Clinical nephrology最新文献_第9页

Thrombotic complications in children with first-episode steroid-sensitive nephrotic syndrome: A single-center experience. 首发类固醇敏感肾病综合征患儿的血栓性并发症:单中心研究

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN110932

Agnieszka Such-Gruchot, Hanna Szymanik-Grzelak, Małgorzata Pańczyk-Tomaszewska, Agata Poźniak, Michał Brzewski

{"title":"Thrombotic complications in children with first-episode steroid-sensitive nephrotic syndrome: A single-center experience.","authors":"Agnieszka Such-Gruchot, Hanna Szymanik-Grzelak, Małgorzata Pańczyk-Tomaszewska, Agata Poźniak, Michał Brzewski","doi":"10.5414/CN110932","DOIUrl":"https://doi.org/10.5414/CN110932","url":null,"abstract":"Objective: The aim of the study was to evaluate the clinical course and risk factors of venous thromboembolic complications (VTEC) in children with a first episode of steroid-sensitive nephrotic syndrome (SSNS).Materials and methods: We retrospectively analyzed the medical records of children hospitalized due to SSNS in one pediatric nephrology unit between 2012 and 2019. Demographic data, clinical symptoms at the onset of NS, and laboratory parameters were compared between patients with and without VTEC.Results: Among 106 children (4.7 ± 3.06 years of age) with a first episode of SSNS, 5 VTEC were diagnosed during 2 - 60 days after onset of NS, on the basis of clinical symptoms and/or results of imaging studies. These were thromboses of femoral vein, central part of the kidney, dorsal veins of the hand, venous sinuses of the brain, and superficial vein in the popliteal fossa region. We found significant higher serum fibrinogen level (p = 0.022) and D-dimers (p = 0.0001) in children with VTEC vs. those without VTEC, but AUC analysis showed that only D-dimers significantly differentiate thrombosis. The clinical risk factors of VTEC were vascular cannulation (100%), infections (80%), and diuretics (80%). In children with VTEC, low molecular weight heparin was used. The outcome was a full recovery in all patients.Conclusion: VTEC occurs in 4.72% of children with a first episode of SSNS. The course of VTEC in children with SSNS may be asymptomatic. The clinical risk factors of VTEC in children with SSNS are vascular cannulation, infections, and diuretics. High D-dimer levels are a sensitive indicator of thrombosis.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"100 1","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Better late than never: Diagnosis of recurrent atypical hemolytic uremic syndrome. 迟做总比不做好:复发性非典型溶血性尿毒症综合征的诊断。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN111047

Sari Aaltonen, Anne Räisänen-Sokolowski, Kati Kaartinen

引用次数: 0

Effects of dexmedetomidine administration on outcomes in critically ill patients with acute kidney injury: A propensity score-matching analysis. 右美托咪定给药对急性肾损伤危重患者预后的影响:倾向评分匹配分析。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN111041

Aixiang Yang, Jing Yang, Biying Zhou, Jinxian Qian, Liyang Jiang, Zhuo Jiang, Guoyuan Lu

{"title":"Effects of dexmedetomidine administration on outcomes in critically ill patients with acute kidney injury: A propensity score-matching analysis.","authors":"Aixiang Yang, Jing Yang, Biying Zhou, Jinxian Qian, Liyang Jiang, Zhuo Jiang, Guoyuan Lu","doi":"10.5414/CN111041","DOIUrl":"https://doi.org/10.5414/CN111041","url":null,"abstract":"Purpose: To evaluate the effects of dexmedetomidine (DEX) on outcomes of critically ill patients with acute kidney injury (AKI).Materials and methods: Data were extracted from the Medical Information Mart for Intensive Care III database (MIMIC III). Propensity score matching (PSM) analysis (1 : 3), Cox proportional hazards model, linear regression and logistic regression model were used to assess the effect of DEX on clinical outcomes.Results: After PSM, 324 pairs of patients were matched between the patients with DEX administration and those without. DEX administration was associated with decreased in-hospital mortality (hazard ratio (HR) 0.287; 95% CI 0.151 - 0.542; p < 0.001) and 90-day mortality (HR 0.344; 95% CI 0.221 - 0.534; p < 0.001), and it was also associated with reduced length of stay (LOS) in ICU (4.54 (3.13,7.72) vs. 5.24 (3.15,10.91), p < 0.001) and LOS in hospital (11.63 (8.02,16.79) vs 12.09 (7.83,20.44), p = 0.002). Subgroup analysis showed that the above associations existed only in the mild and moderate AKI subgroups, but not in the severe AKI subgroup. Nevertheless, DEX administration was not associated with recovery of renal function (HR 1.199; 95% CI 0.851 - 1.688; p = 0.300).Conclusion: DEX administration improved outcomes in critically ill patients with mild and moderate AKI and could be a good choice of sedation.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"100 1","pages":"28-36"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pilot study to investigate the effects of starting peritoneal dialysis 3 days after laparoscopic peritoneal dialysis catheter placement. 初步研究腹腔镜腹膜透析置管后3天开始腹膜透析的效果。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN110986

Kazuya Sugita, Naoki Washida, Masashi Tsunematsu, Kouji Hosoya, Yutaka Suzuki

引用次数: 0

Heparin-induced thrombocytopenia after switching from unfractionated heparin to low-molecular-weight heparin: A case report and literature review. 从未分离肝素切换到低分子量肝素后肝素诱导的血小板减少:一个病例报告和文献综述。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN110947

Fan Zhang, Yiya Yang, Lizhen Li, Li Zhang, Ying Wu, Yumei Liang, Xun Luo

引用次数: 0

Additional antibiotic lock in peritoneal dialysis-associated refractory peritonitis: A case series study and literature survey. 腹膜透析相关难治性腹膜炎的额外抗生素锁定:病例系列研究和文献调查。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN111004

Weijing Lai, Bo Wang, Ruoxi Liao, Ping Fu, Hui Zhong

{"title":"Additional antibiotic lock in peritoneal dialysis-associated refractory peritonitis: A case series study and literature survey.","authors":"Weijing Lai, Bo Wang, Ruoxi Liao, Ping Fu, Hui Zhong","doi":"10.5414/CN111004","DOIUrl":"https://doi.org/10.5414/CN111004","url":null,"abstract":"Background: Refractory peritonitis is one of the leading causes of catheter failure in peritoneal dialysis (PD) patients. However, there are no established curative therapies available, and only catheter removal should be performed. Here we present a case series study to illustrate the efficacy of antibiotic lock for PD-associated refractory peritonitis.Materials and methods: Patients with refractory peritonitis treated with intraperitoneal antibiotics plus antibiotic lock from September 2020 to March 2022 were retrospectively analyzed. Medical cure was identified as a success of treatment.Results: We identified 11 patients, of which 7 (63.64%) had a history of PD-associated peritonitis, with the episode of continuous ambulatory peritoneal dialysis (CAPD) ranging from 1 to 158 months at a median of 36 (9.5, 50.5) months. The dialysis effluent culture showed Gram-positive, Gram-negative bacteria, and was culture-negative in 5, 2, and 4 cases, respectively. The cure rates were 85.71% for culture-positive cases and 25% for culture-negative cases, and the total cure rate was 63.64%. No relevant adverse events occurred, including sepsis.Conclusions: Treatment with the additional antibiotic lock was successful in most cases, especially in those that were culture-positive. Additional antibiotic lock deserves great attention and further investigation in treating PD-associated refractory peritonitis.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"100 1","pages":"12-18"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peritoneal dialysis related non-infectious complications: A single-center experience over 20 years. 腹膜透析相关的非感染性并发症:20多年的单中心经验。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN111092

Elbis Ahbap, Emrah E Mazi, Taner Basturk, Tamer Sakaci, Mahmut B Aykent, Abdulkadir Unsal

{"title":"Peritoneal dialysis related non-infectious complications: A single-center experience over 20 years.","authors":"Elbis Ahbap, Emrah E Mazi, Taner Basturk, Tamer Sakaci, Mahmut B Aykent, Abdulkadir Unsal","doi":"10.5414/CN111092","DOIUrl":"https://doi.org/10.5414/CN111092","url":null,"abstract":"Objectives: Non-infectious complications of peritoneal dialysis (NICPD) are common and could be an important cause of technical failure, especially in the early period of peritoneal dialysis (PD) initiation. NICPD are also center- and provider-dependent. This study aimed to investigate the frequency, etiology, and associated outcomes of NICPD in a single center over a period of 20 years.Materials and methods: Data were retrospectively collected in 262 patients who were initiated on PD between April 2001 and April 2021. Inclusion criteria were age 18 years or older and a minimum follow-up period of 3 months. Patients were grouped according to the reason of NICPD: catheter-related, increased intra-abdominal pressure-related, metabolic, and other complications.Results: There were 142 females and 120 males in the study, with a mean age of 44 ± 16.9 years. The mean time on PD was 52.6 ± 40 months. During the follow-up period, 185 (71%) patients experienced 382 NICPD episodes. 26 patients (9.9%) were switched to maintenance hemodialysis (HD) due to NICPD. Outflow failure was the most common NICPD (n = 97). It was also the most common reason for catheter revision (n = 23) and PD discontinuation (n = 12). Catheter intervention was required in 32 patients (12.2%). Prior HD treatment and male gender were independent risk factors for NICPD and catheter-related complications (OR 2.076; p = 0.037; OR: 1.797, p = 0.042, respectively). Early-start PD was associated with a lower risk for NICPD development (OR: 0.393, p = 0.013).Conclusion: In this select cohort of PD patients, we found that NICPD are common and outflow failure is the most common cause of NICPD. NICPD are associated with major complications requiring catheter removal or transfer to in-center HD. Early recognition and appropriate management of NICPD are essential to prolonging time on PD in end-stage renal disease patients.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"100 1","pages":"19-26"},"PeriodicalIF":1.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diuretic resistance in acute decompensated HFpEF vs. HFrEF. 急性失代偿HFpEF与HFrEF的利尿抵抗。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-07-01 DOI: 10.5414/CN111090

Akash Sharma, Rahul Patel, Anand Prasad, Shweta Bansal

引用次数: 0

Evaluation of encrustation of double J stents with artificial urine. 人工尿对双J型支架结痂的评价。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-06-01 DOI: 10.5414/CN111038

Seung Bae Lee, Se-Hyun Park, Hyoung-Ho Kim, Chang Je Lee, Sang Won Seon, Yasutaka Baba, Kyung-Wuk Kim, Young Ho Choi

{"title":"Evaluation of encrustation of double J stents with artificial urine.","authors":"Seung Bae Lee, Se-Hyun Park, Hyoung-Ho Kim, Chang Je Lee, Sang Won Seon, Yasutaka Baba, Kyung-Wuk Kim, Young Ho Choi","doi":"10.5414/CN111038","DOIUrl":"https://doi.org/10.5414/CN111038","url":null,"abstract":"Purpose: To evaluate the formation of encrustation on double J stents (DJSs) using artificial urine.Materials and methods: In this study, a static urinary system containing artificial urine was created, and a total of 45 DJSs were used to evaluate the formation of encrustation. Three groups of 15 DJSs were tested for 4, 8, or 14 weeks. The formation of encrustation on the DJSs over the weeks was analyzed using methods including X-ray powder diffraction (XRD), inductively coupled plasma spectrophotometer (ICP), and scanning electron microscope (SEM). Statistical analysis and the uncertainty test were used for data analysis using R language.Results: The ICP analyzed the weight of the calcium and magnesium, which are the major components of urinary stones and encrustation, and showed that it was the heaviest at 14 weeks. Measurement of the area of encrustation on the outer surface of the DJSs revealed that the encrustation area at the bottom of the stent was greater than that at the top of the stent, regardless of the experimental period (proximal part: ≤ 41,099 µm2, distal part: ≤ 183,259 µm2). Encrustation occurred around the side holes of DJSs and became bigger over time to fill up the side holes.Conclusion: Encrustation spots included the bottom zone of the DJS and around the side holes. These results indicate that the performance of DJSs would be improved by modifying the shape of DJSs located near the bladder and side holes.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"99 6","pages":"290-298"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9581826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low-solute hyponatremia in a kidney transplant recipient. 肾移植受者低溶质低钠血症。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2023-06-01 DOI: 10.5414/CN111001

Benjamin Y F So, Gary C W Chan

{"title":"Low-solute hyponatremia in a kidney transplant recipient.","authors":"Benjamin Y F So, Gary C W Chan","doi":"10.5414/CN111001","DOIUrl":"https://doi.org/10.5414/CN111001","url":null,"abstract":"Background and aims: Electrolyte and acid-base disturbances are common in kidney transplant recipients, but there are few reports of low-solute hyponatremia or beer potomania in this population. We report herein a case of low-solute hyponatremia in a kidney transplant recipient with impaired graft function, highlighting key issues in diagnosis and management of low-solute hyponatremia, as well as exploring the pathophysiology of hyponatremia after kidney transplantation.Case presentation: A 51-year-old man who had received a cadaveric renal transplant 18 years before presented with symptomatic hyponatremia and seizure. Workup for an underlying intracranial pathology was negative, and subsequent biochemical workup suggested low-solute hyponatremia with potomania, arising from dietary modifications taken by the patient while self-isolating during the COVID-19 pandemic. Correction of hyponatremia was successful with conservative management with close monitoring.Conclusion: This case illustrates key points in the diagnosis and management of low-solute hyponatremia and highlights the pathophysiology of hyponatremia after kidney transplantation.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"99 6","pages":"307-310"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9581827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0