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https://www.readbyqxmd.com/read/29022223/acute-kidney-injury-in-pregnancy-and-the-role-of-underlying-ckd-a-point-of-view-from-m%C3%A3-xico
#1
REVIEW
Margarita Ibarra-Hernández, Oralia Alejandra Orozco-Guillén, María Luz de la Alcantar-Vallín, Ruben Garrido-Roldan, María Patricia Jiménez-Alvarado, Kenia Benitez Castro, Francisco Villa-Villagrana, Mario Borbolla, Juan Manuel Gallardo-Gaona, Guillermo García-García, Norberto Reyes-Paredes, Giorgina Barbara Piccoli
The incidence of acute kidney injury in pregnancy (P-AKI) in developed countries is significantly lower than in developing ones, where it is estimated to range between 4 and 26%. Mortality in cases of P-AKI requiring dialysis is high, varying from 20 to 80%. In developing countries, clinical decisions are often based on the availability of services and not on needs. Prenatal surveillance in Mexico does not include serum creatinine, limiting the potential for early diagnosis of AKI and CKD and their differential diagnosis...
October 11, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28992321/pregnancy-associated-plasma-protein-a-predicts-survival-in-end-stage-renal-disease-confounding-and-modifying-effects-of-cardiovascular-disease-body-composition-and-inflammation
#2
Erik Nilsson, Yang Cao, Bengt Lindholm, Ayane Ohyama, Juan Jesus Carrero, Abdul Rashid Qureshi, Peter Stenvinkel
Background: High pregnancy-associated plasma protein-A (PAPP-A) levels are linked to atherosclerosis and associate with increased mortality in prevalent dialysis patients. We investigated associations of PAPP-A, measured at dialysis initiation, with cardiovascular disease (CVD), CVD risk factors and mortality in incident dialysis patients, and explored if body composition and inflammation modulated these associations. Methods: Baseline plasma PAPP-A levels, inflammation biomarkers and body composition, using dual-energy X-ray absorptiometry, were measured in 286 incident dialysis patients...
July 24, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#3
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918595/successful-pregnancy-in-a-ckd-patient-on-a-low-protein-supplemented-diet-an-opportunity-to-reflect-on-ckd-and-pregnancy-in-mexico-an-emerging-country
#4
Julia Nava, Silvia Moran, Veronica Figueroa, Adriana Salinas, Margy Lopez, Rocio Urbina, Abril Gutierrez, Jose Luis Lujan, Alejandra Orozco, Rafael Montufar, Giorgina B Piccoli
Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28793394/tranexamic-acid-induced-acute-renal-cortical-necrosis-in-post-endoscopic-papillectomy-bleeding
#5
Doo Hyun Ko, Tae Hyung Kim, Jong Wook Kim, Ja Joong Gu, Baek Hyun Yoon, Ji Hong Oh, Seung Goun Hong
Acute renal failure can be the result of acute renal cortical necrosis (RCN), which commonly occurs from complications occurring during pregnancy. RCN is rarely caused by medications, although tranexamic acid, which is used in patients with acute bleeding for its antifibrinolytic effects, reportedly causes acute RCN in rare cases. An 82-year-old woman experienced gastrointestinal bleeding after endoscopic papillectomy of an ampullary adenoma. The bleeding was controlled with tranexamic acid administration; however, 4 days later, her urine volume decreased and she developed pulmonary edema and dyspnea...
August 9, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28762611/pregnancy-on-short-daily-home-hemodialysis-using-low-dialysate-flow-rate-a-new-hope-for-the-end-stage-renal-disease-patients
#6
Vincent Leduc, Maxence Ficheux, Clémence Bechade, Michel Dreyfus, Thierry Lobbedez, Patrick Henri
INTRODUCTION: In France in 2014, there were approximately 1500 patients of reproductive age treated by dialysis. Pregnancy in these patients remains rare, however, the incidence has increased since the 2000s, with a parallel increase in the fetal survival rate. We report 2 cases of pregnancy in short-daily home hemodialysis using low dialysate flow rate. METHODS: Short-daily hemodialysis was continued at the request of the patients. The treatment consisted in an increase of frequency and duration of hemodialysis sessions, an independent blood pressure and dry weight control supervised by nephrological monitoring twice a month and a regular obstetrics follow-up...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28720086/pregnancy-outcomes-in-patients-with-acute-kidney-injury-during-pregnancy-a-systematic-review-and-meta-analysis
#7
Youxia Liu, Xinxin Ma, Jie Zheng, Xiangchun Liu, Tiekun Yan
BACKGROUND: Presently, the matter of pregnancy outcomes of patients with pregnancy related AKI (PR-AKI) were disputed. Thus, we conducted a meta-analysis to evaluate the impact of PR-AKI on pregnancy outcomes. METHOD: We systematically searched MEDLINE, Embase, VIP, CNKI and Wanfang Databases for cohort or case-control studies in women with PR-AKI and those without AKI as a control group to assess the influence of PR-AKI on pregnancy outcomes and kidney outcome...
July 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#8
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28699884/survey-among-nephrologists-in-germany-current-practice-and-management-of-pregnant-women-on-dialysis%C3%A2
#9
Johannes Duffner, Lena Schulte-Kemna, Barbara Reister, Ulla Ludwig, Frieder Keller, Rene van Erp, Bernd Schröppel
BACKGROUND: To assess the experience and practice patterns of nephrologists in Germany with regard to the care of pregnant women on dialysis. METHODS: The 26-item internet survey sent by email asked for demographic information, subjective proficiency, maternal and fetal complications, treatment approaches and goals. RESULTS: Of the 2,015 surveys sent out, 200 (10%) were available for evaluation. 38% of respondents never provided care, whereas 62% treated at least one pregnant patient on dialysis...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28699212/fetal-megacystis-institutional-experience-and-outcomes
#10
Kiarash Taghavi, Caitlin Sharpe, Mark D Stringer, Jane Zuccollo, Jay Marlow
BACKGROUND: Fetal megacystis is a sonographic feature that may be indicative of several underlying pathologies. Despite advances in diagnosis and management, the overall prognosis of affected fetuses remains poor and about 50% of such pregnancies are terminated. AIMS: To define the frequency, management, survival and renal outcomes of fetal megacystis over nine years at Wellington Hospital, New Zealand. MATERIALS AND METHODS: A nine-year retrospective review of fetuses with an antenatal diagnosis of megacystis was undertaken...
July 12, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28596415/hemolytic-uremic-syndrome-in-pregnancy-and-postpartum
#11
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...
August 7, 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
#12
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
#13
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
#14
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
#15
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...
August 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28396746/pregnancy-outcomes-in-women-on-hemodialysis-a-national-survey
#16
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
#17
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
#18
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
#19
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
#20
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
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