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Nefrología

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83 papers 0 to 25 followers
https://www.readbyqxmd.com/read/29091561/nutritional-management-of-chronic-kidney-disease
#1
REVIEW
Kamyar Kalantar-Zadeh, Denis Fouque
New England Journal of Medicine, Volume 377, Issue 18, Page 1765-1776, November 2017.
November 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28645705/acid-load-and-phosphorus-homeostasis-in-ckd
#2
Pascale Khairallah, Tamara Isakova, John Asplin, Lee Hamm, Mirela Dobre, Mahboob Rahman, Kumar Sharma, Mary Leonard, Edgar Miller, Bernard Jaar, Carolyn Brecklin, Wei Yang, Xue Wang, Harold Feldman, Myles Wolf, Julia J Scialla
BACKGROUND: The kidneys maintain acid-base homeostasis through excretion of acid as either ammonium or as titratable acids that primarily use phosphate as a buffer. In chronic kidney disease (CKD), ammoniagenesis is impaired, promoting metabolic acidosis. Metabolic acidosis stimulates phosphaturic hormones, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF-23) in vitro, possibly to increase urine titratable acid buffers, but this has not been confirmed in humans. We hypothesized that higher acid load and acidosis would associate with altered phosphorus homeostasis, including higher urinary phosphorus excretion and serum PTH and FGF-23...
October 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26831434/epidemiology-and-mechanisms-of-uremia-related-cardiovascular-disease
#3
REVIEW
Marcello Tonelli, S Ananth Karumanchi, Ravi Thadhani
Patients with chronic kidney disease and end-stage renal disease are at 5- to 10-fold higher risk for developing cardiovascular disease (CVD) than age-matched controls. Clinically, CVD in this population manifests as coronary artery disease, arrhythmias, stroke, or congestive heart failure. Beyond the traditional risk factors (eg, diabetes mellitus and hypertension), uremia-specific factors that arise from accumulating toxins also contribute to the pathogenesis of CVD. In this review, we summarize the literature on the epidemiology of both traditional and uremia-related CVD and focus on postulated mechanisms of the latter...
February 2, 2016: Circulation
https://www.readbyqxmd.com/read/28984663/practical-management-of-concomitant-acute-heart-failure-and-worsening-renal-function-in-the-emergency-department
#4
João Pedro Ferreira, Tahar Chouihed, Pierre Naseyrollas, Bruno Levy, Marie F Seronde, Pascal Bilbault, François Braun, Gérald Roul, David Kénizou, Noura Zannad, Nicolas Girerd, Patrick Rossignol
Worsening renal function (i.e. any increase in creatinine or decrease in the estimated glomerular filtration rate) is common in patients admitted for acute heart failure in the emergency department. Although worsening renal function (WRF) has been associated with the occurrence of dismal outcomes, this only appears to be the case when associated with clinical deterioration. However, if the clinical status of the patient is improving, a certain increase in serum creatinine may be acceptable. This WRF, which is not associated with clinical deterioration or adverse outcomes (e...
October 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/24463187/a-critical-appraisal-of-intravenous-fluids-from-the-physiological-basis-to-clinical-evidence
#5
REVIEW
David Severs, Ewout J Hoorn, Maarten B Rookmaaker
Fluid management has been a vital part of routine clinical care for more than 180 years. The increasing number of available fluids has generated controversy about the optimal choice of resuscitation fluid. In this review, we provide a critical overview of the different fluids available, their composition, the relevant physiology as well as the published evidence on clinical outcomes to guide their use. Commonly used infusion fluids include semisynthetic colloids and crystalloids; the latter comprises both normal saline (NaCl 0...
February 2015: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/26178649/pathophysiology-and-clinical-presentations-of-salt-losing-tubulopathies
#6
REVIEW
Hannsjörg W Seyberth
At least three renal tubular segments are involved in the pathophysiology of salt-losing tubulopathies (SLTs). Whether the pathogenesis starts either in the thick ascending limb of the loop of Henle (TAL) or in the distal convoluted tubule (DCT), it is the function of the downstream-localized aldosterone sensitive distal tubule (ASDT) to contribute to the adaptation process. In isolated TAL defects (loop disorders) ASDT adaptation is supported by upregulation of DCT, whereas in DCT disorders the ASDT is complemented by upregulation of TAL function...
March 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/25287933/renal-control-of-calcium-phosphate-and-magnesium-homeostasis
#7
REVIEW
Judith Blaine, Michel Chonchol, Moshe Levi
Calcium, phosphate, and magnesium are multivalent cations that are important for many biologic and cellular functions. The kidneys play a central role in the homeostasis of these ions. Gastrointestinal absorption is balanced by renal excretion. When body stores of these ions decline significantly, gastrointestinal absorption, bone resorption, and renal tubular reabsorption increase to normalize their levels. Renal regulation of these ions occurs through glomerular filtration and tubular reabsorption and/or secretion and is therefore an important determinant of plasma ion concentration...
July 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/25864370/magnesium-and-dialysis-the-neglected-cation
#8
REVIEW
Mohamad Alhosaini, David J Leehey
Disorders of magnesium homeostasis are very common in dialysis patients but have received scant attention. In this review, we address measurement of plasma magnesium, magnesium balance and the factors that affect magnesium flux during dialysis, the prevalence of hypo- and hypermagnesemia in dialysis patients, and the potential clinical significance of hypo- and hypermagnesemia in dialysis patients. Many factors can affect plasma magnesium concentration, including diet, nutritional status (including plasma albumin level), medications (such as proton pump inhibitors), and dialysis prescription...
September 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26280171/the-emerging-role-of-the-endocannabinoid-system-in-the-pathogenesis-and-treatment-of-kidney-diseases
#9
REVIEW
Joseph Tam
Endocannabinoids (eCBs) are endogenous lipid ligands that bind to cannabinoid receptors that also mediate the effects of marijuana. The eCB system is comprised of eCBs, anandamide, and 2-arachidonoyl glycerol, their cannabinoid-1 and cannabinoid-2 receptors (CB1 and CB2, respectively), and the enzymes involved in their biosynthesis and degradation. It is present in both the central nervous system and peripheral organs including the kidney. The current review focuses on the role of the eCB system in normal kidney function and various diseases, such as diabetes and obesity, that directly contributes to the development of renal pathologies...
May 1, 2016: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#10
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/23953801/extracellular-potassium-homeostasis-insights-from-hypokalemic-periodic-paralysis
#11
REVIEW
Chih-Jen Cheng, Elizabeth Kuo, Chou-Long Huang
Extracellular potassium makes up only about 2% of the total body's potassium store. The majority of the body potassium is distributed in the intracellular space, of which about 80% is in skeletal muscle. Movement of potassium in and out of skeletal muscle thus plays a pivotal role in extracellular potassium homeostasis. The exchange of potassium between the extracellular space and skeletal muscle is mediated by specific membrane transporters. These include potassium uptake by Na(+), K(+)-adenosine triphosphatase and release by inward-rectifier K(+) channels...
May 2013: Seminars in Nephrology
https://www.readbyqxmd.com/read/28778861/how-dangerous-is-hyperkalemia
#12
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/28817466/mitochondrial-dna-in-acute-kidney-injury-chicken-or-egg
#13
Lukas Martin, Christoph Thiemermann
No abstract text is available yet for this article.
August 16, 2017: Shock
https://www.readbyqxmd.com/read/28778860/pharmacologic-approaches-to-improve-mitochondrial-function-in-aki-and-ckd
#14
REVIEW
Hazel H Szeto
AKI is associated with high morbidity and mortality, and it predisposes to the development and progression of CKD. Novel strategies that minimize AKI and halt the progression of CKD are urgently needed. Normal kidney function involves numerous different cell types, such as tubular epithelial cells, endothelial cells, and podocytes, working in concert. This delicate balance involves many energy-intensive processes. Fatty acids are the preferred energy substrates for the kidney, and defects in fatty acid oxidation and mitochondrial dysfunction are universally involved in diverse causes of AKI and CKD...
October 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28799970/reducing-mortality-in-acute-kidney-injury
#15
Mohamud Egal, Hilde R H de Geus
No abstract text is available yet for this article.
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28801723/a-review-of-the-role-of-immune-cells-in-acute-kidney-injury
#16
REVIEW
Anthony Bonavia, Kai Singbartl
Acute kidney injury (AKI) is a systemic disease occurring commonly in patients who are critically ill. Etiologies of AKI can be septic or aseptic (nephrotoxic, or ischemia-reperfusion injury). Recent evidence reveals that innate and adaptive immune responses are involved in mediating damage to renal tubular cells and in recovery from AKI. Dendritic cells, monocytes/macrophages, neutrophils, T lymphocytes, and B lymphocytes all contribute to kidney injury. Conversely, M2 macrophages and regulatory T cells are essential in suppressing inflammation, tissue remodeling and repair following kidney injury...
August 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28801674/a-new-scoring-model-for-the-prediction-of-mortality-in-patients-with-acute-kidney-injury
#17
Min Luo, Yuan Yang, Jun Xu, Wei Cheng, Xu-Wei Li, Mi-Mi Tang, Hong Liu, Fu-You Liu, Shao-Bin Duan
Currently, little information is available to stratify the risks and predict acute kidney injury (AKI)-associated death. In this present cross-sectional study, a novel scoring model was established to predict the probability of death within 90 days in patients with AKI diagnosis. For establishment of predictive scoring model, clinical data of 1169 hospitalized patients with AKI were retrospectively collected, and 731 patients of them as the first group were analyzed by the method of multivariate logistic regression analysis to create a scoring model and further predict patient death...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28808364/the-effect-of-furosemide-on-the-level-of-neutrophil-gelatinase-associated-lipocalin-in-critically-hospitalized-patients-with-acute-kidney-injury
#18
Hadi Hamishehkar, Sarvin Sanaie, Vahid Fattahi, Mehran Mesgari, Ata Mahmoodpoor
BACKGROUND AND AIMS: Oliguric acute kidney injury (AKI), commonly attributed to a more severe degree of renal injury, is associated with poorer prognosis than nonoliguric form. The aim of this study was to determine the effect of furosemide therapy on kidney function and on the level of neutrophil gelatinase-associated lipocalin (NGAL) in critically hospitalized patients in the Intensive Care Unit (ICU). MATERIALS AND METHODS: In this randomized controlled trial, 106 ICU patients with AKI were assigned into furosemide and control groups...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28747360/cannabinoids-and-the-kidney-effects-in-health-and-disease
#19
Frank Park, Praveen K Potukuchi, Hamid Moradi, Csaba P Kovesdy
Consumption of cannabis and various related products (cannabinoids) for both medicinal and recreational use is gaining popularity. Furthermore, regulatory changes are fostering a cultural shift towards increasing liberalization of cannabis use, thereby increasing the likelihood of even larger numbers of individuals being exposed in the future. The two different types of receptors (CB1 and CB2) that are activated by the pharmacologically active ingredients of cannabis are found in numerous tissues, including the kidneys...
July 26, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28412129/acute-kidney-injury-after-burn
#20
REVIEW
Audra Clark, Javier A Neyra, Tarik Madni, Jonathan Imran, Herb Phelan, Brett Arnoldo, Steven E Wolf
Acute kidney injury (AKI) is a common and morbid complication after severe burn, with an incidence and mortality as high as 30% and 80%, respectively. AKI is a broad clinical condition with many etiologies, which makes definition and diagnosis challenging. The most recent Kidney Disease: Improving Global Outcomes (KDIGO) consensus guidelines defined stage and severity of AKI based on changes of serum creatinine and urine output (UOP) across time. Burn-related kidney injury is typically classified as early (0-3days after injury) or late (4-14days after injury)...
August 2017: Burns: Journal of the International Society for Burn Injuries
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