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Luis

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275 papers 25 to 100 followers
By Luis Trujillo Nefrologo
https://www.readbyqxmd.com/read/29102957/stepwise-dose-increase-of-febuxostat-is-comparable-with-colchicine-prophylaxis-for-the-prevention-of-gout-flares-during-the-initial-phase-of-urate-lowering-therapy-results-from-fortune-1-a-prospective-multicentre-randomised-study
#1
Hisashi Yamanaka, Shigenori Tamaki, Yumiko Ide, Hyeteko Kim, Kouichi Inoue, Masayuki Sugimoto, Yuji Hidaka, Atsuo Taniguchi, Shin Fujimori, Tetsuya Yamamoto
OBJECTIVES: To determine whether febuxostat with stepwise dose increase is as useful as colchicine prophylaxis in reducing gout flares during the initial introduction of urate-lowering therapy in patients with gout in comparison with febuxostat with no dose titration. METHODS: In this prospective, multicentre, randomised open-label comparative study, patients were randomised to group A (stepwise dose increase of febuxostat from 10 to 40 mg/day), group B (fixed-dose febuxostat 40 mg/day plus colchicine 0...
November 4, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28748324/alcohol-drinking-patterns-and-risk-of-diabetes-a-cohort-study-of-70-551-men-and-women-from-the-general-danish-population
#2
Charlotte Holst, Ulrik Becker, Marit E Jørgensen, Morten Grønbæk, Janne S Tolstrup
AIMS/HYPOTHESIS: Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population. METHODS: This cohort study was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4...
October 2017: Diabetologia
https://www.readbyqxmd.com/read/28967969/manifestations-of-lupus-in-the-kidney-and-how-to-manage-them
#3
Hannah R Wilson, Liz Lightstone
No abstract text is available yet for this article.
October 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29043071/recent-advances-in-the-management-of-peptic-ulcer-bleeding
#4
REVIEW
Ian Beales
Acute upper gastrointestinal haemorrhage due to peptic ulcer bleeding remains an important cause of emergency presentation and hospital admission. Despite advances in many aspects of management, peptic ulcer bleeding is still associated with significant morbidity, mortality, and healthcare costs. Comprehensive international guidelines have been published, but advances as well as controversies continue to evolve. Important recent advances include the evidence supporting a more restrictive transfusion strategy aiming for a target haemoglobin of 70-90 g/l...
2017: F1000Research
https://www.readbyqxmd.com/read/29050011/urine-ammonium-metabolic-acidosis-and-progression-of-chronic-kidney-disease
#5
Negiin Pourafshar, Shirin Pourafshar, Manoocher Soleimani
The metabolism of a typical Western diet generates 50-100 mEq of acid (H+) per day, which must be excreted in the urine for the systemic acid-base to remain in balance. The 2 major mechanisms that are responsible for the renal elimination of daily acid under normal conditions are ammonium (NH4+) excretion and titratable acidity. In the presence of systemic acidosis, ammonium excretion is intensified and becomes the crucial mechanism for the elimination of acid. The impairment in NH4+ excretion is therefore associated with reduced acid excretion, which causes excess accumulation of acid in the body and consequently results in metabolic acidosis...
October 19, 2017: Nephron
https://www.readbyqxmd.com/read/29068795/the-role-of-renal-response-to-amino-acid-infusion-and-oral-protein-load-in-normal-kidneys-and-kidney-with-acute-and-chronic-disease
#6
Francis B Gabbai
PURPOSE OF REVIEW: High protein intake and hyperfiltration have been a focus of major interest as potential mechanism(s) of progression of renal disease. This review will examine: the renal response to a protein meal or amino acid infusion and its use to test the renal functional reserve (RFR); new methods to evaluate RFR; the use of RFR in various pathophysiologic conditions. RECENT FINDINGS: The renal response to protein/amino acid infusion involves several mechanisms, including nitric oxide, insulin, glucagon, arginine vasopressin, urea, the renal N-Methyl-D-Aspartate Glutamate receptor and modulation of the activity of the tubuloglomerular feedback system...
October 23, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29020354/the-definition-of-the-brugada-syndrome
#7
Juan Sieira, Pedro Brugada
Brugada syndrome (BS) is an inherited disease characterized by a coved-type ST-segment elevation in the right precordial leads and increased risk of sudden cardiac death (SCD), in the absence of structural abnormalities. The cornerstone of BS diagnosis and definition, is its characteristic ECG pattern that can be present spontaneously or unmasked by drugs. Brugada syndrome was first described 25 years ago; paradoxically, in an era of great technological development, a new syndrome was described with a technology developed almost a century before...
October 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#8
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28938954/blood-pressure-targets-for-hemodialysis-patients
#9
REVIEW
Jeffrey M Turner, Aldo J Peixoto
The association between blood pressure (BP) and mortality is unique in hemodialysis patients compared with that in the general population. This is because of an altered benefit-risk balance associated with BP reduction in these patients. An adequately designed study comparing BP targets in hemodialysis patients remains to be conducted. The current evidence available to guide dialysis providers regarding treatment strategies for managing hypertension in this population is limited to large observational studies and small randomized controlled trials...
October 2017: Kidney International
https://www.readbyqxmd.com/read/28748117/epidemiology-pathophysiology-and-management-of-uric-acid-urolithiasis-a-narrative-review
#10
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
#11
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...
November 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28842398/anca-glomerulonephritis-and-vasculitis
#12
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...
October 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28776086/the-mechanisms-of-action-of-metformin
#13
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
#14
REVIEW
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...
November 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28704915/treatment-of-diabetic-kidney-disease-current-and-future-targets
#15
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%C3%A2-and%C3%A2-reverses-vascular-and-soft-tissue%C3%A2-calcifications-in-uremic-rats
#16
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...
November 2017: Kidney International
https://www.readbyqxmd.com/read/28709637/tubulointerstitial-fibrosis-can-sensitize-the-kidney-to-subsequent-glomerular-injury
#17
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
#18
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
#19
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
#20
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
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