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https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#1
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#2
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#3
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27895448/neonatal-acute-kidney-injury-following-valsartan-exposure-in-utero-report-of-two-cases
#4
E Tsepkentzi, K Sarafidis, A Sotiriadis, K Chatzistamatiou, V Drossou-Agakidou
BACKGROUND: Maternal sartan intake during pregnancy has been associated with several fetal/neonatal complications related to disturbed renal development. Description of cases: We present two cases of neonatal acute kidney injury (AKI) following valsartan administration during pregnancy and provide evidence for the use of novel AKI biomarkers in these neonates. The first case was a female neonate, delivered at 32+4 weeks of gestation after maternal valsartan intake from 24 to 32 gestational weeks...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27890858/predictors-and-outcome-of-acute-kidney-injury-after-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#5
Yan-Biao Liao, Xue-Xue Deng, Yang Meng, Zhen-Gang Zhao, Tian-Yuan Xiong, Xiang-Jun Meng, Zhi-Liang Zuo, Yi-Jian Li, Jia-Yu Cao, Yuan-Ning Xu, Mao Chen, Yuan Feng
AIMS: To investigate the predictors and outcome of acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: There were 35 articles recruiting 13,256 patients included in our study. Hypertension (odds ratio [OR], 1.92, 95% CI, 1.44 to 2.56), diabetes mellitus (OR, 1.33, 95% CI, 1.20 to 1.47), peripheral artery disease (OR, 1.28, 95% CI, 1.14 to 1.45), and a left ventricular ejection fraction <40% (OR, 1.50, 95% CI, 1...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27889773/evaluation-of-kim-1-and-ngal-as-early-indicators-for-assessment-of-gentamycin-induced-nephrotoxicity-in-vivo-and-in-vitro
#6
Qi-Hui Luo, Meng-Lu Chen, Zheng-Li Chen, Chao Huang, An-Chun Cheng, Jing Fang, Li Tang, Yi Geng
BACKGROUND/AIMS: The aminolycoside Gentamicin is a widely used antibiotic, applied in equine medicine. Despite its clinical use, concerns remain regarding the potential toxic side-effects, such as nephrotoxicity. Early detection of renal damage is critical in preclinical drug development. This study was aimed to determine whether kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) may be early indicators in the assessment of Gentamycin-induced nephrotoxicity...
November 28, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27882471/fra-1-regulates-the%C3%A2-expression-of-hmga1-%C3%A2-which-is-associated-with-a-poor-prognosis-in-human-esophageal-squamous-cell-carcinoma
#7
Takeshi Toyozumi, Isamu Hoshino, Masahiko Takahashi, Akihiro Usui, Yasunori Akutsu, Naoyuki Hanari, Kentaro Murakami, Masayuki Kano, Naoki Akanuma, Hiroshi Suitoh, Yasunori Matsumoto, Nobuhumi Sekino, Aki Komatsu, Hisahiro Matsubara
BACKGROUND: The expression of Fos-related antigen 1 (Fra-1) affects tumor progression, migration, and invasion. In this study, we identified the genes regulated by Fra-1 in esophageal squamous cell carcinoma (ESCC). METHODS: We constructed Fra-1 knockdown models via the transfection of small interfering RNA (siRNA) into ESCC cell lines (TE10, TE11). The expression levels of the genes in the knockdown models were analyzed using a microarray and a Biobase Upstream Analysis, while the expression levels of the candidate genes in the primary tumors of surgical specimens obtained from ESCC patients were determined using real-time polymerase chain reaction (PCR) and immunohistochemical staining...
November 23, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27881606/mitochondria-protection-after-acute-ischemia-prevents-prolonged-upregulation-of-il-1%C3%AE-and-il-18-and-arrests-ckd
#8
Hazel H Szeto, Shaoyi Liu, Yi Soong, Surya V Seshan, Leona Cohen-Gould, Viacheslav Manichev, Leonard C Feldman, Torgny Gustafsson
The innate immune system has been implicated in both AKI and CKD. Damaged mitochondria release danger molecules, such as reactive oxygen species, DNA, and cardiolipin, which can cause NLRP3 inflammasome activation and upregulation of IL-18 and IL-1β It is not known if mitochondrial damage persists long after ischemia to sustain chronic inflammasome activation. We conducted a 9-month study in Sprague-Dawley rats after 45 minutes of bilateral renal ischemia. We detected glomerular and peritubular capillary rarefaction, macrophage infiltration, and fibrosis at 1 month...
November 23, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27881143/weekly-versus-every-three-weeks-platinum-based-chemoradiation-regimens-for-head-and-neck-cancer
#9
James M Melotek, Benjamin T Cooper, Matthew Koshy, Joshua S Silverman, Michael T Spiotto
BACKGROUND: The majority of chemoradiation (CRT) trials for locally advanced head and neck squamous cell carcinoma (HNSCC) have relied on platinum-based chemotherapy regimens administered every-3-weeks. However, given the increased utilization of weekly platinum regimens, it remains unclear how different chemotherapy schedules compare regarding efficacy and toxicity. METHODS: We retrospectively identified 212 patients with HNSCC who were treated at a single academic medical center with concurrent platinum-based CRT given weekly (N = 68) or every-three-weeks (N = 144)...
November 24, 2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#10
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27857162/rescue-therapy-with-tanshinone-iia-hinders-transition-of-acute-kidney-injury-to-chronic-kidney-disease-via-targeting-gsk3%C3%AE
#11
Chunming Jiang, Wei Zhu, Xiang Yan, Qiuyuan Shao, Biao Xu, Miao Zhang, Rujun Gong
Acute kidney injury (AKI) remains challenging for clinical practice and poses a risk of developing progressive chronic kidney disease (CKD) with no definitive treatment available yet. Tanshinone IIA, an active ingredient of Chinese herbal Salvia miltiorrhiza, has been widely used in Asia for the remarkable organoprotective activities. Its effect on established AKI, however, remains unknown. In mice with folic acid-induced AKI, delayed treatment with Tanshinone IIA, commenced early or late after injury, diminished renal expression of kidney injury markers, reduced apoptosis and improved kidney dysfunction, concomitant with mitigated histologic signs of AKI to CKD transition, including interstitial fibrosis and tubular atrophy, and with an ameliorated inflammatory infiltration in tubulointerstitium and a favored M2-skewed macrophage polarization...
November 18, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27853882/the-protective-effect-of-human-atrial-natriuretic-peptide-on-renal-damage-during-cardiac-surgery
#12
Takahiro Moriyama, Shintaro Hagihara, Toko Shiramomo, Misaki Nagaoka, Shohei Iwakawa, Yuichi Kanmura
PURPOSE: Acute kidney injury (AKI) is one of the critical complications after cardiac surgery. In the kidney, angiotensin II (Ang II) is formed by independent mechanisms, and activity of the intrarenal renin-angiotensin-aldosterone (RAAS) system contributes to the progression of kidney damage. Although atrial natriuretic peptide (ANP) exerts protective effects against renal injury by inhibiting the RAAS, the mechanisms of this effect have not been completely clarified. We investigated how human ANP (hANP) could prevent renal damage induced by cardiopulmonary bypass...
November 16, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27852609/il-17-mediates-neutrophil-infiltration-and-renal-fibrosis-following-recovery-from-ischemia-reperfusion-compensatory-role-of-natural-killer-cells-in-athymic-rats
#13
Purvi Mehrotra, Jason A Collett, Seth McKinney, Jackson Stevens, Carlie M Ivancic, David P Basile
T cells have been implicated in the pathogenesis of AKI as well as its progression to CKD. Previous studies suggest that Th17 cells participates during the AKI to CKD transition and inhibition of T cell activity by mycophenolate mofetil (MMF) or losartan attenuates the development of fibrosis following AKI. We hypothesized that T cell deficient rats may have reduced levels of IL-17 cytokine leading to decreased fibrosis following AKI. Renal I/R was performed on T cell deficient athymic rats (Foxn1rnu-/rnu-) and control euthymic rats (Foxn1rnu-/+) and CKD progression was hastened by unilateral nephrectomy at Day 33 and subsequent exposure to 4...
November 16, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27850952/1316-early-versus-late-onset-oliguric-aki-for-stage-progression-among-icu-patients-after-cardiac-surgery
#14
Junichi Izawa, Tetsuhisa Kitamura, Shigehiko Uchino, Masanori Takinami, Takashi Kawamura, Taku Iwami
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27829991/p53-inhibitor-pifithrin-%C3%AE-prevents-the-renal-tubular-epithelial-cells-against-injury
#15
Yun-Lin Shen, Lei Sun, Yu-Jie Hu, Hua-Jie Liu, Xin-Yu Kuang, Xiao-Ling Niu, Wen-Yan Huang
The injury and repair of renal tubular epithelial cells play an important role in the pathological process of acute kidney injury (AKI). This study aimed to clarify the role of cell cycle change in renal tubular epithelial cell injury and repair in vivo and in vitro. Sprague-Dawley rats received bilateral renal pedicle clamping for 45 min (ischemia) followed by reperfusion. Pifithrin-α, a p53 inhibitor, was administered at 24 h before renal ischemia and 3 and 14 days after reperfusion. Results showed the tubular epithelial cells in M phase increased significantly at 2 h to 72 h after ischemia/reperfusion (I/R), while pifithrin-α decreased them...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27817055/hypoalbuminemia-a-risk-factor-for-acute-kidney-injury-development-and-progression-to-chronic-kidney-disease-in-critically-ill-patients
#16
Min Shao, Shengyu Wang, Praveen Kolumam Parameswaran
PURPOSE: The increased likelihood of poor outcomes in critically ill patients with hypoalbuminemia is well recognized. However, hypoalbuminemia remains poorly defined as an independent predictor of acute kidney injury (AKI) and stage 4 chronic kidney diseases (CKD4). The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for AKI and CKD4 in critically ill patients. DESIGN: A retrospective cohort study. SETTING: General intensive care unit (ICU) at Anhui Provincial Hospital, PR China...
November 5, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27809280/role-of-oxidative-stress-in-drug-induced-kidney-injury
#17
REVIEW
Keiko Hosohata
The kidney plays a primary role in maintaining homeostasis and detoxification of numerous hydrophilic xenobiotics as well as endogenous compounds. Because the kidney is exposed to a larger proportion and higher concentration of drugs and toxins than other organs through the secretion of ionic drugs by tubular organic ion transporters across the luminal membranes of renal tubular epithelial cells, and through the reabsorption of filtered toxins into the lumen of the tubule, these cells are at greater risk for injury...
November 1, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27799486/sphingosine-kinase-2-deficiency-attenuates-kidney-fibrosis-via-ifn-%C3%AE
#18
Amandeep Bajwa, Liping Huang, Elvira Kurmaeva, Hong Ye, Krishna R Dondeti, Piotr Chroscicki, Leah S Foley, Z Ayoade Balogun, Kyle J Alexander, Hojung Park, Kevin R Lynch, Diane L Rosin, Mark D Okusa
Maladaptive repair after AKI may lead to progressive fibrosis and decline in kidney function. Sphingosine 1-phosphate has an important role in kidney injury and pleiotropic effects in fibrosis. We investigated the involvement of sphingosine kinase 1 and 2 (SphK1 and SphK2), which phosphorylate sphingosine to produce sphingosine 1-phosphate, in kidney fibrosis induced by folic acid (FA) or unilateral ischemia-reperfusion injury. Analysis of Masson trichrome staining and fibrotic marker protein and mRNA expression 14 days after AKI revealed that wild-type (WT) and Sphk1(-/-) mice exhibited more kidney fibrosis than Sphk2(-/-) mice...
October 31, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27797897/progression-of-interstitial-fibrosis-during-the-first-year-after-deceased-donor-kidney-transplantation-among-patients-with-and-without-delayed-graft-function
#19
Raymond L Heilman, Maxwell L Smith, Byron H Smith, Ibrahim Qaqish, Hasan Khamash, Andrew L Singer, Bruce Kaplan, Kunam S Reddy
BACKGROUND AND OBJECTIVES: Delayed graft function is a form of AKI resulting from ischemia-reperfusion injury. Our aim was to study the effect of delayed graft function on the progression of interstitial fibrosis after deceased donor kidney transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our study is a retrospective study of all patients transplanted at our center between July of 2003 and September of 2014 using a kidney from a deceased donor. The primary outcome was the progression of interstitial fibrosis on serial protocol biopsies done during the first year post-transplant...
October 24, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#20
Jennifer Holmes, Timothy Rainer, John Geen, Gethin Roberts, Kate May, Nick Wilson, John D Williams, Aled O Phillips
BACKGROUND AND OBJECTIVES: Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community- and hospital-acquired adult AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults...
October 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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