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Kidney biopsy and complications

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https://www.readbyqxmd.com/read/28303661/immunological-and-physiological-observations-in-baboons-with-life-supporting-genetically-engineered-pig-kidney-grafts
#1
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 17, 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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28267898/laparoscopic-biopsies-in-pancreas-transplantation
#7
P D Uva, J S Odorico, A Giunippero, I C Cabrera, A Gallo, L R Leon, E Minue, F Toniolo, I Gonzalez, E Chuluyan, D H Casadei
As there is no precise laboratory test or imaging study for detection of pancreas allograft rejection, there is increasing interest in obtaining pancreas tissue for diagnosis. Pancreas allograft biopsies are most commonly performed percutaneously, transcystoscopically, or endoscopically, yet pancreas transplant surgeons often lack the skills to perform these types of biopsies. We have performed 160 laparoscopic pancreas biopsies in 95 patients. There were 146 simultaneous kidney-pancreas biopsies and 14 pancreas only biopsies due to pancreas alone, kidney loss or extraperitoneal kidney...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28262208/risk-factors-for-severe-bleeding-complications-in-percutaneous-renal-biopsy
#8
Da-Min Xu, Min Chen, Fu-de Zhou, Ming-Hui Zhao
BACKGROUND: Percutaneous renal biopsy is essential for diagnosis of many renal diseases. Previous studies have revealed a variety of factors associated with bleeding complications of renal biopsy; however, data are not sufficient in the Chinese population. We aimed to investigate the risk factors for severe post-biopsy bleeding events in a large cohort of Chinese patients. MATERIALS AND METHODS: The data of patients who underwent percutaneous renal biopsy from January 2008 to December 2012 were collected...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28260478/ultrasonography-findings-of-acute-tubulointerstitial-nephritis-and-multiple-abscesses-following-renal-transplant-a-case-report
#9
Sehnaz Tezcan, Nihal Uslu, Ebru H Ayvazoglu Soy, Mehmet Haberal
Urinary tract infection is the most common complication after kidney transplant that can cause graft loss. An early diagnosis of urinary infections decreases morbidity and mortality. Besides clinical and laboratory examinations, ultrasonography is considered as the primary imaging modality for the diagnosis of urinary tract infections. Here, we report a 53-year-old woman who presented with fever and pain at surgical site. Ultrasonography examination showed multiple, ill-defined or irregularly margined hypoechoic areas within the cortex...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260443/outcome-of-renal-transplant-in-recipients-with-vasculitis
#10
Samia Barbouch, Meriam Hajji, Raja Aoudia, Monther Ounissi, Asma Zammouri, Rym Goucha, Fathi Ben Hamida, Mohammed Mongi Bacha, Ezzedine Abderrahim, Taieb Ben Abdallah
OBJECTIVES: End-stage renal disease develops in a high percentage of patients with vasculitis, in whom kidney transplant has become a therapeutic option. However, limited data are available on the prognosis and outcomes after kidney transplant in these patients. We aimed to compare the long-term graft survival and graft function in 8 renal transplant recipients with vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis, Goodpasture syndrome, and Henoch-Schonlein purpura) with the other kidney recipients at a single center...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28246612/urinary-excretion-of-kidney-aquaporins-as-possible-diagnostic-biomarker-of-diabetic-nephropathy
#11
Luigi Rossi, Maria Celeste Nicoletti, Monica Carmosino, Lisa Mastrofrancesco, Antonella Di Franco, Francesca Indrio, Rossella Lella, Luigi Laviola, Francesco Giorgino, Maria Svelto, Loreto Gesualdo, Giuseppe Procino
Diabetic nephropathy (DN) is a microangiopathic complication of diabetes mellitus (DM) affecting one-third of diabetic patients. The large variability in the clinical presentation of renal involvement in patients with DM makes kidney biopsy a prerequisite for a correct diagnosis. However, renal biopsy is an invasive procedure associated with risk of major complications. Numerous studies aimed to identify a noninvasive biomarker of DN but, so far, none of these is considered to be sufficiently specific and sensitive...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28237283/ablative-therapies-for-renal-tumors-patient-selection-treatment-planning-and-follow-up
#12
Jean-Michel Correas, Christophe Delavaud, Jules Gregory, Thomas Le Guilchet, Lionel Lamhaut, Marc-Olivier Timsit, Arnaud Méjean, Olivier Hélénon
The increased use of abdominal imaging has led to a major increase in small renal tumors incidence particularly in the elderly population. Their management is evolving with the development of percutaneous ablation, particularly radiofrequency ablation, cryoablation, and microwave ablation. The typical indications that must be validated by a multidisciplinary committee include solid tumors less than 3cm in patients with multiple comorbidity factors (including age), contraindications to surgery, hereditary renal cancer, bilateral renal tumors, solitary kidney, pre-existing chronic kidney disease, or at high risk of predialysis renal function after partial nephrectomy...
February 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28214296/abnormally-high-and-heterogeneous-bone-matrix-mineralization-after-childhood-solid-organ-transplantation-a-complex-pathology-of-low-bone-turnover-and-local-defects-in-mineralization
#13
Nadja Fratzl-Zelman, Helena Valta, Renata C Pereira, Barbara M Misof, Paul Roschger, Hannu Jalanko, Kathrine Wesseling-Perry, Klaus Klaushofer, Outi Mäkitie
Chronic renal, liver and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9) and heart (n = 5) transplant recipients (aged 7...
February 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28205354/mini-review-a-unique-case-of-crescentic-c3-glomerulonephritis
#14
Dharmenaan Palamuthusingam, Murty Mantha, Kimberley Oliver, Ketan Bavishi, Shyam Dheda
Kidney involvement is an under-recognized complication of non-Hodgkin lymphomas. They occur in a variety of mechanisms and differ widely in their clinical presentation. We take this opportunity to report a case of a 65 year-old man who developed a rapidly progressive glomerulonephritis within days after completing his first cycle of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy for newly diagnosed mantle cell lymphoma. He was odematous, hypertensive, oliguric with nephrotic range proteinuria and an active urine sediment...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28203420/the-diagnostic-yield-and-complications-of-open-lung-biopsies-in-kidney-transplant-patients-with-pulmonary-disease
#15
Daniere Yurie Vieira Tomotani, Antônio Tonete Bafi, Eduardo Souza Pacheco, Tainá Veras de Sandes-Freitas, Laila Almeida Viana, Edgar Porto de Oliveira Pontes, Nikkei Tamura, Hélio Tedesco-Silva, Flavia Ribeiro Machado, Flávio Geraldo Rezende Freitas
BACKGROUND: The purpose of this study was to assess the efficacy of open lung biopsy (OLB) in determining the specific diagnosis and the related complications in patients with undiagnosed diffuse pulmonary infiltrates. METHODS: This single center, retrospective study included adult kidney transplant patients who underwent OLB. The patients had diffuse pulmonary infiltrates without definitive diagnoses and failed to respond to empiric antibiotic treatment. We analyzed the number of specific diagnoses, changes in treatment and the occurrence of complications in these patients...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28188334/aicar-ameliorates-high-fat-diet-associated-pathophysiology-in-mouse-and-ex-vivo-models-independent-of-adiponectin
#16
Emma Börgeson, Ville Wallenius, Gulam H Syed, Manjula Darshi, Juan Lantero Rodriguez, Christina Biörserud, Malin Ragnmark Ek, Per Björklund, Marianne Quiding-Järbrink, Lars Fändriks, Catherine Godson, Kumar Sharma
AIMS/HYPOTHESIS: In this study, we aimed to evaluate the therapeutic potential of 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR), an activator of AMP-activated protein kinase, for ameliorating high-fat diet (HFD)-induced pathophysiology in mice. We also aimed to determine whether the beneficial effects of AICAR were dependent on adiponectin. Furthermore, human adipose tissue was used to examine the effect of AICAR ex vivo. METHODS: Six-week-old male C57BL/6J wild-type and Adipoq (-/-) mice were fed a standard-fat diet (10% fat) or an HFD (60% fat) for 12 weeks and given vehicle or AICAR (500 μg/g) three times/week from weeks 4-12...
April 2017: Diabetologia
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#17
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28174184/multiple-myeloma-presenting-with-bilateral-ankle-pain-microangiopathy-and-complicated-by-streptococcal-meningitis-and-pneumocystis-carinii-pneumonia
#18
Louise Dunphy, Neeraj Singh, Elizabeth Keating
Multiple myeloma is characterised by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. This clone of plasma cells proliferates in the bone marrow, resulting in extensive skeletal destruction with osteolytic lesions, osteopenia and pathological fractures. Additional disease-related complications include hypercalcaemia, renal insufficiency, anaemia and infection. We present the case of a 64-year-old woman presenting with rapid onset, painful distal symmetrical lower limb weakness and an acute kidney injury...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28119255/limitations-of-current-liver-transplant-immunosuppressive-regimens-renal-considerations
#19
Wei Zhang, John Fung
BACKGROUND: The use of calcineurin inhibitor (CNI)-based immunosuppressive regimens following liver transplantation (LTx) has improved the outcomes of the recipients. However, CNI has nephrotoxicity and causes short- and long-term renal complications. The progressive structural changes can be irreversible in the long-term, leading to chronic kidney dysfunction. The present review was to evaluate the different strategies of CNI application to renal function in liver recipients. DATA SOURCES: PubMed database was searched for relevant articles in English on the issue of immunosuppressive regimen and kidney injury that related to early minimization of CNI after LTx...
February 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28107603/desmopressin-octostim%C3%A2-before-a-native-kidney-biopsy-can-reduce-the-risk-for-biopsy-complications-in-patients-with-impaired-renal-function-a-pilot-study
#20
Björn Peters, Henrik Hadimeri, Johan Mölne, Salmir Nasic, Gert Jensen, Bernd Stegmayr
AIM: To evaluate if the administration of desmopressin alters the risk for renal biopsy complications. METHODS: A multicenter registry containing 576 native kidney biopsies (NKb) with a serum creatinine above 150 µmol/L in 527 patients (372 men and 155 women, median age 61 years) was used. Most of the data were prospective. At one of the hospitals all biopsies with creatinine above 150 µmol/L received desmopressin before biopsies (NKb 204). These were compared to outcome of biopsy complications against other centres where desmopressin was not given (NKb 372)...
January 20, 2017: Nephrology
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