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https://www.readbyqxmd.com/read/29771702/pathogenesis-of-cerebral-edema-in-patients-with-acute-renal-and-liver-failure-and-the-role-of-the-nephrologist-in-the-management
#1
Tamim Hamdi
PURPOSE OF REVIEW: Acute liver failure (ALF) is a severe and complex illness and one of the most daunting conditions managed in the ICU. Because the renal care is intertwined with multiple disciplines, the aim of this review is to examine the multifactorial pathogenesis of cerebral edema in ALF, covering basic established facts as well as recent advances in our understanding of this condition. RECENT FINDINGS: Acetaminophen remains the most common cause of ALF in the United States and many European countries...
May 15, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29751972/notch3-orchestrates-epithelial-and-inflammatory-responses-to-promote-acute-kidney-injury
#2
Panagiotis Kavvadas, Zela Keuylian, Niki Prakoura, Sandrine Placier, Aude Dorison, Christos E Chadjichristos, Jean-Claude Dussaule, Christos Chatziantoniou
Acute kidney injury is a major risk factor for subsequent chronic renal and/or cardiovascular complications. Previous studies have shown that Notch3 was de novo expressed in the injured renal epithelium in the early phases of chronic kidney disease. Here we examined whether Notch3 is involved in the inflammatory response and the epithelial cell damage that typifies ischemic kidneys using Notch3 knockout mice and mice with short-term activated Notch3 signaling (N3ICD) in renal epithelial cells. After ischemia/reperfusion, N3ICD mice showed exacerbated infiltration of inflammatory cells and severe tubular damage compared to control mice...
May 8, 2018: Kidney International
https://www.readbyqxmd.com/read/29731057/clinical-outcomes-of-kidney-transplantation-in-patients-with-biopsy-proven-glomerulonephritis
#3
H Park, W Y Park, S S Kang, S M Yeo, S Han, S B Park, K Jin
BACKGROUND: The clinical outcomes after kidney transplantation (KT) according to the types of glomerulonephritis (GN) as the cause of end-stage renal disease (ESRD) are various, but there are not many studies on this. METHODS: Among 1,253 patients who had KT between November 1982 and January 2017, 183 recipients with biopsy-proven GN as the primary cause of ESRD were enrolled. We analyzed the incidence of recurrent GN and the factors associated with recurrence and graft and patient survivals...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29707591/miliary-tuberculosis-presenting-with-meningitis-in-a-patient-treated-with-mycophenolate-for-lupus-nephritis-challenges-in-diagnosis-and-review-of-the-literature
#4
Precious Macauley, Mark Rapp, Sarah Park, Olaoluwatomi Lamikanra, Pratibha Sharma, Michael Marcelin, Kavita Sharma
Tuberculosis is one of the top 10 causes of death worldwide according to the World Health Organization. Central nervous system involvement is usually the least common presentation of tuberculosis occurring in about 1% of all cases but yet can have very devastating outcomes. Lupus nephritis is one of the most common complications of systemic lupus erythematosus with up to two thirds of patients presenting with some degree of renal dysfunction. The mainstay of treatment is glucocorticoids; however, to sustain remission, steroid sparing agents such as cyclophosphamide, azathioprine and mycophenolate mofetil are used...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29675946/plasma-proteomics-identifies-a-chemokine-storm-in-idiopathic-multicentric-castleman-disease
#5
Sheila K Pierson, Aaron J Stonestrom, Dustin Shilling, Jason Ruth, Christopher S Nabel, Amrit Singh, Yue Ren, Katie Stone, Hongzhe Li, Frits van Rhee, David C Fajgenbaum
Human Herpesvirus-8 (HHV-8)-negative/idiopathic multicentric Castleman disease (iMCD) is a poorly understood disease involving polyclonal lymphoproliferation with dysmorphic germinal centers, constitutional symptoms, and multi-organ failure. Patients can experience thrombocytopenia, anasarca, reticulin fibrosis, renal dysfunction, organomegaly, and normal immunoglobulin levels, - iMCD-TAFRO. Others experience thrombocytosis, milder effusions, and hypergammaglobulinemia, -iMCD-Not Otherwise Specified (iMCD-NOS)...
April 20, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29669665/diagnosis-pathogenesis-and-treatment-of-chronic-spontaneous-urticaria
#6
Allen P Kaplan
BACKGROUND: Chronic Spontaneous Urticaria (CSU) is an endogenous disorder that is strongly associated with autoimmunity, particularly with immunoglobulin G (IgG) antibody to the alpha subunit of the IgE receptor seen in 35-40% of patients. Basophils and cutaneous mast cells can be activated and lead to a late-phase-like perivascular infiltration about small venules and hive formation. METHODS: Review of current literature. RESULTS: Antibody to thyroid antigens are seen in 25% of patients; a small fraction of these may be clinically hypothyroid (Hashimoto's Thyroiditis)...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29662959/quarter-century-management-of-chronic-ureteropelvic-junction-obstruction-in-a-solitary-kidney-with-a-ureteral-stent
#7
Garen Abedi, Roshan M Patel, Cyrus Lin, Ralph V Clayman
Background: The ureteral stent provides a conduit for urinary drainage from the kidney to the bladder and is integral to contemporary urologic practice. A ureteral stent is often utilized in acute conditions to prevent or overcome obstruction; however, in nonsurgical patients, because of disease or preference, a ureteral stent may be used as a last resort for long-term management of a stricture in lieu of a nephrostomy tube. This case highlights a patient whose chronic ureteral obstruction has been managed with an indwelling ureteral stent for 25 years; remarkably, stent exchanges are currently required only every 2 years...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29606152/bilateral-ureterolithiasis-a-true-positive-and-false-negative-pocus-exam-in-a-patient-with-renal-colic
#8
Matthew P Lowe, Christopher Cox
Acute flank pain from suspected urolithiasis is a common presenting complaint in the Emergency Department. Multiple computed tomography (CT) has traditionally been the standard imaging modality used to diagnose obstructive kidney stones, however point of care ultrasound (PoCUS) can play an important role in the diagnostic algorithm and risk stratification of acute flank pain. Here, we present the case of a 29-year-old female with suspected urolithiasis, who underwent PoCUS that revealed right-sided hydronephrosis and normal left kidney, bladder, and aorta...
April 2, 2018: CJEM
https://www.readbyqxmd.com/read/29602832/intracellular-chloride-and-scaffold-protein-mo25-cooperatively-regulate-transepithelial-ion-transport-through-wnk-signaling-in-the-malpighian-tubule
#9
Qifei Sun, Yipin Wu, Sima Jonusaite, John M Pleinis, John M Humphreys, Haixia He, Jeffrey N Schellinger, Radha Akella, Drew Stenesen, Helmut Krämer, Elizabeth J Goldsmith, Aylin R Rodan
Background With No Lysine kinase (WNK) signaling regulates mammalian renal epithelial ion transport to maintain electrolyte and BP homeostasis. Our previous studies showed a conserved role for WNK in the regulation of transepithelial ion transport in the Drosophila Malpighian tubule. Methods Using in vitro assays and transgenic Drosophila lines, we examined two potential WNK regulators, chloride ion and the scaffold protein mouse protein 25 (Mo25), in the stimulation of transepithelial ion flux. Results In vitro , autophosphorylation of purified Drosophila WNK decreased as chloride concentration increased...
May 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29588419/tweak-and-ripk1-mediate-a-second-wave-of-cell-death-during-aki
#10
Diego Martin-Sanchez, Miguel Fontecha-Barriuso, Susana Carrasco, Maria Dolores Sanchez-Niño, Anne von Mässenhausen, Andreas Linkermann, Pablo Cannata-Ortiz, Marta Ruiz-Ortega, Jesus Egido, Alberto Ortiz, Ana Belen Sanz
Acute kidney injury (AKI) is characterized by necrotic tubular cell death and inflammation. The TWEAK/Fn14 axis is a mediator of renal injury. Diverse pathways of regulated necrosis have recently been reported to contribute to AKI, but there are ongoing discussions on the timing or molecular regulators involved. We have now explored the cell death pathways induced by TWEAK/Fn14 activation and their relevance during AKI. In cultured tubular cells, the inflammatory cytokine TWEAK induces apoptosis in a proinflammatory environment...
April 17, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29581579/restoration-of-e-cadherin-by-ppbica-protects-against-cisplatin-induced-acute-kidney-injury-by-attenuating-inflammation-and-programmed-cell-death
#11
Li Gao, Ming-Ming Liu, Hong-Mei Zang, Qiu-Ying Ma, Qin Yang, Ling Jiang, Gui-Ling Ren, Hai-Di Li, Wei-Feng Wu, Jia-Nan Wang, Biao Wei, Xue-Qi Liu, Cheng Jiang, Cheng Huang, Jun Li, Xiao-Ming Meng
E-cadherin is a major component of tubular adherent proteins that maintain intercellular contacts and cell polarity in epithelial tissue. It is involved in pathological processes of renal cell carcinoma and fibrotic diseases via epithelial-mesenchymal transition. Although studies have shown E-cadherin is significantly downregulated in acute kidney injury (AKI), its function in AKI is unknown. Here, we evaluated cell damage and inflammation in cisplatin-stimulated tubular epithelial cell lines after disrupting E-cadherin and restoring it with PPBICA, a small molecule identified by high-throughput screening...
March 26, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/29527982/transplant-patients-with-failing-renal-allografts
#12
Ali Riza Ucar, Erol Demir, Mehmet Sukru Sever
Progress in patient care and immunosuppressive medications has resulted in improved allograft survival in the early posttransplant period; however, substantial graft loss continues in the long term. Therefore, the number of dialysis patients with failed allografts is increasing progressively. These patients have a worse prognosis than naive dialysis patients. Cardiovascular causes are the leading cause of death, followed by infections and malignancies. Delay in return to dialysis, a chronic inflammatory state, infections, and cancer are contributing factors to mortality, whereas type of dialysis modality does not have a significant effect on outcomes...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29510919/improving-incident-esrd-care-via-a-transitional-care-unit
#13
Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29450214/-mycobacterium-abscessus-complex-infections-a-retrospective-cohort-study
#14
Maroun Sfeir, Marissa Walsh, Rossana Rosa, Laura Aragon, Sze Yan Liu, Timothy Cleary, Marylee Worley, Corey Frederick, Lilian M Abbo
Background: Infections caused by Mycobacterium abscessus group strains are usually resistant to multiple antimicrobials and challenging to treat worldwide. We describe the risk factors, treatment, and clinical outcomes of patients in 2 large academic medical centers in the United States. Methods: A retrospective cohort study of hospitalized adults with a positive culture for M. abscessus in Miami, Florida (January 1, 2011, to December 31, 2014). Demographics, comorbidities, the source of infection, antimicrobial susceptibilities, and clinical outcomes were analyzed...
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29444290/impact-of-renal-allograft-nephrectomy-on-graft-and-patient-survival-following-retransplantation-a-systematic-review-and-meta-analysis
#15
Jinwen Lin, Rending Wang, Ying Xu, Jianghua Chen
Background: It is not clear whether renal allograft removal affects the outcome of renal retransplantation. This study aimed to determine the effect of allograft nephrectomy (AN) and no-AN (No AN) on renal retransplantation. Methods: A systematic review and meta-analysis were conducted using MEDLINE, Embase and the Cochrane Library. Observational studies or randomized controlled trials including renal retransplantation recipients with AN or No-AN were included. The primary outcomes were graft survival, patient survival, acute rejection (AR) and delayed graft dysfunction; the secondary outcomes were positive panel reactive antibody rate and serum creatinine level at 1 year after retransplantation, cold ischemia time and time of hemodialysis before recent transplantation...
February 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29390523/efficacy-of-eculizumab-in-an-adult-patient-with-hiv-associated-hemolytic-uremic-syndrome-a-case-report
#16
Marine Freist, Cyril Garrouste, Nora Szlavik, Paul Coppo, Alexandre Lautrette, Anne Elisabeth Heng
INTRODUCTION: Hemolytic uremic syndrome (HUS) in Human Immunodeficiency Virus (HIV)-positive patients has become a rare cause of kidney injury since the era of highly active antiretroviral therapy (HAART). Plasma exchange and antiretroviral therapy were previously recommended but often failed to achieve remission. We report a case of HUS in a HIV-positive patient treated successfully with eculizumab. CASE SUMMARY: A 52-year-old woman presented to hospital with acute renal failure, thrombocytopenia, anemia, and hypoxemia...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29369303/report-from-the-international-conference-on-viral-hepatitis-2017
#17
Vicente Soriano, Benjamin Young, Nancy Reau
The International Conference on Viral Hepatitis 2017 brought exciting news on the treatment of viral hepatitis. The most recent estimates of the burden for hepatitis B virus and hepatitis C virus (HCV) infections were presented. The current gaps and prospects for regional and global eradication of viral hepatitis were discussed on the light of the WHO roadmap until 2030. Debates focused on hepatitis C and expectations using the new approved HCV pan-genotypic, once daily, oral direct-acting antivirals (DAAs), glecaprevir-pibrentasvir, and sofosbuvir-velpatasvir-voxilaprevir...
January 2018: AIDS Reviews
https://www.readbyqxmd.com/read/29357444/renal-potassium-handling-in-rats-with-subtotal-nephrectomy-modeling-and-analysis
#18
Anita T Layton, Aurélie Edwards, Volker Vallon
We sought to decipher the mechanisms underlying the kidney's response to changes in K+ load and intake, under physiological and pathophysiological conditions. To accomplish that goal, we applied a published computational model of epithelial transport along rat nephrons in a sham rat, an uninephrectomized (UNX) rat, and a 5/6-nephrectomized (5/6-NX) rat that also considers adaptations in glomerular filtration rate and tubular growth. Model simulations of an acute K+ load indicate that elevated expression levels and activities of Na+ /K+ -ATPase, epithelial sodium channels, large-conductance Ca2+ -activated K+ channels, and renal outer medullary K+ channels, together with downregulation of sodium-chloride cotransporters (NCC), increase K+ secretion along the connecting tubule, resulting in a >6-fold increase in urinary K+ excretion in sham rats, which substantially exceeds the filtered K+ load...
April 1, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29356707/outcomes-of-simultaneous-liver-kidney-transplantation-implications-for-patient-selection
#19
Lafaine Grant, Shannan Tujios, Amit G Singal
PURPOSE OF REVIEW: Rates of simultaneous liver kidney (SLK) transplantation have continued to increase despite lack of clear allocation guidelines and outcomes data. The organ procurement and transplantation network (OPTN)/UNOS board approved a new SLK allocation policy to standardize medical eligibility and optimize organ utilization. This review highlights the rationale behind these new selection criteria and posttransplant outcomes in various patient populations. RECENT FINDINGS: Uniform criteria for SLK transplantation were adopted in August 2017 and state SLK should be reserved for select patients with cirrhosis who have chronic kidney disease for longer than 3 months, sustained acute kidney injury, or particular metabolic diseases...
April 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29353893/organ-dysfunctions-among-deaths-in-critically-ill-patients
#20
Leison Maharjan, Aarzoo Shah, Udaya Bajracharya, Gambhir Shrestha
BACKGROUND: Multiple organ failure is recognized as the final pathway preceding majority of deaths in intensive care unit. This study aims to find out the prevalence of organ dysfunctions/ failures in patients at the time of their demise irrespective of the underlying diseases in a tertiary care hospital. METHODS: This study was done in medical intensive care unit of Blue Cross Hospital. Medical records of all deceased patients in two years period were thoroughly reviewed retrospectively...
January 1, 2018: Journal of Nepal Health Research Council
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