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End stage renal failure

Valentina Talarico, Monica Aloe, Alice Monzani, Roberto Miniero, Gianni Bona
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy defined by thrombocytopenia, non-immune microangiopathic hemolytic anemia and acute renal failure. HUS is typically classified into two primary types: 1) HUS due to infections, often associated with diarrhea (D+HUS, Shiga toxin-producing Escherichia Coli-HUS), with the rare exception of HUS due to a severe disseminated infection caused by Streptococcus; 2) HUS related to complement, such HUS is also known as "atypical HUS" and is not diarrhea associated (D-HUS, aHUS); but recent studies have shown other forms of HUS, that can occur in the course of systemic diseases or physiopathological conditions such as pregnancy, after transplantation or after drug assumption...
December 2016: Minerva Pediatrica
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Omesh Goyal, Sandeep Singh Sidhu, Natasha Sehgal, Sandeep Puri
OBJECTIVES: Hepatorenal syndrome (HRS) is a functional renal failure occurring in end stage liver disease, which is associated with poor prognosis. Terlipressin has been shown to be effective in treatment of HRS. More recently, it was suggested that noradrenaline, an alpha-adrenergic drug may be also effective in HRS. We aimed to compare the efficacy of noradrenaline versus terlipressin in treatment of HRS type 1. METHODS: Consecutive patients with cirrhosis and HRS type 1 were enrolled and randomised into 2 groups- Group A received intravenous noradrenaline infusion (0...
September 2016: Journal of the Association of Physicians of India
Masayoshi Okumi, Yasuyuki Sato, Kohei Unagami, Toshihito Hirai, Hideki Ishida, Kazunari Tanabe
BACKGROUND: The reasons for improved outcomes associated with preemptive kidney transplantation (PKT) are incompletely understood, and post-transplant complications have been scarcely investigated. METHODS: We evaluated the outcomes of PKT in both unmatched (n = 1060) and propensity score matched cohorts (n = 186) of adults who underwent living kidney transplant between 2000 and 2014. Outcomes were estimated glomerular filtration rate (eGFR), biopsy-proven rejection, cytomegalovirus (CMV) infection, post-transplant diabetes mellitus (PTDM), cardiovascular disease (CVD), graft failure (non-censored for death), and malignancy...
October 19, 2016: Clinical and Experimental Nephrology
Jérôme Dumortier, François Bailly, Georges-Philippe Pageaux, Anaïs Vallet-Pichard, Sylvie Radenne, François Habersetzer, Marie-Claude Gagnieu, Jean-Didier Grangé, Anne Minello, Olivier Guillaud, Nassim Kamar, Laurent Alric, Vincent Leroy
BACKGROUND: Chronic hepatitis C virus (HCV) infection is the most common chronic liver disease in patients with end-stage renal disease (ESRD). Over the last few years, second-generation direct-acting antivirals have been revolutionary in the treatment of hepatitis C, and sofosbuvir (SOF) is the backbone of most modern treatment strategies. Since SOF is eliminated through the kidney, the aim of this multicentre retrospective study was to assess its antiviral efficacy and safety in HCV-infected patients with severe renal failure [including haemodialysis (HD) patients]...
October 19, 2016: Nephrology, Dialysis, Transplantation
Mei-Rong Du, Gui-Xia Ju, Nian-Sheng Li, Jun-Lin Jiang
Microvascular complications are the leading causes of acquired blindness, end-stage renal failure, and varieties of neuropathy associated with diabetes. Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, is involved in endothelial dysfunction, oxidative stress, and inflammation associated with the progression of diabetic microvascular complications. Elevated ADMA has been detected in experimental animals and patients with diabetic microangiopathy like retinopathy, nephropathy, and neuropathy...
October 2016: Journal of Cardiovascular Pharmacology
Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss
Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative...
October 19, 2016: Minerva Anestesiologica
Rosita Zakeri, Gilles Moulay, Qiang Chai, Ozgur Ogut, Saad Hussain, Hiroyuki Takahama, Tong Lu, Xiao-Li Wang, Wolfgang A Linke, Hon-Chi Lee, Margaret M Redfield
BACKGROUND: Left atrial (LA) compliance and contractility influence left ventricular stroke volume. We hypothesized that diminished LA compliance and contractile function occur early during the development of heart failure with preserved ejection fraction (HFpEF) and impair overall cardiac performance. METHODS AND RESULTS: Cardiac magnetic resonance imaging, echocardiography, left ventricular and LA pressure-volume studies, and tissue analyses were performed in a model of early HFpEF (elderly dogs, renal wrap-induced hypertension, exogenous aldosterone; n=9) and young control dogs (sham surgery; n=13)...
October 2016: Circulation. Heart Failure
IJsbrand T Klip, Adriaan A Voors, Dorine W Swinkels, Stephan J L Bakker, Jenny E Kootstra-Ros, Carolyn S Lam, Pim van der Harst, Dirk J van Veldhuisen, Peter van der Meer
AIMS: Heart failure (HF) is a common manifestation of patients with primary and secondary causes of iron overload, whereas in patients with established HF iron deficiency impairs outcome. Whether iron stores, either depleted or in overload, amplify the risk for new-onset HF among healthy individuals is unknown. The present study aimed to assess whether markers of iron status or the iron-regulatory hormone hepcidin are associated with new-onset HF or cardiovascular (CV) events in the general population...
October 19, 2016: European Journal of Heart Failure
Vishal Dey, Audrey Jones, Elaine M Spalding
INTRODUCTION: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis. METHODS: Peritoneal dialysis patients were provided with computer tablets (PODs)...
2016: SAGE Open Medicine
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
Joo Hoon Lee, Jae Suk Baek, Jeong Jin Yu, Young-Hwue Kim, Jae-Kon Ko, Young Seo Park
OBJECTIVE: To evaluate the relationship between B-type natriuretic peptide (BNP) and cardiac parameters on echocardiography. DESIGN AND METHOD: Echocardiography was checked at 6 months ∼ 1 year interval in children with end-stage renal disease on peritoneal dialysis, which was more frequently done in patients with hypertension or any heart problems. We reviewed blood pressure (BP) and echocardiographic findings of those children (since February 2005). Data were presented as mean ± standard deviation (median, minimum ∼ maximum)...
September 2016: Journal of Hypertension
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: Treatment of hypertension has been shown to reduce mortality and cardiovascular events in high risk hypertension. However, there is a paucity of evidence on benefit of management for hypertension in patients with low cardiovascular risk. We aimed to determine the benefit in reducing mortality for hypertensive patients without previous cardiovascular disease, diabetes mellitus (DM) or chronic kidney disease (CKD). DESIGN AND METHOD: Hypertensive patients were selected from Korea National Health Insurance sample cohort, a retrospective cohort selected to be representative of the total eligible Korean population in 2002...
September 2016: Journal of Hypertension
Franz Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
September 2016: Journal of Hypertension
Masatsugu Horiuchi
Hypertensive patients have greater chances of such cardiovascular events as stroke, coronary heart disease, heart or renal failure, peripheral artery disease, and dementia. It is also well recognized that diabetes increases the cardiovascular risks in concert with hypertension. Therefore, main goals for an innovation of anti-hypertensive therapy would be to achieve further risk reduction by targeting the functional, metabolic, and structural alterations associated with hypertension. Professors Dzau and Braunwald et al proposed the concept of "the cardiovascular disease continuum" in 1991, and that hypertension may trigger the chain of events, leading to end-stage heart disease; however, this concept was quite new at that time, and there was some discussion whether "the cardiovascular disease continuum" is true or not...
September 2016: Journal of Hypertension
Gnanasambandan Ramanathan, Santu Ghosh, Ramprasad Elumalai, Soundararajan Periyasamy, Bhaskar V K S Lakkakula
BACKGROUND & OBJECTIVES: Autosomal dominant polycystic kidney disease (ADPKD) is an inherited systemic disorder, characterized by the fluid filled cysts in the kidneys leading to end stage renal failure in later years of life. Hypertension is one of the major factors independently contributing to the chronic kidney disease (CKD) progression. The renin-angiotensin aldosterone system (RAAS) genes have been extensively studied as hypertension candidate genes. The aim of the present study was to investigate the role of angiotensin converting enzyme tagging - single nucleotide polymorphisms (ACE tag-SNPs) in progression of CKD in patients with ADPKD...
June 2016: Indian Journal of Medical Research
David K Packham, Ian R Fraser, Peter G Kerr, Karen R Segal
BACKGROUND: Diabetic nephropathy is the most common cause of end stage renal failure. We assessed the safety, tolerability, and explored therapeutic effects of adult allogeneic bone-marrow derived mesenchymal precursor cells (MPC) in patients with moderate to severe diabetic nephropathy. METHODS: Multicenter, randomized, double-blind, dose-escalating, sequential, placebo-controlled trial assessing a single intravenous (IV) infusion of allogeneic MPC (United States adopted name: rexlemestrocel-L) 150×10(6) (n=10), 300×10(6) (n=10) or placebo (n=10) in adults with diabetic nephropathy with an estimated glomerular filtration rate (eGFR) 20-50ml/min/1...
September 17, 2016: EBioMedicine
C Pietrement, E Allain-Launay, J Bacchetta, A Bertholet-Thomas, L Dubourg, J Harambat, R Vieux, G Deschênes
These guidelines are intended to assist physicians in the care of children with chronic kidney disease (CKD), defined in children as in adults, regardless of its cause. Often silent for a long time, CKD can evolve to chronic renal failure or end-stage renal disease. Its management aims at slowing disease progression and treating CKD complications as soon as they appear. The different aspects of pediatric CKD care are addressed in these guidelines (screening, treatment, monitoring, diet, quality of life) as proposed by the French Society of Pediatric Nephrology...
October 12, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Veerawat Phongtankuel, Prin X Amorapanth, Eugenia L Siegler
The World Health Organization, one of the leading authorities on pain management, stressed the need for further guidelines to help manage pain in patients with chronic disease. In light of the impact of pain on morbidity and quality of life, this article summarizes current knowledge about pain experienced by older adults in 3 advanced non-cancer-related chronic diseases (ie, congestive heart failure, end-stage renal disease, and stroke) in which pain is common but not typically a primary focus of disease management...
November 2016: Clinics in Geriatric Medicine
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