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https://www.readbyqxmd.com/read/28596415/hemolytic-uremic-syndrome-in-pregnancy-and-post-partum
#1
Alexandra Bruel, David Kavanagh, Marina Noris, Yahsou Delmas, Edwin K S Wong, Elena Bresin, François Provôt, Vicky Brocklebank, Caterina Mele, Giuseppe Remuzzi, Chantal Loirat, Véronique Frémeaux-Bacchi, Fadi Fakhouri
BACKGROUND: Pregnancy is associated with various forms of thrombotic microangiopathy, including hemolytic uremic syndrome. A previous small French study suggested that pregnancy-associated hemolytic uremic syndrome was to be included in the spectrum of atypical hemolytic uremic syndrome linked to complement alternative pathway dysregulation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We sought to retrospectively analyze the presentation, outcome, and frequency of complement alternative pathway gene variants in a larger international (France, United Kingdom, Italy) cohort of patients with pregnancy-associated hemolytic uremic syndrome...
June 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28553036/postpartum-acute-kidney-injury-experience-of-a-tertiary-care-center
#2
M M Mir, M S Najar, A M Chaudary, H Azad, A R Reshi, K A Banday, M A Bhat, I A Wani, M M Wani, M Ursilla
Pregnancy-related-acute kidney injury (PR-AKI) had decreased from 40% to 20% in 1960 to <10% in recent series, mostly due to meticulous antenatal management. Postpartum-AKI (PP-AKI) resulting from late obstetric complications has become more apparent after improvement in antenatal care and legalization of medical termination of pregnancy. Women with renal injury in peripartum period admitted to our hospital over a period of 2 years (April 2013 to May 2015) were studied. Of 713 patients of AKI admitted, 61 had PR-AKI with an incidence of 4...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#3
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28489799/comparison-of-clinical-outcomes-in-peripartum-cardiomyopathy-and-age-matched-dilated-cardiomyopathy-a-15-year-nationwide-population-based-study-in-asia
#4
Cheng-Hui Lu, Wen-Chen Lee, Michael Wu, Shao-Wei Chen, Jih-Kai Yeh, Chun-Wen Cheng, Katie Pei-Hsuan Wu, Ming-Shien Wen, Tien-Hsing Chen, Victor Chien-Chia Wu
Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months.The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM.Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28485834/profile-and-outcomes-of-women-with-pregnancy-related-acute-kidney-injury-requiring-dialysis-at-a-center-in-ethiopia
#5
Delayehu Bekele, Momina Ahmed, Ahmed Ibrahim, Seman Kedir, Grace Chan
OBJECTIVE: To describe the clinical profile and outcomes of women with pregnancy-related acute kidney injury (AKI) undergoing dialysis at Saint Paul's Hospital Millennium Medical College, Addis Ababa, where the first publicly funded large-scale dialysis service in Ethiopia was established. METHODS: In a hospital-based retrospective study, clinical records were reviewed for all women with pregnancy-related AKI attending the hemodialysis unit at the study center between August 2013 and July 2015...
May 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28396746/pregnancy-outcomes-in-women-on-hemodialysis-a-national-survey
#6
Mala Sachdeva, Valerie Barta, Jyotsana Thakkar, Vipulbhai Sakhiya, Ilene Miller
Background. Pregnancy occurs among 1-7% of women on chronic dialysis. Experience regarding pregnancy and dialysis originates from anecdotal reports, case series and surveys. This survey updates the US nephrologists' experience with pregnancy on hemodialysis (HD) over the past 5 years. We evaluated maternal and fetal outcomes, certain practice patterns such as dialysis regimens utilized and nephrologist knowledge and comfort level when caring for a pregnant patient on HD. Methods. An anonymous Internet-based 23-question survey was e-mailed to end-stage renal disease Networks of America program directors for forwarding to practicing nephrologists...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28357675/what-is-the-role-of-nephrologists-and-nurses-of-the-dialysis-department-in-providing-fertility-care-to-ckd-patients-a-questionnaire-study-among-care-providers
#7
Gaby F van Ek, Esmée M Krouwel, Melianthe P J Nicolai, Brenda L Den Oudsten, Marjolein E M Den Ouden, Sandra W M Dieben, Hein Putter, Rob C M Pelger, Henk W Elzevier
PURPOSE: This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department. METHODS: Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211). RESULTS: Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9...
July 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28356062/successful-multigravid-pregnancy-in-a-42-year-old-patient-on-continuous-ambulatory-peritoneal-dialysis-and-a-review-of-the-literature
#8
Thiam Seong Christopher Lim, Malini Shanmuganathan, Irene Wong, Bak Leong Goh
BACKGROUND: For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient's pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#9
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28347277/-let-food-be-thy-medicine%C3%A2-lessons-from-low-protein-diets-from-around-the-world
#10
EDITORIAL
Giorgina B Piccoli, Adamasco Cupisti
In this editorial we present the special issue dedicated to low-protein diets (LPDs) in chronic kidney disease, from a global perspective.The experiences gathered from several countries across all continents have created an issue which we hope you will find insightful, and lead to further discussion on this interesting topic.We discover that LPDs are feasible in both developed and low income countries, in patients where literacy is an issue, and are also safe, including during pregnancy and in old age.Patients prescribed a low protein diet are more inclined to follow and adhere to this change in lifestyle, provided the diet has been adapted to meet their own individual needs...
March 27, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28340831/pregnancy-and-delivery-in-the-sequel-of-kidney-transplantation-single-center-study-of-8-years-experience
#11
Y Yuksel, S Tekin, D Yuksel, I Duman, M Sarier, L Yucetin, E Turan, H Celep, T Ugurlu, M M Inal, Y H Asuman, A Demirbas
BACKGROUND: Depending on hyphothalamic, hyphophyseal, and gonadal axis dysfunction, anovulatory irregular cycles occur and the probability of pregnancy decreases in the patients with chronic kidney disease (CKD). Maternal mortality and morbidity rates are increased in CKD patients; the risk of premature delivery is 70% and the risk of preeclampsia is 40% more than normal among those with a creatine level of >2.5 mg/dL. METHODS: If a pregnancy is expected in the sequel of kidney transplantation (KT), a multidisciplinary team approach should be adopted and both the gynecologist and the nephrologist should follow the patient simultaneously...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28327686/thyroid-hormone-profile-in-patients-with-chronic-kidney-disease-a-single-centre-study
#12
S Singh, A Verma, G Aryal, S Thapa, S Khakurel, K Shrestha
BACKGROUND: Chronic kidney disease (CKD) is a global burden and now recognized as a major public health problem worldwide. Patients with CKD have alteration in thyroid hormone metabolism. This study aims to evaluate the status of thyroid hormone profile in different stages of CKD. METHODS: The cross-sectional study included 103 CKD patients attending Nephrology and Dialysis unit of KIST Medical College Teaching Hospital, Lalitpur, Nepal. Serum creatinine, free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) were measured...
September 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#13
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28216442/a-seven-day-course-of-tmp-smx-may-be-as-effective-as-a-seven-day-course-of-ciprofloxacin-for-the-treatment-of-pyelonephritis
#14
Miriam T Fox, Michael T Melia, Rebecca G Same, Anna T Conley, Pranita D Tamma
BACKGROUND: The Infectious Diseases Society of America guidelines recommend either 14 days of trimethoprim-sulfamethoxazole (TMP-SMX) or 7 days of ciprofloxacin for the treatment of pyelonephritis. Antibiotic courses of 7 days of TMP-SMX vs 7 days of ciprofloxacin for pyelonephritis have not been previously compared. We evaluated the odds of a subsequent, symptomatic urinary tract infection (UTI) for women with Escherichia coli pyelonephritis receiving a 7-day course of TMP-SMX vs a 7-day course of ciprofloxacin...
February 16, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28177093/-pharmacological-and-nutritional-problems-in-pregnant-patient-on-chronic-dialysis
#15
Michele Giannattasio, Federica Giannattasio, Giuseppe Gernone
Many of information on the safety of drugs during pregnancy were obtained many years ago, before the pregnant women were excluded from the study protocols for possible fetal risks. Because randomized trials in pregnancy are complex and considered unethical. For the same reasons, there are no randomized controlled trials in pregnant women on dialysis. Moreover Compared to the normal subject, the pharmacokinetics and pharmacodynamics in these patients are influenced or by pregnancy or from dialysis techniques or from chronic uremia...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#16
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/27932430/bladder-agenesis-ectopic-ureters-and-a-multicystic-dysplastic-horseshoe-kidney-in-one-twin-newborn-with-normal-amniotic-fluid-index-in-utero
#17
Marium Naveed Khan, William F Walsh
A monochorionic-diamniotic twin baby presented with intrauterine growth restriction and anuria. The baby was found to have bladder agenesis, a pelvic dysplastic horseshoe kidney, vertebral anomalies, a ventricular septal defect and facial dysmorphisms. It was surprising to find no abnormalities in amniotic fluid indices prenatally, suggesting the possibility of urine output that declined as the pregnancy proceeded. Some degree of twin-to-twin transfusion of amniotic fluid was also possible, which could have rescued the oligohydramnios known to be associated with kidney and urinary tract abnormalities...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27895019/nephrotoxicity-during-vancomycin-therapy-in-combination-with-piperacillin-tazobactam-or-cefepime
#18
W Cliff Rutter, Jessica N Cox, Craig A Martin, Donna R Burgess, David S Burgess
Recent reports have demonstrated that vancomycin (VAN) may lead to an increase in the incidence of acute kidney injury (AKI) when it is combined with antipseudomonal beta-lactams. This study compared the incidence of AKI associated with VAN plus piperacillin-tazobactam (TZP) or cefepime (FEP). This was a retrospective, matched cohort study that was conducted at an academic medical center between September 2010 and September 2014 and that included adult patients without severe chronic or structural kidney disease, dialysis, pregnancy, cystic fibrosis, or a hospital transfer receiving TZP-VAN or FEP-VAN for at least 48 h...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27821407/role-of-type-2-diabetes-in-determining-retinal-renal-and-cardiovascular-outcomes-in-women-with-previous-gestational-diabetes-mellitus
#19
Ravi Retnakaran, Baiju R Shah
OBJECTIVE: Women who have gestational diabetes mellitus (GDM) have elevated lifetime risks for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), compared with their peers. However, it is not known whether their risk of CVD is dependent upon the development of T2DM. Thus, we sought to evaluate the role of T2DM in determining vascular outcomes in women with previous GDM. RESEARCH DESIGN AND METHODS: All women in Ontario, Canada, with a live-birth pregnancy between April 1994 and March 2014 (n = 1,515,079) were stratified into the following four groups: women with GDM in whom T2DM subsequently developed (n = 15,585, median age 32 years); those with GDM in whom T2DM did not develop (n = 41,299; median age 32 years); women who did not have GDM but in whom T2DM developed (n = 49,397; median age 31 years); and those with neither GDM nor T2DM (n = 1,408,798; median age 30 years)...
January 2017: Diabetes Care
https://www.readbyqxmd.com/read/27816158/management-of-acute-kidney-injury-in-pregnancy-for-the-obstetrician
#20
REVIEW
Anjali Acharya
Acute kidney injury (AKI) is a complex disorder that occurs in several clinical settings. During pregnancy, there are additional unique conditions that contribute to AKI. The clinical manifestations of AKI during pregnancy range from a minimal elevation in serum creatinine to renal failure requiring renal replacement therapy, similar to AKI in the general population. Recent epidemiologic studies in the general population show an increase in mortality associated with AKI, particularly when dialysis is required...
December 2016: Obstetrics and Gynecology Clinics of North America
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