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Potassium Homeostasis 钾平衡
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.08.001
Niraj B. Desai , Melanie P. Hoenig
{"title":"Potassium Homeostasis","authors":"Niraj B. Desai ,&nbsp;Melanie P. Hoenig","doi":"10.1053/j.akdh.2024.08.001","DOIUrl":"10.1053/j.akdh.2024.08.001","url":null,"abstract":"<div><div>Potassium homeostasis is essential for maintaining the normal resting membrane potential of excitable cells. Yet daily dietary potassium typically far exceeds total extracellular potassium, thus the body has elegant strategies to shift potassium into cells promptly after a meal and then the kidneys efficiently excrete potassium. Potassium excretion depends on adequate kidney perfusion and filtration, sodium delivery to the distal nephron and aldosterone action on the distal nephron. Both hypokalemia and hyperkalemia have been associated with an increase in mortality. In this piece, we share 5 challenging cases to explore normal potassium homeostasis and disorders that can lead to derangements in potassium balance or excretion.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 504-513"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693941","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}
引用次数: 0
Rapidly Progressive Glomerulonephritis 快速进展性肾小球肾炎。
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.08.006
Abbal Koirala , Purva D. Sharma , Kenar D. Jhaveri , Koyal Jain , Duvuru Geetha
{"title":"Rapidly Progressive Glomerulonephritis","authors":"Abbal Koirala ,&nbsp;Purva D. Sharma ,&nbsp;Kenar D. Jhaveri ,&nbsp;Koyal Jain ,&nbsp;Duvuru Geetha","doi":"10.1053/j.akdh.2024.08.006","DOIUrl":"10.1053/j.akdh.2024.08.006","url":null,"abstract":"<div><div>Rapidly progressive glomerulonephritis (RPGN) is a syndrome characterized by a swift decline in kidney function, often over a few months, accompanied by features of nephritic syndrome. It can result in decreased urine output and commonly involves the presence of extensive crescents in kidney biopsies. RPGN is classified into 3 main types based on immune deposit distribution and visualization through immunofluorescence and electron microscopy: antiglomerular basement membrane disease, immune complex glomerulonephritis, and pauci-immune glomerulonephritis. Early diagnosis and prompt treatment are critical to prevent progression to ESRD. Standard treatment options for RPGN include glucocorticoids, cyclophosphamide, or rituximab, with plasma exchange especially important for antiglomerular basement membrane disease and select cases of ANCA-associated vasculitis. Clinical trials for glomerular diseases have primarily excluded patients with RPGN or dialysis dependence. Establishment of clinical registries is required for the optimization of therapeutic protocols for the treatment of RPGN.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 485-495"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693943","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}
引用次数: 0
The Nephrology Boards and Certification Exams: A Worldwide Focus on Excellence 肾脏病学委员会和认证考试：全球关注卓越。
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.09.001
Jeffrey H. William MD, Sam Kant MD
{"title":"The Nephrology Boards and Certification Exams: A Worldwide Focus on Excellence","authors":"Jeffrey H. William MD,&nbsp;Sam Kant MD","doi":"10.1053/j.akdh.2024.09.001","DOIUrl":"10.1053/j.akdh.2024.09.001","url":null,"abstract":"","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 483-484"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693945","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}
引用次数: 0
Autosomal Dominant Polycystic Kidney Disease 常染色体显性多囊肾。
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.07.003
Maria Lourdes Gonzalez Suarez , Silvia Titan , Neera K. Dahl
{"title":"Autosomal Dominant Polycystic Kidney Disease","authors":"Maria Lourdes Gonzalez Suarez ,&nbsp;Silvia Titan ,&nbsp;Neera K. Dahl","doi":"10.1053/j.akdh.2024.07.003","DOIUrl":"10.1053/j.akdh.2024.07.003","url":null,"abstract":"<div><div>Over 50% of people affected with autosomal dominant polycystic kidney disease (ADPKD) will develop kidney failure, making ADPKD the 4th most common cause of end-stage kidney disease. ADPKD is a systemic condition affecting the kidneys, liver, heart, vasculature, and other organ systems. A minority of patients may have severe complications such as massive hepatomegaly from a polycystic liver or rupture of an intracranial aneurysm. Recent advances in the understanding of genetics, prognosis, and treatment of this condition have allowed delivery of personalized treatment capable of changing the natural history of the disease. This review focuses on diagnosis, determining risk of kidney failure, treatment, blood pressure management, and preimplantation genetic testing related to ADPKD.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 496-503"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693929","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}
引用次数: 0
Metabolic Alkalosis 代谢性碱中毒
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.08.002
Stewart H. Lecker , Keiko I. Greenberg
{"title":"Metabolic Alkalosis","authors":"Stewart H. Lecker ,&nbsp;Keiko I. Greenberg","doi":"10.1053/j.akdh.2024.08.002","DOIUrl":"10.1053/j.akdh.2024.08.002","url":null,"abstract":"<div><div>Metabolic alkalosis is one of the four cardinal acid-base disorders and perhaps the least well understood by students. Taking a mechanistic approach to etiologies and management can be very helpful in such cases. Particularly, one should focus on the factors that <em>generate</em> the alkalosis (source of fluid loss and composition, less commonly alkali administration) and the factors (extracellular fluid volume status, hormonal systems) that <em>maintain</em> the abnormality.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 523-528"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693937","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}
引用次数: 0
Nephrolithiasis 肾结石。
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.08.007
Megan L. Prochaska, Anna L. Zisman
{"title":"Nephrolithiasis","authors":"Megan L. Prochaska,&nbsp;Anna L. Zisman","doi":"10.1053/j.akdh.2024.08.007","DOIUrl":"10.1053/j.akdh.2024.08.007","url":null,"abstract":"<div><div>Kidney stone prevalence is rapidly increasing worldwide, and decreasing stone growth and recurrence is critical to reducing morbidity. Preventative approaches vary with kidney stone type, so knowledge of stone composition and a thorough history and metabolic evaluation are necessary to individualize therapy. The cases presented herein highlight treatment strategies for the most common stone types seen in clinical practice with practical pearls for the nephrologist.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 529-537"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693939","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}
引用次数: 0
Utilization of Potassium Binders for the Management of Hyperkalemia in Chronic Kidney Disease: A Position Statement by US Nephrologists 利用钾结合剂治疗慢性肾脏病患者的高钾血症：美国肾病学家的立场声明。
Advances in kidney disease and health Pub Date : 2024-11-01 DOI: 10.1053/j.akdh.2024.08.003
Anjay Rastogi , Glenn M. Chertow , Ashté Collins , Ellie Kelepouris , Wayne Kotzker , John P. Middleton , Minesh Rajpal , Prabir Roy-Chaudhury
{"title":"Utilization of Potassium Binders for the Management of Hyperkalemia in Chronic Kidney Disease: A Position Statement by US Nephrologists","authors":"Anjay Rastogi ,&nbsp;Glenn M. Chertow ,&nbsp;Ashté Collins ,&nbsp;Ellie Kelepouris ,&nbsp;Wayne Kotzker ,&nbsp;John P. Middleton ,&nbsp;Minesh Rajpal ,&nbsp;Prabir Roy-Chaudhury","doi":"10.1053/j.akdh.2024.08.003","DOIUrl":"10.1053/j.akdh.2024.08.003","url":null,"abstract":"<div><div>Two potassium (K<sup>+</sup>) binders—patiromer sorbitex calcium and sodium zirconium cyclosilicate—are recommended by international guidelines for the management of hyperkalemia. There is, however, no universally accepted best practice for how to appropriately utilize K<sup>+</sup> binders in the long-term clinical management of CKD. A panel of eight US-based nephrologists convened in October 2022 to develop a consensus statement regarding utilizing K<sup>+</sup> binders in clinical practice to help manage patients with nonemergent, persistent/recurrent hyperkalemia in CKD. Consensus was reached on the following topics: (1) identifying risk factors for hyperkalemia; (2) serum K<sup>+</sup> monitoring before and during K<sup>+</sup> binder use; (3) utilizing K<sup>+</sup> binders in patients receiving renin-angiotensin-aldosterone system inhibitors and dialysis; and (4) when to initiate K<sup>+</sup> binders and their duration of use. These consensus statements for the use of K<sup>+</sup> binders may assist the nephrology community in optimizing management of hyperkalemia in patients across the spectrum of CKD.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 6","pages":"Pages 514-522"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693950","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}
引用次数: 0
Management of Failing Kidney and Pancreas Transplantations 肾脏和胰脏移植失败后的管理
Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.07.001
Michelle Lubetzky , Krutika Chauhan , Louai Alrata , Casey Dubrawka , Farah Abuazzam , Samer Abdulkhalek , Tarek Abdulhadi , Dema Yaseen Alsabbagh , Neeraj Singh , Krista L. Lentine , Bekir Tanriover , Tarek Alhamad
{"title":"Management of Failing Kidney and Pancreas Transplantations","authors":"Michelle Lubetzky ,&nbsp;Krutika Chauhan ,&nbsp;Louai Alrata ,&nbsp;Casey Dubrawka ,&nbsp;Farah Abuazzam ,&nbsp;Samer Abdulkhalek ,&nbsp;Tarek Abdulhadi ,&nbsp;Dema Yaseen Alsabbagh ,&nbsp;Neeraj Singh ,&nbsp;Krista L. Lentine ,&nbsp;Bekir Tanriover ,&nbsp;Tarek Alhamad","doi":"10.1053/j.akdh.2024.07.001","DOIUrl":"10.1053/j.akdh.2024.07.001","url":null,"abstract":"<div><p>Survival rates for allografts have improved over the last 2 decades, yet failing allografts remains a challenge in the field of transplant. The risks of mortality and morbidity associated with failed allografts are compounded by infectious complications and metabolic abnormalities, emphasizing the need for a standardized approach to management. Management of failing allografts lacks consensus, highlighting the need for unified protocols to guide treatment protocols and minimize risks with postdialysis initiation. The decision to wean off immunosuppression depends on various factors, including living donor availability and infectious risks, necessitating improved coordination of care and a standard guideline. Treatment of failed pancreas focuses on glycemic control, with insulin as the mainstay, while considering surgical interventions such as graft pancreatectomy in advanced symptomatic cases. Navigating the complexities of failed allograft management demands a multidisciplinary approach and standardized stepwise protocol. Addressing the gaps in management plans for failing allografts and employing a systematic approach to transplant decisions will enhance patient outcomes and facilitate informed decision-making.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 5","pages":"Pages 476-482"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949813924001174/pdfft?md5=cc9ae1b071152b5c0a8da073841e8ff9&pid=1-s2.0-S2949813924001174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122443","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}
引用次数: 0
Immunosuppression in Kidney Transplant Recipients: An Update for the General Nephrologist 肾移植受者的免疫抑制：普通肾科医生的最新进展
Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.05.001
Bassam G. Abu Jawdeh, Hay Me Me
{"title":"Immunosuppression in Kidney Transplant Recipients: An Update for the General Nephrologist","authors":"Bassam G. Abu Jawdeh,&nbsp;Hay Me Me","doi":"10.1053/j.akdh.2024.05.001","DOIUrl":"10.1053/j.akdh.2024.05.001","url":null,"abstract":"<div><p>Over the last 7 decades, kidney transplantation has evolved from an experiment between identical twins to becoming the gold standard treatment for end-stage kidney disease. To date, mycophenolate and calcineurin inhibitors, with or without prednisone, continue to constitute the backbone of modern maintenance immunosuppression. Despite major strides in improving acute rejection, long-term outcomes remain suboptimal with current regimens. Alternatives to calcineurin inhibitors such as belatacept and mammalian targets of rapamycin inhibitors exist; however, their wider-scale adoption remains relatively delayed due to concerns about increased rejection rates. In addition to continuing the investigation of steroid and calcineurin inhibitor sparing protocols, it is time to identify measurable surrogates for meaningful long-term graft survival. iBOX, a dynamic risk-prediction tool that predicts long-term death-censored graft failure could be a potential surrogate end point for future immunosuppression clinical trials. In this review, we summarize the landmark studies supporting current immunosuppression protocols and briefly discuss challenges and future directions.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 5","pages":"Pages 408-415"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122450","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}
引用次数: 0
Reproductive Health in Kidney Transplant Recipients 肾移植受者的生殖健康
Advances in kidney disease and health Pub Date : 2024-09-01 DOI: 10.1053/j.akdh.2024.04.006
Maitreyee Gupta, Anju Yadav
{"title":"Reproductive Health in Kidney Transplant Recipients","authors":"Maitreyee Gupta,&nbsp;Anju Yadav","doi":"10.1053/j.akdh.2024.04.006","DOIUrl":"10.1053/j.akdh.2024.04.006","url":null,"abstract":"<div><p>Increasing number of women with kidney transplants are of reproductive age and desire successful pregnancies. Successful outcomes of pregnancy can be achieved with preconception counseling, education about contraception use, the timing of pregnancy (delaying by first year post-transplant), and the choice of immunosuppression medication. Ensuring stable renal function including optimized creatinine, proteinuria, and blood pressure increases successful outcomes. Pregnancy with kidney transplant has an increased risk of preeclampsia, gestational diabetes militeus, cesarean section, and preterm delivery. Multidisciplinary cooperation with high-risk obstetrics and transplant nephrologists is vital.</p></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"31 5","pages":"Pages 466-475"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122442","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}
引用次数: 0
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