Результаты поиска

Use of Intravenous Iodinated Contrast Media in Patients With Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation.

Intravenous iodinated contrast media are commonly used with CT to evaluate disease and to determine treatment response. The risk of acute kidney injury (AKI) developing in patients with reduced kidney function following exposure to intravenous iodinated contrast media has been overstated. This is due primarily to historic lack of control groups sufficient to separate contrast-induced AKI (CI-AKI; ie, AKI caused by contrast media administration) from contrast-associated AKI (CA-AKI; ie, AKI coincident to contrast media administration). Although the true risk of CI-AKI remains uncertain for pati

Совпадение в полном тексте источника
… interpretation of recently conducted well-controlled observational studies, 4 , 5 , 6 and differences in recommendations across radiology and medical subspecialties. 15 , 16 , 17 , 18 In this document, joint statements are made by a multidisciplinary group of radiologists (MD, RM, JW, JD, CW) and nephrologists …

Systemic AL Amyloidosis: Current Approaches to Diagnosis and Management.

AL amyloidosis is characterized by a low-level expansion of an indolent, small plasma cell clone that produces amyloidogenic light chains. Amyloid aggregates or preceding intermediaries cause direct cell damage through their proteotoxicity, and amyloid deposits distort tissue architecture, and, eventually, lead to organ impairment. It is a rare, underdiagnosed disease with a diverse clinical presentation depending on the organ tropism of the amyloid fibrils; cardiac and renal involvement is most common, but any organ can be affected, excluding the central nervous system. A high level of awaren

Совпадение в полном тексте источника
… At all stages of treatment, major emphasis is given on supportive management which requires expert input from multiple specialties including cardiologists and nephrologists. Adverse event management and prevention and appropriate organ function support are key to treatment success (Table 3 ). …

Taming renal inflammation: signaling pathways and therapeutic advances in lupus nephritis.

Lupus nephritis (LN), a serious complication of systemic lupus erythematosus (SLE), involves complex immune dysregulation that leads to chronic renal inflammation and progressive tissue damage. Despite decades of use of standard immunosuppressive therapy, treatment responses remain variable, and many patients experience relapses or develop end-stage renal disease. This review synthesizes emerging insights into the immunopathogenesis of LN, drawing on studies from single-cell transcriptomics, signaling pathway analyses and renal tissue immunology. It examines the role of both innate and adaptiv

Совпадение в полном тексте источника
… Partnerships between nephrologists, immunologists, bioinformaticians and systems biologists will be vital to translating bench insights into bedside interventions. …

Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions.

Clinically, it is highly challenging to promote recovery in patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). Despite recent advances in understanding the underlying mechanisms of ALF and ACLF, standard medical therapy remains the primary therapeutic approach. Liver transplantation (LT) is considered the last option, and in several cases, it is the only intervention that can be lifesaving. Unfortunately, this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a transplant. Another option is to

Совпадение в полном тексте источника
… Artificial Liver Support System Improves Short-Term Outcomes of Patients with HBV-Associated Acute-on-Chronic Liver Failure: A Propensity Score Analysis Biomed Res Int 2019 2019 3757149 31871940 10.1155/2019/3757149 PMC6907045 91 Gashti CN Membrane-based Therapeutic Plasma Exchange: A New Frontier for Nephrologists …

The Global Obesity Epidemic: Epidemiology, Health Burden and Policy Priorities.

The global prevalence of obesity has more than tripled since 1975, now affecting nearly one billion adults and over 170 million children and adolescents. In 2025, The Lancet Diabetes & Endocrinology Commission on Clinical Obesity redefined obesity as a chronic, multisystem disease characterised by excess adiposity leading to organ dysfunction, distinguishing between preclinical obesity (excess adiposity without end-organ injury) and clinical obesity (manifest metabolic or structural complications). This framework moves beyond reliance on BMI, acknowledging that ectopic fat deposition in the li

Проблемы, трудности и запоздалый диагноз множественной миеломы.

Фон: Множественная миелома (ММ) представляет собой разнородную плазменную порчу клеток с неконкретными симптомами и разнородностью болезней на клиническом и биологическом уровнях. Этот неконкретный набор симптомов, включая боль в костях, анемию, почечную недостаточность, гиперкальцемию и нейропатию, может ввести в заблуждение диагноз как хронические или доброкачественные заболевания, что приводит к задержкам в диагностике. Своевременное выявление имеет важнейшее значение для предотвращения повреждения органов и снижения заболеваемости. Методы: В настоящем обзоре мы представляем обзор последней

Совпадение в полном тексте источника
… The disease’s clinical features and the potential treatment complications need multidisciplinary assessment between hematologists, laboratory assistants, genetic specialists, nephrologists, radiologists, neurologists, and sometimes neurosurgeons [ 35 ]. …

Nephrotoxicity of recent anti-cancer agents.

Cancer patients may develop a variety of kidney lesions that impair not only their immediate survival but also limit the adequate treatment of the underlying malignant process. This review summarizes the nephrotoxic potential of some of the most recently developed anti-cancer drugs, focusing on those interfering with the vascular endothelial growth factor and epidermal growth factor receptor pathways and mammalian target of rapamycin inhibitors. Thrombotic microangiopathy (haemolytic-uraemic syndrome), proteinuria, hypertension and magnesium depletion are the most common side effects. Also the

Choosing the Right Therapy for Patients with Relapsed/Refractory Multiple Myeloma (RRMM) in Consideration of Patient-, Disease- and Treatment-Related Factors.

Treatment of relapsed/refractory multiple myeloma (RRMM) is more complex today due to the availability of novel therapeutic options, mostly applied as combination regimens. immunotherapy options have especially increased substantially, likewise the understanding that patient-, disease- and treatment-related factors should be considered at all stages of the disease. RRMM is based on definitions of the international myeloma working group (IMWG) and includes biochemical progression, such as paraprotein increase, or symptomatic relapse with CRAB criteria (hypercalcemia, renal impairment, anemia, b

Совпадение в полном тексте источника
… Regarding this complexity, interdisciplinary conferences such as tumor boards are an important tool to ensure state-of-the-art antimyeloma treatment and to discuss individualized therapeutic approaches for symptomatic patients involving experts such as radiation therapists, orthopedists, radiologists, nephrologists …

Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies.

Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is n

New strategies and perspectives on managing IgA nephropathy.

IgA nephropathy is an inflammatory renal disease characterised by the deposition of IgA in the glomerular mesangium and is the most commonly reported primary glomerulonephritis worldwide. Thirty to forty percent of patients with the disease develop progressive renal function decline, requiring renal replacement therapy within two decades of diagnosis. Despite this, accurate individual risk stratification at diagnosis and predicting treatment response remains a challenge. Furthermore, there are currently no disease specific treatments currently licensed to treat the condition due to long standi

Совпадение в полном тексте источника
… As such most nephrologists do not advocate fish oil in IgAN. Renin–angiotensin system blockade The role of RAS blockade in IgAN patients is well established. …

Current progress in CAR-based therapy for kidney disease.

Despite significant breakthroughs in the understanding of immunological and pathophysiological features for immune-mediated kidney diseases, a proportion of patients exhibit poor responses to current therapies or have been categorized as refractory renal disease. Engineered T cells have emerged as a focal point of interest as a potential treatment strategy for kidney diseases. By genetically modifying T cells and arming them with chimeric antigen receptors (CARs), effectively targeting autoreactive immune cells, such as B cells or antibody-secreting plasma cells, has become feasible. The emerg

Совпадение в полном тексте источника
… The challenge of AKI following CAR-T cell therapy will undoubtedly become a perpetual task for nephrologists, underscoring the need for ongoing research and clinical intervention in this domain. …

The Challenging Approach to Multiple Myeloma: From Disease Diagnosis and Monitoring to Complications Management.

The outcome of multiple myeloma (MM) has significantly improved in the last few decades due to several factors such as new biological discoveries allowing to better stratify disease risk, development of more effective therapies and better management of side effects related to them. However, handling all these aspects requires an interdisciplinary approach involving multiple knowledge and collaboration of different specialists. The hematologist, faced with a patient with MM, must not only choose a treatment according to patient and disease characteristics but must also know when therapy needs t

Совпадение в полном тексте источника
… In patients with multiple myeloma (MM), accounting for 10% of all hematological malignancies, the clinical features of the disease and the potential complications caused from therapies require close collaboration between hematologists and different specialists, starting with laboratory assistants, nephrologists …

How I treat elderly patients with plasma cell dyscrasias.

Plasma cell dyscrasias are a rare heterogeneous group of hematological disorders which are more prevalent in the older part of the population. The introduction of novel agents, improved understanding of disease biology and better supportive management have improved outcomes considerably and in the era of the aging population the question of how to best manage older patients with plasma cell dyscrasias has never been more relevant. Data on how to treat these patients comes mostly from subgroup analysis as they are underrepresented in clinical trials. This review will cover issues, available evi

Совпадение в полном тексте источника
… The poor physiological reserves associated with target organ dysfunction require a multidisciplinary approach that requires heart failure specialists, nephrologists, haematologists and nutrition specialists [ 142 – 145 ]. Figure 3 Risk adapted treatment recommendations in systemic AL amyloidosis. …

Repurposing drugs for highly prevalent diseases: pentoxifylline, an old drug and a new opportunity for diabetic kidney disease.

Diabetic kidney disease is one of the most frequent complications in patients with diabetes and constitutes a major cause of end-stage kidney disease. The prevalence of diabetic kidney disease continues to increase as a result of the growing epidemic of diabetes and obesity. Therefore, there is mounting urgency to design and optimize novel strategies and drugs that delay the progression of this pathology and contain this trend. The new approaches should go beyond the current therapy focussed on the control of traditional risk factors such as hyperglycaemia and hypertension. In this scenario, d

Совпадение в полном тексте источника
… At present, the identification of the central role of inflammation in the development and progression of CKD and its possible therapeutic targets constitutes an important field of research for nephrologists. …

Light Chain Amyloidosis.

Light chain (AL) amyloidosis is caused by a usually small plasma-cell clone that is able to produce the amyloidogenic light chains. They are able to misfold and aggregate, deposit in tissues in the form of amyloid fibrils and lead to irreversible organ dysfunction and eventually death if treatment is late or ineffective. Cardiac damage is the most important prognostic determinant. The risk of dialysis is predicted by the severity of renal involvement, defined by the baseline proteinuria and glomerular filtration rate, and by the response to therapy. The specific treatment is chemotherapy targe

Совпадение в полном тексте источника
… However, treatment of concomitant heart failure and nephrotic syndrome in patients who often have concomitant involvement of the autonomic nervous system is extremely complicated, and should be done under close supervisions of specialized cardiologists and nephrologists who have experience in the treatment …

PD-1 Pathway Inhibitors: Immuno-Oncology Agents for Restoring Antitumor Immune Responses.

Immune checkpoint inhibitors are designed to restore a patient's own antitumor immune response that has been suppressed during tumor development. The first monoclonal antibodies against the immune checkpoint programmed death 1 (PD-1) receptor, nivolumab and pembrolizumab, are now approved for clinical use. Both agents are indicated for the treatment of advanced melanoma, as well as for the treatment of metastatic non-small cell lung cancer (NSCLC). Nivolumab is also approved for the treatment of advanced renal cell carcinoma. In patients with melanoma, these agents result in objective response

Cardiac Amyloidosis: Tribulations and New Frontiers.

This review article aims to provide an overview of the pathophysiology, diagnosis, and contemporary management of cardiac amyloidosis (CA) as well as identify the knowledge gaps and areas of potential research. CA can be divided into two main groups: transthyretin cardiac amyloidosis (ATTR-CA) and light chain cardiac amyloidosis (AL-CA). The former further separates into wild-type transthyretin (ATTRwt) and hereditary transthyretin (ATTRv). African Americans, males, and people older than 75 are the most common demographics affected by this disease. Thanks to an increased understanding of this

Совпадение в полном тексте источника
… To mitigate these complications, nephrologists can assist in initiating renal replacement therapy as well as providing input into possible renal transplant. Renal transplantation has better outcomes compared to dialysis. …

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals.

In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The

Совпадение в полном тексте источника
… Cardio-Oncologists and Onco-Hematologists lead the pre-treatment phase while Primary Care Provider (PCP), Primary Care Giver (PCG) and the support team (endocrinologists, geriatricians, palliative care providers, psychologists, nephrologists, nutritionists, nurses, social workers) have a complementary …

Diagnosis and treatment of cardiac amyloidosis: an interdisciplinary consensus statement.

The prevalence and significance of cardiac amyloidosis have been considerably underestimated in the past; however, the number of patients diagnosed with cardiac amyloidosis has increased significantly recently due to growing awareness of the disease, improved diagnostic capabilities and demographic trends. Specific therapies that improve patient prognosis have become available for certain types of cardiac amyloidosis. Thus, the earliest possible referral of patients with suspicion of cardiac amyloidosis to an experienced center is crucial to ensure rapid diagnosis, early initiation of treatmen

Совпадение в полном тексте источника
… A critical aspect is the interdisciplinary collaboration between cardiologists, hematologists, neurologists, nephrologists, geneticists, radiologists, specialists in nuclear medicine, pathologists, and specialists in further disciplines. …

Machine learning for acute kidney injury: Changing the traditional disease prediction mode.

Acute kidney injury (AKI) is a serious clinical comorbidity with clear short-term and long-term prognostic implications for inpatients. The diversity of risk factors for AKI has been recognized in previous studies, and a series of predictive models have been developed using traditional statistical methods in conjunction with its preventability, but they have failed to meet the expectations in limited clinical applications, the rapid spread of electronic health records and artificial intelligence machine learning technology has brought new hope for the construction of AKI prediction models. In

Совпадение в полном тексте источника
… The construction of predictive models for AKI has been an outstanding achievement for nephrologists in the 21st century, and over the past 10–20 years, predictive models have been reported, especially in recent years, the electronic medical record information systems of different medical institutions …