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Journal of Feline Medicine and Surgery Jun 2020The purpose of this study was to evaluate symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after treatment with radioactive iodine and to determine how...
OBJECTIVES
The purpose of this study was to evaluate symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after treatment with radioactive iodine and to determine how pretreatment SDMA relates to the development of post-treatment azotemia.
METHODS
Eighty-four non-azotemic hyperthyroid cats had serum SDMA and creatinine evaluated before and 1, 3 and 6 months after treatment with radioiodine therapy.
RESULTS
Baseline SDMA was increased in 7% (n = 6/84) of cats, whereas SDMA was increased in 19% (n = 15/81), 20% (n = 16/80) and 32% (n = 26/81) at 1 month, 3 months and 6 months after treatment, respectively. Creatinine was not elevated in any of the cats at baseline because of the study design, and was elevated in 6% (n = 5/81), 15% (n = 12/80) and 15% (n = 12/81) of cats at 1, 3 and 6 months after treatment, respectively. SDMA (median 11 μg/dl, range 1-22 μg/dl) was significantly higher at 3 (12 μg/dl, range 6-45 μg/dl; = 0.005) and 6 months (11 μg/dl, 6-25 μg/dl; <0.001) compared with baseline (11 μg /dl, range 1-21 μg/dl). The median baseline SDMA was significantly higher in the azotemic group (13 μg/dl, range 11-22 μg/dl) compared with the non-azotemic group (10 μg/dl, range 1-21 μg/dl, = 0.002). The sensitivity of SDMA for detecting azotemia after treatment was 15.4%, with a specificity of 94.4%. Baseline serum SDMA concentration had a moderately positive association with baseline creatinine concentration ( <0.001, = 0.437). At 6 months, there was a strong positive correlation between SDMA and creatinine concentrations ( <0.001, = 0.721). There was no significant correlation with SDMA and thyroxine at baseline ( = 0.772, = -0.034) or 6 months ( = 0.492, = -0.078).
CONCLUSIONS AND RELEVANCE
SDMA increases in cats treated for hyperthyroidism with radioactive iodine and likely reflects associated changes in glomerular filtration rate. An increased SDMA concentration above the reference interval prior to treatment has a high specificity but poor sensitivity for the prediction of post-treatment azotemia.
Topics: Animals; Arginine; Azotemia; Biomarkers; Cat Diseases; Cats; Creatinine; Female; Hyperthyroidism; Iodine Radioisotopes; Male; Prevalence; Time Factors
PubMed: 31290362
DOI: 10.1177/1098612X19859947 -
Kidney International Oct 1978Growth retardation occurs in 35 to 65% of children with kidney disease. It is especially common in children with congenital diseases of the kidney, anomalies, and... (Review)
Review
Growth retardation occurs in 35 to 65% of children with kidney disease. It is especially common in children with congenital diseases of the kidney, anomalies, and inherited disorders. Acquired disease, however, also may impair growth, particularly where renal function (GFR) is below 25 ml/min/1.73 m2. Therapy used in renal disease, notably prednisone, also impairs growth. Chronic dialysis therapy, both hemodialysis and peritoneal, are associated with poor growth. Several specific changes in renal disease are associated with growth failure. These include, in addition to azotemia, acidosis, hyposthenuria, renal osteodystrophy, endocrine disorders and resistance to hormone action, and nutritional disturbances.
Topics: Body Height; Child; Energy Intake; Growth Disorders; Humans; Kidney Diseases; Nutrition Disorders; Proteins
PubMed: 366227
DOI: 10.1038/ki.1978.133 -
Blood Purification 2011For a long time, acute kidney injury (AKI) was considered to be a primarily hemodynamic condition characterized by a reduction of renal blood flow, induced by either... (Review)
Review
For a long time, acute kidney injury (AKI) was considered to be a primarily hemodynamic condition characterized by a reduction of renal blood flow, induced by either cardiogenic or distributive (septic) shock. Consequently, all efforts to treat AKI were essentially concentrated on increasing renal flow by enhancing cardiac flow output and perfusion pressure. At the beginning of this decade, Bellomo and co-workers produced new and intriguing data in an animal model of septic AKI that undermined existing concepts. They observed that medullar and cortical renal blood flow were both maintained and even increased in septic shock, underscoring that septic AKI was a totally different physiological phenomenon than nonseptic AKI. Also, apoptosis was found to play a more important role in sepsis and septic shock than pure necrosis. Despite these findings, the role of apoptosis as a main mechanism of organ dysfunction remains topic of debate.
Topics: Acute Kidney Injury; Animals; Apoptosis; Azotemia; Caspases; Hemodynamics; Humans; Inflammation; Ischemia; Necrosis; Renal Replacement Therapy; Research; Sepsis
PubMed: 21860231
DOI: 10.1159/000330244 -
Journal of Pathology and Translational... Nov 2019Anti-glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along...
Anti-glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.
PubMed: 31525832
DOI: 10.4132/jptm.2019.08.05 -
BMJ Case Reports Mar 2018is a clinically important pathogen that is emerging globally but remains poorly investigated. Here, we report the first case of acute glomerulonephritis resulting from...
is a clinically important pathogen that is emerging globally but remains poorly investigated. Here, we report the first case of acute glomerulonephritis resulting from infection with Glomerulonephritis is typically caused by and reports secondary to other strains including and exist. Infection with in this patient was associated with acute nephritis (haematuria, oedema and hypertension), nephrotic syndrome and progressive azotemia. There was activation of the complement system. The presence of low C1q and elevated anti-C1q binding complexes points to a potential pathogenic role. Testing for streptococcal antigens was strongly positive. Emerging nephritogenic strains of present a significant health concern for both developed and developing countries.
Topics: Abdominal Pain; Abdominal Wall; Acute Disease; Aftercare; Anti-Bacterial Agents; Azotemia; Complement C1q; Complement C3; Fasciitis, Necrotizing; Female; Glomerulonephritis; Humans; Kidney Diseases; Middle Aged; Nephritis; Nephrotic Syndrome; Proteinuria; Streptococcal Infections; Streptococcus anginosus; Treatment Outcome
PubMed: 29523515
DOI: 10.1136/bcr-2017-223314 -
Indian Journal of Nephrology 2023Immunoglobulin A (IgA) nephropathy is the most common glomerular disease worldwide. It usually presents as a nephritic syndrome with macroscopic hematuria, oliguria, and...
Immunoglobulin A (IgA) nephropathy is the most common glomerular disease worldwide. It usually presents as a nephritic syndrome with macroscopic hematuria, oliguria, and proteinuria with or without azotemia. Rapidly progressive glomerulonephritis with crescents is being described in about 30% of cases and is mostly associated with nephrotic-range proteinuria, accelerated hypertension, and accelerated decline toward end-stage renal disease. Medullary angiitis is a rare finding in renal biopsy and is usually associated with pauci-immune glomerulonephritis. We describe a rare association of medullary angiitis in IgA nephropathy, probably the first reported case in the country.
PubMed: 37448894
DOI: 10.4103/ijn.ijn_358_21 -
Clinical Kidney Journal Oct 2015The histological substrate of many forms of intrinsic acute kidney injury (AKI) has been classically attributed to tubular necrosis. However, more recent studies... (Review)
Review
The histological substrate of many forms of intrinsic acute kidney injury (AKI) has been classically attributed to tubular necrosis. However, more recent studies indicate that necrosis is not the main form of cell death in AKI and that other forms such as apoptosis, regulated necrosis (i.e. necroptosis and parthanatos), autophagic cell death and mitotic catastrophe, also participate in AKI and that their contribution depends on the cause and stage of AKI. Herein, we briefly summarize the main characteristics of the major types of cell death and we also critically review the existing evidence on the occurrence of different types of cell death reported in the most common experimental models of AKI and human specimens. We also discuss the pathophysiological mechanisms linking tubule epithelial cell death with reduced glomerular filtration, azotaemia and hydroelectrolytic imbalance. For instance, special relevance is given to the analysis of the inflammatory component of some forms of cell death over that of others, as an important and differential pathophysiological determinant. Finally, known molecular mechanisms and signalling pathways involved in each cell death type pose appropriate targets to specifically prevent or reverse AKI, provided that further knowledge of their participation and repercussion in each AKI syndrome is progressively increased in the near future.
PubMed: 26413280
DOI: 10.1093/ckj/sfv069 -
AME Case Reports 2024Pleural effusion is a common pulmonary condition affecting millions of individuals worldwide. Pleural effusion of extravascular origin (PEEVO) pertains to a pleural...
BACKGROUND
Pleural effusion is a common pulmonary condition affecting millions of individuals worldwide. Pleural effusion of extravascular origin (PEEVO) pertains to a pleural effusion that does not originate from the pulmonary vasculature. True prevalence of PEEVO, such as urinothorax, is unclear in view of the absence of clear diagnostic criteria. However, it has been observed to follow a bimodal age distribution, with a higher frequency in the age groups of 41-50 and 61-70 years. Additionally, it was more likely to have a unilateral right-sided presentation and occupy over two-thirds of the hemithorax. Pseudo-azotemia is a condition that causes elevated blood urea nitrogen (BUN) and creatinine (Cr) levels without actual kidney dysfunction.
CASE DESCRIPTION
We report an uncommon case of right-sided urinothorax in a middle-aged female presenting with symptoms of postoperative ileus after undergoing total abdominal hysterectomy. She subsequently developed pseudo-azotemia and right-sided pleural effusion. The patient was successfully treated with thoracentesis and chest tube placement, with prompt resolution of effusion and pseudo-azotemia.
CONCLUSIONS
We aim to provide insights into the underlying pathophysiology as well as diagnostic and therapeutic modalities of urinothorax. Prompt recognition and intervention can improve outcomes by decreasing respiratory complications and shorten or avoid intensive care unit stays. Physicians should consider PEEVO within their differential when intrathoracic causes of pleural effusion have been excluded and be equipped to manage it appropriately.
PubMed: 38236466
DOI: 10.21037/acr-23-146 -
Pharmacotherapy May 2008Acute kidney injury in critically ill patients is often a complication of an underlying condition such as organ failure, sepsis, or drug therapy. In these patients,... (Review)
Review
Acute kidney injury in critically ill patients is often a complication of an underlying condition such as organ failure, sepsis, or drug therapy. In these patients, stress-induced hypercatabolism results in loss of body cell mass. Unless nutrition support is provided, malnutrition and negative nitrogen balance may ensue. Because of metabolic, fluid, and electrolyte abnormalities, optimization of nutrition to patients with acute kidney injury presents a challenge to the clinician. In patients treated with conventional intermittent hemodialysis, achieving adequate amino acid intake can be limited by azotemia and fluid restriction. With the use of continuous renal replacement therapy (CRRT), however, better control of azotemia and liberalization of fluid intake allow amino acid intake to be maximized to support the patient's metabolic needs. High amino acid doses up to 2.5 g/kg/day in patients treated with CRRT improved nitrogen balance. However, to our knowledge, no studies have correlated increased amino acid intake with improved outcomes in critically ill patients with acute kidney injury. Data from large, prospective, randomized, controlled trials are needed to optimize the dosing of amino acids in critically ill patients with acute kidney injury who are treated with CRRT and to study the safety of high doses and their effects on patient morbidity and survival.
Topics: Acute Kidney Injury; Amino Acids; Critical Illness; Humans; Proteins; Renal Replacement Therapy
PubMed: 18447659
DOI: 10.1592/phco.28.5.600 -
Journal of Medical Primatology Apr 2018Uremic encephalopathy is uncommon yet is one of the most severe complications of renal failure. We present a case of acute renal failure and associated cerebral and... (Review)
Review
BACKGROUND
Uremic encephalopathy is uncommon yet is one of the most severe complications of renal failure. We present a case of acute renal failure and associated cerebral and vascular lesions consistent with uremic encephalopathy in a rhesus macaque (Macaca mulatta).
METHODS
A 14-year-old, female, specific-pathogen-free rhesus macaque presented in lateral recumbency, obtunded, severely dehydrated, and hypothermic, with severe azotemia, mild hyponatremia, hypokalemia, hypochloremia, increased anion gap, and hypercholesterolemia. Due to poor prognosis, the animal was euthanized and a complete necropsy was conducted.
RESULTS
The animal had diffuse proximal renal tubular epithelial necrosis and loss; regeneration of tubular epithelium was not observed. There was bilateral necrosis and loss of neurons and glial cells in the hippocampus and deep cerebral cortex with edema and multifocal areas of hemorrhage.
CONCLUSION
We present the first reported case of uremic encephalopathy in a rhesus macaque and describe the associated cerebral and vascular lesions.
PubMed: 29693270
DOI: 10.1111/jmp.12348