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https://www.readbyqxmd.com/read/28509129/successful-long-term-effects-of-direct-renin-inhibitor-aliskiren-in-a-patient-with-atherosclerotic-renovascular-hypertension
#1
Norihiko Morisawa, Naoki Sugano, Takafumi Yamakawa, Satoru Kuriyama, Takashi Yokoo
A 64-year-old man visited our hospital with complaints of misty vision and ophthalmalgia. On admission, his blood pressure (BP) was high at 220/135 mmHg with no past history of hypertension, and he had choked discs. He was tentatively diagnosed as having idiopathic intracranial hypertension, and was later found to have atherosclerotic unilateral renovascular hypertension (RVH) based upon the extremely high plasma renin activity together with the radiological image tests. On day 3, combined antihypertensive therapies consisting of oral angiotensin II receptor blocker (ARB) and Ca channel blocker (CCB) along with intravenous CCB induced an abrupt BP lowering which led to deterioration of his renal function, progressing into acute kidney injury (AKI)...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28502971/targeting-the-keap1-nrf2-system-to-prevent-kidney-disease-progression
#2
Masahiro Nezu, Norio Suzuki, Masayuki Yamamoto
BACKGROUND: Nuclear factor erythroid 2-related factor 2 (NRF2) is a critical transcription factor for the antioxidative stress response and it activates a variety of cytoprotective genes related to redox and detoxification. NRF2 activity is regulated by the oxidative-stress sensor molecule Kelch-like ECH-associated protein 1 (KEAP1) that induces proteasomal degradation of NRF2 through ubiquitinating NRF2 under unstressed conditions. Because oxidative stress is a major pathogenic and aggravating factor for kidney diseases, the KEAP1-NRF2 system has been proposed to be a therapeutic target for renal protection...
May 13, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28487870/volume-related-weight-gain-as-an-independent-indication-for-renal-replacement-therapy-in-the-intensive-care-units
#3
REVIEW
Tibor Fülöp, Lajos Zsom, Mihály B Tapolyai, Miklos Z Molnar, László Rosivall
Attempts to identify specific therapies to reverse acute kidney injury (AKI) have been unsuccessful in the past; only modifying risk profile or addressing the underlying disease processes leading to AKI proved efficacious. The current thinking on recognizing AKI is compromised by a "kidney function percent-centered" viewpoint, a paradigm further reinforced by the emergence of serum creatinine-based automated glomerular filtration reporting over the last two decades. Such thinking is, however, grossly corrupted for AKI and poorly applicable in critically ill patients in general...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28485326/clarifications-on-continuous-renal-replacement-therapy-and-hemodynamics
#4
REVIEW
Xiao-Ting Wang, Cui Wang, Hong-Min Zhang, Da-Wei Liu
OBJECTIVE: Continuous renal replacement therapy (CRRT) is a continuous process of bedside blood purification which is widely used in the treatment of acute kidney injury (AKI) and for fluid management. However, since AKI and fluid overload are often found to be associated with hemodynamic abnormalities, determining the relationship between CRRT and hemodynamics remains a challenge in the treatment of critically ill patients. The aim of this review was to summarize key points in the relationship between CRRT and hemodynamics and to understand and monitor renal hemodynamics in critically ill patients, especially those with AKI...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28471327/renal-regenerative-potential-of-different-extra-cellular-vesicle-populations-derived-from-bone-marrow-mesenchymal-stromal-cells
#5
Stefania Bruno, Marta Tapparo, Federica Collino, Giulia Chiabotto, Maria Chiara Deregibus, Rafael Soares Lindoso, Francesco Neri, Sharad Kholia, Sara Giunti, Sicheng Wen, Peter Quesenberry, Giovanni Camussi
Extra-cellular vesicles (EVs) derived from human bone marrow mesenchymal stromal cells (MSCs) promote the regeneration of kidneys in different animal models of AKI in a manner comparable to the cells of origin. However, due to the heterogeneity observed in the EVs isolated from MSC, it is unclear which population is responsible for the pro-regenerative effects. We therefore evaluated the effect of various EV-populations separated by differential ultracentrifugation (10K population enriched with microvesicles and 100K population enriched with exosomes) on AKI recovery...
May 4, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28470347/fluid-management-in-acute-kidney-injury
#6
REVIEW
Anders Perner, John Prowle, Michael Joannidis, Paul Young, Peter B Hjortrup, Ville Pettilä
Acute kidney injury (AKI) and fluids are closely linked through oliguria, which is a marker of the former and a trigger for administration of the latter. Recent progress in this field has challenged the physiological and clinical rational of using oliguria as a trigger for the administration of fluid and brought attention to the delicate balance between benefits and harms of different aspects of fluid management in critically ill patients, in particular those with AKI. This narrative review addresses various aspects of fluid management in AKI outlining physiological aspects, the effects of crystalloids and colloids on kidney function and the effect of various resuscitation and de-resuscitation strategies on the course and outcome of AKI...
May 3, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28468676/blood-pressure-deficits-in-acute-kidney-injury-not-all-about-the-mean-arterial-pressure
#7
Lui G Forni, Michael Joannidis
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points...
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468613/low-mean-perfusion-pressure-is-a-risk-factor-for-progression-of-acute-kidney-injury-in-critically-ill-patients-a-retrospective-analysis
#8
Marlies Ostermann, Anna Hall, Siobhan Crichton
BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28466146/renal-recovery-after-acute-kidney-injury
#9
L G Forni, M Darmon, M Ostermann, H M Oudemans-van Straaten, V Pettilä, J R Prowle, M Schetz, M Joannidis
Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short- and long-term mortality, chronic kidney disease (CKD) and cardiovascular events. The degree of renal recovery from AKI may substantially affect these long-term endpoints. Therefore maximising recovery of renal function should be the goal of any AKI prevention and treatment strategy. Defining renal recovery is far from straightforward due in part to the limitations of the tests available to assess renal function...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28465114/heart-failure-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy-what-are-the-risk-factors
#10
Yoshitaka Kimura, Takashi Noda, Taka-Aki Matsuyama, Yosuke Otsuka, Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Hideo Okamura, Satoshi Nagase, Takeshi Aiba, Shiro Kamakura, Teruo Noguchi, Toshihisa Anzai, Kazuhiro Satomi, Yuko Wada, Seiko Ohno, Minoru Horie, Wataru Shimizu, Satoshi Yasuda, Hiroaki Shimokawa, Kengo Kusano
BACKGROUND: We previously demonstrated that heart failure (HF) was one of the major causes of death in arrhythmogenic right ventricular cardiomyopathy (ARVC). The purpose of this study was to elucidate the clinical impact and risk factors of HF in patients with ARVC. METHODS AND RESULTS: We evaluated cardiac adverse outcomes including HF in 113 consecutive patients with ARVC (85 men, mean age: 44±15years). During a median follow-up of 10.0years (interquartile range: 5...
April 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28463080/lupus-glomerulonephritis-in-788-chinese-children-a-multi-centre-clinical-and-histopathological-analysis-based-on-549-renal-biopsies
#11
Si-Yan Jin, Dan-Lin Huang, Xi-Qiang Dang, Zhu-Wen Yi
BACKGROUND: System lupus erythematosus (SLE) is a severe multisystem autoimmune disease. OBJECTIVE: To describe the clinical and pathological features, treatment, and renal outcome in children under 18 years with lupus nephritis (LN). METHODS: The study was undertaken by a questionnaire completed in 26 Grade 3A hospitals' paediatric renal units in China. The study comprised 788 children (619 girls, 169 boys) diagnosed with SLE by the American College of Rheumatology criteria (1997) during 2005-2010...
May 2, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28453530/intracellular-signaling-entropy-can-be-a-biomarker-for-predicting-the-development-of-cervical-intraepithelial-neoplasia
#12
Masakazu Sato, Kei Kawana, Katsuyuki Adachi, Asaha Fujimoto, Mitsuyo Yoshida, Hiroe Nakamura, Haruka Nishida, Tomoko Inoue, Ayumi Taguchi, Juri Ogishima, Satoko Eguchi, Aki Yamashita, Kensuke Tomio, Osamu Wada-Hiraike, Katsutoshi Oda, Takeshi Nagamatsu, Yutaka Osuga, Tomoyuki Fujii
While the mortality rates for cervical cancer have been drastically reduced after the introduction of the Pap smear test, it still is one of the leading causes of death in women worldwide. Additionally, studies that appropriately evaluate the risk of developing cervical lesions are needed. Therefore, we investigated whether intracellular signaling entropy, which is measured with microarray data, could be useful for predicting the risks of developing cervical lesions. We used three datasets, GSE63514 (histology), GSE27678 (cytology) and GSE75132 (cytology, a prospective study)...
2017: PloS One
https://www.readbyqxmd.com/read/28441528/phosphorylation-of-neurog3-links-endocrine-differentiation-to-the-cell-cycle-in-pancreatic-progenitors
#13
Nicole A J Krentz, Dennis van Hoof, Zhongmei Li, Akie Watanabe, Mei Tang, Cuilan Nian, Michael S German, Francis C Lynn
During pancreatic development, proliferating pancreatic progenitors activate the proendocrine transcription factor neurogenin 3 (NEUROG3), exit the cell cycle, and differentiate into islet cells. The mechanisms that direct robust NEUROG3 expression within a subset of progenitor cells control the size of the endocrine population. Here we demonstrate that NEUROG3 is phosphorylated within the nucleus on serine 183, which catalyzes its hyperphosphorylation and proteosomal degradation. During progression through the progenitor cell cycle, NEUROG3 phosphorylation is driven by the actions of cyclin-dependent kinases 2 and 4/6 at G1/S cell-cycle checkpoint...
April 24, 2017: Developmental Cell
https://www.readbyqxmd.com/read/28440305/acute-kidney-injury-in-cirrhosis-baseline-serum-creatinine-predicts-patient-outcomes
#14
F Wong, J G O'Leary, K R Reddy, G Garcia-Tsao, M B Fallon, S W Biggins, R M Subramanian, P J Thuluvath, P S Kamath, H Patton, B Maliakkal, P Tandon, H Vargas, L Thacker, J S Bajaj
OBJECTIVES: The International Ascites Club (IAC) recently defined Stage 1 acute kidney injury (AKI) for cirrhosis as an acute increase in serum creatinine (SCr) by ≥0.3 mg/dl or by ≥50% in <48 h from a stable value within 3 months. The baseline SCr may influence AKI risk and patient outcomes. The objective of this study is to determine in cirrhosis whether the baseline SCr has any effect on the in-hospital AKI course and patient survival. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a consortium of tertiary-care hepatology centers prospectively enroling non-elective cirrhotic inpatients...
April 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28439485/treatment-of-atypical-hemolytic-uremic-syndrome-in-the-era-of-eculizumab
#15
Rawaa Ebrahem, Salam Kadhem, Quoc Truong
Hemolytic-uremic syndrome (HUS) is the triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI); the main cause of multi-organ failure is related to thrombotic microangiopathy (TMA). Atypical HUS (aHUS) is a disease of uncontrolled complement activation associated with a high mortality rate and most cases progress to end-stage renal disease. About 50% of patients with this syndrome carry mutations in genes that encode complement proteins. Also, aHUS constitutes an over-activation of the complement pathway which is either inherited, acquired, or both...
March 23, 2017: Curēus
https://www.readbyqxmd.com/read/28416224/post-discharge-kidney-function-is-associated-with-subsequent-ten-year-renal-progression-risk-among-survivors-of-acute-kidney-injury
#16
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black
The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes...
April 14, 2017: Kidney International
https://www.readbyqxmd.com/read/28412129/acute-kidney-injury-after-burn
#17
REVIEW
Audra Clark, Javier A Neyra, Tarik Madni, Jonathan Imran, Herb Phelan, Brett Arnoldo, Steven E Wolf
Acute kidney injury (AKI) is a common and morbid complication after severe burn, with an incidence and mortality as high as 30% and 80%, respectively. AKI is a broad clinical condition with many etiologies, which makes definition and diagnosis challenging. The most recent Kidney Disease: Improving Global Outcomes (KDIGO) consensus guidelines defined stage and severity of AKI based on changes of serum creatinine and urine output (UOP) across time. Burn-related kidney injury is typically classified as early (0-3days after injury) or late (4-14days after injury)...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28411243/potent-vasoconstrictor-kisspeptin-10-induces-atherosclerotic-plaque-progression-and-instability-reversal-by-its-receptor-gpr54-antagonist
#18
Kengo Sato, Remina Shirai, Mina Hontani, Rina Shinooka, Akinori Hasegawa, Tomoki Kichise, Tomoyuki Yamashita, Hayami Yoshizawa, Rena Watanabe, Taka-Aki Matsuyama, Hatsue Ishibashi-Ueda, Shinji Koba, Youichi Kobayashi, Tsutomu Hirano, Takuya Watanabe
BACKGROUND: Kisspeptin-10 (KP-10), a potent vasoconstrictor and inhibitor of angiogenesis, and its receptor, GPR54, have currently received much attention in relation to pre-eclampsia. However, it still remains unknown whether KP-10 could affect atherogenesis. METHODS AND RESULTS: We evaluated the effects of KP-10 on human umbilical vein endothelial cells, human monocyte-derived macrophages, human aortic smooth muscle cells in vitro, and atherosclerotic lesions in apolipoprotein E-deficient (ApoE(-/-)) mice in vivo...
April 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28402560/acute-kidney-injury-electronic-alerts-in-primary-care-findings-from-a-large-population-cohort
#19
Jennifer Holmes, Nicholas Allen, Gethin Roberts, John Geen, John D Williams, Aled O Phillips
Background: Electronic reporting of AKI has been used to aid early AKI recognition although its relevance to CA-AKI and primary care has not been described. Aims: We described the characteristics and clinical outcomes of patients with CA-AKI, and AKI identified in primary care (PC-AKI) through AKI e-Alerts. Design: A prospective national cohort study was undertaken to collect data on all e-alerts representing adult CA-AKI. Method: The study utilised the biochemistry based AKI electronic (e)-alert system that is established across the Welsh National Health Service...
April 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28396940/adjunction-of-a-mek-inhibitor-to-vemurafenib-in-the-treatment-of-metastatic-melanoma-results-in-a-60-reduction-of-acute-kidney-injury
#20
Cécile Teuma, Solenne Pelletier, Mona Amini-Adl, Marie Perier-Muzet, Delphine Maucort-Boulch, Luc Thomas, Maurice Laville, Denis Fouque, Stéphane Dalle
INTRODUCTION: A combined therapy MEK inhibitor, Cobimetinib (CB) and BRAF inhibitor, Vemurafenib (VMF), results in an improvement in progression-free survival among patients with BRAF V600-mutated metastatic melanoma. VMF skin adverse effects attributed to ERK paradoxical activation are decreased by the adjunction of CB. The aim of this study was to determine if this combination also improved the renal side effects of VMF. PATIENTS AND METHODS: To investigate the incidence of acute kidney injury (AKI), we conducted a retrospective observational monocentric study in Lyon Sud University Hospital in France...
May 2017: Cancer Chemotherapy and Pharmacology
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