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Effectiveness of Long-Term Shichimotsukokato Administration on the eGFR Slope in Patients With Chronic Kidney Disease: A Retrospective Single-Arm Study.

Introduction The prevalence of chronic kidney disease (CKD) continues to rise worldwide. Patients with CKD are exposed to increased risks of … 38.7 ± 10.0 mL/min/1.73 m², and 9 patients (75.0 %) were classified as CKD stage G3b. Hypertensive nephrosclerosis was the most common primary cause of CKD. There were 11 patients (91.7 %) with concomitant hypertension, and 9 patients (75.0 %) were prescribed renin-angiotensin-aldosterone system (RAAS) inhibitors. The mean daily dose of SCMKT (Tsumura & Co., Tok …

[MORPHOGENETIC PROTEINS--FIBROBLAST GROWTH FACTOR AND KLOTHO, IN THE SERA OF PATIENTS WITH CHRONIC RENAL DISEASE].

The aim of the study was to evaluate the role of morphogenetic proteins--fibroblast growth factor-23 (FGF-23) and extracellular form (alpha) of Klotho protein, present in the sera of patients with chronic renal disease (CRD) as markers of cardiovascular risk. The study included 130 patients (64 men and 66 women) with stage I-VD CRD. The patients'age was 20-65 (mean 41 ± 6.7) years. 30 of them had chronic glomerulonephritis, 23 chronic tubulointerstitial nephritis, 28 hypertensive nephrosclerosis, 22 polycystic kidneys, 27 type 2 diabetes mellitus. Inclusion and exclusion criteria were standard…

HLA-identical sibling renal transplantation--a 21-yr single-center experience.

Human lymphocyte antigen (HLA)-identical sibling organs offer the best long-term outcomes for recipients of a renal transplant apart from an … LE) and chronic glomerulonephritis (CGN)) faired worse as a group than recipients with hypertensive nephrosclerosis (HTN), autosomal dominant polycystic kidney disease (ADPKD), Alport's, reflux or congenital dysplasia (68 vs. 96% at 10 yr, p = 0.0009). Poor patient survival was seen in diabetics (71 vs. 88% at 10 yr, p = 0.01). There was a trend to poorer graft s …

First case report of using Ofatumumab in kidney transplantation AB0 incompatible.

Modern methods for desensitization protocol rely heavily on combined apheresis therapy and Rituximab, a chimeric (murine and human) anti-CD20 antibody used in AB0 incompatible kidney transplants. Severe infusion related reactions due to the administration of Rituximab are reported in 10% of patients. These adverse reactions may hinder the completion of the desensitization protocol. Therefore, it's useful to test alternative B cell depleting therapies. Our clinical case focuses on a 41-year-old male who developed an adverse infusion reaction following the administration of Rituximab and was giv

Cardiovascular and Kidney Outcomes of Non-Diabetic CKD by Albuminuria Severity: Findings From the CRIC Study.

RATIONALE & OBJECTIVE: The clinical trajectory of normoalbuminuric chronic kidney disease (CKD), particularly in the absence of diabetes, has not yet been well-studied. This study evaluated the association of kidney and cardiovascular outcomes with levels of albuminuria in a cohort of patients with nondiabetic CKD. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 1,463 adults with nondiabetic CKD without known glomerulonephritis and diagnosed with hypertensive nephrosclerosis or unknown cause of CKD participating in the Chronic Renal Insufficiency Cohort (CRIC) Study. EXPOSUR…

Klotho and chronic kidney disease.

Through alternative splicing, Klotho protein exists both as a secreted and a membrane form whose extracellular domain could be shed from the cell surface by secretases and released into the circulation to act as endocrine factor. Unlike membrane Klotho which functions as a coreceptor for fibroblast growth factor-23 (FGF23) to modulate FGF23 signal transduction, soluble Klotho is a multifunction protein present in the biological fluids including blood, urine and cerebrospinal fluid and plays important roles in antiaging, energy metabolism, inhibition of Wnt signaling, antioxidation, modulation

The use of bivalirudin in patients with renal impairment.

The majority of patients with acute coronary syndromes have renal impairment from either the aging process or from underlying disease, such as nephrosclerosis or diabetes. For example, in the phase 3 studies of bivalirudin use in PTCA, only 25% of patients had normal renal function: 46% had mild renal impairment, 28% had moderate renal impairment and about 1% had severe renal impairment. In patients with normal renal function, the intravenous pharmacokinetics of bivalirudin are dose proportional (linear) and are characterized by rapid plasma clearance (4.58 ml/minute/kg), a small volume of dis…

Saddle Pulmonary Embolism in a Patient With Chronic Kidney Disease and Gastric Malignancy: A Case Report.

BACKGROUND: Anemia of chronic renal disease as well as cancer and chemotherapy-induced anemia (CIA) are often associated with poor outcomes, and the use of erythropoietin stimulating agents (ESAs) for patients with chronic kidney disease (CKD) and anemia associated with cancer has been a common practice. However, the increased incidence of venous thromboembolism has been reported in these populations. CLINICAL PRESENTATION: A 61-year-old male, known case of CKD stage 3A secondary to hypertension nephrosclerosis since 2019, diagnosed case of gastric adenocarcinoma, poorly differentiated with s…

[Peritoneal dialysis in the aged].

INTRODUCTION: Patients older than 65 years represent the group of patients affected by end-stage renal failure characterized by the most rapid growth. The prevalent causes of end-stage renal disease (ESRD) in the elderly are diabetes mellitus and nephrosclerosis due to long-term arterial hypertension. There are a number of physiologic changes which occur with aging that might have an impact on the choice of renal replacement modality for an elderly patient: clinical or subclinical diminished cardiovascular reserve due to atherosclerosis or impaired baroreceptor function, slow deterioration of …

[Arterial hypertension in patients on chronic hemodialysis].

Arterial hypertension is frequent among chronically dialyzed patients. The kidney obviously plays a major role in arterial blood pressure co … which caused chronic renal failure, was glomerulonephritis (60.0%), then pyelonephritis (17.0%) and nephrosclerosis, nephrolithiasis, polycystic kidney and, finally, renal tumours. The effect of permanent haemodialysis during the first year of treatment, was efficacious on hypertension in 1704 (65.1%) patients; in 672 (25.7%) patients therapeutical effects were a …

Lipid profile before and after renal transplantation--a longitudinal study.

BACKGROUND: The data on lipid profile in renal transplant recipients from the Indian subcontinent is scant. METHODS: Lipid profile was studied in 30 consecutive patients of end stage renal disease before renal transplantation (0 month) and prospectively posttransplantation at 1, 3, and 6 months. The results were compared with 30, age and sex matched, healthy controls. All the patients received triple immunosuppression (prednisolone, azathioprine and cyclosporine). RESULTS: Pretransplantation, the hypertriglyceridemia and hypercholesterolemia was present in 20% and 7% of the patients and the

Renoprotective effect of vasopressin v2 receptor antagonist tolvaptan in Dahl rats with end-stage heart failure.

Tolvaptan is a highly selective and orally effective arginine vasopressin V2 receptor antagonist, and is potentially useful for the treatment of heart failure (HF) patients. However, the renoprotective effect of long-term tolvaptan therapy and its underlying mechanisms remain unknown. We evaluated the effects of chronic treatment with tolvaptan on renal dysfunction, podocyte injury, inflammation, oxidative stress, Rho-kinase, epithelial-mesenchymal transition (EMT), and the extracellular signal-regulated protein kinase (ERK1/2) pathway in the renal cortex of Dahl salt-sensitive hypertensive (D

Clinical features of hemodialysis patients treated for hepatocellular carcinoma: Comparison between resection and radiofrequency ablation.

There is no consensus regarding which therapeutic option is better and/or safer for treating hemodialysis (HD) patients with hepatocellular carcinoma (HCC). The present study compared surgical resection (Hx) and radiofrequency ablation (RFA) with regard to therapeutic efficacy in HD patients with HCC. Of 108 HD patients with naïve HCC treated at 15 institutions between 1988 and 2014 enrolled in the present study, 58 fulfilled the up-to-7 criteria [7 as the sum of the size of the largest tumor (cm) and the number of tumors] and were treated with Hx (n=23) or RFA (n=35); their clinical features,

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… Parameter/characteristic | Value Sex (male/female) (n) | 91:17 Average age (years) | 67.9±8.7 Etiology of HCC (HCV/HBV/HBV + HCV/nonBnonC) (n) | 74:9:3:22 Performance status (0/1/2/3/4/unknown) (n) | 54:35:4:3:12 Basal disease causing ESRD (n) | DM, 72; unknown, 26; nephrosclerosis, 3; chronic glomerulonephritis … , 1; unknown, 5 | DM, 25; multiple myeloma, 1; nephrosclerosis, 1; chronic glomerulonephritis, 1; unknown, 7 | – HD (machine/peritoneal) (n) | 23:0 | 35:0 | – Average period after introducing HD b (years) | 5.3±5.7 | 5.4±5.7 | 0.953 Aspartate aminotransferase b (IU/l) | 23.0±12.1 | 34.4±30.7 | 0.057 …

New Mexico's COVID-19 Experience.

The 2019 novel coronavirus disease (COVID-19) has spread worldwide, infiltrating, infecting, and devastating communities in all locations of varying demographics. An overwhelming majority of published literature on the pathologic findings associated with COVID-19 is either from living clinical cohorts or from autopsy findings of those who died in a medical care setting, which can confound pure disease pathology. A relatively low initial infection rate paired with a high biosafety level enabled the New Mexico Office of the Medical Investigator to conduct full autopsy examinations on suspected C