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Kidney biopsy and complications

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https://www.readbyqxmd.com/read/28431568/a-case-report-of-severe-calciphylaxis-suggested-approach-for-diagnosis-and-treatment
#1
Margret Patecki, Gabriele Lehmann, Jan Hinrich Bräsen, Jessica Schmitz, Anna Bertram, Lars Daniel Berthold, Hermann Haller, Wilfried Gwinner
BACKGROUND: Calciphylaxis is a serious complication in patients with chronic kidney disease associated mineral and bone disorder. It can occur in conditions with low and high bone turnover. So far, there are no definite diagnostic and therapeutic guidelines which may prevent the devastating outcome in many calciphylaxis patients. We report a case which clearly illustrates that knowledge of the underlying bone disorder is essential for a directed treatment. Based on this experience we discuss a systematic diagnostic and therapeutic approach in patients with calciphylaxis...
April 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28429554/is-there-a-practical-role-for-bone-biopsy-in-chronic-kidney-disease
#2
Terrence Diamond, Grahame J Elder
Bone biopsy is currently the only means to accurately assess renal osteodystrophy and responses to therapeutic interventions. With sedation, the technique is relatively painless, and complications are uncommon. Bone biopsy should be considered when the aetiology of symptoms or biochemical abnormalities is in question, and results may lead to changes in therapy. Although it remains prudent to use antiresorptive drugs cautiously in patients with chronic kidney disease (CKD) stages 3a-4 and low bone mineral density, bone biopsy may not be warranted before commencing therapy in these patients...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28420065/a-five-consecutive-years-study-of-renal-function-outcome-among-biopsy-proven-lupus-nephritis-patients-in-southern-iran
#3
M Pakfetrat, L Malekmakan, M Kamranpour, T Tadayon
Introduction Lupus nephritis (LN) is one of the most common complications of systemic lupus erythematous (SLE) responsible for an increase in mortality and morbidity. This study was conducted to evaluate the outcome for LN patients and factors that correlate with their outcome. Materials and methods We included 80 patients with proved LN and more than three-years follow up at Shiraz University of Medical Sciences. We prepared a data gathering sheet for each patient and extracted the data from patients' file records which existed in the hospital...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28420052/lupus-nephritis-in-the-western-cape-a-high-prevalence-area-an-experience-over-three-decades
#4
U Brijlal, W D Bates, M R Moosa
Background Systemic lupus erythematosus is a multisystem disease with serious complications, including lupus nephritis. Systemic lupus erythematosus is prevalent in the Western Cape, predominantly affecting women in the prime of their lives. Renal biopsy is an important tool for the management of the lupus patient with kidney disease, guiding treatment and assessing prognosis. Aims The aim of this study was to ascertain if there has been a change in the spectrum of renal pathology, patient characteristics and long-term outcomes in patients with lupus nephritis in our region over three decades...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28419667/a-simple-risk-score-for-prediction-of-hemorrhagic-complications-after-a-percutaneous-renal-biopsy
#5
Juan M Mejía-Vilet, Manuel A Márquez-Martínez, Bertha M Cordova-Sanchez, Mónica Chapa Ibargüengoitia, Ricardo Correa-Rotter, Luis E Morales-Buenrostro
AIM: To derive a simple risk score to predict the individual risk of major complications for patients undergoing a percutaneous renal biopsy procedure of native kidneys. METHODS: The risk score was derived from a cohort of 1,205 adult patients subject to percutaneous renal biopsy and assigned to training and validation datasets. Factors associated with major complications were derived from univariate analysis and then modeled by stepwise multivariate logistic regression...
April 16, 2017: Nephrology
https://www.readbyqxmd.com/read/28418995/kidney-biopsy-yield-an-examination-of-influencing-factors
#6
Miroslav Sekulic, Gretchen S Crary
Kidney biopsies are conducted under varying scenarios, presenting variables that could potentially influence yield and adequacy of tissue collected. We retrospectively reviewed 636 native and allograft kidney biopsies, and compared tissue collected between differing practitioners performing the biopsy (nephrologists or radiologists), imaging modalities for guidance (ultrasound or computed tomography), gauge needle used (18 or 16 G), and between on-site evaluators of biopsy adequacy conducted at the time of biopsy (general pathologists, renal pathologists, nephrologists)...
April 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#7
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28405603/mtor-inhibition-by-everolimus-does-not-impair-closure-of-punch-biopsy-wounds-in-renal-transplant-patients
#8
Shelley B Dutt, Josephine Gonzales, Megan Boyett, Anne Costanzo, Peggy P Han, Steven Steinberg, Dianne B McKay, Julie M Jameson
BACKGROUND: Mammalian target of rapamycin (mTOR) inhibitors are approved to prevent allograft rejection and control malignancy. Unfortunately, they are associated with adverse effects, such as wound healing complications that detract from more extensive use. There is a lack of prospective wound healing studies to monitor patients treated with mTOR inhibitors, such as everolimus or sirolimus, especially in nondiabetics. METHODS: Patients receiving everolimus with standard immunosuppressant therapy or standard immunosuppressant therapy without everolimus were administered 3-mm skin biopsy punch wounds in the left scapular region...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28382841/hepatocellular-carcinoma-in-fanconi-bickel-syndrome
#9
Jennifer Pogoriler, Allison F O'Neill, Stephan D Voss, Robert C Shamberger, Antonio R Perez-Atayde
Fanconi-Bickel syndrome is a rare autosomal recessive disorder due to mutations in the facilitative glucose transporter 2 ( GLUT2 or SLC2A2) gene resulting in excessive glycogen storage predominantly in the liver and kidney. Previous case reports of this condition have described liver biopsies with glycogen storage and variable steatosis and/or fibrosis. Unlike in other types of glycogen storage disease, hepatocellular adenomas and carcinomas have not been described to date in this syndrome. A 6-year-old boy with consanguineous parents had short stature, poorly controlled rickets, hepatosplenomegaly, and renal tubular dysfunction clinically consistent with Fanconi-Bickel Syndrome...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28376289/the-appropriate-dose-of-thymoglobulin-induction-therapy-in%C3%A2-kidney-transplantation
#10
Mohsen Nafar, Nooshin Dalili, Fatemeh Poor-Reza-Gholi, Pedram Ahmadpoor, Fariba Samadian, Shiva Samavat
BACKGROUND: Thymoglobulin is used effectively as an induction agent in kidney transplantation, but there is no consensus on the optimal dose. In order to delineate the safest effective dose, an open-labeled randomized clinical trial was designed. METHODS: In this study, 90 adult kidney transplant recipients (KTR) were randomized before transplantation in three groups to receive thymoglobulin: Arm A (4.5 mg/kg in 3 days), Arm B (4.5 mg/kg single bolus dose), and Arm C (6 mg/kg in 3 days)...
April 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28375828/autologous-peripheral-blood-haematopoietic-stem-cell-transplantation-for-systemic-lupus-erythematosus-the-observation-of-long-term-outcomes-in-a-chinese-centre
#11
Can Cao, Menglei Wang, Jing Sun, Xuebiao Peng, Qifa Liu, Liang Huang, Yanyan Chai, Kuan Lai, Pingjiao Chen, Qingxiu Liu, Qian Li, Yusheng Peng, Hao Xiong, Jing Zhang, Minghua Chen, Kang Zeng
OBJECTIVES: We aimed to evaluate the safety and long-term efficacy of autologous peripheral blood haematopoietic stem cell transplantation (APHSCT). METHODS: We did not want to evaluate the efficacy of antibodies but rather the clinical response by investigating progression-free survival and serologic response by assessing autoantibody titres and complement levels. RESULTS: Overall, 22 patients with SLE (17 females; median age, 23 years) undergoing APHSCT were included...
March 31, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28359745/laparoscopic-cryoablation-for-renal-cell-carcinoma-100-month-oncologic-outcomes-caputo-pa-ramirez-d-zargar-h-akca-o-andrade-hs-o-malley-c-remer-em-kaouk-jh-j-urol-2015-oct-194-4-892-896-epub-2015-april-23-doi-10-1016-j-juro-2015-03-128
#12
Max Meng
PURPOSE: With the incidence of renal cell carcinoma on the rise treatment options for the small renal mass have broadened. Cryoablation is increasingly used as a therapeutic option for renal tumors in select cases. However, studies with long-term oncologic outcomes are sparse. We evaluated the long-term oncologic outcomes of laparoscopic renal mass cryoablation. MATERIALS AND METHODS: We reviewed our laparoscopic cryoablation database for patients treated with laparoscopic cryoablation from October 1997 to February 2005...
March 27, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28355401/schistosoma-mansoni-associated-glomerulopathy-with-iga-mesangial-deposits-case-report
#13
Fabiana Oliveira Gonçalves, Tânia Maria de Souza Fontes, Ana Paula Pereira Santana Lemes Canuto
INTRODUCTION: Renal involvement is a severe form of schistosomiasis and occurs in 10% to 15% of patients with the hepatosplenic form of the disease. Nephrotic syndrome is the most common clinical presentation. It is a complication caused by immune complexes (IC), it is rare to appear in the Brazilian context with a immunoglobulin A (IgA) deposits. When installed the renal injury by Schistosoma mansoni, classically presents as membranoproliferative glomerulonephritis (mesangiocapillary) with lobular accentuation...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28339949/bone-biopsy-practice-patterns-across-europe-the-european-renal-osteodystrophy-initiative-a-position-paper
#14
Pieter Evenepoel, Patrick D'Haese, Justine Bacchetta, Jorge Cannata-Andia, Anibal Ferreira, Mathias Haarhaus, Sandro Mazzaferro, Marie-Helene Lafage Proust, Syazrah Salam, Goce Spasovski, Mario Cozzolino
Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease (CKD). Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD but do have important inherent limitations. By informing on bone turnover and mineralization, a bone biopsy may help to guide prevention and treatment of ROD and its consequences. According to a recent survey conducted among European nephrologists, bone biopsies are performed rather exceptionally, both for clinical and research purposes...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28303661/immunological-and-physiological-observations-in-baboons-with-life-supporting-genetically-engineered-pig-kidney-grafts
#15
Hayato Iwase, Hidetaka Hara, Mohamed Ezzelarab, Tao Li, Zhongqiang Zhang, Bingsi Gao, Hong Liu, Cassandra Long, Yi Wang, Amy Cassano, Edwin Klein, Carol Phelps, David Ayares, Abhinav Humar, Martin Wijkstrom, David K C Cooper
BACKGROUND: Genetically engineered pigs could provide a source of kidneys for clinical transplantation. The two longest kidney graft survivals reported to date have been 136 and 310 days, but graft survival >30 days has been unusual until recently. METHODS: Donor pigs (n=4) were on an α1,3-galactosyltransferase gene-knockout (GTKO)/human complement regulatory protein (CD46) background (GTKO/CD46). In addition, the pigs were transgenic for at least one human coagulation regulatory protein...
March 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28295760/variability-in-assessing-for-bk-viremia-whole-blood-is-not-reliable-and-plasma-is-not-above-reproach-a-retrospective-analysis
#16
Neerja Agrawal, Ignacio A Echenique, Shane M Meehan, Ajit P Limaye, Linda Cook, Anthony Chang, Robert C Harland, Basit Javaid, Pradeep V Kadambi, Scott Matushek, James Williams, Michelle A Josephson
Polyomavirus nephropathy (PVN) is a major complication of kidney transplantation. Most reports describe polyomavirus viremia either precedes or is detectable at the time of diagnosis of PVN. This association is the basis of current screening recommendations. We retrospectively reviewed the PCR results of blood and urine samples from 29 kidney transplant recipients with biopsy proven PVN. Biopsies were performed for a rise in serum creatinine or persistent high-level BK viruria. All biopsies had polyoma virus large T-antigen expression in tubular epithelium by immunohistochemistry...
March 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28284382/medication-induced-interstitial-nephritis-in-the-21st-century
#17
REVIEW
Cynthia C Nast
Interstitial nephritis is an immune mediated form of tubulointerstitial kidney injury that may occur secondary to drugs, autoimmune disease, infections, and hematologic disorders or as a reactive process. Drug-induced acute interstitial nephritis (DI-AIN) occurs in 0.5%-3% of all kidney biopsies and in 5%-27% of biopsies performed for acute kidney injury. Drugs are implicated in 70%-90% of biopsy-proved IN with a prevalence of 50% in less developed to 78% in more developed countries. DI-AIN typically is idiosyncratic because of a delayed hypersensitivity reaction, although some chemotherapeutic agents are permissive for immune upregulation and injure the kidney in a dose-related manner...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28281441/miliary-tuberculosis
#18
Surendra K Sharma, Alladi Mohan
Miliary tuberculosis (TB) results from a massive lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli and is characterized by tiny tubercles evident on gross pathology resembling millet seeds in size and appearance. The global HIV/AIDS pandemic and widespread use of immunosuppressive drugs and biologicals have altered the epidemiology of miliary TB. Considered to be predominantly a disease of infants and children in the pre-antibiotic era, miliary TB is increasingly being encountered in adults as well...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28273603/rare-presentation-of-wegener-s-granulomatosis-in-the-pituitary-gland-case-report-and-literature-review
#19
Samantha M Baird, Upasna Pratap, Catriona McLean, Candice P Law, Nicholas Maartens
INTRODUCTION: Wegener's granulomatosis (WG) is a systemic vasculitis that can affect a variety of organs including ear, nose and throat, lungs and kidneys. However WG is unusual in the pituitary and rare in the central nervous system. PRESENTATION OF CASE: A 56-year-old male with likely WG presented with polyuria and polydipsia despite six months of conservative medical management. MRI scanning revealed an enlarging heterogeneously enhancing pituitary gland. Following endoscopic transsphenoidal pituitary biopsy and debulking, final tissue pathology was diagnostic for WG in the pituitary gland...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28270649/assessment-of-kidney-function-after-allograft-transplantation-by-texture-analysis
#20
Ali Abbasian Ardakani, Afshin Mohammadi, Bahareh Khalili Najafabad, Jamileh Abolghasemi
INTRODUCTION: Ultrasonography is the preferable imaging technique for monitoring and assessing complications in kidney allograft transplants. Computer-aided diagnostic system based on texture analysis in ultrasonographic imaging is recommended to identify changes in kidney function after allograft transplantation. MATERIALS AND METHODS: A total of 61 biopsy-proven kidney allograft recipients (11 rejected and 50 unrejected) were assessed by a computer-aided diagnostic system...
March 2017: Iranian Journal of Kidney Diseases
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