Seminars in nephrology最新文献_第6页

Diagnosis, Prevention, and Treatment of Infections in Kidney Transplantation. 肾移植感染的诊断、预防和治疗。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-09-01 Epub Date: 2024-02-19 DOI: 10.1016/j.semnephrol.2023.151486

Joyita Bharati, Urmila Anandh, Camille N Kotton, Thomas Mueller, Aakash K Shingada, Raja Ramachandran

{"title":"Diagnosis, Prevention, and Treatment of Infections in Kidney Transplantation.","authors":"Joyita Bharati, Urmila Anandh, Camille N Kotton, Thomas Mueller, Aakash K Shingada, Raja Ramachandran","doi":"10.1016/j.semnephrol.2023.151486","DOIUrl":"10.1016/j.semnephrol.2023.151486","url":null,"abstract":"Kidney transplant often is complicated by infections in the recipient from therapy-related and patient-related risk factors. Infections in kidney transplant recipients are associated with increased morbidity, mortality, and allograft dysfunction. There is a predictable timeline after kidney transplant regarding the types of pathogens causing infections, reflecting the net state of immunosuppression. In the early post-transplant period, bacterial infections comprise two thirds of all infections, followed by viral and fungal infections. Infections occurring early after kidney transplantation are generally the result of postoperative complications. In most cases, opportunistic infections occur within 6 months after kidney transplantation. They may be caused by a new infection, a donor-derived infection, or reactivation of a latent infection. Community-acquired pneumonia, upper respiratory tract infections, urinary tract infections, and gastrointestinal infections are the most common infections in the late period after transplantation when the net immunosuppression is minimal. It is crucial to seek information on the time after transplant, reflecting the net state of immunosuppression, previous history of exposure/infections, geography, and seasonal outbreaks. It is imperative that we develop regionally specific guidelines on screening, prevention, and management of infections after kidney transplantation.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913405","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: Infections and the Kidney: An Area of Resurgent Concern. 导言：感染与肾脏：重新引起关注的领域。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-09-01 Epub Date: 2024-01-03 DOI: 10.1016/j.semnephrol.2023.151463

Robert Kalyesubula, Urmila Anandh

引用次数: 0

Urinary Tract Infection Prevention and Treatment. 尿路感染的预防和治疗。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-09-01 Epub Date: 2024-02-24 DOI: 10.1016/j.semnephrol.2023.151468

Sunita Bavanandan, Niakhaleen Keita

引用次数: 0

Health Systems Preparedness for Infectious Disease Outbreaks: Relevance for Nephrology. 传染病爆发的卫生系统准备工作：肾脏病学的相关性。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-09-01 Epub Date: 2024-01-10 DOI: 10.1016/j.semnephrol.2023.151465

Priti Meena, Dina Abdellatif, Vaibhav Tiwari, Santanu Chatterjee, Valerie A Luyckx

{"title":"Health Systems Preparedness for Infectious Disease Outbreaks: Relevance for Nephrology.","authors":"Priti Meena, Dina Abdellatif, Vaibhav Tiwari, Santanu Chatterjee, Valerie A Luyckx","doi":"10.1016/j.semnephrol.2023.151465","DOIUrl":"10.1016/j.semnephrol.2023.151465","url":null,"abstract":"The coronavirus disease (COVID-19) crisis glaringly highlighted the critical need to develop resilient health care systems that are better prepared for epidemics. Millions of people died from COVID-19 itself, but almost three times as many died from health system disruptions. People living with kidney disease are highly vulnerable during outbreaks and pandemics and their needs must be included in preparedness planning. Health systems preparedness requires not only early identification and containment of outbreaks and maintenance of critical services during crises, but also bolstering population resilience and ensuring the safety of both health personnel and patients. Planning for surge capacity in an outbreak must include provision for both acute and chronic dialysis, and ensure access to medications for people with kidney diseases. Quality of care should not be compromised and must be monitored and improved where necessary. Technology, such as telemedicine, can support quality and continuity of care and minimize infection risks. Communication at all levels is crucial to ensure all stakeholders, including communities, have the necessary information to support cooperation and collaboration in effective outbreak responses. Research is important during and after pandemics to improve knowledge and build resilience at all levels, from outbreak detection to the development of therapeutics and optimizing equity in access to interventions. Only with adequate preparation and more resilient health systems can we hope, as a global community, to build on the harsh lessons learned during COVID-19, and improve the response to the next infectious disease outbreak, epidemic, or even pandemic.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417994","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

HIV and Associated TB: A Lethal Association for Kidney Health? 艾滋病毒与结核病：肾脏健康的致命联系？

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-09-01 Epub Date: 2024-01-20 DOI: 10.1016/j.semnephrol.2023.151470

Robert Kalyesubula, Nicola Wearne, Mary Kubo, Nadia Hussey, Saraladevi Naicker

{"title":"HIV and Associated TB: A Lethal Association for Kidney Health?","authors":"Robert Kalyesubula, Nicola Wearne, Mary Kubo, Nadia Hussey, Saraladevi Naicker","doi":"10.1016/j.semnephrol.2023.151470","DOIUrl":"10.1016/j.semnephrol.2023.151470","url":null,"abstract":"Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading infectious causes of death globally. The combined brunt of these diseases is experienced mainly in low-income and lower-middle-income countries. HIV/TB have devastating effects on the kidneys, leading to accelerated decline of kidney function as well as mortality. Managing the triad of TB/HIV and kidney disease is challenging. We discuss the epidemiology of HIV/TB coinfection and the kidney and the key mechanisms of kidney disease including genetic susceptibility. The clinical presentation and pathology, as well as the challenges of diagnosing CKD in these patients, also are discussed. The strategies to prevent and manage HIV/TB-related kidney disease such as proper assessment, avoiding nephrotoxic regimens, drug dose adjustments, kidney function monitoring, avoidance of drug-drug interactions, and other interventions are explored. We also briefly discuss the complexities around HIV/TB patients on dialysis and kidney transplantation. HIV/TB coinfection presents an increased risk for kidney-related morbidity and mortality; patients with this triad need to be given special consideration for future research and management.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512695","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

Children Are Not Small Adults: Similarities and Differences in Renal Transplantation Between Adults and Pediatrics. 儿童并非小成人：成人与儿科肾移植的异同。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-07-01 Epub Date: 2023-11-10 DOI: 10.1016/j.semnephrol.2023.151442

Dechu Puliyanda, Zibya Barday, Zunaid Barday, Andrew Freedman, Tsuyoshi Todo, Allen Kuang Chung Chen, Bianca Davidson

引用次数: 0

HUS and TTP: traversing the disease and the age spectrum. HUS和TTP：跨越疾病和年龄谱。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-07-01 Epub Date: 2023-11-10 DOI: 10.1016/j.semnephrol.2023.151436

Roberta Donadelli, Aditi Sinha, Arvind Bagga, Marina Noris, Giuseppe Remuzzi

{"title":"HUS and TTP: traversing the disease and the age spectrum.","authors":"Roberta Donadelli, Aditi Sinha, Arvind Bagga, Marina Noris, Giuseppe Remuzzi","doi":"10.1016/j.semnephrol.2023.151436","DOIUrl":"10.1016/j.semnephrol.2023.151436","url":null,"abstract":"Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenia purpura (TTP) are rare diseases sharing a common pathological feature, thrombotic microangiopathy (TMA). TMA is characterized by microvascular thrombosis with consequent thrombocytopenia, microangiopathic hemolytic anemia and/or multiorgan dysfunction. In the past, the distinction between HUS and TTP was predominantly based on clinical grounds. However, clinical presentation of the two syndromes often overlaps and, the differential diagnosis is broad. Identification of underlying pathogenic mechanisms has enabled the classification of these syndromes on a molecular basis: typical HUS caused by Shiga toxin-producing Escherichia coli (STEC-HUS); atypical HUS or complement-mediated TMA (aHUS/CM-TMA) associated with genetic or acquired defects leading to dysregulation of the alternative pathway (AP) of complement; and TTP that results from a severe deficiency of the von Willebrand Factor (VWF)-cleaving protease, ADAMTS13. The etiology of TMA differs between pediatric and adult patients. Childhood TMA is chiefly caused by STEC-HUS, followed by CM-TMA and pneumococcal HUS (Sp-HUS). Rare conditions such as congenital TTP (cTTP), vitamin B12 metabolism defects, and coagulation disorders (diacylglycerol epsilon mutation) present as TMA chiefly in children under 2 years of age. In contrast secondary causes and acquired ADAMT13 deficiency are more common in adults. In adults, compared to children, diagnostic delays are more frequent due to the wide range of differential diagnoses. In this review we focus on the three major forms of TMA, STEC-HUS, aHUS and TTP, outlining the clinical presentation, diagnosis and management of the affected patients, to help highlight the salient features and the differences between adult and pediatric patients which are relevant for management.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72210739","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

Understanding Similarities and Differences in CKD and Dialysis Care in Children and Adults. 了解儿童和成人CKD和透析护理的异同。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-07-01 Epub Date: 2023-11-27 DOI: 10.1016/j.semnephrol.2023.151440

Guillaume Mahamat Abderraman, Abdou Niang, Tahagod Mohamed, John D Mahan, Valerie A Luyckx

{"title":"Understanding Similarities and Differences in CKD and Dialysis Care in Children and Adults.","authors":"Guillaume Mahamat Abderraman, Abdou Niang, Tahagod Mohamed, John D Mahan, Valerie A Luyckx","doi":"10.1016/j.semnephrol.2023.151440","DOIUrl":"10.1016/j.semnephrol.2023.151440","url":null,"abstract":"In lower-income settings there is often a dearth of resources and nephrologists, especially pediatric nephrologists, and individual physicians often find themselves caring for patients with chronic kidney diseases and end-stage kidney failure across the age spectrum. The management of such patients in high-income settings is relatively protocolized and permits high-volume services to run efficiently. The basic principles of managing chronic kidney disease and providing dialysis are similar for adults and children, however, given the differences in body size, causes of kidney failure, nutrition, and growth between children and adults with kidney diseases, nephrologists must understand the relevance of these differences, and have an approach to providing quality and safe dialysis to each group. Prevention, early diagnosis, and early intervention with simple therapeutic and lifestyle interventions are achievable goals to manage symptoms, complications, and reduce progression, or avoid kidney failure in children and adults. These strategies currently are easier to implement in higher-resource settings with robust health systems. In many low-resource settings, kidney diseases are only first diagnosed at end stage, and resources to pay out of pocket for appropriate care are lacking. Many barriers therefore exist in these settings, where specialist nephrology personnel may be least accessible. To improve management of patients at all ages, we highlight differences and similarities, and provide practical guidance on the management of children and adults with chronic kidney disease and kidney failure. It is important that children are managed with a view to optimizing growth and well-being and maximizing future options (eg, maintaining vein health and optimizing cardiovascular risk), and that adults are managed with attention paid to quality of life and optimization of physical health.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452428","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

Approach to Diagnosis and Management of Hypertension: A Comprehensive and Combined Pediatric and Adult Perspective. 高血压的诊断和治疗方法:儿童和成人的综合视角。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-07-01 Epub Date: 2023-11-10 DOI: 10.1016/j.semnephrol.2023.151438

Sabine Karam, Debbie L Cohen, Pauline Abou Jaoude, Janis Dionne, FangChao Linda Ding, Anika Garg, Elliot Koranteng Tannor, Rahul Chanchlani

{"title":"Approach to Diagnosis and Management of Hypertension: A Comprehensive and Combined Pediatric and Adult Perspective.","authors":"Sabine Karam, Debbie L Cohen, Pauline Abou Jaoude, Janis Dionne, FangChao Linda Ding, Anika Garg, Elliot Koranteng Tannor, Rahul Chanchlani","doi":"10.1016/j.semnephrol.2023.151438","DOIUrl":"10.1016/j.semnephrol.2023.151438","url":null,"abstract":"The global prevalence of primary hypertension has been increasing both in children and in the adolescent and adult populations and can be attributed to changes in lifestyle factors with an obesity epidemic, increased salt consumption, and sedentary lifestyles. Childhood blood pressure is the strongest predictor of adult hypertension. Although hypertension in adults is associated strongly with an increased risk for cardiovascular disease, chronic kidney disease, and mortality, outcomes in children are defined less clearly. In adults, major guidelines agree on a threshold of less than 120/80 mm Hg as the optimal blood pressure (BP) and recommend a target of less than 130/80 mm Hg for treatment in most cases. In children, international pediatric guidelines recommend using thresholds based on the normative distribution of BP in healthy normal-weight children. Out-of-office BP assessment is extremely useful for confirming the diagnosis of hypertension and monitoring response to treatment. Lifestyle modifications are instrumental whether coupled or not with pharmacologic management. New agents such as nonsteroidal mineralocorticoid-receptor antagonists, aminopeptidase A inhibitors, aldosterone synthase inhibitors, and dual endothelin antagonists hold significant promise for resistant hypertension. The transition from pediatric to adult care can be challenging and requires careful planning and effective coordination within a multidisciplinary team that includes patients and their families, and pediatric and adult providers.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719472","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: Learning From Each Other: Pediatric and Adult Perspectives to Optimize Kidney Care Across the Life Span. 引言：相互学习：从儿科和成人角度优化整个生命周期的肾脏护理。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-07-01 Epub Date: 2023-10-31 DOI: 10.1016/j.semnephrol.2023.151443

Arpana Iyengar, Valerie A Luyckx

引用次数: 0