International Journal of Nephrology and Renovascular Disease最新文献

{"title":"Post-Operative Kidney Function Using Deep Hypothermic Circulatory Arrest (DHCA) in Aortic Arch Operation.","authors":"Masahide Higo,&nbsp;Yoshio Shimizu,&nbsp;Keiichi Wakabayashi,&nbsp;Takehiko Nakano,&nbsp;Yasuhiko Tomino,&nbsp;Yusuke Suzuki","doi":"10.2147/IJNRD.S373828","DOIUrl":"https://doi.org/10.2147/IJNRD.S373828","url":null,"abstract":"<p><strong>Background: </strong>Although deep hypothermic circulatory arrest (DHCA) is a useful option to protect the central nervous system during aortic arch operations, the influence of simultaneous renal ischemia remains controversial.</p><p><strong>Patients and methods: </strong>This is a retrospective observational study. Sixty-three patients who underwent thoracic aortic surgery with DHCA and 24 patients who underwent cardiac surgery without DHCA were included in this study. The mean age, preoperative serum creatinine (Cr) level, preoperative estimated glomerular filtration rate (eGFR), peak serum Cr level up to 48 hrs post-operative, elevation rate of Cr compared to the preoperative serum Cr, urine volume rate up to 48 hrs post-operative and AKI staging using the KDIGO criteria were estimated for each patient. Clinical parameters for 3 months after the operation and the 3-month post-operative mortality rate were assessed. Mean values indicating kidney function or distribution of the AKI stages were compared between patients with and without DHCA. Patients with DHCA were further divided according to the duration of ischemia to compare the values for the kidney function of each group, distribution of AKI stages and mortality.</p><p><strong>Results: </strong>The parameters indicating AKI of the patients with DHCA were significantly more severe than those without DHCA. Patients who had undergone an ischemic state for more than 40 min revealed significantly higher peak serum Cr, elevation rate of serum Cr, less urine volume up to 48 hrs post-operative compared with those without DHCA. Distribution of the AKI stages was related to the duration of ischemia. The 3-month post-operative mortality of the patients with DHCA was significantly higher than those without DHCA.</p><p><strong>Limitations: </strong>This study had limitations such as its retrospective design and small number patients, and the data will be required confirmation with other prospective studies.</p><p><strong>Conclusion: </strong>DHCA is closely related to AKI up to 48 hrs post-operative and death during the 3 months following surgery.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":" ","pages":"239-252"},"PeriodicalIF":2.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/66/ijnrd-15-239.PMC9524279.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393163","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":"Hyperkalemia in Chronic Kidney Disease: Links, Risks and Management.","authors":"Alexander Sarnowski,&nbsp;Rouvick M Gama,&nbsp;Alec Dawson,&nbsp;Hannah Mason,&nbsp;Debasish Banerjee","doi":"10.2147/IJNRD.S326464","DOIUrl":"https://doi.org/10.2147/IJNRD.S326464","url":null,"abstract":"<p><p>Hyperkalemia is a common clinical problem with potentially fatal consequences. The prevalence of hyperkalemia is increasing, partially due to wide-scale utilization of prognostically beneficial medications that inhibit the renin-angiotensin-aldosterone-system (RAASi). Chronic kidney disease (CKD) is one of the multitude of risk factors for and associations with hyperkalemia. Reductions in urinary potassium excretion that occur in CKD can lead to an inability to maintain potassium homeostasis. In CKD patients, there are a variety of strategies to tackle acute and chronic hyperkalemia, including protecting myocardium from arrhythmias, shifting potassium into cells, increasing potassium excretion from the body, addressing dietary intake and treating associated conditions, which may exacerbate problems such as metabolic acidosis. The evidence base is variable but has recently been supplemented with the discovery of novel oral potassium binders, which have shown promise and efficacy in studies. Their use is likely to become widespread and offers another tool to the clinician treating hyperkalemia. Our review article provides an overview of hyperkalemia in CKD patients, including an exploration of relevant guidelines and nuances around management.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":" ","pages":"215-228"},"PeriodicalIF":2.0,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/18/ijnrd-15-215.PMC9356601.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40704509","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":"Lipoprotein Glomerulopathy, First Case Report from Canada.","authors":"Julie Anne Ting,&nbsp;Susanna A McRae,&nbsp;Daniel Schwartz,&nbsp;Sean J Barbour,&nbsp;Maziar Riazy","doi":"10.2147/IJNRD.S364890","DOIUrl":"https://doi.org/10.2147/IJNRD.S364890","url":null,"abstract":"<p><p>Lipoprotein glomerulopathy (LPG) is caused by a mutation in the apolipoprotein E gene (<i>APOE</i>) gene and is characterized by lipoprotein thrombi in glomerular capillaries. Here, we describe a case of LPG, the first to be reported from Canada and the first case of LPG in North America to be associated with the <i>APOE</i> Tokyo/Maebashi mutation (p.Leu162_Lys164del, traditional nomenclature 142_144del). A 49-year-old man of Chinese descent with a previous diagnosis of dyslipidemia and a new diagnosis of hypertension was found to have proteinuria on routine urinalysis. Renal biopsy showed markedly dilated glomerular capillaries filled with pale staining mesh-like material that stained positive for Oil-Red-O, consistent with lipoprotein thrombi. <i>APOE</i> gene sequencing confirmed the diagnosis of LPG. The patient was treated with fenofibrate and perindopril. His lipid profile normalized and proteinuria dropped to minimal levels. Repeat renal biopsy 2 years after the first showed resolution of lipoprotein thrombi but with rare residual granular densities by electron microscopy consistent with lipoprotein in the subendothelial space, supporting the hypothesis that this subendothelial material contains precursors to lipoprotein thrombi.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":" ","pages":"207-214"},"PeriodicalIF":2.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/c4/ijnrd-15-207.PMC9233511.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40401374","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":"Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges","authors":"P. Menè, A. Stoppacciaro, S. Lai, F. Festuccia","doi":"10.2147/IJNRD.S280179","DOIUrl":"https://doi.org/10.2147/IJNRD.S280179","url":null,"abstract":"Abstract “Cast nephropathy” (CN) is a pathological feature of myeloma kidney, also seen to a lesser extent in the context of severe nephrotic syndrome from non-haematological diseases. The name relates to obstruction of distal tubules by “casts” of luminal proteins concentrated by intensive water reabsorption resulting from dehydration or high-dose diuretics. Filtered proteins form complexes with endogenous tubular Tamm-Horsfall glycoprotein. The resulting gel further slows or stops luminal flow upon complete obstruction of distal convoluted tubules and collecting ducts. Thus, a tubular obstructive form of acute kidney injury (AKI) is a common consequence of CN. The pathogenesis of CN will be reviewed in light of recent advances in the understanding of monoclonal disorders of B lymphocytes, leading to the release of immunoglobulin components (free light chains, FLC) into the bloodstream and their filtration across the glomerular basement membrane. Treatment aiming at reduction of the circulating burden of FLC may help recovery of renal function in a fraction of these patients, besides filling the void between the onset of AKI, histopathological diagnosis, and full response to pharmacologic treatment.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"173 - 183"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Factors Associated with Serum Magnesium Concentration in Patients Undergoing Peritoneal Dialysis: A Single-Center Observational Study","authors":"S. Kaneko, S. Ookawara, Y. Morishita","doi":"10.2147/IJNRD.S357130","DOIUrl":"https://doi.org/10.2147/IJNRD.S357130","url":null,"abstract":"Purpose Magnesium (Mg) is an essential element that is associated with various physiological functions, such as maintenance of blood pressure, muscle contraction, and nerve function. In patients undergoing hemodialysis, hypomagnesemia is associated with cardiovascular and all-cause mortality. However, in patients undergoing peritoneal dialysis (PD), clinical factors associated with Mg have not been fully investigated. Patients and Methods Clinical factors including anthropometric data, comorbidities, laboratory data, medications, and dialysis methods were collected from the medical records of patients undergoing PD. The associations of these factors with the serum Mg concentration were investigated by univariate and multivariate analyses. Results Sixty patients undergoing PD were investigated. The univariate analysis showed that the serum Mg concentration was significantly associated with treatment by hybrid PD (daily PD + once-weekly hemodialysis) (β = 0.264, P = 0.04), administration of phosphate binders (β = 0.294, P = 0.02), the serum C-reactive protein concentration (β = −0.318, P = 0.01), the serum potassium (K) concentration (β = 0.451, P < 0.01), and the serum intact parathormone concentration (β = −0.333, P = 0.01). The multivariate analysis using these factors showed an independent association between the serum Mg and K concentrations (β = 0.333, P = 0.01). Conclusion The serum Mg concentration was independently associated with the serum K concentration in patients undergoing PD.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"185 - 195"},"PeriodicalIF":2.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41829673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients","authors":"Y. Shimizu, Keiichi Wakabayashi, Junichiro Nakata, H. Io, C. Hamada, Y. Tomino, Yusuke Suzuki","doi":"10.2147/IJNRD.S358915","DOIUrl":"https://doi.org/10.2147/IJNRD.S358915","url":null,"abstract":"Background We experienced a sudden breakdown of hemodialysis system during a clinical study of dermal itch and serum BNP concentrations. Patients and Methods Forty-eight hemodialysis patients were enrolled in the itch-related study. It was intended to improve itch by lowering BNP with supportive communication between the patients and the dialysis staff. We planned to collect data, including visual analogue scale (VAS), dermatology life quality index (DLQI), blood samples and QOL score (KDQOL-SF), four times over a four week interval. The first data was obtained just prior to switching facilities due to a breakdown. The patients underwent hemodialysis in other facilities for two weeks and underwent determination of their clinical data, including QOL scores, three times. Results While mean blood pressure showed no significant differences, serum albumin, iron and phosphate levels were worsened significantly between pre- and post-relocation. Serum BNP and DLQI showed no significant changes. VAS was significantly worsened. The mean values of the cognitive function in the KDQOL-SF and sleep and the role-physical, role-emotional, social function, dialysis staff’s encouragement in SF-36 analysis were identified as statistically significant items by MANOVA. Both SF-12 physical and mental composites were also statistically significant. Although SF-12 physical composites were significant among the patients under 66 yrs of age (median), eight factors were significant among those over 66 yrs. Independent analyses revealed every item that was detected worsened significantly after the switch of facilities. Conclusion Unexpected switching of hemodialysis facilities severely impacts the QOL for a long duration as well as the patients’ symptom and laboratory data.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"151 - 160"},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47410249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental Hemodialysis: What We Know so Far","authors":"V. Soi, M. Faber, Ritika Paul","doi":"10.2147/IJNRD.S286947","DOIUrl":"https://doi.org/10.2147/IJNRD.S286947","url":null,"abstract":"Abstract Traditionally, patients that develop progressive chronic kidney disease in need of kidney replacement therapy are prescribed thrice weekly in-center hemodialysis sessions at the beginning of therapy. This empiric prescription is based on historic trials that were comprised of mostly prevalent patients. Incremental hemodialysis is the process of performing <3 sessions of dialysis per week or limiting dialysis dose by duration at the initial onset of treatment to provide a more gradual transition, mimicking the progressive nature of kidney disease. Adding clearance contributions from residual kidney function is the standard of care with peritoneal dialysis but has not routinely been employed with hemodialysis. Accounting for residual kidney function accompanied by improvement in adjuvant pharmacotherapy, such as newer potassium binding agents and dietary modification, can augment dialytic clearances and allow for an incremental approach. Utilizing incremental dialysis has been associated with both preserving residual kidney function as well as improving patient quality of life. Barriers to this approach include concerns regarding patient acceptance of dialysis prescription changes, adherence to therapy, and provider factors that would require a restructuring of the current thrice weekly hemodialysis rubric. Candidacy for incremental therapy has shown the best outcomes when urea clearances exceed 3 mL/min and urine volumes are >500 mL/day, although these measures have been deemed conservative. A significant amount of retrospective and registry data has been supportive of initiating incremental hemodialysis and several pilot studies have shown the feasibility of implementing such an approach. Larger, randomized control trials are needed to fully evaluate safety and efficacy to allow for more widespread acceptance of this patient-centered approach to chronic kidney disease.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"161 - 172"},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41335501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Phosphorus and Pill Burden Among Hemodialysis Patients Prescribed Sucroferric Oxyhydroxide: One-Year Follow-Up on a Contemporary Cohort","authors":"J. Kendrick, Mei Zhou, Linda H. Ficociello, Vidhya Parameswaran, C. Mullon, M. Anger, D. Coyne","doi":"10.2147/IJNRD.S353213","DOIUrl":"https://doi.org/10.2147/IJNRD.S353213","url":null,"abstract":"Purpose In prior analyses of real-world cohorts of hemodialysis patients switched from one phosphate binder (PB) to sucroferric oxyhydroxide (SO), SO therapy has been associated with improvements in serum phosphorus (sP) and reductions in daily PB pill burden. To characterize how SO initiation patterns have changed over time, we examined the long-term effectiveness of SO in a contemporary (2018–2019) cohort. Patients and Methods Adult Fresenius Kidney Care hemodialysis patients first prescribed SO monotherapy as part of routine care between May 2018 and May 2019 (N = 1792) were followed for 1 year. All patients received a non-SO PB during a 91-day baseline period before SO prescription. Mean PB pills/day and laboratory parameters were compared before and during SO treatment. Results were divided into consecutive 91-day intervals (Q1–Q4) and analyzed using linear mixed-effects regression and Cochran’s Q test. These results were contrasted with findings from a historical (2014–2015) cohort (N = 530). Results The proportion of patients achieving sP ≤5.5 mg/dl increased after switching to SO (from 27.0% at baseline to 37.8%, 45.1%, 44.7%, and 44.0% at Q1, Q2, Q3, and Q4, respectively; P < 0.0001 for all). The mean daily PB pill burden decreased from a baseline of 7.7 to 4.4, 4.6, 4.8, and 4.9, respectively, across quarters (P < 0.0001 for all). Patients in the contemporary cohort had improved sP control (27.0% achieving sP ≤5.5 mg/dl vs 17.7%) and lower daily PB pill burden (mean 7.7 vs 8.5 pills/day) at baseline than those in the historical cohort. Overall use of active vitamin D was similar between cohorts, although higher use of oral active vitamin D (63.9% vs 15.7%) and lower use of IV active vitamin D lower (23.4% vs 74.2%) was observed in the contemporary cohort. Conclusion Despite evolving treatment patterns, switching to SO resulted in improved sP control with fewer pills per day in this contemporary hemodialysis cohort.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"139 - 149"},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41324026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, Impact, and Management Strategies of Anti-Glomerular Basement Membrane Disease","authors":"Muhammad Asim, M. Akhtar","doi":"10.2147/IJNRD.S326427","DOIUrl":"https://doi.org/10.2147/IJNRD.S326427","url":null,"abstract":"Abstract Anti-glomerular basement membrane (anti-GBM) disease is a rare but serious autoimmune disease, which is characterized by the development of pathogenic antibodies to type IV collagen antigens in the glomerular and alveolar basement membranes. This results in rapidly progressive glomerulonephritis (GN), alveolar hemorrhage, or both. A variety of environmental factors can trigger the disease in genetically predisposed patients. Temporal associations with influenza, SARS-CoV-2 infection, and COVID-19 vaccination have been described although there is insufficient evidence to suggest causality. Anti-GBM disease accounts for approximately 20% of the cases of rapidly progressive GN cases secondary to crescentic GN, but is an uncommon cause of end-stage kidney disease. Early diagnosis by detection of circulating antibodies, increased awareness of atypical as well as complex clinical variants of the disease, and combined therapy with immunosuppression and plasma exchange has improved the prognosis of patients with this potentially fatal disease. Progress has been hampered by the rarity of anti-GBM disease, but new agents and therapeutic regimens are emerging.","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"129 - 138"},"PeriodicalIF":2.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45401220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat Free Weight Prediction in Morbidly Obese Females [Corrigendum]","authors":"","doi":"10.2147/IJNRD.S366708","DOIUrl":"https://doi.org/10.2147/IJNRD.S366708","url":null,"abstract":"[This corrects the article DOI: 10.2147/IJNRD.S24173.].","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"15 1","pages":"127 - 128"},"PeriodicalIF":2.0,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44804738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}