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Kidney, hemodialysis, clinical pathology

Elena Zakharova
Background: The anatomy and physiology of kidneys as well as kidney diseases have been studied in Russia since the 18th century. However, there was a surge in interest in the 1920s, with numerous researchers and clinicians making substantial advances in the understanding of the pathophysiology, pathology, and diagnostics of kidney diseases. The field of nephrology as clinical practice can be traced back to 1957-1958, when the first beds for patients with kidney diseases became available and the first hemodialysis procedure was performed...
November 2018: Kidney Diseases
Juan Esteban Muñoz Montoya, Carlos Pérez Cataño, Angela María Tapicha Cuellar, Maria Paula Vargas Osorio, Jimar Rivero Cano, Juan Carlos Luque Suarez, Marco Luciano Charry Lopez
Background: In 1988, Modic and his colleagues described changes in the subchondral bone marrow of the vertebral plates in patients with degenerative disease or other pathologies, which were observed in the nuclear magnetic resonance (NMR) of the spine and were subdivided into three patterns of signal changes, called Modic type I, Modic type II and Modic type III. The main differential diagnosis of the Modic I changes of the vertebral plates due to degenerative disease in spine NMR, is infection in its early stages...
September 2018: Journal of Spine Surgery (Hong Kong)
Claudia Teodora Judea-Pusta, Gabriela Muţiu, Andrei Vasile Paşcalău, Camelia Liana Buhaş, Adina Nicoleta Ciursaş, Carmen Delia Nistor-Cseppento, Alina Bodea, Adrian Sorin Judea, Răzvan Marius Vicaş, Luciana Dobjanschi, Ovidiu Laurean Pop
Ethylene glycol is a toxic alcohol that is mainly introduced into an organism through the digestive pathway. Its priority toxic metabolites are glycolic acid and oxalic acid. We present the case of a young person, of the male persuasion, without any personal pathological history, found unconscious and presenting signs of violence. The patient is emergency hospitalized presenting coma, convulsive syndrome, severe metabolic acidosis and a positive result for alcoholism. Anamnestic data is extremely poor. The results of the clinical and paraclinical examinations suggest a possible poisoning with toxic alcohols...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Takaaki Higashihara, Akira Okada, Yukiko Kishida, Sayako Maruno, Mimiko Matsumura, Koichi Tamura, Hideki Takano
BACKGROUND: Patients with end-stage kidney disease (ESKD) most commonly complain of gastrointestinal symptoms, such as diarrhea. Diarrhea negatively affects patient quality of life and has miscellaneous etiologies, such as Clostridium difficile-associated diarrhea (CDAD) and ischemic colitis. However, it is sometimes extremely difficult to determine the true etiology given the comorbidities and complications the patients have. A rare cause of diarrhea is ulcerative colitis (UC), which commonly affects the rectum and proximal colon in a continuous fashion...
November 1, 2018: BMC Nephrology
Ping Li, Yani He, Guangyan Cai, Fei Xiao, Jie Yang, Qinggang Li, Xiangmei Chen
Ciliopathies-are widely recognized and associated with a wide variety of developmental and degenerative disorders. Most cilia-related diseases have renal manifestation, and there is a cross- overlapping relationship between gene mutations and cilia disease. Here, we investigated the clinical and pathological manifestation of a rare disease patient. We present the case of a 15-year-old child with dysplasia and multiple-organ damage who was initially diagnosed with nephrotic syndrome. The patient's kidney disease progressed to renal failure and received hemodialysis 10 months after renal biopsy...
October 5, 2018: Journal of Human Genetics
Koichi Kodama, Yasukazu Takase, Ryutaro Tokai, Katsuhiko Saito
Renal arteriovenous fistula (AVF) is a rare but potentially severe and life-threatening entity. It can occur after various invasive renal interventions, including resection of a localized renal tumor, renal biopsy, percutaneous renal surgery, and even blunt injury of the kidney. The time of clinical presentation of a renal AVF is variable and may occur decades after the injury originally occurred. Here, we report a case of renal AVF induced by extracorporeal shock wave lithotripsy 11 years earlier in an asymptomatic 72-year-old woman...
September 21, 2018: Asian Journal of Endoscopic Surgery
Alexandru Oanță, Veronica Iliescu, Smaranda Țărean
Half and half nails or Lindsay's nails were first mentioned by Bean (1) in 1964 and later described by Lindsay (2) in 1967 in patients with chronic kidney disease. They can occur in various diseases but also in healthy individuals. A 57-year-old patient with no significant pathological personal history consulted us for discoloration of all his nails on the fingers (Figure 1) and toes (Figure 2). The change in color occurred 17 years ago and had persisted since. The patient had no significant family history and denied a longer period of consumption of drugs, tobacco, or alcohol...
December 2017: Acta Dermatovenerologica Croatica: ADC
Yoshiko Iwasaki
Increased fracture incidence and ectopic calcifications which are accompanied with mineral metabolic disorders are well seen in dialysis patients. The role of bone in chronic kidney disease patients including dialysis has been investigated in clinical findings and experimental examinations. The abnormalities of osteocyte function have been pointed to as an active inducer of pathology of a deregulated endocrine organ.
2018: Clinical Calcium
Mariana Murea, Bryan M Tucker
Uric acid-mediated biological effects are milieu dependent. In a physiological milieu, serum uric acid serves as an antioxidant; when homeostasis is perturbed, divergent effects are observed depending on the clinical context. Several epidemiologic studies indicated the presence of a direct relationship between higher concentrations of serum uric acid and cardiovascular mortality; yet not all studies support this conclusion. Although high serum levels of uric acid are associated with higher mortality in patients with nondialysis-dependent chronic kidney disease and perhaps in those with end-stage kidney disease receiving peritoneal dialysis, the opposite relationship is seen in patients with end-stage kidney disease on hemodialysis...
July 10, 2018: Seminars in Dialysis
Alice Sabatino, Giuseppe Regolisti, Marco Delsante, Tommaso Di Motta, Chiara Cantarelli, Sarah Pioli, Giulia Grassi, Valentina Batini, Mariacristina Gregorini, Enrico Fiaccadori
BACKGROUND & AIMS: Protein-Energy Wasting (PEW) is a pathological condition of renal patients with advanced Chronic Kidney Disease characterized by a progressive reduction of energy and protein assets. Nutritional status assessment, especially for what concerns muscle mass, is essential for both the identification of patients at risk for the development of PEW, as well as monitoring the effects of nutritional interventions. Ultrasound methods are easily applicable at the bedside for quantitative assessment of skeletal muscle...
May 19, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Cherie Stayner, Darby G Brooke, Michael Bates, Michael R Eccles
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common life-threatening genetic disease in humans, affecting approximately 1 in 500 people. ADPKD is characterized by cyst growth in the kidney leading to progressive parenchymal damage and is the underlying pathology in approximately 10% of patients requiring hemodialysis or transplantation for end-stage kidney disease. The two proteins that are mutated in ADPKD, polycystin-1 and polycystin-2, form a complex located on the primary cilium and the plasma membrane to facilitate calcium ion release in the cell...
May 7, 2018: Current Medicinal Chemistry
N G Toapanta-Gaibor, M Suñer-Poblet, M Cintra-Cabrera, M Á Pérez-Valdivia, A Suárez-Benjumea, F M Gonzalez-Roncero, G Bernal-Blanco, J L Rocha-Castilla, M Á Gentil-Govantes
INTRODUCTION: End-stage renal disease patients' access to the renal transplant (RT) waiting list (WL) depends on general criteria and their specific application in the different treatment units. METHODS: Study in nonhospital hemodialysis centers (n = 9), dependent on an adult RT center. Cases included 228 patients considered to have nonactive status on the WL due to incomplete immunologic data (no blood group or HLA typing) or temporary contraindication from an incomplete pretransplant study (nonimmunologic) or comorbidity...
March 2018: Transplantation Proceedings
Vinod Krishnappa, Mohit Gupta, Haikoo Shah, Abhijit Das, Natthavat Tanphaichitr, Robert Novak, Rupesh Raina
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure...
January 12, 2018: BMC Nephrology
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2 CO3 /HCO3 - ) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
February 2018: Néphrologie & Thérapeutique
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Zohre Khodamoradi, Maryam Pakfetrat, Simin Torabinezhad, Mohammad Mahdi Sagheb
BACKGROUND: Acute interstitial nephritis (AIN) is an emerging cause of acute kidney injury (AKI) during the recent years. OBJECTIVES: There is no data about prevalence, causes, clinical manifestation and outcomes of AIN in our region. Hence, in this study we aimed to find the prevalence of AIN and describe the causes, clinical presentation, and the outcome of AIN in the native kidney biopsies. PATIENTS AND METHODS: We reviewed 934 native kidney biopsies from 2006 to 2014 and collected the data of patients with the diagnosis of AIN including medical history, clinical findings, para-clinical data, pathologic findings, treatment and outcomes...
July 2017: Journal of Nephropathology
Faisal M Huq Ronny, George Kleinman, Paul James Kurtin, John Thomas Fallon
Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years...
January 2017: Autopsy & Case Reports
Kosuke Honda, Minoru Ando, Masaharu Tsubokura, Takuya Yamashita, Hideki Akiyama, Hisashi Sakamaki
A 48-year-old Japanese woman, who had been diagnosed with smoldering adult T-cell leukemia, was admitted to our hospital for hematopoietic stem cell transplantation (HSCT) because of an acute exacerbation of her disease. After myeloablative conditioning procedures, comprising cytarabine with cyclophosphamide and total body irradiation, the HLA-matched unrelated bone marrow stem cells were infused (day 0). Her serum creatinine concentration, having been 0.6 mg/dL at baseline, began to increase from day 1 and was 2...
May 2014: CEN Case Reports
Reiko Inoue, Yoshihide Fujigaki, Kana Kobayashi, Yoshifuru Tamura, Tatsuru Ota, Shigeru Shibata, Tsuyoshi Ishida, Fukuo Kondo, Yutaka Yamaguchi, Shunya Uchida
We report a 70-year-old woman with Sjögren's syndrome who had severe renal dysfunction with mild proteinuria and elevated urinary low-molecular-weight proteins. Based on these clinical presentations, interstitial nephritis due to Sjögren's syndrome was strongly suspected. Unexpectedly, renal pathology revealed amyloid light-chain (AL) lambda-type depositions predominantly in the vasculatures with severe tubulointerstitial damage. Concentrated urine immunofixation was positive for Bence Jones lambda-type monoclonal proteins...
2017: Internal Medicine
Toshio Takagi, Tsunenori Kondo, Masayoshi Okumi, Hideki Ishida, Kazunari Tanabe
We compared the clinical features, pathological features, and prognoses of patients with renal cell carcinoma (RCC) arising in the native kidney after kidney transplantation (RCC-transplant) or on hemodialysis (RCC-HD), and analyzed predictive factors for survival at a Japanese single institution. This cohort included 42 patients in the RCC-transplant group and 467 patients in the RCC-HD group. RCC-transplant patients were younger (53 years vs. 56 years, P = 0.0358) and had less frequent symptoms (12% vs...
April 2017: Therapeutic Apheresis and Dialysis
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