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https://www.readbyqxmd.com/read/28432751/acute-kidney-injury-plasma-lactate-concentrations-and-lactic-acidosis-in-metformin-users-a-godarts-study
#1
Paul J Connelly, Mike Lonergan, Enrique Soto-Pedre, Louise Donnelly, Kaixin Zhou, Ewan R Pearson
AIMS: Metformin is renally excreted and has been associated with the development of lactic acidosis. Although current advice is to omit metformin during illnesses that may increase risk of acute kidney injury (AKI), the evidence supporting this is lacking. We investigated the relationship between AKI, lactate concentrations and the risk of lactic acidosis in those exposed to metformin. METHODS: We undertook a population-based case-control study of lactic acidosis in 1,746 participants with Type 2 diabetes and 846 individuals without diabetes with clinically measured lactates with and without AKI between 1994-2014...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432640/osteoporosis-bone-mineral-density-and-ckd-mbd-treatment-considerations
#2
REVIEW
Jordi Bover, Lucía Bailone, Víctor López-Báez, Silvia Benito, Paola Ciceri, Andrea Galassi, Mario Cozzolino
Osteoporosis and chronic kidney disease (CKD) have both independently important potential impact on bone health. A significant number of patients with CKD stages 3a-5D have been shown to have low bone mineral density (BMD), leading to a strikingly elevated risk of fractures (mainly hip fractures) and higher associated morbidity and mortality. Mechanical properties of bone beyond age and menopausal status are additionally affected by intrinsic uremic factors. Therefore, we review in this article not only general concepts of osteoporosis and related consequences, but also the diagnostic and therapeutic implications of low BMD and bone fractures in CKD, beyond increased vascular calcification...
April 21, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28432606/neuromuscular-electrostimulation-a-new-therapeutic-option-to-improve-radio-cephalic-arteriovenous-fistula-maturation-in-end-stage-chronic-kidney-disease-patients
#3
Lucia Martinez, Vicent Esteve, Montserrat Yeste, Vicent Artigas, Secundino Llagostera
BACKGROUND: Radio-cephalic arteriovenous fistula (RCAVF) is the gold standard vascular access for end-stage chronic kidney disease patients. Exercises after arteriovenous fistula (AVF) creation improve maturation. No articles are published regarding neuromuscular electrostimulation (NMES) in AVF maturation. OBJECTIVES: To assess the usefulness of a NMES programme on RCAVF maturation process. METHODS: An 8-week single-centre prospective study...
April 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28432319/diabetic-retinopathy-and-clinical-parameters-favoring-the-presence-of-diabetic-nephropathy-could-predict-renal-outcome-in-patients-with-diabetic-kidney-disease
#4
Chi-Chih Hung, Hugo You-Hsien Lin, Daw-Yang Hwang, I-Ching Kuo, Yi-Wen Chiu, Lee-Moay Lim, Shang-Jyh Hwang, Hung-Chun Chen
Diabetes duration, diabetic retinopathy (DR), and a diagnostic model have been proposed as clinical parameters favoring the presence of diabetic nephropathy (DN) in biopsied patients with diabetic kidney disease. DN, compared with non-diabetic renal disease, had poorer renal outcomes. We tested whether these clinical parameters favoring DN are associated with poorer renal outcomes in non-biopsied patients. In this study, 1330 patients with type 2 diabetes and chronic kidney disease stages 1-4 were included and divided according to diabetes mellitus (DM) duration >8 years, DR, or a diagnostic model for DN...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#5
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431809/pilot-study-of-changes-in-presepsin-concentrations-compared-with-changes-in-procalcitonin-and-c-reactive-protein-concentrations-after-cardiovascular-surgery
#6
Junichi Saito, Eiji Hashiba, Akio Mikami, Tomoyuki Kudo, Hidetomo Niwa, Kazuyoshi Hirota
OBJECTIVE: The authors investigated the presepsin-concentration profile after cardiac surgery compared with those of procalcitonin (PCT) and C-reactive protein (CRP). DESIGN: A single-center, prospective, observational clinical study. SETTING: Hirosaki University Hospital. PARTICIPANTS: Patients who underwent cardiovascular surgery without preoperative infection and end-stage kidney disease requiring dialysis. The patients also were subdivided into 2 groups with respect to the use of cardiopulmonary bypass (CPB)...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28431157/agreement-between-renal-prescribing-references-and-determination-of-prescribing-appropriateness-in-hospitalised-patients-with-chronic-kidney-disease
#7
Michelle O'Shaughnessy, Niamh Allen, John O'Regan, Edwina Payne-Danson, Lise Mentre, Dawn Davin, Peter Lavin, Tamasine Grimes
Background: Chronic kidney disease (CKD) is a risk factor for adverse drug events. The clinical significance of discordance between renal prescribing references is unknown. Aim: We determined the prevalence of potentially inappropriate prescribing (PIP) in CKD, measured agreement between two prescribing references, and assessed potential for harm consequent to PIP. Design: Single-centre observational study. Methods: A random sample of hospitalised patients with CKD were grouped according to baseline CKD stage (3, 4, or 5)...
April 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28431138/cardiovascular-outcome-trials-in-patients-with-chronic-kidney-disease-challenges-associated-with-selection-of-patients-and-endpoints
#8
Patrick Rossignol, Rajiv Agarwal, Bernard Canaud, Alan Charney, Gilles Chatellier, Jonathan C Craig, William C Cushman, Ronald T Gansevoort, Bengt Fellström, Dahlia Garza, Nicolas Guzman, Frank A Holtkamp, Gerard M London, Ziad A Massy, Alexandre Mebazaa, Peter G M Mol, Marc A Pfeffer, Yves Rosenberg, Luis M Ruilope, Jonathan Seltzer, Amil M Shah, Salim Shah, Bhupinder Singh, Bergur V Stefánsson, Norman Stockbridge, Wendy Gattis Stough, Kristian Thygesen, Michael Walsh, Christoph Wanner, David G Warnock, Christopher S Wilcox, Janet Wittes, Bertram Pitt, Aliza Thompson, Faiez Zannad
Although cardiovascular disease is a major health burden for patients with chronic kidney disease, most cardiovascular outcome trials have excluded patients with advanced chronic kidney disease. Moreover, the major cardiovascular outcome trials that have been conducted in patients with end-stage renal disease have not demonstrated a treatment benefit. Thus, clinicians have limited evidence to guide the management of cardiovascular disease in patients with chronic kidney disease, particularly those on dialysis...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430920/rates-and-predictors-of-hospital-readmission-after-transcatheter-aortic-valve-implantation
#9
Anna Franzone, Thomas Pilgrim, Nicolas Arnold, Dik Heg, Bettina Langhammer, Raffaele Piccolo, Eva Roost, Fabien Praz, Lorenz Räber, Marco Valgimigli, Peter Wenaweser, Peter Jüni, Thierry Carrel, Stephan Windecker, Stefan Stortecky
Aims: To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and Results: Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive of hospital readmission within 1 year after TAVI with bootstrap analysis for internal validation. Of 868 patients alive at discharge, 221 (25.4%) were readmitted within 1 year...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430784/non-invasive-quantification-of-collagen-turnover-in-renal-transplant-recipients
#10
Elisabeth G D Stribos, Signe Holm Nielsen, Susanne Brix, Morten Asser Karsdal, Marc A Seelen, Harry van Goor, Stephan J L Bakker, Peter Olinga, Henricus A M Mutsaers, Federica Genovese
Kidney allograft failure due to chronic injury/rejection remains the main cause of graft loss in renal transplant recipients (RTR). Here, we investigated whether specific biomarkers of extracellular matrix (ECM) turnover are associated with allograft function and chronic kidney disease (CKD) stage in RTR. Seventy-eight patients who attended the University Medical Center Groningen for a routine check-up after kidney transplantation were enrolled in the study. Plasma and/or 24h-urine samples were collected and specific matrix-metalloproteinase-generated neo-epitope fragments of collagens were measured by enzyme-linked immunosorbent assay...
2017: PloS One
https://www.readbyqxmd.com/read/28430301/towards-a-bioengineered-kidney-recellularization-strategies-for-decellularized-native-kidney-scaffolds
#11
Michele Fedecostante, Oana G Onciu, Koen G C Westphal, Rosalinde Masereeuw
Patients with end-stage renal disease often undergo dialysis as a partial substitute for kidney function while waiting for their only treatment option: a kidney transplant. Several research directions emerged for alternatives in support of the ever-growing numbers of patients. Recent years brought big steps forward in the field, with researchers questioning and improving the current dialysis devices as well as moving towards the design of a bioengineered kidney. Whole-organ engineering is also being explored as a possibility, making use of animal or human kidney scaffolds for engineering a transplantable organ...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28429558/is-there-a-role-or-target-value-for-nutritional-vitamin-d-in-chronic-kidney-disease
#12
Wai H Lim, Emma L Duncan
Vitamin D is important for bone health in the general population but the value of vitamin D supplementation, and the role of 25-hydroxyvitamin D independently of 1,25-dihydroxyvitmain D, in individuals with chronic kidney disease (CKD), particularly in those who require dialysis, remains uncertain. Supplementation may improve some biochemical parameters, such as reducing PTH levels in patients to CKD-stage 4 who have vitamin D deficiency; but it remains to be established whether the role of nutritional vitamin D in maintaining bone health in the general population can be extrapolated to the CKD population...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429557/use-of-dual-energy-x-ray-absorptiometry-the-trabecular-bone-score-and-quantitative-computed-tomography-in-the-evaluation-of-chronic-kidney-disease-mineral-and-bone-disorders
#13
Nicholas Pocock
In subjects with chronic kidney disease (CKD) who suffer a minimal trauma fracture, the problem is to differentiate between osteoporosis and the various forms of renal bone disease associated with CKD-mineral and bone disorder. This problem is exacerbated by the fact that renal osteodystrophy may coexist with osteoporosis. The World Health Organization's bone mineral density (BMD) criteria for osteopenia ( -2.5 < T-score < -1.0) and osteoporosis (a T-score ≤ -2.5) may be used in patients with CKD stages 1-3...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429554/is-there-a-practical-role-for-bone-biopsy-in-chronic-kidney-disease
#14
Terrence Diamond, Grahame J Elder
Bone biopsy is currently the only means to accurately assess renal osteodystrophy and responses to therapeutic interventions. With sedation, the technique is relatively painless, and complications are uncommon. Bone biopsy should be considered when the aetiology of symptoms or biochemical abnormalities is in question, and results may lead to changes in therapy. Although it remains prudent to use antiresorptive drugs cautiously in patients with chronic kidney disease (CKD) stages 3a-4 and low bone mineral density, bone biopsy may not be warranted before commencing therapy in these patients...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#15
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#16
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429545/do-the-benefits-of-using-calcitriol-and-other-vitamin-d-receptor-activators-in-patients-with-chronic-kidney-disease-outweigh-the-harms
#17
Nigel D Toussaint, Matthew J Damasiewicz
The primary indication for administration of calcitriol or other vitamin D receptor activators (VDRA) in chronic kidney disease (CKD) is secondary hyperparathyroidism (SHPT). Prevention and treatment of SHPT appears important, as imbalances in mineral metabolism are associated with renal osteodystrophy, and higher parathyroid hormone (PTH) levels are associated with increased rates of mortality and morbidity in CKD patients. There is, however, a lack of controlled trial data that show lowering PTH with calcitriol/VDRA equates to improved clinical outcomes...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429277/primary-ewing-sarcoma-primitive-neuroectodermal-tumor-of-the-kidney-a-clinicopathologic-study-of-23-cases
#18
Paari Murugan, Priya Rao, Pheroze Tamboli, Bogdan Czerniak, Charles C Guo
Primary Ewing sarcoma / primitive neuroectodermal tumor (ES) of the kidney is a rare neoplasm with limited clinicopathologic data. We report 23 such cases with no history of ES elsewhere in the body. The patients included 13 male and 10 female, aged 8-70 years (mean, 31 years). The average tumor size was 11.7 cm (range, 5-20 cm). Microscopic analysis showed predominantly lobular growth (n = 14), with focal papillary (n = 3), alveolar (n = 1), and hemangiopericytoma-like (n = 1) patterns. Several tumors (n = 11) exhibited robust mitotic activity (>10 mitoses/10 high-power fields)...
April 20, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28429072/kidney-development-and-perspectives-for-organ-engineering
#19
REVIEW
Ganna Reint, Aleksandra Rak-Raszewska, Seppo J Vainio
Organ transplantation is currently the best strategy for treating end stage renal disease (ESRD) but the numbers of donor kidneys available are not sufficient to meet the needs of the ever-increasing ESRD population. Therefore, developments in the field of tissue engineering are necessary to provide alternative treatments. Decellularization and three-dimensional (3D) bioprinting strategies may serve as attractive novel options. Since successful tissue engineering requires an in -depth understanding of organ development and regulatory pathways, we discuss signaling in renal development and the composition of the renal extracellular matrix before presenting progress in the decellularization and 3D bioprinting fields...
April 20, 2017: Cell and Tissue Research
https://www.readbyqxmd.com/read/28428030/complement-inhibition-with-eculizumab-for-thrombotic-microangiopathy-rescues-a-living-donor-kidney-transplant-in-a-patient-with-antiphospholipid-antibody-syndrome
#20
Praveen Ramakrishnan Geethakumari, Patrick Mille, Rakesh Gulati, Srikanth Nagalla
Antiphospholipid antibody syndrome (APS) is an enigmatic heterogeneous disorder despite several revelations in its pathobiology. Renal transplantation in patients with APS has been notoriously difficult due to the high risk of development of thrombotic microangiopathy (TMA), which is often refractory to conventional treatment modalities such as aggressive anticoagulation and plasmapheresis. We describe a case of a 58-year-old male with secondary APS undergoing living unrelated renal transplantation for end-stage renal disease from lupus nephritis...
March 10, 2017: Transfusion and Apheresis Science
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