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https://www.readbyqxmd.com/read/28722618/clinical-evidence-of-acute-mesoamerican-nephropathy
#1
Rebecca S B Fischer, Sreedhar Mandayam, Denis Chavarria, Chandan Vangala, Melissa N Garcia, Linda L Garcia, Lesbia Palma, Felix Garcia, Ramón García-Trabanino, Kristy O Murray
Mesoamerican nephropathy (MeN), an epidemic of unexplained kidney disease in Central America, affects mostly young, healthy individuals. Its etiology is a mystery that requires urgent investigation. Largely described as a chronic kidney disease (CKD), no acute clinical scenario has been characterized. An understanding of the early disease process could elucidate an etiology and guide treatment and prevention efforts. We sought to document the earliest clinical signs in patients with suspected MeN in a high-risk population in Nicaragua...
July 17, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28721063/annual-deterioration-of-renal-function-in-hypertensive-patients-with-and-without-diabetes
#2
Jorge Polonia, André Azevedo, Miguel Monte, José A Silva, Susana Bertoquini
BACKGROUND: Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control. MATERIALS AND METHODS: Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28718614/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update
#3
Whitney K. Bryant, Sanjay Shewakramani
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28717990/iron-based-phosphate-binders-a-paradigm-shift-in-the-treatment-of-hyperphosphatemic-anemic-ckd-patients
#4
REVIEW
Francesco Locatelli, Lucia Del Vecchio
The partial correction of anemia and the normalization of phosphate and blood pressure are the mainstay of treatment of patients with chronic kidney disease (CKD). Available anti-hypertensive drugs, erythropoiesis stimulating agents (ESAs) and iron supplements have resolved quite satisfactorily the goal of controlling hypertension and partially correcting anemia. Unfortunately, the treatment of hyperphosphatemia is still far from resolved. Phosphate binders have poor tolerability and/or limited efficacy, leading to the prescription of many tablets that achieve only a mild-to-moderate effect...
July 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28712176/ecg-abnormalities-in-patients-with-chronic-kidney-disease
#5
Salman Shafi, Mohammad Saleem, Roshina Anjum, Wajid Abdullah, Tahir Shafi
BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease. Electrocardiographic (ECG) abnormalities are common in CKD patients. However, there is variation in literature regarding frequency of ECG abnormalities in CKD patients and limited information in local population. METHODS: The study design was cross-sectional in nature. All patients between ages of 20-80 years with CKD not previously on renal replacement therapy who were admitted to nephrology ward at a tertiary care facility over a 6-month period were included...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711960/chronic-kidney-disease-ckd-an-observational-study-of-etiology-severity-and-burden-of-comorbidities
#6
Nivedita Kamath, Arpana Aprameya Iyengar
OBJECTIVES: To study the etiology and burden of comorbidities across stages of chronic kidney disease (CKD). METHODS: Children, 2-16 y of age with CKD Stages II- IV were recruited over 12 mo. The etiology, clinical presentation and severity of complications were studied. RESULTS: Among 78 children [Stage II (n = 21), Stage III (n = 26), Stage IV (n = 31)], congenital anomalies of the kidney and urinary tract (CAKUT) was the commonest etiology and 28 were newly diagnosed in Stage III /IV...
July 15, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28711905/the-prevalence-subtypes-and-associated-factors-of-hyperuricemia-in-lupus-nephritis-patients-at-chronic-kidney-disease-stages-1-3
#7
Simeng Liu, Yijun Gong, Hong Ren, Wen Zhang, Xiaonong Chen, Tong Zhou, Xiao Li, Nan Chen
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28711075/diabetic-nephropathy-and-pregnancy
#8
Kate Bramham
Women with diabetic nephropathy have challenging pregnancies, with pregnancy outcomes far worse than expected for the stage of chronic kidney disease. The underlying mechanisms that cause the adverse events remain poorly understood, but it is a widely held belief that substantial endothelial injury in these women likely contributes. Maternal hypertension, preeclampsia, and cesarean section rates are high, and offspring are often preterm and of low birth weight, with additional neonatal complications associated with glycemic control...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#9
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711069/preterm-birth-and-its-impact-on-renal-health
#10
Valerie A Luyckx
Preterm birth occurs in approximately 10% of all births worldwide. Preterm infants have reduced nephron numbers at birth in proportion to gestational age, and are at increased risk of neonatal acute kidney injury as well as higher blood pressure, proteinuria, and chronic kidney disease later in life. Rapid catch-up growth in preterm infants, especially if resulting in obesity, is a risk factor for end-stage kidney disease among children with proteinuric renal disease. Preterm birth, however, is a risk factor not only for the infant because mothers who deliver preterm have an increased risk of having subsequent preterm deliveries as well as hypertension, cardiovascular disease, and renal disease later in life...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28710615/aldosterone-antagonist-therapy-and-its-relationship-with-inflammation-fibrosis-thrombosis-mineral-bone-disorder-and-cardiovascular-complications-in-peritoneal-dialysis-pd-patients
#11
Rafał Donderski, Paweł Stróżecki, Beata Sulikowska, Magdalena Grajewska, Ilona Miśkowiec, Anna Stefańska, Joanna Siódmiak, Grażyna Odrowąż-Sypniewska, Jacek Manitius
BACKGROUND: High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment...
July 14, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28710094/perspectives-from-the-kidney-health-initiative-on-advancing-technologies-to-facilitate-remote-monitoring-of-patient-self-care-in-rrt
#12
Mitchell H Rosner, Susie Lew, Paul Conway, Jennifer Ehrlich, Robert Jarrin, Uptal D Patel, Karen Rheuban, R Brooks Robey, Neal Sikka, Eric Wallace, Patrick Brophy, James Sloand
Telehealth and remote monitoring of a patient's health status has become more commonplace in the last decade and has been applied to conditions such as heart failure, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Conversely, uptake of these technologies to help engender and support home RRTs has lagged. Although studies have looked at the role of telehealth in RRT, they are small and single-centered, and both outcome and cost-effectiveness data are needed to inform future decision making...
July 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28706894/developmental-origins-and-nephron-endowment-in-hypertension
#13
REVIEW
Shari Gurusinghe, Anita Tambay, Christine B Sethna
Primary hypertension continues to be one of the main risk factors for cardiovascular disease worldwide. A stable intrauterine environment is critical for the future development and health of the fetus. The developing kidney has been found to be especially vulnerable during this time period, and epidemiological studies have demonstrated that an adverse in utero environment is associated with an increased risk of hypertension and chronic kidney disease. Macro- and micronutrient deficiencies as well as exposure to tobacco, alcohol, and certain medications during gestation have been shown to negatively impact nephrogenesis and reduce one's nephron number...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28704407/variations-in-achievement-of-evidence-based-high-impact-quality-indicators-in-general-practice-an-observational-study
#14
Thomas A Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy
BACKGROUND: There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected 'big data' in the evaluation of healthcare. We developed a set of evidence-based 'high impact' quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). METHODS: Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89)...
2017: PloS One
https://www.readbyqxmd.com/read/28701959/renal-oxygenation-in-the-pathophysiology-of-chronic-kidney-disease
#15
REVIEW
Zhi Zhao Liu, Alexander Bullen, Ying Li, Prabhleen Singh
Chronic kidney disease (CKD) is a significant health problem associated with high morbidity and mortality. Despite significant research into various pathways involved in the pathophysiology of CKD, the therapeutic options are limited in diabetes and hypertension induced CKD to blood pressure control, hyperglycemia management (in diabetic nephropathy) and reduction of proteinuria, mainly with renin-angiotensin blockade therapy. Recently, renal oxygenation in pathophysiology of CKD progression has received a lot of interest...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28701739/hypertension-with-diabetes-mellitus-significance-from-an-epidemiological-perspective-for-japanese
#16
Yukako Tatsumi, Takayoshi Ohkubo
The prevalence of both hypertension and diabetes mellitus is increasing worldwide. Both diseases lead to severe complications such as cardiovascular and chronic kidney diseases, which increase the risk of death over a long period of time. Therefore, the prevention and aggravation of hypertension and diabetes mellitus are major challenges. Because few review articles have focused on the epidemiological perspective of hypertension and diabetes mellitus, we reviewed major observational studies mainly from Japan and from Western countries that have reported on the prevalence of hypertension and diabetes mellitus, the binominal risk of hypertension and diabetes mellitus, and the risk of their coexistence...
July 13, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28695552/glycaemic-blood-pressure-and-lipid-goal-attainment-and-chronic-kidney-disease-stage-of-type-2-diabetic-patients-treated-in-primary-care-practices
#17
Antonella Corcillo, Edward Pivin, Fabrice Lalubin, Nelly Pitteloud, Michel Burnier, Anne Zanchi
INTRODUCTION: The prevalence of chronic kidney disease and diabetes is rising in Europe. These patients are at high cardiovascular and renal risk and need a challenging multifactorial therapeutic approach. METHOD: The goal of this cross-sectional study was to examine the treatment and attainments of goals related to cardiovascular risk factors within chronic kidney disease stages in type 2 diabetic patients followed up by primary care physicians in Switzerland. Each participating physician entered into a web database the anonymised data of up to 15 consecutive diabetic patients attending her/his office between December 2013 and June 2014...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692165/clinical-and-prognostic-significance-of-a-reverse-dipping-pattern-on-ambulatory-monitoring-an-updated-review
#18
REVIEW
Cesare Cuspidi, Carla Sala, Marijana Tadic, Elisa Gherbesi, Antonio De Giorgi, Guido Grassi, Giuseppe Mancia
Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm...
July 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28683789/circulating-osteoprotegerin-is-associated-with-chronic-kidney-disease-in-hypertensive-patients
#19
Stella Bernardi, Barbara Toffoli, Fleur Bossi, Riccardo Candido, Elisabetta Stenner, Renzo Carretta, Fabio Barbone, Bruno Fabris
BACKGROUND: Osteoprotegerin (OPG) is a glycoprotein that plays an important regulatory role in the skeletal, vascular, and immune system. It has been shown that OPG predicts chronic kidney disease (CKD) in diabetic patients. We hypothesized that OPG could be a risk marker of CKD development also in non-diabetic hypertensive patients. METHODS: A case-control study was carried out to measure circulating OPG levels in 42 hypertensive patients with CKD and in 141 hypertensive patients without CKD...
July 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28682567/-pres-posterior-reversible-encephalopathy-syndrome-potential-complication-of-hypertensive-crisis-case-report-and-literature-review
#20
Michele Vergura, Michele Prencipe, Antonio Maria Del Giudice, Rachele Grifa, Filomena Miscio, Anna Maria Pennelli, Teresa Popolizio, Anna Simeone, Mariangela Ferrara, Maurizio Leone, Filippo Aucella
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, usually reversible, characterized by vasogenic oedema in cerebral posterior regions in patients with autoimmune diseases, nephropathies, hypertensive crisis, eclampsia and exposure to cytotoxic drugs. The main symptoms are: headache, nausea, vomiting, seizures, visual disturbance and altered consciousness. Complications as cerebral hemorrhage and recurrences are rare. We describe a case of a 65 years old woman, affected by chronic kidney disease, recently exacerbated, diabetes and hypertension in treatment, who showed an heterogeneous clinical presentation with vomiting, headache, blurred vision and impaired consciousness during an episode of acute hypertension...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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