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Missouri Medicine 2011In today's clinical practice, a physician takes care of increasing number of patients with both cardiac and renal dysfunction. Due to our increased understanding of... (Review)
Review
In today's clinical practice, a physician takes care of increasing number of patients with both cardiac and renal dysfunction. Due to our increased understanding of pathogenesis of cardiac dysfunction in patients with renal failure and vice versa, the definition of Cardio-Renal Syndrome has undergone a change. This article discusses briefly the types and pathogenesis of the Cardio-Renal Syndromes.
Topics: Heart Failure; Humans; Renal Insufficiency; Syndrome
PubMed: 21462610
DOI: No ID Found -
Annals of Hematology May 2021Carfilzomib, a next-generation proteasome inhibitor, improves outcomes in patients with multiple myeloma (MM); however, a proportion of those treated develop renal...
Carfilzomib, a next-generation proteasome inhibitor, improves outcomes in patients with multiple myeloma (MM); however, a proportion of those treated develop renal failure due to adverse event, comorbidity, or myeloma progression. The rate of renal failure and associated risk factors remains unknown in real-world populations. Adults with relapsed/refractory MM who received carfilzomib between the years 2013 and 2016 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Renal failure was defined using the corresponding International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) diagnostic codes and procedure codes for dialysis. Patients with a pre-existing diagnosis of renal failure were excluded to distinguish an adverse event from comorbidity. Multivariate cox regression analysis was performed to identify the variables independently associated with the development of renal failure among MM patients utilizing carfilzomib. A total of 1950 patients were included in the analysis. Renal failure developed in 22% of patients during the study period. The median time to development of renal failure from first carfilzomib administration was 1.6 months (range < 0.1-23.3). Increasing age (adjusted hazard ratio [aHR] 1.01 per year, p = 0.018), pre-existing heart failure (aHR 1.50, p = 0.005), and pre-existing chronic kidney disease (aHR 2.00, p < 0.001) were associated with a higher risk of developing renal failure. Renal failure occurred in up to 22% of patients on carfilzomib therapy. The exact cause and mechanism of renal failure cannot be determined from our study and may be multifactorial. Future studies are needed to further understand the cause of renal failure among patients on carfilzomib and devise strategies to mitigate the risk.
Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Male; Middle Aged; Multiple Myeloma; Oligopeptides; Proportional Hazards Models; Proteasome Inhibitors; Renal Insufficiency; Risk Factors
PubMed: 33475778
DOI: 10.1007/s00277-021-04420-3 -
Current Topics in Microbiology and... 2012The kidneys are the major organs affected in diarrhea-associated hemolytic uremic syndrome (D(+)HUS). The pathophysiology of renal disease in D(+)HUS is largely the... (Review)
Review
The kidneys are the major organs affected in diarrhea-associated hemolytic uremic syndrome (D(+)HUS). The pathophysiology of renal disease in D(+)HUS is largely the result of the interaction between bacterial virulence factors such as Shiga toxin and lipopolysaccharide and host cells in the kidney and in the blood circulation. This chapter describes in detail the current knowledge of how these bacterial toxins may lead to kidney disease and renal failure. The toxin receptors expressed by specific blood and resident renal cell types are also discussed as are the actions of the toxins on these cells.
Topics: Blood Cells; Fibrinolysis; Glycolipids; Hemolytic-Uremic Syndrome; Humans; Inflammation; Kidney; Lipopolysaccharides; Renal Insufficiency; Shiga Toxin; Sphingolipids; Thrombosis; Virulence Factors
PubMed: 21983749
DOI: 10.1007/82_2011_172 -
Clinical Journal of the American... Apr 2022
Topics: Humans; Kidney; Kidney Failure, Chronic; Kidneys, Artificial; Renal Insufficiency; Uremia
PubMed: 35246459
DOI: 10.2215/CJN.02050222 -
Kidney International. Supplement Dec 1998Data provided by end-stage renal disease (ESRD) registries document a progressive and striking increase in the incidence of hypertension-related ESRD over the years, and... (Review)
Review
Data provided by end-stage renal disease (ESRD) registries document a progressive and striking increase in the incidence of hypertension-related ESRD over the years, and its prevalence supports the classic statement that the kidney may be a victim of hypertension. Two clinical conditions should be considered separately when the role of hypertension in progressive renal disease is discussed: (a) hypertension and primary renal disease and (b) progressive renal disease in essential hypertension. The appearance of systemic hypertension is one of the major risk factors for the progressive deterioration of primary renal disease both in experimental models and in humans. Strict blood pressure control is able to significantly reduce the disease progression to renal failure. Angiotensin-converting enzyme inhibitors probably show a better nephroprotective action than other antihypertensive agents. Long-lasting hypertension may induce ESRD in some patients through hypertensive nephrosclerosis. In many cases of progressive renal disease associated with essential hypertension, particularly in elderly Caucasians, atheromatous renovascular disease via renal artery stenosis and/or cholesterol microembolization represent the main cause of ESRD.
Topics: Disease Progression; Humans; Nephrosclerosis; Renal Insufficiency
PubMed: 9839285
DOI: 10.1046/j.1523-1755.1998.06814.x -
Genes Jul 2020Renal disease is the common denominator of a number of underlying disease conditions, whose prevalence has been dramatically increasing over the last two decades. Two... (Review)
Review
Renal disease is the common denominator of a number of underlying disease conditions, whose prevalence has been dramatically increasing over the last two decades. Two aspects are particularly relevant to the subject of this review: (I) most cases are gathered under the umbrella of chronic kidney disease since they require-predictably for several lustrums-continuous clinical monitoring and treatment to slow down disease progression and prevent complications; (II) cardiovascular disease is a terrible burden in this population of patients, in that it claims many lives yearly, while only a scant minority reach the renal disease end stage. Why indeed a review on DNA methylation and renal disease? As we hope to convince you, the present evidence supports the role of the existence of various derangements of the epigenetic control of gene expression in renal disease, which hold the potential to improve our ability, in the future, to more effectively act toward disease progression, predict outcomes and offer novel therapeutic approaches.
Topics: Cardiovascular Diseases; DNA Methylation; Disease Progression; Epigenesis, Genetic; Humans; Kidney Failure, Chronic; Prognosis; Renal Insufficiency, Chronic; Therapies, Investigational
PubMed: 32708735
DOI: 10.3390/genes11070811 -
Medicina Clinica May 2010
Topics: Acute Kidney Injury; Cardiovascular Diseases; Glomerular Filtration Rate; Humans; Interdisciplinary Communication; Kidney Failure, Chronic; Patient Care Team; Predictive Value of Tests; Prognosis; Renal Insufficiency; Shock, Cardiogenic; Syndrome
PubMed: 20381099
DOI: 10.1016/j.medcli.2009.12.007 -
International Journal of Environmental... Sep 2022The existing trials have focused on a variety of interventions to improve outcomes in renal failure; however, quantitative evidence comparing the effect of performing... (Meta-Analysis)
Meta-Analysis Review
The existing trials have focused on a variety of interventions to improve outcomes in renal failure; however, quantitative evidence comparing the effect of performing multidimensional interventions is scarce. The present paper reviews data from previous randomized controlled trials (RCTs), examining interventions performed for patients with chronic kidney disease (CKD) and transplants by multidisciplinary teams, including pharmacists. Methods: A systematic search with quality assessment was performed using the revised Cochrane Collaboration's 'Risk of Bias' tool. Results and Conclusion: Thirty-three RCTs were included in the review, and the data from nineteen protocols were included in further quantitative analyses. A wide range of outcomes was considered, including those associated with progression of CKD, cardiovascular risk factors, patient adherence, quality of life, prescription of relevant medications, drug-related problems (DRPs), rate of hospitalizations, and death. The heterogeneity between studies was high. Despite low-to-moderate quality of evidence and relatively short follow-up, the findings suggest that multidimensional interventions, taken by pharmacists within multidisciplinary teams, are important for improving some clinical outcomes, such as blood pressure, risk of cardiovascular diseases and renal progression, and they improve non-adherence to medication among individuals with renal failure.
Topics: Hospitalization; Humans; Pharmacists; Quality of Life; Renal Insufficiency; Renal Insufficiency, Chronic
PubMed: 36141441
DOI: 10.3390/ijerph191811170 -
Clinical Journal of the American... May 2020
Topics: Angiotensin-Converting Enzyme Inhibitors; Child; Humans; Renal Insufficiency, Chronic; Renin-Angiotensin System
PubMed: 32253276
DOI: 10.2215/CJN.02920320 -
Cytokine Feb 2024To explore the association between fibroblast growth factor 23 (FGF23) and hearing in chronic renal failure (CRF).
BACKGROUND
To explore the association between fibroblast growth factor 23 (FGF23) and hearing in chronic renal failure (CRF).
METHODS
Pure tone audiometry was used to detect the hearing of patients with CRF; the level of serum FGF23, creatinine, blood urea nitrogen (BUN), parathyroid hormone (PTH), and mean binaural hearing threshold were compared to the control group (people without kidney disease). The rat model of renal failure was established by 5/6 nephrectomy, and the auditory brainstem response (ABR) of rats after modeling was detected by the Tucker Davis Technologies (TDT) system; the expression level of FGF23 in the peripheral blood, renal and cochlear tissue was also detected.
RESULTS
The incidence of hearing loss (HL) and serum FGF23 were higher in CRF patients than the control group; the sFGF23 was positively correlated with the mean binaural hearing threshold. Animal studies showed that the ABR threshold, creatinine, FGF23, BUN, and PTH increased after modeling; although, an increase in FGF23 was observed earlier than other indicators. The HL of rats with renal failure was significantly correlated with BUN, phosphate, PTH, sFGF23, kFGF23/β-actin, eFGF23/β-actin, weight, and modeling cycle.
CONCLUSIONS
Both CRF patients and rat models showed high-frequency HL. FGF23 was highly expressed in the serum of HL renal failure patients and rats, as well as in the renal tissue and cochlea of renal failure rats. Therefore, FGF23 may be involved in the occurrence and development of HL caused by CRF.
Topics: Animals; Humans; Rats; Actins; Creatinine; Fibroblast Growth Factors; Hearing; Kidney Failure, Chronic; Parathyroid Hormone; Renal Insufficiency; Renal Insufficiency, Chronic
PubMed: 38134554
DOI: 10.1016/j.cyto.2023.156478