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Ten tips for an onco-nephrology clinic.

An increasing number of cancer patients are benefiting from long term cancer-directed therapy with an ever-expanding arsenal of novel agents from monoclonal antibodies to small molecules and cellular therapies in addition to the mainstay cytotoxic chemotherapy. All these therapies are accompanied by a unique array of adverse events, which include kidney toxicity. In this context, the need for onco-nephrology expertise continues to grow. Oncologists and hematologists collaborate closely with onco-nephrologists to determine: (i) treatment options for special populations based on accurate assessm

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… The most accurate assessment of GFR is obtained using exogenous filtration markers, such as iohexol or iothalamate, and monitoring their plasma or urinary clearance to obtain a measured GFR (mGFR). … As mGFR uptake has increased in Europe, the European Kidney Function Consortium recently published a consensus statement on protocol standardization using iohexol mGFR [ 6 ]. …

Сочетание низкотемпературной радиочастотной термокоагуляции и импульсной радиочастоты двустороннего ганглиона Гассериана для двусторонней тригеминной нейронгии из-за множественного склероза: отчет о деле.

Двусторонний тригеминальный нейронный вторичный склероз является крайне редким заболеванием. Когда проводится ганглионный блок Гассериана, необходимо добиться надежного долгосрочного анальгетического эффекта, избегая при этом осложнений, связанных с лечением. КИСЛОТА: 49-летний самец с множественным склерозом продемонстрировал стойкую скучную боль и пароксисмическую электрическую боль, похожую на шоковую, в своих двусторонних максимальных миллиардных молярах и челюсти. У него был диагностирован тригеминальный нейронный диагноз, вызванный множественным склерозом. Из-за серьезных побочных эффект

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… Subsequently, we advanced the needle with the loss of resistance technique using iohexol, and confirmed its retention when the resistance disappeared. We confirmed the tip of the needle did not exceed the clivus in the lateral view. …

Axial Multicentric Osteosarcoma in an English Cocker Spaniel.

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… Footnotes 1.5 tesla Intera, Philips Medical System, Eindhoven, the Netherlands 0.1 mL/kg Gadovist (gadobutrol), Bayer Pharma AG, Berlin, Germany PQ 500, Universal Systems, Solon, OH 2 mg/kg Omnipaque (iohexol), GE Healthcare AS, Oslo, Norway Toceranib, Palladia TM , Zoetis, Louvain‐la‐Neuve, Belgium …

Accuracy of dynamic perfusion CT with deconvolution in detecting acute hemispheric stroke.

BACKGROUND AND PURPOSE: Dynamic perfusion CT (PCT) with deconvolution produces maps of time-to-peak (TTP), mean transit time (MTT), regional cerebral blood flow (rCBF), and regional cerebral blood volume (rCBV), with a computerized automated map of the infarct and penumbra. We determined the accuracy of these maps in patients with suspected acute hemispheric stroke. METHODS: Forty-six patients underwent nonenhanced CT and dynamic PCT, with follow-up CT or MR imaging. Two observers reviewed the nonenhanced studies for signs of stroke and read the PCT maps for TTP, MTT, rCBF, and rCBV abnormali

Circulating Levels of Soluble α-Klotho and FGF23 in Childhood Cancer Survivors: Lack of Association with Nephro- and Cardiotoxicity-A Preliminary Study.

Background/Objectives: The survival rate among pediatric cancer patients has reached 80%; however, these childhood cancer survivors (CCSs) are at a heightened risk of developing chronic conditions in adulthood, particularly kidney and cardiovascular diseases. The aims of this study were to assess the serum α-Klotho and FGF23 levels in CCSs and to determine their association with nephro- and cardiotoxicity. Methods: This study evaluated a cohort of 66 CCSs who remained in continuous remission, with a mean follow-up of 8.41 ± 3.76 years. Results: The results of this study revealed that CCSs exhi

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… Another limitation is that eGFR was estimated from creatinine values, rather than measured with techniques such as plasma clearance of iohexol. The available literature lacks data on the role of α-Klotho and FGF23 in children treated for cancer. …

Повторная оценка биопсии почек в связи с диабетической болезнью почек: гистопатология, курс клинической медицины и будущее точной нефрологии.

Фон: диабетическое заболевание почек (DKD) one :: основные причины хронических заболеваний и почечной недостаточности во всем мире. Хотя большинство пациентов, страдающих диабетом, диагностируются клинически на основе албуминурии, предполагаемого снижения уровня глумерной фильтрации и диабетической ретинопатии, одни только клинические параметры не могут надежно отличать биопсию, подтвержденную диабетической нефропатией (ННН), от недиабетической болезни почек (НДКД) или смешанных повреждений. Таким образом, биопсия почек для больных диабетом по-прежнему носит избирательный, а не рутинный характ

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… It can be assessed using estimated glomerular filtration rate (eGFR) derived from serum creatinine-based equations, or more accurately by measured GFR using exogenous markers such as inulin, iohexol, or iothalamate. …

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors.

The objectives of this study were to evaluate urinary beta-2-microglobulin (β2M) levels in long-term childhood cancer survivors and to establish its association with anticancer drug-induced nephrotoxicity. The study consisted of 165 childhood cancer survivors (CCS) who were in continuous complete remission. We reported that CCS had a significantly higher level of β2M (p < 0.001) and β2M/Cr. ratio (p < 0.05) than healthy peers. Among all participants, 24 (14.5%) had decreased eGFR (<90 mL/min/1.73 m2). A significant positive correlation between β2M/Cr. ratio and body mass index (coef. 14.48, p

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… Third, we used the GFR estimated from creatinine level rather than measured by standard techniques such as plasma clearance of iohexol. …

Abstracts from the 8th Drug Hypersensitivity Meeting (DHM)

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Cancer and the kidney: dangereoux liasons or price paid for the progress in medicine?

A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem. Thus, all these kidney-relat

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… They used low-osmolar, non-ionic contrast agents i.e. iopromide (428 mOsmol/l) or iohexol (465 mOsmol/l). They suggested that patients undergoing CT with contrast within 45 days after chemotherapy were at the increased risk for CIN. … Inulin is the gold standard of exogenous filtration marker, however, using alternative filtration markers (such as radioactive or nonradioactive; iohexol, iothalamate, ethylenediaminetetraacetic acid- EDTA or diethylenetriaminepentaacetate-DTPA), bolus administration of the marker (intravenous or subcutaneous …

Prior cancer history and suitability for kidney transplantation.

Kidney transplantation is the optimal treatment for most patients with kidney failure. For patients with a prior history of treated cancers, listing and transplant eligibility decisions are complex. Patients and health professionals are obliged to consider the time-periods between cancer cure and transplantation, the risk of cancer recurrence under the influence of immunosuppression and anti-cancer treatment options if the disease recurs. Cancer recurrence is associated with a high mortality rate, thus potentially reduces the projected survival benefit of transplantation, and dampens the utili

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… Directly measured GFR, expressed in mL/min, refers to a direct measurement of the clearance of exogenous markers (filtered by the glomerulus and neither reabsorbed nor secreted by the kidney tubules), such as iohexol, iothalamate, 51Cr-EDTA or 99mTc-DTPA. …

Acute kidney injury manifesting as renal tubular acidosis with proximal and distal renal tubular dysfunction in a dog with acute pancreatitis.

OBJECTIVE: To describe the clinical presentation and management of a critically ill dog with profound renal tubular acidosis (RTA) with proximal and distal renal tubular dysfunction. CASE SUMMARY: A 3-year-old neutered female Border Terrier was presented with frequent regurgitation resulting from acute pancreatitis with severe ileus. Venous acid-base analysis and complete urinalysis confirmed the presence of normal anion gap metabolic acidosis with inappropriately alkaline urine (pH 8), consistent with distal RTA. Urinalysis, urine amino acids, and urinary fractional excretion of electrolytes

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… The GFR, by plasma iohexol clearance or plasma exogenous creatinine clearance, 21 could not be measured on an emergency basis in our dog. …

Lipocalin 2-not only a biomarker: a study of current literature and systematic findings of ongoing clinical trials.

Lipocalin 2 (Lcn2), also known as neutrophil gelatinase-associated lipocalin, is an innate immune protein encoded by the LCN2 gene. In this study, we investigated various roles and functions of Lcn2 characterized in a systems-based format and evaluated its therapeutic potentials and clinical relevance for diagnosis and prognosis. An additional systematic presentation was presented for 70 ongoing clinical trials utilizing Lcn2 in the diagnostic and prognostic setting as a key outcome measure. With trials being conducted through December 2030, Lcn2 will become all the more relevant given its ass

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… urine tumor necrosis factor alpha (TNF-Î ±) [ng/mL]; change of urine vascular cell adhesion molecule-1 (VCAM-1) NCT04482920 | Effect of Hormone Therapy on Renal Function | Recruiting | Transgenderism; kidney diseases; kidney injury | Diagnostic test: p-aminohippurate clearance study; diagnostic test: iohexol … oscillometry; change in peripheral microvascular endothelial function assessed in the fingertip NCT04407481 | PErfusioN, OxyGen ConsUmptIon and ENergetics in ADPKD (PENGUIN) | Recruiting | Polycystic kidney disease, adult; polycystic kidney, autosomal dominant | Drug: aminohippurate sodium inj 20%; drug: iohexol …

Acute Kidney Injury Associated with Anticancer Therapies: Small Molecules and Targeted Therapies.

Molecular targeted therapy has revolutionized cancer treatment by significantly improving patient survival compared with standard conventional chemotherapies. The use of these drugs targets specific molecules or targets, which block growth and spread of cancer cells. Many of these therapies have been approved for use with remarkable success in breast, blood, colorectal, lung, and ovarian cancers. The advantage over conventional chemotherapy is its ability to deliver drugs effectively with high specificity while being less toxic. Although known as "targeted," many of these agents lack specifici

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… Ideal filtration markers that exhibit very accurate measurements of GFR and can differentiate between true AKI and pseudo-AKI would be the use of exogenous filtration markers, such as radionuclides ( 51 Cr-EDTA, 99m Tc-DTPA) and contrast agents (iothalamate, iohexol). …

2020 ACVIM Forum On Demand Research Abstract Program.

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… N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), quality‐of‐life (QOL) scoring, renal function (iohexol clearance ELISA‐estimated glomerular filtration rate, symmetric dimethylarginine, and creatinine concentration), and echocardiographic cardiac size and function were evaluated before and 7–10 …

Treating anemia of chronic kidney disease in the primary care setting: cardiovascular outcomes and management recommendations.

Anemia is an underrecognized but characteristic feature of chronic kidney disease (CKD), associated with significant cardiovascular morbidity, hospitalization, and mortality. Since their inception nearly two decades ago, erythropoiesis-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia, and their use has been associated with improved quality of life and reduced hospitalizations, inpatient costs, and mortality. Hemoglobin targets >/=13 g/dL have been linked with adverse events in recent randomized trials, raising concerns over the proper hemoglobin range for ES

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… 42 | EPO to Hct 33–35% | | | SrCr 2–4 mg/dL, Hematocrit>30%;28 mo median follow-up | 35 | Nonanemic control | | Rossert et al. [66] (r, mc, uncontrolled) a | Iothalamate GFR 25–60 mL/min; 40 mo | 108 | EPO for Hb 14–15 g/dL (men) and 13–14 g/dL (women) | Change-from-baseline GFR as estimated by iohexol …

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

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… Contrast-associated AKI There are no confirmed clinically relevant differences in risk of CA-AKI between low-osmolality contrast media (LOCM) and iso-osmolarity contrast media (IOCM) for intravenous applications. 31 Indirect evidence suggests that the LOCM iohexol may have a higher risk compared with …

Pharmacological treatment options for mast cell activation disease.

Mast cell activation disease (MCAD) is a term referring to a heterogeneous group of disorders characterized by aberrant release of variable subsets of mast cell (MC) mediators together with accumulation of either morphologically altered and immunohistochemically identifiable mutated MCs due to MC proliferation (systemic mastocytosis [SM] and MC leukemia [MCL]) or morphologically ordinary MCs due to decreased apoptosis (MC activation syndrome [MCAS] and well-differentiated SM). Clinical signs and symptoms in MCAD vary depending on disease subtype and result from excessive mediator release by MC

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… metamizol Local anesthetics Amide-type: lidocaine articaine Ester-type: tetracaine, procaine prefer amide-Type, e.g., bupivacaine Peptidergic drugs Icatibant, cetrorelix, sermorelin, octreotide, leuprolide X-ray contrast medium Iodinated contrast medium Gadolinium chelate Non-ionic contrast media: iohexol … Local anesthetics | Amide-type: lidocaine articaine Ester-type: tetracaine, procaine | prefer amide-Type, e.g., bupivacaine Peptidergic drugs | Icatibant, cetrorelix, sermorelin, octreotide, leuprolide | X-ray contrast medium | Iodinated contrast medium Gadolinium chelate | Non-ionic contrast media: iohexol …

Miscellaneous Spinal Cord Diseases

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… Myelography consists of injection of a nonionic contrast medium (0.3 to 0.45 ml/kg of iohexol [240 mg/ml] or iopamidol [200 mg/ml]) into the subarachnoid space of the low lumbar spine (L6-L7 or L5-L6) or the cerebellomedullary cistern. …

Treatment effects of human amnion-derived mesenchymal stem cells for skin lesions and metastatic pulmonary calcification in calciphylaxis patients - case series and literature review.

BACKGROUND: Calciphylaxis, also termed calcific uremic arteriolopathy (CUA) in patients with end-stage kidney disease (ESKD), is a rare and fatal condition characterized by cutaneous ischemic necrosis. METHODS: Three patients with calciphylaxis and metastatic pulmonary calcification (MPC) were treated with human amnion-derived mesenchymal stem cells (hAMSCs). Effects were evaluated using the Visual Analogue Scale (VAS), modified Bates-Jensen Wound Assessment Tool for CUA (BWAT-CUA), wound quality of life questionnaire (Wound-QoL), and histological analysis. MPC was assessed by high-resolution

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… Optimal imaging of the vessel tree was obtained using Iohexol and digital subtraction angiography. A 0.014’ wire (Boston Scientific, Marlborough, MA) was used to cross the lesions with the assistance of a 3-Fr multipurpose support-catheter (Cook Medical, Bloomington, Indiana). …

Guidelines for treatment of renal injury during cancer chemotherapy 2016.

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… In Japan, the gold standard is inulin clearance; other countries, however, measure clearance of substances such as 51Cr-EDTA, I-125 sodium iothalamate, or iohexol. …