Seminars in nephrology最新文献

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Pediatric Kidney Transplantation: Cancer and Cancer Risk 小儿肾移植:癌症与癌症风险
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2024-01-01 DOI: 10.1016/j.semnephrol.2024.151501
Kaitlyn E. Order MD, Nancy M. Rodig MD
{"title":"Pediatric Kidney Transplantation: Cancer and Cancer Risk","authors":"Kaitlyn E. Order MD,&nbsp;Nancy M. Rodig MD","doi":"10.1016/j.semnephrol.2024.151501","DOIUrl":"10.1016/j.semnephrol.2024.151501","url":null,"abstract":"<div><p>Children with end-stage kidney disease (ESKD) face a lifetime of complex medical care, alternating between maintenance chronic dialysis and kidney transplantation. Kidney transplantation has emerged as the optimal treatment of ESKD for children and provides important quality of life and survival advantages. Although transplantation is the preferred therapy, lifetime exposure to immunosuppression among children with ESKD is associated with increased morbidity, including an increased risk of cancer. Following pediatric kidney transplantation, cancer events occurring during childhood or young adulthood can be divided into two broad categories: post-transplant lymphoproliferative disorders and non-lymphoproliferative solid tumors. This review provides an overview of cancer incidence, types, outcomes, and preventive strategies in this population.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Infections and Acute Kidney Injury: A Global Perspective 感染与急性肾损伤:全球视角
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-12-28 DOI: 10.1016/j.semnephrol.2023.151466
Anthony Batte, Lubaba Shahrin, Rolando Claure-Del Granado, Valerie A. Luyckx, Andrea L. Conroy
{"title":"Infections and Acute Kidney Injury: A Global Perspective","authors":"Anthony Batte, Lubaba Shahrin, Rolando Claure-Del Granado, Valerie A. Luyckx, Andrea L. Conroy","doi":"10.1016/j.semnephrol.2023.151466","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2023.151466","url":null,"abstract":"<p>Globally, there are an estimated 13.3 million cases of acute kidney injury<span><span><span> (AKI) annually. Although infections are a common cause of AKI globally, most infection-associated AKI occurs in low- and lower-middle-income countries. There are marked differences in the etiology of infection-associated AKI across age groups, populations at risk, and geographic location. This article provides a global overview of different infections that are associated commonly with AKI, including severe acute respiratory syndrome coronavirus 2<span> (SARS-CoV-2), human immunodeficiency virus, malaria, dengue, </span></span>leptospirosis, tick-borne illnesses, and </span>viral hemorrhagic fevers<span>. Further discussion focuses on infectious conditions associated with AKI including sepsis, diarrheal diseases and pregnancy, peripartum and neonatal AKI. This article also discusses the future of infection-associated AKI in the framework of climate change. It explores how increased investment in achieving the sustainable development goals may contribute to the International Society of Nephrology's 0 by 25 objective to curtail avoidable AKI-related fatalities by 2025.</span></span></p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139068524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Introduction: ISN Frontiers Meeting on “Infections and the Kidney” 导言:关于 "感染与肾脏 "的 ISN 前沿会议
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-12-18 DOI: 10.1016/j.semnephrol.2023.151464
Saraladevi Naicker, Chih-Wei Yang, Vivekanand Jha
{"title":"Introduction: ISN Frontiers Meeting on “Infections and the Kidney”","authors":"Saraladevi Naicker, Chih-Wei Yang, Vivekanand Jha","doi":"10.1016/j.semnephrol.2023.151464","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2023.151464","url":null,"abstract":"Abstract not available","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Avoiding Systemic Heparinization During Hemodialysis: How the Dialysis Setup Might Help. 在血液透析过程中避免全身肝素化:透析装置如何提供帮助?
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-13 DOI: 10.1016/j.semnephrol.2023.151483
Florine V Janssens, Björn Meijers, Karlien François
{"title":"Avoiding Systemic Heparinization During Hemodialysis: How the Dialysis Setup Might Help.","authors":"Florine V Janssens, Björn Meijers, Karlien François","doi":"10.1016/j.semnephrol.2023.151483","DOIUrl":"10.1016/j.semnephrol.2023.151483","url":null,"abstract":"<p><p>Heparin is the most widely used anticoagulant for maintaining patency of the extracorporeal blood circuit during intermittent hemodialysis. Inadvertently, this leads to systemic heparinization of the patient. Repeated intermittent heparinization during hemodialysis has been associated with increased bleeding risks and metabolic and immunologic effects. Alternative strategies for minimizing systemic anticoagulation encompass dilution methods, regional citrate anticoagulation, priming of the extracorporeal circuit, and modifications to dialyzer membranes and dialysate composition. The effectiveness of these alternatives in maintaining patency of the extracorporeal circuit varies substantially. Although most studies have focused on particular changes in the hemodialysis setup, several combined interventions for adapting the hemodialysis setup are now being studied. This narrative review aims to present an overview of the current landscape of hemodialysis setup strategies aimed at limiting or avoiding systemic anticoagulation during treatment. Additionally, this review intends to shed light on the underlying pathophysiological mechanisms that contribute to variations observed in reported outcomes.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Lipid and Bone Effects of Heparin Use During Hemodialysis. 血液透析期间使用肝素对血脂和骨骼的影响
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-09 DOI: 10.1016/j.semnephrol.2023.151480
Bernd Stegmayr, Li Zuo, Ward Zadora
{"title":"Lipid and Bone Effects of Heparin Use During Hemodialysis.","authors":"Bernd Stegmayr, Li Zuo, Ward Zadora","doi":"10.1016/j.semnephrol.2023.151480","DOIUrl":"10.1016/j.semnephrol.2023.151480","url":null,"abstract":"<p><p>Unfractionated heparin (UFH) and low-molecular-weight heparins (LMWHs) are commonly prescribed anticoagulants for chronic hemodialysis (HD). The dialysis population comprises a unique group that receives heparin three times per week for a long period, with potential long-term cumulative metabolic effects such as osteoporosis and worsening lipid profile. HD patients have approximately half the number of lipases as healthy individuals, and their lipid metabolism is limited because of this decrease as well as partially inhibited function. Administration of UFH or LMWHs for anticoagulation can lead to metabolic starvation despite high triglyceride levels at the end of HD. In vitro studies indicate that UFH and LMWHs inhibit osteoblasts and promote osteoclasts. In patients on HD, long-term use of UFH or LMWHs did not worsen chronic kidney disease-mineral bone disease. Further investigation is needed to elucidate the underlining mechanisms of UFH and LMWHs and their possible influences on maintenance HD patients.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Clotting Propensity of Surface-Treated Membranes in a Hemodialysis Set-up That Avoids Systemic Anticoagulation. 避免全身抗凝的血液透析装置中表面处理膜的凝血倾向
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-23 DOI: 10.1016/j.semnephrol.2023.151482
Hideki Kawanishi, Masahide Koremoto, Casper F M Franssen, Marco van Londen
{"title":"Clotting Propensity of Surface-Treated Membranes in a Hemodialysis Set-up That Avoids Systemic Anticoagulation.","authors":"Hideki Kawanishi, Masahide Koremoto, Casper F M Franssen, Marco van Londen","doi":"10.1016/j.semnephrol.2023.151482","DOIUrl":"10.1016/j.semnephrol.2023.151482","url":null,"abstract":"<p><p>The development of biocompatible membranes, aiming to limit the inflammatory response, oxidative stress, and coagulability during hemodialysis, has been an important step in reducing dialysis-related adverse outcomes. This includes a reduction in the risk of clotting of the extracorporeal circuit, thus enabling hemodialysis with a reduced dose or even without systemic anticoagulant drugs in patients with an increased bleeding risk. In this article, we summarize the in vitro research and clinical evidence on the antithrombotic properties of vitamin E- and heparin-coated membranes.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Anticoagulation for Hemodialysis: A Hidden Quest to Ensure Safe Dialysis. 血液透析中的抗凝治疗:确保安全透析的隐性探索。
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-10 DOI: 10.1016/j.semnephrol.2023.151485
Karlien François, Björn Meijers
{"title":"Anticoagulation for Hemodialysis: A Hidden Quest to Ensure Safe Dialysis.","authors":"Karlien François, Björn Meijers","doi":"10.1016/j.semnephrol.2023.151485","DOIUrl":"10.1016/j.semnephrol.2023.151485","url":null,"abstract":"","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Factor XI Inhibitors: Potential Role in End-Stage Kidney Disease. 因子 XI 抑制剂:在终末期肾病中的潜在作用。
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-24 DOI: 10.1016/j.semnephrol.2023.151484
Matthew Ades, Camille Simard, Thomas Vanassche, Peter Verhamme, John Eikelboom, Thomas A Mavrakanas
{"title":"Factor XI Inhibitors: Potential Role in End-Stage Kidney Disease.","authors":"Matthew Ades, Camille Simard, Thomas Vanassche, Peter Verhamme, John Eikelboom, Thomas A Mavrakanas","doi":"10.1016/j.semnephrol.2023.151484","DOIUrl":"10.1016/j.semnephrol.2023.151484","url":null,"abstract":"<p><p>Patients with end-stage kidney disease (ESKD) experience a high thrombotic risk but are also at increased risk of bleeding. There is an unmet need for safer antithrombotic therapy in patients with ESKD on hemodialysis. Factor XI (FXI) represents an attractive therapeutic target for anticoagulation because of the potential to mitigate the bleeding risks associated with currently approved anticoagulants, especially in patients at high risk of bleeding. FXI inhibition is also an attractive option in settings where coagulation is activated by exposure of the blood to artificial surfaces, including the extracorporeal circuit during hemodialysis. Therapies targeting FXI that are in the most advanced stages of clinical development include antisense oligonucleotides, monoclonal antibodies, and synthetic small molecules, which serve either to lower FXI levels or block its physiological effects. This review article presents the most recent pharmacological data with FXI inhibitors, briefly describes phase 2 and 3 clinical trials with these agents, and critically examines the potential future use of FXI inhibitors for extracorporeal circuit anticoagulation in patients with ESKD. In addition, laboratory monitoring and reversal of FXI inhibitors are briefly discussed.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Patient Perspectives on Clotting in the Extracorporeal Circuit and Decision-Making Regarding Anticoagulation Therapy. 患者对体外循环凝血的看法以及抗凝疗法的决策。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-17 DOI: 10.1016/j.semnephrol.2023.151475
Chandana Guha, Daniel Gallego, Amanda Grandinetti, Madeleine Warren, Allison Jaure
{"title":"Patient Perspectives on Clotting in the Extracorporeal Circuit and Decision-Making Regarding Anticoagulation Therapy.","authors":"Chandana Guha, Daniel Gallego, Amanda Grandinetti, Madeleine Warren, Allison Jaure","doi":"10.1016/j.semnephrol.2023.151475","DOIUrl":"10.1016/j.semnephrol.2023.151475","url":null,"abstract":"<p><p>Clotting of the extracorporeal circuit is a complication in the process of hemodialysis that can result in missed or shortened dialysis sessions, higher nursing workload, and elevated cost of treatment. Repercussions of inadequate dialysis may include patient blood loss, fluid overload, build-up of minerals, higher hospitalization rates, and poor quality of life, contributing to increased patient distress. Preventing clotting through anticoagulation therapy is the key to maintaining patency of the dialysis circuit and supporting dialysis adequacy. Despite the severe consequences of clotting in the extracorporeal circuit patients encounter, their perspectives on decision-making regarding anticoagulation therapy are not well known. In this article, we discuss patients' perspectives and priorities around clotting and anticoagulation therapy and outline ways to support their treatment through shared decision-making. Insights into patients' perspectives on addressing thrombotic complications of the extracorporeal circuit can inform strategies to improve care and outcomes for patients receiving hemodialysis.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Immunologic Effects of Heparin Associated With Hemodialysis: Focus on Heparin-Induced Thrombocytopenia. 与血液透析有关的肝素免疫效应:关注肝素诱发的血小板减少症。
IF 3.3 3区 医学
Seminars in nephrology Pub Date : 2023-11-01 Epub Date: 2024-01-08 DOI: 10.1016/j.semnephrol.2023.151479
Theodore E Warkentin
{"title":"Immunologic Effects of Heparin Associated With Hemodialysis: Focus on Heparin-Induced Thrombocytopenia.","authors":"Theodore E Warkentin","doi":"10.1016/j.semnephrol.2023.151479","DOIUrl":"10.1016/j.semnephrol.2023.151479","url":null,"abstract":"<p><p>Intermittent hemodialysis (HD) is almost invariably performed with heparin, and thus HD patients are at risk of developing the immune-mediated adverse effect heparin-induced thrombocytopenia (HIT), caused by anti-platelet factor 4/heparin IgG, which strongly activates platelets. HIT patients develop hypercoagulability with greatly increased risk of thrombosis, both venous and arterial. Certain HIT-associated complications are more likely to develop among HD patients, including hemofilter thrombosis despite heparin, intravascular catheter and/or arteriovenous fistula-associated thrombosis, post-heparin bolus anaphylactoid/anaphylactic reactions, and thrombotic stroke and acute limb artery thrombosis (reflecting the high frequency of underlying arteriopathy in many patients with renal failure). Management of HIT in HD usually requires use of an alternative (non-heparin) anticoagulant; for example, danaparoid sodium (outside the USA) or argatroban (USA and elsewhere). Whether heparin-grafted hemodialyzers (without systemic heparin) can be used safely in acute HIT is unknown. The HIT immune response is remarkably transient and usually not retriggered by subsequent heparin administration. Accordingly, since renal failure patients often require long-term HD, there may be the opportunity-following seroreversion (loss of platelet-activating HIT antibodies)-to restart heparin for HD, a practice that appears to have a low likelihood of retriggering HIT.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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