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By Luis Trujillo Nefrologo
Timothy S Laux, Joaquin Barnoya, Ever Cipriano, Erick Herrera, Noemi Lopez, Vicente Sanchez Polo, Marcos Rothstein
Objective To document the prevalence of patients on hemodialysis in southwestern Guatemala who have chronic kidney disease (CKD) of non-traditional causes (CKDnt). Methods This cross-sectional descriptive study interviewed patients on hemodialysis at the Instituto Guatemalteco de Seguridad Social on their health and occupational history. Laboratory serum, urine and vital sign data at the initiation of hemodialysis were obtained from chart reviews. Patients were classified according to whether they had hypertension or obesity or neither...
April 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Christian Pagnoux
Antineutrophil cytoplasm antibody (ANCA)-associated vasculitides are small-vessel vasculitides that include granulomatosis with polyangiitis (formerly Wegener's granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome). Renal-limited ANCA-associated vasculitides can be considered the fourth entity. Despite their rarity and still unknown cause(s), research pertaining to ANCA-associated vasculitides has been very active over the past decades. The pathogenic role of antimyeloperoxidase ANCA (MPO-ANCA) has been supported using several animal models, but that of antiproteinase 3 ANCA (PR3-ANCA) has not been as strongly demonstrated...
September 2016: Eur J Rheumatol
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
Osama W Amro, Jessica K Paulus, Farzad Noubary, Ronald D Perrone
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) affects millions of people worldwide. Vasopressin promotes disease progression. STUDY DESIGN: A randomized controlled trial with equal (1:1) allocation. SETTING & PARTICIPANTS: This trial examined the effect of combining a low-osmolar (low-sodium [1,500mg/d], low-protein [0.8g per kilogram of body weight]) diet and adjusted water intake on vasopressin secretion in 34 patients with ADPKD...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Erin Frazee, Kianoush Kashani
BACKGROUND: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients...
June 2016: Kidney Diseases
Lyanne M Kieneker, Stephan J L Bakker, Rudolf A de Boer, Gerjan J Navis, Ron T Gansevoort, Michel M Joosten
It is unclear whether sodium and potassium intake is relevant to the development of chronic kidney disease (CKD) in the general population. Our aim was to examine the associations of urinary sodium (UNaV) and potassium excretion (UKV), as estimates of intake, with risk of developing CKD in a population-based cohort. We studied 5315 individuals free of CKD at baseline of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study, a prospective, population-based cohort of Dutch men and women aged 28 to 75 years...
October 2016: Kidney International
A A Khan, D A Hanley, R Rizzoli, J Bollerslev, J E M Young, L Rejnmark, R Thakker, P D'Amour, T Paul, S Van Uum, M Zakaria Shrayyef, D Goltzman, S Kaiser, N E Cusano, R Bouillon, L Mosekilde, A W Kung, S D Rao, S K Bhadada, B L Clarke, J Liu, Q Duh, E Michael Lewiecki, F Bandeira, R Eastell, C Marcocci, S J Silverberg, R Udelsman, K Shawn Davison, J T Potts, M L Brandi, J P Bilezikian
The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH)...
September 9, 2016: Osteoporosis International
Rolando Claure-Del Granado, Ravindra L Mehta
BACKGROUND: Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. DISCUSSION: In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential...
August 2, 2016: BMC Nephrology
Cristiana Rollino
No abstract text is available yet for this article.
August 2016: Journal of Nephrology
Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian, Sumitra Balasubramanian, Ziyad Al-Aly
The association between proton pump inhibitors (PPI) use and risk of acute interstitial nephritis has been described. However, whether exposure to PPI associates with incident CKD, CKD progression, or ESRD is not known. We used Department of Veterans Affairs national databases to build a primary cohort of new users of PPI (n=173,321) and new users of histamine H2-receptor antagonists (H2 blockers; n=20,270) and followed these patients over 5 years to ascertain renal outcomes. In adjusted Cox survival models, the PPI group, compared with the H2 blockers group, had an increased risk of incident eGFR<60 ml/min per 1...
October 2016: Journal of the American Society of Nephrology: JASN
Philip Kam-Tao Li, Cheuk Chun Szeto, Beth Piraino, Javier de Arteaga, Stanley Fan, Ana E Figueiredo, Douglas N Fish, Eric Goffin, Yong-Lim Kim, William Salzer, Dirk G Struijk, Isaac Teitelbaum, David W Johnson
No abstract text is available yet for this article.
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis...
2016: Journal of Intensive Care
Abhijeet Pal, Frederick Kaskel
The recognition, evaluation, and early treatment of nephrotic syndrome in infants and children originate from physicians dating back to Hippocrates. It took nearly another 1000 years before the condition was described for its massive edema requiring treatment with herbs and other remedies. A rich history of observations and interpretations followed over the course of centuries until the recognition of the combination of clinical findings of foamy urine and swelling of the body, and measurements of urinary protein and blood analyses showed the phenotypic characteristics of the syndrome that were eventually linked to the early anatomic descriptions from first kidney autopsies and then renal biopsy analyses...
2016: Frontiers in Pediatrics
Katsuhiko Iwakiri, Yoshikazu Kinoshita, Yasuki Habu, Tadayuki Oshima, Noriaki Manabe, Yasuhiro Fujiwara, Akihito Nagahara, Osamu Kawamura, Ryuichi Iwakiri, Soji Ozawa, Kiyoshi Ashida, Shuichi Ohara, Hideyuki Kashiwagi, Kyoichi Adachi, Kazuhide Higuchi, Hiroto Miwa, Kazuma Fujimoto, Motoyasu Kusano, Yoshio Hoshihara, Tatsuyuki Kawano, Ken Haruma, Michio Hongo, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015...
August 2016: Journal of Gastroenterology
Meng Yang, Ling Zhang, Linping Huang, Xiaoliang Sun, Haoyang Ji, Yao Lu
BACKGROUND: Severe hypocalcemia is the most dangerous complication occurring after total parathyroidectomy without autotransplantation (TPTX) for secondary hyperparathyroidism (SHPT). We aim to identify the prevalence and potential risk factors of very severe hypocalcemia in patients with SHPT undergoing TPTX. METHODS: From April 2012 to August 2015, 157 patients with SHPT undergoing TPTX were reviewed. The critical value of hypocalcemia (CVH) was postoperative serum Ca(2+) levels of ≤1...
September 2016: Renal Failure
Usama Abdel Azim Sharaf El Din, Mona Mansour Salem, Dina Ossama Abdulazim
Progression of chronic kidney disease (CKD) is inevitable. However, the last decade has witnessed tremendous achievements in this field. Today we are optimistic; the dream of withholding this progression is about to be realistic. The recent discoveries in the field of CKD management involved most of the individual diseases leading the patients to end-stage renal disease. Most of these advances involved patients suffering diabetic kidney disease, chronic glomerulonephritis, polycystic kidney disease, renal amyloidosis and chronic tubulointerstitial disease...
May 6, 2016: World Journal of Nephrology
Jeffrey A Kraut, Nicolaos E Madias
Mortality rates associated with severe lactic acidosis (blood pH<7.2) due to sepsis or low-flow states are high. Eliminating the triggering conditions remains the most effective therapy. Although recommended by some, administration of sodium bicarbonate does not improve cardiovascular function or reduce mortality. This failure has been attributed to both reduction in serum calcium concentration and generation of excess carbon dioxide with intracellular acidification. In animal studies, hyperventilation and infusion of calcium during sodium bicarbonate administration improves cardiovascular function, suggesting that this approach could allow expression of the positive aspects of sodium bicarbonate...
September 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Matthieu Legrand, Can Ince
Acute kidney injury (AKI) has been associated with an increased risk of death and morbidity in many clinical scenarios. The prevention and treatment of AKI therefore has been advocated as a high-priority research focus. However, nearly all strategies tested in this setting have failed to prevent or cure AKI and fluid loading remains a cornerstone of preventive and curative treatment of AKI. Concerns have been raised, however, regarding both the efficacy and safety of fluid loading to prevent or reverse AKI...
January 2016: Seminars in Nephrology
Susan M Blankschaen, Sharmeela Saha, Jay B Wish
No abstract text is available yet for this article.
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Shinichi Nishi, Yoshifumi Ubara, Yasunori Utsunomiya, Koichi Okada, Yoko Obata, Hiroyasu Kai, Hideyasu Kiyomoto, Shin Goto, Tsuneo Konta, Yoshie Sasatomi, Yoshinobu Sato, Tomoya Nishino, Kazuhiko Tsuruya, Kengo Furuichi, Junichi Hoshino, Yasuhiro Watanabe, Kenjiro Kimura, Seiichi Matsuo
No abstract text is available yet for this article.
June 2016: Clinical and Experimental Nephrology
2016-06-01 14:40:51
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