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Dialysis,renal transplantation,hypertension,acute kidney injury,

Vivek Nagaraja
PURPOSE OF REVIEW: Scleroderma renal crisis (SRC) is a life-threatening manifestation in systemic sclerosis (SSc) and is usually presented by an acute onset of severe hypertension together with an acute kidney injury. We can conceptualize SRC as a systemic syndrome with features that extend beyond the involvement of the kidney. The goal of this review is to inform clinicians about the risk factors for SRC in patients with SSc and to emphasize the importance of early identification and initiation of treatment...
March 5, 2019: Current Opinion in Rheumatology
Victoria Birlutiu, Rares Mircea Birlutiu
RATIONALE: Haemolytic-uremic syndrome is a rare but serious complication of bacterial and viral infections, which is characterized by the triad of: acute renal failure, microangiopathic haemolytic anemia and thrombocytopenia, sometimes severe, requiring peritoneal dialysis. In Europe, hemolytic-uremic syndrome (HUS) in paediatric pathology is primarily caused by Shiga toxin-producing Escherichia coli (STEC) O157, followed by O26. Beside these etiologies, there are other bacterial and viral infections, and also noninfectious ones that have been associated to lead to HUS as well: in the progression of neoplasia, medication-related, post-transplantation, during pregnancy or associated with the antiphospholipid syndrome, systemic lupus erythematosus or family causes with autosomal dominant or recessive inheritance...
February 2018: Medicine (Baltimore)
Katherine Garlo, Doug Dressel, Marizela Savic, John Vella
Postpartum atypical hemolytic uremic syndrome (aHUS) is a rare disorder associated with poor maternal and fetal outcomes. We describe a case of severe postpartum aHUS with recurrence in a kidney allograft after a second pregnancy. The patient had initially presented age 28 years with aHUS that developed after her first delivery. In spite of treatment with plasma exchange, she developed end-stage renal disease (ESRD) requiring years of hemodialysis before receiving a kidney transplant from a living unrelated donor...
2015: Clinical Nephrology. Case Studies
Mary Lynn Davis-Ajami, Jeffery C Fink, Jun Wu
BACKGROUND: Nephrotoxic medication exposure increases risks for acute kidney injury, permanent renal function loss, and costly preventable adverse drug events. Exposure to medications associated with inducing acute tubular nephritis or tubular toxicity versus nonexposure among those with predialysis renal disease-a population vulnerable to increased risk of kidney injury-may affect health services utilization and cost outcomes. Few studies quantify nephrotoxic medication exposure in chronic kidney disease (CKD) and associated costs...
August 2016: Journal of Managed Care & Specialty Pharmacy
Alan R Parrish
The incidence of chronic kidney disease (CKD) is increasing, with an estimated prevalence of 12% in the United States (Synder et al., 2009). While CKD may progress to end-stage renal disease (ESRD), which necessitates renal replacement therapy, i.e. dialysis or transplantation, most CKD patients never reach ESRD due to the increased risk of death from cardiovascular disease. It is well-established that regardless of the initiating insult - most often diabetes or hypertension - fibrosis is the common pathogenic pathway that leads to progressive injury and organ dysfunction (Eddy, 2014; Duffield, 2014)...
October 2016: Pharmacology & Therapeutics
Julie R Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer
World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life...
March 2016: Saudi Journal of Kidney Diseases and Transplantation
Michael Heung, Diane E Steffick, Kara Zivin, Brenda W Gillespie, Tanushree Banerjee, Chi-Yuan Hsu, Neil R Powe, Meda E Pavkov, Desmond E Williams, Rajiv Saran, Vahakn B Shahinian
BACKGROUND: Studies suggest an association between acute kidney injury (AKI) and long-term risk for chronic kidney disease (CKD), even following apparent renal recovery. Whether the pattern of renal recovery predicts kidney risk following AKI is unknown. STUDY DESIGN: Retrospective cohort. SETTING & PARTICIPANTS: Patients in the Veterans Health Administration in 2011 hospitalized (> 24 hours) with at least 2 inpatient serum creatinine measurements, baseline estimated glomerular filtration rate > 60 mL/min/1...
May 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Thomas M Leventhal, Kathleen D Liu
Although relatively rare in the United States, acute liver failure (ALF) is associated with very high rates of morbidity and mortality. A leading cause of morbidity and mortality is cerebral edema and intracranial hypertension. Hypothermia, osmotic diuretics, and hyperosmolar therapy are commonly used to manage these complications; however, when these are ineffective, renal replacement therapy may be needed for volume management. Acute kidney injury is a common complication of ALF and may arise from a number of etiologies, including hepatorenal syndrome and acute tubular necrosis...
September 2015: Advances in Chronic Kidney Disease
Violeta Rabrenović, Zoran Mijušković, Slobodan Marjanović, Milorad Rabrenović, Dragan Jovanović, Svetlana Antić, Ljiljana Ignjatović, Milica Petrović, Dejan Pilcević
INTRODUCTION: Immunoglobulin D (IgD) myeloma is a rare disease, about 2% of all myelomas, even rarer when accompanied with another multiple myeloma in biclonal gammopathy. We presented a case of biclonal gammopathy-as-sociated manifestation of IgD myeloma and light chain disease in a patient who initially had renal failure. CASE REPORT: 37-year-old male approximately one month before hospitalization began to feel malaise and fatigue along with decreased urination...
February 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Marília Galvão Cruz, João Gabriel Athayde de Oliveira Dantas, Talita Machado Levi, Mário de Seixas Rocha, Sérgio Pinto de Souza, Ney Boa-Sorte, Carlos Geraldo Guerreiro de Moura, Constança Margarida Sampaio Cruz
OBJECTIVE: This study aimed to describe and compare the characteristics and clinical outcomes of patients with septic and non-septic acute kidney injury. METHODS: This study evaluated an open cohort of 117 critically ill patients with acute kidney injury who were consecutively admitted to an intensive care unit, excluding patients with a history of advanced-stage chronic kidney disease, kidney transplantation, hospitalization or death in a period shorter than 24 hours...
October 2014: Revista Brasileira de Terapia Intensiva
Liliane Hobeika, Sally E Self, Juan Carlos Q Velez
BACKGROUND: Proteasome inhibitors are a relatively new class of chemotherapeutic agents. Bortezomib is the first agent of this class and is currently being used for the treatment of multiple myeloma. However, recent reports have linked exposure to bortezomib with the development of thrombotic microangiopathy. A new agent in this class, carfilzomib, has been recently introduced as alternative therapy for relapsing and refractory multiple myeloma. We report a case of renal thrombotic microangiopathy associated with the use of carfilzomib in a patient with refractory multiple myeloma...
2014: BMC Nephrology
B Saeed
Although the number of children with end-stage renal disease (ESRD) in need for renal transplantation is small compared with adults, the problem associated with renal transplant in children are numerous, varied, and often peculiar. Pre-emptive transplantation has recently been growing in popularity as it avoids many of the associated long-term complications of ESRD and dialysis. Changes in immunosuppression to more potent agents over the years will have affected transplant outcome; there is also evidence that tacrolimus is more effective than cyclosporine...
2012: International Journal of Organ Transplantation Medicine
Luc Mouthon, Guillaume Bussone, Alice Berezné, Laure-Hélène Noël, Loïc Guillevin
Scleroderma renal crisis (SRC) is characterized by malignant hypertension and oligo-anuric acute renal failure. It occurs in 5% of patients with systemic sclerosis (SSc), particularly in patients with diffuse disease during the first years. SRC is more common in patients receiving corticosteroids, the risk increasing with increasing dose. The disease is sometimes triggered by use of nephrotoxic drugs and/or intravascular volume depletion. Left ventricular insufficiency and hypertensive encephalopathy are typical clinical features...
June 2014: Journal of Rheumatology
Evangéline Pillebout
Hepatorenal syndrome is a severe complication of end-stage liver disease. The pathophysiological hallmark is severe renal vasoconstriction, resulting from peripheral and splanchnic vasodilation as well as activation of renal vasoconstrictor molecules, which induce the effective arterial volume reduction and the functional renal failure. The diagnosis of hepatorenal syndrome is currently based on the exclusion of other causes of renal failure (especially prerenal). Spontaneous bacterial peritonitis is one of the triggering factors and should be sought in all patients with severe liver disease and acute renal failure...
February 2014: Néphrologie & Thérapeutique
O Okunola, A Akinsola, O Ayodele
AIM: To review available literature on the burden of kidney diseases in Africa from the perspective of acute kidney injury and chronic kidney disease. It also aims to provide information on the status of renal replacement therapy activities, and the emerging roles of the double burden of communicable and non communicable diseases interfacing with the kidney in a continent with distinct environmental, socio-cultural, infrastructural and economical peculiarities. METHODS: A literature search was conducted on the aetiopathogenesis, management options of peculiar diseases causing both acute kidney injury and chronic kidney diseases and renal replacement therapies in Africa...
June 2012: African Journal of Medicine and Medical Sciences
Christina M Wyatt
Acute kidney injury (AKI) and chronic kidney disease (CKD) are more common in HIV-infected persons than in the general population. AKI is associated with poor health outcomes, including increased risk of heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality. The most common causes of AKI in HIV-infected persons are systemic infections and adverse drug effects. The prevalence of CKD is rising in the HIV-infected population and CKD is increasingly likely to be caused by comorbid conditions, such as diabetes and hypertension, that frequently cause CKD in the general population...
August 2012: Topics in Antiviral Medicine
Dongmei Chen, Zheng Tang, Chunlei Luo, Huiping Chen, Zhihong Liu
AIM: To study the clinical and pathological characteristics of aristolochic acid nephropathy (AAN). METHODS: 86 patients with AAN during 2001 and 2009 in our department were recruited in this retrospective study. The clinical and pathological features were analyzed. RESULTS: There were 47 males and 39 females, aging from 12 to 69 years old. Abnormal urine analysis and gastro-intestinal diseases were two main underlying causes for patients taking aristolochic acid (AA) containing drugs...
July 2012: Clinical Nephrology
Jose M Miro, Federico Cofan, Joan C Trullas, Christian Manzardo, Carlos Cervera, Montserrat Tuset, Federico Oppenheimer, Mercedes Brunet, Asuncion Moreno, Josep M Campistol, Jose M Gatell
Antiretroviral therapy has been immensely successful in reducing the incidence of opportunistic infections and death after HIV infection. This has resulted in heightened interest in noninfectious comorbidities including kidney disease. Although HIV-associated nephropathy, the most ominous kidney disease related to the direct effects of HIV, may be prevented and treated with antiretrovirals, kidney disease remains an important issue in this population. In addition to the common risk factors for kidney disease of diabetes mellitus and hypertension, HIV-infected individuals have a high prevalence of other risk factors, including hepatitis C and exposure to antiretrovirals and other medications...
September 2012: Current HIV/AIDS Reports
Brian J Nankivell, Dirk R J Kuypers
Kidney transplantation is the best possible treatment for many patients with end-stage renal failure, but progressive dysfunction and eventual allograft loss with return to dialysis is associated with increased mortality and morbidity. Immune injury from acute or chronic rejection and non-immune causes, such as nephrotoxicity from calcineurin inhibitors, ischaemia-reperfusion injury, recurrent glomerular disease, and allograft BK viral infection, are potential threats. Serial monitoring of renal function enables early recognition of chronic allograft dysfunction, and investigations such as therapeutic drug concentrations, urinalysis, imaging, and a diagnostic biopsy should be undertaken before irreversible nephron loss has occurred...
October 15, 2011: Lancet
F Tinti, I Umbro, A Meçule, M Rossi, M Merli, I Nofroni, S Ginanni Corradini, L Poli, F Pugliese, F Ruberto, P B Berloco, A P Mitterhofer
Renal dysfunction in cirrhotic patients is primary related to disturbances of circulatory function, triggered by portal hypertension with chronic intrarenal vasoconstriction and hypoperfusion. Pretransplant renal function is an important factor implicated in the development of acute renal failure (ARF) after liver transplantation (OLT), but other factors mostly related to liver function seem to influence the development of ARF. The Acute Dialysis Quality Initiative workgroup developed the RIFLE classification to define ARF...
May 2010: Transplantation Proceedings
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