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renal haemodynamics

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https://www.readbyqxmd.com/read/28212603/effects-of-renal-denervation-on-cardiac-oxidative-stress-and-local-activity-of-the-sympathetic-nervous-system-and-renin-angiotensin-system-in-acute-myocardial-infracted-dogs
#1
Qiaoli Feng, Chengzhi Lu, Li Wang, Lijun Song, Chao Li, Ravi Chandra Uppada
BACKGROUND: This study sought to evaluate the therapeutic effects of renal denervation (RDN) on acute myocardial infarction (MI) in canines and explore its possible mechanisms of action. METHODS: Eighteen healthy mongrel dogs were randomly assigned to either the control group, the MI group or the MI + RDN group. To assess cardiac function, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD) and fraction shortening (FS) were recorded...
February 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28208979/evaluation-of-the-efficacy-of-bupivacaine-0-5-alone-or-with-clonidine-1%C3%AE-g-kg-versus-control-in-a-single-level-paravertebral-blockin-patients-undergoing-pcnl-procedure
#2
Trupti S Kamble, Charulata Mahesh Deshpande
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is a widely used procedure to remove complex upper tract renal calculi by means of a nephroscope. Although less invasive, PCNL is associated with significant pain owing to soft tissue injury. Most of these patients have mild to moderately compromised renal function. An anaesthesia plan that reduces intraoperative requirement of anaesthetics, analgesics, muscle relaxants and postoperative requirement of systemic analgesics is essential...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28188168/metformin-associated-lactic-acidosis-treated-with-continuous-renal-replacement-therapy
#3
Akihide Nakamura, Kei Suzuki, Hiroshi Imai, Naoyuki Katayama
Metformin-associated lactic acidosis (MALA) is a rare but life-threatening complication. We report a case of MALA in a man aged 71 years who was treated with continuous renal replacement therapy (CRRT). The patient was brought to the hospital for prolonged and gradual worsening gastrointestinal symptoms. Although he received intravenous treatment, he developed catecholamine-resistant shock, and blood gas analysis revealed lactic acidosis. Bicarbonate and antibiotics for possible sepsis were initiated, but with no clear benefit...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28181735/the-innervation-of-the-kidney-in-renal-injury-and-inflammation-a-cause-and-consequence-of-deranged-cardiovascular-control
#4
REVIEW
Mohammed H Abdulla, Edward J Johns
Extensive investigations have revealed that renal sympathetic nerves regulate renin secretion, tubular fluid reabsorption and renal haemodynamics which can impact on cardiovascular homoeostasis normally and in pathophysiological states. The significance of the renal afferent innervation and its role in determining the autonomic control of the cardiovascular system is uncertain. The transduction pathways at the renal afferent nerves have been shown to require pro-inflammatory mediators and TRPV1 channels. Reno-renal reflexes have been described, both inhibitory and excitatory, demonstrating that a neural link exists between kidneys and may determine the distribution of excretory and haemodynamic function between the two kidneys...
February 9, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28153377/effects-of-reducing-blood-pressure-on-renal-outcomes-in-patients-with-type-2-diabetes-focus-on-sglt2-inhibitors-and-empa-reg-outcome
#5
REVIEW
A J Scheen, P Delanaye
Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has enabled remarkable reductions in cardiovascular and all-cause mortality as well as in renal outcomes in patients with type 2 diabetes (T2D) and a history of cardiovascular disease in the EMPA-REG OUTCOME. These results have been attributed to haemodynamic rather than metabolic effects, in part due to the osmotic/diuretic action of empagliflozin and the reduction in arterial blood pressure (BP). The present narrative review includes the results of meta-analyses of trials evaluating the effects on renal outcomes of lowering BP in patients with T2D, with a special focus on the influence of baseline and achieved systolic BP, and compares the renal outcome results of the EMPA-REG OUTCOME with those of other major trials with inhibitors of the renin-angiotensin system in patients with T2D and the preliminary findings with other SGLT2 inhibitors, and also evaluates post hoc analyses from the EMPA-REG OUTCOME of special interest as regards the BP-lowering hypothesis and renal function...
January 30, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28148536/impact-of-rapid-ultrafiltration-rate-on-changes-in-the-echocardiographic-left-atrial-volume-index-in-patients-undergoing-haemodialysis-a-longitudinal-observational-study
#6
Jwa-Kyung Kim, Young Rim Song, GunHa Park, Hyung Jik Kim, Sung Gyun Kim
OBJECTIVE: Optimal fluid management is essential when caring for a patient on haemodialysis (HD). However, if the fluid removal is too rapid, the resultant higher ultrafiltration rate (UFR) disadvantageously promotes haemodynamic instability and cardiac injury. We evaluated the effects of a rapid UFR on changes in the echocardiographic left atrial volume index (LAVI) over a period of time. DESIGN: Longitudinal observational study. SETTING AND PARTICIPANTS: A total of 124 new patients on HD...
February 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#7
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#8
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#9
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#10
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#11
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28052944/acute-traumatic-renal-arteriocalyceal-fistula-selective-angioembolisation-for-haemodynamic-instability
#12
Adam Carl Philipoff, Duncan Ramsay, Dieter G Weber
Abdominal angiography with selective arteriography and subsequent embolisation is an accepted management modality in the treatment of selected solid organ injuries following blunt abdominal trauma. This management practice is well established in the haemodynamically stable patient; however, this remains more controversial in haemodynamically compromised patients, though warrants consideration in both cases due to the associated benefits of non-operative management. This case report describes the successful non-operative management of a severe renal injury in a young polytraumatised patient following a high-speed motor vehicle crash...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28031848/spontaneous-hepatic-artery-dissection-a-rare-presentation-of-fibromuscular-dysplasia
#13
Kevin Y C Su, Melanie L Stanhope, Brendan P W Kaufman
Fibromuscular dysplasia (FMD) is a rare condition that causes structural compromise of the blood vessel presenting either as an incidental radiological finding, dissection or stenosis usually of the renal or craniocervical arteries. Seldom, patients present with spontaneous dissection in visceral arteries and there are few reports of hepatic involvement. This report outlines the case of a 43-year-old female who presented with severe right upper quadrant pain with a subsequent diagnosis of FMD manifesting as spontaneous hepatic artery dissection...
November 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28026729/-traumatic-thrombosis-of-the-renal-artery-following-seat-belt-injury
#14
B Čertík, V Třeška, J Bierhanzlová, J Matějka, J Zeman, T Matějka
Renal artery thrombosis is a rare complication of blunt abdominal injury. It occurs most frequently in car accidents in which sudden deceleration results in multiple internal injuries. Renal artery occlusion occurs rarely as an isolated blunt trauma. This report presents a case of traumatic occlusion of the left renal artery with complete ischaemia of the left kidney in a haemodynamically stable girl who suffered multiple seat-belt injuries in a car crash. Ambiguous findings on a CT scan of the abdominal cavity indicated surgical inspection of the abdomen and, since the injury-to-surgery interval was short, an attempt at revascularisation of the left kidney was made...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28024102/elevated-ischaemia-associated-lysyl-oxidase-activity-in-delayed-graft-failure-6-12%C3%A2-months-after-renal-transplantation
#15
Zhi Chen, Yiyang Li, Hongmei Xu, Fuzhe Ma, Jia Li, Lei Zhao, Ying Xu
What is the central question of this study? What potential biochemical changes are associated with renal parenchyma 6-12 months after renal transplantation and delayed graft failure? What is the main finding and its importance? Tissue fibrosis, mediated by tissue ischaemia-induced induction of hypoxia-inducible factor-1α and fibronectin and consequent activation of lysyl oxidase, is a major underlying pathophysiological mechanism that contributes to delayed graft failure several months after renal transplantation...
February 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28007879/transcatheter-versus-surgical-aortic-valve-replacement-in-moderate-and-high-risk-patients-a-meta-analysis
#16
Manuel Carnero-Alcázar, Luis Carlos Maroto, Javier Cobiella-Carnicer, Isidre Vilacosta, Luis Nombela-Franco, Ali Alswies, Enrique Villagrán-Medinilla, Carlos Macaya
OBJECTIVES: The evidence of the benefits of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) for patients of high or intermediate surgical risk is not consistent. We performed a meta-analysis to compare major adverse outcomes after TAVR or SAVR. METHODS: We searched propensity score matched studies or randomized clinical trials comparing the risks of mortality, stroke, major bleeding, acute renal injury, pacemaker implantation, vascular complications and prostheses haemodynamic performance between TAVR and SAVR in patients with moderate or high risk...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27999663/implementation-of-goal-directed-fluid-therapy-during-hip-revision-arthroplasty-a-matched-cohort-study
#17
Marit Habicher, Felix Balzer, Viktor Mezger, Jennifer Niclas, Michael Müller, Carsten Perka, Michael Krämer, Michael Sander
BACKGROUND: Several randomized controlled trials (RCTs) have demonstrated that intraoperative goal-directed fluid therapy (GDFT) can decrease postsurgical complications in patients undergoing major abdominal surgery. However, very few studies have demonstrated the value of goal-directed therapy (GDT) in patients undergoing orthopaedic surgery and confirmed it is as useful in real-life conditions. Therefore, we initiated a GDFT implementation programme in patients undergoing hip revision arthroplasty in order to assess its effects on postoperative complications (e...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27984414/noninvasive-assessment-of-haemodynamics-in-resistant-hypertension-the-role-of-the-renal-resistive-index
#18
Konstantinos Kintis, Costas Tsioufis, Alexandros Kasiakogias, Kyriakos Dimitriadis, Dimitris Konstantinidis, Eirini Andrikou, Ioannis Andrikou, Sotirios Patsilinakos, Dimitris Petras, Demetrios Vlahakos, Dimitris Tousoulis
OBJECTIVE: The association of resistant hypertension (RHTN) with renal haemodynamics is unclear. Our aim was to evaluate differences in haemodynamic characteristics of patients with RHTN compared with patients with controlled hypertension (HTN) at the level of the heart, kidney and aorta. METHODS: We studied 50 patients with RHTN confirmed by ambulatory blood pressure monitoring and 50 controlled hypertensive patients matched for age and sex. All participants underwent renal Doppler ultrasound to determine the renal resistive index (RRI), a complete echocardiographic study including measurements of diastolic function and evaluation of augmentation index...
March 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27941935/renal-metabolic-and-cardiovascular-considerations-of-sglt2-inhibition
#19
REVIEW
Ralph A DeFronzo, Luke Norton, Muhammad Abdul-Ghani
The kidney has a pivotal role in maintaining glucose homeostasis by using glucose as a metabolic fuel, by producing glucose through gluconeogenesis, and by reabsorbing all filtered glucose through the sodium-glucose cotransporters SGLT1 and SGLT2 located in the proximal tubule. In patients with diabetes, the maximum glucose reabsorptive capacity (TmG) of the kidney, as well as the threshold for glucose spillage into the urine, are elevated, contributing to the pathogenesis of hyperglycaemia. By reducing the TmG and, more importantly, the threshold of glucosuria, SGLT2 inhibitors enhance glucose excretion, leading to a reduction in fasting and postprandial plasma glucose levels and improvements in both insulin secretion and insulin sensitivity...
January 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27933463/effect-of-tempol-and-tempol-plus-catalase-on-intra-renal-haemodynamics-in-spontaneously-hypertensive-stroke-prone-shsp-and-wistar-rats
#20
Ahmad F Ahmeda, Mark G Rae, Mohammed F Al Otaibi, Lamyia M Anweigi, Edward J Johns
Vasoconstriction within the renal medulla contributes to the development of hypertension. This study investigated the role of reactive oxygen species (ROS) in regulating renal medullary and cortical blood perfusion (MBP and CBP respectively) in both stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar rats. CBP and MBP were measured using a laser-Doppler flow meter before and after intra-renal infusion of tempol, the superoxide dismutase (SOD) mimetic or tempol plus catalase, the hydrogen peroxide-degrading enzyme...
December 9, 2016: Journal of Physiology and Biochemistry
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