International Journal of Nephrology最新文献

{"title":"Calcific Uremic Arteriolopathy: A Case Series and Review from an Inner-City Tertiary University Center in End-Stage Renal Disease Patients on Renal Replacement Therapy.","authors":"Mohamed Omer,&nbsp;Zeenat Yousuf Bhat,&nbsp;Nanette Fonte,&nbsp;Nashat Imran,&nbsp;James Sondheimer,&nbsp;Yahya Osman-Malik","doi":"10.1155/2021/6661042","DOIUrl":"https://doi.org/10.1155/2021/6661042","url":null,"abstract":"<p><strong>Materials and methods: </strong>24 patients with CUA and on RRT were evaluated at Detroit Medical Center from 2007 to 2016. Skin biopsy was used in almost all patients, along with the radiological and clinical findings. The patient's clinical and paraclinical data were retrieved from the electronic medical records. The effect of treatment modalities and the underlying hyperparathyroidism management were compared to the clinical outcomes using appropriate statistical tests.</p><p><strong>Results: </strong>Twenty-one patients were on hemodialysis, two patients received renal transplants, and one patient was on peritoneal dialysis. Diabetes mellitus was the most prevalent cause of ESRD. The parathyroid hormone level (PTH) was elevated in 22 patients. Fifteen patients were diagnosed 2 weeks or more prior to skin lesion onset. Twenty-two and thirteen patients received sodium thiosulphate and cinacalcet, respectively. Patients with lower PTH and the calcium-phosphate product levels had a relatively better outcome of CUA.</p><p><strong>Conclusions: </strong><i>A m</i>ultifaceted approach may play a role in treating CUA. Referral to a nephrologist may aid in the early diagnosis and prompt management of CUA.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"6661042"},"PeriodicalIF":2.1,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeat and Relapsing Peritonitis Microbiological Trends and Outcomes: A 21-Year Single-Center Experience.","authors":"Marina Reis,&nbsp;Catarina Ribeiro,&nbsp;Ana Marta Gomes,&nbsp;Clara Santos,&nbsp;Daniela Lopes,&nbsp;João Carlos Fernandes","doi":"10.1155/2021/6662488","DOIUrl":"https://doi.org/10.1155/2021/6662488","url":null,"abstract":"<p><p>Peritonitis is a major peritoneal dialysis complication. Despite a high cure rate, relapsing and repeat peritonitis is associated with Tenckhoff catheter biofilm and multiple episodes of peritoneal damage. In relapsing peritonitis, prompt catheter removal is mandatory; otherwise, in repeat peritonitis, there is not a clear indication for catheter removal. It is questionable if the approach to removal should be different. There are few recent data on repeat and relapsing peritonitis microbiology and clinical outcomes since most studies are from the past decade. This study evaluates the microbiology, clinical outcomes, and impact of relapsing and repeat peritonitis on technique survival and the impact of catheter removal in development of further peritonitis episodes by the same microorganism. We developed a single-center retrospective study from 1998 to 2019 that compared repeat and relapsing peritonitis with a control group in terms of causative microorganisms, cure rate, catheter removal, and permanent and temporary transfer to hemodialysis. We also compared repeat and relapsing peritonitis clinical outcomes when Tenckhoff catheter was not removed. Comparing to the control group, the repeat/relapsing group had a higher cure rate (80.4% <i>versus</i> 74.5%, <i>p</i>=0.01) and lower rate of hospitalization (10.9% versus 27.7%, <i>p</i>=0.01). Technique survival was superior in the repeat/relapsing group (log rank = 4.5, <i>p</i>=0.03). Gram-positive peritonitis was more common in the repeat/relapsing group especially <i>Streptococci viridans</i> (43.5% versus 21.3%, <i>p</i>=0.01) and Gram-negatives in the control group (26.6% vs 9.0%, <i>p</i>=0.02). When the Tenckhoff catheter was not removed after a repeat episode, 58.6% developed a new repeat/relapsing episode versus 60.0% in the relapsing group. Although repeat and relapsing peritonitis have a higher cure rate, it leads to further episodes of peritonitis and consequent morbidity. When Tenckhoff catheter was not removed, the probability of another peritonitis episode by the same microorganism is similar in repeat and relapsing peritonitis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"6662488"},"PeriodicalIF":2.1,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25351261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Prolonged-Release Pirfenidone on Renal Function in Septic Acute Kidney Injury Patients: A Double-Blind Placebo-Controlled Clinical Trial.","authors":"Jonathan S Chávez-Iñiguez,&nbsp;Jorge L Poo,&nbsp;Miguel Ibarra-Estrada,&nbsp;Leonel García-Benavides,&nbsp;Guillermo Navarro-Blackaller,&nbsp;Cynthia Cervantes-Sánchez,&nbsp;Eduardo Nungaray-Pacheco,&nbsp;Ramón Medina-González,&nbsp;Juan Armendariz-Borunda,&nbsp;Guillermo García-García","doi":"10.1155/2021/8833278","DOIUrl":"https://doi.org/10.1155/2021/8833278","url":null,"abstract":"<p><strong>Background: </strong>There is no treatment for septic acute kidney injury (sAKI). The anti-inflammatory activity of prolonged-release pirfenidone (PR-PFD) could be beneficial in this clinical setting.</p><p><strong>Methods: </strong>This study was a double-blind randomized clinical trial in sAKI patients with nephrology consultation at the Civil Hospital of Guadalajara, in addition to the usual treatment of AKI associated with sepsis; patients were randomized to receive either PR-PFD at 1,200 mg/day (group A) or 600 mg/day (group B) or a matched placebo for 7 consecutive days. The primary objective was the decrease in serum creatinine (sCr) and increase in urinary volume (UV); the secondary objectives were changes in serum electrolytes, acid-base status, and mortality.</p><p><strong>Results: </strong>Between August 2016 and August 2017, 88 patients were randomized. The mean age was 54 (17 ± SD) years, and 47% were male. The main site of infection was the lung (39.8%), septic shock was present in 39.1% of the cases, and the mean SOFA score was 8.8 points. 28 patients received PFD 1,200 mg, 30 patients received PFD 600 mg, and 30 patients received placebo. During the study, sCr did not differ among the groups. The reversion rate of sCr, UV, and mortality was not different among the groups (<i>p</i>=0.70, <i>p</i>=0.47, and <i>p</i>=0.38, respectively). Mild adverse events were not different among the groups.</p><p><strong>Conclusion: </strong>PR-PFD did not improve the clinical course of sAKI and seemed to be safe in terms of adverse events. This trial is registered with NCT02530359.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"8833278"},"PeriodicalIF":2.1,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognition and Implementation of Disaster Preparedness among Japanese Dialysis Facilities.","authors":"Hidehiro Sugisawa,&nbsp;Toshio Shinoda,&nbsp;Yumiko Shimizu,&nbsp;Tamaki Kumagai","doi":"10.1155/2021/6691350","DOIUrl":"https://doi.org/10.1155/2021/6691350","url":null,"abstract":"<p><strong>Introduction: </strong>Few quantitative studies have explored disaster preparedness in dialysis facilities worldwide. This study examined the levels of disaster preparedness and their related factors in dialysis facilities in Japan.</p><p><strong>Methods: </strong>We conducted a mail survey using a self-administered questionnaire for key persons responsible for disaster preparedness in dialysis facilities (<i>N</i> = 904) associated with the Japanese Association of Dialysis Physicians. Levels of disaster preparedness were evaluated by the implementation rates of four domains: (1) patient, (2) administration, (3) network, and (4) safety. Additionally, we focused on cognitive factors related to disaster preparedness, such as risk perception, outcome expectancy, self-efficacy, self-responsibility, and support from the surroundings.</p><p><strong>Results: </strong>A total of 517 participants answered the survey (response rate: 57.2%). Implementation rates differed according to the domains of disaster preparedness. While the average implementation rate of the safety domain was 81.8%, each average implementation rate was 57.9%, 48.3%, and 38.4% for the administration, network, and patient domains, respectively. The study found that self-efficacy and support from the surroundings of the participants were significantly associated with the four domains of disaster preparedness. Alternatively, risk perception and support from surroundings were significantly associated with one particular domain each.</p><p><strong>Conclusion: </strong>Our results suggest that boosting self-efficacy and support from surroundings among key persons of disaster preparedness in dialysis facilities may contribute to the advancement of the different domains of disaster preparedness.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"6691350"},"PeriodicalIF":2.1,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Method for the Measurement of International Normalized Ratio in Hemodialysis Patients with Heparin-Locked Tunneled Dialysis Catheters.","authors":"Céline B Seghers, Kristien Ver Elst, Jolien Claessens, Steven Weekx, Sigrid Vermeiren, Manu Henckes","doi":"10.1155/2020/7586437","DOIUrl":"10.1155/2020/7586437","url":null,"abstract":"<p><strong>Background: </strong>To measure International Normalized Ratio (INR) in hemodialysis patients with tunneled dialysis catheters (TDCs), blood sampling is frequently obtained via the catheter at the start of the session. INR measurements via finger-prick point of care testing (POCT) and via blood sampling taken from the dialysis circuit are evaluated as alternatives.</p><p><strong>Methods: </strong>In 14 hemodialysis patients with TDCs, treated with vitamin K antagonists (VKA), INR measurements via POCT were compared with plasma INR samples taken via the catheter at the start of dialysis and via the dialysis circuit after 30 and 60 minutes during 3 nonconsecutive dialysis sessions.</p><p><strong>Results: </strong>Blood samples taken at the start of dialysis at the catheter site were frequently contaminated with heparin originating from the locking solution (unfractionated heparin concentration (UFH) >1.0 IU/ml in 13.2%). POCT INR at the start of dialysis was not different from plasma INR after 30 and 60 minutes (Wilcoxon test <i>p</i>=0.113, <i>n</i> = 37, and <i>p</i>=0.631, <i>n</i> = 36, respectively). Moreover, there was no difference between POCT INR at the start of dialysis and POCT INR after 30 and 60 minutes (Wilcoxon test <i>p</i>=0.797 and <i>p</i> = 0.801, respectively; <i>n</i> = 36). Passing and Bablok regression equation was used, <i>y</i> = 0.460 + 0.733x; <i>n</i> = 105. Treatment decisions based on these 2 methods showed a very good overall agreement (kappa = 0.810; 95% CI: 0.732-0.889; <i>n</i> = 105).</p><p><strong>Conclusions: </strong>Measuring plasma INR via the TDC at the start of dialysis should be abandoned. Measuring POCT INR via a finger prick at the start or even after 30 to 60 minutes is an alternative. The most elegant alternative is to take plasma INR samples via the dialysis circuit 30 minutes or later after the start of the dialysis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"7586437"},"PeriodicalIF":2.1,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39151891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Prognosis of Hyperferritinemia Induced by Intravenous Iron Therapy in Patients Undergoing Maintenance Hemodialysis: A 10-Year, Single-Center Study.","authors":"Sayako Maeda,&nbsp;Ryo Konishi,&nbsp;Takuya Morinishi,&nbsp;Yoko Shimizu,&nbsp;Haruomi Nishio,&nbsp;Koji Takaori","doi":"10.1155/2020/8864400","DOIUrl":"https://doi.org/10.1155/2020/8864400","url":null,"abstract":"<p><p>Optimal ferritin level in hemodialysis patients between Japan and other countries is controversial. Long-term side effects of iron supplementation in these patients remain unclear. We aimed to elucidate whether past hyperferritinemia in hemodialysis patients was associated with high risk of death and cerebrovascular and cardiovascular diseases (CCVDs). This small retrospective cohort study included approximately 44 patients unintentionally supplemented with excessive intravenous iron. A significantly higher risk of CCVDs was observed in patients with initial serum ferritin levels ≥1000 ng/mL than in the remaining patients. High ferritin levels slowly decreased to <300 ng/mL in a median of 24.2 (10.5-46.5) months without treatment. However, compared with the remaining patients, only patients whose ferritin levels did not decrease to <300 ng/mL steadily had a significantly higher risk of all-cause death (hazard ratio, 9.6). Long-term hyperferritinemia due to intravenous iron therapy is a risk factor for death in maintenance hemodialysis patients. For a prolonged better prognosis, intravenous iron should be carefully administered so as to avoid hyperferritinemia in patients with hemodialysis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"8864400"},"PeriodicalIF":2.1,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38767733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Transplant Pathology: Demographic Features and Histopathological Analysis of the Causes of Graft Dysfunction.","authors":"Shaarif Bashir,&nbsp;Mudassar Hussain,&nbsp;Azhar Ali Khan,&nbsp;Usman Hassan,&nbsp;Khawaja Sajid Mushtaq,&nbsp;Maryam Hameed,&nbsp;Usman Ayub Awan","doi":"10.1155/2020/7289701","DOIUrl":"https://doi.org/10.1155/2020/7289701","url":null,"abstract":"<p><strong>Background: </strong>Renal transplant has emerged as a preferred treatment modality in cases of end-stage renal disease; however, a small percentage of cases suffer from graft dysfunction.</p><p><strong>Aim: </strong>To evaluate the renal transplant biopsies and analyze the various causes of graft dysfunction.</p><p><strong>Materials and methods: </strong>163 renal transplant biopsies, reported between 2014 and 2019 and who fulfilled the inclusion criteria, were evaluated with respect to demographics, clinical, histological, and immunohistochemical features.</p><p><strong>Results: </strong>Of 163 patients, 26 (16%) were females and 137 (84%) were males with a mean age of 34 ± 7 years. 53 (32.5%) cases were of rejection (ABMR and TCMR), 1 (0.6%) was borderline, 15 were of IFTA, and rest of 94 cases (57.7%) belonged to the others category. SCr (serum creatinine) in cases of rejection was 3.85 ± 0.55 mg/dl. Causes of early graft dysfunction included active ABMR (7.1 ± 4.7 months), acute TCMR (5.5 months), and acute tubular necrosis (after 6 ± 2.2 months of transplant) while the causes of late rejection were CNIT and IFTA (34 ± 4.7 and 35 ± 7.8 months, respectively).</p><p><strong>Conclusion: </strong>Renal graft dysfunction still remains a concerning area for both clinicians and patients. Biopsy remains the gold standard for diagnosing the exact cause of graft dysfunction and in planning further management.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"7289701"},"PeriodicalIF":2.1,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7289701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional Interaction of Thyroid-Kidney Organs in Disease States.","authors":"Fateme Shamekhi Amiri","doi":"10.1155/2020/5248365","DOIUrl":"https://doi.org/10.1155/2020/5248365","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid hormones play an important role in growth, development, and physiology of the kidney. The kidney plays a key role in the metabolism, degradation, and excretion of thyroid hormones and its metabolites. The aim of this study is to investigate the prevalence of disease states of thyroid-kidney organs and detecting the correlation between thyroid and kidney function abnormalities.</p><p><strong>Materials and methods: </strong>In this retrospective study, a total of forty-five patients with thyroid and kidney dysfunction were investigated. Clinical features, laboratory data at initial presentation, management, and outcomes were collected. The paper has been written based on searching PubMed and Google Scholar to identify potentially relevant articles or abstracts. Median, percentage, mean ± standard deviation (SD), and the two-tailed <i>t</i>-test were used for statistical analyses. The correlation between variables was assessed by Pearson's, Spearman's correlation tests and regression analyses.</p><p><strong>Results: </strong>The mean ± SD of age of study patients was 48.2 ± 22.93 years (ranging from 1 to 90 years). There was no correlation between serum thyroid-stimulating hormone, free thyroxine levels with estimated glomerular filtration rate, and proteinuria. No association between antimicrosomal antibodies with estimated glomerular filtration rate was seen. Cardiovascular disease was the most common complication of overt hypothyroidism in kidney dysfunction patients.</p><p><strong>Conclusion: </strong>The present study showed more prevalence of primary hypothyroidism in comparison with other thyroid dysfunctions in patients with kidney dysfunction. Reduced mean values of thyroid function profiles after treatment suggest that this thyroid disease should be considered and ameliorated with thyroid hormone replacement therapy in patients with kidney disease.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"5248365"},"PeriodicalIF":2.1,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5248365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38735036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Urine Dilution Ability between Adult Dominant Polycystic Kidney Disease, Other Chronic Kidney Diseases, and Healthy Control Subjects: A Case-Control Study.","authors":"M H Malmberg,&nbsp;F H Mose,&nbsp;E B Pedersen,&nbsp;J N Bech","doi":"10.1155/2020/4108418","DOIUrl":"https://doi.org/10.1155/2020/4108418","url":null,"abstract":"<p><p>The final dilution of urine is regulated via aquaporin-2 water channels in the distal part of the nephron. It is unclear whether urine dilution ability in autosomal dominant polycystic kidney disease patients (ADPKD patients) differs from other patients with similar degree of impaired renal function (non-ADPKD patients). The purpose of this case control study was to measure urine dilution ability in ADPKD patients compared to non-ADPKD patients and healthy controls. <i>Methods</i>. Eighteen ADPKD, 16 non-ADPKD patients (both with chronic kidney disease, stage I-IV), and 18 healthy controls received an oral water load of 20 ml/kg body weight. Urine was collected in 7 consecutive periods. We measured free water clearance (C_H2O), urine osmolality, urine output, fractional excretion of sodium, urine aquaporin2 (u-AQP2), and urine epithelial sodium channel (u-ENaC). Blood samples were drawn four times (at baseline, 2 h, 4 h, and 6 hours after the water load) for analyses of plasma osmolality, vasopressin, renin, angiotensin II, and aldosterone. Brachial and central blood pressure was measured regularly during the test. <i>Results</i>. The three groups were age and gender matched, and the patient groups had similar renal function. One hour after water load, the ADPKD patients had an increased C_H2O compared to non-ADPKD patients (2.97 ± 2.42 ml/min in ADPKD patients vs. 1.31 ± 1.50 ml/min in non-ADPKD patients, <i>p</i>0.029). The reduction in u-AQP2 and u-ENaC occurred earlier in ADPKD than in non-ADPKD patients. Plasma concentrations of vasopressin, renin, angiotensin II, and aldosterone and blood pressure measurements did not show any differences that could explain the deviation in urine dilution capacity between the patient groups. <i>Conclusions</i>. ADPKD patients had a higher C_H2O than non-ADPKD patients after an oral water load, and u-AQP2 and u-ENaC were more rapidly reduced than in non-ADPKD patients. Thus, urine-diluting capacity may be better preserved in ADPKD patients than in non-ADPKD patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"4108418"},"PeriodicalIF":2.1,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4108418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38735035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Kidney Injury Caused by Obstructive Nephropathy.","authors":"Jonathan S Chávez-Iñiguez,&nbsp;Goretty J Navarro-Gallardo,&nbsp;Ramón Medina-González,&nbsp;Luz Alcantar-Vallin,&nbsp;Guillermo García-García","doi":"10.1155/2020/8846622","DOIUrl":"https://doi.org/10.1155/2020/8846622","url":null,"abstract":"<p><p>Acute kidney injury secondary to obstructive nephropathy is a frequent event that accounts for 5 to 10% of all acute kidney injury cases and has a great impact on the morbidity and mortality in those affected. The obstruction in the urinary tract has a profound impact on kidney function due to damage produced by ischemic and inflammatory factors that have been associated with intense fibrosis. This pathology is characterized by its effects on the management of fluids, electrolytes, and the acid-base mechanisms by the renal tubule; consequently, metabolic acidosis, hyperkalemia, uremia, and anuria are seen during acute kidney injury due to obstructive nephropathy, and after drainage, polyuria may occur. Acute urine retention is the typical presentation. The diagnosis consists of a complete medical history and should include changes in urinary voiding and urgency and enuresis, history of urinary tract infections, hematuria, renal lithiasis, prior urinary interventions, and constipation. Imaging studies included tomography or ultrasound in which hydronephrosis can be seen. Management includes, in addition to drainage of the obstructed urinary tract system, providing supportive treatment, correcting all the metabolic abnormalities, and initiating renal replacement therapy when required. Although its recovery is in most cases favorable, it seems to be an undervalued event in nephrology and urology. This is because it is mistakenly believed that the resolution and recovery of kidney function is complete once the urinary tract is unobstructed. It can have serious kidney sequelae. In this review, we report the epidemiology, incidence, pathophysiological mechanisms, diagnosis, and treatment of acute kidney injury due to obstructive nephropathy.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2020 ","pages":"8846622"},"PeriodicalIF":2.1,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8846622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38708521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}