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https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#1
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27918931/effectiveness-of-an-educational-intervention-the-encourage-autonomous-self-enrichment-program-in-patients-with-chronic-kidney-disease-a-randomized-controlled-trial
#2
Hiroko Joboshi, Michiyo Oka
BACKGROUND: Self-management is an important step toward preventing and impeding the progression of chronic kidney disease. However, patients with chronic kidney disease may have few or no subjective symptoms and therefore might consider self-management to be unnecessary. Effective support and encouragement of self-management in patients with chronic kidney disease is therefore required. OBJECTIVES: This study tested the effectiveness of the Encourage Autonomous Self-Enrichment patient education program, which supports patient autonomy and intrinsic motivations with the aim of improving self-efficacy and sustaining self-management, on perceived self-efficacy, self-management behaviors, and physiological endpoints (blood pressure and renal function parameters) in patients with chronic kidney disease...
November 22, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27918762/alternating-treatment-with-pazopanib-and-everolimus-vs-continuous-pazopanib-to-delay-disease-progression-in-patients-with-metastatic-clear-cell-renal-cell-cancer-the-ropetar-randomized-clinical-trial
#3
Geert A Cirkel, Paul Hamberg, Stefan Sleijfer, Olaf J L Loosveld, M Wouter Dercksen, Maartje Los, Marco B Polee, Franchette van den Berkmortel, Maureen J Aarts, Laurens V Beerepoot, Gerard Groenewegen, Martijn P Lolkema, Metin Tascilar, Johanna E A Portielje, Frank P J Peters, Heinz-Josef Klümpen, Vincent van der Noort, John B A G Haanen, Emile E Voest
Importance: To our knowledge, this is the first randomized clinical trial evaluating an alternating treatment regimen in an attempt to delay disease progression in clear cell renal cell carcinoma. Objective: To test our hypothesis that an 8-week rotating treatment schedule with pazopanib and everolimus delays disease progression, exhibits more favorable toxic effects, and improves quality of life when compared with continuous treatment with pazopanib. Design, Setting, and Participants: This was an open-label, randomized (1:1) study (ROPETAR trial)...
December 1, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27917897/blood-borne-phagocytes-internalize-urate-microaggregates-and-prevent-intravascular-netosis-by-urate-crystals
#4
Elmar Pieterse, Ivica Jeremic, Christine Czegley, Daniela Weidner, Mona H C Biermann, Susan Veissi, Christian Maueröder, Christine Schauer, Rostyslav Bilyy, Tetiana Dumych, Markus Hoffmann, Luis E Munoz, Anders A Bengtsson, Georg Schett, Johan van der Vlag, Martin Herrmann
Hyperuricemia is strongly linked to cardiovascular complications including atherosclerosis and thrombosis. In individuals with hyperuricemia, needle-shaped monosodium urate crystals (nsMSU) frequently form within joints or urine, giving rise to gouty arthritis or renal calculi, respectively. These nsMSU are potent instigators of neutrophil extracellular trap (NET) formation. Little is known on the mechanism(s) that prevent nsMSU formation within hyperuricemic blood, which would potentially cause detrimental consequences for the host...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27917541/fish-pollutants-mehg-and-aroclor-cause-permanent-structural-damage-in-male-gonad-and-kidney-after-prepubertal-exposure
#5
Mariana S Garcia, Dulce Helena J Constantino, Ana P G Silva, Juliana E Perobelli
This study investigated whether or not prepubertal exposure to the fish contaminants methylmercury (MeHg) and the polychlorinated bisphenol Aroclor in low doses interferes with the histomorphometry of the testes, epididymis, liver and kidneys in rats. Wistar male rats, 21 days old, were allocated into the following: control (n = 17, received corn oil), MeHg (n = 17, received MeHg at 0.5 mg/kg/day), Aroclor (n = 17, received Aroclor at 1.0 mg/kg/day), low mix (n = 18, received MeHg at 0.05 mg/kg/day and Aroclor at 0...
December 5, 2016: International Journal of Experimental Pathology
https://www.readbyqxmd.com/read/27917266/telbivudine-vs-tenofovir-in-hepatitis-b-e-antigen-negative-chronic-hepatitis-b-patients-optima-roadmap-study
#6
Zahari Krastev, Diana Petrova, Iskren Kotzev, Mustafa Kemal Celen, Meryl Mendelson, Richa Chandra, Priti Pandey, Kamal Hamed
AIM: To make efficacy and safety comparison of telbivudine-raodmap and tenofovir-roadmap in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. METHODS: This was the first prospective, randomised, two-arm, open-label, non-inferiority study in HBeAg-negative CHB patients that compared telbivudine and tenofovir administered as per roadmap concept. Patients were treated up to 24 wk and, depending on virologic response, continued the same therapy or received add-on therapy up to 104 wk...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27916081/-clinical-comparison-of-modified-laparoscopic-and-conventional-placement-of-peritoneal-dialysis-catheters
#7
Q D Tu, Q He, X G Shen, X X Jiang, Y M Liu, Q Q Shen, H J Zhang, W F Chen, L X Yao
Objective: To explore the clinical efficacy of the modified laparoscopic placement of peritoneal dialysis catheters by nephrologists. Methods: A total of 188 patients diagnosed as end-stage renal disease (ESRD) were enrolled, who received catheter and continuous ambulatory peritoneal dialysis (CAPD) therapy from January 2011 to May 2016 in Zhejiang Provincial People's Hospital. They were divided into group A (with modified laparoscopic placement of peritoneal dialysis catheters, n=59) and group B (with conventional placement of peritoneal dialysis catheter, n=129)...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27915418/in-vivo-cns-infection-model-of-acanthamoeba-genotype-t4-the-early-stages-of-infection-lack-presence-of-host-inflammatory-response-and-are-a-slow-and-contact-dependent-process
#8
Maritza Omaña-Molina, Dolores Hernandez-Martinez, Raquel Sanchez-Rocha, Ulises Cardenas-Lemus, Citlaltepetl Salinas-Lara, Adolfo Rene Mendez-Cruz, Laura Colin-Barenque, Patricia Aley-Medina, Jesus Espinosa-Villanueva, Leticia Moreno-Fierros, Jacob Lorenzo-Morales
This study was developed in order to describe the early morphological events observed during the invasion of two pathogenic strains of Acanthamoeba (genotype T4); A. castellanii and A. culbertsoni, at the olfactory meatus and cerebral, pulmonary, renal, hepatic and splenic tissues levels, an in vivo invasion study. Histological and immunohistochemical description of the events at 24, 48, 72, and 96 h postintranasal inoculations of BALB/c mice was performed. A. castellanii showed a higher invasion rate than A...
December 3, 2016: Parasitology Research
https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#9
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27914711/proteomic-based-research-strategy-identified-laminin-subunit-alpha-2-as-a-potential-urinary-specific-biomarker-for-the-medullary-sponge-kidney-disease
#10
Antonia Fabris, Maurizio Bruschi, Laura Santucci, Giovanni Candiano, Simona Granata, Alessandra Dalla Gassa, Nadia Antonucci, Andrea Petretto, Gian Marco Ghiggeri, Giovanni Gambaro, Antonio Lupo, Gianluigi Zaza
Medullary sponge kidney (MSK) disease, a rare kidney malformation featuring recurrent renal stones and nephrocalcinosis, continues to be diagnosed using expensive and time-consuming clinical/instrumental tests (mainly urography). Currently, no molecular diagnostic biomarkers are available. To identify such we employed a proteomic-based research strategy utilizing urine from 22 patients with MSK and 22 patients affected by idiopathic calcium nephrolithiasis (ICN) as controls. Notably, two patients with ICN presented cysts...
November 30, 2016: Kidney International
https://www.readbyqxmd.com/read/27914671/current-practice-in-continuous-renal-replacement-therapy-an-epidemiological-multicenter-study
#11
T M Tomasa Irriguible, J Sabater Riera, E Poch López de Briñas, J Fort Ros, M J Lloret Cora, J Roca Antònio, A Navas Pérez, P Ortiz Ballujera, L Servià Goixart, F J González de Molina Ortiz, C Rovira Anglès, A Roglan Piqueras, M Rodríguez López
OBJECTIVE: The aim of the study is to ascertain the most relevant aspects of the current management of renal replacement therapy (RRT) in critically ill patients, and to analyze renal function recovery and mortality in patients undergoing RRT. METHODS: A non-interventional three-month observational study was made in 2012, with a follow-up period of 90 days, in 21 centers in Catalonia (Spain). Demographic information, severity scores and clinical data were obtained, as well as RRT parameters...
November 30, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27913775/role-of-b-type-natriuretic-peptide-in-predicting-in-hospital-outcomes-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-preserved-left-ventricular-function-a-5-year-retrospective-analysis
#12
Saraschandra Vallabhajosyula, Toufik Mahfood Haddad, Pranathi R Sundaragiri, Anas A Ahmed, Muhammad Sarfraz Nawaz, Hamza A A Rayes, Harish C Devineni, Arun Kanmanthareddy, Dustin A McCann, Christopher S Wichman, Ariel M Modrykamien, Lee E Morrow
BACKGROUND: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). METHODS: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively...
December 2, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27913748/a-3-year-follow-up-of-a-patient-with-acute-renal-failure-caused-by-thrombotic-microangiopathy-related-to-antiphospholipid-syndrome-case-report
#13
X-J Zhou, M Chen, S-X Wang, F-D Zhou, M-H Zhao
BACKGROUND: Microvascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric. CASE REPORT: A 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression...
December 2, 2016: Lupus
https://www.readbyqxmd.com/read/27910947/renal-cell-carcinoma-with-tfe3-translocation-and-succinate-dehydrogenase-b-mutation
#14
Anna Calió, David J Grignon, Bradley A Stohr, Sean R Williamson, John N Eble, Liang Cheng
Translocation renal cell carcinoma and succinate dehydrogenase (SDH)-deficient renal cell carcinoma are now recognized as specific renal tumor types in the World Health Organization (WHO) classification. Both have limited immunohistochemical positivity for epithelial markers, and the spectrum of morphology continues to widen for both of these entities. We identified four renal cell carcinomas with positive TFE3 immunohistochemical staining and negative SDHB staining. The patients (2F, 2M) ranged in age from 19 to 65 years...
December 2, 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/27910004/dabigatran-overdose-a-case-report-of-acute-hepatitis-extracorporeal-treatment
#15
Mariagrazia Porru, Antonella Mameli, Maria E Cianchetti, Mario Musu, Paola Schirru, Maria F Ruberto, Doris Barcellona, Francesco Marongiu
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration...
December 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27909620/is-normal-saline-the-best-irrigation-fluid-to-be-used-during-percutaneous-nephrolithotomy-in-renal-failure-patient-a-prospective-randomized-controlled-trial
#16
Bimalesh Purkait, Manoj Kumar, Ankur Bansal, Ashok Kumar Sokhal, Satya Narayan Sankhwar, Kawaljit Singh
OBJECTIVE: Endoscopic procedures like percutaneous nephrolithotomy (PCNL) needs continuous irrigation for better vision and to wash away stone fragments and blood clots. Systemic absorption of irrigation fluids may lead to fluid overload and electrolyte disequilibrium. Renal failure patients are more prone to these electrolyte disturbances. We have evaluated the outcomes of normal saline as irrigation solution to be used in renal failure patient in comparison to distilled water. METHODS: Seventy-six patients with renal calculi were enrolled in this study between September, 2014, and December, 2015...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27908924/excess-weight-as-a-risk-factor-common-to-many-cancer-sites-words-of-caution-when-interpreting-meta-analytic-evidence
#17
Melina Arnold, Andrew G Renehan, Graham A Colditz
For over a decade, excess body weight, commonly categorized as overweight (body mass index, BMI: 25.0 to 29.9 kg/m2) and obesity (BMI: ≥ 30 kg/m2) has been an established incidence risk factor for several adult cancers (1). For 2012, the burden of disease attributed to elevated BMI was estimated as nearly half-million new cancers worldwide, making this the third highest ranked cancer risk factor globally after smoking and infections (ranked second in most western populations) and an important public health problem (2, 3)...
December 1, 2016: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/27906840/renal-artery-denervation-for-treatment-of-patients-with-self-reported-obstructive-sleep-apnea-and-resistant-hypertension-results-from-the-global-symplicity-registry
#18
Dominik Linz, Giuseppe Mancia, Felix Mahfoud, Krzysztof Narkiewicz, Luis Ruilope, Markus Schlaich, Ingrid Kindermann, Roland E Schmieder, Sebastian Ewen, Bryan Williams, Michael Böhm
BACKGROUND: Sleep-disordered breathing, predominantly obstructive sleep apnea (OSA), is highly prevalent in patients with hypertension. OSA may underlie the progression to resistant hypertension, partly due to increased activation of the sympathetic nervous system. This analysis of patients with and without OSA evaluated the blood pressure (BP)-lowering effect of sympathetic modulation by renal denervation (RDN) in a real-world setting. METHODS: The Global SYMPLICITY Registry (NCT01534299) is a prospective, open-label, multicenter registry conducted worldwide to evaluate the safety and effectiveness of RDN in patients with uncontrolled hypertension...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27904663/t-type-calcium-channel-blocker-attenuates-unilateral-ureteral-obstruction-induced-renal-interstitial-fibrosis-by-activating-the-nrf2-antioxidant-pathway
#19
Sungjin Chung, Soojeong Kim, Minyoung Kim, Eun Sil Koh, Hye Eun Yoon, Ho-Shik Kim, Cheol Whee Park, Yoon Sik Chang, Seok Joon Shin
Besides its effect on high blood pressure, T-type calcium channel blocker is renoprotective in experimental models of renal fibrosis. However, the exact mechanism of T-type calcium channel blocker on tubulointerstitial fibrosis is unclear. We investigated whether the renoprotective effect of T-type calcium channel blocker is associated with modulation of the signaling of oxidative stress-induced renal fibrosis. Treatment with a non-hypotensive dose of efonidipine, a T-type calcium channel blocker, or nifedipine, an L-type channel blocker, was initiated one day before unilateral ureteral obstruction (UUO) in C57BL6/J mice, and was continued until 3 and 7 days after UUO...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27901208/gastric-and-renal-effects-of-cox-2-selective-and-non-selective-nsaids-in-rats-receiving-low-dose-aspirin-therapy
#20
Marcella Goetz Moro, Paula Katherine Vargas Sanchez, Mayara Vitorino Gevert, Emeline Maria Baller, Ana Flávia Tostes, Ana Caroline Lupepsa, Sinvaldo Baglie, Gilson Cesar Nobre Franco
The consumption of low-dose aspirin (LDA) to prevent cardiovascular disease continues to increase worldwide. Consequently, the number of chronic LDA users seeking dental procedures that require complementary acute anti-inflammatory medication has also grown. Considering the lack of literature evaluating this interaction, we analyzed the gastric and renal effects caused by a selective COX-2 inhibitor (etoricoxib) and a non-selective COX-2 inhibitor (ibuprofen) nonsteroidal anti-inflammatory drug (NSAID) in rats receiving chronic LDA therapy...
November 28, 2016: Brazilian Oral Research
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