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drug dosing in renal disease

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https://www.readbyqxmd.com/read/28625368/effect-of-aspirin-on-renal-disease-progression-in-patients-with-type-2-diabetes-a-multicenter-double-blind-placebo-controlled-randomized-trial-the-renal-disease-progression-by-aspirin-in-diabetic-patients-leda-trial-rationale-and-study-design
#1
Francesco Violi, Giovanni Targher, Annarita Vestri, Roberto Carnevale, Maurizio Averna, Alessio Farcomeni, Andrea Lenzi, Francesco Angelico, Francesco Cipollone, Daniele Pastori
Type 2 diabetes mellitus (T2DM) is one of the most common causes of chronic kidney disease and kidney failure. It has been estimated that the annual decline of estimated glomerular filtration rate (eGFR) among patients with T2DM is approximately 2.0-2.5mL min(-1) y(-1). Cyclooxygenase-dependent eicosanoids, such as 11-dehydro-thromboxane (Tx)B2, are increased in T2DM patients and are potentially involved in the regulation of renal blood flow. Animal models showed that cyclooxygenase inhibitors, such as aspirin, are associated with improvements in renal plasma flow and eGFR values...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#2
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28607667/cardiovascular-and-cerebrovascular-risk-with-nonsteroidal-anti-inflammatory-drugs-and-cyclooxygenase-2-inhibitors-latest-evidence-and-clinical-implications
#3
REVIEW
Andrea Fanelli, Daniela Ghisi, Pierangelo Lora Aprile, Francesco Lapi
Observational studies and meta-analyses have shown that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs), especially when prescribed at high doses for long periods of time, can potentially increase the risk of cardiovascular diseases. The increased thrombotic risk related to the use of NSAIDs is mainly due to their cyclooxygenase 2 selectivity. The dosage use, the formulation selected and the duration of the therapy are other factors that can significantly impact on the cardiovascular risk...
June 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28599300/cancer-and-the-kidney-dangereoux-liasons-or-price-paid-for-the-progress-in-medicine
#4
REVIEW
Jolanta Małyszko, Leszek Kozlowski, Klaudia Kozłowska, Maciej Małyszko, Jacek Małyszko
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28596512/paricalcitol-as-an-antiproteinuric-agent-can-result-in-the-deterioration-of-renal-and-heart-function-in-a-patient-with-fabry-disease
#5
Tajda Keber, Martin Tretjak, Andreja Cokan Vujkovac, Marija Mravljak, Katja Ravber, Bojan Vujkovac
BACKGROUND Fabry disease is a rare and progressive X-linked inherited disorder of glycosphingolipid metabolism that is due to deficient or absent lysosomal a-galactosidase A activity. Among its other associated signs and symptoms, patients present with renal failure and proteinuria, which are markers of disease progression. Renin-angiotensin-aldosterone system (RAAS) blockers can slow the progression of chronic renal failure and proteinuria. In fact, some studies have shown the beneficial effects of paricalcitol on proteinuria...
June 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28595692/non-vitamin-k-antagonist-oral-anticoagulant-dosing-in-patients-with-atrial-fibrillation-and-renal-dysfunction
#6
Xiaoxi Yao, Nilay D Shah, Lindsey R Sangaralingham, Bernard J Gersh, Peter A Noseworthy
BACKGROUND: Dose reduction of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. Failure to reduce the dose in patients with severe kidney disease may increase bleeding risk, whereas dose reductions without a firm indication may decrease the effectiveness of stroke prevention. OBJECTIVES: The goal of this study was to investigate NOAC dosing patterns and associated outcomes, i.e., stroke (ischemic stroke and systemic embolism) and major bleeding in patients treated in routine clinical practice...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28584558/chemical-composition-and-hypotensive-effect-of-campomanesia-xanthocarpa
#7
Liane Santariano Sant'Anna, Liara Merlugo, Catrine Santos Ehle, Jessica Limberger, Maquelen Blanco Fernandes, Marí Castro Santos, Andreas Sebastian Loureiro Mendez, Fávero Reisdorfer Paula, Cleci Menezes Moreira
Campomanesia xanthocarpa is known in Brazil as Guabiroba and is popularly used for various diseases, such as inflammatory, renal, and digestive diseases and dyslipidemia. The aim of the study was to analyze the chemical composition and investigate the effects of aqueous extract of C. xanthocarpa on the blood pressure of normotensive rats, analyzing the possible action mechanism using experimental and in silico procedures. The extract was evaluated for total phenolic compounds and total flavonoid content. The chemical components were determined by HPLC analyses...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28582998/comparison-of-levetiracetam-dosing-regimens-in-end-stage-renal-disease-patients-undergoing-intermittent-hemodialysis
#8
Harn J Shiue, Maria Taylor, Kara A Sands
BACKGROUND: Levetiracetam (LEV) is primarily renally eliminated. In end-stage renal disease (ESRD) patients on hemodialysis (HD), pharmacokinetic studies recommend daily dosing with 50% supplemental doses after 4-hour HD sessions. However, poor medication adherence after HD could result in fluctuating plasma drug levels. OBJECTIVE: To compare two LEV dosing regimens, daily versus twice-daily (BID), in ESRD patients undergoing HD. METHODS: Consecutive ESRD patients (April 2013 to May 2014) receiving maintenance inpatient HD and prescribed LEV prior to admission to our academic tertiary hospital were prospectively analyzed...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28577742/dual-renin-angiotensin-system-blockade-for-nephroprotection
#9
Piero Ruggenenti
In experimental diabetic and nondiabetic chronic kidney disease, angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockers (ARB) combination therapy reduce proteinuria and prevent structural lesions more effectively than either drug alone. Consistently, in humans, a multidrug individually tailored antiproteinuric treatment based on combination therapy with maximum tolerated doses of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers ("Remission Clinic") reduced proteinuria and prevented end-stage renal disease more effectively than angiotensin-converting enzyme/angiotensin receptor blockers monotherapy, in particular in subjects with nondiabetic chronic kidney disease...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28564489/graphene-oxide-ag-nanoparticles-cooperated-with-simvastatin-as-a-high-sensitive-x-ray-computed-tomography-imaging-agent-for-diagnosis-of-renal-dysfunctions
#10
Zhan Li, Longlong Tian, Jianli Liu, Wei Qi, Qiang Wu, Haijing Wang, Mohammad Chand Ali, Wangsuo Wu, Hongdeng Qiu
Graphene oxides (GO) are attracting much attention in the diagnosis and therapy of the subcutaneous tumor as a novel biomaterial, but its diagnosis to tissue dysfunction is yet to be found. Here, a novel application of GO for diagnosis of renal dysfunction via contrast-enhanced computed tomography (CT) is proposed. In order to serve as contrast-enhanced agent, Ag nanoparticles (AgNPs) are composited on the surface of GO to promote its X-ray absorption, and then simvastatin is coinjected for eliminating in vivo toxicity induced by AgNPs...
May 31, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28560688/anca-associated-vasculitis-with-renal-involvement
#11
REVIEW
Valentina Binda, Gabriella Moroni, Piergiorgio Messa
Systemic vasculitis is a rare but severe group of diseases characterized by inflammation and necrosis of blood vessels. The size of the vessel affected varies among the different forms of vasculitis and there are three main subgroups: large, medium and small vessel vasculitis. Among small vessel vasculitis, the antineutrophil cytoplasmic antibody (ANCA)-associated forms are of particular importance. This subgroup includes: microscopic polyangiitis, granulomatosis with polyangiitis (Wegener's), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and the form limited to the kidney...
May 30, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28546463/a-phase-ii-study-of-everolimus-plus-oral-prednisone-in-patients-with-metastatic-renal-cell-cancer
#12
Cristian Lolli, Valentina Gallà, Giuseppe Schepisi, Domenico Barone, Salvatore Luca Burgio, Antonio Maugeri, Bernadette Vertogen, Dino Amadori, Ugo De Giorgi
LESSONS LEARNED: The combination of everolimus and low-dose prednisone administered daily was hypothesized to prevent noninfectious pneumonitis (NIP) and mucositis, two common adverse events related to everolimus. Although mucositis was detected in only one case, all-grade NIP occurred in four of eight cases (50%), and this was considered enough to stop accrual of the study.These data suggest the need for careful monitoring of patients receiving everolimus who are treated with corticosteroids...
May 25, 2017: Oncologist
https://www.readbyqxmd.com/read/28544106/inappropriate-prescribing-in-chronic-kidney-disease-a-systematic-review-of-prevalence-associated-clinical-outcomes-and-impact-of-interventions
#13
REVIEW
Wubshet Hailu Tesfaye, Ronald L Castelino, Barbara C Wimmer, Syed Tabish R Zaidi
INTRODUCTION: Adjusting doses of renally cleared medications and/or avoidance of nephrotoxic medications are standard clinical practices in chronic kidney disease (CKD), albeit the prevalence of inappropriate prescribing (IP) in these patients remains high. Therefore, this work sought to systematically review the prevalence of IP and compare the relative effectiveness of available interventions in reducing IP in CKD. METHODS: Studies were identified searching PubMed/Medline, EMBASE, Cochrane Library, IPA, Web of Science, Ovid/Medline, CINAHL, and PsychINFO databases...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28540990/change-in-renal-function-among-hiv-infected-koreans-receiving-tenofovir-disoproxil-fumarate-backbone-antiretroviral-therapy-a-3-year-follow-up-study
#14
Kyoung Hwa Lee, Ji Un Lee, Nam Su Ku, Su Jin Jeong, Sang Hoon Han, Jun Yong Choi, Young Goo Song, June Myung Kim
PURPOSE: Tenofovir disoproxil fumarate (TDF) is commonly prescribed as a fixed-dose, co-formulated antiretroviral drug for HIV-1 infection. The major concern of long-term TDF use is renal dysfunction. However, little is known about the long-term patterns of changes in renal function in HIV-infected Koreans receiving TDF. MATERIALS AND METHODS: We prospectively followed 50 HIV-infected Koreans, performing laboratory tests every 3 months during the first year and every 6 months for the next 2 years...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28530212/-measurements-of-vancomycin-concentrations-in-the-blood-a-method-of-personalization-the-antibiotic-therapy-in-patients-with-chronic-kidney-disease
#15
Joanna Pondel, Piotr Krajewski, Natalia Królikowska, Aleksandra Tobiasz, Hanna Augustyniak-Bartosik, Magdalena Hurkacz
Therapeutic Drug Monitoring is a recognized method of personalizing treatment, having particular application in patients with chronic kidney disease who have frequent infections, requiring administration of vancomycin. International guidelines indicate the need to adjust the dose of the drug to the state of renal function. The recommended therapeutic ranges of minimum and maximum levels should be achieved in order to increase the effectiveness and safety of treatment. AIM: The aim of this study was to evaluate the usefulness of measuring the concentration of vancomycin in patients with chronic kidney disease due to bacterial infection...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28527109/erratum-to-clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#16
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a twofold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
May 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#17
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28512328/tacrolimus-blood-level-fluctuation-predisposes-to-coexisting-bk-virus-nephropathy-and-acute-allograft-rejection
#18
Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28507922/sofosbuvir-use-in-the-setting-of-end-stage-renal-disease-a-single-center-experience
#19
Avin Aggarwal, Eric R Yoo, Ryan B Perumpail, George Cholankeril, Radhika Kumari, Tami J Daugherty, Alex S Lapasaran, Aijaz Ahmed
Background and Aims: Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) who are dialysis-dependent form a unique group, in which safety, tolerability and efficacy of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) need further evaluation. Methods: We performed a retrospective analysis of 14 patients with CHC and ESRD on dialysis who received 15 courses of SOF-based therapy. We evaluated dose escalation to standard-dose SOF in this proof-of-principle experience. Results: Sustained virological response (defined as undetectable viral load at 12 weeks, SVR-12) was achieved in 13 out of the 15 (86...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28507915/smoking-in-renal-transplantation-facts-beyond-myth
#20
REVIEW
Ahmed Aref, Ajay Sharma, Ahmed Halawa
Smoking is one of the preventable leading causes of death worldwide. Most of the studies focused on the association between smoking and cardiovascular disease, pulmonary diseases, malignancy and death. However, the direct effect of smoking on the renal system was undermind. There are emerging evidence correlating tobacco use with pathological changes in the normal kidneys. The effect is more obvious on the renal allograft most probably due to the chronic immune suppression status and the metabolic effect of the drugs...
April 24, 2017: World Journal of Transplantation
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