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https://www.readbyqxmd.com/read/29644064/intensive-haemodialysis-using-pmma-dialyser-does-not-increase-renal-response-rate-in-multiple-myeloma-patients-with-acute-kidney-injury
#1
Laurent Hudier, Olivier Decaux, Atmann Haddj-Elmrabet, Marie Lino, Lise Mandart, Pascale Siohan, Eric Renaudineau, Theophile Sawadogo, Thierry Lamy De La Chapelle, Emmanuel Oger, Frank Bridoux, Cécile Vigneau
Background: Intensive haemodialysis (IHD) in addition to bortezomib-based chemotherapy might be efficient to rapidly decrease serum immunoglobulin-free light chains removal in patients with multiple myeloma (MM) and to improve renal prognosis and survival. Methods: The aim of this retrospective multi-centre study was to compare the efficacy (renal recovery rate) of IHD and of standard haemodialysis (SHD) in patients with MM and dialysis-dependent acute kidney injury (AKI), concomitantly treated with bortezomib-based chemotherapy...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29574675/warfarin-related-nephropathy-with-acute-kidney-injury-in-a-patient-with-immunoglobulin-a-nephropathy
#2
Hiroki Ishii, Keiji Hirai, Katsunori Yanai, Taisuke Kitano, Mitsutoshi Shindo, Haruhisa Miyazawa, Kiyonori Ito, Yuichiro Ueda, Yoshio Kaku, Taro Hoshino, Honami Mori, Susumu Ookawara, Yoshihiko Ueda, Yoshiyuki Morishita
A 55-year-old man with Marfan syndrome taking warfarin for anticoagulant therapy after aortic valve replacement developed acute kidney injury (serum creatinine level of 9.01 mg/dL) and gross macrohematuria. Renal biopsy showed red cell casts in the renal tubules, glomerular crescent formation in the glomeruli with immunoglobulin A deposition, and global sclerosis. Based on these findings, the patient was diagnosed with warfarin-related nephropathy with acute kidney injury characterized by immunoglobulin A nephropathy with crescents...
March 24, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29523959/the-light-at-the-end-of-the-tunnel-an-unusual-case-of-acute-kidney-injury-in-a-pediatric-patient-answers
#3
Miriam Steinberg, Joseph P Gaut, Stanley Paul Hmiel, Aadil Kakajiwala
Monoclonal gammopathies are a rare diagnosis in pediatric patients. A 19-year-old female patient with past medical history of hypogammaglobulinemia and natural killer cell deficiency and stage III follicular lymphoma, in remission, presented with a right-sided pneumonia, noted to have acute kidney injury and proteinuria. Complement C3 and C4 levels were normal. Anti-double-stranded DNA antibodies, antinuclear antibodies, anti-extractable nuclear antigen antibodies, and antineutrophil cytoplasmic antibodies were negative...
March 9, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29515298/a-study-of-clinical-presentation-and-correlative-histopathological-patterns-in-renal-parenchymal-disease
#4
K Ganesh, R R Nair, N V Seethalekshmy, G Kurian, A Mathew, S Sreedharan, Z Paul
Suspicion and subsequent detection of renal disease is by an assessment of the urinalysis and renal function in the clinical context. Our attempt in this study is to correlate initial presenting features of urinalysis and renal function to the final histopathological diagnosis. A retrospective analysis of 1059 native kidney biopsies performed from January 2002 to June 2015 at Amrita Institute of Medical Sciences was conducted. Correlative patterns between urinalysis, renal function, and final histopathological diagnosis were studied...
January 2018: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29477943/the-use-of-emergency-apheresis-in-the-management-of-plasma-cell-disorders
#5
REVIEW
Sevgi Kalayoglu-Besisik
Hyperviscosity syndrome (HVS) develops most commonly in Waldenström's macroglobulinemia (WM) and multiple myeloma (MM). Plasmapheresis is the immediate therapy and very effective at relieving symptoms by removing paraprotein. The most commonly used replacement fluid is 4%-5% human albumin in physiologic saline. FFP may be used in patients with coagulation abnormalities. Plasmapheresis should be continued until acute symptoms abate. Hyperviscosity impairs the circulation in the retina and causes hemorrhages around the small retinal vessels...
February 20, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29456220/importance-of-renal-biopsy-in-patients-aged-60-years-and-older-experience-from-a-tertiary-care-hospital
#6
Pallav Gupta, Devinder Singh Rana
As the life expectancy is increasing, there is a rise in elderly population and consequent increase in the patients with renal disease. There is an inconsistency between clinical and histopathological diagnosis in elderly, and so renal biopsy is important in these patients to decide appropriate clinical management and prognosis. This study outlines the importance of renal biopsy in elderly and describes the clinical and pathologic spectrum of renal diseases in patient ≥60 years. All patients (age ≥60 years) undergoing renal biopsies from January 2011 to December 2014 were included in this retrospective study...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29427353/rapid-reduction-of-extremely-high-kappa-free-light-chains-in-a-patient-with-myeloma-cast-nephropathy
#7
Christine L H Snozek, Theresa N Kinard, Jill Adamski
This report describes a patient with light chain myeloma and acute renal injury. Serum kappa free light chain (FLC) was extremely elevated, >33,000 mg/dL. Treatment with therapeutic plasma exchange (TPE) started day 2 for biopsy-confirmed cast nephropathy. Bortezomib-containing chemotherapy was initiated on day 5, and hemodialysis for tumor lysis syndrome on day 7. TPE alone decreased kappa FLC >70% by day 5, indicating direct FLC removal was successful in this patient. A total of 25 TPE procedures were performed in a 31-day hospitalization...
February 10, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29397599/-the-clinical-characteristics-of-takayasu-s-arteritis-with-glomerulonephropathy
#8
Z Chen, Y J Yang, J Li, X P Tian
Objective: To investigate the clinical features of Takayasu's arteritis (TAK) with glomerulonephropathy and to improve physicians' understanding of this complication in patients with TAK. Methods: Clinical data were retrospectively collected including manifestations, laboratory tests, image findings and treatment of 8 patients diagnosed as Takayasu's arteritis with glomerulonephropathy from January 2002 to January 2017 in Peking Union Medical College Hospital. Results: Glomerulonephropathy was confirmed based on percutaneous renal biopsy...
February 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29301798/enhanced-elimination-of-cyclophosphamide-by-high-cut-off-haemodialysis-single-dose-pharmacokinetics-in-a-patient-with-cast-nephropathy
#9
Gabriele Eden, W Nikolaus Kühn-Velten, Carsten Hafer, Jan T Kielstein
High cut-off (HCO) haemodialysis removes free light chains in patients with multiple myeloma. This is possible as HCO dialysers allow clearance of molecules up to a molecular weight of 65 kDa. In contrast, high-flux dialysers, which are used in routine haemodialysis, only remove molecules up to a molecular weight of 20 kDa. Even though patients with advanced myeloma frequently need dialysis and alkylating agents, drug dosing recommendations in this patient population are scarce at best or absent as for cyclophosphamide dosing in patients with myeloma undergoing HCO dialysis...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29285431/acute-kidney-injury-aggravated-by-treatment-initiation-with-apixaban-another-twist-of-anticoagulant-related-nephropathy
#10
Sergey V Brodsky, Nilesh S Mhaskar, Sampath Thiruveedi, Rajnish Dhingra, Sharon C Reuben, Edward Calomeni, Iouri Ivanov, Anjali Satoskar, Jessica Hemminger, Gyongyi Nadasdy, Lee Hebert, Brad Rovin, Tibor Nadasdy
Anticoagulant-related nephropathy (ARN) was initially described in patients on warfarin (as warfarin-related nephropathy) and recently in those using dabigatran. Herein, we report clinical history and kidney biopsy findings in a patient on apixaban (Eliquis). Initiation of treatment with apixaban resulted in aggravation of preexisting mild acute kidney injury (AKI). A few days after apixaban therapy, the patient became oligoanuric, and kidney biopsy showed severe acute tubular necrosis with numerous occlusive red blood cell casts...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29285109/acute-kidney-injury-in-cancer-patients-and-impedance-cardiography-assisted-renal-replacement-therapy-experience-from-the-onconephrology-unit-of-a-chinese-tertiary-hospital
#11
Tao Wang, Yan Zhang, Qingxia Li, Shumin Jia, Changjin Shi, Kai Niu, Bing Liu
Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29234203/cholemic-or-bile-cast-nephropathy-in-a-child-with-liver-failure
#12
Vikrant Sood, Bikrant B Lal, Suman Lata, Archana Rastogi, Seema Alam
Cholemic or bile cast nephropathy is an under-reported entity characterized by acute renal dysfunction in patients with hepatic insult. Limited literature is available regarding its clinical presentation, pathogenesis and prognosis. We hereby present a pediatric case who presented with acute on chronic liver failure with renal dysfunction secondary to cholemic nephropathy.
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29209721/effect-of-high-cutoff-hemodialysis-vs-conventional-hemodialysis-on-hemodialysis-independence-among-patients-with-myeloma-cast-nephropathy-a-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Frank Bridoux, Pierre-Louis Carron, Brigitte Pegourie, Eric Alamartine, Karine Augeul-Meunier, Alexandre Karras, Bertrand Joly, Marie-Noëlle Peraldi, Bertrand Arnulf, Cécile Vigneau, Thierry Lamy, Alain Wynckel, Brigitte Kolb, Bruno Royer, Nolwenn Rabot, Lotfi Benboubker, Christian Combe, Arnaud Jaccard, Bruno Moulin, Bertrand Knebelmann, Sylvie Chevret, Jean-Paul Fermand
Importance: Cast nephropathy is the main cause of acute kidney injury in multiple myeloma and persistent reduction in kidney function strongly affects prognosis. Strategies to rapidly remove nephrotoxic serum-free light chains combined with novel antimyeloma agents have not been evaluated prospectively. Objective: To compare the hemodialysis independence rate among patients newly diagnosed with myeloma cast nephropathy treated with hemodialysis using a high-cutoff dialyzer (with very large membrane pores and high permeability to immunoglobulin light chains) or a conventional high-flux dialyzer (with small pores and lower permeability)...
December 5, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29209704/high-cutoff-hemodialysis-in-myeloma-cast-nephropathy
#14
EDITORIAL
Kenar D Jhaveri, Ruben Niesvizky
No abstract text is available yet for this article.
December 5, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29163997/evans-syndrome-complicated-by-intratubular-hemoglobin-cast-nephropathy
#15
Iván González, Rehan Rais, Joseph P Gaut, Louis P Dehner
Evans syndrome (ES) is a rare autoimmune disorder whose exact pathophysiology is unknown. It is characterized by the simultaneous or subsequent development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Intravascular hemolysis, with hemoglobinemia, is known to produce acute kidney injury; however, the development of intratubular hemoglobin casts (hemoglobin cast nephropathy) in the setting of acute hemolysis is uncommon. Likewise, the association of ES and acute renal failure is equally uncommon...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29153147/trifecta-of-light-chain-cast-nephropathy-monoclonal-plasma-cell-infiltrates-and-light-chain-proximal-tubulopathy
#16
Abhilash Koratala, A Ahsan Ejaz, Wesley M Hiser, William L Clapp
No abstract text is available yet for this article.
December 2017: Kidney International
https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#17
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3-) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#18
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29066226/cast-nephropathy-and-deceptively-low-absolute-serum-free-light-chain-levels-resolution-of-a-challenging-case-and-systematic-review-of-the-literature
#19
Michael P Rassner, Maximilian Seidl, Ulrich Salzer, S Vincent Rajkumar, Thomas Epting, Ralph Wäsch, Elke Neumann-Haefelin, Monika Engelhardt
No abstract text is available yet for this article.
January 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29052601/intratubular-amyloid-in-light-chain-cast-nephropathy-is-a-risk-factor-for-systemic-light-chain-amyloidosis
#20
Jean-Baptiste Gibier, Viviane Gnemmi, François Glowacki, Eileen M Boyle, Benjamin Lopez, Evelyne MacNamara, Maxime Hoffmann, Raymond Azar, Thomas Guincestre, Franck Bourdon, Marie-Christine Copin, David Buob
Light chain cast nephropathy is the most common form of kidney disease in patients with multiple myeloma. Light chain casts may occasionally show amyloid staining properties, that is, green birefringence after Congo red staining. The frequency and clinical significance of this intratubular amyloid are poorly understood. Here, we retrospectively assessed the clinicopathological features of 60 patients with histologically proven light chain cast nephropathy with a specific emphasis on intratubular amyloid, especially, its association with extrarenal systemic light chain amyloidosis...
October 20, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
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