Результаты поиска

Диагностика и лечение ИГАН: стероиды, Будесонид, или, возможно, и то, и другое?

Нефропатия Ига (IgAN), наиболее часто встречающаяся в мире первичная гломерулонефрит, характеризуется мезангиальным залежем Ига и различными гистологическими повреждениями, как описано в Оксфордской системе классификации. Несмотря на хорошо описываемыеfour-Гипотеза, все еще существует множество менее или неописываемых механизмов, которые участвуют в болезнетворном патогенезе, например B-клеток, который, как представляется, инициируется различными антигенами в кишечном микробиоте. Диагноз болезни в настоящее время основан на результатах биопсии почек, поскольку чувствительность и специфичность

Совпадение в полном тексте источника
… The combination of its high incidence, especially among young people, with its relatively poor renal prognosis forces nephrologists to determine an effective treatment. IgAN is an autoimmune disease, and thus, the administration of a treatment that inhibits immunological cascade is anticipated. … However, this dual therapy will probably cause significant side effects and the clinical nephrologist should be aware of that. …

Molecular Mechanisms and Biomarkers Associated with Chemotherapy-Induced AKI.

Acute kidney injury (AKI) is a life-threatening condition characterized by a rapid and transient decrease in kidney function. AKI is part of an array of conditions collectively defined as acute kidney diseases (AKD). In AKD, persistent kidney damage and dysfunction lead to chronic kidney disease (CKD) over time. A variety of insults can trigger AKI; however, chemotherapy-associated nephrotoxicity is increasingly recognized as a significant side effect of chemotherapy. New biomarkers are urgently needed to identify patients at high risk of developing chemotherapy-associated nephrotoxicity and s

Совпадение в полном тексте источника
… In this review, we aim to (1) provide an overview of the mechanisms involved in chemotherapy-associated AKI; (2) discuss the biomarkers currently available and propose additional biomarkers for early AKI detection, and (3) raise awareness of chemotherapy-induced AKI and promote collaboration between nephrologists … Thus, it is likely that nephrologists will be increasingly charged with diagnosing and managing AKI following ICPi administration [ 103 ]. …

Fatal Type B Lactic Acidosis Associated With Metastatic Colorectal Cancer: A Case Report With Review of Literature, Pathogenesis, and Treatment.

Type B lactic acidosis associated with malignancy is a life-threatening complication and mostly seen in hematological malignancies but can also be seen in solid tumors. We report a rare case of a 64-year-old female diagnosed with metastatic adenocarcinoma of the colon with liver metastasis associated with severe type B lactic acidosis. We discuss pathophysiology, previously reported cases, and their outcomes. The most widely used therapies are bicarbonate infusion, thiamine supplementation, chemotherapy, and supportive care but is associated with poor outcomes, and no standard treatment recomm

High-cutoff hemodialysis in multiple myeloma patients with acute kidney injury.

Multiple myeloma (MM), an incurable hematological malignancy with clonal proliferation of plasma cells, is mainly characterized by excessive production of monoclonal immunoglobulins and free light chains (FLCs). Kidney injury is one of the main clinical manifestations and is also a significant predictor of the prognosis of symptomatic MM patients, especially those who require dialysis-supported treatment. Overproduction of FLCs is the trigger for kidney injury, as they can induce the transcription of inflammatory and profibrotic cytokines in the proximal tubule and bind to Tamm-Horsfall protei

Совпадение в полном тексте источника
… After day 12, 8 h/session on alternate days and from day 21, 6 h/session thrice weekly up to 90 days | Nephrologist determined hemodialysis withdrawal e | 60 g in the last hour of dialysis | NA | NA Other extracorporeal techniques can be available to achieve a reduction in FLCs Although the reduction … Therefore, there is an urgent need for a strong working relationship between nephrologists and hematologists. There is no doubt that the timely adoption of HCO-HD in conjunction with antimyeloma treatment in patients who require dialysis support is important. …

Healthcare workload associated with transition onto kidney replacement therapy: a retrospective cohort study.

BACKGROUND AND HYPOTHESIS: Transition onto kidney replacement therapy (KRT) is a complex, intensive phase for patients with advanced chronic kidney disease (CKD), characterised by high healthcare utilisation. Frequent outpatient visits, surgical and radiological procedures, hospitalisations and haemodialysis (HD) sessions impose a significant time burden on patients. The concept of time toxicity is widely described in oncology, and captures the disruption to patients' lives due to treatment-related demands. We aimed to quantify time- based healthcare workload during the transition onto KRT and

Совпадение в полном тексте источника
… Suboptimal initiation of Dialysis with and without early referral to a nephrologist. Nephrol Dialysis Transplantation. 2011;26(9):2959–65. 35. Zhang Y, Baharani J. Dialysis education and options for late presenters—An ongoing dilemma. … Nephrologists’ Perspectives on Gender Disparities in CKD and Dialysis. Kidney Int Rep [Internet]. 2021 Mar 1 [cited 2025 Oct 28];7(3):424. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8897691/ 43. Rocque GB, Williams CP, Ingram SA, Azuero A, Mennemeyer ST, Young Pierce J, et al. …

Early detection of acute cisplatin nephrotoxicity: interest of urinary monitoring of proximal tubular biomarkers.

BackgroundRenal toxicity induced by cisplatin (CisPt) is a clinical issue in patients with or without chronic kidney disease (CKD). Proximal tubular injury can result in acute kidney injury (AKI), which may compromise the course of chemotherapy and the prognosis. The purpose of this study was to investigate the time course of urinary markers of acute tubulotoxicity and to assess the usefulness of such monitoring in a routine clinical setting.MethodsThis work is an open prospective pilot study carried out among 23 patients receiving a platinum-based chemotherapy. Individual comorbidities, plasm

Совпадение в полном тексте источника
… These could help oncologists and nephrologists to agree on possible adjustments of the chemotherapy cycles in order to preserve kidney function without compromising anticancer drug efficacy (adapted doses to GFR, longer recovery periods between cycles, systematic diuresis monitoring, switch from CisPt … Indeed, for several cases included in this study, a nephrologist could have identified patients at risk of AKI, those already suffering from CKD or medications/practices known to increase the risk for CisPt-induced AKI. …

Ренальные результаты после автономной трансплантации стволовых клеток у пациентов, страдающих диализом-депендентом с множественными миеломами: одноцентральное исследование из страны с низким и средним уровнем дохода.

Множественная миелома (ММ) часто вызывает почечные расстройства, и подгруппа пациентов переходит к конечной стадии почечной болезни (ESRD), требующей диализа. Зависимость от диабета традиционно считалась относительным противопоставлением к кондиционирования при высоких дозах и автоматической трансплантации стволовых клеток (ASCT). Появляющиеся данные свидетельствуют о том, что ACCT может обеспечивать эффективный гематологический контроль, а в отдельных пациентах - почечную реабилитацию. Мы провели серию ретроспективных дел five Зависящие от диализа пациенты с MM, которые прошли ACCT в больнице

Совпадение в полном тексте источника
… Patients were monitored by a multidisciplinary team that included hematologists, nephrologists, infectious‐disease specialists, and transplant nurses throughout the transplantation period [ 16 ]. No backup stem‐cell product was used. …

Corticosteroids or immunosuppressants were not superior to supportive care in IgA nephropathy patients with mild proteinuria.

BackgroundWe aimed to evaluate the effect of immunosuppressant therapy for immunoglobulin A nephropathy (IgAN) patients with mild proteinuria (MethodsWe recruited patients with biopsy-proven IgAN from 4 study centers. Patients were followed for more than 1 year or up to the study end point. Clinical indexes, renal pathological data, and treatment information were collected during the follow-up period. IgAN patients with mild proteinuria (Results295 patients (36.3% male and 63.7% female) were included in this study and were followed for 49.46 ± 24.35 months. We found a significant difference in

High-Cutoff Hemodialysis Therapy for Patients with Light Chain Cast Nephropathy and AKI Requiring Dialysis: PRO.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Acute Kidney Injury in Monoclonal Gammopathies.

Monoclonal gammopathies (MG) encompass a variety of disorders related to clonal expansion and/or malignant transformation of B lymphocytes. Deposition of free immunoglobulin (Ig) components (light or heavy chains, LC/HC) within the kidney during MG may result over time in multiple types and degrees of injury, including acute kidney injury (AKI). AKI is generally a consequence of tubular obstruction by luminal aggregates of LC, a pattern known as "cast nephropathy". Monoclonal Ig LC can also be found as intracellular crystals in glomerular podocytes or proximal tubular cells. Proliferative glom

Совпадение в полном тексте источника
… Thus, careful evaluation of renal function and electrolyte balance is mandatory for all patients being treated for MM or related gammopathies, under the direct supervision of an onco-nephrologist with experience in the quickly growing field of anti-cancer treatments [ 75 ]. 9. … Conclusions In summary, MG are an area in which the collaboration of hematologists and nephrologists is highly recommended and quite effective. …

Preventive strategies for acute kidney injury in cancer patients.

Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregatio

Pre-existing oncohematological disease in kidney transplant recipients: impact on graft survival, acute rejection, and long-term clinical outcomes.

INTRODUCTION: Oncohematological disorders are heterogeneous conditions that present significant challenges in management prior to transplantation. Data about rejection risk, disease recurrence, eligibility criteria, and requested remission time before kidney transplant (KT) are still lacking. METHODS: All KTRs between January 1, 2000, and March 31, 2023 (n = 2871) were analyzed. All patients with an oncohematological disease (hematological cohort, including plasma cell dyscrasias [PCDs], acute leukemia, high-grade lymphoma/post-transplant lymphoproliferative disorders [PTLDs], myeloproliferat

Совпадение в полном тексте источника
… After discharge, post-transplant care followed a standardized schedule, and every recipient was monitored by the Hub transplant center with at least one annual visit, as well as by the local nephrologist (eleven peripheral centers covering most of the Piedmont region) for periodic follow-up. … They also clearly stated that transplant suitability and waiting time for candidates with cancer should be individualized, with the decision to consider transplantation made by a multidisciplinary team involving oncologists/hematologists, transplant nephrologists, patients, and their caregivers. …

The Onco-Nephrology Field: The Role of Personalized Chemotherapy to Prevent Kidney Damage.

In recent years, the onco-nephrology field has acquired a relevant role in internal medicine due to the growing number of cases of renal dysfunction that have been observed in cancer patients. This clinical complication can be induced by the tumor itself (for example, due to obstructive phenomena affecting the excretory tract or by neoplastic dissemination) or by chemotherapy, as it is potentially nephrotoxic. Kidney damage can manifest as acute kidney injury or represent a worsening of pre-existing chronic kidney disease. In cancer patients, physicians should try to set preventive strategies

Совпадение в полном тексте источника
… Indeed, we re-affirm the necessity of a multidisciplinary team (including oncologists, nephrologists, hematologists and pharmacologists) to manage cancer patients. … Onconephrology: A New Challenge for the Nephrologist. Contrib. Nephrol. 2021;199:91–105. doi: 10.1159/000517695. 2. Rosner M.H., Jhaveri K.D., McMahon B.A., Perazella M.A. Onconephrology: The intersections between the kidney and cancer. CA Cancer J. …

The Amyloidosis Forum: a public private partnership to advance drug development in AL amyloidosis.

BACKGROUND: Immunoglobulin light chain (AL) amyloidosis is a rare, multi-systemic disorder characterized by two disease processes: an underlying plasma cell dyscrasia that provides the source of pathologic light chains, and the resulting organ dysfunction caused by deposition of amyloid light chain fibrils. There are no FDA approved treatments for AL amyloidosis; regimens developed for multiple myeloma are used off-label to treat the plasma cell disorder and no therapies are directed at organ deposition. Thus, an unmet medical need persists despite advances in disease management. A public-priv

Совпадение в полном тексте источника
… The diagnosis of AL amyloidosis was most commonly obtained from hematologist/oncologists (34.1%), followed by nephrologists (22.6%) and cardiologists (18.7%) [ 4 ]. New approaches are needed to identify AL patients earlier. … To this end, panel representatives from the Divisions of Hematologic Malignancies II; Gastroenterology and Inborn Errors Products; Cardiovascular and Renal Products (cardiologist and nephrologist); Neurology Products, the Rare Diseases Program, and Clinical Outcomes Assessments Staff each provided perspectives …

Реналь-лимитированный амилоидный лайт-чаин (Ламбда) Амилоидоз, представленный как Моноклональная Гаммопатия Ренального Значения: доклад по делу.

Моноклональная гаммопатия почечной значимости (MGRS) охватывает почечные заболевания, вызываемые нефротоксичными моноклональными иммуноглобулинами, производимыми небольшими клонами B-клеток или плазменными клонами, которые не отвечают критериям явной гематологической злокачественности. Ренал амилоидный светоцепный (AL) амилоидоз — признанное повреждение в диапазоне MGRS. Мы сообщаем о случае 66-year-old Женщина с нефротическим синдромом и почечной дисфункцией, связанными с моноклональными лямбдами. Биопсия реала подтвердила амилоидоз AL (ламбда), в то время как анализ костного мозга и системна

Совпадение в полном тексте источника
… This case underscores the need for a multidisciplinary approach involving nephrologists, hematologists, and pathologists to ensure accurate diagnosis and optimal management. …

PD 1 checkpoint inhibition in solid organ transplants: 2 sides of a coin - case report.

BACKGROUND: The management of malignancy post kidney transplantation includes reduction in immunosuppression and referral to an oncologist management of their malignancy. Recent advances in oncology have resulted in the approval of several classes of drugs with immune-modulatory activity. However, activation of the immune system against malignant cells may precipitate allograft rejection in solid organ transplant recipients. CASE PRESENTATION: Herein we present a case of acute kidney allograft rejection in a 50 year old man following administration of the novel immune-modulatory agent nivolum

Diagnostic accuracy of monoclonal antibody based serum immunoglobulin free light chain immunoassays in myeloma cast nephropathy.

UnlabelledBackgroundThe development of serum immunoassays for the measurement of immunoglobulin free light chains has led to a paradigm shift in the diagnosis, assessment and monitoring of patients with plasma cell dyscrasias. The impact of these immunoassays which employ polyclonal antibodies was most notable for those patients who were previously classified as non-secretory multiple myeloma. Recently new monoclonal antibody based assays have become available. The purpose of this study was to compare the diagnostic sensitivity of these new assays with those already in clinical practice.Method

Crystalline deposits in the cornea and various areas of the kidney as symptoms of an underlying monoclonal gammopathy: a case report.

BACKGROUND: Plasma cell dyscrasias (PCD) are characterized by an abnormal production of intact monoclonal immunoglobulins or parts such as heavy or light chains. In most cases, the monoclonal protein (also termed paraprotein) is produced by a clonal plasma cell population. The production of monoclonal proteins can result in deposits of various types and localization depending on the type, amount, and electrochemical properties of the paraprotein. One histopathologic presentation, albeit rare, are crystalline deposits. They can form in various organs and hence cause a wide spectrum of symptoms.

Haematological malignancies and acute kidney injury requiring nephrology consultation: challenging the worst of the worst.

BackgroundAcute kidney injury (AKI) often complicates the course of haematological malignancies (HMs) and confers a worse prognosis. The majority of these patients are managed by the attending physician, yet, a small group, mostly coincident with the worst presentation and outcomes, requires nephrology consultation, challenging the clinician with ethical issues regarding the decision to initiate or forgo renal support therapy. The purpose of this work is to identify the prognostic determinants for in-hospital mortality in this population.MethodsA retrospective, observational chart review was u

Patients and healthcare professionals' perspectives on the implementation of shared decision making in multiple myeloma: a multinational qualitative study.

BACKGROUND: Shared decision making (SDM) is highly relevant in oncology and cancer care, yet its application within multiple myeloma (MM) remains underexplored. This study aims to (1) investigate SDM implementation in MM clinical practice, (2) assess the role of various stakeholders next to haematologists in the SDM process, and (3) identify barriers and potential solutions to SDM implementation in MM care. METHODS: This qualitative study consisted of semi-structured interviews with patients (n = 39), haematologists (n = 15), and haematology nurses (n = 5) from nine countries in Europe and Is