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Luis

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194 papers 25 to 100 followers
By Luis Trujillo Nefrologo
https://www.readbyqxmd.com/read/27621641/rituximab-use-in-adult-primary-glomerulopathy-where-is-the-evidence
#1
REVIEW
Samir G Mallat, Houssam S Itani, Rana M Abou-Mrad, Rima Abou Arkoub, Bassem Y Tanios
Rituximab is a chimeric anti-CD20 antibody that results in depletion of B-cell lymphocytes. It is currently used in the treatment of a variety of autoimmune diseases, in addition to CD20-positive lymphomas. The use of rituximab in the treatment of the adult primary glomerular diseases has emerged recently, although not yet established as first-line therapy in international guidelines. In patients with steroid-dependent minimal change disease or frequently relapsing disease, and in patients with idiopathic membranous nephropathy (IMN), several retrospective and prospective studies support the use of rituximab to induce remission, whereas in idiopathic focal and segmental glomerulosclerosis (FSGS), the use of rituximab has resulted in variable results...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28159829/iga-nephropathy
#2
Jennifer C Rodrigues, Mark Haas, Heather N Reich
IgA nephropathy (IgAN) is a leading cause of CKD and renal failure. Recent international collaborative efforts have led to important discoveries that have improved our understanding of some of the key steps involved in the immunopathogenesis of IgAN. Furthermore, establishment of multicenter networks has contributed to rigorous design and execution of clinical trials that have provided important insights regarding immunotherapy in IgAN. In this article, we review emerging developments in clinical and translational IgAN research and describe how these novel findings will influence future strategies to improve the outcome of patients with IgAN...
February 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28050897/fluid-resuscitation-in-human-sepsis-time-to-rewrite-history
#3
REVIEW
Liam Byrne, Frank Van Haren
Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity with its use in the resuscitation of other forms of shock, as well as on an incomplete and incorrect understanding of the pathophysiology of sepsis. Recently, the safety of intravenous fluids in patients with sepsis has been called into question with both prospective and observational data suggesting improved outcomes with less fluid or no fluid...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/27522622/lactic-acidosis-an-update
#4
Jansen Seheult, Gerard Fitzpatrick, Gerard Boran
Lactate is one of the most crucial intermediates in carbohydrate and nonessential amino acid metabolism. The complexity of cellular interactions and metabolism means that lactate can be considered a waste product for one cell but a useful substrate for another. The presence of elevated lactate levels in critically ill patients has important implications for morbidity and mortality. In this review, we provide a brief outline of the metabolism of lactate, the pathophysiology of lactic acidosis, the clinical significance of D-lactate, the role of lactate measurement in acutely ill patients, the methods used to measure lactate in blood or plasma and some of the methodological issues related to interferences in these assays, especially in the case of ethylene glycol poisoning...
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28008953/glycosuria-and-renal-outcomes-in-patients-with-nondiabetic-advanced-chronic-kidney-disease
#5
Chi-Chih Hung, Hugo You-Hsien Lin, Jia-Jung Lee, Lee Moay Lim, Yi-Wen Chiu, Heng-Pin Chiang, Shang-Jyh Hwang, Hung-Chun Chen
Sodium glucose cotransporter 2 inhibitors have shown a potential for renoprotection beyond blood glucose lowering. Glycosuria in nondiabetic patients with chronic kidney disease (CKD) is sometimes noted. Whether glycosuria in CKD implies a channelopathy or proximal tubulopathy is not known. The consequence of glycosuria in CKD is also not studied. We performed a cross-sectional study for the association between glycosuria and urine electrolyte excretion in 208 nondiabetic patients. Fractional excretion (FE) of glucose >4% was 3...
December 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/28115864/continuous-ambulatory-peritoneal-dialysis-perspectives-on-patient-selection-in-low-to-middle-income-countries
#6
REVIEW
Nicola Wearne, Kajiru Kilonzo, Emmanuel Effa, Bianca Davidson, Peter Nourse, Udeme Ekrikpo, Ikechi G Okpechi
Chronic kidney disease is a major public health problem that continues to show an unrelenting global increase in prevalence. The prevalence of chronic kidney disease has been predicted to grow the fastest in low- to middle-income countries (LMICs). There is evidence that people living in LMICs have the highest need for renal replacement therapy (RRT) despite the lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, much infrastructure, or need for dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27273494/adverse-effects-of-proton-pump-inhibitors-in-chronic-kidney-disease
#7
Roberto Lozano
No abstract text is available yet for this article.
June 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28114140/peritoneal-dialysis-treatment-modality-option-in-acute-kidney-injury
#8
Daniela Ponce, Mariele Gobo-Oliveira, Andre Luís Balbi
BACKGROUND: Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMMARY: The interest in PD to manage AKI patients has been increased and PD is now frequently used in developing countries because of its lower cost and minimal infrastructural requirements...
January 24, 2017: Blood Purification
https://www.readbyqxmd.com/read/27932336/heat-stress-hydration-and-uric-acid-a-cross-sectional-study-in-workers-of-three-occupations-in-a-hotspot-of-mesoamerican-nephropathy-in-nicaragua
#9
Catharina Wesseling, Aurora Aragón, Marvin González, Ilana Weiss, Jason Glaser, Christopher J Rivard, Carlos Roncal-Jiménez, Ricardo Correa-Rotter, Richard J Johnson
OBJECTIVES: To study Mesoamerican nephropathy (MeN) and its risk factors in three hot occupations. DESIGN: Cross-sectional. SETTING: Chinandega and León municipalities, a MeN hotspot on the Nicaraguan Pacific coast, January-February 2013. PARTICIPANTS: 194 male workers aged 17-39 years: 86 sugarcane cutters, 56 construction workers, 52 small-scale farmers. OUTCOME MEASURES: (1) Differences between the three occupational groups in prevalences/levels of socioeconomic, occupational, lifestyle and health risk factors for chronic kidney disease (CKD) and in biomarkers of kidney function and hydration; (2) differences in prevalences/levels of CKD risk factors between workers with reduced estimated glomerular filtration rate (eGFRCKD-EPI <80 mL/min/1...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/28032484/treatment-of-methicillin-resistant-staphylococcus-aureus-bacteremia
#10
REVIEW
Eun Ju Choo, Henry F Chambers
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.
December 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#11
Steven Guest, John K Leypoldt, Michelle E Cassin, Martin J Schreiber
♦ Background: Incremental peritoneal dialysis (PD), the gradual introduction of dialysate exchanges at less than full-dose therapy, has been infrequently described in clinical reports. One concern with less than full-dose dialysis is whether urea clearance targets are achievable with an incremental regimen. In this report, we used a large database of PD patients, across all membrane transport types, and performed urea kinetic modeling determinations of possible incremental regimens for an individual membrane type...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28065518/membranous-nephropathy-integrating-basic-science-into-improved-clinical-management
#12
REVIEW
Daniel C Cattran, Paul E Brenchley
Idiopathic membranous nephropathy (INM) remains a common cause of the nephrotic syndrome in adults. The autoimmune nature of IMN was clearly delineated in 2009 with the identification of the glomerular-deposited IgG to be a podocyte receptor, phospholipase A2 receptor (PLA2R) in 70% to 75% of cases. This anti-PLA2R autoantibody, predominantly the IgG4 subclass, has been quantitated in serum using an enzyme-linked immunosorbent assay and has been used to aid diagnosis and monitor response to immunosuppressive therapy...
January 5, 2017: Kidney International
https://www.readbyqxmd.com/read/27729952/cirrhosis-and-autoimmune-liver-disease-current-understanding
#13
REVIEW
Rodrigo Liberal, Charlotte R Grant
Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues...
October 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#14
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27887750/chronic-kidney-disease
#15
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
November 22, 2016: Lancet
https://www.readbyqxmd.com/read/27853353/update-on-sepsis-associated-acute-kidney-injury-emerging-targeted-therapies
#16
REVIEW
James F Doyle, Lui G Forni
Sepsis-associated acute kidney injury (SA-AKI) is an independent predictor of increased mortality and morbidity. It is essential that further advances in the treatment of sepsis should prioritize targeted therapies in SA-AKI in order to improve these bleak outcomes. As yet, a unique therapy that effectively reduces the impact of acute kidney injury has not been demonstrated. However, the emergence of novel targeted therapies, perhaps in combination, has the possibility of significantly reducing the long-term sequelae of an episode of SA-AKI...
2016: Biologics: Targets & Therapy
https://www.readbyqxmd.com/read/27657183/prevalence-of-chronic-kidney-disease-of-non-traditional-causes-in-patients-on-hemodialysis-in-southwest-guatemala
#17
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
https://www.readbyqxmd.com/read/27733943/updates-in-anca-associated-vasculitis
#18
REVIEW
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: European Journal of Rheumatology
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#19
REVIEW
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
https://www.readbyqxmd.com/read/27663039/low-osmolar-diet-and-adjusted-water-intake-for-vasopressin-reduction-in-autosomal-dominant-polycystic-kidney-disease-a%C3%A2-pilot-randomized-controlled-trial
#20
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...
December 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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2016-10-17 20:46:05
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