collection
https://read.qxmd.com/read/37086496/hypomagnesemia-in-patients-with-cancer-the-forgotten-ion
#21
REVIEW
Marco Bonilla, Biruh T Workeneh, Nupur N Uppal
Magnesium is crucial for various cellular and enzymatic processes, yet it often is overlooked or underappreciated. Hypomagnesemia, a deficiency of magnesium in the blood, is a frequent problem in cancer patients and can lead to severe symptoms and morbidity. In this review, we provide an in-depth analysis of the physiology and regulation of magnesium, and signs and symptoms of hypomagnesemia in cancer patients. We also examine the causes and mechanisms of magnesium imbalances in cancer patients, specifically focusing on cancer-specific therapies that can lead to hypomagnesemia...
November 2022: Seminars in Nephrology
https://read.qxmd.com/read/37053100/imaging-patients-with-kidney-failure
#22
REVIEW
Mary Jennings Clingan, Zhao Zhang, Melanie P Caserta, Kelly L Cox, Vivek Gupta, Deborah A Baumgarten, Qihui Jim Zhai, Lauren F Alexander
The approach to imaging a patient with kidney failure continues to evolve. Overstatement of the risk of iodinated contrast material-induced (ie, contrast-induced) acute kidney injury and new guidelines for administration of gadolinium-based contrast media affect screening and the choice of contrast material. Treatment of kidney failure requires dialysis or a kidney transplant. Pretransplant imaging includes assessment for the feasibility of performing a transplant and evaluation for underlying malignancy and peripheral vascular disease...
May 2023: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://read.qxmd.com/read/37401137/sepsis-associated-acute-kidney-injury-treatment-standard
#23
REVIEW
Alexander Zarbock, Jay L Koyner, Hernando Gomez, Peter Pickkers, Lui Forni
Sepsis is a host's deleterious response to infection, which could lead to life-threatening organ dysfunction. Sepsis-associated acute kidney injury (SA-AKI) is the most frequent organ dysfunction and is associated with increased morbidity and mortality. Sepsis contributes to ≈50% of all AKI in critically ill adult patients. A growing body of evidence has unveiled key aspects of the clinical risk factors, pathobiology, response to treatment and elements of renal recovery that have advanced our ability to detect, prevent and treat SA-AKI...
December 20, 2023: Nephrology, Dialysis, Transplantation
https://read.qxmd.com/read/37397940/recent-advances-in-pathophysiology-diagnosis-and-management-of-hepatorenal-syndrome-a-review
#24
REVIEW
Calvin Kiani, Andreas G Zori
Hepatorenal syndrome with acute kidney injury (HRS-AKI) is a form of rapidly progressive kidney dysfunction in patients with decompensated cirrhosis and/or acute severe liver injury such as acute liver failure. Current data suggest that HRS-AKI occurs secondary to circulatory dysfunction characterized by marked splanchnic vasodilation, leading to reduction of effective arterial blood volume and glomerular filtration rate. Thus, volume expansion and splanchnic vasoconstriction constitute the mainstay of medical therapy...
June 27, 2023: World Journal of Hepatology
https://read.qxmd.com/read/37395330/management-of-hypocalcaemia-in-the-critically-ill
#25
REVIEW
Max Melchers, Arthur Raymond Hubert van Zanten
PURPOSE OF REVIEW: To better understand the established associations between hypocalcaemia and clinical outcomes, we synopsize the mechanisms involved in hypocalcaemia in the critically ill. We also provide an overview of the current evidence on managing hypocalcaemia in critical illness. RECENT FINDINGS: Hypocalcaemia is reported to occur in 55-85% of ICU patients. It appears to be associated with poor outcomes. It appears to be associated with poor outcomes, but it may be a marker rather than a direct cause of disease severity...
August 1, 2023: Current Opinion in Critical Care
https://read.qxmd.com/read/37258011/secondary-hypertension-overview-and-workup-for-the-primary-care-physician
#26
REVIEW
Jeffrey M Turner, Mikhail Dmitriev
Secondary hypertension occurs in 5% to 10% of all patients with hypertension. Given the majority of patients with hypertension will not have a secondary cause, only select patients with specific characteristics should be screened. The causes include a range of abnormalities, some are quite rare, such as pheochromocytoma, while others are much more common, such as chronic kidney disease. When considering which disorders to test for, it is important to incorporate the clinical history, family history, and prevalence of each disease...
July 2023: Medical Clinics of North America
https://read.qxmd.com/read/37258012/onco-nephrology-kidney-disease-in-the-cancer-patient
#27
REVIEW
Niloufarsadat Yarandi, Anushree C Shirali
Patients with cancer may develop kidney disease with a variety of different clinical manifestations including acute kidney injury, chronic kidney disease, hypertension, proteinuria and electrolyte disturbances. Onco-nephrology is the subspecialty of nephrology that diagnoses and manages kidney disease in patients with cancer. In this article, we review major topics in Onco-Nephrology that may be encountered by the general internist.
July 2023: Medical Clinics of North America
https://read.qxmd.com/read/37258013/updates-in-cardiorenal-syndrome
#28
REVIEW
Wendy McCallum, Jeffrey M Testani
Cardiorenal syndrome is a term that refers to a collection of disorders involving both the heart and kidneys, encompassing multi-directional pathways between the 2 organs mediated through low arterial perfusion, venous congestion, and neurohormonal activation. The pathophysiology is complex and includes hemodynamic and neurohormonal changes, but inconsistent findings from recent studies suggest this is very heterogenous disorder. Management for ADHF remains focused on decongestion and neurohormonal blockade to overcome the intense sodium and fluid avidity of the CRS...
July 2023: Medical Clinics of North America
https://read.qxmd.com/read/36872000/acute-kidney-injury-and-renal-replacement-therapy-a-review-and-update-for-the-perioperative-physician
#29
REVIEW
Christopher W Tam, Shreyajit R Kumar, Jarva Chow
Post-operative acute kidney injury is a devastating complication with significant morbidity and mortality associated with it. The perioperative anesthesiologist is in a unique position to potentially mitigate the risk of postoperative AKI, however, understanding the pathophysiology, risk factors and preventative strategies is paramount. There are also certain clinical scenarios, where renal replacement therapy may be indicated intraoperatively including severe electrolyte abnormalities, metabolic acidosis and massive volume overload...
March 2023: Anesthesiology Clinics
https://read.qxmd.com/read/36775691/therapeutic-plasma-exchange-core-curriculum-2023
#30
REVIEW
C Elena Cervantes, Evan M Bloch, C John Sperati
From producing individual blood components for transfusion to the removal of pathogenic substances, apheresis is a cornerstone of modern medical therapies. The use of therapeutic plasma exchange (TPE), in which plasma and its soluble constituents are removed from the body in exchange for a replacement fluid, can be organ- and life-saving in many diseases. Given the notable similarities between TPE and hemodialysis, the nephrologist is often responsible for managing TPE. As such, one must be familiar with the technologies, approach to therapy, indications for use, and complications...
April 2023: American Journal of Kidney Diseases
https://read.qxmd.com/read/36812435/acute-kidney-injury-in-patients-with-cirrhosis
#31
REVIEW
Mitra K Nadim, Guadalupe Garcia-Tsao
New England Journal of Medicine, Volume 388, Issue 8, Page 733-745, February 2023.
February 23, 2023: New England Journal of Medicine
https://read.qxmd.com/read/36823168/sepsis-associated-acute-kidney-injury-consensus-report-of-the-28th-acute-disease-quality-initiative-workgroup
#32
REVIEW
Alexander Zarbock, Mitra K Nadim, Peter Pickkers, Hernando Gomez, Samira Bell, Michael Joannidis, Kianoush Kashani, Jay L Koyner, Neesh Pannu, Melanie Meersch, Thiago Reis, Thomas Rimmelé, Sean M Bagshaw, Rinaldo Bellomo, Vicenzo Cantaluppi, Akash Deep, Silvia De Rosa, Xose Perez-Fernandez, Faeq Husain-Syed, Sandra L Kane-Gill, Yvelynne Kelly, Ravindra L Mehta, Patrick T Murray, Marlies Ostermann, John Prowle, Zaccaria Ricci, Emily J See, Antoine Schneider, Danielle E Soranno, Ashita Tolwani, Gianluca Villa, Claudio Ronco, Lui G Forni
Sepsis-associated acute kidney injury (SA-AKI) is common in critically ill patients and is strongly associated with adverse outcomes, including an increased risk of chronic kidney disease, cardiovascular events and death. The pathophysiology of SA-AKI remains elusive, although microcirculatory dysfunction, cellular metabolic reprogramming and dysregulated inflammatory responses have been implicated in preclinical studies. SA-AKI is best defined as the occurrence of AKI within 7 days of sepsis onset (diagnosed according to Kidney Disease Improving Global Outcome criteria and Sepsis 3 criteria, respectively)...
February 23, 2023: Nature Reviews. Nephrology
https://read.qxmd.com/read/36723347/medication-management-in-the-critically-ill-patient-with-acute-kidney-injury
#33
JOURNAL ARTICLE
Michael L Behal, Alexander H Flannery, Erin F Barreto
AKI occurs frequently in critically ill patients. Patients with AKI, including those who require KRT, experience multiple pharmacokinetic and pharmacodynamic perturbations that dynamically influence medication effectiveness and safety. Patients with AKI may experience both subtherapeutic drug concentrations, which lead to ineffective therapy, and supratherapeutic drug concentrations, which increase the risk for toxicity. In critically ill patients with AKI not requiring KRT, conventional GFR estimation equations, especially those based on serum creatinine, have several limitations that can limit the accuracy when used for medication dosing...
February 1, 2023: Clinical Journal of the American Society of Nephrology: CJASN
https://read.qxmd.com/read/36509342/renal-thrombotic-microangiopathy-a-review
#34
REVIEW
Dominique Suzanne Genest, Christopher J Patriquin, Christoph Licht, Rohan John, Heather N Reich
Thrombotic microangiopathy (TMA), a pathological lesion observed in a wide spectrum of diseases, is triggered by endothelial injury and/or dysfunction. Although TMA lesions are often accompanied by clinical features of microangiopathic hemolytic anemia, thrombocytopenia, and ischemic end-organ injury, renal-limited forms of TMA are not infrequently encountered in clinical practice. The presence of renal-limited manifestations can be diagnostically challenging, often delaying the initiation of targeted therapy...
May 2023: American Journal of Kidney Diseases
https://read.qxmd.com/read/36470740/risk-classification-and-subphenotyping-of-acute-kidney-injury-concepts-and-methodologies
#35
REVIEW
Javier A Neyra, Jin Chen, Sean M Bagshaw, Jay L Koyner
Acute kidney injury (AKI) is a complex syndrome with a paucity of therapeutic development. One aspect that could explain the lack of implementation science in the AKI field is the vast heterogeneity of the AKI syndrome, which hinders precise therapeutic applications for specific AKI subpopulations. In this context, there is a consensual focus of the scientific community toward the development and validation of tools to better subphenotype AKI and therefore facilitate precision medicine approaches. The subphenotyping of AKI requires the use of specific methodologies suitable for interrogation of multimodal data inputs from different sources such as electronic health records, organ support devices, and/or biospecimens and tissues...
May 2022: Seminars in Nephrology
https://read.qxmd.com/read/36400435/overview-of-the-medical-management-of-the-critically-ill-patient
#36
JOURNAL ARTICLE
Rebecca H Martinez, Kathleen D Liu, J Matthew Aldrich
The medical management of the critically ill patient focuses predominantly on treatment of the underlying condition ( e g , sepsis or respiratory failure). However, in the past decade, the importance of initiating early prophylactic treatment for complications arising from care in the intensive care unit setting has become increasingly apparent. As survival from critical illness has improved, there is an increased prevalence of postintensive care syndrome-defined as a decline in physical, cognitive, or psychologic function among survivors of critical illness...
December 2022: Clinical Journal of the American Society of Nephrology: CJASN
https://read.qxmd.com/read/36322940/how-i-diagnose-and-treat-atypical-hemolytic-uremic-syndrome
#37
JOURNAL ARTICLE
Fadi Fakhouri, Nora Schwotzer, Véronique Frémeaux-Bacchi
Our understanding and management of atypical hemolytic uremic syndrome (aHUS) have dramatically improved in the last decade. aHUS has been established as a prototypic disease resulting from a dysregulation of the complement alternative C3 convertase. Subsequently, prospective nonrandomized studies and retrospective series have shown the efficacy of C5 blockade in the treatment of this devastating disease. C5 blockade has become the cornerstone of the treatment of aHUS. This therapeutic breakthrough has been dulled by persistent difficulties in the positive diagnosis of aHUS, and the latter remains, to date, a diagnosis by exclusion...
March 2, 2023: Blood
https://read.qxmd.com/read/36324003/kidney-dysfunction-after-traumatic-brain-injury-pathophysiology-and-general-management
#38
REVIEW
Greet De Vlieger, Geert Meyfroidt
Traumatic brain injury (TBI) remains a major cause of mortality and morbidity, and almost half of these patients are admitted to the intensive care unit. Of those, 10% develop acute kidney injury (AKI) and 2% even need kidney replacement therapy (KRT). Although clinical trials in patients with TBI who have AKI are lacking, some general principles in this population may apply. The present review is an overview on the epidemiology and pathophysiology of AKI in patients with TBI admitted to the intensive care unit who are at risk for or who have developed AKI...
April 2023: Neurocritical Care
https://read.qxmd.com/read/36191596/novel-biomarkers-of-aki-in-cirrhosis
#39
REVIEW
Adrià Juanola, Ann T Ma, Elisa Pose, Pere Ginès
Acute kidney injury (AKI) is a frequent complication in patients with cirrhosis that is associated with poor outcomes and decreased survival. The definition of AKI in cirrhosis is currently based on changes of serum creatinine levels with respect to baseline values. Differential diagnosis of the causes of AKI is of major relevance, considering that some causes of AKI, such as hepatorenal syndrome, have specific treatment options and different prognosis. Prediction of kidney function recovery and patients' survival is also crucial in this patient population to guide clinical decisions...
November 2022: Seminars in Liver Disease
https://read.qxmd.com/read/36272423/haemolytic-uraemic-syndrome
#40
REVIEW
Mini Michael, Arvind Bagga, Sarah E Sartain, Richard J H Smith
Haemolytic uraemic syndrome (HUS) is a heterogeneous group of diseases that result in a common pathology, thrombotic microangiopathy, which is classically characterised by the triad of non-immune microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. In this Seminar, different causes of HUS are discussed, the most common being Shiga toxin-producing Escherichia coli HUS. Identifying the underlying thrombotic microangiopathy trigger can be challenging but is imperative if patients are to receive personalised disease-specific treatment...
November 12, 2022: Lancet
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