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Xingxing S Cheng, Jane C Tan, W Ray Kim
Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This review seeks to summarize and critically appraise common therapies used in this setting, including pharmacologic agents, procedures (transjugular intrahepatic portosystemic shunt, renal replacement therapy), and simultaneous liver-kidney transplantation. More experimental extracorporal modalities, eg, albumin dialysis or bioartificial livers, will not be discussed...
December 2016: Liver Transplantation
Franca Iorember, Diego Aviles
Nephrotic syndrome is one of the most common glomerular diseases that affect in children. Complications may occur in nephrotic syndrome as a result of the disease itself as well as its treatment. Most of these complications result from excessive urinary protein losses, and control of proteinuria is the most effective treatment strategy. Anemia is one of the many complications seen in patients with persistent nephrotic syndrome and may occur as a result of excessive urinary losses of iron, transferrin, erythropoietin, transcobalamin and/or metals...
December 21, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Annette L Mazzone, Robert A Baker, Jonathan M Gleadle
The incidence of acute kidney injury (AKI) is a frequent and serious complication of cardiac surgery. In 2013, 95% of cardiac surgical procedures performed in Australia and New Zealand used cardiopulmonary bypass (CPB). AKI following CPB is well known, yet the perioperative factors contributing to its development are incompletely understood. AKI following CPB has significant implications on both short-term and long-term outcomes. The techniques for conducting CPB have evolved, moving towards evidence-based practice; however, there is still no generally accepted definition of optimal perfusion and its conduct...
October 2016: Nephrology
Fernando Beltramo, Joseph DiCarlo, Balagangadhar Totapally
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Lesley Rees
Chronic irreversible kidney disease requiring dialysis is rare in the neonate. Many such neonates are diagnosed following antenatal ultrasound with congenital abnormalities of the kidneys and urinary tract. There is an increased incidence of prematurity and infants that are small for gestational age. Given the natural improvement in renal function that occurs in the neonatal period, some with extremely poor renal function may, with careful management of fluid and electrolytes, be kept off dialysis until the creatinine reaches a nadir when a definitive plan can be made...
November 11, 2016: Seminars in Fetal & Neonatal Medicine
Scott E Wenderfer, Natasha M Ruth, Hermine I Brunner
The care of children with lupus nephritis (LN) has changed dramatically over the past 50 y. The majority of patients with childhood-onset systemic lupus erythematosus (cSLE) develop LN. In the 1960's, prognosis in children was worse than in adults; therapies were limited and toxic. Nearly half of cases resulted in death within 2 y. Since this time, several diagnostic recommendations and disease-specific indices have been developed to assist physicians caring for patients with LN. Pediatric researchers are validating and adapting these indices and guidelines for the treatment of LN in cSLE...
January 4, 2017: Pediatric Research
Cynthia Wong, Arlene Gerson, Stephen R Hooper, Matthew Matheson, Marc Lande, Juan Kupferman, Susan Furth, Bradley Warady, Joseph Flynn
BACKGROUND: Although hypertension is known to have an adverse impact on health-related quality of life (HRQoL) in adults, little is known about the effects of hypertension and use of antihypertensive medications on HRQoL in hypertensive children with chronic kidney disease (CKD). METHODS: Cross-sectional and longitudinal assessment of impact of elevated blood pressure (BP) and antihypertensive medication use on HRQoL scores obtained in children enrolled in the Chronic Kidney Disease in Children (CKiD) Study...
July 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Thomas M Hooton
No abstract text is available yet for this article.
March 15, 2012: New England Journal of Medicine
Anthony J Schaeffer, Lindsay E Nicolle
No abstract text is available yet for this article.
February 11, 2016: New England Journal of Medicine
Stephen J McWilliam, Daniel J Antoine, Rosalind L Smyth, Munir Pirmohamed
Aminoglycoside antibiotics, in particular gentamicin and tobramycin, are still commonly used in paediatric clinical practice. These drugs cause nephrotoxicity, which particularly affects the proximal tubule epithelial cells due to selective endocytosis and accumulation of aminoglycosides via the multi-ligand receptor megalin. Recent epidemiological studies, using more widely accepted definitions of acute kidney injury (AKI), have suggested that AKI may occur in between 20 and 33 % of children exposed to aminoglycosides...
November 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: Among critically ill patients, acute kidney injury (AKI) is still a common and serious complication with a tremendous impact on short-term and long-term outcomes. The objective of this review is to discuss strategies for renal protection and prevention of AKI in ICU patients. RECENT FINDINGS: It is fundamental to identify patients at risk for AKI as soon as possible and as accurately as possible. In order to achieve these goals, translational approaches implementing new biomarkers have shown promising results...
December 2016: Current Opinion in Critical Care
Samriti Dogra, Frederick Kaskel
Steroid-resistant nephrotic syndrome remains a challenge to treat, but various efforts are underway to better understand the pathogenesis and improve patient outcomes. This review provides an update on the newer advances in understanding the molecular etiologies for a variety of podocyte abnormalities, potential circulating factors that may initiate and sustain the steroid-resistant state, genetic mutations, and precision medicine treatment modalities in this continuously perplexing disorder.
October 26, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Laurent Chevret, Philippe Durand, Jerome Lambert, Sandrine Essouri, Laurent Balu, Denis Devictor, Pierre Tissieres
OBJECTIVES: High-volume hemofiltration has shown beneficial effects in severe sepsis and multiple organ failure, improving hemodynamics and fluid balance. Recent studies suggest that acute liver failure shares many pathophysiologic similarities with sepsis. Therefore, we assessed the systemic effects of high-volume hemofiltration in children with acute liver failure. DESIGN: Retrospective observational cohort study. PATIENTS: Twenty-two children...
September 2014: Pediatric Critical Care Medicine
Akash Deep, Claire E Stewart, Anil Dhawan, Abdel Douiri
OBJECTIVES: To establish the effect of continuous renal replacement therapy on outcome in pediatric acute liver failure. DESIGN: Retrospective cohort study. SETTING: Sixteen-bed PICU in a university-affiliated tertiary care hospital and specialist liver centre. PATIENTS: All children (0-18 yr) admitted to PICU with pediatric acute liver failure between January 2003 and December 2013. INTERVENTIONS: Children with pediatric acute liver failure were managed according to a set protocol...
October 2016: Critical Care Medicine
Min Shao, Shengyu Wang, Praveen Kolumam Parameswaran
PURPOSE: The increased likelihood of poor outcomes in critically ill patients with hypoalbuminemia is well recognized. However, hypoalbuminemia remains poorly defined as an independent predictor of acute kidney injury (AKI) and stage 4 chronic kidney diseases (CKD4). The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for AKI and CKD4 in critically ill patients. DESIGN: A retrospective cohort study. SETTING: General intensive care unit (ICU) at Anhui Provincial Hospital, PR China...
November 5, 2016: International Urology and Nephrology
Midori Awazu
ABP is more reliable and reproducible than casual BP, enables computation of the mean, daytime, night-time ABP, and 24-h pulse pressure, detects white coat effect or reversed white coat effect, and provides information regarding diurnal BP pattern as well as BP variability. ABP correlates better with target-organ damage than casual BP. ABPM is now widely used also in children. Increasing age and higher mean BP are factors that improve the success rate of ABPM. There is a guideline from American Heart Association to standardize the use of ABPM in children, including the detailed recommendations for the use of ABPM and for the interpretation of the data...
September 2016: Journal of Hypertension
Joshua Samuels
No abstract text is available yet for this article.
August 2012: Hypertension
Patricia K Castelli, Jonathan R Dillman, Ethan A Smith, Ranjith Vellody, Kyung Cho, James C Stanley
OBJECTIVE: The purpose of this article is to review the imaging findings of common and uncommon causes of renin-mediated hypertension in children using a multimodality radiologic approach. CONCLUSION: Pediatric hypertension, although uncommon, is often due to aortic or renal artery narrowing. Imaging plays an important role in the diagnosis and characterization of pediatric renin-mediated causes of hypertension.
June 2013: AJR. American Journal of Roentgenology
Rajiv Agarwal, Joseph Flynn, Velvie Pogue, Mahboob Rahman, Efrain Reisin, Matthew R Weir
Hypertension is common, difficult to diagnose, and poorly controlled among patients with ESRD. However, controversy surrounds the diagnosis and treatment of hypertension. Here, we describe the diagnosis, epidemiology, and management of hypertension in dialysis patients, and examine the data sparking debate over appropriate methods for diagnosing and treating hypertension. Furthermore, we consider the issues uniquely related to hypertension in pediatric dialysis patients. Future clinical trials designed to clarify the controversial results discussed here should lead to the implementation of diagnostic and therapeutic techniques that improve long-term cardiovascular outcomes in patients with ESRD...
August 2014: Journal of the American Society of Nephrology: JASN
Jiahong Sun, Lyn M Steffen, Bo Xi
OBJECTIVE: The 2004 US Fourth Report recommends that diagnosis of pediatric hypertension should be based on blood pressure (BP) measurements on at least three separate occasions. However, there is no sufficient evidence to support this decision. The aim of this study was to assess the change in prevalence of elevated BP obtained on three separate visits in children and adolescents worldwide. DESIGN AND METHOD: Pubmed and Embase databases were searched for eligible studies published in English up to November 15, 2015...
September 2016: Journal of Hypertension
2016-11-06 16:15:35
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