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The Veterinary Clinics of North... Apr 2022Chronic kidney disease (CKD) is rare in horses with an overall prevalence reported to be 0.12%. There is often a continuum from Acute Kidney Injury (AKI) to CKD, and... (Review)
Review
Chronic kidney disease (CKD) is rare in horses with an overall prevalence reported to be 0.12%. There is often a continuum from Acute Kidney Injury (AKI) to CKD, and patients with CKD may be predisposed to episodes of AKI. The most common clinical signs are non-specific with weight loss, polyuria/polydipsia and ventral edema. Less common clinical signs are poor appetite and performance, dull hair coat, oral ulcerations, gastro-intestinal ulceration, gingivitis, dental tartar and diarrhea. Rarely, horses may develop forebrain signs. Creatinine increases when at least 2/3 of kidney function have been lost and a more accurate assessment of kidney function is an estimated glomerular filtration rate measuring iohexol clearance time combined with protein content in the urine. Tubulointerstitial disease and glomerulonephritis are common causes of chronic kidney disease together with pyelonephritis and nephrolithiasis. Dietary changes and avoiding nephrotoxic drugs are key in slowing down the degenerative process.
Topics: Animals; Glomerular Filtration Rate; Horse Diseases; Horses; Kidney Failure, Chronic; Prognosis; Renal Insufficiency, Chronic
PubMed: 35365250
DOI: 10.1016/j.cveq.2021.11.003 -
Acta Physiologica (Oxford, England) May 2021
Topics: Acute Kidney Injury; Humans; Kidney Failure, Chronic; Renal Insufficiency
PubMed: 33704909
DOI: 10.1111/apha.13645 -
Der Internist Jul 2012
Topics: Cardiovascular Diseases; Humans; Renal Insufficiency
PubMed: 22714580
DOI: 10.1007/s00108-011-2980-7 -
Seminars in Pediatric Surgery Jun 2022
Topics: Humans; Renal Insufficiency
PubMed: 35725056
DOI: 10.1016/j.sempedsurg.2022.151195 -
Saudi Journal of Kidney Diseases and... 2017
Review
Topics: Arbovirus Infections; Arboviruses; Host-Pathogen Interactions; Humans; Kidney; Prognosis; Renal Insufficiency; Risk Factors
PubMed: 28937090
DOI: 10.4103/1319-2442.215124 -
The New England Journal of Medicine Sep 2009
Review
Topics: Diagnosis, Differential; Humans; Kidney; Liver Cirrhosis; Liver Transplantation; Prognosis; Renal Insufficiency; Renal Replacement Therapy; Vasoconstrictor Agents
PubMed: 19776409
DOI: 10.1056/NEJMra0809139 -
Bone Marrow Transplantation Jun 2011Up to 50% of newly diagnosed plasma cell myeloma (PCM) patients can present with renal insufficiency, 20% with severe renal impairment and 10% requiring dialysis. PCM... (Review)
Review
Up to 50% of newly diagnosed plasma cell myeloma (PCM) patients can present with renal insufficiency, 20% with severe renal impairment and 10% requiring dialysis. PCM patients account for 2% of the dialysis population, adding 5000 new patients each year worldwide. Dialysis-dependent PCM patients have a 2.77 higher risk of death compared with other dialysis-dependent patients without this diagnosis. Renal failure and especially dialysis dependency is an independent poor prognostic factor in PCM, with the majority unable to achieve dialysis independence. Renal failure in PCM is a medical emergency with the need for rapid accurate diagnosis and prompt institution of supportive care and PCM-directed therapy, because reversal of renal impairment and recovery from dialysis dependency can occur in up to half the patients early in the course of disease and can lead to enormous survival benefits. Recently, the serum free light chain (SFLC) assay and serum β-2-microglobulin free heavy chain (SFHC) assay have been used to rapidly diagnose PCM in renal failure and provide prognostic information in the setting of renal failure where the Durie-Salmon and International Staging Systems do not. A renal biopsy early in the course of renal impairment can provide diagnostic and prognostic information. A new generation of dialyzers with larger pores than routine dialyzers can be used with extended hemodialysis to remove SFLC more efficiently than plasmapheresis, allowing for greater renal recovery. Novel chemotherapy agents such as bortezomib are associated with an improved renal response and have moved to the front line of therapy. Successful use of high-dose therapy and autologous hematopoietic cell transplantation (HCT) in PCM with renal failure and even dialysis dependency has been associated with late renal recovery and also allowed for the subsequent use of renal transplantation to provide even greater survival benefits. Combined non-myeloablative allogeneic HCT with renal transplant in PCM patients with end-stage renal disease on dialysis is now being studied in prospective trials.
Topics: Emergencies; Hematopoietic Stem Cell Transplantation; Humans; Kidney Transplantation; Leukemia, Plasma Cell; Multiple Myeloma; Renal Dialysis; Renal Insufficiency
PubMed: 21339749
DOI: 10.1038/bmt.2011.8 -
Vnitrni Lekarstvi 2020Renal failure is a serious complication of multiple myeloma, and up to 50% of patients with this most frequent haematological malignancy may develop some form of renal...
Renal failure is a serious complication of multiple myeloma, and up to 50% of patients with this most frequent haematological malignancy may develop some form of renal impairment. The aetiology of renal damage is multifactorial, but increased production of free light chains that are filtered into the urine is crucial for the development of renal failure and could be associated with distal tubule involvement (myeloma kidney, light chain cast nephropathy) or with fully developed Fanconi syndrome in proximal tubule damage (proximal tubulopathy, light chain proximal tubulopathy). Glomerular damage most often manifests as AL amyloidosis or light chain deposition disease; both cause severe nephrotic syndrome. Early and adequate chemotherapy in association with symptomatic treatment can lead to rapid reduction of serum light chain concentration which is necessary to prevent development of renal failure. At present, effective therapeutic procedures can be used for this purpose, where especially a triple combination of treatment containing one of the proteasome inhibitors (bortezomib, carfilzomib or ixazomib) is able to elicit a haematological response within a few days. If there is a good haematological response to treatment, up to 50% of patients with renal failure will restore their renal function. Renal function repair can be accelerated by removing light chains from serum by dialysis with high-cutoff membrane (HCO-HD). Using this procedure can increase the chance of dialysis independence in more than 60% of patients with renal failure. Data from previously published studies on HCO-HD (MYRE or EuLITE study) have not yielded as optimistic results as originally expected, however, HCO-HD could be beneficial for some subgroup of patients with renal failure in myeloma kidney. Despite the fact that overall prognosis and survival of patients with multiple myeloma have dramatically improved, the condition with renal failure in these patients remains serious.
Topics: Bortezomib; Humans; Immunoglobulin Light Chains; Kidney Diseases; Multiple Myeloma; Renal Dialysis; Renal Insufficiency
PubMed: 33380121
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... Mar 1995Renal failure is a common complication of multiple myeloma, because the kidney is a major target organ for the deposition of paraproteins such as Bence Jones protein... (Review)
Review
Renal failure is a common complication of multiple myeloma, because the kidney is a major target organ for the deposition of paraproteins such as Bence Jones protein (BJP), light chain fragment of monoclonal immunoglobulins, secreted by plasmacytoma. There are three forms of renal involvements related to multiple myeloma. The most common form is cast nephropathy ("myeloma kidney") due to precipitation of BJP combined with Tamm-Horsfall protein in the distal nephron. Other two forms are amyloid nephropathy and light chain deposition disease (LCDD). Renal failure is usually arising from myeloma kidney and is exacerbated by many other factors, for example, concurrently imposed chemical agents. In this manuscript, the mechanism of renal failure mainly due to myeloma kidney and its managements are mainly described.
Topics: Humans; Multiple Myeloma; Renal Insufficiency
PubMed: 7699909
DOI: No ID Found -
Seminars in Thoracic and Cardiovascular... 2021
Topics: Cardiac Surgical Procedures; Humans; Renal Insufficiency; Treatment Outcome
PubMed: 33600973
DOI: 10.1053/j.semtcvs.2021.01.021