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Luis

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266 papers 25 to 100 followers
By Luis Trujillo Nefrologo
https://www.readbyqxmd.com/read/28748117/epidemiology-pathophysiology-and-management-of-uric-acid-urolithiasis-a-narrative-review
#1
REVIEW
A Abou-Elela
An in-depth comprehension of the epidemiology as well as pathophysiology of uric acid urolithiasis is important for the identification, treatment, and prophylaxis of calculi in these patients. Persistently low urinary pH, hyperuricosuria, and low urinary volume are the most important factors in pathogenesis of uric acid urolithiasis. Other various causes of calculus formation comprises of chronic diarrhea, renal hyperuricosuria, insulin resistance, primary gout, extra purine in the diet, neoplastic syndromes, and congenital hyperuricemia...
September 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28905856/position-paper-revised-2017-international-consensus-on-testing-of-ancas-in-granulomatosis-with-polyangiitis-and-microscopic-polyangiitis
#2
REVIEW
Xavier Bossuyt, Jan-Willem Cohen Tervaert, Yoshihiro Arimura, Daniel Blockmans, Luis Felipe Flores-Suárez, Loïc Guillevin, Bernhard Hellmich, David Jayne, J Charles Jennette, Cees G M Kallenberg, Sergey Moiseev, Pavel Novikov, Antonella Radice, Judith Anne Savige, Renato Alberto Sinico, Ulrich Specks, Pieter van Paassen, Ming-Hui Zhao, Niels Rasmussen, Jan Damoiseaux, Elena Csernok
Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications...
September 14, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28842398/anca-glomerulonephritis-and-vasculitis
#3
J Charles Jennette, Patrick H Nachman
ANCA vasculitis has an associated autoimmune response that produces ANCAs that induce distinct pathologic lesions. Pauci-immune necrotizing and crescentic GN is a frequent component of ANCA vasculitis. ANCA vasculitis is associated with ANCA specific for myeloperoxidase (MPO-ANCA) or proteinase 3 (PR3-ANCA). A diagnosis of ANCA vasculitis should always specify the serotype as MPO-ANCA positive, PR3-ANCA positive, or ANCA-negative. To fully characterize a patient, the serotype also should be accompanied by the clinicopathologic variant if this can be determined: microscopic polyangiitis, granulomatosis with polyangiitis (Wegener), eosinophilic granulomatosis with polyangiitis (Churg-Strauss), or renal-limited vasculitis...
August 25, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28776086/the-mechanisms-of-action-of-metformin
#4
REVIEW
Graham Rena, D Grahame Hardie, Ewan R Pearson
Metformin is a widely-used drug that results in clear benefits in relation to glucose metabolism and diabetes-related complications. The mechanisms underlying these benefits are complex and still not fully understood. Physiologically, metformin has been shown to reduce hepatic glucose production, yet not all of its effects can be explained by this mechanism and there is increasing evidence of a key role for the gut. At the molecular level the findings vary depending on the doses of metformin used and duration of treatment, with clear differences between acute and chronic administration...
August 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/28778861/how-dangerous-is-hyperkalemia
#5
John R Montford, Stuart Linas
Hyperkalemia is a potentially life-threatening electrolyte disorder appreciated with greater frequency in patients with renal disease, heart failure, and with use of certain medications such as renin angiotensin aldosterone inhibitors. The traditional views that hyperkalemia can be reliably diagnosed by electrocardiogram and that particular levels of hyperkalemia confer cardiotoxic risk have been challenged by several reports of patients with atypic presentations. Epidemiologic data demonstrate strong associations of morbidity and mortality in patients with hyperkalemia but these associations appear disconnected in certain patient populations and in differing clinical presentations...
August 4, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28704915/treatment-of-diabetic-kidney-disease-current-and-future-targets
#6
REVIEW
Mi-Kyung Kim
Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease in Korea and worldwide, and is a risk factor for the development of cardiovascular complications. The conventional treatments for DKD are control of blood glucose and blood pressure levels by inhibiting the renin-angiotensin system. However, the prevalence of DKD continues to increase and additional therapies are required to prevent or ameliorate the condition. Many drugs have been, or are being, developed to target the molecular mechanisms in play in DKD...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28760336/dietary-magnesium-supplementation-prevents-and-reverses-vascular-and-soft-tissue-calcifications-in-uremic-rats
#7
Juan M Diaz-Tocados, Alan Peralta-Ramirez, María E Rodríguez-Ortiz, Ana I Raya, Ignacio Lopez, Carmen Pineda, Carmen Herencia, Addy Montes de Oca, Noemi Vergara, Sonja Steppan, M Victoria Pendon-Ruiz de Mier, Paula Buendía, Andrés Carmona, Julia Carracedo, Juan F Alcalá-Díaz, Joao Frazao, Julio M Martínez-Moreno, Antonio Canalejo, Arnold Felsenfeld, Mariano Rodriguez, Escolástico Aguilera-Tejero, Yolanda Almadén, Juan R Muñoz-Castañeda
Although magnesium has been shown to prevent vascular calcification in vitro, controlled in vivo studies in uremic animal models are limited. To determine whether dietary magnesium supplementation protects against the development of vascular calcification, 5/6 nephrectomized Wistar rats were fed diets with different magnesium content increasing from 0.1 to 1.1%. In one study we analyzed bone specimens from rats fed 0.1%, 0.3%, and 0.6% magnesium diets, and in another study we evaluated the effect of intraperitoneal magnesium on vascular calcification in 5/6 nephrectomized rats...
July 28, 2017: Kidney International
https://www.readbyqxmd.com/read/28709637/tubulointerstitial-fibrosis-can-sensitize-the-kidney-to-subsequent-glomerular-injury
#8
Beom Jin Lim, Jae Won Yang, Jun Zou, Jianyong Zhong, Taiji Matsusaka, Ira Pastan, Ming-Zhi Zhang, Raymond C Harris, Hai-Chun Yang, Agnes B Fogo
Chronic glomerular injury is associated with eventual development of tubulointerstitial fibrosis. Here we aimed to assess whether, and how, mild chronic tubulointerstitial injury affects glomeruli. For this, we generated mice expressing different toxin receptors, one on their proximal tubular epithelial cells (diphtheria toxin receptor [DTR]) and the other only on podocytes (human CD25 [IL-2R] driven by the nephrin promoter [Nep25]), allowing serial induction of tubule-specific and glomerular (podocyte)-specific injury, respectively...
July 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28578341/association-between-periodontitis-and-low-grade-albuminuria-in-non-diabetic-adults
#9
Seok Hui Kang, Jong Won Park, Kyu Hyang Cho, Jun-Young Do
BACKGROUND/AIMS: The objective of the present study was to evaluate the clinical association between periodontitis and a high urinary albumin/creatinine ratio (UACR) in individuals without diabetes mellitus. METHODS: Data from the Korean National Health and Nutrition Examination Survey were used for this analysis. A high UACR was defined as UACR≥3.9 mg/g for men and UACR≥7.5 mg/g for women. The WHO community periodontal index (CPI) was used to define periodontitis and assess its severity...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#10
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
July 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28614118/the-renal-response-to-potassium-stress-integrating-past-with-present
#11
Cary R Boyd-Shiwarski, Arohan R Subramanya
PURPOSE OF REVIEW: The current review combines past findings with recent advances in our understanding of the homeostatic response to potassium imbalance. RECENT FINDINGS: Following the ingestion of a dietary potassium load, a combination of extrarenal and renal mechanisms act to maintain extracellular K+ within a tight window. Through hormonal regulation and direct K+ sensing, the nephron is ideally suited to respond to wide shifts in external K+ balance. Current evidence indicates that dietary K+ loading triggers a coordinated kaliuretic response that appears to involve voltage-dependent changes in sodium transport across multiple nephron segments, including the proximal tubule, medullary loop of Henle, and distal tubule...
September 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28720208/treatment-of-uremic-pruritus-a-systematic-review
#12
Elizabeth Simonsen, Paul Komenda, Blake Lerner, Nicole Askin, Clara Bohm, James Shaw, Navdeep Tangri, Claudio Rigatto
BACKGROUND: Uremic pruritus is a common and burdensome symptom afflicting patients with advanced chronic kidney disease (CKD) and has been declared a priority for CKD research by patients. The optimal treatments for uremic pruritus are not well defined. STUDY DESIGN: Systematic review. SETTING & POPULATION: Adult patients with advanced CKD (stage ≥ 3) or receiving any form of dialysis. SELECTION CRITERIA FOR STUDIES: PubMed, CINAHL, Embase, International Pharmaceutical Abstracts, Scopus, Cochrane Library, and ClinicalTrials...
July 15, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28676507/length-of-time-on-peritoneal-dialysis-and-encapsulating-peritoneal-sclerosis-position-paper-for-ispd-2017-update
#13
Edwina A Brown, Joanne Bargman, Wim van Biesen, Ming-Yang Chang, Frederic O Finkelstein, Helen Hurst, David W Johnson, Hideki Kawanishi, Mark Lambie, Thyago Proença de Moraes, Johann Morelle, Graham Woodrow
No abstract text is available yet for this article.
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28674042/a-novel-hypokalemic-alkalotic-salt-losing-tubulopathy-in-patients-with-cldn10-mutations
#14
Ernie M H F Bongers, Luke M Shelton, Susanne Milatz, Sjoerd Verkaart, Anneke P Bech, Jeroen Schoots, Elisabeth A M Cornelissen, Markus Bleich, Joost G J Hoenderop, Jack F M Wetzels, Dorien Lugtenberg, Tom Nijenhuis
Mice lacking distal tubular expression of CLDN10, the gene encoding the tight junction protein Claudin-10, show enhanced paracellular magnesium and calcium permeability and reduced sodium permeability in the thick ascending limb (TAL), leading to a urine concentrating defect. However, the function of renal Claudin-10 in humans remains undetermined. We identified and characterized CLDN10 mutations in two patients with a hypokalemic-alkalotic salt-losing nephropathy. The first patient was diagnosed with Bartter syndrome (BS) >30 years ago...
July 3, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27641135/scleroderma-renal-crisis-and-renal-involvement-in-systemic-sclerosis
#15
REVIEW
Thasia G Woodworth, Yossra A Suliman, Daniel E Furst, Philip Clements
Scleroderma renal crisis (SRC) is a rare, potentially life-threatening complication that affects 2-15% of patients with systemic sclerosis (SSc, also known as scleroderma). SRC typically presents in patients with early, rapidly progressive, diffuse cutaneous SSc within the first 3-5 years after the onset of a non-Raynaud sign or symptom. SRC is characterized by an acute, usually symptomatic increase in blood pressure, a rise in serum creatinine levels, oliguria and thrombotic microangiopathy in about 50% of patients...
November 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28151411/immunologic-effects-of-the-renin-angiotensin-system
#16
REVIEW
Steven D Crowley, Nathan P Rudemiller
Inappropriate activation of the renin-angiotensin system (RAS) exacerbates renal and vascular injury. Accordingly, treatment with global RAS antagonists attenuates cardiovascular risk and slows the progression of proteinuric kidney disease. By reducing BP, RAS inhibitors limit secondary immune activation responding to hemodynamic injury in the target organ. However, RAS activation in hematopoietic cells has immunologic effects that diverge from those of RAS stimulation in the kidney and vasculature. In preclinical studies, activating type 1 angiotensin (AT1) receptors in T lymphocytes and myeloid cells blunts the polarization of these cells toward proinflammatory phenotypes, protecting the kidney from hypertensive injury and fibrosis...
May 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28301792/systemic-lupus-erythematosus-an-update
#17
REVIEW
Vera Golder, Alberta Hoi
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease predominantly affecting women of childbearing age. New classification criteria for SLE have greater sensitivity and therefore improve the diagnostic certainty for some patients, especially those who may previously have been labelled as having undifferentiated symptoms. Uncontrolled disease activity leads to irreversible end-organ damage, which in turn increases the risk of premature death; early and sustained control of disease activity can usually be achieved by conventional immunosuppressant therapy...
March 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28599903/metabolic-acidosis-or-respiratory-alkalosis-evaluation-of-a-low-plasma-bicarbonate-using-the-urine-anion-gap
#18
Daniel Batlle, Jamie Chin-Theodorou, Bryan M Tucker
Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history...
September 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#19
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/27814935/diuretic-resistance
#20
REVIEW
Ewout J Hoorn, David H Ellison
Diuretic resistance is defined as a failure to achieve the therapeutically desired reduction in edema despite a full dose of diuretic. The causes of diuretic resistance include poor adherence to drug therapy or dietary sodium restriction, pharmacokinetic issues, and compensatory increases in sodium reabsorption in nephron sites that are not blocked by the diuretic. To illustrate the pathophysiology and management of diuretic resistance, we describe a patient with nephrotic syndrome. This patient presented with generalized pitting edema and weight gain despite the use of oral loop diuretics...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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