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End stage renal failure

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https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#1
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28527110/a-review-of-the-hemodynamic-factors-believed-to-contribute-to-vascular-access-dysfunction
#2
Connor V Cunnane, Eoghan M Cunnane, Michael T Walsh
A vascular access (VA) is used to facilitate hemodialysis in patients that suffer from end-stage renal disease. However, they suffer from high failure rates due to non-maturation and venous stenosis, with intimal hyperplasia (IH) the underlying cause of both conditions. Abnormal hemodynamic profiles, which arise following VA creation, are believed to lead to the development of IH. However, the exact physiological response that initiates this process is unknown. This review evaluates the different hemodynamic parameters that are hypothesised to correlate with the development of IH...
May 19, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28527109/erratum-to-clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#3
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a twofold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
May 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28523502/maldi-ms-imaging-in-the-study-of-glomerulonephritis
#4
Andrew Smith, Manuel Galli, Vincenzo L'Imperio, Fabio Pagni, Fulvio Magni
Glomerulonephritis (GNs) are one of the most frequent causes of chronic kidney disease (CKD), a renal condition that often leads to end-stage renal failure, and a careful assessment of these diseases is essential for prognostic and therapeutic purposes. The application of MALDI-MSI directly on bioptic renal tissue represents a new stimulating perspective and facilitates the detection of specific proteomic indicators that are directly correlated with the pathological alterations that occur within the glomeruli during the development of glomerulonephritis...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28522697/circulating-microrna-125b-predicts-the-presence-and-progression-of-uremic-vascular-calcification
#5
Chia-Ter Chao, You-Pi Liu, Sheng-Fang Su, Hsiang-Yuan Yeh, Hsuan-Yu Chen, Pei-Jung Lee, Wan-Jiun Chen, Yee-Ming Lee, Jenq-Wen Huang, Chih-Kang Chiang, Kuan-Yu Hung, Huei-Wen Chen
OBJECTIVE: Vascular calcification (VC) is a major cause of mortality in patients with end-stage renal diseases. Biomarkers to predict the progression of VC early are in urgent demand. APPROACH AND RESULTS: We identified circulating, cell-free microRNAs as potential biomarkers using in vitro VC models in which both rat and human aortic vascular smooth muscle cells were treated with high levels of phosphate to mimic uremic hyperphosphatemia. Using an Affymetrix microRNA array, we found that miR-125b and miR-382 expression levels declined significantly as biomineralization progressed, but this decline was only observed for miR-125b in the culture medium...
May 18, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28520568/endothelin-a-receptor-antagonists-in-diabetic-kidney-disease
#6
Panagiotis I Georgianos, Rajiv Agarwal
PURPOSE OF REVIEW: Despite optimal therapy of diabetic nephropathy with agents blocking the renin-angiotensin-aldosterone system, the residual risk of nephropathy progression to end-stage renal disease (ESRD) remains high. The purpose of this review is to discuss the potential role of endothelin antagonism as a therapeutic tool to reduce residual proteinuria and delay kidney injury progression among patients with diabetic nephropathy. RECENT FINDINGS: Preclinical studies have shown that endothelin receptor antagonists (ERAs) exert proteinuria lowering and nephroprotective actions in experimental models of diabetic nephropathy...
May 17, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28514894/successful-repair-of-acute-type-b-and-retrograde-type-a-aortic-dissection-with-kidney-ischemia
#7
Jeko M Madjarov, Michael G Katz, Hector Crespo-Soto, Svetozar Madzharov, Timothy Roush, Francis Robicsek
Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia. Evaluation of renal function was performed by the means of internationally accepted Risk, Injury, Failure, Loss of kidney function, End stage kidney disease and Acute Kidney Injury Network classifications for acute kidney injury, renal duplex sonography, and intravascular ultrasound that demonstrated left renal artery dissection with a flap completely compressing the true lumen...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28509626/custom-compounded-bioidentical-hormone-therapy-why-so-popular-despite-potential-harm-the-case-against-routine-use
#8
M L'Hermite
Wide rejection of conventional hormone therapy (HT) after the initial publication of the Women's Health Initiative (WHI) led to unjustified use of custom-compounded bioidentical hormones. In the USA, it became an unregulated drug manufacturer industry in disguise, without proper control and making false claims and misleading advertisements. Manufacturing quality is not ensured. Unspecific harm from compounding has occurred on a large scale, such as deaths from infected products and end-stage renal failure plus carcinoma due to confusion between different Chinese herbs...
June 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28509133/denosumab-for-treatment-of-immobilization-related-hypercalcemia-in-a-patient-with-end-stage-renal-disease
#9
Atsuko Uehara, Masahiko Yazawa, Atsumi Kawata, Rina Hachisuka, Yugo Shibagaki
The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28507910/penile-calciphylaxis-the-use-of-radiological-investigations-in-the-management-of-a-rare-and-challenging-condition
#10
Rebecca A Campbell, Laith M Alzweri, Nikolai A Sopko, Katarzyna J Macura, Arthur L Burnett
Penile calciphylaxis is a rare phenomenon of penile necrosis observed in patients with hemodialysis-dependent end-stage renal failure. Multiple treatments have been proposed including conservative management, surgical debridement and penectomy; yet, the prognosis remains extremely poor. Here, we describe a patient with protracted resolution of dry gangrene of the glans, which failed conservative management of wound care and pain management. Radiological studies revealed extensive calcification of abdominal aorta and branching vessels including the penile arteries...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28506691/urinary-lysophopholipids-are-increased-in-diabetic-patients-with-nephropathy
#11
Jean-Sébastien Saulnier-Blache, Eva Feigerlova, Jean Michel Halimi, Pierre Gourdy, Ronan Roussel, Bruno Guerci, Aude Dupuy, Justine Bertrand-Michel, Jean-Loup Bascands, Samy Hadjadj, Joost P Schanstra
Diabetic nephropathy (DN) is a major cause of chronic kidney disease that frequently leads to end stage renal failure. Lysophosphatidic acid (LPA) and lysophosphatidylcholine (LPC) are lysophospholipid mediators shown to accumulate in kidney and to promote renal inflammation and tubulo-interstitial fibrosis in diabetic rodent models. Here we assessed whether LPA and LPC were associated to the development of nephropathy in diabetic human patients. Several molecular species of LPA and LPC were quantified by LC/MS-MS in urine and plasma from type 2 diabetic patients with (cases; n=41) or without (controls, n=41) nephropathy symptoms (micro/macro-albuminuria and eGFR<60ml/min/1...
May 10, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28502331/risk-factors-and-outcomes-of-acute-kidney-injury-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#12
Wei Yuan, Yu-Yi Zhang, Zheng-Guo Zhang, Ying Zou, Hong-Zhou Lu, Zhi-Ping Qian
BACKGROUND: Acute kidney injury (AKI) is common in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF); however, few studies concerning the risk factors and recovery patterns of renal function have been published. MATERIALS AND METHODS: A retrospective analysis of 150 patients with HBV-ACLF was performed. The occurrence, risk factors and functional recovery of AKI among patients with HBV-ACLF were investigated. RESULTS: A total of 90 patients (60%) with HBV-ACLF developed AKI...
May 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#13
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
May 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#14
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28499030/moderator-s-view-predictive-models-a-prelude-to-precision-nephrology
#15
Carmine Zoccali
Appropriate diagnosis is fundamental in medicine because it sets the basis for the prediction of disease outcome at the single patient level (prognosis) and decisions regarding the most appropriate therapy. However, given the large series of social, clinical and biological factors that determine the likelihood of an individual's future outcome, prognosis only partly depends on diagnosis and aetiology and treatment is not decided solely on the basis of the underlying diagnosis. This issue is crucial in multifactorial diseases like atherosclerosis, where the use of statins has now shifted from 'treating hypercholesterolaemia' to 'treating the risk of adverse cardiovascular events'...
May 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28497088/pulmonary-hypertension-among-patients-undergoing-hemodialysis
#16
Fatemeh Hayati, Seyed Seifollah Beladi Mousavi, Seyed Majid Mousavi Movahed, Maryam Mofrad Bushehri
Introduction: The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. Objectives: The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). Patients and Methods: In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28496531/differential-simultaneous-liver-and-kidney-transplant-benefit-based-on-severity-of-liver-damage-at-the-time-of-transplantation
#17
Shahid Habib, Khalid Khan, Chiu-Hsieh Hsu, Edward Meister, Abbas Rana, Thomas Boyer
BACKGROUND: We evaluated the concept of whether liver failure patients with a superimposed kidney injury receiving a simultaneous liver and kidney transplant (SLKT) have similar outcomes compared to patients with liver failure without a kidney injury receiving a liver transplantation (LT) alone. METHODS: Using data from the United Network of Organ Sharing (UNOS) database, patients were divided into five groups based on pre-transplant model for end-stage liver disease (MELD) scores and categorized as not having (serum creatinine (sCr) ≤ 1...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28495592/mir-21-promotes-fibrogenesis-in-peritoneal-dialysis
#18
Melisa Lopez-Anton, Mark Lambie, Manuel Lopez-Cabrera, Claus P Schmitt, Vicente Ruiz-Carpio, Maria Bartosova, Betti Schaefer, Simon Davies, Timothy Stone, Robert Jenkins, Philip R Taylor, Nicholas Topley, Timothy Bowen, Donald Fraser
Peritoneal dialysis (PD) is a life-saving form of renal replacement therapy for those with end-stage kidney disease. Mesothelial cells (MCs) line the peritoneal cavity and help define peritoneal response to treatment-associated injury, a major reason for treatment failure. miRNAs are important regulators, but their roles in peritoneal fibrosis are largely unknown. In this study, miR-21 was one of the most abundant miRNAs in primary MCs, and was up-regulated by the profibrotic cytokine transforming growth factor-β1 and in PD effluent-derived MCs exhibiting mesenchymal phenotypic change...
May 8, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28490956/changes-in-the-nf%C3%AE%C2%BAb-and-e-cadherin-expression-are-associated-to-diabetic-nephropathy-inpsammomys-obesus
#19
Djamila Aroune, Farid Libdiri, Sophie Leboucher, Boubekeur Maouche, Sergio Marco, Salima El-Aoufi
Diabetes mellitus is a major leading cause of end-stage renal failure, characterized by kidney inflammation and glomerular dysfunction, in worldwide. Kidney inflammation is associated to modifications in the expression levels of pro-inflammatory molecules, such as nuclear factor-κB (NFκB) and adhesion molecules, such as E-cadherin, leading to glomerular dysfunction. However, the relationships between these two processes in human diabetic nephropathy remain an open question. Since Psammomys obesus is an ideal animal model to study diabetes mellitus temporal evolution, we have used this model to study the correlation between kidney structural changes and modification on the expression levels of NFκB and E-cadherin over time...
May 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28490481/vitamin-a-deficiency-due-to-chronic-malabsorption-an-ophthalmic-manifestation-of-a-systemic-condition
#20
James Cheshire, Sai Kolli
A 47-year-old woman presented with a 4-week history of progressive loss of vision, first manifesting as night blindness. Additionally, the patient reported frequent severe episodes of diarrhoea over the past month. Her medical history included end-stage renal failure for which she was currently on haemodialysis after a failed renal transplant, chronic pancreatitis and autonomic diabetes mellitus. Ophthalmological examination revealed severe bilateral corneal xerosis, bilateral Bitot's spots and inferior ulceration of the right cornea...
May 10, 2017: BMJ Case Reports
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