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Rheumatic Diseases Clinics of North... Aug 2015Scleroderma renal crisis is a rare complication of systemic sclerosis (SSc) that remains severe. Prompt recognition and initiation of therapy with an... (Review)
Review
Scleroderma renal crisis is a rare complication of systemic sclerosis (SSc) that remains severe. Prompt recognition and initiation of therapy with an angiotensin-converting-enzyme inhibitor offer the best chance to achieve a good outcome. SSc prevalence is poorly known, with disparities among countries.
Topics: Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Male; Middle Aged; Pregnancy; Pregnancy Complications; Renal Insufficiency; Scleroderma, Systemic
PubMed: 26210130
DOI: 10.1016/j.rdc.2015.04.008 -
Current Gastroenterology Reports Sep 2015There is an intricate relationship between the liver and the kidney, with renal physiology and function intimately involved in many primary disorders of pediatric liver... (Review)
Review
There is an intricate relationship between the liver and the kidney, with renal physiology and function intimately involved in many primary disorders of pediatric liver disease. The hemodynamic changes of progressive cirrhosis affect and are directly affected by changes in renal blood flow and renal handling of sodium and free water excretion. Resulting complications of worsening ascites, hyponatremia, and acute kidney injury frequently complicate the care of children with advanced liver disease and contribute significant morbidity and mortality. While liver transplantation may restore hemodynamic stability, nearly 40% of pediatric liver transplant recipients develop chronic kidney disease post-transplant and approximately 25% are left with clinical hypertension. This review seeks to provide a basic understanding of this relationship to enable the provision of optimal care to children with liver disease.
Topics: Acute Kidney Injury; Ascites; Child; Hepatorenal Syndrome; Humans; Hypertension; Hyponatremia; Liver Cirrhosis; Liver Diseases; Liver Transplantation; Postoperative Complications; Renal Insufficiency
PubMed: 26289614
DOI: 10.1007/s11894-015-0457-x -
Journal of Nephrology Oct 2018Kidneys may fail post-partum in a number of circumstances due, for example, to post-partum haemorrhage, preeclampsia, amniotic fluid embolism or septic abortion. All... (Review)
Review
Kidneys may fail post-partum in a number of circumstances due, for example, to post-partum haemorrhage, preeclampsia, amniotic fluid embolism or septic abortion. All these conditions in pregnancy and post partum represent a threat not only to the endothelium but also to the renal tubular epithelium, and as such may lead to rapid and also irreversible impairment of the renal function. This paper is a non-systematic review of the literature and of our experience, in which we discuss the main open issues on kidney disease in pregnancy and following delivery, in particular as regards tubular damage, with the aim to help reasoning on acute kidney injury (AKI) following delivery. The review will emphasize the often under-estimated importance of the tubular epithelium in the peri-partum period and will: (1) describe the main characteristics of the renal tissues around delivery; (2) define pregnancy-related AKI according to recent Kidney Disease/Improving Global Outcome (KDIGO) guidelines; (3) discuss the most common circumstances of post-partum AKI; and (4) describe the input expected from urinalysis, renal imaging and kidney biopsy.
Topics: Acute Kidney Injury; Epithelial Cells; Female; Humans; Kidney Tubules; Postpartum Period; Pregnancy; Prognosis; Puerperal Disorders; Renal Insufficiency; Risk Assessment; Risk Factors
PubMed: 29637465
DOI: 10.1007/s40620-018-0488-0 -
JAMA Apr 2019
Topics: Aged; Humans; Iatrogenic Disease; Kidney Transplantation; Male; Medical Overuse; Patient Care Team; Quality of Life; Recovery of Function; Renal Dialysis; Renal Insufficiency; Virus Diseases
PubMed: 30938799
DOI: 10.1001/jama.2019.2134 -
Kidney International Jul 2021Epidemiologic studies document strong associations between acute or chronic kidney injury and kidney tumors. However, whether these associations are linked by causation,... (Review)
Review
Epidemiologic studies document strong associations between acute or chronic kidney injury and kidney tumors. However, whether these associations are linked by causation, and in which direction, is unclear. Accumulating data from basic and clinical research now shed light on this issue and prompt us to propose a new pathophysiological concept with immanent implications in the management of patients with kidney disease and patients with kidney tumors. As a central paradigm, this review proposes the mechanisms of kidney damage and repair that are active during acute kidney injury but also during persistent injuries in chronic kidney disease as triggers of DNA damage, promoting the expansion of (pre-)malignant cell clones. As renal progenitors have been identified by different studies as the cell of origin for several benign and malignant kidney tumors, we discuss how the different types of kidney tumors relate to renal progenitors at specific sites of injury and to germline or somatic mutations in distinct signaling pathways. We explain how known risk factors for kidney cancer rather represent risk factors for kidney injury as an upstream cause of cancer. Finally, we propose a new role for nephrologists in kidney cancer (i.e., the primary and secondary prevention and treatment of kidney injury to reduce incidence, prevalence, and recurrence of kidney cancer).
Topics: Acute Kidney Injury; Humans; Kidney; Kidney Neoplasms; Neoplasm Recurrence, Local; Renal Insufficiency, Chronic
PubMed: 33794229
DOI: 10.1016/j.kint.2021.03.011 -
Critical Care Medicine Jul 2021
Topics: Acute Kidney Injury; Humans; Renal Insufficiency, Chronic
PubMed: 34135284
DOI: 10.1097/CCM.0000000000005021 -
Pediatric Nephrology (Berlin, Germany) May 2016Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the... (Review)
Review
Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.
Topics: Age Factors; Body Weight; Child Development; Donor Selection; Graft Survival; Humans; Infant; Infant, Newborn; Intraoperative Care; Kidney Transplantation; Postoperative Complications; Renal Insufficiency; Risk Factors; Severity of Illness Index; Time Factors; Time-to-Treatment; Treatment Outcome
PubMed: 26115617
DOI: 10.1007/s00467-015-3144-0 -
Journal of Nephrology Oct 2021Acute renal infarction is a rare occurence, whose prognosis and long-term outcomes remain poorly studied. This study evaluated whether clinical and radiological...
INTRODUCTION
Acute renal infarction is a rare occurence, whose prognosis and long-term outcomes remain poorly studied. This study evaluated whether clinical and radiological features at diagnosis can be associated with the long-term outcomes (blood pressure, kidney function and mortality).
METHODS
We retrospectively analyzed the demographic, clinical, biological and radiological data of patients with acute renal infarction hospitalized at Rennes University Hospital between 1997 and 2017 (n = 94).
RESULTS
Patients were followed-up for a median of 60 months. At time of diagnosis of acute renal infarction median age was 53 years, 45% of the patients had acute hypertension, and 31% had Acute Kidney Injury (AKI) requiring dialysis in seven patients. The median Lactate DeHydrogenase (LDH) level was 977 IU/mL. The median extent of kidney damage was 14%, with left renal involvement in 51% of patients. At 60 months of follow-up, 66% of patients had developed Chronic Kidney Disease (CKD) stage 3 or higher, and 55% had hypertension since diagnosis. Age, acute development of hypertension and AKI at diagnosis were associated with long-term CKD (stage 3 or higher) in multivariate analyses, but the extent of kidney damage was not. During the follow-up, 21% of patients died, and only age resulted as a predisposing factor. No tested factor was correlated with long-term hypertension.
DISCUSSION
Age, acute development of hypertension, and AKI were correlated with long term CKD, whereas no factor was correlated with long-term hypertension after acute renal infarction.
Topics: Acute Kidney Injury; Humans; Infarction; Kidney; Middle Aged; Prognosis; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors
PubMed: 33765299
DOI: 10.1007/s40620-020-00953-4 -
International Journal of Molecular... Jan 2017Evidence suggests a link between opioid use and kidney disease. This review summarizes the known renal manifestations of opioid use including its role in acute and... (Review)
Review
Evidence suggests a link between opioid use and kidney disease. This review summarizes the known renal manifestations of opioid use including its role in acute and chronic kidney injury. Both the direct and indirect effects of the drug, and the context which leads to the development of renal failure, are explored. While commonly used safely for pain control and anesthesia in those with kidney disease, the concerns with respect to side effects and toxicity of opioids are addressed. This is especially relevant with the worldwide increase in the use of opioids for medical and recreational use.
Topics: Acute Kidney Injury; Analgesics, Opioid; Humans; Incidence; Kidney; Renal Insufficiency
PubMed: 28117754
DOI: 10.3390/ijms18010223 -
European Journal of Internal Medicine Dec 2016Cross-talk is broadly defined as endogenous homeostatic signaling between vital organs such as the heart, kidneys and brain. Kidney-brain cross-talk remains an area with... (Review)
Review
Cross-talk is broadly defined as endogenous homeostatic signaling between vital organs such as the heart, kidneys and brain. Kidney-brain cross-talk remains an area with excitingly few publications despite its purported clinical relevance in the management of currently undertreated conditions such as resistant hypertension. Therefore, this review aims to establish an organ-specific definition for kidney-brain cross-talk and review the available and forthcoming literature on this topic.
Topics: Blood Pressure; Blood-Brain Barrier; Brain; Brain Diseases; Humans; Kidney; Leukoaraiosis; Osmolar Concentration; Renal Dialysis; Renal Insufficiency; Renal Insufficiency, Chronic
PubMed: 27531628
DOI: 10.1016/j.ejim.2016.07.032