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https://www.readbyqxmd.com/read/28638567/nephrology-key-information-for-internists
#1
Sohail Abdul Salim, Juan A Medaura, Bharat Malhotra, Vishnu Garla, Shradha Ahuja, Nicki Lawson, Amaleswari Pamarthy, Hardik Sonani, Karthik Kovvuru, Venkataraman Palabindala
Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Other causes of immediate consultation are cresenteric glomerulonephritis / rapidly progressive glomerulonephritis in which renal prognosis of the patient depends on timely intervention...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28616216/warfarin-related-nephropathy-induced-by-three-different-vitamin-k-antagonists-analysis-of-13-biopsy-proven-cases
#2
Léonard Golbin, Cécile Vigneau, Guy Touchard, Eric Thervet, Jean-Michel Halimi, Théophile Sawadogo, Nathan Lagoutte, Pascale Siohan, Elie Zagdoun, Alexandre Hertig, Nathalie Rioux-Leclercq, Thierry Frouget
Background: Acute kidney injury (AKI) with renal tubular obstruction by red blood cell casts (RBCC) has been described in patients treated with warfarin and is known as warfarin-related nephropathy (WRN). Methods: To determine whether other vitamin K antagonists (VKA) cause WRN, we retrospectively collected and analyzed the clinical and histological data of 13 patients treated with different VKA (seven with fluindione, four with warfarin and two with acenocoumarol) in seven French hospitals. Results: They all developed gross hematuria following overanticoagulation complicated by severe AKI (median serum creatinine concentration = 693 μmol/L)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#3
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614822/drug-discovery-to-halt-the-progression-of-acute-kidney-injury-to-chronic-kidney-disease-a-case-for-phenotypic-drug-discovery-in-acute-kidney-injury
#4
Neil Hukriede, Andreas Vogt, Mark de Caestecker
The cellular responses that occur following acute kidney injury (AKI) are complex and dynamic, involving multiple cells types and molecular pathways. For this reason, early selection of defined molecular targets for therapeutic intervention is unlikely to be effective in complex in vivo models of AKI, let alone Phase 3 clinical trials in patients with even more complex AKI pathobiology. Phenotypic screening using zebrafish provides an attractive alternative that does not require prior knowledge of molecular targets and may identify compounds that modify multiple targets that might be missed in more traditional target-based screens...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#5
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28601878/role-of-immune-cells-in-acute-kidney-injury-and-repair
#6
Sul A Lee, Sanjeev Noel, Mohanraj Sadasivam, Abdel R A Hamad, Hamid Rabb
Acute kidney injury (AKI) is a significant problem in both native and transplant kidneys. There have been significant advances in understanding the role of immune cells in the early injury and repair from AKI. In this brief review, we aim to update information on the pathophysiologic impact of various immune cells in AKI, with special emphasis on repair. An improved understanding of the AKI immunopathology will lead to new therapies that prevent AKI, accelerate repair, and prevent the progression of AKI to chronic kidney disease...
June 10, 2017: Nephron
https://www.readbyqxmd.com/read/28596472/dipeptidyl-peptidase-4-inhibitor-use-is-associated-with-a-lower-risk-of-incident-acute-kidney-injury-in-patients-with-diabetes
#7
Chia-Ter Chao, Jui Wang, Hon-Yen Wu, Kuo-Liong Chien, Kuan-Yu Hung
OBJECTIVES: Dipeptidyl peptidase 4 inhibitor (DPP4i) use potentially slows the progression of diabetic kidney disease, but its effects on the risk of acute kidney injury (AKI) are unclear. We aimed to assess the association between DPP4i use and incident AKI episodes from a nationally representative cohort in Taiwan. MATERIALS AND METHODS: All patients newly diagnosed with diabetes mellitus (DM) between 2008, when DPP4i use was first approved in Taiwan, and mid-2013 were enrolled...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28595180/fibrotic-changes-mediating-acute-kidney-injury-to-chronic-kidney-disease-transition
#8
Eoghainín Ó hAinmhire, Benjamin D Humphreys
End-stage renal disease (ESRD) is common, costly, and it results from progressive chronic kidney disease (CKD). ESRD claims many lives every year. It is increasingly recognized that episodes of acute kidney injury (AKI) predispose to the future development of CKD and ESRD. While our understanding of the pathophysiology of the AKI to CKD transition is improving, there are no validated therapeutic strategies to prevent this transition. In this review, we summarize the recent progress made in defining the cellular and molecular events underlying the AKI to CKD transition and highlight potential therapeutic targets and strategies to reduce the incidence of CKD following AKI...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28588162/role-of-prifle-criteria-in-early-diagnosis-of-severity-staging-of-neonatal-aki-and-its-impact-on-management
#9
S Afroz, T Ferdaus, M Hanif, A H Mollah, M Banerjee, T H Khan
Mortality is high among sick neonates who have concomitant acute kidney injury (AKI). This observational study was done at Special Care Baby Unit (SCABU) of Dhaka Medical College Hospital (DMCH), Bangladesh from October 2013 to March 2014 to find out the role of pRIFLE criteria in prediction of severity stages of AKI in neonate and early intervention to see the immediate outcome. A total of 44 neonates with AKI were included, all were treated conservatively and with intermittent peritoneal dialysis (IPD) as needed...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28586398/the-protective-effects-of-zhen-wu-tang-against-cisplatin-induced-acute-kidney-injury-in-rats
#10
Qi Liu, Shouyu Hu, Yi He, Jiashu Zhang, Xiaona Zeng, Fengtao Gong, Li'na Liang
Acute kidney injury (AKI) is a common clinical condition that confers a risk of progression of chronic kidney disease and a high risk of death. The purpose of the current study is to investigate the anti-apoptotic and anti-fibrotic effects of Zhen-Wu-Tang (ZWT) on cisplatin (CIS)-induced renal injury and elucidate the involvement of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), the PI3K/Akt signaling pathway, transforming growth factor (TGF)-β and the Wnt/β-catenin signaling pathway in the positive effects of Zhen-Wu-Tang on the kidneys...
2017: PloS One
https://www.readbyqxmd.com/read/28583827/association-between-proton-pump-inhibitor-use-and-risk-of-progression-of-chronic-kidney-disease
#11
Derk C F Klatte, Alessandro Gasparini, Hong Xu, Pietro de Deco, Marco Trevisan, Anna L V Johansson, Björn Wettermark, Johan Ärnlöv, Cynthia J Janmaat, Bengt Lindholm, Friedo W Dekker, Josef Coresh, Morgan E Grams, Juan J Carrero
BACKGROUND & AIMS: Proton pump inhibitors (PPI) have been associated with acute kidney injury (AKI) and recent studies suggest that they may be associated with the risk of chronic kidney disease (CKD). METHODS: We performed a retrospective analysis using the Stockholm creatinine measurements database, which contains information on diagnoses, dispensation claims, and laboratory test results for all citizens in the Stockholm region from 2007 through 2010. We identified new users of PPIs (n= 105305) and new users of H2 blockers (H2B; n= 9578); data on renal outcomes were collected for a median 2...
June 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28574107/continuous-renal-replacement-therapy-forty-year-anniversary
#12
Claudio Ronco
In 1977 Peter Kramer performed the first CAVH (continuous arteriovenous hemofiltration) treatment in Gottingen, Germany. CAVH soon became a reliable alternative to hemo- or peritoneal dialysis in critically ill patients. The limitations of CAVH spurred new research and the discovery of new treatments such as CVVH and CVVHD (continuous veno-venous hemofiltration and continuous veno-venous hemodialysis). The alliance with industry led to development of new specialized equipment with improved accuracy and performance in delivering continuous renal replacement therapies (CRRTs)...
May 31, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28573142/advances-in-the-diagnosis-and-treatment-of-acute-kidney-injury-in-cirrhosis-patients
#13
REVIEW
Lei Lei, Liangping Li, Hu Zhang
Liver cirrhosis is a common progressive and chronic clinical liver disease. Due to the strong compensation ability of the liver, no obvious symptoms develop in the early stage. However, multiple systems are involved in decompensation of the liver. Acute kidney injury (AKI) is one of the most serious complications, characterized by a sharp drop in the glomerular filtration rate (GFR); a rapid increase in Scr and BUN, as well as sodium and water storage; and a disturbance of acid-base balance. The mortality rate is high, and the prognosis is very poor...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28571139/invasive-mucormycosis-in-a-case-of-aluminium-phosphide-poisoning
#14
Nitin Gupta, Gagandeep Singh, Karan Aggarwal, Alok Thakar, Immaculata Xess
Mucormycosis is a rapidly progressive disease with high mortality reported mostly in immunocompromised individuals. We report a case of Rhino-orbital mucormycosis (Lichtheimia corymbifera) in an immunocompetent individual with history of consumption of Aluminium Phosphide (ALP) tablets. We postulated the following effects of ALP poisoning that would have increased the chances of mucormycosis in this patient: 1) Metabolic acidosis; 2) Acute Kidney Injury (AKI); and 3) Liberation of free oxygen radicals.
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28569136/molecular-differences-in-susceptibility-of-the-kidney-to-sepsis-induced-kidney-injury
#15
Martin Matejovic, Lenka Valesova, Jan Benes, Roman Sykora, Roman Hrstka, Jiri Chvojka
BACKGROUND: Septic acute kidney injury affects 40-50% of all septic patients. Molecular differences between septic patients with and without acute kidney injury (AKI) are only poorly understood. Here, we investigated gene expression changes that differentiated the subjects who developed septic AKI from those who did not and coupled this approach with traditional parameters of renal physiology. METHODS: In 15 anesthetized, mechanically ventilated and instrumented pigs, progressive sepsis was induced either by peritonitis or by continuous intravenous infusion of Pseudomonas aeruginosa...
May 31, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28565850/metabolic-acidosis-as-a-risk-factor-for-the-development-of-acute-kidney-injury-and-hospital-mortality
#16
Jiachang Hu, Yimei Wang, Xuemei Geng, Rongyi Chen, Xialian Xu, Xiaoyan Zhang, Jing Lin, Jie Teng, Xiaoqiang Ding
Metabolic acidosis has been proved to be a risk factor for the progression of chronic kidney disease, but its relation to acute kidney injury (AKI) has not been investigated. In general, a diagnosis of metabolic acidosis is based on arterial blood gas (ABG) analysis, but the diagnostic role of carbon dioxide combining power (CO2CP) in the venous blood may also be valuable to non-respiratory patients. This retrospective study included all adult non-respiratory patients admitted consecutively to our hospital between October 01, 2014 and September 30, 2015...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28562793/nursing-activities-score-and-acute-kidney-injury
#17
Filipe Utuari de Andrade Coelho, Mirian Watanabe, Cassiane Dezoti da Fonseca, Katia Grillo Padilha, Maria de Fátima Fernandes Vattimo
Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28560778/daily-oral-administration-of-low-dose-methotrexate-has-greater-antirheumatic-effects-in-collagen-induced-arthritis-rats
#18
Aoi Koyama, Aki Tanaka, Hideto To
OBJECTIVES: Methotrexate (MTX) is administered once or thrice weekly to patients with rheumatoid arthritis (RA). Even though RA continually progresses, MTX is not administered daily. Therefore, we investigated whether the daily administration of a low dose of MTX inhibits the progression of arthritis in collagen-induced arthritis (CIA) rats. METHODS: Methotrexate was orally administered once weekly, thrice weekly and once daily to CIA rats, and arthritis scores were measured...
May 31, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28551805/mitochondria-damage-and-kidney-disease
#19
Pu Duann, Pei-Hui Lin
The kidney is a vital organ that demands an extraordinary amount of energy to actively maintain the body's metabolism, plasma hemodynamics, electrolytes and water homeostasis, nutrients reabsorption, and hormone secretion. Kidney is only second to the heart in mitochondrial count and oxygen consumption. As such, the health and status of the energy power house, the mitochondria, is pivotal to the health and proper function of the kidney. Mitochondria are heterogeneous and highly dynamic organelles and their functions are subject to complex regulations through modulation of its biogenesis, bioenergetics, dynamics and clearance within cell...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28509129/successful-long-term-effects-of-direct-renin-inhibitor-aliskiren-in-a-patient-with-atherosclerotic-renovascular-hypertension
#20
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
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