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https://www.readbyqxmd.com/read/28926966/augmented-renal-clearance-in-critical-illness-an-important-consideration-in-drug-dosing
#1
REVIEW
Sherif Hanafy Mahmoud, Chen Shen
Augmented renal clearance (ARC) is a manifestation of enhanced renal function seen in critically ill patients. The use of regular unadjusted doses of renally eliminated drugs in patients with ARC might lead to therapy failure. The purpose of this scoping review was to provide and up-to-date summary of the available evidence pertaining to the phenomenon of ARC. A literature search of databases of available evidence in humans, with no language restriction, was conducted. Databases searched were MEDLINE (1946 to April 2017), EMBASE (1974 to April 2017) and the Cochrane Library (1999 to April 2017)...
September 16, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28924378/vasopressin-mediates-the-renal-damage-induced-by-limited-fructose-rehydration-in-recurrently-dehydrated-rats
#2
Fernando E García-Arroyo, Edilia Tapia, Mónica G Blas-Marron, Guillermo Gonzaga, Octaviano Silverio, Magdalena Cristóbal, Horacio Osorio, Abraham S Arellano-Buendía, Cecilia Zazueta, Omar Emiliano Aparicio-Trejo, Juan G Reyes-García, José Pedraza-Chaverri, Virgilia Soto, Carlos Roncal-Jiménez, Richard J Johnson, Laura G Sánchez-Lozada
Recurrent dehydration and heat stress cause chronic kidney damage in experimental animals. The injury is exacerbated by rehydration with fructose-containing beverages. Fructose may amplify dehydration-induced injury by directly stimulating vasopressin release and also by acting as a substrate for the aldose reductase-fructokinase pathway, as both of these systems are active during dehydration. The role of vasopressin in heat stress associated injury has not to date been explored. Here we show that the amplification of renal damage mediated by fructose in thermal dehydration is mediated by vasopressin...
2017: International Journal of Biological Sciences
https://www.readbyqxmd.com/read/28924104/validation-of-the-r2chads2-and-chads2-scores-for-predicting-post-stroke-cognitive-impairment
#3
Kazuo Washida, Hisatomo Kowa, Hirotoshi Hamaguchi, Fumio Kanda, Tatsushi Toda
Objective Post-stroke cognitive impairment often afflicts stroke survivors and is a major obstacle both for cognitive and physical rehabilitation. Stroke risk scores ["Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Stroke" (CHADS2) and "CHADS2 + creatinine clearance <60 mL/min" (R2CHADS2)] are used to assess the future risk of cardioembolic stroke in patients with atrial fibrillation (AF). However, congestive heart failure, hypertension, aging, diabetes mellitus, stroke, and renal dysfunction are also risk factors for cognitive impairment...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28921624/pharmacodynamics-and-pharmacokinetics-of-ticagrelor-versus-clopidogrel-in-patients-with-acute-coronary-syndromes-and-chronic-kidney-disease
#4
Heyang Wang, Jing Qi, Yi Li, Yunbiao Tang, Chao Li, Jing Li, Yaling Han
BACKGROUND: Pivotal clinical trials found ticagrelor reduced ischemic complications to a greater extent than clopidogrel and what is more, the benefit gradually increased with the reduction on creatinine clearance. However, the underlying mechanisms remains poorly explored. METHODS: This is a single-center, prospective, randomized clinical trial involving 60 hospitalized P2Y12 inhibitor naïve patients with CKD (eGFR<60ml/min/1.73m(2) ) and NSTE-ACS. Eligible patients were randomly assigned in a 1:1 ratio to receive ticagrelor(180 mg loading dose, then 90 mg twice daily followed) or clopidogrel(600 mg loading dose, then 75 mg qd followed)...
September 15, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28920466/annals-express-evaluation-of-common-paediatric-creatinine-based-glomerular-filtration-rate-gfr-estimating-equations-in-black-african-children-in-kwazulu-natal-south-africa
#5
Yashna Rampursat, Rajendra Bhimma, Elaene Naicker, Fozy Peer, Verena Gounden
Background The use of serum creatinine (S-Cr) equations for estimating glomerular filtration rate (GFR) is well known in adults and children. We evaluated the revised Schwartz creatinine based estimated GFR (eGFR) prediction equation in Black African children in KwaZulu-Natal, South Africa. Methods Review of medical records of all Black African patients aged 2-18 years old who have had GFR determined by intravenous Technetium-99m-diethylene-triamine-pentaacetate((9)(9)(m)Tc DTPA), for the period 1 January 2010 to 31 December 2014 at the Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa was performed...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28919990/pharmacological-targeting-of-peptidylarginine-deiminase-4-prevents-cancer-associated-kidney-injury-in-mice
#6
Jessica Cedervall, Anca Dragomir, Falk Saupe, Yanyu Zhang, Johan Ärnlöv, Erik Larsson, Anna Dimberg, Anders Larsson, Anna-Karin Olsson
Renal insufficiency is a frequent cancer-associated problem affecting more than half of all cancer patients at the time of diagnosis. To minimize nephrotoxic effects the dosage of anticancer drugs are reduced in these patients, leading to sub-optimal treatment efficacy. Despite the severity of this cancer-associated pathology, the molecular mechanisms, as well as therapeutic options, are still largely lacking. We here show that formation of intravascular tumor-induced neutrophil extracellular traps (NETs) is a cause of kidney injury in tumor-bearing mice...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28918602/population-pharmacokinetics-and-optimal-sampling-strategy-for-model-based-precision-dosing-of-melphalan-in-patients-undergoing-hematopoietic-stem-cell-transplantation
#7
Kana Mizuno, Min Dong, Tsuyoshi Fukuda, Sharat Chandra, Parinda A Mehta, Scott McConnell, Elias J Anaissie, Alexander A Vinks
BACKGROUND: High-dose melphalan is an important component of conditioning regimens for patients undergoing hematopoietic stem cell transplantation. The current dosing strategy based on body surface area results in a high incidence of oral mucositis and gastrointestinal and liver toxicity. Pharmacokinetically guided dosing will individualize exposure and help minimize overexposure-related toxicity. OBJECTIVE: The purpose of this study was to develop a population pharmacokinetic model and optimal sampling strategy...
September 16, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28915690/efficacy-and-safety-of-a-reduced-calcineurin-inhibitor-dose-combined-with-mycophenolate-mofetil-in-liver-transplant-patients-with-chronic-renal-dysfunction
#8
Pusen Wang, Weitao Que, Hao Li, Lvnan Yan, Zhiren Fu, Qifa Ye, Guihua Chen, Kefeng Dou, Shichun Lu, Zhanyu Yang, Zhijun Zhu, Zhihai Peng, Lin Zhong
Calcineurin inhibitors (CNIs) are frequently given at a reduced dose in combination with mycophenolate mofetil (MMF) to avoid nephrotoxicity, but the optimal reduction in CNI dose has not been established. In this prospective, open-label, multicenter study, liver transplant recipients with chronic renal dysfunction who were administered a CNI-based immunosuppressive regimen were included in the intent-to-treat (ITT) population. The primary endpoint was declination in renal function, which was defined as a ≥ 20% decrease in the glomerular filtration rate during the year following regimen adjustment...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28914202/statins-and-contrast-induced-nephropathy-a-systematic-review-and-meta-analysis
#9
Alexandros Briasoulis, Mohan Pala, Tesfaye Telila, Obsinet Merid, Emmanuel Akintoye, Georgia Vogiatzi, Evangelos Oikonomou, Dimitris Tousoulis
Contrast-induced nephropathy (CIN) is a type of acute kidney injury associated with intravascular administration of iodinated contrast, usually reversible. Contrast agents are an essential component of invasive and noninvasive coronary angiography. These agents have been modified over time to enhance patient safety and tolerability, but adverse reactions still occur. CIN has been variably defined, as a rise in serum creatinine of 0.5 mg/dl, or a 25% increase in serum creatinine above baseline within 24-72 hours after the procedure...
September 13, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28898907/effects-of-cobalamin-vitamin-b12-on-gentamicin-induced-nephrotoxicity-in-rat
#10
Saeed Hajihashemi, Zeinab Hamidizad, Ali Rahbari, Fatemeh Ghanbari, Zohre Aghaee Motealeghi
Background The main side effect of gentamicin is nephrotoxicity. The effect of cobalamin (Cob) was investigated on gentamicin nephrotoxicity in rats. Methods Renal injury induced by i.p. injection of gentamicin (100 mg/kg) for 8 consecutive days. Cobalamin (6 mg/kg/day, i.p) treatment was done for 8 consecutive days as co-treatment and post-treatment protocol. Results Cobalamin significantly increased creatinine clearance levels and renal blood flow which were reduced by gentamicin. Also, cobalamin significantly improved serum electrolytes (sodium and potassium) levels which were disturbed by gentamicin...
September 12, 2017: Drug Research
https://www.readbyqxmd.com/read/28895201/long-term-kidney-transplant-survival-in-patients-with-continent-urinary-diversion
#11
Romain Fournier, Ricardo Codas-Duarte, Theresa Daily, Xavier Martin, Lionel Badet, Hakim Fassi-Fehri
OBJECTIVES: To report the long-term survival of transplanted kidneys in patients with a continent urinary diversion. METHODS: Between January 1987 and July 2015, 16 patients with a median age of 37 years (range 21-63 years) underwent kidney transplantation on a continent urinary diversion. A total of 14 patients presented irreversible dysfunction of the lower urinary tract, and two patients had required radical cystectomy because of bladder cancer. All continent urinary diversions were carried out before the transplantation...
September 11, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28893792/influence-of-mechanical-ventilation-on-vancomycin-pharmacokinetics-administered-by-continuous-infusion-in-critically-ill-patients
#12
Susanna Edith Medellín-Garibay, Silvia Romano-Moreno, Pilar Tejedor-Prado, Noelia Rubio-Álvaro, Aida Rueda-Naharro, Miguel Angel Blasco-Navalpotro, Benito García, Emilia Barcia
Pathophysiological changes involved on drug disposition in critically ill patients, should be considered on the dosing optimization of vancomycin administered by continuous infusion, and certain strategies must be applied to reach therapeutic targets on the first day of treatment. The aim of this study was to develop a population pharmacokinetic model of vancomycin to determine clinical covariates, including mechanical ventilation, that influence the wide variability of this antimicrobial. Vancomycin plasma concentrations from 54 critically ill patients were simultaneously analyzed by population pharmacokinetic approach...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28891536/urine-osmolality-in-treatment-na%C3%A3-ve-hiv-positive-subjects-in-southeast-nigeria
#13
E N Anyabolu, I I Chukwuonye, I Ezeani
BACKGROUND AND OBJECTIVES: Urine osmolality varies over a wide range of values in a healthy state. Dilute urine or concentrated urine may be observed in many environmental, physiologic, and disease conditions. Urine osmolality is not commonly evaluated in routine clinical practice and in human immunodeficiency virus (HIV) subjects. The factors that influence urine osmolality have not been completely identified. The aim of this study was to evaluate urine osmolality in treatment-naïve HIV subjects and to identify the factors that may influence dilute and concentrated urine in this group of patients...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28889825/enhancement-of-diuresis-with-metolazone-in-infant-paediatric-cardiac-intensive-care-patients
#14
Russell T Wise, Brady S Moffett, Ayse Akcan-Arikan, Marianne Galati, Natasha Afonso, Paul A Checchia
BACKGROUND: Few data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population. METHODS: This is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28887027/accurate-egfr-reporting-for-children-without-anthropometric-data
#15
Emil den Bakker, Reinoud Gemke, Joanna A E van Wijk, Isabelle Hubeek, Birgit Stoffel-Wagner, Anders Grubb, Arend Bökenkamp
INTRODUCTION: Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. AIM: To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data...
September 6, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28884894/cdp-choline-circumvents-mercury-induced-mitochondrial-damage-and-renal-dysfunction
#16
Mabel Buelna-Chontal, Martha Franco, Luz Hernández-Esquivel, Natalia Pavón, José S Rodríguez-Zavala, Francisco Correa, Ricardo Jasso, Gregorio Pichardo-Ramos, José Santamaría, Héctor González-Pacheco, Virgilia Soto, Jorge Luis Díaz-Ruíz, Edmundo Chávez
Heavy metal ions are known to produce harmful alterations on kidney function. Specifically, the accumulation of Hg(2+) in kidney tissue may induce renal failure. In this work the protective effect of CDP-choline against the deleterious effects induced by Hg(2+) on renal function were studied. CDP-choline administered ip at a dose of 125 mg/kg body weight prevented the damage induced by Hg(2+) administration at a dose of 3 mg/kg body weight. The findings indicate that CDP-choline guards mitochondria against Hg(2+) -toxicity by preserving their ability to retain matrix content, such as accumulated Ca(2+) ...
September 8, 2017: Cell Biology International
https://www.readbyqxmd.com/read/28877825/effectiveness-of-peritoneal-dialysis-in-treating-adult-end-stage-renal-disease-patients-with-polycystic-kidney-disease
#17
Ying Ma, Hai-Yun Wang, Zi-Juan Zhou, Yang Li, Wei Yang, Bing-Yan Liu, Jing-Hua Xia, Xue-Mei Li, Li-Meng Chen
Objective To observe the clinical characteristics,dialysis modalities,and outcomes of end stage renal disease(ESRD)patients with polycystic kidney disease(PKD)and to evaluate the feasibility of peritoneal dialysis in these population. Methods The clinical data of ESRD patient whose primary diagnosis was PKD in Peking Union Medical College Hospital were retrospectively collected from January 1993 to December 2015.PKD patients were divided into two groups according to dialysis modality,namely peritoneal dialysis group(PKD-PD)group and hemodialysis(PKD-HD)group...
August 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28876374/do-we-need-to-personalize-renal-function-assessment-in-the-stratification-of-patients-undergoing-cardiac-surgery
#18
Camila P S Arthur, Omar A V Mejia, Diogo Osternack, Marcelo Arruda Nakazone, Maxim Goncharov, Luiz A F Lisboa, Luís A O Dallan, Pablo M A Pomerantzeff, Fabio B Jatene
BACKGROUND: Renal dysfunction is an independent predictor of morbidity and mortality in cardiac surgery. For a better assessment of renal function, calculation of creatinine clearance (CC) may be necessary. OBJECTIVE: To objectively evaluate whether CC is a better risk predictor than serum creatinine (SC) in patients undergoing cardiac surgery. METHODS: Analysis of 3,285 patients registered in a prospective, consecutive and mandatory manner in the Sao Paulo Registry of Cardiovascular Surgery (REPLICCAR) between November 2013 and January 2015...
September 4, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28875952/role-of-r-e-n-a-l-nephrometry-score-in-laparoscopic-partial-nephrectomy
#19
Hai-Jiang Zhou, Yong Yan, Jian-Zhong Zhang, Li-Rong Liang, Shu-Bin Guo
Background: Preoperative anatomical scoring system is conducive to comparison between treatment options and evaluation of postoperative outcomes in patients with small renal tumors. This study aimed to evaluate the clinical application efficacy of the R.E.N.A.L. nephrometry score (RNS) in predicting perioperative outcomes in patients with renal tumor who underwent laparoscopic partial nephrectomy (LPN). Methods: The clinical data of 139 patients with renal tumors who underwent LPN between 2009 and 2015 were collected and analyzed...
September 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28872000/renal-function-outcomes-of-high-risk-neuroblastoma-patients-undergoing-radiation-therapy
#20
Thomas H Beckham, Dana L Casey, Michael P LaQuaglia, Brian H Kushner, Shakeel Modak, Suzanne L Wolden
PURPOSE: To analyze the renal function outcomes in patients undergoing radiation therapy for neuroblastoma. METHODS AND MATERIALS: The clinical metrics of renal function were analyzed in patients undergoing radiation therapy for high-risk neuroblastoma from 2000 to 2015. The blood urea nitrogen (BUN) and creatinine values before radiation therapy were compared with last available follow-up values and analyzed with the clinical circumstances, including follow-up length, age at primary irradiation, nephrectomy, and radiation technique...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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