFR). This study was conducted to assess the impact of the learning curve on surgical outcomes in patients undergoing RAPN...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Serkan Feyyaz Yalin, Sinan Trabulus, Nurhan Seyahi, Mahir Cengiz, Mustafa Erdogan Cicik, Mehmet Riza Altiparmak
In renal transplantation, living donations have more significant benefits compared to cadaveric donations. However, a probable increase in blood pressure following donation should also be kept in mind. In this study, we investigated the long-term changes in blood pressure in living kidney donors using ambulatory blood pressure monitoring and we explored the e-GFR and albuminuria/proteinuria measurements at three time points. Twenty-eight living kidney donors and 39 healthy individuals were evaluated and compared at the baseline and later at the 10th year...
February 19, 2018: Clinical Transplantation
Thibault Duburcq, Arthur Durand, Antoine Tournoys, Viviane Gnemmi, Valery Gmyr, François Pattou, Mercedes Jourdain, Fabienne Tamion, Emmanuel Besnier, Sebastien Préau, Erika Parmentier-Decrucq, Daniel Mathieu, Julien Poissy, Raphaël Favory
BACKGROUND: Sodium lactate seemed to improve fluid balance and avoid fluid overload. The objective of this study was to determine if these beneficial effects can be at least partly explained by an improvement in disseminated intravascular coagulation (DIC)-associated renal microvascular thrombosis. METHODS: Ancillary work of an interventional randomized open label controlled experimental study. Fifteen female "Large White" pigs (2 months old) were challenged with intravenous infusion of E...
February 14, 2018: Annals of Intensive Care
Keith C Norris, Karen E Smoyer, Catherine Rolland, Jan Van der Vaart, Eliza Beth Grubb
BACKGROUND: Albuminuria, elevated serum creatinine and low estimated glomerular filtration rate (eGFR) are pivotal indicators of kidney decline. Yet, it is uncertain if these and emerging biomarkers such as uric acid represent independent predictors of kidney disease progression or subsequent outcomes among individuals with type 2 diabetes mellitus (T2DM). This study systematically examined the available literature documenting the role of albuminuria, serum creatinine, eGFR, and uric acid in predicting kidney disease progression and cardio-renal outcomes in persons with T2DM...
February 9, 2018: BMC Nephrology
Farrukh M Koraishy, Denise Hooks-Anderson, Joanne Salas, Michael Rauchman, Jeffrey F Scherrer
BACKGROUND: Fast glomerular filtration rate (GFR) decline is associated with adverse outcomes, but the associated risk factors among patients without chronic kidney disease (CKD) are not well defined. METHODS: From a primary care registry of 37,796, we identified 2219 (6%) adults with at least three estimated (e)GFR values and a baseline eGFR between 60 and 119 ml/min/1.73 m2 during an observation period of 8 years. We defined fast GFR decline as > 5 ml/min/1...
February 5, 2018: International Urology and Nephrology
Tae Dong Jeong, Jaeryuk Kim, Woochang Lee, Sail Chun, Ki Sook Hong, Won Ki Min
The 1B equation is recommended for calculating the glomerular filtration rate (GFR) in children. Since few reports have evaluated the performance of the 1B equation, we investigated the performance of estimated GFR (eGFR) equations with the blood urea nitrogen (BUN) variable for pediatric cancer patients. In total, 203 children with cancer who underwent measured GFR (mGFR) assessment were enrolled. The median (range) mGFR and eGFR calculated using the updated Schwartz equation were 118 (43-241) and 135 (34-257) mL/min/1...
May 2018: Annals of Laboratory Medicine
Ayse L Mindikoglu, Antone R Opekun, William E Mitch, Laurence S Magder, Robert H Christenson, Thomas C Dowling, Matthew R Weir, Stephen L Seliger, Charles D Howell, Jean-Pierre Raufman, Abbas Rana, John A Goss, Saira A Khaderi, John M Vierling
BACKGROUND: Lower serum Cr levels in women as compared to men result in underestimation of renal dysfunction and lower model for end-stage liver disease-sodium scores leading to reduced access to liver transplantation in women compared to men with comparable hepatic dysfunction. AIM: The aim of this study was to determine the gender differences in serum Cr, cystatin C, and other endogenous glomerular filtration rate (GFR) biomarkers, measured and estimated GFR, Cr clearance, and Cr production rates...
February 1, 2018: Digestive Diseases and Sciences
Baris U Agar, James A Sloand
BACKGROUND: Incremental dialysis utilizes gradually increasing dialysis doses in response to declines in residual kidney function, and it is the preferred renal replacement therapy for patients who have just transitioned to end-stage renal disease (ESRD). Incremental peritoneal dialysis (PD) may impose fewer restrictions on patients' lifestyle, help attenuate lifetime peritoneal and systemic exposure to glucose and its degradation products, and minimize connections that could compromise the sterile fluid path...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Wan-Wan Xu, Ying-Ying Zhang, Juan Su, Ao-Fei Liu, Kai Wang, Chen Li, Yun-E Liu, Yi-Qun Zhang, Jin Lv, Wei-Jian Jiang
Ischemia-reperfusion injury (IRI) is an important cause of adverse prognosis after recanalization in patients with acute occlusion of major intracranial artery (AOMIA). Here, we provided data indicating that gradual flow restoration (GFR) would be superior to rapid flow restoration (RFR) in alleviating cerebral IRIs in middle cerebral artery occlusion (MCAO) rats. A total of 94 MCAO rats with 15, 30 and 60-minute occlusion were randomly assigned to receive either GFR or RFR intervention. There were significant differences between GFR and RFR group in mean neurological severity score (1...
January 26, 2018: Scientific Reports
Yoshimitsu Gotoh, Osamu Uemura, Kenji Ishikura, Tomoyuki Sakai, Yuko Hamasaki, Yoshinori Araki, Riku Hamda, Masataka Honda
BACKGROUND: The gold standard for evaluation of kidney function is renal inulin clearance (Cin). However, the methodology for Cin is complicated and difficult, especially for younger children and/or patients with bladder dysfunction. Therefore, we developed a simple and easier method for obtaining the estimated glomerular filtration rate (eGFR) using equations and values for several biomarkers, i.e., serum creatinine (Cr), serum cystatin C (cystC), serum beta-2 microglobulin (β2MG), and creatinine clearance (Ccr)...
January 25, 2018: Clinical and Experimental Nephrology
Radhika Devraj, Matthew E Borrego, A Mary Vilay, Junvie Pailden, Bruce Horowitz
AIM: To determine the relationship between chronic kidney disease (CKD) awareness (CKD-A), self-management behaviors (CKD-SMB) knowledge, performance of CKD-SMBs, health literacy (HL) and kidney function. METHODS: Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-management knowledge tool (CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR (eGFR) was determined using the MDRD-4 equation...
January 6, 2018: World Journal of Nephrology
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