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https://www.readbyqxmd.com/read/28211054/real-world-use-of-pomalidomide-and-dexamethasone-in-double-refractory-multiple-myeloma-suggests-benefit-in-renal-impairment-and-adverse-genetics-a-multi-centre-uk-experience
#1
Nicola Maciocia, Andrew Melville, Simon Cheesman, Faye Sharpley, Karthik Ramasamy, Matthew Streetly, Matthew Jenner, Reuben Benjamin, Steve Schey, Paul Maciocia, Rakesh Popat, Shirley D'sa, Ali Rismani, Aviva Cerner, Kwee Yong, Neil Rabin
Myeloma patients who become refractory to immunomodulatory agents (IMiDs) and bortezomib have poor survival, with limited therapeutic options. Pomalidomide has shown improved survival and good tolerability in this patient cohort in clinical trials, but real world data are scarce. We retrospectively analysed all patients treated with pomalidomide at five UK centres between 2013 and 2016. Of 85 patients identified, 70 had sufficient information for response assessments. Median age was 66 years [40-89], 96·5% were refractory to IMiDs, 72·9% were refractory to both an IMiD and bortezomib and 92·9% were refractory to their last treatment...
February 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28209982/severe-decline-of-estimated-glomerular-filtration-rate-associates-with-progressive-cognitive-deterioration-in-the-elderly-a-community-based-cohort-study
#2
Yi-Chi Chen, Shuo-Chun Weng, Jia-Sin Liu, Han-Lin Chuang, Chih-Cheng Hsu, Der-Cherng Tarng
Cognitive dysfunction is closely related to aging and chronic kidney disease (CKD). However, the association between renal function changes and the risk of developing cognitive impairment has not been elucidated. This longitudinal cohort study was to determine the influence of annual percentage change in estimated glomerular filtration rate (eGFR) on subsequent cognitive deterioration or death of the elderly within the community. A total of 33,654 elders with eGFR measurements were extracted from the Taipei City Elderly Health Examination Database...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28208936/supra-hepatic-inferior-vena-cava-thrombosis-surgical-challenges
#3
Senthil Muthuraman, Anand Ramamurthy, Mahesh Gopashetty, Cuddalore Sadasivam Vijayshankar, Anand Khakhar
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts. There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of the retrohepatic Inferior Vena Cava (IVC) by an enlarged polycystic liver may impede clear visualization on pre-operative imaging and miss an underlying thrombosis or obliteration. This may result in an intra-operative surprise. Management can be challenging requiring modification of conventional surgical approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207801/kidney-dysfunction-and-cerebral-microbleeds-in-neurologically-healthy-adults
#4
Sang Hyuck Kim, Dong Wook Shin, Jae Moon Yun, Ji Eun Lee, Jae-Sung Lim, Be Long Cho, Hyung-Min Kwon, Jin-Ho Park
INTRODUCTION: Cerebral microbleed (CMB) is a potent risk factor for overt cerebrovascular disease. Although some studies indicated the possible role of renal dysfunction as a risk factor of CMB, the findings could not be generalized. This study aimed to investigate the association between renal dysfunction and cerebral microbleed (CMB) in neurologically healthy adults. MATERIALS AND METHODS: A total of 2,518 subjects who underwent brain MRI as part of health screening were involved in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28207287/thiamine-as-a-renal-protective-agent-in-septic-shock-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#5
Ari Moskowitz, Lars W Andersen, Michael N Cocchi, Mathias Karlsson, Parth V Patel, Michael W Donnino
RATIONALE: Acute kidney injury (AKI) is common in patients with sepsis and has been associated with high mortality rates. The provision of thiamine to septic patients may reduce the incidence and severity of sepsis-related AKI and thereby prevent renal failure requiring renal replacement therapy (RRT). OBJECTIVES: To test the hypothesis that thiamine supplementation mitigates kidney injury in septic shock. METHODS: This was a secondary analysis of a single-center, randomized, double-blind trial comparing thiamine to placebo in patients with septic shock...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28203358/the-renal-effects-of-sglt2-inhibitors-and-a-mini-review-of-the-literature
#6
REVIEW
Vasileios Andrianesis, Spyridoula Glykofridi, John Doupis
Sodium-glucose linked transporter 2 (SGLT2) inhibitors are a new and promising class of antidiabetic agents which target renal tubular glucose reabsorption. Their action is based on the blockage of SGLT2 sodium-glucose cotransporters that are located at the luminal membrane of tubular cells of the proximal convoluted tubule, inducing glucosuria. It has been proven that they significantly reduce glycated hemoglobin (HbA1c), along with fasting and postprandial plasma glucose in patients with type 2 diabetes mellitus (T2DM)...
December 2016: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28202852/association-of-serum-uric-acid-levels-with-leg-ischemia-in-patients-with-peripheral-arterial-disease-after-treatment
#7
Yoko Sotoda, Shigeki Hirooka, Hiroyuki Orita, Ichiro Wakabayashi
AIM: We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment. METHODS: Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI. RESULTS: Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, -0...
February 15, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28202171/residual-renal-function-a-paradigm-shift
#8
Jerome Lowenstein, Jared J Grantham
Residual renal function (RRF) in patients undergoing dialysis treatments is currently viewed as glomerular filtrate that has escaped tubular reabsorption. RRF has been quantified as a clearance of urea or creatinine, or urea + creatinine. A major paradigm shift has followed the recognition that a substantial number of organic anion retention solutes (possible "uremic toxins") are protein-bound and therefore are not readily filtered. These protein-bound aryl compounds are secreted by renal tubular organic anion transporters (OATs)...
March 2017: Kidney International
https://www.readbyqxmd.com/read/28202167/acute-changes-in-glomerular-filtration-rate-with-renin-angiotensin-system-ras-inhibition-clinical-implications
#9
Matthew R Weir
Renin-angiotensin system inhibition with either angiotensin-converting enzyme inhibitors or angiotensin receptor blockers has been shown to be effective in reducing progression of renal and cardiovascular disease. However, these medications are often associated with an initial reduction of estimated glomerular filtration rate, which is thought to be functional but may be of clinical significance. Newer insights from secondary analyses of large clinical trials may provide important clinical perspective.
March 2017: Kidney International
https://www.readbyqxmd.com/read/28201968/common-drugs-for-stabilization-of-renal-function-in-the-progression-of-diabetic-nephropathy-and-their-relations-with-hypertension-therapy
#10
Yuxuan Wang, Chengcheng Wang, Xiuli Zhang, Harvest F Gu, Liang Wu
Diabetic nephropathy is characterized by hypertension, progressive albuminuria, glomerulosclerosis and declines in glomerular filtration rate leading to end stage renal disease. Although the pathogenesis of diabetic nephropathy is not fully understood, current treatment of the patients with diabetic nephropathy is mainly based upon the control of hyperglycaemia and management of blood pressures. Several drugs, which are originally developed for hypertension therapy, have been adopted for stabilization of renal function in diabetic nephropathy...
February 14, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28198769/imaging-leukocyte-responses-in-the-kidney
#11
Michaela Finsterbusch, A Richard Kitching, Michael J Hickey
The kidney can be negatively affected by a range of innate and adaptive immune responses, resulting in alterations in the functions of the kidney and, in some cases, progression to renal failure. In many of these responses, infiltration of blood-borne leukocytes into the kidney is central to the response. In addition, a large population of mononuclear phagocytes resident in the kidney can modulate these responses. A great deal of research has investigated both the mechanisms of leukocyte recruitment to the kidney and the actions of immune cells resident within the kidney...
March 2017: Transplantation
https://www.readbyqxmd.com/read/28198397/cystinosis-ctns-zebrafish-mutant-shows-pronephric-glomerular-and-tubular-dysfunction
#12
Mohamed A Elmonem, Ramzi Khalil, Ladan Khodaparast, Laleh Khodaparast, Fanny O Arcolino, Joseph Morgan, Anna Pastore, Przemko Tylzanowski, Annelii Ny, Martin Lowe, Peter A de Witte, Hans J Baelde, Lambertus P van den Heuvel, Elena Levtchenko
The human ubiquitous protein cystinosin is responsible for transporting the disulphide amino acid cystine from the lysosomal compartment into the cytosol. In humans, Pathogenic mutations of CTNS lead to defective cystinosin function, intralysosomal cystine accumulation and the development of cystinosis. Kidneys are initially affected with generalized proximal tubular dysfunction (renal Fanconi syndrome), then the disease rapidly affects glomeruli and progresses towards end stage renal failure and multiple organ dysfunction...
February 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28196295/association-of-pre-transplant-kidney-function-with-outcomes-after-lung-transplantation
#13
Amit Banga, Manish Mohanka, Jessica Mullins, Srinivas Bollineni, Vaidehi Kaza, Fernando Torres, Bekir Tanriover
PURPOSE: There is a lack of data regarding the independent association of pre-transplant kidney function with early and late outcomes among lung transplant (LT) recipients. METHODS: We queried the UNOS database for adult patients (≥ 18 years of age) undergoing LT between 1987 and 2013. Glomerular filtration rate (GFR) was estimated using the Modification of diet in renal disease (MDRD) and the Chronic kidney disease epidemiology collaboration (CKD-EPI) equations...
February 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28195182/prognostic-significance-of-left-ventricular-mass-index-and-renal-function-decline-rate-in-chronic-kidney-disease-g3-and-g4
#14
Jiun-Chi Huang, Szu-Chia Chen, Yi-Chun Tsai, I-Ching Kuo, Yi-Wen Chiu, Jer-Ming Chang, Shang-Jyh Hwang, Hung-Chun Chen
The effect of left ventricular mass index (LVMI) and estimated glomerular filtration rate (eGFR) decline rate on outcome prediction in patients with chronic kidney disease (CKD) remains unclear. We included 306 CKD G3 and G4 patients with LVMI assessed through echocardiography. Rapid decline in renal function was defined as the eGFR slope <-3 mL/min/1.73 m(2)/year. Patients were stratified into four groups using sex-specific median values of LVMI and rapid eGFR decline. The composite outcome was progression to maintenance dialysis or death...
February 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28194034/high-pressure-carbon-monoxide-preserves-rat-kidney-grafts-from-apoptosis-and-inflammation
#15
Toyofumi Abe, Koji Yazawa, Masayuki Fujino, Ryoichi Imamura, Naoyuki Hatayama, Yoichi Kakuta, Koichi Tsutahara, Masayoshi Okumi, Naotsugu Ichimaru, Jun-Ya Kaimori, Yoshitaka Isaka, Kunihiro Seki, Shiro Takahara, Xiao-Kang Li, Norio Nonomura
Renal ischemia-reperfusion (I/R) injury is unavoidable in kidney transplantation (KTx) and frequently influences both short- and long-term allograft survival. Carbon monoxide (CO) has attracted attention as a medical gas with anti-inflammatory and anti-apoptotic effects. We investigated a new strategy for organ preservation using ex vivo application of high-pressure CO in an experimental rat KTx model. We preserved kidney grafts using a high-pressure chamber filled with mixed gases composed of CO and O2. We found that cold I/R injury resulted in progressive deterioration of renal graft function in University of Wisconsin solution, whereas CO significantly improved renal function...
February 13, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28192060/macrophages-in-renal-injury-and-repair
#16
Sarah C Huen, Lloyd G Cantley
Acute kidney injury (AKI) is a growing global health concern, yet no treatment is currently available to prevent it or to promote kidney repair after injury. Animal models demonstrate that the macrophage is a major contributor to the inflammatory response to AKI. Emerging data from human biopsies also corroborate the presence of macrophages in AKI and their persistence in progressive chronic kidney disease. Macrophages are phagocytic innate immune cells that are important mediators of tissue homeostasis and host defense...
February 10, 2017: Annual Review of Physiology
https://www.readbyqxmd.com/read/28191609/complement-blockade-in-anca-associated-vasculitis-an-index-case-current-concepts-and-future-perspectives
#17
REVIEW
Lucio Manenti, Maria Letizia Urban, Federica Maritati, Maricla Galetti, Augusto Vaglio
Complement alternative pathway (cAP) hyperactivation seems to be involved in ANCA-associated vasculitis (AAV). We here describe a case of AAV with severe activation of cAP that developed acute renal failure. No mutation predisposing to cAP dysregulation was identified. We treated our patient with the standard immunosuppressive therapy, but disease progression was only reversed after the addition of eculizumab, a monoclonal antibody against C5; the patient eventually achieved an almost complete renal function recovery...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28190774/reducing-vegf-b-signaling-ameliorates-renal-lipotoxicity-and-protects-against-diabetic-kidney-disease
#18
Annelie Falkevall, Annika Mehlem, Isolde Palombo, Benjamin Heller Sahlgren, Lwaki Ebarasi, Liqun He, A Jimmy Ytterberg, Hannes Olauson, Jonas Axelsson, Birgitta Sundelin, Jaakko Patrakka, Pierre Scotney, Andrew Nash, Ulf Eriksson
Diabetic kidney disease (DKD) is the most common cause of severe renal disease, and few treatment options are available today that prevent the progressive loss of renal function. DKD is characterized by altered glomerular filtration and proteinuria. A common observation in DKD is the presence of renal steatosis, but the mechanism(s) underlying this observation and to what extent they contribute to disease progression are unknown. Vascular endothelial growth factor B (VEGF-B) controls muscle lipid accumulation through regulation of endothelial fatty acid transport...
February 1, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28188683/functional-kras-mutations-and-a-potential-role-for-pi3k-akt-activation-in-wilms-tumors
#19
Dina Polosukhina, Harold D Love, Hernan Correa, Zengliu Su, Kimberly B Dahlman, William Pao, Harold L Moses, Carlos L Arteaga, Harold N Lovvorn, Roy Zent, Peter E Clark
Wilms tumor (WT) is the most common renal neoplasm of childhood and affects 1 in 10,000 children aged less than 15 years. These embryonal tumors are thought to arise from primitive nephrogenic rests that derive from the metanephric mesenchyme during kidney development and are characterized partly by increased Wnt/β-catenin signaling. We previously showed that coordinate activation of Ras and β-catenin accelerates the growth and metastatic progression of a murine WT model. Here, we show that activating KRAS mutations can be found in human WT...
February 11, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28187983/intensified-multifactorial-intervention-in-type-2-diabetics-with-microalbuminuria-leads-to-long-term-renal-benefits
#20
Jens Oellgaard, Peter Gæde, Peter Rossing, Frederik Persson, Hans-Henrik Parving, Oluf Pedersen
In the present post hoc analyses we studied the impact of intensified, multifactorial treatment on renal outcomes in patients with type 2 diabetes and microalbuminuria enrolled in the Steno-2 Study. Outcome measures were progression to macroalbuminuria, decline in the glomerular filtration rate (GFR), and development of end stage renal disease (ESRD). In total, 160 patients with type 2 diabetes and microalbuminuria were recruited and assigned to conventional or intensified therapy targeting multiple risk factors...
February 7, 2017: Kidney International
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