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renal haemodynamics

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https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-uk-major-trauma-centres
#1
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma from two urban major trauma centres and discuss contemporary management of these injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11 year period, 63 patients presented with penetrating renal injuries...
February 13, 2018: BJU International
https://www.readbyqxmd.com/read/29423201/rituximab-induced-serum-sickness-in-the-treatment-of-idiopathic-membranous-nephropathy
#2
Jamie Cheong, Khai Ooi
We report a case of rituximab-induced serum sickness in a 50-year-old female with idiopathic membranous nephropathy. Presentation was characterized by a widespread rash 1 week after rituximab administration followed by fever and profound haemodynamic instability, mimicking sepsis. Symptoms resolved over 48 h, although adjunct antibiotics, steroids and inotropes were used. This case is notable for being the first reaction with rituximab for a renal indication as well as the severity of presentation.
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29398426/the-influence-of-fluid-management-on-outcomes-in-preeclampsia-a-systematic-review-and-meta-analysis
#3
T Pretorius, G van Rensburg, R A Dyer, B M Biccard
BACKGROUND: The optimal fluid management strategy to ensure best outcomes in preeclamptic patients remains a controversial issue, with little evidence to support any one approach. OBJECTIVE: The aim of this systematic review was to investigate the effect of various fluid management strategies on clinical outcomes, haemodynamic indices and biochemical markers in preeclamptic women and their babies. Primary outcome measures were the occurrence of pulmonary oedema and/or the development of renal impairment...
December 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29383017/highly-potent-antioxidant-olea-europaea-l-leaf-extract-affects-carotid-and-renal-haemodynamics-in-experimental-hypertension-the-role-of-oleuropein
#4
Milan Ivanov, Una-Jovana Vajic, Nevena Mihailovic-Stanojevic, Zoran Miloradovic, Djurdjica Jovovic, Jelica Grujic-Milanovic, Danijela Karanovic, Dragana Dekanski
Haemodynamic alterations in carotid and renal arteries are associated with the severity of target organ damage in patients with hypertension. Dietary habits, such as the Mediterranean diet, regulate blood pressure and oxidative stress, thus reduce the mortality rate due to cardiovascular diseases. In this study, our aim was to evaluate the reducing activity, antioxidant capacity and metal chelating ability of standardized Olea europaea L. leaf extract (OLE), and to test its (5, 25, 50 mg/kg) acute in vivo effects, as well as oleuropein's (OP, 10 mg/kg) on oxidative stress, carotid, renal and systemic haemodynamic parameters (blood pressure, heart rate, cardiac output, peripheral resistance) in spontaneously hypertensive rats (SHR)...
2018: EXCLI Journal
https://www.readbyqxmd.com/read/29372357/micro-ureteroscopy-vs-ureteroscopy-effects-of-miniaturization-on-renal-vascularization-and-intrapelvic-pressure
#5
Juan-Pablo Caballero-Romeu, Jua-Antonio Galán-Llopis, Federico Soria, Esther Morcillo-Martín, Pablo Caballero-Pérez, Alejandro Garcia, Julia E De La Cruz-Conty, Jesús Romero-Maroto
PURPOSE: Ureteroscopy (URS) is related to complications, as fever or postoperative urinary sepsis, due to high intrapelvic pressure (IPP) during the procedure. Micro-ureteroscopy (m-URS) aims to reduce morbidity by miniaturizing the instrument. The objective of this study is to compare IPP and changes in renal haemodynamics, while performing m-URS vs. conventional URS. METHODS: A porcine model involving 14 female pigs was used in this experimental study. Two surgeons performed 7 URS (8/9...
January 25, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29366912/change-in-physiological-variables-in-the-last-2-weeks-of-life-an-observational-study-of-hospitalized-adults-with-heart-failure
#6
Paul Taylor, Simon Crouch, Debra A Howell, Dawn W Dowding, Miriam J Johnson
CONTEXT: Recognition of dying is a difficult task in end-stage heart failure, yet it remains an important clinical skill in providing good palliative care to these patients. OBJECTIVES: To use routinely collected data to explore evidence for physiological change in the final two weeks of life in end-stage heart failure. METHODS: This was a retrospective cohort study of routinely collected data from hospital in-patients dying as a result of heart failure during a 1-year period in a UK hospital...
January 20, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29352349/factors-affecting-n-terminal-pro-b-type-natriuretic-peptide-levels-in-preterm-infants-and-use-in-determination-of-haemodynamic-significance-of-patent-ductus-arteriosus
#7
Sarah Louise Harris, Kiran More, Bronwyn Dixon, Richard Troughton, Chris Pemberton, John Horwood, Nicola Ellis, Nicola Austin
This study aimed to investigate factors affecting N-terminal pro-B-type natriuretic peptide (NTproBNP) in preterm infants and the ability of NTproBNP to predict haemodynamically significant patent ductus arteriosus (HsPDA). Prospective cohort study of 51 infants < 30 weeks gestation. Blood NTproBNP and heart ultrasound were performed on day of life 3, 10, 28 and 36 weeks corrected age. NTproBNP levels analysed for prediction of HsPDA. The effect of gestational age, ventilation, hypoxia, bronchopulmonary dysplasia (BPD), creatinine and haemoglobin levels on NTproBNP levels were investigated...
January 19, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29251818/acutely-decompensated-heart-failure-with-preserved-and-reduced-ejection-fraction-present-with-comparable-haemodynamic-congestion
#8
Lucas N L Van Aelst, Mattia Arrigo, Rui Placido, Eiichi Akiyama, Nicolas Girerd, Faiez Zannad, Philippe Manivet, Patrick Rossignol, Marc Badoz, Malha Sadoune, Jean-Marie Launay, Etienne Gayat, Carolyn S P Lam, Alain Cohen-Solal, Alexandre Mebazaa, Marie-France Seronde
AIMS: Congestion is a central feature of acute heart failure (HF) and its assessment is important for clinical decisions (e.g. tailoring decongestive treatments). It remains uncertain whether patients with acute HF with preserved ejection fraction (HFpEF) are comparably congested as in acute HF with reduced EF (HFrEF). This study assessed congestion, right ventricular (RV) and renal dysfunction in acute HFpEF, HFrEF and non-cardiac dyspnoea. METHODS AND RESULTS: We compared echocardiographic and circulating biomarkers of congestion in 146 patients from the MEDIA-DHF study: 101 with acute HF (38 HFpEF, 41 HFrEF, 22 HF with mid-range ejection fraction) and 45 with non-cardiac dyspnoea...
December 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29191504/predictors-of-in-hospital-mortality-in-patients-with-st-segment-elevation-myocardial-infarction-complicated-with-cardiogenic-shock
#9
Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Okan Uzun, Duygu İlke Yıldırım, Adnan Kaya, Göksel Çinier, Emrah Bozbeyoğlu, Özlem Yıldırımtürk, Ömer Kozan, Seçkin Pehlivanoğlu
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS) remains as an unresolved condition causing high morbidity and mortality despite advances in medical treatment and coronary intervention procedures. In the current study, we evaluated the predictors of in-hospital mortality of STEMI complicated with CS. METHODS: In this retrospective study, we evaluated the predictive value of baseline characteristics, angiographic, echocardiographic and laboratory parameters on in-hospital mortality of 319 patients with STEMI complicated with CS who were treated with primary percutaneous coronary intervention...
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29181400/effects-of-nitric-oxide-on-renal-proximal-tubular-na-transport
#10
REVIEW
Nobuhiko Satoh, Motonobu Nakamura, Atsushi Suzuki, Hiroyuki Tsukada, Shoko Horita, Masashi Suzuki, Kyoji Moriya, George Seki
Nitric oxide (NO) has a wide variety of physiological functions in the kidney. Besides the regulatory effects in intrarenal haemodynamics and glomerular microcirculation, in vivo studies reported the diuretic and natriuretic effects of NO. However, opposite results showing the stimulatory effect of NO on Na+ reabsorption in the proximal tubule led to an intense debate on its physiological roles. Animal studies have showed the biphasic effect of angiotensin II (Ang II) and the overall inhibitory effect of NO on the activity of proximal tubular Na+ transporters, the apical Na+/H+ exchanger isoform 3, basolateral Na+/K+ ATPase, and the Na+/HCO3- cotransporter...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29159789/heart-failure-and-kidney-disease
#11
Dario Grande, Margherita Ilaria Gioia, Paola Terlizzese, Massimo Iacoviello
Kidney disease is commonly found in heart failure (HF) patients. They share many risk factors and common pathophysiological pathways which often lead to mutual dysfunction. Both haemodynamic and non-haemodynamic mechanisms are involved in the development of renal impairment in heart failure patients. Moreover, the presence of a chronic kidney disease is a significant independent predictor of worse outcome in chronic as well as in acute decompensated HF. As a consequence, an accurate evaluation of renal function plays a key role in the management of HF patients...
November 21, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29127739/renal-haemodynamics-and-oxygenation-during-and-after-cardiac-surgery-and-cardiopulmonary-bypass
#12
REVIEW
R G Evans, Y R Lankadeva, A D Cochrane, B Marino, N Iguchi, M Z L Zhu, S G Hood, J A Smith, R Bellomo, B S Gardiner, C-J Lee, D W Smith, C N May
Acute kidney injury (AKI) is a common complication following cardiac surgery performed on cardiopulmonary bypass (CPB) and has important implications for prognosis. The aetiology of cardiac surgery-associated AKI is complex, but renal hypoxia, particularly in the medulla, is thought to play at least some role. There is strong evidence from studies in experimental animals, clinical observations and computational models that medullary ischaemia and hypoxia occur during CPB. There are no validated methods to monitor or improve renal oxygenation during CPB, and thus possibly decrease the risk of AKI...
November 11, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29092921/contrast-induced-acute-kidney-injury-and-mortality-in-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#13
Johanne Silvain, Lee S Nguyen, Vincent Spagnoli, Mathieu Kerneis, Paul Guedeney, Nicolas Vignolles, Kristel Cosker, Olivier Barthelemy, Claude Le Feuvre, Gérard Helft, Jean-Philippe Collet, Gilles Montalescot
OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29084002/central-arteriovenous-anastomosis-to-treat-resistant-hypertension
#14
Vikas Kapil, Paul A Sobotka, Mel D Lobo, Roland E Schmieder
PURPOSE OF REVIEW: Novel, interventional treatments have emerged in the last decade for the treatment of resistant hypertension. This review focuses on a unique device that creates a fixed calibre, central iliac arteriovenous anastomosis that is significantly different in haemodynamic and safety profile from traditional haemodialysis fistulae. The background, physiology, and clinical data to date will be presented. RECENT FINDINGS: The single, randomized, controlled clinical trial using the ROX coupler in patients with resistant hypertension demonstrated substantial reductions in both office and ambulatory blood pressure to 12-month postimplantation...
October 27, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29082816/pilot-study-to-evaluate-the-potential-use-of-the-renal-resistive-index-as-a-preliminary-diagnostic-tool-for-chronic-kidney-disease-in-cats
#15
Ines Matos, Pedro Azevedo, L Miguel Carreira
Objectives Chronic kidney disease (CKD) is the most common renal pathology diagnosed in geriatric cats, and its prevalence increases with age. The arterial resistive index (RI) is important when evaluating vascular resistance and compliance, and can be applied in the kidney (renal RI [RRI]), allowing the evaluation of its vascular haemodynamics. The present study aimed to: (1) investigate in cats with CKD the relationships between the RRI and the following parameters: age, sex, body weight, plasmatic creatinine, blood urea nitrogen, potassium, urine specific gravity, urine protein:creatinine ratio, systolic arterial pressure; and (2) evaluate the potential use of the RRI as a preliminary diagnostic tool in cats with CKD...
October 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29074483/transjugular-intrahepatic-portosystemic-shunt-impact-on-systemic-haemodynamics-and-renal-and-cardiac-function-in-patients-with-cirrhosis
#16
Troels Malte Busk, Flemming Bendtsen, Jørgen Hjelm Poulsen, Jens Otto Clemmesen, Fin Stolze Larsen, Jens Peter Goetze, Jens Schmidt Iversen, Magnus Thorsten Jensen, Rasmus Møgelvang, Erling Bjerregaard Pedersen, Jesper Noergaard Bech, Søren Møller
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension and possibly increases central blood volume (CBV). Moreover, renal function often improves; however, its effects on cardiac function are unclear. The aims of our study were to examine the effects of TIPS on hemodynamics and renal and cardiac function in patients with cirrhosis. METHODS: In 25 cirrhotic patients, we analyzed systemic, cardiac, and splanchnic hemodynamics by catheterization of the liver veins and right heart chambers before and 1 week after TIPS...
October 26, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29064276/predictors-of-acute-kidney-injury-in-patients-admitted-with-st-elevation-myocardial-infarction-results-from-the-bremen-stemi-registry
#17
Johannes Schmucker, Andreas Fach, Matthias Becker, Susanne Seide, Stefanie Bünger, Robert Zabrocki, Eduard Fiehn, Bettina Würmann-Busch, Hermann Pohlabeln, Kathrin Günther, Wolfgang Ahrens, Rainer Hambrecht, Harm Wienbergen
BACKGROUND: Deterioration of renal function after exposition to contrast media is a common problem in patients with myocardial infarction undergoing percutaneous coronary interventions. The aim of the present study was to assess the incidence of acute kidney injury in patients admitted with ST-elevation-myocardial infarction (STEMI) and its association with infarction severity, comorbidities and treatment modalities, including amount of contrast media applied. METHODS: All patients with STEMI from the metropolitan area of Bremen, Germany are treated at the Bremen Heart Centre and since 2006 documented in the Bremen STEMI-Registry...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29058354/the-practice-of-diagnosing-and-reporting-transfusion-associated-circulatory-overload-a-national-survey-among-physicians-and-haemovigilance-officers
#18
J J Bosboom, R B Klanderman, A L Peters, E K van de Weerdt, E J Goudswaard, J M Binnekade, J J Zwaginga, E A M Beckers, B F Geerts, M W Hollmann, S S Zeerleder, M van Kraaij, A P Vlaar
OBJECTIVES: This study aims at identifying factors that disciplines consider when diagnosing and reporting transfusion-associated circulatory overload ('TACO'). BACKGROUND: TACO is a clinical diagnosis based mainly on subjective factors. Therefore, TACO could be an underreported complication of blood transfusion. METHODS: A survey was conducted among critical care physicians, anaesthesiologists, haematologists, transfusion medicine physicians and haemovigilance officers using case vignettes and a questionnaire...
October 23, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29056991/atherosclerotic-renovascular-disease-epidemiology-treatment-and-current-challenges
#19
REVIEW
Diana Vassallo, Philip A Kalra
The neutral results of recent large randomized controlled trials comparing renal revascularization with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD) have cast doubt on the role of revascularization in the management of unselected patients with this condition. However, these studies have strengthened the evidence base for the role of contemporary intensive medical vascular protection therapy and aggressive risk factor control in improving clinical outcomes in ARVD. Patients presenting with 'high-risk' clinical features such as uncontrolled hypertension, rapidly declining renal function or flash pulmonary oedema are underrepresented in these studies; hence these results may not be applicable to all patients with ARVD...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29054907/secondary-aortoduodenal-fistula-and-the-unrecognised-herald-bleed
#20
Francesc Simó Alari, Esther Molina González, Israel Gutierrez, Aïcha Ahamdanech-Idrissi
A 65-year-old man with history of aortobifemoral surgery 4 years ago was admitted to hospital after sudden abdominal pain. Initially misdiagnosed as renal colic, he was treated with analgesics, and while on observation he started with haematemesis, rapidly responding to volume infusion. Upper gastrointestinal endoscopy showed fresh blood in the stomach with no visible active bleeding. CT scan showed an important contrast extravasation from the aorta to the third duodenal portion, restarting haemodynamic instability and a cardiac arrest...
October 20, 2017: BMJ Case Reports
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