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Renal older

Tsugumichi Koshinaga, Tetsuya Takimoto, Hajime Okita, Yukichi Tanaka, Eisuke Inoue, Takaharu Oue, Miwako Nozaki, Kunihiko Tsuchiya, Masayuki Haruta, Yasuhiko Kaneko, Masahiro Fukuzawa
BACKGROUND: Persistence of blastemal components after chemotherapy is a marker of poor outcome in Wilms tumor. Recent reports from local Japanese areas have described prechemotherapy blastemal predominant type Wilms tumor to be also a risk factor for relapse. However, significance of blastemal predominant WT remains to be evaluated in a larger study. This study aimed to retrospectively evaluate the prognostic significance of prechemotherapy blastemal predominant type Wilms tumor in the Japan Wilms tumor Study (JWiTS) trials...
February 20, 2019: Pediatrics International: Official Journal of the Japan Pediatric Society
Kathleen Nolte, Christoph Herrmann-Lingen, Lars Platschek, Volker Holzendorf, Stefan Pilz, Andreas Tomaschitz, Hans-Dirk Düngen, Christiane E Angermann, Gerd Hasenfuß, Burkert Pieske, Rolf Wachter, Frank Edelmann
AIMS: Vitamin D deficiency is prevalent in heart failure (HF), but its relevance in early stages of heart failure with preserved ejection fraction (HFpEF) is unknown. We tested the association of 25-hydroxyvitamin D [25(OH)D] serum levels with mortality, hospitalizations, cardiovascular risk factors, and echocardiographic parameters in patients with asymptomatic diastolic dysfunction (DD) or newly diagnosed HFpEF. METHODS AND RESULTS: We measured 25(OH)D serum levels in outpatients with risk factors for DD or history of HF derived from the DIAST-CHF study...
February 19, 2019: ESC Heart Failure
John Esther, Peter Hale, Andrew W Hahn, Neeraj Agarwal, Benjamin L Maughan
Given the underrepresentation of older patients in registration trials for metastatic renal cell carcinoma (mRCC), data to support the use of any particular systemic therapy over others, based on age, is limited. This is further complicated by clinical trials not commonly reporting adverse events by age. Thus, recommendations on treatment of older patients with mRCC are generally extrapolated from data on younger patients enrolled in these trials, which may not be ideal as many older patients are frail, have age-related organ dysfunction, or have multiple medical co-morbidities...
February 20, 2019: Drugs & Aging
Tali Siegal, Osnat Bairey
Primary central nervous system (CNS) lymphoma is an aggressive brain tumor sensitive to chemotherapy and radiotherapy. Its incidence has increased in the elderly, and they account for the majority of patients. The median survival of patients older than 70 years did not change over the last 40 years and remained in the range of 6-7 months. The definition of elderly is nonuniform, and chronological age is not the best marker of treatment tolerability or a predictor of treatment-related toxicity. Some patients who are fit can tolerate induction, consolidation, and even high-dose chemotherapy with autologous stem cell transplantation, whereas others who have multiple comorbidities with reduced renal and bone marrow function can tolerate only intermediate doses of methotrexate...
February 15, 2019: Acta Haematologica
Andrew D Smith, J Daniel Carson, Reza Sirous, Rupan Sanyal, Erick M Remer, Brian C Allen, Kelly L Cox, Brian Shuch, Asser Abou Elkassem, Xu Zhang
OBJECTIVE: The objective of our study was to evaluate the cost-effectiveness of active surveillance (AS) versus nephron-sparing surgery (NSS) in patients with a Bosniak IIF or III renal cyst. MATERIALS AND METHODS: Markov models were developed to estimate life expectancy and lifetime costs for 60-year-old patients with a Bosniak IIF or III renal cyst (the reference cases) managed by AS versus NSS. The models incorporated the malignancy rates, reclassification rates during follow-up, treatment effectiveness, complications and costs, and short- and long-term outcomes...
February 19, 2019: AJR. American Journal of Roentgenology
Emily Hart, Terry E Dunn, Steven Feuerstein, David M Jacobs
BACKGROUND: Proton pump inhibitors (PPIs) have been linked to acute kidney injury (AKI) and chronic kidney disease (CKD); however, current evidence has only been evaluated in a small number of studies with short follow-up periods. This study examined the association between PPI use and risk of incident AKI and CKD in a large, population-based health-maintenance organization (HMO) cohort. METHODS: Patients aged 18 years or older, without evidence of pre-existing renal disease, started on PPI therapy, and continuously enrolled for at least 12 months between July 1993 and September 2008 were identified in an HMO database...
February 18, 2019: Pharmacotherapy
Besma Nejim, Devin Zarkowsky, Caitlin W Hicks, Satinderjit Locham, Hanaa Dakour Aridi, Mahmoud Malas
BACKGROUND: Endovascular aneurysm repair (EVAR) offered outstanding survival benefit but at the expense of cost, periodic radiographic monitoring, and higher reinterventions rates. Perioperative complications, although rare, can occur after EVAR, contributing to longer hospitalization, higher cost, and significant comorbidity and mortality. Therefore, the aim of this study was to identify the predictors of in-hospital events (IHEs) after elective EVAR. METHODS: The Vascular Quality Initiative database was explored from 2003 to 2017...
February 15, 2019: Journal of Vascular Surgery
Erhan Tatar, Murat Karataş, Mustafa Kılıç, Ismail Can Tercan, Gokalp Okut, Berkant Usoğlu, Ahmet Aykas, Adam Uslu
OBJECTIVES: The development of hypertension can negatively affect cardiovascular and renal outcomes in renal kidney donors. Here, we retrospectively investigated the frequency and risk factors of hypertension development in healthy renal donors at our center. MATERIALS AND METHODS: Living donors of kidney transplants performed between January 1998 and December 2016 were evaluated. Those > 18 years old, having glomerular filtration rate > 70 mL/min/1.72 m², body mass index ≤ 35 kg/m², and proteinuria < 300 mg/day were eligible...
January 2019: Experimental and Clinical Transplantation
Osama Gheith, Medhat A Halim, Torki Al-Otaibi, Ayman El-Sayed, Prasad Nair, Tarek Mahmoud, Ahmed Fathy, Mohamed Abdul Hameed, Ahmed Samy, Nabil El Serwy, Ayman M Nagib
OBJECTIVES: The number of renal transplants in elderly patients is increasing as age per se does not constitute a contraindication to transplant. We compared renal transplant outcomes in elderly recipients versus a group of middle-aged patients. MATERIALS AND METHODS: Our retrospective casecontrolled study compared elderly transplant recipients (n = 252; > 60 y old) with a matched cohort of younger adult recipients (n = 710; between 40 and 60 years old) who underwent renal transplant at the Hamed Al-Essa Organ Transplant Center of Kuwait between 2000 and 2014...
January 2019: Experimental and Clinical Transplantation
Fei Chen, Zhi-Liang Zuo, Fang-Yang Huang, Tian-Li Xia, Bao-Tao Huang, Hua Chai, Qiao Li, Xiao-Bo Pu, Yi-Yue Gui, Yong Peng, Mao Chen, De-Jia Huang
BACKGROUND: Ageing is a risk factor for both coronary artery disease (CAD) and reduced renal function (RRF), and it is also associated with poor prognosis in patients with CAD or RRF. However, little is known about whether the impact of RRF on clinical outcomes are different in CAD patients at different age groups. This study aimed to investigate whether ageing influences the effect of RRF on long-term risk of death in patients with CAD. METHODS: A retrospective analysis was conducted using data from a single-center cohort study...
February 18, 2019: BMC Public Health
Zhimin Chen, Abdul Rashid Qureshi, Torkel B Brismar, Jonaz Ripsweden, Mathias Haarhaus, Peter Barany, Olof Heimburger, Bengt Lindholm, Peter Stenvinkel
BACKGROUND: Risk of cardiac events and cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients are predicted by coronary artery calcification (CAC) independently. It is not clear to what extent low bone mineral density (BMD) is associated with higher risk of CAC and if sex interacts. We investigated the sex-specific associations of CAC score with total body BMD (tBMD) as well as with BMD of different skeletal sub-regions. METHODS: In 174 ESRD patients, median age 57 (10th-90th percentiles 29-75) years, 63% males, BMD (measured by dual-energy X-ray absorptiometry; DXA), CAC score (measured by cardiac CT) and circulating inflammatory biomarkers were analysed...
February 18, 2019: BMC Nephrology
Karin Weissenborn
Mild cognitive dysfunction as in minimal or covert hepatic encephalopathy (HE) can be found in a variety of metabolic disturbances, several neurological diseases, and even older age. Because liver cirrhosis usually is accompanied by one or the other of these, a differentiation between HE and cognitive decline because of comorbidities is difficult. Somehow discriminating is the impairment of motor speed and accuracy, which is more prominent in HE than in any of the comorbidities. The observation that, for example, diabetes mellitus, renal dysfunction, infections, or hyponatremia as well as older age increase the risk of developing HE indicates the interaction between these factors and liver dysfunction in the development of HE and the necessity to adjust the therapy accordingly...
January 2019: Journal of Clinical and Experimental Hepatology
Yingxin Zhao, Yuanli Dong, Juan Wang, Lin Sheng, Qiang Chai, Hua Zhang, Zhendong Liu
The aim of this study was to investigate the associations between carotid wall shear stress (WSS) and renal function impairment (RFI) and albuminuria in aging adults. A total of 1,447 subjects aged 60 years and older with normal estimated glomerular filtration rate (eGFR ≥ 60 mL·min-1 ·1.72 m-2 ) and albumin/creatinine ratio (ACR < 30 mg·g-1 ) were enrolled between April 2007 and October 2009 in the Shandong area, China. Carotid WSS was assessed at baseline, and eGFR, which is based on serum creatinine and cystatin C, and ACR were assessed at baseline and at the annual follow-up visits...
February 14, 2019: Scientific Reports
Yuliya Lytvyn, Petter Bjornstad, Julie A Lovshin, Sunita K Singh, Genevieve Boulet, Mohammed A Farooqi, Vesta Lai, Josephine Tse, Leslie Cham, Leif E Lovblom, Alanna Weisman, Hillary A Keenan, Michael H Brent, Narinder Paul, Vera Bril, Andrew Advani, Etienne Sochett, Bruce A Perkins, David Z I Cherney
AIMS: Higher plasma uric acid (PUA) concentrations are associated with renal vasoconstriction, renin angiotensin aldosterone system (RAAS) activation and vascular stiffness, however the timeline for these associations in type 1 diabetes (T1D) is not clear. We aimed to compare the changes in such associations over a wide range of T1D duration. MATERIALS AND METHODS: PUA, glomerular filtration rate (GFRINULIN ), effective renal plasma flow (ERPFPAH ), vascular stiffness parameters (aortic augmentation index [AIx], carotid AIx, carotid femoral pulse wave velocity [cfPWV]), plasma renin and aldosterone were measured during a euglycemic clamp in participants with T1D: 27 adolescents (age 16...
February 13, 2019: Diabetes, Obesity & Metabolism
Hui Zhang, Hongqin Xu, Ruihong Wu, Ge Yu, Haibo Sun, Juan Lv, Xiaomei Wang, Xiumei Chi, Xiuzhu Gao, Fei Kong, Mingyuan Zhang, Lei Hang, Jing Jiang, Yu Pan, Junqi Niu
Hepatitis C virus (HCV) infection greatly increases the risk of nephropathy. In this observational study, we aimed to explore the relationship between viral hepatitis infection and chronic kidney disease (CKD), identify risk factors, and determine the effect of antiviral treatment on CKD in Chinese patients with chronic HCV infection. A total of 2,435 study subjects were enrolled and divided into four groups: the HCV infection, HBV infection, HBV and HCV co-infection, and uninfected control groups. Of these, 207 patients with chronic hepatitis C (CHC) were given standard dual therapy [subcutaneous injection of recombinant interferon (IFN)-α2b and oral ribavirin (RBV)] for 48 weeks...
February 13, 2019: Scientific Reports
Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Alaide Chieffo, Anna S Petronio, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuela Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, David Jochheim, Magda Zadrozny, Ghada W Mikhail, Samin Sharma, Maria C Ferrer, Christoph Naber, Peter Kievit, Kamilia Moalem, Usman Baber, Clayton Snyder, Madhav Sharma, Marie C Morice, Roxana Mehran
BACKGROUND: Several clinical and procedural factors determine outcomes after transcatheter aortic valve replacement (TAVR), but data are scarce on the impact of post-TAVR discharge disposition on long-term outcomes. We sought to analyse whether discharge location after TAVR is associated with 1-year outcomes in women undergoing contemporary TAVR. METHODS: The Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) registry is the first all-female TAVR registry to study the safety and performance of contemporary TAVR in women (n = 1019)...
February 2019: Canadian Journal of Cardiology
Riobaldo Cintra, Filipe A Moura, Luis Sergio F de Carvalho, Joaquim Barreto, Marcos Tambascia, Roberto Pecoits-Filho, Andrei C Sposito
The prevalence of type 2 diabetes mellitus (T2DM) in the elderly grew sharply over the last decade. Reduced insulin sensitivity and secretory capacity, weight gain, sarcopenia, and elevated adiposity are all common metabolic and body changes in the aging population that favor an increased risk of hypoglycemia, frailty syndrome, falls, and cognitive dysfunction. First line antidiabetic therapy is frequently not safe in older individuals because of its high risk of hypoglycemia and prevalent co-morbid diseases, such as chronic kidney disease, osteoporosis, cardiovascular disease, and obesity...
January 2019: Revista da Associação Médica Brasileira
O F Miah, R M Hossain, A Latif, U Sarkar, S K Paul, R S Paul, T Ahammod, M S Islam, F A Dowel, M A Mahmud, M K Podder, A S Bhuiyan, U W Chowdhury
The prevalence of chronic kidney disease (CKD) in Bangladesh is increasing. Chronic kidney disease refers to an irreversible deterioration in renal function which classically develops over a period of years. Initially, it manifest's only as a biochemical abnormality. Eventually loss of excretory, metabolic and endocrine functions of the kidneys leads to clinical symptoms and signs of renal failure, which are referred to as uraemia. In our country the number of CKD patient is increasing day by day, probably due to having uncontrolled DM, GN(Glumerulonephritis), uncontrolled hypertension, interstitial nephritis in addition to indiscriminate drugs & using of chemicals in fruits and foods...
January 2019: Mymensingh Medical Journal: MMJ
Jennifer Chung, Louis-Mathieu Stevens, Maral Ouzounian, Ismail El-Hamamsy, Ismail Bouhout, François Dagenais, Andréanne Cartier, Mark Peterson, Munir Boodhwani, Ming Hao Guo, John Bozinovski, Michael H Yamashita, Carly Lodewyks, Rony Atoui, Bindu Bittira, Darrin Payne, Christopher Tarola, Michael W A Chu
BACKGROUND: Contemporary outcomes following surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood. METHODS: A total of 1653 patients (498 (30.1%) female) underwent thoracic aortic surgery with hypothermic circulatory arrest between 2002 and 2017 in ten institutions of the Canadian Thoracic Aortic Collaborative. Outcomes of interest were in-hospital death, stroke and a modified Society of Thoracic Surgeons-defined composite (STS-COMP) for mortality or major morbidity (stroke, renal failure, deep sternal wound infection, reoperation, prolonged ventilation)...
February 13, 2019: Circulation
Richard S Hotchkiss, Elizabeth Colston, Sachin Yende, Derek C Angus, Lyle L Moldawer, Elliott D Crouser, Greg S Martin, Craig M Coopersmith, Scott Brakenridge, Florian B Mayr, Pauline K Park, June Ye, Ian M Catlett, Ihab G Girgis, Dennis M Grasela
OBJECTIVES: To assess for the first time the safety and pharmacokinetics of an antiprogrammed cell death-ligand 1 immune checkpoint inhibitor (BMS-936559, Bristol-Myers Squibb, Princeton, NJ) and its effect on immune biomarkers in participants with sepsis-associated immunosuppression. DESIGN: Randomized, placebo-controlled, dose-escalation. SETTING: Seven U.S. hospital ICUs. STUDY POPULATION: Twenty-four participants with sepsis, organ dysfunction (hypotension, acute respiratory failure, and/or acute renal injury), and absolute lymphocyte count less than or equal to 1,100 cells/μL...
February 8, 2019: Critical Care Medicine
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