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https://www.readbyqxmd.com/read/29778548/risk-factors-of-the-peptic-ulcer-bleeding-in-aging-uremia-patients-under-regular-hemodialysis
#1
Xi-Hsuan Lin, Chung-Chi Lin, Yuan-Jen Wang, Jiing-Chyuan Luo, Shih-Hao Young, Ping-Hsien Chen, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: Previous studies have shown that uremia patients under hemodialysis (HD) have a significantly higher occurrence of peptic ulcer bleeding (PUB) than healthy controls and that elderly patients remain at high risk of peptic ulcer disease (PUD) and PUB. Here we aimed to identify the risk factors for PUB in aging (≥65-years-old) uremic patients under regular HD. METHODS: Using data from the National Health Insurance Research Database of Taiwan, we compared 18,252 aging regular HD patients and 17,883 age-, gender-, and medication-matched patients without kidney disease (control group)...
May 16, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29772737/distal-colon-motor-dysfunction-in-mice-with-chronic-kidney-disease-putative-role-of-uremic-toxins
#2
Elsa Hoibian, Nans Florens, Laetitia Koppe, Hubert Vidal, Christophe O Soulage
Although gastrointestinal complications are a common feature of patients with chronic kidney disease (CKD), the impact of uremia on bowel motility remains poorly understood. The present study was, therefore, designed to investigate the impact of uremia on gut motility. Kidney failure was induced in mice by chemical nephrectomy using an adenine diet (0.25% w/w ). Gastrointestinal transit time and colon motility were explored in vivo and ex vivo . Colons from control mice were incubated with uremic plasma or uremic toxins (urea, indoxyl-sulfate or p-cresyl-sulfate) at concentrations encountered in patients with end-stage renal disease...
May 16, 2018: Toxins
https://www.readbyqxmd.com/read/29763891/endothelial-progenitor-cells-and-kidney-diseases
#3
Abdullah Ozkok, Alaattin Yildiz
Endothelial progenitor cells (EPC) are bone marrow derived or tissue-resident cells that play major roles in the maintenance of vascular integrity and repair of endothelial damage. Although EPCs may be capable of directly engrafting and regenerating the endothelium, the most important effects of EPCs seem to be depended on paracrine effects. In recent studies, specific microvesicles and mRNAs have been found to mediate the pro-angiogenic and regenerative effects of EPCs on endothelium. EPC counts have important prognostic implications in cardiovascular diseases (CVD)...
May 10, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29763365/effect-of-cross-linked-chitosan-iron-iii-on-vascular-calcification-in-uremic-rats
#4
Barbara Bruna Abreu de Castro, Wander Barros do Carmo, Paulo Giovani de Albuquerque Suassuna, Moises Carminatti, Julia Bianchi Brito, Wagner Vasques Dominguez, Ivone Braga de Oliveira, Vanda Jorgetti, Melani Ribeiro Custodio, Helady Sanders-Pinheiro
Cross-linked chitosan iron (III) is a chitin-derived polymer with a chelating effect on phosphorus, but it is untested in vascular calcification. We evaluated this compound's ability to reduce hyperphosphatemia and its effect on vascular calcification in uremic rats using an adenine-based, phosphorus-rich diet for seven weeks. We used a control group to characterize the uremia. Uremic rats were divided according the treatment into chronic kidney disease, CKD-Ch-Fe(III)CL (CKD-Ch), CKD-calcium carbonate, or CKD-sevelamer groups...
May 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29758204/association-between-hippuric-acid-and-left-ventricular-hypertrophy-in-maintenance-hemodialysis-patients
#5
Teng-Hung Yu, Wei-Hua Tang, Yung-Chuan Lu, Chao-Ping Wang, Wei-Chin Hung, Cheng-Ching Wu, I-Ting Tsai, Fu-Mei Chung, Jer-Yiing Houng, Wen-Chun Lan, Yau-Jiunn Lee
BACKGROUND: Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end-stage renal disease. Hippuric acid (HA), a harmful uremic toxin, is known to be elevated in patients with uremia, and serum HA levels are associated with neurological symptoms, metabolic acidosis, and accelerated renal damage associated with chronic kidney disease. However, the pathophysiological role of HA in patients with uremia remains unclear. We investigated the association between serum HA levels and echocardiographic measurements in patients undergoing hemodialysis (HD) treatment...
May 11, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29743031/safety-and-effectiveness-of-low-protein-diet-supplemented-with-ketoacids-in-diabetic-patients-with-chronic-kidney-disease
#6
Vincenzo Bellizzi, Patrizia Calella, Julia Nava Hernández, Verónica Figueroa González, Silvia Moran Lira, Serena Torraca, Rocio Urbina Arronte, Pietro Cirillo, Roberto Minutolo, Rafael A Montúfar Cárdenas
BACKGROUND: The impact of the low-protein diet on nutrition in CKD diabetics is uncertain. METHODS: The metabolic and nutritional effects of a low-protein (0.5-0.6 g/kg/d), normal-high energy (30-35 kcal/kg/d) diet supplemented with ketoacids (LPD-KA) were prospectively evaluated in CKD patients with (DM) and without (non-DM) diabetes mellitus. RESULTS: 197 patients on CKD stages 3-5 were enrolled. DM (n = 81) and non-DM (n = 116) were comparable for gender (Male 58 vs 55%), age (66 ± 9 vs 63 ± 18 years), renal function (eGFR 23 ± 13 vs 24 ± 13 mL/min)...
May 9, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29716796/protein-carbamylation-exacerbates-vascular-calcification
#7
Daisuke Mori, Isao Matsui, Akihiro Shimomura, Nobuhiro Hashimoto, Ayumi Matsumoto, Karin Shimada, Satoshi Yamaguchi, Tatsufumi Oka, Keiichi Kubota, Sayoko Yonemoto, Yusuke Sakaguchi, Atsushi Takahashi, Yasunori Shintani, Seiji Takashima, Yoshitsugu Takabatake, Takayuki Hamano, Yoshitaka Isaka
Protein carbamylation is a posttranslational modification that can occur non-enzymatically in the presence of high concentrations of urea. Although carbamylation is recognized as a prognostic biomarker, the contribution of protein carbamylation to organ dysfunction remains uncertain. Because vascular calcification is common under carbamylation-prone situations, we investigated the effects of carbamylation on this pathologic condition. Protein carbamylation exacerbated the calcification of human vascular smooth muscle cells (hVSMCs) by suppressing the expression of ectonucleotide pyrophosphate/phosphodiesterase 1 (ENPP1), a key enzyme in the generation of pyrophosphate, which is a potent inhibitor of ectopic calcification...
April 28, 2018: Kidney International
https://www.readbyqxmd.com/read/29710830/zebrafish-a-novel-model-system-to-study-uremic-toxins-the-case-for-the-sulfur-amino-acid-lanthionine
#8
Alessandra F Perna, Evgeniya Anishchenko, Carmela Vigorito, Miriam Zacchia, Francesco Trepiccione, Salvatore D'Aniello, Diego Ingrosso
The non-proteinogenic amino acid lanthionine is a byproduct of hydrogen sulfide biosynthesis: the third endogenous vasodilator gas, after nitric oxide and carbon monoxide. While hydrogen sulfide is decreased in uremic patients on hemodialysis, lanthionine is increased and has been proposed as a new uremic toxin, since it is able to impair hydrogen sulfide production in hepatoma cells. To characterize lanthionine as a uremic toxin, we explored its effects during the early development of the zebrafish ( Danio rerio ), a widely used model to study the organ and tissue alterations induced by xenobiotics...
April 29, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29682371/colonic-mucosal-ulceration-and-gastrointestinal-bleeding-associated-with-sevelamer-crystal-deposition-in-a-patient-with-end-stage-renal-disease
#9
Sudheer Nambiar, Unnikrishnan Kunjan Pillai, Joe Devasahayam, Tony Oliver, Asha Karippot
End stage renal disease (ESRD) population account for 1.9 per patient year of hospital admissions annually. ESRD population are at increased risk of bleeding secondary to use of anticoagulation during hemodialysis and uremia induced platelet dysfunction. Gastrointestinal bleeding accounts for 3-7% of all deaths in ESRD population. Lower gastrointestinal bleeding refers to blood loss from a site in the gastrointestinal tract distal to the ligament of Treitz. It is usually suspected when a patient complains of hematochezia...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29680422/effect-of-kidney-transplantation-on-sleep-disordered-breathing-in-patients-with-end-stage-renal-disease-a-polysomnographic-study
#10
Sanjiv Mahajan, Kartik Gupta, Sanjeev Sinha, Atul Malhotra, Sandeep Mahajan
BACKGROUND: Sleep-disordered breathing (SDB) is common in patients with end-stage renal disease (ESRD). SDB is associated with comorbidities such as hypertension, diabetes mellitus, and obesity, interplaying with metabolic derangements in the form of uremia, acidosis, and hypervolemia. Renal transplant has been observed to correct most of these metabolic derangements and to control progression of comorbidities. While SDB is highly prevalent among patients in the pretransplant stage, it remains to be seen whether the beneficial aspects of transplant are extended to improvement in SDB in patients with ESRD...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29672279/associations-between-apolipoprotein-e-gene-polymorphisms-and-cardiovascular-complications-of-uremic-patients-on-maintenance-hemodialysis
#11
Chang-Zhi Zheng, Xiang-Ming Qi, Yong-Bing Shu, You-Wei Bai, Yong-Gui Wu
This study is to investigate the associations between apolipoprotein E (ApoE) gene polymorphisms and cardiovascular complications of uremic patients on maintenance hemodialysis (MHD). Uremic patients on MHD (189, case group) and healthy people (165, control group) were recruited. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to test ApoE gene polymorphisms. Indicators of MHD and cardiovascular complications were observed. Compared with the control group, the case group had decreased frequency of ε3/3 genotype and ε3 allele and increased ε4/3 genotype and ε4 allele...
April 19, 2018: Blood Purification
https://www.readbyqxmd.com/read/29657215/acute-gastric-dilatation-in-a-patient-with-lupus-nephritis-an-uncommon-presentation-of-lupus-mesenteric-vasculitis
#12
S Ezhilnilavan, P S Priyamvada, S Haridasan, N G Rajesh, S Parameswaran
Abdominal symptoms are common in patients with lupus nephritis and are often attributed to drugs or uremia per se. Lupus mesenteric vasculitis (LMV) or lupus enteritis is a rare entity reported in patients with active systemic lupus erythematosus. It usually occurs in patients with a long-standing history of lupus with high disease activity. Usually, small bowel is predominantly affected. The stomach and rectum are spared in view of significant collateral circulation. Here, we describe an 18-year-old boy who presented with nephrotic syndrome without any extrarenal features of lupus...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29644053/the-dialysis-orders-objective-structured-clinical-examination-osce-a-formative-assessment-for-nephrology-fellows
#13
Lisa K Prince, Ruth C Campbell, Sam W Gao, Jessica Kendrick, Christopher J Lebrun, Dustin J Little, David L Mahoney, Laura A Maursetter, Robert Nee, Mark Saddler, Maura A Watson, Christina M Yuan
Background: Few quantitative nephrology-specific simulations assess fellow competency. We describe the development and initial validation of a formative objective structured clinical examination (OSCE) assessing fellow competence in ordering acute dialysis. Methods: The three test scenarios were acute continuous renal replacement therapy, chronic dialysis initiation in moderate uremia and acute dialysis in end-stage renal disease-associated hyperkalemia. The test committee included five academic nephrologists and four clinically practicing nephrologists outside of academia...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29622969/relationship-between-serum-osteoprotegerin-and-vascular-calcifications-in-hemodialysis-patients
#14
Tarek Z El Baz, Osama A Khamis, Amal El-Shehaby, Hussein Chahine, Ahmad Alaa Al-Din Ahmed, Mostafa A Alsawasany
Background: Uremia is a vasculopathic process, and both cardiac calcification and vascular calcification seen from the early stages of chronic kidney disease. Osteoprotegerin could play a crucial role in atherosclerotic plaque formation, maturation and calcification. The goal of this study was to determine the relationship of serum osteoprotegerin with vascular calcification in patients with end stage kidney disease who were maintained on regular hemodialysis. Methods: Sixty clinically stable chronic renal failure patients undergoing regular hemodialysis were enrolled in this cross sectional study...
June 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29596042/ten-tips-nephrologists-wish-the-palliative-care-team-knew-about-caring-for-patients-with-kidney-disease
#15
Amar D Bansal, Amanda Leonberg-Yoo, Jane O Schell, Jennifer S Scherer, Christopher A Jones
Many patients with chronic kidney disease (CKD) and end-stage renal disease have unmet palliative care (PC) needs. Physical and emotional symptoms are common. Some, like uremia and fluid overload, improve with dialysis, but the increasing age of patients initiating renal replacement therapy leaves many untreatable comorbidities like dementia and frailty to negatively impact quality of life. Written by nephrologists and PC clinicians, this article will help PC providers to have a richer understanding of kidney disease-related symptom burden, disease trajectory, prognosis, and barriers to hospice enrollment for patients with CKD and end-stage renal disease...
April 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29593228/chronic-kidney-disease-induces-a-systemic-microangiopathy-tissue-hypoxia-and-dysfunctional-angiogenesis
#16
Hans-Ulrich Prommer, Johannes Maurer, Karoline von Websky, Christian Freise, Kerstin Sommer, Hamoud Nasser, Rudi Samapati, Bettina Reglin, Pedro Guimarães, Axel Radlach Pries, Uwe Querfeld
Chronic kidney disease (CKD) is associated with excessive mortality from cardiovascular disease (CVD). Endothelial dysfunction, an early manifestation of CVD, is consistently observed in CKD patients and might be linked to structural defects of the microcirculation including microvascular rarefaction. However, patterns of microvascular rarefaction in CKD and their relation to functional deficits in perfusion and oxygen delivery are currently unknown. In this in-vivo microscopy study of the cremaster muscle microcirculation in BALB/c mice with moderate to severe uremia, we show in two experimental models (adenine feeding or subtotal nephrectomy), that serum urea levels associate incrementally with a distinct microangiopathy...
March 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29588907/disseminated-toxoplasmosis-in-a-patient-with-advanced-acquired-immunodeficiency-syndrome
#17
Ricardo Garcia Pastorello, Anderson da Costa Lino Costa, Marcio Valente Yamada Sawamura, Antonio Carlos Nicodemo, Amaro Nunes Duarte-Neto
Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis...
January 2018: Autopsy & case reports
https://www.readbyqxmd.com/read/29583052/associations-between-dialysate-sodium-concentration-and-plasma-sodium-concentration-of-dogs-receiving-intermittent-hemodialysis-treatments
#18
Jonathan D Foster, Kenneth J Drobatz, Larry D Cowgill
OBJECTIVE To compare dialysate sodium concentration and patient plasma sodium concentration of dogs during intermittent hemodialysis treatments. SAMPLE 211 intermittent hemodialysis treatments performed on 40 client-owned dogs for the management of dialysis-dependent uremia. PROCEDURES Medical records were reviewed to determine the plasma sodium concentration of each dog before and after routine hemodialysis treatments. Associations between detected changes in plasma sodium concentration and dialysate sodium concentration were evaluated by use of Spearman rank correlations and linear regression analysis...
April 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29581966/impaired-gut-epithelial-tight-junction-expression-in-hemodialysis-patients-complicated-with-intradialytic-hypotension
#19
Tsai-Kun Wu, Paik-Seong Lim, Jong-Shiaw Jin, Ming-Ying Wu, Chang-Hsu Chen
Background: There is accumulating evidence pointing to uremia-induced impairment of the intestinal epithelial barrier structure in advanced chronic kidney disease (CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic hypotension on intestinal barrier integrity is being explored. Methods: Immunohistochemical staining was used to detect the expression of 4 types of tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1), claudin-1, and claudin-4, in colonic samples of a group of patients receiving segmental colectomy...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29529595/rankl-opg-system-regulation-by-endogenous-pth-and-pth1r-atf4-axis-in-bone-implications-for-bone-accrual-and-strength-in-growing-rats-with-mild-uremia
#20
Beata Znorko, Dariusz Pawlak, Ewa Oksztulska-Kolanek, Tomasz Domaniewski, Anna Pryczynicz, Alicja Roszczenko, Joanna Rogalska, Paweł Lipowicz, Michał Doroszko, Malgorzata Michalina Brzoska, Krystyna Pawlak
Osteoprotegerin (OPG), receptor activator of NF-κB ligand (RANKL), and parathyroid hormone (PTH) play a central role in the regulation of bone turnover in chronic kidney disease (CKD), but their influence on bone mineral density (BMD) and strength remains unclear, particularly in children. We studied the clinical significance of OPG and RANKL in relation to PTH, femur weight, BMD, and bone biomechanical properties in growing rats after one month (CKD-1) and three months (CKD-3) of surgically-induced mild CKD...
June 2018: Cytokine
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