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renal protection in major surgery

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https://www.readbyqxmd.com/read/29568103/incidence-of-end-stage-renal-disease-following-bariatric-surgery-in-the-swedish-obese-subjects-study
#1
A Shulman, M Peltonen, C D Sjöström, J C Andersson-Assarsson, M Taube, K Sjöholm, C W le Roux, L M S Carlsson, P-A Svensson
BACKGROUND: Obesity is a major public health problem leading to co-morbidities such as diabetes, hypertension and kidney failure. Bariatric surgery results in pronounced and maintained weight loss and prevention of obesity-related diseases and their complications. Most studies of bariatric surgery on kidney disease show improvements after surgery. However, long-term studies analyzing hard end-points are lacking. Here we report on the long-term effects of bariatric surgery compared to usual obesity care on incidence of end-stage renal disease (ESRD) alone and in combination with chronic kidney disease stage 4 (CKD4/ESRD)...
February 26, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29563990/insulin-alleviates-mitochondrial-oxidative-stress-involving-upregulation-of-superoxide-dismutase-2-and-uncoupling-protein-2-in-septic-acute-kidney-injury
#2
Guang-Dao Chen, Jun-Liang Zhang, Yi-Ting Chen, Ju-Xing Zhang, Tao Wang, Qi-Yi Zeng
The aim of the present study was to explore the effects and mechanisms of insulin on mitochondrial oxidative stress in septic acute kidney injury (AKI). Male Sprague Dawley rats were divided randomly into four groups: Control group, sham surgery group, cecal ligation and puncture (CLP) group, and CLP plus insulin group. Blood specimens and kidney tissues were obtained at 12 and 24 h after surgery as separate experiments. Analyses of histology and indicators of renal injury [blood urea nitrogen (BUN) and serum creatinine (CRE) and neutrophil gelatinase-associated lipocalin (NGAL)], mitochondrial function [adenosine triphosphate (ATP) and mitochondrial membrane potential (MMP)], oxidative stress [inducible nitric oxide synthase (iNOS), reactive oxygen species (ROS) and nitric oxide (NO)], endogenous antioxidant systems [superoxide dismutase (SOD) and glutathione (GSH)] as well as the expression of uncoupling protein (UCP), PINK1 protein (a major mediator of mitophagy), PGC1α protein (a major regulator of mitochondrial biogenesis) were performed...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29468090/the-role-of-bmi-in-hip-fracture-surgery
#3
Sheriff D Akinleye, Garret Garofolo, Maya Deza Culbertson, Peter Homel, Orry Erez
Introduction: Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. Methods: The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29397002/contemporary-surgical-management-of-renal-oncocytoma-a-nation-s-outcome
#4
Joana B Neves, John Withington, Sarah Fowler, Prasad Patki, Ravi Barod, Faiz Mumtaz, Tim O'Brien, Michael Aitchison, Axel Bex, Maxine G B Tran
OBJECTIVE: To report on the contemporary UK experience of surgical management of renal oncocytomas. PATIENTS AND METHODS: Descriptive analysis of practice and postoperative outcomes of patients with a final histological diagnosis of oncocytoma included in The British Association of Urological Surgeons (BAUS) nephrectomy registry from 01/01/2013 to 31/12/2016. Short-term outcomes were assessed over a follow-up of 60 days. RESULTS: Over 4 years, 32 130 renal surgical cases were recorded in the UK, of which 1202 were oncocytomas (3...
February 3, 2018: BJU International
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#5
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29260413/berberine-protects-hk-2-cells-from-hypoxia-reoxygenation-induced-apoptosis-via-inhibiting-sphk1-expression
#6
Jianrao Lu, Yang Yi, Ronghua Pan, Chuanfu Zhang, Haiyan Han, Jie Chen, Wenrui Liu
Renal ischemia reperfusion injury (RIRI) refers to the irreversible damage for renal function when blood perfusion is recovered after ischemia for an extended period, which is common in clinical surgeries and has been regarded as a major risk for acute renal failures (ARF) that is accompanied with unimaginably high morbidity and mortality. Hypoxia during ischemia followed by reoxygenation via reperfusion serves as a major event contributing to cell apoptosis, which has been widely accepted as the vital pathogenesis in RIRI...
March 2018: Journal of Natural Medicines
https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#7
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29122552/nephroprotection-through-the-akt-enos-pathway-by-centrally-administered-erythropoietin-in-a-rat-model-of-fixed-volume-hemorrhage
#8
Behjat Seifi, Mehri Kadkhodaee, Mina Ranjbaran, Enayatollah Bakhshi
AIMS: This study was designed to investigate the protective effects of centrally administered erythropoietin (EPO) on brain oxidative stress and inflammatory markers to protect the kidneys during hemorrhagic shock (HS). MAIN METHODS: Animals were assigned into three groups (n=6). Sham rats were subjected to cannulation of femoral artery and vein as well as stereotaxic surgery. In HS group, 50% of total blood volume was withdrawn and resuscitation was started 2h later...
January 15, 2018: Life Sciences
https://www.readbyqxmd.com/read/29079006/risk-factors-for-unplanned-readmission-and-stump-complications-after-major-lower-extremity-amputation
#9
John Phair, Charles DeCarlo, Larry Scher, Issam Koleilat, Saadat Shariff, Evan C Lipsitz, Karan Garg
OBJECTIVE: The unplanned 30-day readmission rate is a marker of quality of patient care across many disciplines. Data regarding risk factors for unplanned readmission after major lower extremity amputation (LEA) are limited. We evaluated predictors of readmission at our institution after major LEA. METHODS: We conducted a retrospective review of all patients undergoing above-knee amputation (AKA) or below-knee amputation (BKA) between November 2009 and November 2014...
March 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28987762/protective-outcomes-of-low-dose-doxycycline-on-renal-function-of-wistar-rats-subjected-to-acute-ischemia-reperfusion-injury
#10
Aline L Cortes, Sabrina R Gonsalez, Lilimar S Rioja, Simone S C Oliveira, André L S Santos, Minolfa C Prieto, Paulo A Melo, Lucienne S Lara
Renal ischemia-reperfusion injury (IRI) is a major cause of acute renal failure. Doxycycline (Dc) belongs to the tetracycline-class of antibiotics with demonstrated beneficial molecular effects in the brain and heart, mainly through matrix metalloproteinases inhibition (MMP). However, Dc protection of renal function has not been demonstrated. We determined whether low doses of Dc would prevent decreases in glomerular filtration rate (GFR) and maintain tubular Na+ handling in Wistar rats subjected to kidney I/R...
January 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28921938/prostate-cancer-treatment-in-renal-transplant-recipients-a-systematic-review
#11
REVIEW
Giancarlo Marra, Ettore Dalmasso, Marco Agnello, Stefania Munegato, Andrea Bosio, Omidreza Sedigh, Luigi Biancone, Paolo Gontero
The aim of this review was to summarize the current evidence and to highlight the main issues future research needs to address regarding prostate cancer (PCa) treatment in renal transpant recipients (RTRs). We conducted a search of AMED, Medline and Embase up to 17 November 2016 to investigate oncological and functional outcomes of PCa treatment in RTR. Type and use/protocols of immunosuppression and peri-operative antibiotic drugs were also assessed. The search was implemented manually. Exclusion criteria were absence of full text or absence of information that allowed us to differentiate oncological and/or functional outcomes of each therapeutic approach used...
March 2018: BJU International
https://www.readbyqxmd.com/read/28861303/flouroscopy-free-technique-is-safe-and-feasible-in-retrograde-intrarenal-surgery-for-renal-stones
#12
Hacı İbrahim Çimen, Fikret Halis, Hasan Salih Sağlam, Ahmet Gökçe
OBJECTIVE: The aim of this study was to present outcomes of our patients who had undergone retrograde intrarenal surgery (RIRS) with fluoroscopy-free technique and evaluate the efficacy and safety of the technique. MATERIAL AND METHODS: Between January 2013 and June 2015 the outcomes of 93 patients who had undergone RIRS with fluoroscopy-free technique were retrospectively evaluated. Our RIRS technique involved preoperative assessment of ureter by semi-rigid ureteroscope, inserting guidewire through semi-rigid ureteroscope, inserting ureteral access sheath over the guidewire with the visiual guidance of semi-rigid ureteroscope, passing flexible ureteroscope through the sheath, dusting the stone with holmium laser, rechecking the ureter with semi-rigid ureteroscope and inserting double J stent through semi-rigid ureteroscope...
September 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28860786/risk-factors-and-early-outcomes-of-acute-renal-injury-after-thoracic-aortic-endograft-repair-for-type-b-aortic-dissection
#13
Songyuan Luo, Huanyu Ding, Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become an emerging treatment modality for acute type B aortic dissection (TBAD) patients in recent years. The risk factors and impacts of acute kidney injury (AKI) after percutaneous TEVAR, however, have not been widely established. METHODS: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28729966/causal-relationship-between-hypoalbuminemia-and-acute-kidney-injury
#14
REVIEW
Christian J Wiedermann, Wolfgang Wiedermann, Michael Joannidis
Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a significant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28710786/comparison-of-perioperative-and-functional-outcomes-of-robotic-partial-nephrectomy-for-ct1a-vs-ct1b-renal-masses
#15
COMPARATIVE STUDY
Christopher R Reynolds, Joan C Delto, David J Paulucci, Corey Weinstein, Ketan Badani, Daniel Eun, Ronney Abaza, James Porter, Akshay Bhandari, Ashok K Hemal
OBJECTIVE: To compare perioperative and functional outcomes of patients with cT1a or cT1b renal masses undergoing robotic partial nephrectomy (RPN) in a large multi-institutional study PATIENTS AND METHODS: The present retrospective Institutional Review Board-approved multi-institutional study utilised a prospectively maintained database to identify patients undergoing RPN by six surgeons for a solitary cT1a (n = 1 307) or cT1b (n = 377) renal mass from 2006 to 2016. Perioperative and renal function outcomes at discharge and at a median follow-up of 12...
December 2017: BJU International
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#16
REVIEW
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28543216/bridging-with-tirofiban-during-oral-antiplatelet-interruption-a-single-center-case-series-analysis-including-patients-on-hemodialysis
#17
Elizabeth A Walker, William E Dager
INTRODUCTION: Patients requiring an interruption in dual-antiplatelet therapy (DAPT) within 6 months of cardiac stenting are at risk for thrombotic events. Bridging with short-acting intravenous antiplatelet agents has been proposed to minimize the risk of thrombotic and hemorrhagic complications. METHODS: This retrospective analysis of a tirofiban bridging strategy did not use an initial bolus loading dose. Tirofiban infusions were initiated 24-48 hours after the last oral antiplatelet dose at a rate of 0...
August 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28464554/does-training-of-fellows-affect-peri-operative-outcomes-of-robot-assisted-partial-nephrectomy
#18
COMPARATIVE STUDY
Zine-Eddine Khene, Benoit Peyronnet, Elise Bosquet, Benjamin Pradère, Corentin Robert, Tarek Fardoun, Solène-Florence Kammerer-Jacquet, Grégory Verhoest, Nathalie Rioux-Leclercq, Romain Mathieu, Karim Bensalah
OBJECTIVE: To evaluate the impact of fellows' involvement on the peri-operative outcomes of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) and fellow operating under the supervision of the expert surgeon (fellow group)...
October 2017: BJU International
https://www.readbyqxmd.com/read/28342285/development-of-a-human-cadaver-model-for-training-in-laparoscopic-donor-nephrectomy
#19
Erica R H Sutton, Adrian Billeter, Devin Druen, Henry Roberts, Jonathan Rice
BACKGROUND: The organ procurement network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies (LDN) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress, and efficiency in each of the major steps involved in LDN...
March 25, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-perioperative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#20
RANDOMIZED CONTROLLED TRIAL
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
Perioperative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intraoperative portal pressures and improve renal function. Its role and safety profile have never been evaluated in a double-blind randomized controlled trial (RCT). The aim was to evaluate the hemodynamic effects, clinical benefits, and safety of perioperative Tp infusion in adult LDLT. This was a single-center double-blind RCT. Consenting adults with chronic liver disease and low risk of posttransplant renal dysfunction undergoing their first LDLT were randomized...
August 2017: Liver Transplantation
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