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Nephrology review

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https://www.readbyqxmd.com/read/29786189/-renal-infarction-multicentric-cases-in-piedmont
#1
Daria Motta, Andrea Airoldi, Serena Bainotti, Manuel Burdese, Andrea Campo, Luigia Costantini, Raffaella Cravero, Paola Mesiano, Giorgina B Piccoli, Olga Randone, Andrea Serra, Patrizia Vio, Roberto Boero
We describe factors associated to renal infarction, clinical, instrumental and laboratoristic features, and therapeutic strategies too. This is an observational, review and polycentric study of cases in Nephrologic Units in Piedmont during 2013-2015, with diagnosis of renal infarction by Computed Tomography Angiography (CTA). We collected 48 cases (25 M, age 57±16i; 23 F age 70±18, p = 0.007), subdivided in 3 groups based on etiology: group 1: cardio-embolic (n=19) ; group 2: coagulation abnormalities (n= 9); group 3: other causes or idiopathic (n=20)...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29786186/-ebv-associated-pneumonia-in-patient-with-granulomatosis-with-polyangiitis-gpa-in-immunosoppressive-therapy-treated-with-aciclovir
#2
Nicola Mongera, Vittorio Di Maso, Elisabetta Ermacora, Michele Carraro, Cristina Bregant, Martina Pian, Umberto Savi, Eric Lorenzon, Giuliano Boscutti
We describe the case of a 74-year-old man admitted to our Nephrology Unit with nephrotic syndrome and mild kidney disease. A complete panel of laboratoristic and instrumental tests did not provide useful information for diagnosis. No specific signs or symptoms suggested the presence of AL amyloidosis. As a matter of fact, diagnosis was reached thanks to the hystopathologic examination of renal tissue and bone marrow, since the associated B-cell lymphoproliferative disorder had not revealed itself through serum and urine electrophoresis and immunofixation...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29786185/-an-unusual-presentation-of-amyloidosis-al
#3
Anna Zito, Antonio De Pascalis, Paolo Ria, Annarita Armeni, Alessandro D'Amelio, Marcello Napoli
We describe the case of a 74-year-old man admitted to our Nephrology Unit with nephrotic syndrome and mild kidney disease. A complete panel of laboratoristic and instrumental tests did not provide useful information for diagnosis. No specific signs or symptoms suggested the presence of AL amyloidosis. As a matter of fact, diagnosis was reached thanks to the hystopathologic examination of renal tissue and bone marrow, since the associated B-cell lymphoproliferative disorder had not revealed itself through serum and urine electrophoresis and immunofixation...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29739260/timing-of-renal-replacement-therapy-for-acute-kidney-injury
#4
Nithin Karakala, Ashita J Tolwani
Acute kidney injury (AKI) is common in critically ill patients and associated with increased morbidity and mortality. With the increased use of renal replacement therapy (RRT) for severe AKI, the optimal time for initiation of RRT has become one of the most probed and debated topic in the field of nephrology and critical care. There appears to be an increased trend toward earlier initiation of RRT to avoid life-threatening complications associated with AKI. Despite the presence of a plethora of studies in this field, the lack of uniformity in study design, patient population types, definition of early and late initiation, modality of RRT, and results, the optimal time for starting RRT in AKI still remains unknown...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29713256/primary-glomerulonephritis-with-unique-c4d-deposition-and-concurrent-non-infectious-intermediate-uveitis-a-case-report-and-literature-review
#5
Jong Man Park, Harin Lee, Sangheon Song, Eun Young Seong, Ihm Soo Kwak, Sung Who Park, Young-Keum Kim, Nari Shin, Mee Young Sol
C4 glomerulopathy is a recently introduced entity that presents with bright C4d staining and minimal or absent immunoglobulin and C3 staining. We report a case of a 62-year-old man with C4 glomerulonephritis (GN) and uveitis. He presented to the nephrology department with proteinuria and hematuria. The patient also had intermediate uveitis along with proteinuria and hematuria. A kidney biopsy that was performed in light of continuing proteinuria and hematuria showed a focal proliferative, focal sclerotic glomerulopathy pattern on light microscopy, absent staining for immunoglobulin or C3 by immunofluorescence microscopy, with bright staining for C4d on immunohistochemistry, and electron-dense deposits on electron microscopy...
April 30, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29709849/sources-behaviour-and-environmental-and-human-health-risks-of-high-technology-rare-earth-elements-as-emerging-contaminants
#6
REVIEW
Willis Gwenzi, Lynda Mangori, Concilia Danha, Nhamo Chaukura, Nothando Dunjana, Edmond Sanganyado
Recent studies show that high-technology rare earth elements (REEs) of anthropogenic origin occur in the environment including in aquatic systems, suggesting REEs are contaminants of emerging concern. However, compared to organic contaminants, there is a lack of comprehensive reviews on the anthropogenic sources, environmental behaviour, and public and ecological health risks of REEs. The current review aims to: (1) identify anthropogenic sources, transfer mechanisms, and environmental behaviour of REEs; (2) highlight the human and ecological health risks of REEs and propose mitigation measures; and (3) identify knowledge gaps and future research directions...
April 26, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29705806/vancomycin-associated-acute-kidney-injury-with-a-steep-rise-in-serum-creatinine
#7
Juan Carlos Q Velez, Ndidiamaka O Obadan, Amit Kaushal, Mohammed Alzubaidi, Bhavna Bhasin, Sachin H Sachdev, Nithin Karakala, John M Arthur, Ross M Nesbit, Gautam M Phadke
BACKGROUND: Vancomycin-associated (VA) acute kidney injury (AKI) is being increasingly recognized. A distinct pattern of rapid rise in serum creatinine (sCr) during VA-AKI has occasionally been observed. However, such scenarios remain underreported. METHODS: We conducted an online survey at the American Society of Nephrology Communities forum and reviewed publications of VA-AKI via PubMed or Google searching for cases of precipitous AKI (those with rise in sCr ≥1...
April 27, 2018: Nephron
https://www.readbyqxmd.com/read/29700696/the-vexed-question-of-whether-or-not-to-measure-levels-of-direct-oral-anticoagulants-before-surgery-or-invasive-procedures
#8
REVIEW
Armando Tripodi, Francesco Marongiu, Marco Moia, Gualtiero Palareti, Vittorio Pengo, Daniela Poli, Domenico Prisco, Sophie Testa, Maria Zanazzi
Direct oral anticoagulants (DOAC) possess high bioavailability, and their anticoagulant effect is more predictable than that of vitamin K antagonists, hence they do not require routine dose adjustment based on laboratory testing. However, there are circumstances when laboratory testing may be useful, including patients who need to undergo surgery or invasive procedures. Most guidelines state that patients on DOAC may safely undergo surgery/invasive procedures by stopping anticoagulation for a few days before intervention without testing if renal function is within normal limits...
April 26, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29697879/drawing-attention-to-a-neglected-injecting-related-harm-a-systematic-review-of-aa-amyloidosis-among-people-who-inject-drugs
#9
REVIEW
Magdalena Harris, Rachel Brathwaite, Jenny Scott, Gail Gilchrist, Dan Ciccarone, Vivian Hope, Catherine R McGowan
BACKGROUND AND AIMS: Chronic skin and soft tissue infections (SSTI) among people who inject drugs (PWID) can lead to AA-amyloidosis: a serious, yet neglected, multi-organ disease. We aim to synthesise findings on the epidemiology, risk factors, clinical outcomes, screening recommendations, and challenges to treatment for AA-amyloidosis among PWID. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
April 26, 2018: Addiction
https://www.readbyqxmd.com/read/29674195/thrombotic-microangiopathies-of-pregnancy-differential-diagnosis
#10
REVIEW
M Gupta, B B Feinberg, R M Burwick
Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic thrombocytopenic purpura (TTP) or atypical hemolytic uremic syndrome (aHUS). Due to overlapping clinical and laboratory features, TTP and aHUS are often mistaken for preeclampsia or HELLP...
February 16, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29671145/nephrotoxicity-of-ciprofloxacin-five-cases-and-a-review-of-the-literature
#11
Meriam Hajji, Hela Jebali, Aymen Mrad, Yassine Blel, Nozha Brahmi, Rania Kheder, Soumaya Beji, Lilia Ben Fatma, Wided Smaoui, Madiha Krid, Fethi Ben Hmida, Lamia Rais, Mohammed Karim Zouaghi
Fluoroquinolones are usually well tolerated with a minimum of serious adverse effects; renal toxicity is uncommon. Apart from the renal side effects of ciprofloxacin, we aimed to highlight the renal impact of a ciprofloxacin overdose, and thus conducted a prospective study in the Department of Nephrology at La Rabta Hospital between 2010 and 2015. The cohort database was continually updated until the inclusion of five patients who were subjected to an overdose and who were initially admitted to the medical intensive care unit and then transferred to our department for acute renal failure (ARF) due to ciprofloxacin ingestion requiring urgent hemodialysis...
April 18, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29657218/rapidly-progressive-glomerulonephritis-a-wild-card-manifestation-of-lupus-nephritis
#12
Opeyemi O Komolafe
A significant proportion of individuals with systemic lupus erythematosus (SLE) will have clinical or laboratory evidence of renal involvement at some point in the course of their disease. Lupus nephritis (LN) is one of the more important systemic manifestations of SLE and although progression to end-stage renal disease (ESRD) is not usually the norm, a significant minority of patients will do so, some in a rather dramatic fashion. It is in such instances that LN constitutes a true nephrologic emergency. Gratifyingly, it is rarely a silent emergency and heightened awareness amongst clinicians about its unpredictable course should lead to earlier recognition and intervention...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29644056/lung-ultrasonography-in-end-stage-renal-disease-moving-from-evidence-to-practice-a-narrative-review
#13
Daniel W Ross, Mohammed M Abbasi, Kenar D Jhaveri, Mala Sachdeva, Ilene Miller, Richard Barnett, Mangala Narasimhan, Paul Mayo, Massini Merzkani, Anna T Mathew
Traditionally, point of care ultrasonography in nephrology has been used for renal biopsies and dialysis line placement. However, there is an emerging literature supporting the value of point of care lung ultrasonography in the assessment of volume status for dialysis patients. We conducted a review and identified 12 studies that examined the utility of lung ultrasonography in assessing volume status in patients with end-stage renal disease. We conclude that lung ultrasonography can be used to determine volume status in chronic dialysis patients by identifying lung congestion using the B-line score...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29622009/health-service-utilisation-during-the-last-year-of-life-a-prospective-longitudinal-study-of-the-pathways-of-patients-with-chronic-kidney-disease-stages-3-5
#14
Shirley Chambers, Helen Healy, Wendy E Hoy, Adrian Kark, Sharad Ratanjee, Geoffrey Mitchell, Carol Douglas, Patsy Yates, Ann Bonner
BACKGROUND: Chronic kidney disease (CKD) is a growing global problem affecting around 10% of many countries' populations. Providing appropriate palliative care services (PCS) to those with advanced kidney disease is becoming paramount. Palliative/supportive care alongside usual CKD clinical treatment is gaining acceptance in nephrology services although the collaboration with and use of PCS is not consistent. METHODS: The goal of this study was to track and quantify the health service utilisation of people with CKD stages 3-5 over the last 12 months of life...
April 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29620510/therapy-of-rituximab-in-idiopathic-membranous-nephropathy-with-nephrotic-syndrome-a-systematic-review-and-meta-analysis
#15
Pei-Mei Zou, Hang Li, Jian-Fang Cai, Zhen-Jie Chen, Chao Li, Xue-Wang Li
Objective To investigate the efficacy and safety of rituximab (RTX) in the treatment of idiopathic membranous nephropathy (IMN) with nephrotic syndrome with a systematic review and meta-analysis. Methods PubMed, Embase, Cochrane Library and Clinical Trials (December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission (CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated...
March 30, 2018: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/29602399/metabolomics-and-metabolic-reprogramming-in-kidney-cancer
#16
REVIEW
Robert H Weiss
Kidney cancer, or renal cell carcinoma (RCC), is a disease of increasing incidence that commonly is seen in the general practice of nephrology. Despite this state of affairs, this fascinating and highly morbid disease frequently is under-represented, or even absent, from the curriculum of nephrologists in training and generally is underemphasized in national nephrology meetings, both scientific as well as clinical. Although classic concepts in cancer research in general had led to the concept that cancer is a disease resulting from mutations in the control of growth-regulating pathways, reinforced by the discovery of oncogenes, more contemporary research, particularly in kidney cancer, has uncovered changes in metabolic pathways mediated by those same genes that control tumor energetics and biosynthesis...
March 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29602398/genome-wide-association-studies-of-metabolite-concentrations-mgwas-relevance-for-nephrology
#17
REVIEW
Anna Köttgen, Johannes Raffler, Peggy Sekula, Gabi Kastenmüller
Metabolites are small molecules that are intermediates or products of metabolism, many of which are freely filtered by the kidneys. In addition, the kidneys have a central role in metabolite anabolism and catabolism, as well as in active metabolite reabsorption and/or secretion during tubular passage. This review article illustrates how the coupling of genomics and metabolomics in genome-wide association analyses of metabolites can be used to illuminate mechanisms underlying human metabolism, with a special focus on insights relevant to nephrology...
March 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29602397/a-systems-level-view-of-renal-metabolomics
#18
REVIEW
Eugene P Rhee
The measurement of select circulating metabolites such as creatinine, glucose, and cholesterol are integral to clinical medicine, with implications for diagnosis, prognosis, and treatment. Metabolomics studies in nephrology research seek to build on this paradigm, with the goal to identify novel markers and causal participants in the pathogenesis of kidney disease and its complications. This article reviews three themes pertinent to this goal. Each is rooted in long-established principles of human physiology, with recent updates enabled by metabolomics and other tools...
March 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29582959/-a-cause-of-acute-renal-dysfunction-a-giant-bladder-diverticulum
#19
Laura Rivoli, Giuseppe Leonardi, Chiara Scafuro, Giuseppe Ucciero, Michele Palumbo, Giuseppe Galluccio, Mariadelina Simeoni, Maria Capria, Giorgio Fuiano
We describe the case of a previously 77-year-old man who accessed in our Nephrology Unit for acute kidney injury (AKI) on chronic kidney disease (CKD), gastric discomfort and vague urinary symptoms with apparently preserved diuresis and suspected "ascites". Physical examination confirmed the presence of abdominal effusion, even though ultrasound abdominal examination revealed the presence of a giant diverticular urinary bladder with bilateral hydronephrosis. We discuss the diagnostic and therapeutic approach of these rare complications by briefly reviewing the technical aspects and the possible consequences...
March 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29569423/the-roles-of-social-support-and-health-literacy-in-self-management-among-patients-with-chronic-kidney-disease
#20
Yu-Chi Chen, Li-Chun Chang, Chieh-Yu Liu, Ya-Fang Ho, Shuo-Chun Weng, Tzu-I Tsai
AIMS: To investigate the relationships among social support, health literacy, and self-management, and the factors influencing self-management of chronic kidney disease (CKD). DESIGN: Cross-sectional study. METHODS: A random sample of 410 patients was recruited from nephrology clinics. Data were collected using structured questionnaires and chart reviews from January 2013 to February 2014. Hierarchical regression analysis was used to determine the predictive factors of self-management behaviors and ∆R2 to determine each variable's explanatory power...
March 23, 2018: Journal of Nursing Scholarship
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