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https://www.readbyqxmd.com/read/28223003/treatment-of-metformin-intoxication-complicated-by-lactic-acidosis-and-acute-kidney-injury-the-role-of-prolonged-intermittent-hemodialysis
#1
Giuseppe Regolisti, Riccardo Antoniotti, Filippo Fani, Paolo Greco, Enrico Fiaccadori
Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28217249/cockcroft-gault-revisited-new-de-liver-ance-on-recommendations-for-use-in-cirrhosis
#2
REVIEW
Gianni B Scappaticci, Randolph E Regal
The Cockcroft-Gault (CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the limitations of the original serum creatinine (SCr) based equation, but also may not appreciate the validity of the many variations used to compensate for these limitations. For cirrhotic patients in particular, the underlying pathophysiology of the disease contributes to a falsely low SCr, thereby overestimating renal function with use of the CG equation in this population...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28213685/prasugrel-for-japanese-patients-with-acute-coronary-syndrome-in-short-term-clinical-practice-prasfit-practice-i-a-postmarketing-observational-study
#3
Masato Nakamura, Tomoko Iizuka, Kei Sagawa, Kenji Abe, Shuichi Chikada, Miyuki Arai
: Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment ≥1 month before the end of the study period...
February 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28212220/hcv-antiviral-therapy-in-liver-transplant-candidates-and-recipients-with-renal-insufficiency
#4
Elizabeth C Verna, Robert S Brown
Hepatitis C virus (HCV) remains the leading indication for liver transplant in much of the world, and has traditionally been associated with diminished posttransplant survival due to recurrent HCV-related liver disease. This field has been dramatically changed by the advent of safe and effective directly active antiviral (DAA) therapy, such that most patients can be cured in the pre or posttransplant setting. In addition, there are now DAA regimens specifically approved for use in patients with severe renal insufficiency...
February 16, 2017: Transplantation
https://www.readbyqxmd.com/read/28184381/a-multicenter-longitudinal-interventional-double-blind-randomized-clinical-trial-in-hematopoietic-cell-transplant-recipients-residing-in-remote-areas-lessons-learned-from-the-late-cytomegalovirus-prevention-trial
#5
Louise E Kimball, Terry Stevens-Ayers, Margaret L Green, Hu Xie, Mary E D Flowers, Keith R Jerome, Renee LeBlanc, Christi Dahlgren, W Garrett Nichols, Roy F Chemaly, G Papanicolaou, Michael Boeckh
PURPOSE: The logistics of conducting double-blinded phase III clinical trials with participants residing in remote locations are complex. Here we describe the implementation of an interventional trial for the prevention of late cytomegalovirus (CMV) disease in hematopoietic cell transplantation (HCT) subjects in a long-term follow-up environment. METHODS: A total of 184 subjects at risk for late CMV disease surviving 80 days following allogeneic HCT were randomized to receive six months of valganciclovir or placebo...
December 15, 2016: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/28177092/-newer-anti-diabetic-therapies-and-chronic-kidney-disease
#6
Luca Di Lullo, Claudio Ronco, Vincenzo Barbera, Mario Cozzolino, Francesca Santoboni, Annalisa Villani, Antonio De Pascalis, Antonio Bellasi
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD. Intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 25) and without dose adjustment...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28176199/effects-of-antirheumatic-drug-underutilization-on-rheumatoid-arthritis-disease-activity
#7
Mohammad A Y Alqudah, Sayer Al-Azzam, Karem Alzoubi, Mohammad Alkhatatbeh, Khaldoon Alawneh, Ola Alazzeh, Bayan Ababneh
BACKGROUND: Following the recommended guidelines is crucial for achieving patient remission in rheumatoid arthritis. The aim of this study was to assess the effect of proper drug utilization of antirheumatic drugs on disease activity and drug safety in Jordan. METHODS: In a retrospective cross-sectional study, patient's demographics, clinical variables, drug regimens and side effects were recorded and the 28-joint disease activity scores were calculated. Patients were stratified into high, moderate, low disease activity or remission group...
February 8, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28167538/application-of-physiologically-based-pharmacokinetic-modeling-to-understanding-of-bosutinib-pharmacokinetics-prediction-of-drug-drug-and-drug-disease-interactions
#8
Chiho Ono, Poe-Hirr Hsyu, Richat Abbas, Cho-Ming Loi, Shinji Yamazaki
Bosutinib (Bosulif®) is an orally available Src/Abl tyrosine kinase inhibitor indicated for the treatment of patients with Ph+ chronic myelogenous leukemia. Bosutinib is predominantly metabolized by CYP3A4 as the primary clearance mechanism. The main objectives of the present study were to: 1) develop physiologically-based pharmacokinetic (PBPK) models of bosutinib, 2) verify and refine the PBPK models based upon clinical study results of bosutinib single-dose drug-drug interaction (DDI) with ketoconazole and rifampin, and single-dose drug-disease interaction (DDZI) in patients with renal and hepatic impairment, 3) apply the PBPK models to predict DDI outcome in patients with weak and moderate CYP3A inhibitors, and 4) apply the PBPK models to predict DDZI outcomes in renally and hepatically impaired patients after multiple-dose administration...
February 6, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28153389/gold-nanoparticles-ameliorate-acetaminophen-induced-hepato-renal-injury-in-rats
#9
Mohd Salim Reshi, Sadhana Shrivastava, Amita Jaswal, Neelu Sinha, Chhavi Uthra, Sangeeta Shukla
Valuable effects of gold particles have been reported and used in complementary medicine for decades. The aim of this study was to evaluate the therapeutic efficacy of gold nanoparticles (AuNPs) against acetaminophen (APAP) induced toxicity. Albino rats were administered APAP at a dose of 2g/kg p.o. once only. After 24h of APAP intoxication, animals were treated with three different doses of AuNPs (50μg/kg, 100μg/kg, 150μg/kg) orally or silymarin at a dose of 50mg/kg p.o., once only. Animals of all the groups were sacrificed after 24h of last treatment...
January 30, 2017: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
https://www.readbyqxmd.com/read/28134407/-metformin-associated-lactic-acidosis-and-acute-kidney-injury
#10
Paolo Greco, Giuseppe Regolisti, Riccardo Antoniotti, Caterina Maccari, Elisabetta Parenti, Silvia Corrado, Enrico Fiaccadori
Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28122312/sorafenib-a-potential-therapeutic-drug-for-hepatic-fibrosis-and-its-outcomes
#11
REVIEW
Rui Ma, Jiang Chen, Yuelong Liang, Shuang Lin, Linghua Zhu, Xiao Liang, Xiujun Cai
Hepatic fibrosis is a common response to liver injury that occurs in almost all liver diseases and is characterized by an excessive deposition of extracellular matrix, which can cause hepatic dysfunction and develop into cirrhosis. There is no curative treatment except liver transplantation and few treatments have been thoroughly validated in the clinic or commercialized as a therapy. Recently, sorafenib, an FDA approved molecular targeted drug for the treatment of advanced hepatocellular and renal cell carcinomas, has been reported to exert anti-fibrotic effects in liver fibrosis...
January 22, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28104152/experience-of-quatro-therapy-with-everolimus-to-minimize-calcineurin-inhibitor-for-kidney-transplant-recipients
#12
N Nakamura, T Miyazaki, H Matsuzaki, R Furuya, S Miyajima, S Irie, H Matsuoka, M Tanaka
BACKGROUND: This study was divided into three phases, on the occasion of the introduction of everolimus (EVR) in our hospital. METHODS: In the first phase, a study group of six maintenance patients (three living related donors, three deceased donors) who had a history of malignant disease with less than 500 mg/day of proteinuria were enrolled; a high serum creatinine and upper limit of duration after kidney transplant operation was not considered. EVR was discontinued in four of the six patients because of side effects or worsening renal function...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#13
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28064418/novel-antiretroviral-drugs-in-patients-with-renal-impairment-clinical-and-pharmacokinetic-considerations
#14
Dario Cattaneo, Cristina Gervasoni
Highly active antiretroviral therapy (HAART) has dramatically increased the survival of HIV-infected patients from Western countries reducing the incidence of opportunistic infections and AIDS-related malignancies, and improving the patients' quality of life compared with the pre-HAART era. HIV is thus now considered in the West as a chronic disease, with the majority of HIV-infected patients successfully reaching an optimal immune and virological outcome a few months after starting HAART. However, this switch from acute to chronic disease has been accompanied by an increased incidence of chronic kidney disease (CKD), reported in up to 60% of HIV-infected patients...
January 7, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28058212/complement-related-kidney-diseases-recurrence-after-transplantation
#15
REVIEW
Maurizio Salvadori, Elisabetta Bertoni
The recurrence of renal disease after renal transplantation is becoming one of the main causes of graft loss after kidney transplantation. This principally concerns some of the original diseases as the atypical hemolytic uremic syndrome (HUS), the membranoproliferative glomerulonephritis (MPGN), in particular the MPGN now called C3 glomerulopathy. Both this groups of renal diseases are characterized by congenital (genetic) or acquired (auto-antibodies) modifications of the alternative pathway of complement...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28029509/renal-function-and-venous-thromboembolic-diseases
#16
N Janus, I Mahé, V Launay-Vacher, J-P Laroche, G Deray
Anticoagulant agents have been approved by international regulatory agencies to prevent and treat venous thromboembolism (VTE). However, chronic kidney disease (CKD) is: (1) highly frequent in VTE patients; (2) strongly linked to VTE; and (3) a risk factor for cardiovascular morbidity/mortality and fatal pulmonary embolism. Therefore, an increasing number of patients are presented with CKD and VTE and more and more physicians must face the questions of the management of these patients and that of the handling of anticoagulant agents in CKD patients because of the pharmacokinetic modifications of these drugs in this population...
October 28, 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/28013453/pk-pd-target-attainment-with-ceftolozane-tazobactam-using-monte-carlo-simulation-in-patients-with-various-degrees-of-renal-function-including-augmented-renal-clearance-and-end-stage-renal-disease
#17
Alan J Xiao, Luzelena Caro, Myra W Popejoy, Jennifer A Huntington, Ravina Kullar
INTRODUCTION: Ceftolozane/tazobactam is an antibacterial agent with potent in vitro activity against Gram-negative pathogens, including many extended-spectrum β-lactamase-producing Enterobacteriaceae and drug-resistant Pseudomonas aeruginosa. Because ceftolozane/tazobactam is primarily excreted renally, appropriate dose adjustments are needed for patients with renal impairment. Monte Carlo simulations were used to determine the probability of pharmacokinetic/pharmacodynamic target attainment for patients with varying degrees of renal function, including augmented renal clearance (ARC) and end-stage renal disease (ESRD) with hemodialysis...
December 24, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27995343/pre-procedural-renal-resistive-index-accurately-predicts-contrast-induced-acute-kidney-injury-in-patients-with-preserved-renal-function-submitted-to-coronary-angiography
#18
Maciej T Wybraniec, Maria Bożentowicz-Wikarek, Jerzy Chudek, Katarzyna Mizia-Stec
The study aimed to evaluate the clinical utility of ultrasonographic intra-renal blood flow parameters, together with the wide range of different risk factors, for the prediction of contrast-induced acute kidney injury (CI-AKI) in patients with preserved renal function, referred for coronary angiography or percutaneous coronary interventions (CA/PCI). This prospective study covered 95 consecutive patients (69.5% men; median age 65 years) subject to elective or urgent CA/PCI. Data regarding 128 peri-procedural variables were collected...
December 19, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27993418/comparison-of-intravenous-ketorolac-at-three-single-dose-regimens-for-treating-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#19
Sergey Motov, Matthew Yasavolian, Antonios Likourezos, Illya Pushkar, Rukhsana Hossain, Jefferson Drapkin, Victor Cohen, Nicholas Filk, Andrew Smith, Felix Huang, Bradley Rockoff, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Nonsteroidal anti-inflammatory drugs are used extensively for the management of acute and chronic pain, with ketorolac tromethamine being one of the most frequently used parenteral analgesics in the emergency department (ED). The drugs may commonly be used at doses above their analgesic ceiling, offering no incremental analgesic advantage while potentially adding risk of harm. We evaluate the analgesic efficacy of 3 doses of intravenous ketorolac in ED patients with acute pain...
December 16, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27988400/alibertia-edulis-l-c-rich-a-c-rich-a-potent-diuretic-arising-from-brazilian-indigenous-species
#20
Diana Figueiredo de Santana Aquino, Cleide Adriane Signor Tirloni, Sara Emília Lima Tolouei Menegati, Claudia Andrea Lima Cardoso, Silvia Cristina Heredia Vieira, Maria do Carmo Vieira, Ana María Simonet, Francisco Antonio Macías, Arquimedes Gasparotto
ETHNOPHARMACOLOGICAL RELEVANCE: Although Alibertia edulis (L.C. Rich.) A.C. Rich decoction is used in Brazilian folk medicine due to its possible antihypertensive effect, this species has never been critically investigated as a hypotensive drug. So, the aim of this study was to evaluate the possible hypotensive and antihypertensive effects of the oral administration of Alibertia edulis aqueous extract (AEAE) in normotensive and hypertensive rats, and evaluate its inter-relation with a possible diuretic activity...
January 20, 2017: Journal of Ethnopharmacology
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