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Genetics, Genomics, and Precision Medicine in End-Stage Kidney Disease.

Recent advances in genetics of renal disease have deepened our understanding of progressive kidney disease. Here, we review genetic variants that are of particular importance to progressive glomerular disease that result in end-stage kidney disease (ESKD). Some of the most striking findings relate to APOL1 genetic variants, seen exclusively in individuals of sub-Saharan African descent, that create a predisposition to particular renal disorders, including focal segmental glomerulosclerosis and arterionephrosclerosis. We also review the genetics of cardiovascular disease in ESKD and note that l…

Renal microRNA- and RNA-profiles in progressive chronic kidney disease.

BACKGROUND: MicroRNAs (miRNAs) contribute to chronic kidney disease (CKD) progression via regulating mRNAs involved in renal homeostasis. However, their association with clinical outcome remains poorly understood. MATERIALS AND METHODS: We performed miRNA and mRNA expression profiling on renal biopsy sections by qPCR (miRNA) and microarrays (mRNA) in a discovery (n = 43) and in a validation (n = 29) cohort. miRNAs differentiating stable and progressive cases were inversely correlated with putative target mRNAs, which were further characterized by pathway analysis using KEGG pathways. RESULTS

[Hemolytic anemia caused by graft-versus-host reaction in ABO-nonidentical renal transplants from blood group O donors].

Acute hemolytic anemia is one of the side effects associated with cyclosporin and tacrolimus therapy, and three mechanisms have been described to account for hemolytic anemia in patients receiving these drugs: drug induced hemolysis, autoimmune hemolysis and alloimmune hemolysis resulting from donor lymphocytes derived from the allograft (passenger lymphocyte syndrome). We report four cases of renal transplant recipients who developed alloimmune hemolytic anemia due to minor ABO incompatibility while under treatment with cyclosporin (two) and tacrolimus (two). The anti-erythrocyte antibodies r

How to improve survival in geriatric peritoneal dialysis patients.

BACKGROUND: Recently, more elderly patients who are independent or able to live at home with the support of family are opting for continuous … original disease was chronic glomerulonephritis in 21 patients, diabetic nephropathy in 2 patients, nephrosclerosis in 2 patients, and polycystic kidney disease in 2 patients. The causes of death in the elderly PD patients at our hospital were heart failure (20.3%), cerebrovascular disease (17.7%), myocardial infarction (15.2%), debilitation (12.7%), peritonitis …

Clinical Presentation, Renal Histopathological Findings, and Outcome in Patients with Monoclonal Gammopathy and Kidney Disease.

Monoclonal gammopathies are associated with acute and chronic kidney injury. Nephrotoxicity of the secreted monoclonal (M)-protein is related to its biological properties and blood concentration. Little is known about epidemiology, clinical manifestations, and outcome of monoclonal gammopathies in patients with kidney disease. We retrospectively collected data about demographics, clinical manifestations, and renal histological lesions of all patients (n = 1334) who underwent kidney biopsy between January 2000 and March 2017. Monoclonal gammopathy was detected in 174 (13%) patients with a mean

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… Cryoglobulinemic glomerulonephritis was found in two-thirds of the patients (66.6%) and hypertensive nephrosclerosis in one (33.3%). 3.6. AL Amyloidosis Amyloidosis, defined as primary amyloidosis or AL amyloidosis, was diagnosed in 16 patients (9.1%). … Histological evaluation of biopsy specimen revealed amyloidosis (25%), glomerular injury with membranoproliferative pattern (16.6%), LCDD (25%), ANCA-associated vasculitis (8.3%), cast nephropathy (8.3%), and hypertensive nephrosclerosis (8.3%). …

Glomerular filtration rate prior to high-dose melphalan 200 mg/m(2) as a surrogate marker of outcome in patients with myeloma.

We correlated age and body surface area corrected glomerular filtration rate (GFR) at the time of high-dose melphalan (HDM) administration with treatment-related toxicity (TT), time to disease progression and survival. Between 8/85 and 6/98, 144 newly diagnosed myeloma patients with a median age of 53 years (range, 31-72) received infusional chemotherapy with vincristine, doxorubicin and methylprednisolone, with/without cyclophosphamide or verapamil, followed by HDM 200 mg/m(2)and stem cell rescue. An additional patient received HDM at diagnosis. GFR was below normal in 38 patients (26%). At p

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… Evaluation of serum creatinine for estimating glomerular filtration rate in African Americans with hypertensive nephrosclerosis: results from the African-American Study of Kidney Disease and Hypertension (AASK) Pilot Study. J Am Soc Nephrol. 1997 Feb;8(2):279–287. doi: 10.1681/ASN.V82279. …

Risk of relapse of multiple myeloma following kidney transplantation.

BACKGROUND: Autologous stem cell transplantation (ASCT) and novel therapies have improved the prognosis for patients with multiple myeloma (MM). For those who undergo ASCT while on dialysis, a similar survival compared with the overall MM population has been reported. Therefore, for patients achieving remission following ASCT, kidney transplantation is an attractive option, offering an improved quality of life and significant economic advantage. METHOD: This case series investigates the outcome of five patients who underwent an ASCT for MM with subsequent kidney transplantation between 2006 a

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… kidney transplant after remission (months) Type of kidney transplant and immunosuppression Last follow-up after kidney transplant (months) Haematological response at last follow-up eGFR at last follow-up (mL/min) Lum et al . [ 10 ] 67-year-old male No biopsy but renal disease thought to be hypertensive nephrosclerosis … transplant after remission (months) | Type of kidney transplant and immunosuppression | Last follow-up after kidney transplant (months) | Haematological response at last follow-up | eGFR at last follow-up (mL/min) Lum et al . [ 10 ] | 67-year-old male | No biopsy but renal disease thought to be hypertensive nephrosclerosis …

Secondary Hyperparathyroidism Presenting as a Brown Tumor: A Case Report and Review of the Literature.

Severe secondary hyperparathyroidism in advanced stages of chronic kidney disease (CKD) is associated with CKD-related mineral and bone disease (CKD-MBD). A 70-year-old woman was admitted at the Hospital for generalized bone pain and peripheral edema. Initial laboratory tests revealed normocytic anemia and severe renal dysfunction, and further tests evidenced severe secondary hyperparathyroidism. Full-body computerized tomography showed an osteolytic lesion in the right iliac wing. The iliac bone lesion was biopsied and histological examination was consistent with the diagnosis of a brown tumo

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… Araújo et al., 2013 [ 19 ] | 47 | M | Lumbosacral region | Hypertensive nephrosclerosis | 265.1 | Normal - high | Normal | Normal - high | Osteoarticular pain and paraplegia | Dialysis; percutaneous ethanol injection (parathyroidectomy indicated but not performed due to surgical risk). …

Возрастной состав Ассоциации по борьбе с диетическим протеином зависит от смертности всех пациентов с хроническими почечными заболеваниями.

Различается ли воздействие низкобелкового рациона питания на переход к конечной стадии почечных заболеваний (ЭСРД) и риск смертности среди молодых и пожилых людей с хроническими почечными заболеваниями (КХД) неясным. Мы провели ретроспективное когортное исследование CKD для изучения связи между потреблением белка и смертностью или почечными результатами, и влияет ли возраст на эту связь. В состав группы входили: 352 пациенты со стадией G3-5 CKD, за которым последовали на медиане 4.2 годы, прошли учебную госпитализацию и для которых исходное потребление белка оценивалось на основе 24-h Образцы

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… The CKD was due to nephrosclerosis (ICD-10 code N26) in 174 patients (49.4%), diabetic nephropathy (ICD-10 code N083) in 120 (34.1%), chronic glomerulonephritis (ICD-10 code N039) in 35 (9.9%), polycystic kidney disease (ICD-10 code Q613) in 8 (2.3%), and other causes in 15 (4.3%). … These controversial results may be due to differences in study design, method and amount of protein intake, primary disease (such as diabetes or nephrosclerosis), and the observation periods. One meta-analysis reported that an LPD has an inverse association with ESRD risk [ 14 ]. …

Kidney Biopsy Findings Among Allogenic Hematopoietic Stem Cell Transplant Recipients With Kidney Injury: A Case Series.

RATIONALE AND OBJECTIVE: The incidence of kidney disease is high in patients after allogeneic hematopoietic cell transplantation (aHCT). Although rarely performed, kidney biopsy may be useful to make a precise diagnosis because several mechanisms and risk factors can be involved, and to adjust the treatment accordingly. This case series aimed to report the spectrum of biopsy findings from patients with kidney injury after aHCT. STUDY DESIGN: Single-center retrospective case series. SETTING AND PARTICIPANTS: All individuals who underwent a native kidney biopsy, among all adult patients who re

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… 13 (2007) Switzerland 3 2 AML 1 ALL 2 BMT 1 PBHCT 3/3 3 NS 20 [14-21] 2 MN 1 MPGN type 1 Terrier et al, 14 (2007) France 5 2 NHL 1 AML 1 CLL 1 MDS NA 5/5 5 NS 21 [14-37] 5 MN Chan et al 15 (2008) China 9 4 CML 2 ALL 1 AML 1 MDS 1 MM NA 7/9 3 NS 3 CKD 3 AKI 34 [1-134] 3 MN 2 TMA 1 IgAN 1 Hypertensive nephrosclerosis … 1 PBHCT | 3/3 | 3 NS | 20 [14-21] | 2 MN 1 MPGN type 1 Terrier et al, 14 (2007) | France | 5 | 2 NHL 1 AML 1 CLL 1 MDS | NA | 5/5 | 5 NS | 21 [14-37] | 5 MN Chan et al 15 (2008) | China | 9 | 4 CML 2 ALL 1 AML 1 MDS 1 MM | NA | 7/9 | 3 NS 3 CKD 3 AKI | 34 [1-134] | 3 MN 2 TMA 1 IgAN 1 Hypertensive nephrosclerosis …

Multiple myeloma presenting as acute tubulointerstitial nephritis.

BACKGROUND: Acute tubulointerstitial nephritis (ATIN) is a very rare paraneoplastic manifestation in patients with multiple myeloma (MM). It is an uncommon pattern of renal disease in such patients. CASE PRESENTATION: We report a case of an 82-year-old male who was admitted with acute kidney injury. Renal biopsy showed typical findings of light chain-associated ATIN with scattered inflammatory cells in the interstitium and associated active tubulitis. No other common manifestations of MM were present at the time of presentation, including hypercalcemia, hyperuricemia, proteinuria, bone pain o

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… It also revealed vascular nephrosclerosis and moderate glomerulosclerosis, both of which are consistent with the patient’s long-term history of hypertension and diabetes. In our case, acute kidney failure would be best explained by the ATIN process related to light chains. …

После-пересадки двойное злодейство: Множественная миелома и папиллярная рентгеновская ячейка Карцинома-А.

Фон и клиническая значимость: получатели почечных трансплантаций имеют 2-4-fold более высокий риск раковых заболеваний по сравнению с населением в целом. Целостное появление карциномы миеломы (ММ) и почечной клетки коренных почек (КЦК) является редким явлением и создает конкурирующие приоритеты между эффективностью борьбы с миломой и сохранением сплава. Представление дела: A 54-year-old с женщиной 2020 Пересадка живой донорской почки 2024 с болью в костях и опухолью плеча. КТ всего тела с низкой дозой выявила множественные остеолитические повреждения. Проверка показала, что М-протеин ИгГ. 38.5

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… Marina”, Varna with edema and a worsened kidney function; given bilateral ultrasound nephrosclerosis, a kidney biopsy was not performed (hypertensive nephropathy and a latent glomerulonephritis were considered in the differential). …

The adductor pollicis muscle thickness is not associated with physical function, lean mass, and nutritional status in patients on maintenance hemodialysis.

BackgroundThe adductor pollicis muscle thickness (APMT) may be associated with the muscle strength in patients on hemodialysis. However, the association of APMT with other physical function assessment tests has not yet been tested. Moreover, because it is considered a good nutritional indicator and not influenced by fluid overload, the APMT may be associated with the muscle mass and nutritional status of these patients. Therefore, the objective was to assess the association of APMT with physical function, muscle mass and nutritional status in patients on hemodialysis.MethodsThe APMT was measur

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… The most prevalent underlying kidney disease was hypertensive nephrosclerosis ( n = 21, 41.2%), followed by undefined causes ( n = 14, 27.5%), diabetic nephropathy ( n = 3, 5.9%), autosomal recessive polycystic kidney disease ( n = 2, 3.9%), and other causes ( n = 11, 21.7%), such as benign prostatic …

Optimal predialysis care.

Management of severe chronic kidney disease (CKD) involves dealing with medical, nursing and psychosocial problems and therefore warrants support from a multidisciplinary team. In the Kidney Disease Outcomes Quality Initiative (KDOQI) classification system of CKD, preparation for renal replacement therapy has been recommended in CKD stage 4, characterized by a reduction in the estimated glomerular filtration rate (GFR) of <30 ml/min. In this article we share our approach to perfecting predialysis care. Tools are given to make an estimation of the progression of kidney disease. Also the prevent

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… At this stage, diabetic nephropathy, glomerular and polycystic diseases are characterized by more rapid deterioration compared to patients with nephrosclerosis. Young, male or black patients also have the tendency to lose renal function at a faster rate. …

Распространение значительного стеноза коронарной артерии и связи с каротидной максимальной токсикоманией в асимптоматических пациентах с умеренной хронической почечной болезнью: один-центральный, перспективный, межсекторальный анализ.

AIM: Болезнь коронарной артерии является одной из основных причин смертности пациентов с хроническими заболеваниями почек (CKD); однако фактическое бремя асимптомного коронарного стеноза у пациентов с продвинутой стадией CKD остается неясным. Мы изучили распространенность и связанные с этим факторы значительного строения коронарной артерии.≥ 50%) у асимптоматических пациентов с умеренно-тяжелыми (стадия) G3-5CKD. Кроме того, мы провели оценку полезности максимальной интимной толщины сонной артерии (ИМТ) для прогнозирования значительного коронарного стеноза у этих пациентов.МЕТОДЫ: 128 пациенты

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… | All Patients (n=128) | | All Patients (n=128) Age (year) | 70.3 ± 11.2 | Primary cause of CKD (number, %) | Hypertensive nephrosclerosis | 52 (40.6%) Male sex (number, %) | 87 (68.0%) | Diabetic kidney disease | 34 (26.6%) Body mass index (kg/m 2 ) | 24.1 ± 4.8 | Chronic glomerulonephritis | 33 …

Primary Health Care approach to managing chronic kidney disease.

Chronic kidney disease (CKD) is a growing global health issue among ageing populations, driven by increasing diabetes and hypertension. Managing advanced stages of CKD with dialysis or transplants is costly. Early stages often have no symptoms, making early detection important for prevention. Primary care providers can help identify and manage CKD early by performing annual screening for high-risk patients, including blood pressure checks, urine tests for albuminuria or proteinuria and estimating glomerular filtration rate from serum creatinine. For those with CKD, renal protective measures ar

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… System affected | Underlying Causes Pre-renal causes | Cardiorenal syndrome – chronic heart failure may lead to CKD Liver cirrhosis Renal vascular causes | Hypertensive nephrosclerosis Renal artery stenosis Athero-emboli of renal vasculature Vasculitis Fibromuscular dysplasia Glomerular disease – characterised …

Экономия и безопасность дотинурада в связи с кислотой и реанимацией у пациентов с гиперперурицемией и повышенными хроническими почечными заболеваниями: единый центр, ретроспективный анализ.

ЦЕЛЬ: мы изучили эффективность и безопасность дотинурада, селективного ингибитора реабсорбции у гиперурисемичных пациентов с продвинутой хронической болезнью почек (CKD) (стадия) G3-5). ВОЗМОЖНОСТИ И МЕТОДЫ: Мы ретроспективно проанализировали случаи 34 больные (средний возраст, 68.6 ± 13.3 годы; 17 мужчин и женщин 17 женщин) после 12 Количество месяцев дотинурадной обработки на основе изменений в мочеисперсной кислоте (UA) и соотношении белков и креатининов мочи (UPCR) плюс ежегодное изменение расчетной гермекулярной фильтрации (eGFR). Гиперурикемия (UA) ≥6.0 мг/дл) и усовершенствованная CKD (

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… 17.6) | 0.17 CCB, n (%) | 22 (64.7) | 22 (64.7) | 1.00 RAS inhibitor, n (%) | 22 (64.7) | 21 (61.8) | 0.81 BUN, mg/dL | 29.8 ± 12.7 | 31.8 ± 18.7 | 0.61 Creatinine mg/dL | 1.8 ± 0.8 | 1.9 ± 0.9 | 0.85 eGFR, mL/min/1.73m 2 | 32.0 ± 13.3 | 32.6 ± 15.2 | 0.88 Primary cause of CKD, n (%) | Hypertensive nephrosclerosis …

The perioperative management of geriatric patients in transplantation surgery-clinical, immunological, and translational considerations.

Transplant surgery encompasses two primary branches: solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA). As the global population ages, elderly transplant patients become a more pressing clinical challenge. Elderly transplant recipients require specialized care that addresses their unique needs, including increased comorbidities and frailty. Despite the growing recognition of these challenges, there is a paucity of studies that synthesize the current knowledge on this patient cohort, from immunological changes over translational challenges to tailored clinic

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… In elderly patients, whose baseline renal function may already be compromised due to aging-related nephrosclerosis, the risk of CNI-induced nephrotoxicity is magnified, often leading to progressive renal dysfunction post-transplant. … Calcineurin inhibitors (e.g., tacrolimus, cyclosporine) accelerate chronic kidney damage and exacerbate age-related nephrosclerosis. …

Implementing a Protocol for Incremental Hemodialysis in Incident Patients With Kidney Failure: A Quality Improvement Initiative.

BACKGROUND: Incremental hemodialysis (iHD), which adapts dialysis frequency to a patient's residual kidney function, may ease the transition to dialysis, improve quality of life, and reduce costs. OBJECTIVES: In our tertiary care center, we aimed to develop and implement an iHD protocol and to safely initiate 75% of eligible patients starting incident dialysis on iHD, defined as twice-weekly dialysis, over a two-year period. This project was a nephrology fellow-led quality improvement (QI) initiative conducted as part of the Canadian Society of Nephrology's Quality Improvement and Implementat

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… Hypertension | 38 (86) | 72 (79) Coronary artery disease | 9 (20) | 18 (20) Congestive heart failure | 6 (14) | 31 (34) Cerebral vascular accident | 4 (9) | 4 (4) Peripheral vascular disease | 3 (7) | 12 (13) Cause of end-stage kidney disease, n (%) Diabetic nephropathy | 16 (36) | 34 (37) Hypertensive nephrosclerosis …