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https://www.readbyqxmd.com/read/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#1
REVIEW
Philip Webster, Liz Lightstone, Dianne B McKay, Michelle A Josephson
Chronic kidney disease (CKD) affects up to 6% of women of childbearing age in high income countries, and is estimated to affect 3% of pregnant women. Advanced renal dysfunction, proteinuria, hypertension, and poorly controlled underlying primary renal disease are all significant risks for adverse maternal, fetal, and renal outcomes. In order to achieve the best outcomes, it is therefore of paramount importance that these pregnancies are planned, where possible, to allow the opportunity to counsel women and their partners in advance and to optimize these risks...
February 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28202440/exposure-to-placental-ischemia-impairs-postpartum-maternal-renal-and-cardiac-function-in-rats
#2
Nina D Paauw, Jaap A Joles, Frank T Spradley, Bhavisha Bakrania, Zsuzsanna K Zellenger, Arie Franx, Marianne C Verhaar, Joey P Granger, A Titia Lely
INTRODUCTION: Women with a history of preeclampsia (PE) have an increased risk to develop cardiovascular and renal diseases later in life, but the mechanisms underlying this effect are unknown. In rats, we assessed whether placental ischemia results in long-term effects on the maternal cardiovascular and renal systems using the Reduced Uterine Perfusion Pressure (RUPP) model for PE. METHODS: Sprague-Dawley rats received either a SHAM or RUPP operation at gestational day 14...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28191659/lumbar-syndrome-a-case-manifesting-as-cutaneous-infantile-hemangiomas-of-the-lower-extremity-perineum-and-gluteal-region-and-a-review-of-published-work
#3
Xia Yu, Jia Zhang, Zhouwei Wu, Ming Liu, Ruhong Chen, Yan Gu, Ming Li, Zhirong Yao
We herein report a rare case of LUMBAR syndrome. A 1-month-old female infant presented with extensive segmental hemangiomas on the left lower extremity, left perineum and gluteal region with ulceration. Bilateral labia minoras were asymmetrical. Both legs were asymmetrical with left leg atrophy, and the intergluteal cleft was deviated. A dark red pustule and a sacrococcygeal dimple could be seen in the lumbosacral region. Lipomyelomeningocele, tethered cord and sacrum dysplasia were noted by magnetic resonance imaging...
February 13, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28188955/increased-podocyturia-in-pregnant-women-compared-to-non-pregnant-women
#4
Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Kinuko Nakagawa, Rina Akaishi, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
AIM: Hyperfiltration is a cause of podocyturia and occurs physiologically in the kidney of pregnant women. Podocyturia is increased in preeclamptic pregnancies, but it is unclear whether there is also any increase in uncomplicated pregnancies. This study was performed to examine whether podocyturia and urine aquaporin 2 mRNA expression are increased in healthy pregnant women (PW) compared to healthy non-pregnant women (NPW). METHODS: Eleven urines obtained from 11 NPW and longitudinal 76 urines from 40 PW with uncomplicated pregnancies (median number [range] of urine samples/person, 2 [1 - 3]) were studied...
February 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#5
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28167587/snake-bite-induced-acute-kidney-injury-report-of-a-successful-outcome-during-pregnancy
#6
Sanjay Vikrant, Anupam Parashar
Snake bite is an important health hazard in tropics. Snake envenomation in pregnancy may cause fetal death and maternal mortality or morbidity. However, little is known about the toxic effects and optimal management during pregnancy after snake envenomation because of the rarity of cases. Herein, we report a case of a pregnant woman who was successfully treated for snake bite-induced acute kidney injury during the third trimester. She was treated with equine-derived polyvalent anti-snake venom without development of any adverse effects, hemodialysis, and supportive therapy...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28161265/-reasons-for-first-consultation-in-nephrology-in-the-health-area-5-of-britanny-during-the-year-2014
#7
Jeanne Prévot, Sahar Bayat-Makoei, Cécile Vigneau
BACKGROUND: In France, the coordinated healthcare circuit means that patients should be referred to specialists, for example nephrologists, by another physician. However, there are no recommendations concerning the reasons justifying the referral to a nephrologist. The main purpose of our study is to describe the motif of first consultations in nephrology in the health area 5 of Brittany. METHODS: We retrospectively collected medical reports of first consultations by 17 nephrologists in the 4 centers of the study area, during the year 2014...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28151023/emtricitabine-tenofovir-alafenamide-for-the-treatment-of-hiv
#8
Katya C Corado, Eric S Daar
Tenofovir alafenamide is a new oral prodrug of tenofovir resulting in relatively low plasma levels and rapid uptake into peripheral blood mononuclear cells in its active form. The United States Food and Drug Administration has now approved this drug coformulated with elvitegravir/cobicistat/emtricitabine, rilpivirine/emtricitabine and emtricitabine. United States guidelines now list this formulation as one of the preferred components of a variety of antiretroviral regimens, and is included as an alternative in other international guidelines, with the notable exception of the World Health Organization, mostly due to limited availability...
February 2, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28143670/maternal-and-fetal-folate-vitamin-b12-and-homocysteine-concentrations-and-childhood-kidney-outcomes
#9
Kozeta Miliku, Anne Mesu, Oscar H Franco, Albert Hofman, Eric A P Steegers, Vincent W V Jaddoe
BACKGROUND: Folate, vitamin B12, and homocysteine concentrations during pregnancy are important factors for early development and may persistently influence kidney function in the offspring. We examined the associations of folate, vitamin B12, and homocysteine concentrations during pregnancy with kidney outcomes in school-aged children. STUDY DESIGN: Population-based prospective cohort study from fetal life onward. SETTINGS & PARTICIPANTS: This study was performed among 4,226 pregnant women and their children...
January 28, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28114169/outcomes-of-pregnancies-after-kidney-transplantation-lessons-learned-from-ckd-a-comparison-of-transplanted-nontransplanted-chronic-kidney-disease-patients-and-low-risk-pregnancies-a-multicenter-nationwide-analysis
#10
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Rossella Attini, Martina Gerbino, Paola Todeschini, Maria Luisa Perrino, Ana Maria Manzione, Gian Benedetto Piredda, Elisa Gnappi, Flavia Caputo, Giuseppe Montagnino, Vincenzo Bellizzi, Pierluigi Di Loreto, Francesca Martino, Domenico Montanaro, Michele Rossini, Santina Castellino, Marilisa Biolcati, Federica Fassio, Valentina Loi, Silvia Parisi, Elisabetta Versino, Antonello Pani, Tullia Todros
BACKGROUND: Kidney transplantation (KT) may restore fertility in CKD. The reasons why materno-foetal outcomes are still inferior to the overall population are only partially known. Comparison with the CKD population may offer some useful insights for management and counselling.Aim of this study was to analyse the outcomes of pregnancy after KT, compared with a large population of non-transplanted CKD patients and with low-risk control pregnancies, observed in Italy the new millennium...
January 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28101502/pregnant-woman-with-atypical-hemolytic-uremic-syndrome-delivered-a-healthy-newborn-under-eculizumab-treatment
#11
Erol Demir, Halil Yazici, Yasemin Ozluk, Isin Kilicaslan, Aydin Turkmen
Pregnancy-associated thrombotic microangiopathy is a very rare condition; however, it significantly increases fetal or maternal morbidity and mortality. Pregnancy may trigger atypical hemolytic uremic syndrome (aHUS) or thrombotic thrombocytopenic purpura. The risk for pregnancy-associated aHUS is highest during the second pregnancy. The outcome is usually poor with 50-60% mortality; renal dysfunction and hypertension are the rule in those who survive the acute episode. After the development of complement regulation mechanisms and aHUS pathogenesis, eculizumab has been widely used as a first-line treatment in aHUS...
September 2016: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28101432/atypical-hemolytic-uremic-syndrome-in-first-trimester-pregnancy-successfully-treated-with-eculizumab
#12
Gabriela Andries, Michael Karass, Srikanth Yandrapalli, Katherine Linder, Delong Liu, John Nelson, Rahul Pawar, Savneek Chugh
BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#13
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28079791/a-possible-new-approach-in-the-prediction-of-late-gestational-hypertension-the-role-of-the-fetal-aortic-intima-media-thickness
#14
Silvia Visentin, Ambrogio P Londero, Martina Camerin, Enrico Grisan, Erich Cosmi
The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28074992/-antineutrophil-cytoplasmic-antibody-anca-associated-renal-vasculitis-and-pregnancy-report-of-one-case
#15
Jorge Vega, Gonzalo P Méndez
ANCA mediated vasculitis mainly occur between the fourth and fifth decade of life; therefore, it is very uncommon to see pregnant patients with the disease. Vasculitis may affect significantly the course of pregnancy; in turn pregnancy can change the course of vasculitis. We report a 20 years old woman with ANCA-mediated renal vasculitis lasting 10 years who consulted with a pregnancy of 15 weeks. She was in remission and had amenorrhea attributed to ovarian toxicity due to cyclophosphamide. Pregnancy had an uneventful course with spontaneous delivery at the 37th week, giving birth to a healthy newborn...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28062422/spontaneous-rupture-of-renal-angiomyolipoma-during-pregnancy
#16
Li Ao, Eriko Ogasahara, Yasuhiko Okuda, Shuji Hirata
A renal angiomyolipoma (AML) is a rare benign tumour of kidney origin. Pregnancy is known to be associated with an increased risk of tumour rupture causing hypovolaemic shock, which is usually managed surgically or through an embolisation procedure. However, having surgery during pregnancy predisposes the mother to a preterm delivery, and the unknown influences of radiation exposure to the fetus make the management of such cases very challenging. A 30-year-old pregnant woman had a sudden onset of gross haematuria at the 20th week of her pregnancy...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28040140/gestational-choriocarcinoma-with-renal-and-pulmonary-metastases-lacking-a-primary-uterine-origin
#17
Hao-Ming Li, Wen-Chien Hou, Yu-Ju Lai, Chien-Chang Kao, Tai-Kuang Chao, Mu-Hsien Yu, Her-Young Su
OBJECTIVE: We describe a case of gestational choriocarcinoma metastasized to the kidney and lung, which presented initially as refractory hematuria after a term pregnancy 5 years earlier. CASE REPORT: A 35-year-old woman, G2P1, with a previous history of full-term pregnancy in 2009, presented to the emergency department complaining of intermittent gross hematuria for 2 months. Abdominal computed tomography showed a suspicious arteriovenous malformation in the right kidney and a thrombus within the right renal vein...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28018795/nephrotoxicity-of-methadone-a-systematic-review
#18
REVIEW
Samira Alinejad, Kazem Ghaemi, Mohammad Abdollahi, Omid Mehrpour
BACKGROUND: Methadone is commonly administered for chronic pain relief and treatment of opioid dependence. Concurrent with its increased consumption, toxicities and fatalities have increased. One of the adverse effects of opioid analgesics, including methadone, is that of nephrotoxicity. Opioids can have an effect on renal function through several different mechanisms. METHODS: We searched common bibliographical databases for the terms methadone, toxicity, poisoning, kidney, renal, and nephrotoxicity and summarize our findings in this review...
2016: SpringerPlus
https://www.readbyqxmd.com/read/28008002/pregnancy-outcomes-after-clinical-recovery-from-aki
#19
Jessica Sheehan Tangren, Camille E Powe, Elizabeth Ankers, Jeffrey Ecker, Kate Bramham, Michelle A Hladunewich, S Ananth Karumanchi, Ravi Thadhani
The effect of clinically recovered AKI (r-AKI) on future pregnancy outcomes is unknown. We retrospectively studied all women who delivered infants between 1998 and 2007 at Massachusetts General Hospital to assess whether a previous episode of r-AKI associated with subsequent adverse maternal and fetal outcomes, including preeclampsia. AKI was defined as rise in serum creatinine concentration to 1.5-fold above baseline. We compared pregnancy outcomes in women with r-AKI without history of CKD (eGFR>90 ml/min per 1...
December 22, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28005708/an-early-life-course-association-of-pulse-pressure-with-adulthood-estimated-glomerular-filtration-rate-evidence-from-a-large-community-based-birth-cohort-study
#20
Sumon K Das, Harold D McIntyre, Abdullah Al Mamun
BACKGROUND: Little is known about pulse pressure (PP) during early life and its association with renal function at young adulthood. This study describes an early life course association of PP with adult renal function at 30 years from a large community-based birth cohort study in Australia. METHOD: Sample comprises 1169 young adults aged 30 years from the Mater-University of Queensland Study of Pregnancy, whose blood pressure was recorded in at least three follow-ups (5, 14, 21, and 30 years) and renal function was assessed at 30 years...
February 2017: Journal of Hypertension
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