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chronic renal insufficiency

Jingwen Tan, Shuiqing Liu, Jodi B Segal, G Caleb Alexander, Mara McAdams-DeMarco
BACKGROUND: Patients with end stage renal disease (ESRD), including stage 5 chronic kidney disease (CKD), hemodialysis (HD) and peritoneal dialysis (PD), are at high risk for stroke-related morbidity, mortality and bleeding. The overall risk/benefit balance of warfarin treatment among patients with ESRD and AF remains unclear. METHODS: We systematically reviewed the associations of warfarin use and stroke outcome, bleeding outcome or mortality in patients with ESRD and AF...
October 21, 2016: BMC Nephrology
Sergio Mazzola Poli de Figueiredo, Andrea Olivares Magalhães, Patrícia Malafronte, José Ferraz de Souza, Yvoty Alves Santos Sens
High prevalence of hypovitaminosis D has been observed in patients with chronic kidney disease. However, there is not much data about its prevalence in kidney transplant recipients (KTRs). The study included 83 adult KTRs at a single center to calculate the prevalence of hypovitaminosis D. Among the 83 patients, those with incomplete data were excluded leaving 22 patients available for study. The demographic and biochemical data were analyzed retrospectively. Serum concentrations of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), phosphorus, calcium, and creatinine were evaluated...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
A Illés, B Nemes, L Zsom, S Kovács, A Bugán
OBJECTIVE: The aim of this work was the exploration of chronic renal insufficiency patients' attitudes toward treatment, various motifs underlying their acceptance or refusal of kidney therapy, and understanding of their psychologic content. Examinations were carried out of chronic renal insufficiency patients' attitudes toward renal treatments, and a questionnaire suitable for its assessment was developed. METHODS: Suppositions of patients before and after renal transplantation were explored by means of semistructured interviews...
September 2016: Transplantation Proceedings
Ryoichi Sugisawa, Emiri Hiramoto, Shigeru Matsuoka, Satomi Iwai, Ryosuke Takai, Tomoko Yamazaki, Nobuko Mori, Yuki Okada, Naoki Takeda, Ken-Ichi Yamamura, Toshiro Arai, Satoko Arai, Toru Miyazaki
Renal failure is one of the most important social problems for its incurability and high costs for patients' health care. Through clarification of the underlying mechanism for the high susceptibility of cats to renal disease, we here demonstrates that the effective dissociation of serum AIM protein from IgM is necessary for the recovery from acute kidney injury (AKI). In cats, the AIM-IgM binding affinity is 1000-fold higher than that in mice, which is caused by the unique positively-charged amino-acid cluster present in feline AIM...
October 12, 2016: Scientific Reports
Afshin Parsa, Peter A Kanetsky, Rui Xiao, Jayanta Gupta, Nandita Mitra, Sophie Limou, Dawei Xie, Huichun Xu, Amanda Hyre Anderson, Akinlolu Ojo, John W Kusek, Claudia M Lora, L Lee Hamm, Jiang He, Niina Sandholm, Janina Jeff, Dominic E Raj, Carsten A Böger, Erwin Bottinger, Shabnam Salimi, Rulan S Parekh, Sharon G Adler, Carl D Langefeld, Donald W Bowden, Per-Henrik Groop, Carol Forsblom, Barry I Freedman, Michael Lipkowitz, Caroline S Fox, Cheryl A Winkler, Harold I Feldman
The rate of decline of renal function varies significantly among individuals with CKD. To understand better the contribution of genetics to CKD progression, we performed a genome-wide association study among participants in the Chronic Renal Insufficiency Cohort Study. Our outcome of interest was CKD progression measured as change in eGFR over time among 1331 blacks and 1476 whites with CKD. We stratified all analyses by race and subsequently, diabetes status. Single-nucleotide polymorphisms (SNPs) that surpassed a significance threshold of P<1×10(-6) for association with eGFR slope were selected as candidates for follow-up and secondarily tested for association with proteinuria and time to ESRD...
October 11, 2016: Journal of the American Society of Nephrology: JASN
Bum-Sul Choi, Hyeong-Sun Moon, Sang-Hyuk Seo, Changbaig Hyun
Reduction in glomerular filtration rate (GFR) is a common complication in advanced stages of heart failure (HF). The convenient and precise assessment for GFR would be useful for early detection of renal impairment in HF dogs. Our hypothesis of this study was the GFR would be reduced in advanced stages of HF from chronic mitral valvular disease (CMVI), as indicated by renal markers including serum cystatin-C (Cys-C) and symmetric dimethylarginine (SDMA) concentrations. Forty-three client-owned dogs consisting of 33 dogs with different stages of HF from CMVI and 10 age-matched healthy dogs were enrolled in this study...
September 30, 2016: Journal of Veterinary Medical Science
Nisha Bansal, Charles E McCulloch, Feng Lin, Cassianne Robinson-Cohen, Mahboob Rahman, John W Kusek, Amanda H Anderson, Dawei Xie, Raymond R Townsend, Claudia M Lora, Jackson Wright, Alan S Go, Akinlolu Ojo, Arnold Alper, Eva Lustigova, Magda Cuevas, Radhakrishna Kallem, Chi-Yuan Hsu
Blood pressure is a modifiable risk for cardiovascular disease (CVD). Among hemodialysis patients, there is a U-shaped association between blood pressure and risk of death. However, few studies have examined the association between blood pressure and CVD in patients with stage 4 and 5 chronic kidney disease. Here we studied 1795 Chronic Renal Insufficiency Cohort (CRIC) Study participants with estimated glomerular filtration rate <30 ml/min per 1.73 m(2) and not on dialysis. The association of systolic (SBP), diastolic (DBP), and pulse pressure with the risk of physician-adjudicated atherosclerotic CVD (stroke, myocardial infarction, or peripheral arterial disease) and heart failure was tested using Cox regression adjusted for demographics, comorbidity and medications...
October 4, 2016: Kidney International
Francesco Pelliccia, Salvatore Rosanio, Giuseppe Marazzi, Sara Poggi, Alessandra Tanzilli, Cesare Greco, Carlo Gaudio, Giuseppe Rosano
The high risk of both stroke and major bleeding in atrial fibrillation (AF) patients with chronic kidney disease (CKD) defines an important population for whom the assessment of the balance between the risk of ischemic stroke and of bleeding is essential. The use of novel oral anticoagulants (NOACs) may be a viable option in this population due to their greater net clinical benefit than warfarin, as demonstrated by the results of the clinical phase III trials. NOACs have been found to have a greater net clinical benefit than warfarin in patients at high risk of either stroke (CHADS2≥1 or CHA2DS2-VASc score≥2) or bleeding (HAS-BLED≥3)...
October 1, 2016: International Journal of Cardiology
J M Ramos, M M García-Navarro, M P González de la Aleja, R Sánchez-Martínez, A Gimeno-Gascón, S Reus, E Merino, J C Rodríguez-Díaz, J Portilla
OBJECTIVE: Seasonal influenza is responsible for high annual morbidity and mortality worldwide, especially in elderly patients. The aim of the study was to analyse the epidemiological, clinical and prognostic features of influenza in octogenarians and nonagenarians admitted to a general hospital, as well as risk factors associated with mortality. METHODS: Retrospective, cross-sectional, descriptive study in patients admitted and diagnosed with influenza by molecular biology in the General University Hospital of Alicante from 1 January to 31 April 2015...
October 7, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Belinda Spoto, Anna Pisano, Carmine Zoccali
Insulin resistance (IR) is an early metabolic alteration in CKD patients, being apparent when the glomerular filtration rate is still within the normal range and becoming almost universal in those who reach the ESKF. The skeletal muscle represents the primary site of IR in CKD and post-receptor alterations are recognized as the main defect underlying IR in this condition. Estimates of IR based on fasting insulin concentration are easier but may not be adequate in CKD patients because renal insufficiency reduces insulin catabolism...
October 5, 2016: American Journal of Physiology. Renal Physiology
Mayank K Mittal, Natraj Katta, Martin A Alpert
Chronic congestive heart failure (CHF) and acute decompensated heart failure (ADHF) refractory to medical therapy represent therapeutic challenges. In such patients, attempts to reduce pulmonary and systemic congestion frequently produce deterioration of renal function. In studies of patients with chronic severe CHF refractory to medical therapy (including loop diuretics), isolated ultrafiltration was frequently able to relieve congestive symptoms by precise removal of extracellular water and sodium, and in some cases was able to restore responsiveness to loop diuretics...
October 2016: Hemodialysis International
Nicolas Noiseux, Samer Mansour, Richard Weisel, Louis-Mathieu Stevens, Shant Der Sarkissian, Katherine Tsang, Andrew M Crean, Eric Larose, Shu-Hong Li, Bernd Wintersperger, Minh Quan Vu, Ignacio Prieto, Ren-Ke Li, Denis Claude Roy, Terrence M Yau
OBJECTIVES: The IMPACT-CABG trial is the first North American multicenter phase II randomized study of intramyocardial delivery of autologous CD133(+) stem cells in patients with chronic ischemic cardiomyopathy undergoing coronary artery bypass grafting. The primary objective was to demonstrate safety, including freedom from major adverse cardiac events. The secondary objective was to evaluate feasibility of same-day autologous cell preparation. Although the trial was not powered to evaluate LV function, exploratory data were collected...
August 13, 2016: Journal of Thoracic and Cardiovascular Surgery
Xun Liu, Meredith C Foster, Hocine Tighiouart, Amanda H Anderson, Gerald J Beck, Gabriel Contreras, Josef Coresh, John H Eckfeldt, Harold I Feldman, Tom Greene, L Lee Hamm, Jiang He, Edward Horwitz, Julia Lewis, Ana C Ricardo, Haochang Shou, Raymond R Townsend, Matthew R Weir, Lesley A Inker, Andrew S Levey
BACKGROUND: Unlike the case with creatinine, conditions affecting the non-glomerular filtration rate (GFR) determinants of low-molecular-weight serum proteins, β-trace protein (BTP), β2-microglobulin (B2M), and cystatin C, are not well characterized. STUDY DESIGN: Pooled cross-sectional analysis of 3 studies. SETTING & PARTICIPANTS: 3,156 persons with chronic kidney disease from the MDRD (Modification of Diet in Renal Disease) Study, AASK (African American Study of Kidney Disease and Hypertension), and CRIC (Chronic Renal Insufficiency Cohort) Study...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jason Roy, Haochang Shou, Dawei Xie, Jesse Y Hsu, Wei Yang, Amanda H Anderson, J Richard Landis, Christopher Jepson, Jiang He, Kathleen D Liu, Chi-Yuan Hsu, Harold I Feldman
Prediction models are often developed in and applied to CKD populations. These models can be used to inform patients and clinicians about the potential risks of disease development or progression. With increasing availability of large datasets from CKD cohorts, there is opportunity to develop better prediction models that will lead to more informed treatment decisions. It is important that prediction modeling be done using appropriate statistical methods to achieve the highest accuracy, while avoiding overfitting and poor calibration...
September 22, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Sheena Sharma, Jennifer M Kalish, Ethan M Goldberg, Francis Jeshira Reynoso, Madhura Pradhan
Background. Oral-facial-digital syndrome type 1 (OFD1) is a rare condition with X-linked dominant inheritance caused by mutations in the Cxorf5 (OFD1) gene. This gene encodes the OFD1 protein located within centrosomes and basal bodies of primary cilia. Approximately 15-50% of patients with OFD1 progress to end-stage kidney disease following development of polycystic changes within the kidneys. This condition almost always causes intrauterine lethality in males. Description of Case Diagnosis and Treatment. A Caucasian male aged 9 years and 9 months presented with increased urinary frequency, increased thirst, and decreased appetite...
2016: Case Reports in Nephrology
Nikhil R Kalva, Madhusudhan R Tokala, Sonu Dhillon, Watcoun-Nchinda Pisoh, Saqib Walayat, Vishwas Vanar, Srinivas R Puli
Acute esophageal necrosis (AEN), also called "black esophagus," is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition...
2016: Case Reports in Gastrointestinal Medicine
Paolo Strati, Kari G Chaffee, Sara J Achenbach, Susan L Slager, Nelson Leung, Timothy G Call, Wei Ding, Sameer A Parikh, Neil E Kay, Tait D Shanafelt
No abstract text is available yet for this article.
September 15, 2016: Haematologica
R I Khabazov, A V Chupin, R V Kolosov, S V Deriabin
Endovascular repair of the abdominal aorta is a method of choice in pronounced concomitant pathology and high risk of open surgical treatment. The article deals with a clinical case report of successful surgical management of a patient with an infrarenal aortic aneurysm, transplanted kidney, chronic renal insufficiency, secondary diabetes mellitus, multifocal atherosclerosis with predominant involvement of coronary arteries and lower-limb arteries, in whom open surgical treatment was associated with high risk...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
R Flisiak, E Janczewska, M Wawrzynowicz-Syczewska, J Jaroszewicz, D Zarębska-Michaluk, K Nazzal, B Bolewska, J Bialkowska, H Berak, K Fleischer-Stępniewska, K Tomasiewicz, K Karwowska, K Rostkowska, A Piekarska, O Tronina, G Madej, A Garlicki, M Lucejko, A Pisula, E Karpińska, W Kryczka, A Wiercińska-Drapało, I Mozer-Lisewska, M Jabłkowski, A Horban, B Knysz, M Tudrujek, W Halota, K Simon
BACKGROUND: Virologic and safety outcomes of ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin (OBV/PTV/r ± DSV ± RBV) therapy have shown high sustained virologic response (SVR) rates and good tolerability in most patient populations in pre-registration studies. AIM: To confirm these clinical trial findings in the treatment of genotype 1 and 4 hepatitis C under real-world conditions. METHODS: Patients enrolled for treatment with OBV/PTV/r ± DSV ± RBV based on therapeutic guidelines were included, and the regimen was administered according to product characteristics...
November 2016: Alimentary Pharmacology & Therapeutics
Kui Hu, Jun Li, Yun Wan, Tao Hong, Shu-Yang Lu, Chang-Fa Guo, Chun-Sheng Wang
BACKGROUND: A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively despite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment decision-making and therapeutic outcomes. METHODS: Patients (n = 234, mean age: 78.5 ± 3.7 years) with symptomatic severe heart valve disease hospitalized in our center were included. One hundred and fifty-one patients (65%) were treated surgically (surgical group) and 83 (35%) were treated conservatively (conservative group)...
July 2016: Journal of Geriatric Cardiology: JGC
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