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Sample records for renal insufficiency ri

  1. Prevalence of renal insufficiency in individuals with obesity

    OpenAIRE

    Vasiljević Nađa; Zuković Milica; Žakula Dejan; Živadinović Nenad; Žarković Boris; Živković Bojana; Zlatić Nataša; Zogović Jovana; Ležaić Višnja

    2011-01-01

    Introduction. The association of obesity with renal function disorders has been demonstrated by some studies. Objective. The aim of this study was to assess the prevalence of renal insufficiency (RI), measured as glomerular filtration rate (GFR) <60 ml/min and impact of weight loss on kidney function in a cohort of 109 obese patients (body mass index - BMI >25 kg/m2), without previous kidney disease, and who underwent the dietician’s treatment. Methods. According to body mass inde...

  2. Establishment of a model of renal impairment with mild renal insufficiency associated with atrial fibrillation in canines.

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    Zhuo Liang

    Full Text Available Chronic kidney disease and occurrence of atrial fibrillation (AF are closely related. No studies have examined whether renal impairment (RI without severe renal dysfunction is associated with the occurrence of AF.Unilateral RI with mild renal insufficiency was induced in beagles by embolization of small branches of the renal artery in the left kidney for 2 weeks using gelatin sponge granules in the model group (n = 5. The sham group (n = 5 underwent the same procedure, except for embolization. Parameters associated with RI and renal function were tested, cardiac electrophysiological parameters, blood pressure, left ventricular pressure, and AF vulnerability were investigated. The activity of the sympathetic nervous system, renin-angiotensin-aldosterone system, inflammation, and oxidative stress were measured. Histological studies associated with atrial interstitial fibrosis were performed.Embolization of small branches of the renal artery in the left kidney led to ischemic RI with mild renal insufficiency. The following changes occurred after embolization. Heart rate and P wave duration were increased. Blood pressure and left ventricular systolic pressure were elevated. The atrial effective refractory period and antegrade Wenckebach point were shortened. Episodes and duration of AF, as well as atrial and ventricular rate during AF were increased in the model group. Plasma levels of norepinephrine, renin, and aldosterone were increased, angiotensin II and aldosterone levels in atrial tissue were elevated, and atrial interstitial fibrosis was enhanced after 2 weeks of embolization in the model group.We successfully established a model of RI with mild renal insufficiency in a large animal. We found that RI with mild renal insufficiency was associated with AF in this model.

  3. Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

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    El-Menyar, Ayman A.; Al Suwaidi, Jassim; Holmes, David R.

    2010-01-01

    Renal insufficiency (RI) has been shown to be associated with increased major adverse cardiovascular events after percutaneous coronary intervention. We reviewed the impact of RI on the pathogenesis of coronary artery disease and outcomes after percutaneous coronary intervention in the form of drug-eluting stent (DES) implantation in these high-risk patients. We searched the English-language literature indexed in MEDLINE, Scopus, and EBSCO Host research databases from 1990 through January 2009, using as search terms coronary revascularization, drug-eluting stent, and renal insufficiency. Studies that assessed DES implantation in patients with various degrees of RI were selected for review. Most of the available data were extracted from observational studies, and data from randomized trials formed the basis of a post hoc analysis. The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare-metal stents. Randomized trials are needed to define optimal treatment of these high-risk patients with coronary artery disease. PMID:20118392

  4. Prevalence of renal insufficiency in individuals with obesity

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    Vasiljević Nađa

    2011-01-01

    Full Text Available Introduction. The association of obesity with renal function disorders has been demonstrated by some studies. Objective. The aim of this study was to assess the prevalence of renal insufficiency (RI, measured as glomerular filtration rate (GFR <60 ml/min and impact of weight loss on kidney function in a cohort of 109 obese patients (body mass index - BMI >25 kg/m2, without previous kidney disease, and who underwent the dietician’s treatment. Methods. According to body mass index (BMI, the patients were classified as overweight (25-29.9 kg/m2, 25 patients, obesity grade I (30-34.9 kg/m2, 37 patients, obesity grade II (35 to 39.9 kg/m2, 23 patients, and obesity grade III (>40 kg/m2, 24 patients. Data on hypertension, cardiovascular diseases, diabetes, family illness history on diabetes, obesity and hypertension, smoking and medications, lipid profile, serum creatinine (sCr measured before and after diet, and urine examination were collected from the patients’ records. GFR was estimated using MDRD formula (modification of diet in renal disease. Results The patients groups were similar in age and co-morbidities, lipids, and sCr values. In comparison to other obese patients, blood pressure was the highest in obesity grade III patients (p=0.0001. Mean GFR rate before diet was satisfactory in all studied groups. RI was present in 12.8% patients. After diet nine patients still had GFR < 60ml/min, while lipids decreased in all groups. Patients with the highest decrease of BMI also showed best improvement in GFR. The risk for the development of decreased GFR was higher in elderly patients (estimated rate: -0.434, p<0.0001. Conclusion. Obesity is a potentially reversible risk factor for the development of decreased GFR. The relationship between obesity and decreased GFR may be mediated by the presence of known cardiovascular risk factors. In order to clarify the obesity influence on renal functioning, further studies are needed.

  5. Treatment of osteoporosis in renal insufficiency

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    Schipper, L.G.; Fleuren, H.W.; Bergh, J.P. van den; Meinardi, J.R.; Veldman, B.A.; Kramers, C.

    2015-01-01

    Patients with osteoporosis often have chronic kidney disease (CKD). CKD is associated with bone and mineral disturbances, renal osteodystrophy, which like osteoporosis leads to a higher risk of fractures. Bisphosphonates are first-line therapy for osteoporosis; however, these are contra-indicated in

  6. Unrecognized renal insufficiency and chemotherapy-associated adverse effects among breast cancer patients.

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    Lotan, Eyal; Leader, Avi; Lishner, Michael; Gottfried, Maya; Pereg, David

    2012-10-01

    Several studies have shown that more than half of cancer patients have unrecognized renal insufficiency (RI), which is a reduced glomerular filtration rate (GFR) with normal serum creatinine. The aim of this study was to determine whether unrecognized RI is associated with an increased risk for chemotherapy-associated adverse effects in breast cancer patients treated with combined doxorubicin and cyclophosphamide treatment. GFR was estimated for 95 breast cancer patients from January 2005 to August 2009 using the Cockcroft-Gault formula. Unrecognized RI was defined as GFR less than 75 ml/min/1.73 m and the patients were grouped according to their estimated GFR. Logistic regression models were used to assess the effect of GFR on clinical outcomes. In total, 49 (52%) patients experienced at least one of the following chemotherapy-associated adverse effects during the course of treatment: an episode of neutropenic fever with hospital admission, a delay in chemotherapy treatment for a medical reason, a need for dose adjustment because of toxicity of the chemotherapeutic drugs, and the need for use of granulocyte colony-stimulating factor. The incidence of these adverse effects occurred more frequently in patients with GFR less than 75 compared with patients with GFR at least 75 (64 vs. 42%, odds ratio 5.29, 95% confidence interval 2.10-13.33) and remained statistically significant after adjustment for age, BMI, and initial doses of chemotherapeutic drugs (odds ratio 3.56, 95% confidence interval 1.08-11.67). Neutropenic fever, dose delay, and dose adjustment as separate outcomes occurred more frequently in the GFR less than 75 group but lost statistical significance after adjustment. Our results demonstrate that unrecognized RI is associated with an increased risk for chemotherapy-associated adverse events in this patient population. Further prospective studies are required to determine whether a dose reduction in patients with unrecognized RI reduces adverse effects

  7. Safety and tolerability of voriconazole in patients with baseline renal insufficiency and candidemia.

    NARCIS (Netherlands)

    Oude Lashof, A.M.L.; Sobel, J.D.; Ruhnke, M.; Pappas, P.G.; Viscoli, C.; Schlamm, H.T.; Rex, J.H.; Kullberg, B.J.

    2012-01-01

    Acutely ill patients with candidemia frequently suffer from renal insufficiency. Voriconazole's intravenous formulation with sulfobutylether beta-cyclodextrin (SBECD) is restricted in patients with renal insufficiency. We evaluated the use of intravenous voriconazole formulated with SBECD in candide

  8. Safety and tolerability of voriconazole in patients with baseline renal insufficiency and candidemia.

    NARCIS (Netherlands)

    Oude Lashof, A.M.L.; Sobel, J.D.; Ruhnke, M.; Pappas, P.G.; Viscoli, C.; Schlamm, H.T.; Rex, J.H.; Kullberg, B.J.

    2012-01-01

    Acutely ill patients with candidemia frequently suffer from renal insufficiency. Voriconazole's intravenous formulation with sulfobutylether beta-cyclodextrin (SBECD) is restricted in patients with renal insufficiency. We evaluated the use of intravenous voriconazole formulated with SBECD in

  9. Pharmacokinetics and pharmacodynamics of roxatidine in patients with renal insufficiency.

    OpenAIRE

    1995-01-01

    1. Roxatidine acetate, a new histamine H2-receptor antagonist, was administered in the evening (75 mg p.o.) to eight patients with renal insufficiency (CLCR 8-17 ml min-1) for 12 days and plasma drug concentrations were measured. 2. Ambulatory intragastric pH was monitored following the last dose and values were compared with those on day 1 when all patients received a placebo. 3. The terminal elimination half-life (mean +/- s.d.) of roxatidine was 10.8 +/- 2.4 h and its oral clearance was 17...

  10. Drug administration in patients with renal insufficiency. Minimising renal and extrarenal toxicity.

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    Matzke, G R; Frye, R F

    1997-03-01

    Renal insufficiency has been associated with an increased risk of adverse effects with many classes of medications. The risk of some, but not all, adverse effects has been linked to the patient's degree of residual renal function. This may be the result of inappropriate individualisation of those agents that are primarily eliminated by the kidney, or an alteration in the pharmacodynamic response as a result of renal insufficiency. The pathophysiological mechanism responsible for alterations in drug disposition, especially metabolism and renal excretion, is the accumulation of uraemic toxins that may modulate cytochrome P450 enzyme activity and decrease glomerular filtration as well as tubular secretion. The general principles to enhance the safety of drug therapy in patients with renal insufficiency include knowledge of the potential toxicities and interactions of the therapeutic agent, consideration of possible alternatives therapies and individualisation of drug therapy based on patient level of renal function. Although optimisation of the desired therapeutic outcomes are of paramount importance, additional pharmacotherapeutic issues for patients with reduced renal function are the prevention or minimisation of future acute or chronic nephrotoxic insults, as well as the severity and occurrence of adverse effects on other organ systems. Risk factors for the development of nephrotoxicity for selected high-risk therapies (e.g. aminoglycosides, nonsteroidal anti-inflammatory drugs, ACE inhibitors and radiographic contrast media) are quite similar and include pre-existing renal insufficiency, concomitant administration of other nephrotoxins, volume depletion and concomitant hepatic disease or congestive heart failure. Investigations of prophylactic approaches to enhance the safety of these agents in patients with renal insufficiency have yielded inconsistent outcomes. Hydration with saline prior to drug exposure has given the most consistent benefit, while sodium

  11. Pulmonary thromboembolism associated with renal insufficiency due to renal artery thrombosis

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    Vučičević-Trobok Jadranka

    2002-01-01

    Full Text Available Pulmonary thromboembolism is a clinical and pathophysiological condition caused by occlusion of pulmonary arteries by thrombotic embolus. Deep venous thrombosis needn't necessarily be evident. Acute renal insufficiency is a syndrome manifested by rapid decrease or even complete urinary retention which may be due to obturation of renal arteries by a thrombus. The condition is clinically manifested by hematuria, oliguria, anuria and death due to uremia. Case Report The patient had a history of disease and a chest X-ray finding both irrelevant for establishing the working diagnosis. Blood gas analysis presented prominent hypoxemia with hyperventilation and ECG finding exhibited right heart overload, pointing to pulmonary thromboembolism. On the third day of treatment with heparin, the patient developed hematuria, oliguria and excessive elevation of nitrogen in blood as a sign of acute renal insufficiency, leading to fatal outcome. Autopsy revealed deep venous thrombosis of the left femoral vein, with massive pulmonary thromboembolism and thrombosis of both femoral arteries, inducing acute renal failure. Discussion Although the patient had a typical radiologic presentation of pulmonary thromboembolism, treatment with heparin was initiated on the basis of his blood gas analysis and ECG findings. Deep venous thrombosis was not clinically evident and acute renal failure could not be explained during patient's lifetime. Conclusion This is a rare case of acute renal failure due to a rare occurrence of bilateral acute thrombosis of renal arteries.

  12. CERTIFY: prophylaxis of venous thromboembolism in patients with severe renal insufficiency.

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    Bauersachs, R; Schellong, S M; Haas, S; Tebbe, U; Gerlach, H-E; Abletshauser, C; Sieder, C; Melzer, N; Bramlage, P; Riess, H

    2011-06-01

    Patients with severe renal insufficiency (sRI) have been suggested to be at an increased risk of bleeding with low-molecular-weight heparins (LMWH). We aimed at assessing the benefits and risks of certoparin in comparison to unfractionated heparin (UFH) in these patients. In this subgroup analysis of the CERTIFY trial, acutely ill, non-surgical patients ≥70 years received certoparin 3,000U aXa o.d. or UFH 5,000 IU t.i.d. One hundred eighty-nine patients had a glomerular filtration rate (GFR) ≤30 ml/min/1.73 m2, 3,050 patients served as controls. Patients with sRI had a mean age of 85.9 ± 6.6 years (controls 78.4 ± 6.0) and were treated for a mean of 9.3 ± 3.7 days (9.9 ± 4.3). Thromboembolic event rates were comparable (4.55 vs. 4.21%; OR1.08; 95%CI 0.5-2.37) but bleeding was increased in sRI (9.52 vs. 3.54%; OR2.87; 95%CI 1.70-4.83). The incidence of the combined end-point of proximal DVT, symptomatic non-fatal PE and VTE related death was 6.49% with certoparin and 2.60% with UFH (OR2.60; 95%CI 0.49-13.85). There was a decrease in total bleeding with certoparin (OR0.33; 95%CI 0.11-0.97), which was non-significant in patients with GFR >30 ml/min/1.73 m2. In two multivariable regression models certoparin and immobilisation 30 ml/min/1.73 m2). In conclusion, certoparin 3,000U anti Xa o.d. was as efficacious as 5,000 IU UFH t.i.d. in patients with sRI but had a reduced risk of bleeding.

  13. Riñón en herradura asociado a poliquistosis renal

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    David Rodríguez Palomo; Yéssica de la Paz García; Roberto Salazar Villanea

    2010-01-01

    Este trabajo describe la variante anatómica en un caso incidental de disección en la Escuela de medicina de la Universidad de Ciencias Médicas, el cual presenta un riñón en herradura con variante arteriovenosa que consta de cinco arterias renales y cuatro venas renales asociado poliquistosis renal.This work describes the anatomic variation from an incidental case of dissection found at Universidad de Ciencias Medicas, which presents horseshoe kidney with a right arteriovenous variant which co...

  14. Pharmacokinetics and pharmacodynamics of roxatidine in patients with renal insufficiency.

    Science.gov (United States)

    Gladziwa, U; Wagner, S; Sieberth, H G; Klotz, U

    1995-02-01

    1. Roxatidine acetate, a new histamine H2-receptor antagonist, was administered in the evening (75 mg p.o.) to eight patients with renal insufficiency (CLCR 8-17 ml min-1) for 12 days and plasma drug concentrations were measured. 2. Ambulatory intragastric pH was monitored following the last dose and values were compared with those on day 1 when all patients received a placebo. 3. The terminal elimination half-life (mean +/- s.d.) of roxatidine was 10.8 +/- 2.4 h and its oral clearance was 178 +/- 43 ml min-1. 4. During roxatidine treatment gastrin levels increased slightly (median 189 vs 289 ng l-1) and the hyperparathyroid status of the patients was almost normalized (parathyroid hormone levels: median 199 vs 132 ng l-1). 5. The mean latency to a gastric pH of at least 4 was 4.3 +/- 1.4 h. The duration of action (intragastric pH > 4) was 10.6 +/- 3.9 h. 6. As in a pilot study with six patients (CLCR 4 for more than 6 h, daily nocturnal intake of 75 mg roxatidine acetate appears appropriate to elevate gastric pH > 4 for a sufficient period of time.

  15. Renal insufficiency after heart transplantation: a case-control study

    NARCIS (Netherlands)

    T. van Gelder (Teun); R. Zietse (Bob); C.J. Hesse (Cees); W. Weimar (Willem); A.H.M.M. Balk (Aggie); B. Mochtar (Bas)

    1998-01-01

    textabstractBACKGROUND: In Rotterdam 304 heart transplants have been performed since 1984. End-stage renal failure, necessitating renal replacement therapy, has developed in 24 patients (8%) after an interval of 25-121 months (median 79 months). After starting renal rep

  16. Mieloma Múltiplo e insuficiência renal Multiple Myeloma and renal insufficiency

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    Angelo Maiolino

    2007-03-01

    Full Text Available A insuficiência renal (IR é uma complicação freqüente em pacientes com mieloma múltiplo (MM podendo estar presente em 35% dos pacientes ao diagnóstico e em mais de 50% durante a evolução da doença. O mecanismo mais freqüente de IR é o assim chamado "rim do mieloma" decorrente da excreção de cadeias leves provocando um dano tubular. Outros mecanismos de IR são o depósito tissular de cadeias leves e a Síndrome de Fanconi Adquirida. Determinados fatores podem precipitar e agravar a IR tais como a hipercalcemia, hiperuricemia, desidratação, hiperviscosidade e drogas nefrotóxicas. O tratamento de suporte deve ser feito em todos os pacientes e nos casos em que a função renal não possa ser revertida deve ser considerado o tratamento dialítico. O tratamento específico do MM em pacientes com IR tem papel importante e impacto na sobrevida. A quimioterapia inicial mais adequada é VAD ou combinação de ciclofosfamida e dexametasona. Quimioterapia em altas doses e transplante autólogo podem ser considerados para pacientes com idade inferior a 60 anos e um bom performance status (PS.Renal insufficiency is a frequent complication in patients with Multiple Myeloma (MM. It occurs in 35% of newly diagnosed patients and in more than 50% during the evolution of the disease. The most frequent mechanism of renal failure is the so-called "myeloma kidney", which is the renal tubular damage caused by the excretion of light chains. Other mechanisms of renal damage are light chain tissue deposition and acquired Fanconi's syndrome. This renal impairment might be aggravated by precipitating factors such as hypercalcemia, hyperuricemia, dehydration, hyperviscosity, and nephrotoxic drugs. Supportive measures must be taken for all patients; for those with an irreversible renal function, dialysis must be considered. Specific myeloma treatment has an important prognostic value for patients with renal impairment. The recommendation of induction

  17. Amantadine neurotoxicity in a pediatric patient with renal insufficiency.

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    Strong, D K; Eisenstat, D D; Bryson, S M; Sitar, D S; Arbus, G S

    1991-11-01

    Amantadine hydrochloride, a dopamine agonist with antiviral and antiparkinsonism properties, is used for the prevention and treatment of influenza A respiratory infections in high-risk populations. The occurrence of amantadine-induced hallucinations and tremors is described in a young, renal transplant patient with declining renal function. Following discontinuation of amantadine, plasma amantadine concentrations were correlated with central nervous system toxicity. In view of the usage of amantadine in renal transplant recipients and the elderly, clinicians must be alert to the possibility of amantadine-induced neurotoxicity in patients with changing renal function.

  18. Impact of renal insufficiency on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Sabroe, Jonas Emil; Thayssen, Per; Antonsen, Lisbeth

    2014-01-01

    -year all-cause mortality was 13.4% vs. 47.4% (log-rank p year mortality compared to patients with a preserved renal function (CrCl ≤30 60 mL/min: adjusted HR 2.71 [95% CI 2.09-3.51], p ... and more likely to have diabetes mellitus, hypertension and to present with a higher Killip class.Among patients with a preserved kidney function and patients with RI, 30-day all-cause mortality was 3.5% vs. 20.9% (log-rank p year all-cause mortality was 5.7% vs. 29.4% (log-rank p ...BACKGROUND: Chronic kidney disease is associated with increased risk of mortality. We examined the impact of moderate and severe renal insufficiency (RI) on short- and long-term mortality among unselected patients with ST-segment elevation myocardial infarction (STEMI) treated with primary...

  19. Screening for renal insufficiency following ESUR (European Society of Urogenital Radiology) guidelines with on-site creatinine measurements in an outpatient setting

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    Ledermann, H.P.; Mengiardi, B.; Schmid, A. [IMAMED Radiologie Nordwest, Basel (Switzerland); Froehlich, J.M. [Guerbet AG, Medical Affairs, Zurich (Switzerland); University of Bern, Radiology Department, Bern (Switzerland)

    2010-08-15

    To report the results and implications for workflow following introduction of ESUR guidelines to screen for potential renal insufficiency (RI) in private practice with on-site creatinine measurements. A total of 1,766 consecutive outpatients scheduled for contrast-enhanced CT (CECT) completed the ESUR questionnaire enquiring about kidney disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout or use of nephrotoxic drugs. Patients with positive risk factors underwent on-site creatinine measurement and calculation of estimated glomerular filtration rate (eGFR). Attending radiologists adapted subsequent imaging depending on renal function and presence of risk factors. One or more ESUR risk factors were present in 796 (45.1%) patients, including hypertension (37.7%), nephrotoxic medication (21.3%), diabetes mellitus (8.0%), proteinuria (3.9%), renal disease (4.1%), gout (3.1%) and renal surgery (2.6%). Pre-procedural creatinine measurements revealed severe RI (eGFR < 30 ml min{sup -1} 1.73 m{sup -2}) in 10 (1.3%) and moderate RI (eGFR 30-59 ml min{sup -1} 1.73 m{sup -2}) in 106 (13.8%). Imaging work-up was adapted in 132 (16.6%) as follows: reduction of contrast material dose (n = 85), CT without contrast (n = 40), changeover to MRI (n = 3) or scintigraphy (n = 4). Screening for RI following ESUR guidelines requires creatinine measurements in nearly half of outpatients scheduled for CECT and reveals moderate to severe renal impairment in 6.6%. (orig.)

  20. Concomitant renal insufficiency and diabetes mellitus as prognostic factors for acute myocardial infarction

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    Kim Chang Seong

    2011-10-01

    Full Text Available Abstract Background Diabetes mellitus and renal dysfunction are prognostic factors after acute myocardial infarction (AMI. However, few studies have assessed the effects of renal insufficiency in association with diabetes in the context of AMI. Here, we investigated the clinical outcomes according to the concomitance of renal dysfunction and diabetes mellitus in patients with AMI. Methods From November 2005 to August 2008, 9905 patients (63 ± 13 years; 70% men with AMI were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR and were categorized into 4 groups: Group I (n = 5700 had neither diabetes nor renal insufficiency (glomerular filtration rate [GFR] ≥ 60 ml/min/1.73 m2, Group II (n = 1730 had diabetes but no renal insufficiency, Group III (n = 1431 had no diabetes but renal insufficiency, and Group IV (n = 1044 had both diabetes and renal insufficiency. The primary endpoints were major adverse cardiac events (MACE, including a composite of all cause-of-death, myocardial infarction, target lesion revascularization, and coronary artery bypass graft after 1-year clinical follow-up. Results Primary endpoints occurred in 1804 (18.2% patients. There were significant differences in composite MACE among the 4 groups (Group I, 12.5%; Group II, 15.7%; Group III, 30.5%; Group IV, 36.5%; p p = 0.001; and HR, 2.42; 95% CI, 1.62-3.62; p Conclusions Renal insufficiency, especially in association with diabetes, is associated with the occurrence of composite MACE and indicates poor prognosis in patients with AMI. Categorization of patients with diabetes and/or renal insufficiency provides valuable information for early-risk stratification of AMI patients.

  1. Renal clearance of pancreatic and salivary amylase relative to creatinine in patients with chronic renal insufficiency.

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    Keogh, J B; McGeeney, K F; Drury, M I; Counihan, T B; O'Donnell, M D

    1978-12-01

    Pancreatic and salivary amylase/creatinine clearance ratios in patients with various degrees of renal impairment were compared with those obtained for control subjects. In chronic renal insufficiency (mean GFR 30 ml/min +/- 15 SD; n = 13) the clearance ratios for pancreatic (mean 3.5 +/- 1.85 SD) and salivary (mean 2.3 +/- 1.3 SD) amylase were significantly higher (P less than 0.05) than those in controls. Corresponding control values (n = 26) were 2.64 +/- 0.86 (pancreatic) and 1.64 +/- 0.95 (salivary). Three patients showed values above the normal limit. In the diabetic group (mean GFR 41 ml/min +/- 22 SD; n = 10) salivary amylase/creatinine clearance ratios (mean 2.36 +/- 1.55 SD) were significantly higher than in controls (P less than 0.05). Three patients showed raised values. Pancreatic amylase clearance was raised in only one of these patients. Three patients with terminal disease (mean GFR 10 ml/min) showed markedly raised (two- to threefold) clearance ratios for both salivary and pancreatic amylase. Of a total of 26 patients, eight had increased total amylase/creatinine clearance ratios. Pancreatic amylase/creatinine clearance was increased in seven patients, while nine patients showed raised salivary amylase/creatinine ratios. Patients with raised clearance ratios did not have clinical evidence of pancreatitis. We suggest that, in the presence of impaired renal function, a high amylase/creatinine clearance ratio need not be indicative of pancreatic disease.

  2. Reversible Renal Insufficiency Secondary to Extrinsic Splenic Compression of the Kidney in a Patient with Chronic Lymphocytic Leukemia

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    Miriam Hadj-Moussa

    2010-01-01

    Full Text Available While increased renal venous and direct renal parenchymal pressure may cause renal insufficiency, there are no prior reports of hypersplenism secondary to chronic lymphocytic leukemia (CLL doing so. This first report of massive splenomegaly leading to marked compression of the left kidney associated with renal insufficiency that resolved after splenectomy illustrates that profound extrinsic renal compression from splenomegaly may significantly compromise left renal function and splenectomy should be considered in this situation.

  3. Renal and suprarenal insufficiency secondary to familial Mediterranean fever associated with amyloidosis: a case report

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    Sari Nagehan

    2011-08-01

    Full Text Available Abstract Introduction Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA amyloidosis. Case presentation In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest. Conclusion Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.

  4. X-ray changes of children with chronic renal insufficiency

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    Ponhold, W.; Balzar, E. (Vienna Univ. (Austria). Kinderklinik)

    1983-01-01

    The typical changes of renal osteopathy are shown in the X-rays of 7 children with end-stage renal disease treated with chronic intermittent hemodialysis. The exact evaluation of the granular structural changes of the cranium, the evidence of osteomalacia because of the hazy appearance of the vertebrae and the broadening of the sacroilical joints depend highly on subjective judgement and the technical X-ray procedures used. Unmistakable radiological diagnoses can be made when a broadening of the metalphyseal zones, epiphysioloysis as well as characteristic changes in the finder phalanges (acroosteolyses, spiculae, tunnelation) are present.

  5. Association of high blood pressure with renal insufficiency: role of albuminuria, from NHANES, 1999-2006.

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    Ping Yan

    Full Text Available BACKGROUND: The relationship between hypertension and kidney disease is complicated. Clinical trials found intense blood pressure control was not associated with alterations in glomerular filtration rate (GFR in all patients but did slow the rate of GFR decline among those with a higher baseline proteinuria. However, the underlying mechanism has been unclear. METHODS: We tested the hypothesis that the association between high blood pressure and renal function is modified by albuminuria status by conducting analyses in a cross-sectional study with 12,440 adult participants without known kidney diseases, diabetes or cardiovascular diseases, participating in the National Health and Nutrition Examination Survey (NHANES 1999-2006. RESULTS: 1226 out of 12440 were found to have unknown high blood pressure and 4494 were found to have reduced renal function. Overall, a moderate association was found between high blood pressure and renal function insufficiency in all participants analyzed. However, among participants with albuminuria, the prevalence of moderate-severe renal insufficiency substantially and progressively increased from normal subjects to prehypertensive and undiagnosed hypertensive subjects (1.43%, 3.44%, 10.96%, respectively, P for trend<0.0001; on the other hand, the prevalence of undiagnosed hypertension was also significantly higher among subjects with moderate-severe renal insufficiency than those with mild renal insufficiency (35.54% Vs 19.09%, P value <0.05, supporting an association between hypertension and renal function damage. In contrast, no association between hypertension and renal insufficiency was observed among those without albuminuria in this population. Similar findings were observed when the CKD-EPI equation was used. CONCLUSIONS: The association between high blood pressure and reduced renal function could be dependent upon the albuminuria status. This finding may provide a possible explanation for results observed in

  6. A Multicentre Prospective Evaluation of the Impact of Renal Insufficiency on In-hospital and Long-term Mortality of Patients with Acute ST-elevation Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Chao Li; Dayi Hu; Xubo Shi; Li Li; Jingang Yang; Li Song; Changsheng Ma

    2015-01-01

    Background:Numerous previous studies have shown that renal insufficiency (RI) in patients with acute coronary syndrome is associated with poor cardiovascular outcomes.These studies do not well address the impact of RI on the long-term outcome of patients with acute ST-elevation myocardial infarction (STEMI) in China.The aim of this study was to investigate the association of admission RI and inhospital and long-term mortality of patients with acute STEMI.Methods:This was a multicenter,observational,prospective-cohort study.718 consecutive patients were admitted to 19 hospitals in Beijing within 24 hours of onset of STEMI,between January 1,2006 and December 31,2006.Estimation of glomerular filtration rate (eGFR) was calculated using the modified abbreviated modification of diet in renal disease equation-based on the Chinese chronic kidney disease patients.The patients were categorized according to eGFR,as normal renal dysfunction (eGFR ≥ 90 ml·min-1·1.73 m-2),mild RI (60 ml·min-1· 1.73 m-2 < eGFR < 90 ml·min-1· 1.73 m2) and moderate or severe RI (eGFR < 60 ml·min-1· 1.73 m2).The association between RI and inhospital and 6-year mortality of was evaluated.Results:Seven hundred and eighteen patients with STEMI were evaluated.There were 551 men and 167 women with a mean age of 61.0 ± 13.0 years.Two hundred and eighty patients (39.0%) had RI,in which 61 patients (8.5%) reached the level of moderate or severe RI.Patients with RI were more often female,elderly,hypertensive,and more patients had heart failure and stroke with higher killip class.Patients with RI were less likely to present with chest pain.The inhospital mortality (1.4% vs.5.9% vs.22.9%,P < 0.001),6-year all-cause mortality (9.5% vs.19.8 vs.45.2%,P < 0.001) and 6-year cardiac mortality (2.9% vs.12.2% vs.23.8%,P < 0.001) were markedly increased in patients with RI.After adjusting for other confounding factors,classification of admission renal function was an

  7. [Acute renal insufficiency: nutrition disorders and therapeutic consequences].

    Science.gov (United States)

    Canaud, B; Leblanc, M; Leray-Moragues, H; Delmas, S; Klouche, K; Vela, C; Béraud, J J

    1998-01-01

    Catabolism is usually enhanced in acute renal failure (ARF). Its magnitude varies from one patient to another and can change significantly in the same patient from day to day, reflecting its clinical course. It depends on the severity of the ARF, the underlying process, the associated co-morbidity, and therapeutic approach. The detection of patients at high risk for malnutrition is extremely important; nutritional markers and indexes of caloric and protein requirements are useful to adapt renal replacement and nutritional support to ARF patients. Various biochemical parameters (namely, serum albumin and prealbumin), anthropometic measures, indirect calorimetry, urea and creatinine kinetics are all useful tools to evaluate metabolic status and requirements nutritional. Commonly, the caloric requirements are nearly 35 kcal/kg/24 h with correction factors applied for certain clinical situations: carbohydrates account for 50 to 60% of those needs whereas lipids account for the rest. The total amount of fluid administered has to be adapted to the possible ultrafiltration achieved by dialysis. Daily dialysis sessions and continuous renal replacement therapy allow larger volumes and thus facilitate nutritional support. Protein needs frequently exceed 1.2 g/kg/24 h to maintain the nitrogen balance, with a calorie to protein ration close to 150 kcal per g of nitrogen. Sufficient amounts of vitamins and oligo-elements are necessary. Stimulating anabolism by exogenous mediators, such as androgenic hormones or growth factors (rh-IGF1, rh-GH) is an avenue that deserves better definition in critically ill ARF patients.

  8. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

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    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki (Dept. of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)), email: utsunomi@kumamoto-u.ac.jp; Awai, Kazuo (Dept. of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima Univ., Hiroshima (Japan)); Funama, Yoshinori (Dept. of Medical Physics, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan))

    2011-06-15

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 +- 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m2) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 < =eGFR < 90, 45 < =eGFR < 60, 30 < =eGFR < 45 and eGFR < 30, respectively. Results Of the 6586 patients, 1.6%, 3.7%, 13.7%, and 54.2% were judged to present with severe, moderate-b, moderate-a, and mild RI, respectively. While moderate-b-to-severe RI was recorded in 133 (3.2%) of 4161 patients aged 70 years or less, it was observed in 218 (9.0%) of the 2425 patients who were 71 years or older. Among the 829 CVD patients, 9.9% manifested moderate-b-to-severe- and 73.0% mild-to-moderate-a RI. The corresponding rates were 4.4% and 68.9% for oncologic disease, 16.9% and 61.2% for DM, and 4.8% and 71.5% for CLD patients. By univariate analysis, there was a significant association between moderate-b-to-severe RI and the advanced age, CVD, DM, and non-oncologic disease. Multivariate analysis showed that the advanced age, DM, and non-oncologic disease were statistically associated with moderate-b-to-severe RI. Conclusion The incidence of RI of eGFR < 45mL/min/1.73 m2 at baseline was high in patients with advanced age, CVD and DM and

  9. The relationship between heart rate variability and prostaglandin E2 in patients with renal insufficiencies

    Institute of Scientific and Technical Information of China (English)

    陈伊伦; 朱建华; 胡申江; 王磊; 赵力; 陈宝仙

    2003-01-01

    Objective To investigate the relationship between heart rate variability (HRV) and prostaglandin E2 (PGE2) in patients with renal insufficiencies. Methods HRV blood and 24-hour urine prostagladin E2 (PGE2) detection were detected in the following 4 groups of people: group A was a control group comprised of 20 normal individuals; group B had 20 patients with renal disease but exhibiting normal renal function; group C contained 20 patients with renal disease and compensatory renal function; group D had 20 patients demonstrating renal insufficiencies. The indices standard deviation of all NN intervals (SDNN), index of standard deviation of the averages of NN intervals (SDANN), mean of the standard deviation of all NN intervals performed on all 5-minute segments of the entire recording (SDNNindex), square root of the mean of the sum of the squares of differences between adjacent NN intervals (rMSSD) and NN50 count divided by the total number of all NN intervals (PNN50) were used to evaluate HRV, blood and 24-hour urine were determined by specific radioimmunoassay (RIA). Results PGE2 in blood and urine and HRV exactly within 24 hours in patients with renal insufficiencies, negatively correlated with worsening damage to renal function. There was a slight or moderate correlation between blood and urine PGE2 and the SDNNindex, SDANNindex, SDNN, rMSSD and PNN50 indices (P<0.05). Conclusions HRV and cardiac autonomic regulatory functions are decreased in the patients with renal insufficiencies, while lower levels of PGE2 may be a related factor.

  10. Amylase-creatinine clearance ratios and serum amylase isoenzymes in moderate renal insufficiency.

    Science.gov (United States)

    Banks, P A; Sidi, S; Gelman, M L; Lee, K H; Warshaw, A L

    1979-12-01

    Both the amylase-creatinine clearance ratio (normal 1.55%) and proportion of pancreatic isoamylase in serum (normal 41.0%) increase in acute pancreatitis, and are therefore useful measurements to support that diagnosis. Whether renal insufficiency interferes with the accuracy and specificity of these tests has been debated. Our study indicates that even moderate renal insufficiency (creatinine clearance 30.5 ml/minute) raises the amylase-creatinine clearance ratio (3.23%) close enough to values characteristic of acute pancreatitis (4.41%) to cause potential diagnostic confusion. The fraction of pancreatic isoamylase in serum is also increased (69.9%), but not to the levels of acute pancreatitis (91.0%). We therefore caution against the use of the amylase-creatinine clearance ratio for the diagnosis of acute pancreatitis in patients with moderate renal insufficiency.

  11. Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency.

    Science.gov (United States)

    Tedesco, F J; Harter, H R; Alpers, D H

    1976-10-01

    Patients with severe chronic renal failure may have significant hyperamylasemia in the absence of clinical symptoms or signs of acute pancreatitis. Amylase to creatinine clearance (CA/CC) ratios were usually elevated in patients with chronic renal failure and were not helpful in evaluating the possibility of acute pancreatitis. The mean amylase to creatinine clearance ratio for the controls with normal renal function was 1.24 +/- 0.13. In patients with chronic renal failure, it was 3.17 +/- 0.42 (P less than 0.001). Serum amylase isoenzyme patterns revealed no difference in salivary to pancreatic isoenzyme ratios between normals (1.04 +/- 0.12) and patients with severe renal insufficiency without evidence of pancreatic disease (1.07 +/- 0.13). The isoenzymes were helpful in excluding the diagnosis of pancreatic in 1 renal failure patient whose hyperamylasemia was primarily salivary in origin and in confirming the diagnosis in another who had only a pancreatic band.

  12. Effectiveness of theophylline prophylaxis of renal impairment after coronary angiography in patients with chronic renal insufficiency.

    Science.gov (United States)

    Huber, Wolfgang; Schipek, Chrysantha; Ilgmann, Kathrin; Page, Michael; Hennig, Michael; Wacker, Annette; Schweigart, Ursula; Lutilsky, Leopoldo; Valina, Christian; Seyfarth, Melchior; Schömig, Albert; Classen, Meinhard

    2003-05-15

    Contrast media can lead to renal impairment that results in longer hospitalization and increased mortality. Adenosine is a crucial mediator of contrast-induced nephropathy (CIN; an increase in serum creatinine of >or=0.5 mg/dl within 48 hours). Therefore, it was the purpose of our study to investigate whether the adenosine antagonist theophylline reduces the incidence of CIN after coronary angiography. We also characterized risk factors for CIN after coronary angiography. One hundred patients with serum creatinine concentrations of >or=1.3 mg/dl randomly received 200 mg IV theophylline or placebo 30 minutes before coronary angiography (amount of contrast medium >or=100 ml). Patients who received theophylline and the controls were comparable with regard to baseline creatinine levels (means +/- SD) (1.65 +/- 0.41 vs 1.72 +/- 0.69 mg/dl) and the amount of contrast medium received (235 +/- 89 vs 261 +/- 139 ml). Theophylline significantly reduced the incidence of CIN (4% vs 20%, p = 0.0138). With placebo, creatinine significantly increased at 12 (1.82 +/- 0.79 mg/dl, p = 0.0057), 24 (1.90 +/- 0.86 mg/dl, p = 0.0001), and 48 hours (1.90 +/- 0.89 mg/dl, p = 0.0007) after administration of contrast medium. With pretreatment with theophylline, mean creatinine only increased 24 hours after contrast medium administration (1.70 +/- 0.40 mg/dl, p = 0.029), but was stable 12 hours (1.65 +/- 0.43 mg/dl, p = 0.99) and 48 hours after contrast medium administration (1.65 +/- 0.41 mg/dl, p = 0.99). The following parameters were significantly associated with contrast-induced renal impairment: Cigarroa quotient >5 (contrast medium [milliters] x serum creatinine/body weight [kg]), elevated troponin T, >300 ml of contrast medium, and emergency angiography. In conclusion, theophylline reduces the incidence of CIN in patients with chronic renal insufficiency undergoing coronary angiography. It should be used especially in patients receiving large amounts of contrast medium, and in

  13. Contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

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    Murakami, Ryusuke; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Yoshida, Tamiko; Okazaki, Emi; Kumita, Shin-ichiro; Owan, Chojin [Nippon Medical School, Department of Radiology, Graduate School of Medicine, Tokyo (Japan)

    2012-10-15

    To evaluate the safety of contrast-enhanced MDCT in patients with renal impairment. We conducted a retrospective review of 938 patients with stable renal insufficiency (eGFR between 15 and 60 ml/min) who underwent contrast-enhanced MDCT. SCr levels were measured at baseline and 48-72 h after contrast medium administration. The incidence of contrast-induced nephropathy (CIN) in the total study population was assessed. As a control group, 1,164 separate patients with renal insufficiency who did not receive contrast medium for CT were also reviewed. The overall incidence of CIN in the patient population with renal insufficiency was 6.1 %; the incidence was 4.4 %, 10.5 % and 10.0 % for patients whose eGFR was 45-60, 30-45 and {<=}30 ml/min, respectively (P < 0.01). In the control group, 5.8 % of patients showed an increase in the SCr level from the baseline. The increase in the SCr level showed no significant difference between the patients who received CM and those who did not (P = 0.82) The risk of CIN from contrast-enhanced MDCT in patients with renal insufficiency appeared to be low, and there was no significant difference in the incidence of CIN in comparison with patients who did not receive CM. (orig.)

  14. Dietary supplements of vitamins E and C and beta-carotene reduce oxidative stress in cats with renal insufficiency.

    Science.gov (United States)

    Yu, S; Paetau-Robinson, I

    2006-05-01

    Oxidative stress may contribute to the progression of chronic renal failure. In this study, cats with spontaneous renal insufficiency were fed a dry cat food supplemented with the antioxidants vitamins E and C, and beta-carotene for 4 weeks. When compared with healthy cats, cats with renal insufficiency had a tendency to oxidative stress. The antioxidant supplements significantly reduced DNA damage in cats with renal insufficiency as evidenced by reduced serum 8-OHdG and comet assay parameters. Therefore, supplements of vitamins E and C and beta-carotene as antioxidants may be beneficial to cats with renal disease.

  15. Influence of Renal Insufficiency on the Prescription of Evidence-Based Medicines in Patients With Coronary Artery Disease and Its Prognostic Significance

    Science.gov (United States)

    Peng, Yong; Xia, Tian-li; Huang, Fang-yang; Huang, Bao-tao; Liu, Wei; Chai, Hua; Zhao, Zhen-gang; Zhang, Chen; Liao, Yan-biao; Pu, Xiao-bo; Chen, Shi-jian; Li, Qiao; Xu, Yuan-ning; Luo, Yang; Chen, Mao; Huang, De-jia

    2016-01-01

    Abstract The purpose of this study was to discuss the present situation of discharge medications in coronary artery disease (CAD) patients with different levels of renal function and assess the potential impact of these medications on the prognosis of this patient population. A retrospective cohort study was conducted. From July 2008 to Jan 2012, consecutive patients with CAD confirmed by coronary angiography of West China Hospital were enrolled and were grouped into 3 estimated glomerular filtration rate (eGFR) categories: ≥60, 30 to 60, and ACEIs] or angiotensin-receptor blockers [ARBs]) was a factor in reducing the risk of all-cause death and cardiovascular death. However, EBMs prescribed at discharge revealed an obvious underuse in renal insufficiency (RI) patients. The results of Cox regression showed that irrespective of the eGFR level, greater use of EBMs resulted in a greater reduction in the risk of all-cause death and cardiovascular death. A higher percentage of patients with CAD and concomitant RI suffered from cardiovascular disease (CVD) risk factors, whereas a lower percentage of these patients used EBMs to prevent CVD events. Strict use of EBMs, including beta-blockers, statins, and ACEIs or ARBs, can lead to more clinical benefits, even for patients with CAD and concomitant RI. Thus, treatment of this patient population with EBMs should be stressed. PMID:26871817

  16. [Features of episodes of mental disorders in chronic renal insufficiency (clinico-morphologic study)].

    Science.gov (United States)

    Korkina, M V; Tsivil'ko, V S; Tsivil'ko, M A

    1976-01-01

    The authors studied the traits of psychotic attacks in 40 patients with terminal stages of chronic renal insufficiency. They were expressed in atypical delirious, delirio-amentive and amentive conditions. 8 cases were studied morphologically. The pathological process in the brain was characterized as toxico-dyshomeostatic encephalopathy. The pathogenesis of such disorders is discussed.

  17. The predictive value of mild renal insufficiency on the prognosis of patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    张建华

    2014-01-01

    Objective To investigate the predictive value of mild renal insufficiency on the endpoint events in patients with acute coronary syndrome(ACS).Methods A total of 552 patients with ACS were enrolled in the present study.According to the levels of estimated glomerular filtration rate(eGFR),patients were divided into two groups,normal

  18. [Hyperparathyroidism secondary to renal insufficiency. Physiopathology, clinicoradiological aspects and treatment].

    Science.gov (United States)

    Ben Hamida, F; Ghazali, A; Boudzernidj, M; Amar, M; Morinière, P; Westeel, P; Fournier, A

    1994-01-01

    Stimulation of PTH secretion and synthesis in chronic renal failure involves direct and indirect factors. The indirect ones are those contributing to a decrease of plasma ionized calcium concentration which stimulates the release of PTH (1) primarily the negative calcium balance due to the iatrogenic reduction of dietary calcium intake associated with an inadequate synthesis of calcitriol, this latter being explained by a reduction in the nephronic mass, the phosphate retention, the acidosis and the retention of uremic toxins (2) more accessorily, the physicochemical dysequilibrium induced by the late occurring hyperphosphatemia. The factors acting directly on the parathyroid gland stimulating synthesis of prepro PTH at its transcription level: not only hypocalcitriolemia but also hypocalcemia and hyperphosphatemia. The clinicoradiological manifestations appear late, mostly only after the patient has been put on dialysis. The most precocious sign is the subperiosteal resorption assessed on the hand X-rays. Therefore diagnosis of hyperparathyroidism relies mainly on the measurement of plasma concentration of intact PTH. In dialysis patients the optimal range corresponding to the best bone histology is between 1 an 3 times the upper limit of normal. No such data exist for predialysis patients. Medical treatment of hyperparathyroidism should primarily be preventive, probably in predialysis lipin patient as soon as plasma intact PTH is greater than the normal upper limit. This treatment is based primarily on the prevention of phosphate retention, of negative calcium balance and acidosis by the use of oral alkaline salts of calcium given with the meals in association with appropriate dietary protein and phosphate restriction. Native vitamin D depletion should also be prevented but use of 1 alpha OH vitamin D3 metabolites in controversial: it is reasonable to administer them only when plasma intent PTH is above 3-7 the normal upper limit and when plasma phosphate is

  19. Prevalence of nephrogenic systemic fibrosis in renal insufficiency patients: Results of the FINEST study

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    Janus, Nicolas [Department of Nephrology, Pitie-Salpetriere Hospital, 83 boulevard de l' Hopital, 75013 Paris (France)], E-mail: nicolas.janus@psl.aphp.fr; Launay-Vacher, Vincent; Karie, Svetlana [Department of Nephrology, Pitie-Salpetriere Hospital, 83 boulevard de l' Hopital, 75013 Paris (France); Clement, Olivier [Department of Radiology, Georges Pompidou European Hospital, Paris (France); Ledneva, Elena [Department of Nephrology, Pitie-Salpetriere Hospital, 83 boulevard de l' Hopital, 75013 Paris (France); Frances, Camille [Department of Dermatology, Tenon Hospital, Paris (France); Choukroun, Gabriel [Department of Nephrology, Amiens University Hospital, Amiens (France); Deray, Gilbert [Department of Nephrology, Pitie-Salpetriere Hospital, 83 boulevard de l' Hopital, 75013 Paris (France)

    2010-02-15

    Purpose: Nephrogenic systemic fibrosis (NSF) is characterized by widespread tissue fibrosis, mainly affecting the skin. Gadolinium chelates have been implicated in the onset of NSF in patients with renal impairment (RI). The FINEST study (FIbrose Nephrogenique SysTemique) was designed to determine the prevalence of NSF after magnetic resonance imaging (MRI) in French RI patients. Materials and methods: We studied all patients with RI who had at least one MRI examination during a one-year period, with or without gadolinium chelate administration. Data were collected retrospectively from 9 Nephrology Departments in France, and included sex, age, renal function, type of gadolinium administered, and subsequent cutaneous disorders. If a patient presented a cutaneous disorder, a skin biopsy was performed to confirm the diagnostic. Results: The 308 eligible patients had a mean age of 59.9 years, 59% were men, and 54% had stage 5 RI. 75% of those 308 patients received a Gadolinium chelate. Among those patients who received a gadolinium chelate, 76% received gadoterate, 20% gadopentetate, 3% gadodiamide and 1% gadobenate. No cutaneous disorders were recorded after MRI. Conclusion: These results confirm that NSF is a rare disease. Based on a reported frequency, {approx}3.5% in patients with glomerular filtration rate <30 ml/min/1.73 m{sup 2}), some cases should have been observed in our study which included 308 patients. Most patients received gadoterate, a macrocyclic gadolinium chelate for which no case of NSF has been observed worldwide. This suggests that more stable macrocyclic agents may be less likely to induce NSF.

  20. Sirolimus conversion efficacy for graft function improvement and histopathology in renal recipients with mild to moderate renal insufficiency.

    Science.gov (United States)

    Joo, Dong Jin; Yang, Chul Woo; Jeong, Hyeon Joo; Lim, Beom Jin; Huh, Kyu Ha; Chung, Byung Ha; Choi, Yeong Jin; Kang, Shin-Wook; Kim, Yu Seun

    2014-08-01

    This study was designed to evaluate whether sirolimus (SRL) conversion effectively improves renal function and histopathology in calcineurin inhibitor (CNI)-treated renal recipients with mild to moderate renal insufficiency. SRL conversion from CNI was performed in patients who underwent kidney transplantation from 6 months to 5 yr prior to screening. Forty-five patients were enrolled. The effect of SRL conversion on graft function was evaluated, and protocol biopsies were performed preconversion and 1 yr after conversion. Overall graft function after SRL conversion gradually improved, and the improvement in renal function was closely associated with the shorter duration of CNI exposure. When we divided the patients by the duration of CNI exposure, the patients with less than 1 yr of CNI exposure demonstrated significant improvement, but patients with a greater than 1 yr CNI exposure did not exhibit significant improvement. In contrast, protocol biopsies demonstrated no significant improvements in the modified "ah" score or other Banff scores after SRL conversion. Furthermore, the duration of CNI treatment prior to SRL conversion was not associated with histological findings 1 yr after SRL conversion. SRL conversion improved graft function in renal recipients with mild to moderate renal insufficiency, but this effect is not accompanied by histological improvement.

  1. The efficacy of hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency.

    Science.gov (United States)

    Zhai, Hongxia; Li, Liang; Yin, Yaxin; Zhang, Jinjin; Chen, Haiwei; Liu, Runmei; Xia, Yun-feng

    2016-01-01

    The aim of this study was to explore the efficacy and safety of hemodialysis in interventional therapy for patients with coronary artery disease combined with chronic renal insufficiency. With the aging and social development, the number of coronary artery disease patients with chronic renal insufficiency gradually increased. Total 58 coronary heart disease patients with chronic renal dysfunction were selected. These patients were characterized with typical angina symptoms and typical electrocardiogram (ECG) changes of onset angina. Continuous oral administration of sodium bicarbonate tablets 1 g 3/day × 3 days and slow intravenous input sodium chloride 1000 ∼1500 mL 3-12 h before operation were given. By this way, all patients were treated by hydration and alkalization. After percutaneous coronary intervention (PCI) treatment, patients were immediately transferred to undergo 4 h of dialysis treatment without removing indwelling of femoral artery puncture sheath tube to protect renal function. Changes in renal function including serum creatinine, glomerular filtration rate, and urine were observed and recorded. All patients were successfully underwent PCI treatment. Within one month after PCI, there were no obvious complication and no stent thrombosis occurred. Among of 58 patients, 56 cases showed no significant increase in serum creatinine levels compared with those before operation. However, serum creatinine level of one patient increased to 251 umol/L and one patient still required permanent dialysis. Using hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency could significantly improve the prognosis of the patients.

  2. Piperazine side-effects in a patient with pre-existing renal insufficiency

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2014-01-01

    Full Text Available Piperazine as an antihelminth has many adverse effects, especially on patients with renal insufficiency. We report the use of piperazine in a girl with a moderately severe kidney disease due to Biedl Bardet syndrome. She developed coma and acute kidney injury due to acute interstitial nephritis (AIN, anemia and thrombocytopenia. The presence of fever, proteinuria, acidosis, anemia, sterile pyuria and non-oliguric renal failure strongly suggested AIN. Her problems abated mostly by discontinuing of piperazine and supportive therapy, except anemia and thrombocytopenia.

  3. The effect of bacterial lipopolysaccharide on gastric emptying in rats suffering from moderate renal insufficiency

    Directory of Open Access Journals (Sweden)

    Rigatto S.Z.P.

    1998-01-01

    Full Text Available The objective of the present study was to evaluate the response of rats suffering from moderate renal insufficiency to bacterial lipopolysaccharide (LPS, or endotoxin. The study involved 48 eight-week-old male SPF Wistar rats (175-220 g divided into two groups of 24 animals each. One group underwent 5/6 nephrectomy while the other was sham-operated. Two weeks after surgery, the animals were further divided into two subgroups of 12 animals each and were fasted for 20 h but with access to water ad libitum. One nephrectomized and one sham-treated subgroup received E. coli LPS (25 µg/kg, iv while the other received a sterile, pyrogen-free saline solution. Gastric retention (GR was determined 10 min after the orogastric infusion of a standard saline test meal labeled with phenol red (6 mg/dl. The gastric emptying of the saline test meal was studied after 2 h. Renal function was evaluated by measuring the plasma levels of urea and creatinine. The levels of urea and creatinine in 5/6 nephrectomized animals were two-fold higher than those observed in the sham-operated rats. Although renal insufficiency did not change gastric emptying (median %GR = 26.6 for the nephrectomized subgroup and 29.3 for the sham subgroup, LPS significantly retarded the gastric emptying of the sham and nephretomized groups (median %GR = 42.0 and 61.0, respectively, and was significantly greater (P<0.01 in the nephrectomized rats. We conclude that gastric emptying in animals suffering from moderate renal insufficiency is more sensitive to the action of LPS than in sham animals

  4. Upper Digestive Endoscopic Findings in Patients with Chronic Renal Insufficiency in Phase of Dialysis

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    Marcos Félix Osorio Pagola

    2009-12-01

    Full Text Available Background: Patients with chronic renal insufficiency in phase of dialysis present clinical manifestations that can include different symptoms. Morbidity due to gastric, esophageal and duodenal disturbances is significant and constitutes a considerable risk before, while and after a renal transplant. Objective: To identify the most frequent disturbances of the upper digestive tract in patients with chronic renal insufficiency who require dialysis. Methods: An observational, descriptive and retrospective study was carried out in this search. The universe was composed by all the patients with a diagnosis of chronic renal insufficiency in a dialysis phase, who had been included in the Hemodialysis Program at the University Hospital “Dr. Gustavo Aldereguía Lima” from Cienfuegos and who had undergone an upper digestive endoscopy from January to May, 2008. The patient’s health record was studied to get information for the variables under study. Results: the average age was 46,7 years and the most affected patients were males. The mean value for serum creatinine was 929,7 mMol/L, for serum urea 21,4 mMol/L and for hemoglobin 8,4 g/L. The most frequent cause of chronic nephropathy was High Blood Pressure in 25 patients (56,8 %, followed by Diabetes Mellitus in 9 patients (20,5 %. 52,3 % of the patients were asymptomatic, but the most frequent symptoms reported by the patients were flatulence (25 % and nausea (15,9 %. Endoscopy revealed normal results in most of the patients (40,9 %. Conclusions: Antral erythematous endoscopic gastritis was the most frequent endoscopic diagnosis followed by duodenal ulcer

  5. Congestive heart failure and converting enzyme inhibition: failure of current prognostic criteria for predicting subsequent renal insufficiency.

    OpenAIRE

    1991-01-01

    Angiotensin-1-converting enzyme inhibitors have an effective and established role in the treatment of patients with congestive heart failure. However, a small number of such patients will subsequently develop renal insufficiency. These patients may be identified prior to, or shortly after, commencement of therapy by recognized criteria. This report describes 4 patients with congestive heart failure who developed severe renal insufficiency secondary to either enalapril or captopril therapy in ...

  6. Síndrome pulmón-riñón Pulmonary-renal syndrome

    Directory of Open Access Journals (Sweden)

    Jorge A. Risso

    2009-12-01

    Full Text Available El síndrome pulmón-riñón se define como una combinación de hemorragia alveolar difusa y glomerulonefritis. La coexistencia de estas dos afecciones clínicas se produce por enfermedades con distintos mecanismos patogénicos. Las vasculitis sistémicas primarias y el síndrome de Goodpasture son las etiologías más frecuentes. El lupus eritematoso sistémico, otras colagenopatías, las vasculitis con anticuerpos anticitoplasma de los neutrófilos negativos y las secundarias a drogas son causas mucho menos comunes. El diagnóstico temprano basado en criterios clínicos, radiológicos, de laboratorio e histológicos, permite iniciar el tratamiento disminuyendo su elevada morbi-mortalidad. La terapéutica se basa en altas dosis de corticoides, inmunosupresores, inhibidores del factor de necrosis tumoral y plasmaféresis.The pulmonary-renal syndrome is defined as a combination of diffuse alveolar hemorrhage and glomerulonephritis. The coexistence of these two clinical conditions is due to diseases with different pathogenic mechanisms. Primary systemic vasculitis and Goodpasture syndrome are the most frequent etiologies. Systemic lupus erythematosus, connective tissue diseases, negative anti neutrophil cytoplasmic antibody vasculitis and those secondary to drugs are far less common causes. An early diagnosis based on clinical, radiologic, laboratory and histologic criteria enables early treatment, thus diminishing its high morbility-mortality rate. Therapy is based on high doses of corticosteroids, immunosuppressants, tumor necrosis factor inhibitors and plasmapheresis.

  7. Role of Soluble ST2 as a Prognostic Marker in Patients with Acute Heart Failure and Renal Insufficiency.

    Science.gov (United States)

    Kim, Min-Seok; Jeong, Tae-Dong; Han, Seung-Bong; Min, Won-Ki; Kim, Jae-Joong

    2015-05-01

    This study sought to assess the relationship between serum concentrations of the soluble ST2 (sST2) and B-type natriuretic peptide (BNP) and investigate the role of sST2 as a prognosticator in patients hospitalized with acute heart failure (HF) and renal insufficiency. sST2 was measured at admission and discharge in 66 patients hospitalized with acute decompensated HF and renal insufficiency (estimated glomerular filtration rate [eGFR] renal insufficiency (eGFR renal function, even though BNP level was much higher in patients with severe renal insufficiency. During 3 month follow-up, 9 (13.6%) died and 16 (24.2%) were readmitted due to HF aggravation.On multivariate analysis, sST2 at discharge was independently associated with death or HF readmission during 3 months after discharge (hazard ratio, 1.038; 95% confidence interval, 1.011-1.066, P = 0.006). In conclusion, sST2 is not affected by renal function compared with BNP in acute HF patients. The measurement of predischarge sST2 can be helpful in predicting short-term outcomes in acute decompensated HF patients with renal insufficiency.

  8. Correlation of Preoperative Renal Insufficiency With Mortality and Morbidity After Aortic Valve Replacement: A Propensity Score Matching Analysis

    Science.gov (United States)

    Lin, Chun-Yu; Tsai, Feng-Chun; Chen, Yung-Chang; Lee, Hsiu-An; Chen, Shao-Wei; Liu, Kuo-Sheng; Lin, Pyng-Jing

    2016-01-01

    Abstract Preoperative end-stage renal disease carries a high mortality and morbidity risk after aortic valve replacement (AVR), but the effect of renal insufficiency remains to be clarified. Through propensity score analysis, we compared the preoperative demographics, perioperative profiles, and outcomes between patients with and without renal insufficiency. From August 2005 to November 2014, 770 adult patients underwent AVR in a single institution. Patients were classified according to their estimated glomerular infiltration rate (eGFR) as renal insufficiency (eGFR: 30–89 mL/min/1.73 m2) or normal (eGFR, ≥90 mL/min/1.73 m2). Propensity scoring was performed with a 1:1 ratio, resulting in a matched cohort of 88 patients per group. Demographics, comorbidities, and surgical procedures were well balanced between the 2 groups, except for diabetes mellitus and eGFR. Patients with renal insufficiency had higher in-hospital mortality (19.3% versus 3.4%, P 72 hour; 25% versus 9.1%, P = .008), intensive care unit stays (8.9 ± 9.9 versus 4.9 ± 7.5 days, P = .046), and hospital stays (35.3 ± 31.7 versus 24.1 ± 20.3 days, P = .008), compared with those with normal renal function. Multivariate analysis confirmed that preoperative renal insufficiency was an in-hospital mortality predictor (odds ratio, 2.33; 95% confidence interval, 1.343–4.043; P = .003), as were prolonged cardiopulmonary bypass time, intraaortic balloon pump support, and postoperative hemodialysis. The 1-year survival significantly differed between the 2 groups including (normal 87.5% versus renal insufficiency 67.9%, P < .001) or excluding in-hospital mortality (normal 90.7% versus renal insufficiency 82.1%, P = .05). Patients with preoperative renal insufficiency who underwent AVR had higher in-hospital mortality rates and increased morbidities, especially those associated with hemodynamic instabilities requiring intraaortic balloon pump support or

  9. Retinopathy and Chronic Kidney Disease in the Chronic Renal Insufficiency Cohort Study (CRIC)

    Science.gov (United States)

    Grunwald, Juan E.; Alexander, Judith; Ying, Gui-Shuang; Maguire, Maureen; Daniel, Ebenezer; Whittock-Martin, Revell; Parker, Candace; McWilliams, Kathleen; Lo, Joan C.; Go, Alan; Townsend, Raymond; Gadegbeku, Crystal A.; Lash, James P.; Fink, Jeffrey C.; Rahman, Mahboob; Feldman, Harold; Kusek, John W.; Xie, Dawei; Jaar, Bernard G.

    2013-01-01

    Objectives Retinal vascular and anatomic abnormalities caused by diabetes, hypertension, and other conditions can be observed directly in the ocular fundus and may reflect severity of chronic renal insufficiency. The purpose of this study was to investigate the association between retinopathy and chronic kidney disease (CKD). Methods In this observational, cross-sectional study, 2605 participants of the Chronic Renal Insufficiency Cohort (CRIC) study, a multi-center study of CKD, were offered participation. Non-mydriatic fundus photographs of the disc and macula in both eyes were obtained in 1936 of these subjects. Photographs were reviewed in a masked fashion at a central photograph reading center using standard protocols. Presence and severity of retinopathy (diabetic, hypertensive or other) and vessel diameter caliber were assessed by trained graders and a retinal specialist using protocols developed for large epidemiologic studies. Kidney function measurements and information on traditional and non-traditional risk factors for decreased kidney function were obtained from the CRIC study. Results Greater severity of retinopathy was associated with lower estimated glomerular filtration rate (eGFR) after adjustment for traditional and non-traditional risk factors. Presence of vascular abnormalities usually associated with hypertension was also associated with lower eGFR. We found no strong direct relationship between eGFR and average arteriolar or venular calibers. Conclusions Our findings show a strong association between severity of retinopathy and its features and level of kidney function after adjustment for traditional and non-traditional risk factors for CKD, suggesting that retinovascular pathology reflects renal disease. PMID:22965589

  10. [A case of cryptococcal meningitis with nephrotic syndrome and renal insufficiency under immunosuppressive therapy].

    Science.gov (United States)

    Tsuchida, Hiroki; Ichikawa, Daisuke; Shima, Yoshinori; Yasuda, Takashi; Sato, Takeo; Kimura, Kenjiro

    2007-01-01

    A 76 year-old woman was admitted to our hospital because of pyrexia and fatigue. One year earlier, she was diagnosed as nephrotic syndrome(NS) caused by focal segmental glomerulosclerosis and immunosuppressive therapy was started with marked amelioration of proteinuria. Thereafter, her renal function worsened, but only supportive treatment was continued. After admission, a cerebrospinal fluid (CSF) examination revealed Cryptococcus neoformans (C. neoformans) by india ink staining and a subsequent CSF culture confirmed C. neoformans infection. Accordingly, we made the diagnosis of cryptococcal meningitis and immediately started multiple anti fungal drugs with dosage modification according to her impaired renal function. Immunosuppressive therapy for NS was temporarily terminated. The inflammatory signs and symptoms soon were markedly improved, but the anti cryptococcal antibody titer in the serum and CSF remained high. Immunosuppressive therapy was started again at a low dosage because urinary protein had increased again. One hundred and eight days from admission, she was discharged with a regimen of multiple anti fungal drugs. Proteinuria and renal insufficiency was almost stable during hospitalization. Most fungal infection develops in patients in an immunosuppressive state induced by immunosuppressive drugs, HIV infection and so on. Patients with NS are frequently in an immunosuppressive state because of urinary loss of immunoglobulins and the use of immunosuppressive drugs. Therefore, it should be remembered that patients with NS are at a high risk of suffering from fungal infection.

  11. [Respiratory and renal insufficiency as risk factors of surgical treatment of patients with aortic aneurysm of the infrarenal segment].

    Science.gov (United States)

    Iaitskiĭ, N A; Bedrov, A Ia; Martynenko, G I; Vrabiĭ, A A; Moiseev, A A

    2013-01-01

    Retrospective analysis of data in 188 patients showed, that chronic nonspecific pulmonary disease was diagnosed in 65.4% of all. Disorders of bronchial patency of different degrees of manifestation were noted in 61.2% and 19.7% of patients had a hypoxemia. Renal diseases were found in 59% of patients, resulting in the development of chronic renal insufficiency in 17%. The data obtained indicate, that the presence of coexisting pulmonary pathology directly influences the frequency and severity of respiratory complications after surgery, which can be the cause of fatal outcome. The presence of renal diseases results in three times higher risk of the development of postoperative renal complications.

  12. Coronary stenting does not improve the long-term cardiovascular outcome of patients with mild to moderate renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    XIE Di; HOU Yu-qing; HOU Fan-fan; ZHANG Wei-ru; LI Yong; GUO Zhi-gang; GUO Zhi-jian; ZHANG Xun

    2009-01-01

    Background Several studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency. Methods The study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate <60 ml·min-1·1.73 m-2. The major adverse cardiac events were compared for patients with (n=160) and without (n=442) renal insufficiency. Results After the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P=0.001; 29.4% vs 15.8%, P <0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P <0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P=0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio: 1.488, 95% confidence interval: 1.051-2.106, P=0.025) and de novo stenosis (hazard ratio: 5.505, 95% confidence interval: 2.151-14.090, P <0.001 ). Conclusions The late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate <60 ml·min-1·1.73 m2. This might be associated with increased risk of de novo stenosis in this population.

  13. Restricted Crystalloid Fluid Therapy during Orthotopic Liver Transplant Surgery and its Effect on Respiratory and Renal Insufficiency in the Early Post-operative Period: A Randomized Clinical Trial

    OpenAIRE

    Sahmeddini, M. A.; Janatmakan, F.; Khosravi, M. B.; Ghaffaripour, S.; Eghbal, M. H.; Nickeghbalian, S.; Malek-Hosseini, S. A.

    2014-01-01

    Background: Respiratory and renal insufficiencies are common dysfunctions during post-liver transplantation period that increase post-operative mortality and morbidity rates. Intra-operative fluid therapy is an important factor associated with pulmonary and renal insufficiency. Objective: To evaluate the relation between intra-operative fluid therapy and early renal and respiratory insufficiency after liver transplantation. Methods: In this randomized clinical study, 67 adult patients with en...

  14. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

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    Murakami, Ryusuke, E-mail: rywakana@nms.ac.jp; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-10-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.

  15. The predictive role of histopathological findings in renal insufficiency and complete remission in Iranian adults with primary focal segmental glomerulosclerosis

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    Diana Taheri

    2010-01-01

    Full Text Available Objectives: to identify the histopathological findings that may act as possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis (FSGS. Methods: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patient’s identities or outcomes. We divided the patients based on their histopathological findings, and compared the outcomes (renal insufficiency and complete remission among these groups. Results: There were significant differences in the complete remission in subject with and without mesangial hypercellularity (p<0.05, and in patients with and without hyalinosis (p<0.05. According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p<0.05.Also multiple logistic regression analysis strongly suggest the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively. Conclusion: In the studied patients, presence of mesangial hypercellularity and hyalinosis have been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only the presence of mesangial hypercellularity and global scar were found as independent prognostic predictors to lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.

  16. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  17. Clinical effect of trimetazidine on prevention of contrast-induced nephropathy in patients with renal insufficiency

    Science.gov (United States)

    Ye, Ziliang; Lu, Haili; Su, Qiang; Guo, Wenqin; Dai, Weiran; Li, Hongqing; Yang, Huafeng; Li, Lang

    2017-01-01

    Abstract Background: With the continuous development of cardiac interventional medicine, the incidence of contrast-induced nephropathy (CIN) is increasing every year, which is a serious threat to people's physical and mental health. Trimetazidine (TMZ) is a type of anti-ischemic drug developed in recent years, which can significantly reduce the incidence of CIN. At present, a systematic review and meta-analysis was conducted to evaluate the clinical effect of TMZ on prevention of CIN in patients with renal insufficiency. However, the study did not include patients from other countries and speaking different languages. So we conducted this study to update the previous meta-analysis that investigated the effects of TMZ on prevention of CIN in patients with renal insufficiency, and provided some theoretical reference for clinical. Methods: By searching PubMed, Embase, the Cochrane Library, Web of Science, CBM, CNKI, VIP database, and Wang Fang database for randomized controlled trial, which is comparing TMZ versus conventional hydration for prevention of CIN. Two researchers independently screened literature, and then evaluated the quality of literature and extracted the relevant data. Stata 11.0 software was used for statistical analysis. Results: Finally, this updated review showed that 3 studies that were not included in the previous meta-analysis were included in our study (3 articles were published in the Chinese Journal, 1 study for CIN, 1 study for CIN, serum creatinine (Scr), and superoxide dismutase, 1 study for CIN and Scr), and 1 outcome (Scr) reflecting the change of renal function was additionally included in our study. Of the 932 studies, 6 randomized controlled trials met the criteria, including 377 patients in TMZ group and 387 patients in control group. This meta-analysis for all studies showed that TMZ can significantly reduce the incidence of CIN (relative risk 0.27, 95% confidence interval [CI] 0.16, 0.46, P = 0.000), and can decrease the level

  18. Nitrofurantoin safety and effectiveness in treating acute uncomplicated cystitis (AUC) in hospitalized adults with renal insufficiency: antibiotic stewardship implications.

    Science.gov (United States)

    Cunha, B A; Cunha, C B; Lam, B; Giuga, J; Chin, J; Zafonte, V F; Gerson, S

    2017-02-02

    Nitrofurantoin remains a key oral antibiotic stewardship program (ASP) option in the treatment of acute uncomplicated cystitis (AUC) due to multi-drug resistant (MDR) Gram negative bacilli (GNB). However, there have been concerns regarding decreased nitrofurantoin efficacy with renal insufficiency. In our experience over the past three decades, nitrofurantoin has been safe and effective in treating AUC in hospitalized adults with renal insufficiency. Accordingly, we retrospectively reviewed our recent experience treating AUC in hospitalized adults with decreased renal function (CrCl urinary tract infections. Urinary isolated susceptibility testing was done by micro broth dilution (MBD). Treatment duration was 5-7 days. Cure was defined as eradication of the uropathogen and failure was defined as minimal/no decrease in urine colony counts. Of 26 evaluable patients with renal insufficiency (CrCl < 60 ml/min), nitrofurantoin eradicated the uropathogen in 18/26 (69%) of patients, and failed in 8/26 (31%). Of the eight failures, five were due to intrinsically resistant uropathogens, e.g., Proteus sp., and one failure was related to an alkaline urine. Of the treatment failures, only two were due to renal insufficiency, i.e., CrCl < 30 ml/min. Since there are few oral antibiotics available to treat AUC due to MDR GNB uropathogens, these results have important ASP implications. Currently, nitfurantoin is not recommended if CrCl < 60 ml/min. In our experience, used appropriately against susceptible uropathogens, nitrofurantoin was highly effective in nearly all patients with CrCl = 30-60 ml/min., and only failed in two patients due to renal insufficiency (CrCl < 30 ml/ml).

  19. Chronic renal insufficiency among Asian Indians with type 2 diabetes: I. Role of RAAS gene polymorphisms

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    Chandra T Satish

    2006-05-01

    Full Text Available Abstract Background Renal failure in diabetes is mediated by multiple pathways. Experimental and clinical evidences suggest that renin-angiotensin-aldosterone system (RAAS has a crucial role in diabetic kidney disease. A relationship between the RAAS genotypes and chronic renal insufficiency (CRI among type 2 diabetes subjects has therefore been speculated. We investigated the contribution of selected RAAS gene polymorphisms to CRI among type 2 diabetic Asian Indian subjects. Methods Twelve single nucleotide polymorphisms (SNPs from six genes namely-renin (REN, angiotensinogen (ATG, angiotensin converting enzyme I (ACE, angiotensin II type 1 receptor (AT1 and aldosterone synthase (CYP11B2 gene from the RAAS pathway and one from chymase pathway were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP method and tested for their association with diabetic CRI using a case-control approach. Successive cases presenting to study centres with type 2 diabetes of ≥2 years duration and moderate CRI diagnosed by serum creatinine ≥3 mg/dl after exclusion of non-diabetic causes of CRI (n = 196 were compared with diabetes subjects with no evidence of renal disease (n = 225. Logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study pair wise interactions between SNPs of different genes. Results Of the 12 SNPs genotyped, Glu53Stop in AGT and A>T (-777 in AT1 genes, were monomorphic and not included for further analysis. We observed a highly significant association of Met235Thr SNP in angiotensinogen gene with CRI (O.R. 2.68, 95%CI: 2.01–3.57 for Thr allele, O.R. 2.94, 95%CI: 1.88–4.59 for Thr/Thr genotype and O.R. 2.68, 95%CI: 1.97–3.64 for ACC haplotype. A significant allelic and genotypic association of T>C (-344 SNP in aldosterone synthase gene (O.R. 1.57, 95%CI: 1.16–2.14 and O.R. 1.81, 95%CI: 1.21–2.71 respectively, and genotypic association of

  20. Genome-Wide Association of CKD Progression: The Chronic Renal Insufficiency Cohort Study.

    Science.gov (United States)

    Parsa, Afshin; Kanetsky, Peter A; Xiao, Rui; Gupta, Jayanta; Mitra, Nandita; Limou, Sophie; Xie, Dawei; Xu, Huichun; Anderson, Amanda Hyre; Ojo, Akinlolu; Kusek, John W; Lora, Claudia M; Hamm, L Lee; He, Jiang; Sandholm, Niina; Jeff, Janina; Raj, Dominic E; Böger, Carsten A; Bottinger, Erwin; Salimi, Shabnam; Parekh, Rulan S; Adler, Sharon G; Langefeld, Carl D; Bowden, Donald W; Groop, Per-Henrik; Forsblom, Carol; Freedman, Barry I; Lipkowitz, Michael; Fox, Caroline S; Winkler, Cheryl A; Feldman, Harold I

    2017-03-01

    The rate of decline of renal function varies significantly among individuals with CKD. To understand better the contribution of genetics to CKD progression, we performed a genome-wide association study among participants in the Chronic Renal Insufficiency Cohort Study. Our outcome of interest was CKD progression measured as change in eGFR over time among 1331 blacks and 1476 whites with CKD. We stratified all analyses by race and subsequently, diabetes status. Single-nucleotide polymorphisms (SNPs) that surpassed a significance threshold of P<1×10(-6) for association with eGFR slope were selected as candidates for follow-up and secondarily tested for association with proteinuria and time to ESRD. We identified 12 such SNPs among black patients and six such SNPs among white patients. We were able to conduct follow-up analyses of three candidate SNPs in similar (replication) cohorts and eight candidate SNPs in phenotype-related (validation) cohorts. Among blacks without diabetes, rs653747 in LINC00923 replicated in the African American Study of Kidney Disease and Hypertension cohort (discovery P=5.42×10(-7); replication P=0.039; combined P=7.42×10(-9)). This SNP also associated with ESRD (hazard ratio, 2.0 (95% confidence interval, 1.5 to 2.7); P=4.90×10(-6)). Similarly, rs931891 in LINC00923 associated with eGFR decline (P=1.44×10(-4)) in white patients without diabetes. In summary, SNPs in LINC00923, an RNA gene expressed in the kidney, significantly associated with CKD progression in individuals with nondiabetic CKD. However, the lack of equivalent cohorts hampered replication for most discovery loci. Further replication of our findings in comparable study populations is warranted.

  1. The influence of Helicobacter pylori infection on the occurrence of gastroesophageal reflux in patients with renal insufficiency

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    Stolić Radojica

    2007-01-01

    Full Text Available Introduction/Aim. Gastric acid is a key factor in the pathophysiology of gastroesophageal reflux disease. A plausible mechanism by which the Helicobacter pylori infection might protect against reflux disease is by its propensity to produce atrophic gastritis. The aim of the study was to establish the influence of Helicobacter pylori infection on the occurrence of gastroesophageal reflux in patients with different stages of renal insufficiency. Methods. The examination was organized as a prospective, clinical study and involved 68 patients − 33 patients with preterminal stage of renal failure and 35 patients with terminal renal insufficiency. Due to dyspeptic difficulties, in all the patients there was preformed upper esophagogastroscopy and Helicobacter pylori infection was found by ureasa test. Results. The patients with preterminal renal insufficiency were significantly younger than patients with terminal renal failure (53.4±11.1 vs. 65.4±12.3 years; p = 0.014. There was found a statistically significant difference between the groups in Helicobacter pylori infection (p = 0.03, hiatal hernia (p = 0.008, gastroesophageal reflux disease (p = 0.007, and duodenal ulcer (p = 0.002. Using the multiple non-parametric correlative analysis there was confirmed a negative correlation between Helicobacter pylori infection and gastro-esophageal reflux disease (Kendal τB = -0.523; p = 0.003 and hiatal hernia (Kendal τB = 0.403; p = 0.021, while there was found a positive correlation between gastro-esophageal reflux disease and hiatal hernia (Kendal τB = 0.350; p = 0.044. Conclusion. Helicobacter pylori infection is a significant protective parameter of the incidence of gastro-esophageal reflux disease in patients with both pre-terminal and terminal renal insufficiency.

  2. Síndrome pulmón-riñón Pulmonary-renal syndrome

    OpenAIRE

    Jorge A. Risso; Octavio Mazzocchi; Jorge De All; César A. Gnocchi

    2009-01-01

    El síndrome pulmón-riñón se define como una combinación de hemorragia alveolar difusa y glomerulonefritis. La coexistencia de estas dos afecciones clínicas se produce por enfermedades con distintos mecanismos patogénicos. Las vasculitis sistémicas primarias y el síndrome de Goodpasture son las etiologías más frecuentes. El lupus eritematoso sistémico, otras colagenopatías, las vasculitis con anticuerpos anticitoplasma de los neutrófilos negativos y las secundarias a drogas son causas mucho me...

  3. Current evidence on treatment of patients with chronic systolic heart failure and renal insufficiency: practical considerations from published data.

    Science.gov (United States)

    Damman, Kevin; Tang, W H Wilson; Felker, G Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J V

    2014-03-11

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients with (severe) renal dysfunction. The benefit of these evidence-based therapies in this high-risk patient group is largely unknown. This paper reviews data from randomized clinical trials in systolic heart failure and the interactions between baseline renal dysfunction and the effect of randomized treatment. It highlights that most evidence-based therapies show consistent outcome benefit in patients with moderate renal insufficiency (stage 3 CKD), whereas there are very scarce data on patients with severe (stage 4 to 5 CKD) renal insufficiency. If any, the outcome benefit might be even greater in stage 3 CKD compared with those with relatively preserved renal function. However, prescription of therapies should be individualized with consideration of possible harm and benefit, especially in those with stage 4 to 5 CKD where limited data are available.

  4. Efficacy and Toxicity of Mammalian Target Rapamycin Inhibitors in Patients with Metastatic Renal Cell Carcinoma with Renal Insufficiency: The Korean Cancer Study Group GU 14-08

    Science.gov (United States)

    Kim, Ki Hyang; Kim, Joo Hoon; Lee, Ji Young; Kim, Hyo Song; Heo, Su Jin; Kim, Ji Hyung; Kim, Ho Young; Rha, Sun Young

    2016-01-01

    Purpose We evaluated the efficacy and toxicity of mammalian target rapamycin inhibitors in Korean patients with metastatic renal cell carcinoma (mRCC) with chronic renal insufficiency not requiring dialysis. Materials and Methods Korean patients with mRCC and chronic renal insufficiency not requiring dialysis treated with everolimus or temsirolimus between January 2008 and December 2014 were included. Patient characteristics, clinical outcomes, and toxicities were evaluated. Overall survival (OS) and progression-free survival (PFS) durations were evaluated according to the degree of renal impairment. Results Eighteen patients were considered eligible for the study (median age, 59 years). The median glomerular filtration rate was 51.5 mL/min/1.73 m2. The best response was partial response in six patients and stable disease in 11 patients. The median PFS and OS durations were 8 months (95% confidence interval [CI], 0 to 20.4) and 32 months (95% CI, 27.5 to 36.5), respectively. The most common non-hematologic and grade 3/4 adverse events included stomatitis, fatigue, flu-like symptoms, and anorexia as well as elevated creatinine level. Conclusion Mammalian target rapamycin inhibitors were efficacious and did not increase toxicity in Korean patients with mRCC and chronic renal insufficiency not requiring dialysis. PMID:26875195

  5. NSS for an RCC in a patient with renal insufficiency after heart transplant because of right ventricular tumor.

    Science.gov (United States)

    Prokopowicz, Grzegorz; Zyczkowski, Marcin; Nowakowski, Krzysztof; Bryniarski, Piotr; Paradysz, Andrzej

    2013-01-01

    The effect of the immunosuppressive therapy on the development of neoplasms has become the object of an ever increasing interest for clinicians all over the world. The literature on neoplasms development in the course of therapy following transplants has confirmed a considerable increase in the incidence of neoplasms of the skin and lymph nodes. Organ neoplasms developing in patients after transplants are characterized by increased progression, poor cellular diversification and a more unfavorable prognosis than in the general population The aim of the study is to present the case of a nephron-sparing surgery of a renal tumor (NSS) without any intraoperative ischaemia in a 55-year-old female patient with an orthotopic heart transplant and renal insufficiency following a prolonged immune suppression. It is estimated that the patients at the highest risk of neoplasm development are those in the first months after transplant, especially heart transplant. They require maximum doses of immunosuppressive drugs. In the case of patients with initial renal insufficiency the duration of ischaemia of the organ operated on should be minimized, and if possible, surgery should be conducted without clamping the renal pedicle. The surgical treatment of RCC (renal cell carcinoma) in transplant patients does not require any reduction in the amount of the immunosuppressive drugs.

  6. Towards a rational screening strategy for albuminuria: results from the unreferred renal insufficiency trial.

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    Arjan van der Tol

    Full Text Available BACKGROUND: There remains debate about the screening strategies for albuminuria. This study evaluated whether a screening strategy in an apparently healthy population based on basic clinical and biochemical parameters could be more effective than a strategy where screening for albuminuria is performed unselectively. METHODOLOGY/PRINCIPAL FINDINGS: The Unreferred Renal Insufficiency (URI Study is a cross-sectional study on the prevalence of metabolic risk factors in Belgian workers, volunteering to be screened during a routine yearly occupational check-up. Subjects (n = 295 with treated hypertension, known diabetes, treated dyslipidaemia, cardiovascular and renal disease were excluded. Among 1,191 apparently healthy subjects, 23% had unknown hypertension, 13% had impaired glucose tolerance, 15.4% had normoalbuminuria, 4.2% had microalbuminuria and 0.4% had macroalbuminuria. Subjects with resting heart rate ≥85 bpm, plasma glucose ≥5.6 mmol/L and blood pressure ≥140/90 mmHg were associated with albuminuria of any degree. A strategy where only subjects with at least one of these risk factors (n = 431 were screened for albuminuria, would identify all subjects with macroalbuminuria (5/5, 64% of those with microalbuminuria (32/50, and less than half of those with normoalbuminuria (81/183. An alternative strategy whereby subjects were first screened for presence of albuminuria, and additional cardiovascular risk factors were only measured in subjects positive for albuminuria (n = 238, would identify only 27% (118/431 of the subjects with additional and potentially modifiable cardiovascular risk factors. On the other hand, half of the subjects in this study with albuminuria (120/238, of which 102 had normoalbuminuria, had no additional cardiovascular risk factor at all. CONCLUSIONS: Screening an apparently healthy population directly for albuminuria will result in a high percentage of false positives, mostly measured in the normal

  7. Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort

    Science.gov (United States)

    Isakova, Tamara; Anderson, Cheryl A. M.; Leonard, Mary B.; Xie, Dawei; Gutiérrez, Orlando M.; Rosen, Leigh K.; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P.; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R.; He, Jiang; Feldman, Harold I.; Wolf, Myles

    2011-01-01

    Background. Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. Methods. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Results. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P < 0.001), higher adjusted PTH [67.9, 95% confidence interval (CI) 65.2–70.7 pg/mL, versus 52.8, 95% CI 51.1–54.6 pg/mL, P < 0.001] and greater odds of secondary hyperparathyroidism (odds ratio 2.1; 95% CI 1.7–2.6). Thiazide monotherapy was associated with lower calciuria (25.5 versus 39.6 mg/day; P < 0.001) but only modestly lower PTH levels (50.0, 95% CI 47.8–52.3, versus 520.8, 95% CI 51.1–54.6 pg/mL, P = 0.04) compared with no diuretics. However, coadministration of thiazide and loop diuretics was associated with blunted urinary calcium (30.3 versus 55.0 mg/day; P <0.001) and odds of hyperparathyroidism (odds ratio 1.3 versus 2.1; P for interaction = 0.05) compared with loop diuretics alone. Conclusions. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered

  8. Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Anderson, Amanda Hyre; Yang, Wei; Hsu, Chi-yuan; Joffe, Marshall M.; Leonard, Mary B.; Xie, Dawei; Chen, Jing; Greene, Tom; Jaar, Bernard G.; Kao, Patricia; Kusek, John W.; Landis, J. Richard; Lash, James P.; Townsend, Raymond R.; Weir, Matthew R.; Feldman, Harold I.

    2012-01-01

    Background Glomerular filtration rate (GFR) is considered the best measure of kidney function, but repeated assessment is not feasible in most research studies. Study Design Cross-sectional study of 1,433 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study (i.e., the GFR subcohort) to derive an internal GFR estimating equation using a split sample approach. Setting & Participants Adults from 7 US metropolitan areas with mild to moderate chronic kidney disease; 48% had diabetes and 37% were black. Index Test CRIC GFR estimating equation Reference Test or Outcome Urinary 125I-iothalamate clearance testing (measured GFR) Other Measurements Laboratory measures including serum creatinine and cystatin C, and anthropometrics Results In the validation dataset, the model that included serum creatinine, serum cystatin C, age, gender, and race was the most parsimonious and similarly predictive of mGFR compared to a model additionally including bioelectrical impedance analysis phase angle, CRIC clinical center, and 24-hour urinary creatinine excretion. Specifically, the root mean square errors for the separate model were 0.207 vs. 0.202, respectively. The performance of the CRIC GFR estimating equation was most accurate among the subgroups of younger participants, men, non-blacks, non-Hispanics, those without diabetes, those with body mass index <30 kg/m2, those with higher 24-hour urine creatinine excretion, those with lower levels of high-sensitivity C-reactive protein, and those with higher mGFR. Limitations Urinary clearance of 125I-iothalamate is an imperfect measure of true GFR; cystatin C is not standardized to certified reference material; lack of external validation; small sample sizes limit analyses of subgroup-specific predictors. Conclusions The CRIC GFR estimating equation predicts measured GFR accurately in the CRIC cohort using serum creatinine and cystatin C, age, gender, and race. Its performance was best among younger and healthier

  9. Impaired Renal Function

    Directory of Open Access Journals (Sweden)

    Kentaro Ide

    2011-01-01

    Full Text Available Patients requiring liver transplantation (LT frequently experience renal insufficiency (RI, which affects their survival. Although calcineurin inhibitor-sparing immunosuppressive regimens (CSRs are well known to prevent RI, the immune state in recipients receiving CSR remains to be intensively investigated. Among 60 cases of living-donor LT at our institute, 68% of the patients had none to mild RI (non-RI group and 32% of the patients had moderate to severe RI (RI group. The RI group received a CSR comprising reduced dose of tacrolimus, methylprednisolone, and mycophenolate mofetil, while the non-RI group received a regimen comprising conventional dose of tacrolimus and methylprednisolone. One year after LT, the mean estimated glomerular filtration rate (eGFR in the RI group had significantly improved, although it was still lower than that of the non-RI group. Serial mixed lymphocyte reaction assays revealed that antidonor T-cell responses were adequately suppressed in both groups. Thus, we provide evidence that CSR leads to improvement of eGFR after LT in patients with RI, while maintaining an appropriate immunosuppressive state.

  10. Associations of Conventional Echocardiographic Measures with Incident Heart Failure and Mortality: The Chronic Renal Insufficiency Cohort.

    Science.gov (United States)

    Dubin, Ruth F; Deo, Rajat; Bansal, Nisha; Anderson, Amanda H; Yang, Peter; Go, Alan S; Keane, Martin; Townsend, Ray; Porter, Anna; Budoff, Matthew; Malik, Shaista; He, Jiang; Rahman, Mahboob; Wright, Jackson; Cappola, Thomas; Kallem, Radhakrishna; Roy, Jason; Sha, Daohang; Shlipak, Michael G

    2017-01-06

    Heart failure is the most frequent cardiac complication of CKD. Left ventricular hypertrophy is common and develops early in CKD, but studies have not adequately evaluated the association of left ventricular mass index with heart failure incidence among men and women with CKD. We evaluated echocardiograms of 2567 participants without self-reported heart failure enrolled in the Chronic Renal Insufficiency Cohort Study. Two-dimensional echocardiograms were performed at the year 1 study visit and interpreted at a central core laboratory. Left ventricular mass index was calculated using the linear method, indexed to height(2.7), and analyzed using sex-specific quartiles. The primary outcomes of incident heart failure and all-cause mortality were adjudicated over a median of 6.6 (interquartile range, 5.7-7.6) years. Among 2567 participants, 45% were women, and 54% were nonwhite race; mean (SD) age was 59±11 years old, and mean eGFR was 44±17 ml/min per 1.73 m(2). During a median follow-up period of 6.6 years, 262 participants developed heart failure, and 470 participants died. Compared with participants in the first quartile of left ventricular mass index, those in the highest quartile had higher rates of incident heart failure (hazard ratio, 3.96; 95% confidence interval, 1.96 to 8.02) and mortality (hazard ratio, 1.86; 95% confidence interval, 1.22 to 2.85), even after adjustment for B-type natriuretic peptide, troponin T, mineral metabolism markers, and other cardiovascular disease risk factors. Those in the lowest quartile of ejection fraction had higher rates of incident heart failure (hazard ratio, 3.01; 95% confidence interval, 1.94 to 4.67) but similar mortality rates (hazard ratio, 1.18; 95% confidence interval, 0.89 to 1.57) compared with those in the highest quartile. Diastolic dysfunction was not significantly associated with heart failure or death. Among persons with CKD and without history of cardiovascular disease, left ventricular mass index is

  11. Electrocardiogram Feature for Chronic Renal Insufficiency%慢性肾功能不全心电图分析

    Institute of Scientific and Technical Information of China (English)

    付新

    2015-01-01

    目的:探讨慢性肾功能不全患者心电图变化特点。方法回顾性总结186例慢性肾功能不全患者心电图(观察组),并选择同期100例肾功能正常患者(对照组)。结果观察组186例患者,其中144例(77.42%)心电图异常,主要表现为心律失常、ST-T变化及左心室肥大等;对照组仅36例(36.0%)心电图异常。结论慢性肾功能不全患者的异常心电图发生率较高,因此应提高对心电图的重视力度,积极进行防治措施,从而改善患者生存质量。%Objective To study the characteristic of electrocardiogram(ecg)changes in patients with chronic renal insufficiency. Methods We summaried the ecg data in 186 cases of chronic renal insufficiency patients(observation group)retrospectively,and selected the same period 100 patients with normal renal function(control group). Results 144 cases(77.42%)in the observation group was abnormal ecg,the main clinical was arrhythmia,ST-t change and left ventricular hypertrophy,etc,only 36 cases(36.0%)in the control group was abnormal ecg. Conclusion The incidence of abnormal ecg in patients with chronic renal insufficiency is higher,we should increase efforts to the attention of the ecg,positive for prevention and control measures,to improve the patients quality of life.

  12. Efficacious response with low-dose indapamide therapy in the treatment of type II diabetic patients with normal renal function or moderate renal insufficiency and moderate hypertension.

    Science.gov (United States)

    Madkour, Hosameldin; Ali, Kareim; Nosrati, Saeid; Massry, Shaul G

    2002-01-01

    We examined the efficacy of low daily dose (1.25 mg/day) of indapamide in the treatment of high blood pressure in patients with diabetes mellitus with normal renal function and those with moderate renal insufficiency (serum creatinine <1.5 mg/dl). The study was an open label one of four months duration. Twenty-eight patients were enrolled in the study and only 15 completed it. Within 2 weeks of therapy, systolic blood pressure fell from 173 +/- 4.5 to 144 +/- 2.0 mm Hg and diastolic blood pressure from 96 +/- 2.1 to 80 +/- 1.8 mm Hg (p < 0.01) and blood pressure remained at these levels throughout the study. The results show that low dose indapamide is effective in the treatment of moderate hypertension in patients with diabetes mellitus who have normal renal function or moderate renal insufficiency. Therefore, this dose of 1.25 mg/day is recommended for the treatment of such patients.

  13. Indapamide is superior to thiazide in the preservation of renal function in patients with renal insufficiency and systemic hypertension.

    Science.gov (United States)

    Madkour, H; Gadallah, M; Riveline, B; Plante, G E; Massry, S G

    1996-02-22

    The long-term effects of indapamide or hydrochlorothiazide on blood presssure and renal function were examined in patents with impaired renal function and moderate hypertension. Both drugs controlled hypertension and blood pressure remained normal during the 2 years of the study. Despite this comparable control of hypertension, indapamide therapy was associated with a 28.5 +/- 4.4% increase in creatinine clearance, whereas treatment with hydrochlorothiazide was associated with a 17.4 +/- 3.0% decrease in creatinine clearance. The results of the study indicate that indapamide is superior to hydrochlorothiazide in the treatment of patients with impaired renal function and moderate hypertension.

  14. Prevalence of anemia and renal insufficiency in non-hospitalized patients with heart failure.

    Science.gov (United States)

    Reis, Francisco José Farias Borges dos; Fernandes, André Maurício Souza; Bitencourt, Almir Galvão Vieira; Neves, Flávia Branco Cerqueira Serra; Kuwano, André Yoichi; França, Victor Hugo Pinheiro; Macedo, Cristiano Ricardo Bastos de; Cruz, Cristiano Gonçalves da; Sahade, Viviane; Aras Júnior, Roque

    2009-09-01

    Heart Failure (HF) is a common disease with a high rate of mortality. Anemia and renal failure (RF) are often found in patients with HF associated with higher severity of the heart disease and a worse prognosis. To evaluate the prevalence of anemia and RF, as well as the association between these two conditions, in non-hospitalized patients with HF. Patients treated at the HF Outpatient Clinic of a university hospital were followed from July 2003 to November 2006. Anemia was defined as hemoglobin levels Renal function was assessed by the glomerular filtration rate (GFR), calculated by the simplified formula of the MDRD (Modification of Diet in Renal Disease) study. Of the 345 patients included in this study, 26.4% (n = 91) had anemia and 29.6% had moderate to severe renal failure (GFR anemia and a higher prevalence of renal failure was statistically significant (41.8% vs. 25.2%; p = 0.005). The patients at functional class III and IV presented a higher incidence of anemia (39.0% vs. 19.4%; p renal failure (38.2% vs. 24.8%; p = 0.007). No association was observed between anemia or renal failure and history of hypertension, diabetes, systolic function or etiology of HF. The prevalence of anemia and renal failure was high in this population and was associated with the severity of the HF (functional classes III and IV).

  15. An examination on the correction of attenuation for calculating the renal RI accumulation

    Energy Technology Data Exchange (ETDEWEB)

    Onoue, Koichi; Tachibana, Keizo; Maeda, Yoshihiro; Yanoo, Sanae; Morishita, Etsuko; Kawanaka, Masahiro; Kashiwagi, Toru; Fukuchi, Minoru [Hyogo Coll. of Medicine, Nishinomiya (Japan). Hospital

    1999-10-01

    An examination was made on the attenuation coefficients for calculation of true renal accumulation rate together with the precision of measurement of depth in the kidney. Kidney phantom for attenuation coefficients was a 20 x 20 cm cube where water was filled and radioactivity source of {sup 99m}Tc was placed at various depths. Radioactivity was measured by four kinds of scinti-camera with the collimator LEGP and LEHR. The phantom for radioactivity accumulation in the kidney was a 10 x 5 x 1, 3 or 5 cm box where {sup 99m}Tc solution of the standard 30 MBq was filled, and subjected to radioactivity measurement from various angles. Phantom radioactivity was found corrected by the effective attenuation coefficient, 0.131 cm, within the range of 98-114% of the standard counts. The precision of measurement of the depth was examined in sideways scintigrams obtained in clinical practice and was found to have the deviation of 1.1 cm as the mean of maximum ones and the variation coefficient of 7.1%. Measured depth was found to be well correlated with estimated ones by the method of Tonnesen or Ito which had the maximum deviation of 5.4 or 3.5 cm, respectively. (K.H.)

  16. CLINICAL PROFILE OF NON-ALBUMINURIC RENAL INSUFFICIENCY IN TYPE 2 DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    P. Sathya Murthy

    2016-07-01

    Full Text Available INTRODUCTION Diabetes mellitus is one of the most prevalent metabolic diseases which is characterised by elevated blood sugar levels. Type 2 diabetes mellitus constitutes about 90 percent of this group. Untreated DM leads to many complications which are traditionally classified as acute and chronic. The microvascular complications include retinopathy, nephropathy and peripheral neuropathy. Diabetic nephropathy is the most common cause for dialysis and end-stage renal failure across the world. Diabetic nephropathy usually starts with microalbuminuria (UAE 30-300 mg/dL followed by macroalbuminuria (UAE > 300 mg/dL and eventually there is progressive loss of renal function by tissue scarring leading on to end-stage renal disease. However, in type 2 DM, there can be a group of patients who can have impaired renal function without albuminuria (UAE<30 mg/ day. This is being called as “non-albuminuric renal failure”. Reduced GFR in long duration diabetic patients with normal urine albumin excretion have been reported in increasing frequency. There are very few Indian studies which have been done on this group of type 2 diabetic patients. Hence, this study is aimed to evaluate the clinical profile of non-albuminuric renal insufficiency in type 2 diabetes mellitus. AIM To study the clinical profile of non-albuminuric renal insufficiency in type 2 DM. MATERIALS AND METHODS The study population included 97 patients with non-albuminuric (urine microalbumin less than 30 mg/day, renal insufficiency (GFR less than 60 mL/min. as per Cockcroft–Gault formula and are diabetic (type 2 admitted in the Department of General Medicine and Nephrology. Patients with comorbidities other than diabetes which can cause renal insufficiency were excluded from the study. A detailed history was taken and clinical assessment was done for all patients. All patients underwent a panel of tests which included complete blood count, blood urea nitrogen, serum creatinine

  17. [The application of artificial protein premixes for nutritive support of patients with chronic renal insufficiency, being treated by perinateal dialysis].

    Science.gov (United States)

    Pichugina, I S; Vetchinnikova, O N; Vereshchagina, V M; Gapparov, M M; Vatazin, A V

    2008-01-01

    As a result of a survey of 56 patients with chronic renal insufficiency, who undergone hemodialysis, it was established, that clinical condition of patients, biochemical and hematological blood indices as well as results of anthropometric research improve upon application of artificial balanced high-protein premixes -"Nutrinil" and "Nutrien-Nefro". Irrespective of way of administration - introperitoneal ("Nutrinil" solution) or enteral ("Nutrien-Nefro" mixture) protein-energetic insufficiency diminishes or totally disappears, body weight, fat and muscle content of the body weight, as well as indices of whole protein, albumine, lymphocytes, haemoglobin, pH approache the norm. Intraperitoneal way of administration of artificial protein premixes increase patients adherence to this procedure, though enteral way of their administration is more preferable from economic point of view.

  18. Comparison between CT Colonography and Double-Contrast Barium Enema for Colonic Evaluation in Patients with Renal Insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Sun Young; Park, Seong Ho; Lee, Seung Soo; Lee, Ju Hee; Kim, Ah Young; Park, Su Ki; Han, Duck Jong; Ha, Hyun Kwon [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency. Two sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean {+-} SD in age, 51 {+-} 6.4 years) and CTC (n = 176; 50 {+-} 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of {>=} 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups. Both the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p 0.046). Electrolyte changes were similar in the two groups. In patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.

  19. Distribution of Arsenic, Manganese, and Selenium in the Human Brain in Chronic Renal Insufficiency, Parkinsons Disease and Amyotrophic Lateral Sclerosis

    DEFF Research Database (Denmark)

    Larsen, N. A.; Pakkenberg, H.; Damsgaard, Else;

    1981-01-01

    The concentrations of arsenic, manganese and selenium/g wet tissue weight were determined in samples from 24 areas of the human brain from 3 patients with chronic renal insufficiency, 2 with Parkinson's disease and 1 with amyotrophic lateral sclerosis. The concentrations of the 3 elements were...... determined for each sample by neutron activation analysis with radiochemical separation. Overall arsenic concentrations were about 2.5 times higher in patients with chronic renal failure than in controls, and lower than normal in the patients with Parkinson's disease and amyotrophic lateral sclerosis....... There were no obvious differences in the overall concentrations of manganese and selenium from one group to another. Even multivariate data analysis by the SIMCA method failed to reveal any significant difference in the distribution pattern of manganese and selenium in Parkinson's disease compared to normal...

  20. Proteinuria, but Not eGFR, Predicts Stroke Risk in Chronic Kidney Disease: Chronic Renal Insufficiency Cohort Study.

    Science.gov (United States)

    Sandsmark, Danielle K; Messé, Steven R; Zhang, Xiaoming; Roy, Jason; Nessel, Lisa; Lee Hamm, Lotuce; He, Jiang; Horwitz, Edward J; Jaar, Bernard G; Kallem, Radhakrishna R; Kusek, John W; Mohler, Emile R; Porter, Anna; Seliger, Stephen L; Sozio, Stephen M; Townsend, Raymond R; Feldman, Harold I; Kasner, Scott E

    2015-08-01

    Chronic kidney disease is associated with an increased risk of cardiovascular events. However, the impact of chronic kidney disease on cerebrovascular disease is less well understood. We hypothesized that renal function severity would be predictive of stroke risk, independent of other vascular risk factors. The study population included 3939 subjects enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study, a prospective observational cohort. Stroke events were reported by participants and adjudicated by 2 vascular neurologists. Cox proportional hazard models were used to compare measures of baseline renal function with stroke events. Multivariable analysis was performed to adjust for key covariates. In 3939 subjects, 143 new stroke events (0.62 events per 100 person-years) occurred over a mean follow-up of 6.4 years. Stroke risk was increased in subjects who had worse baseline measurements of renal function (estimated glomerular filtration rate and total proteinuria or albuminuria). When adjusted for variables known to influence stroke risk, total proteinuria or albuminuria, but not estimated glomerular filtration rate, were associated with an increased risk of stroke. Treatment with blockers of the renin-angiotensin system did not decrease stroke risk in individuals with albuminuria. Proteinuria and albuminuria are better predictors of stroke risk in patients with chronic kidney disease than estimated glomerular filtration rate. The impact of therapies targeting proteinuria/albuminuria in individuals with chronic kidney disease on stroke prevention warrants further investigation. © 2015 American Heart Association, Inc.

  1. Direct magnification technique of radiographs of the hand in children with chronic renal insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W.; Balzar, E.

    1984-04-01

    The characteristic changes of renal osteopathy in the hand are shown by the X-rays of seven children with end stage renal disease using the direct magnification technique. All children had pathologic conditions in the hands. Most frequently tunnelation, spiculae in the phalanges and metaphyseal translucent bands in the forearm were seen. Less constantly acroosteolyses and generalized osteoporosis could be observed. The X-rays of the hands using the direct magnification technique with rare earth film-screen system and a microfocus X-ray tube are sufficient to determine renal osteopathy. If clinical symptoms are present, X-rays of other parts of the skeleton are necessary. By using the above mentioned radiologic technique the radiographic diagnostic effort could be minimized.

  2. Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Anne-Kathrin Tausche

    2011-01-01

    Full Text Available The prevalence of gout is increasing with increased life expectancy. Approximately half of the patients with gout have some degree of renal impairment. If both conditions persistently coexist, and in severe tophaceous gout, in particular, treatment has been difficult. We here report on the case of an 87-year-old woman, who had been suffering from recurrent gouty arthritis over 4 years. Monthly polyarthritis attacks were accompanied by subcutaneous tophi. Serum uric acid levels were constantly above 600 μmol/L (10 mg/dL. Allopurinol was no option because of intolerance, while benzbromarone was ineffective because of renal impairment. Therefore, the novel xanthin oxidase inhibitor febuxostat was started, achieving rapid control of serum urate levels (<360 μmol/L. After initial worsening of inflammation in the first weeks, gouty attacks stopped and all tophi resolved within the following 10 months. Renal function remained stable.

  3. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  4. Clorazepate dipotassium and diazepam in renal insufficiency: serum concentrations and protein binding of diazepam and desmethyldiazepam.

    Science.gov (United States)

    Ochs, H R; Rauh, H W; Greenblatt, D J; Kaschell, H J

    1984-01-01

    5 patients with chronic renal failure on maintenance hemodialysis and 5 healthy matched controls received single 20-mg intravenous doses of clorazepate dipotassium. Clearance of pharmacologically active unbound desmethyldiazepam was reduced in renal failure patients as opposed to controls, and free fraction in serum was greater. Since desmethyldiazepam distribution was reduced in renal patients, elimination half-life was actually shorter than in controls (36 vs. 57 h). In 10 dialysis patients receiving chronic diazepam treatment (5-15 mg/day), steady-state concentrations of diazepam (56 ng/ml) and desmethyldiazepam (77 ng/ml) were significantly lower than in age- and weight-matched controls receiving similar doses (189 and 216 ng/ml, respectively). However after correction for the higher free fractions of both compounds in renal patients as opposed to controls, steady-state concentrations of unbound drug were found to be similar between groups. Interpretation of kinetic variables and steady-state serum concentrations of extensively protein-bound drugs requires consideration of alterations in protein binding that may occur in disease states.

  5. Cardiovascular disease and renal insufficiency:special considerations with cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    Colin Lenihan; Donal Reddan

    2005-01-01

    Cardiovascular disease is an important cause of mortality in the chronic kidney disease (CKD) population. This review discusses cardiac surgery in the CKD population and considers ostoperative acute renal failure (ARF). CKD patients have worse outcomes following coronary artery bypass grafting (CABG) and cardiac valvular surgery than the general population. However,surgical revascularization is an effective treatment for coronary artery disease (CAD) in this population and may be associated with improved survival over percutaneous intervention (PCI) in advanced CKD. Cardiac surgery in the CKD population requires careful perioperative planning and management. Acute renal failure (ARF) is a serious complication following cardiac surgery, occurring in 1 to 8% of cases. Management of postoperative ARF is largely supportive and emphasis is placed on preoperative risk stratification and prevention.

  6. Fournier's gangrene (necrotising fasciitis) complicated by renal and respiratory insufficiency: a case report.

    Science.gov (United States)

    Frisman, E; Rácz, O; Beck, J; Firment, J; Bodnárová, L

    2016-01-01

    A case report of a 68-year-old male obese diabetic patient with an abscess of left femoral region, and diffuse inflammation of abdominal wall and genital region developing sepsis, respiratory and renal failure. At admission in the regional hospital a diagnosis of polymicrobial necrotising fasciitis with suspected sepsis was declared. The patient was transferred to the special intensive care unit (SICU) of Burns and reconstructive surgery at the Kosice-Saca. The patient was treated surgically, with hyperbaric oxygen and pharmacologically to control his diabetes. The main aetiological agent of the condition was identified as Stenotrophomonas maltophilia. In addition to respiratory and metabolic acidosis and gastric bleeding occurred. Due to acute renal failure (day 38) the patient was transferred to clinic of anaesthesiology and the intensive care medicine at the University Hospital in Kosice. The patient was treated by continuous veno-venous haemodialysis, mechanical ventilation and nasogastric nutritional support. On day 48 the conscious sub-febrile patient with healed wounds was transferred back to the regional hospital with ventilation support and continuous renal replacement therapy. His diabetes was uncontrolled, and only kidney parameters remained pathological. The survival of this patient with an extremely poor prognosis was achieved through prompt transfer to a specialised centre, early identification of the aetiological agent and immediate appropriate antibiotic treatment as a result of good cooperation between surgeons and laboratory specialists.

  7. Serum aldosterone and death, end-stage renal disease, and cardiovascular events in blacks and whites: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

    Science.gov (United States)

    Deo, Rajat; Yang, Wei; Khan, Abigail M; Bansal, Nisha; Zhang, Xiaoming; Leonard, Mary B; Keane, Martin G; Soliman, Elsayed Z; Steigerwalt, Susan; Townsend, Raymond R; Shlipak, Michael G; Feldman, Harold I

    2014-07-01

    Prior studies have demonstrated that elevated aldosterone concentrations are an independent risk factor for death in patients with cardiovascular disease. Limited studies, however, have evaluated systematically the association between serum aldosterone and adverse events in the setting of chronic kidney disease. We investigated the association between serum aldosterone and death and end-stage renal disease in 3866 participants from the Chronic Renal Insufficiency Cohort. We also evaluated the association between aldosterone and incident congestive heart failure and atherosclerotic events in participants without baseline cardiovascular disease. Cox proportional hazards models were used to evaluate independent associations between elevated aldosterone concentrations and each outcome. Interactions were hypothesized and explored between aldosterone and sex, race, and the use of loop diuretics and renin-angiotensin-aldosterone system inhibitors. During a median follow-up period of 5.4 years, 587 participants died, 743 developed end-stage renal disease, 187 developed congestive heart failure, and 177 experienced an atherosclerotic event. Aldosterone concentrations (per SD of the log-transformed aldosterone) were not an independent risk factor for death (adjusted hazard ratio, 1.00; 95% confidence interval, 0.93-1.12), end-stage renal disease (adjusted hazard ratio, 1.07; 95% confidence interval, 0.99-1.17), or atherosclerotic events (adjusted hazard ratio, 1.04; 95% confidence interval, 0.85-1.18). Aldosterone was associated with congestive heart failure (adjusted hazard ratio, 1.21; 95% confidence interval, 1.02-1.35). Among participants with chronic kidney disease, higher aldosterone concentrations were independently associated with the development of congestive heart failure but not for death, end-stage renal disease, or atherosclerotic events. Further studies should evaluate whether mineralocorticoid receptor antagonists may reduce adverse events in individuals with

  8. [20 years' experience in the treatment of children with terminal renal insufficiency in Yugoslavia].

    Science.gov (United States)

    Peco-Antić, A; Popović-Rolović, M; Jovanović, O; Marsenić, O; Babić, D; Kostić, M; Kruscić, O; Culić, D; Trajković, D

    2000-01-01

    The first specialized haemodialysis (HD) paediatric centre in former Yugoslavia was established at the University Children's Hospital in Belgrade in January 1980. A total of 194 children (F: 98, M: 96), aged less than 19 years (10.12 +/- 4.23), were treated for renal replacement therapy (RRT) over 20 years. Average annual incidence rate was 1.59 per million of child population (pmcp) aged less than 19 years for the period 1980-1990 (former Yugoslavia) and 2.85 pmcp aged less than 19 years for the period 1990-2000 (present Yugoslavia). Reflux nephropathy was the most frequent underlying disease and accounted for 37.06% of total cases, while other primary renal diseases were: glomerulonephritis (GN) 17.26%, cystic/hereditary familial nephropathy 12.69%, congenital disease 11.68%, interstitial nephritis 5.58%, non-recovered tubular necrosis 3.55%, secondary GN 1.52% and 10.66% remained with doubtful diagnosis. HD was the first RRT in 84.02%, peritoneal dialysis (PD) in 14.43% and pre-emptive transplantation in 1.55% of all patients. A total of 53 patients (27.3% of total terminal renal failure (TRF) patients) received 56 kidney transplants (58.93% live related, 37.50% cadaveric, 3.57% live-non related). Actual survival in RRT was 64.53% 5 in years; 51.68% in 10 and 48.23% in 15 years. Patient survival in HD was significantly better over the last ten-year period than in the first ten-year period (35.88% vs. 75.75%; p Yugoslavia.

  9. [Aorto-caval fistula as a results of abdominal aortic aneurysm rupture imitating acute renal insufficiency].

    Science.gov (United States)

    Zaniewski, Maciej; Ludyga, Tomasz; Kazibudzki, Marek; Kowalewska-Twardela, Teresa

    2002-01-01

    Aorto-caval fistula (ACF) is a rare complication of abdominal aortic aneurysm. It occurs in 1-6% of cases. The classic diagnostic signs of an ACF (pulsatile abdominal mass with bruit and right ventricular failure) are present only in a half of the patients. The most common diagnostic imaging procedures like ultrasound and computed tomography often are not sufficient enough. This leads to the delay in diagnosis, which has a great impact on the results of operation. We report a case of a patient, who was treated before admission to the Clinic because of azotemia and oliguria suggesting renal failure.

  10. Prevalent Rate of Nonalbuminuric Renal Insufficiency and Its Association with Cardiovascular Disease Event in Korean Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Hye Won Lee

    2016-12-01

    Full Text Available BackgroundNonalbuminuric renal insufficiency is a unique category of diabetic kidney diseases. The objectives of the study were to evaluate prevalent rate of nonalbuminuric renal insufficiency and to investigate its relationship with previous cardiovascular disease (CVD event in Korean patients with type 2 diabetes mellitus (T2DM.MethodsLaboratory and clinical data of 1,067 subjects with T2DM were obtained and reviewed. Study subjects were allocated into four subgroups according to the CKD classification. Major CVD events were included with coronary, cerebrovascular, and peripheral vascular events.ResultsNonalbuminuric stage ≥3 CKD group, when compared with albuminuric stage ≥3 CKD group, had shorter diabetic duration, lower concentrations of glycated hemoglobin, high density lipoprotein cholesterol, and high-sensitivity C-reactive protein, lower prevalent rates of retinopathy and previous CVD, and higher rate of treatment with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Nonalbuminuric stage ≥3 CKD group showed a greater association with prior CVD events than no CKD group; however, albuminuric stage ≥3 CKD group made addition to increase prevalence of prior CVD events significantly when CKD categories were applied as covariates. Association of prior CVD events, when compared with normal estimated glomerular filtration rate (eGFR and nonalbuminuria categories, became significant for declined eGFR, which was higher for eGFR of <30 mL/min/1.73 m2, and albuminuria.ConclusionThe results show that subjects with nonalbuminuric stage ≥3 CKD is significantly interrelated with occurrence of prior CVD events than those with normal eGFR with or without albuminuria. Comparing with normal eGFR and nonalbuminuria categories, the combination of increased degree of albuminuria and declined eGFR is becoming significant for the association of prior CVD events.

  11. Characteristics and Outcomes Among Heart Failure Patients With Anemia and Renal Insufficiency With and Without Blood Transfusions (Public Discharge Data from California 2000–2006)

    Science.gov (United States)

    Kao, David P.; Kreso, Elma; Fonarow, Gregg C.; Krantz, Mori J.

    2013-01-01

    Renal insufficiency and anemia are increasingly recognized as predictors of adverse events in heart failure. The impact of blood transfusion on mortality in patients with heart failure has not been previously characterized. We examined temporal changes in admissions and in-hospital mortality using public discharge data from California (2000 to 2006) and then evaluated the impact of renal insufficiency, anemia, and transfusion on in-hospital mortality in univariate and multivariate analyses. In total 596,456 unique patient admissions for heart failure were recorded. Renal insufficiency and anemia were common co-morbidities (27.4% and 27.1%, respectively) and 6.2% of patients received a transfusion of red blood cells. Renal insufficiency and anemia were associated with increased mortality (unadjusted odds ratio [OR] 2.45, 95% confidence interval [CI] 2.39 to 2.52, and 1.27, 95% CI 1.24 to 1.30, respectively). After adjustment, renal insufficiency (OR 2.54, 95% CI 2.46 to 2.62) and anemia (OR 1.12 95% CI 1.07 to 1.17) remained significant; however, transfusion emerged as the strongest single predictor (OR 3.81, 95% CI 3.51 to 4.13) of mortality. In conclusion, these data suggest that anemia and renal insufficiency are independently associated with mortality in an unselected heart failure population. This is the first study to demonstrate that transfusion magnifies this effect and is associated with a particularly poor prognosis. PMID:21146689

  12. Usefulness of sup(99m)Tc-DTPA renogram in the functional and diagnostic evaluations of chronic renal insufficiency in children

    Energy Technology Data Exchange (ETDEWEB)

    Matsueda, Y.; Hiraiwa, M.; Meguro, H.; Fujii, R. (Teikyo Univ., Tokyo (Japan). Faculty of Medicine)

    1980-09-01

    As there are some difficulties in the performance of renal biopsy and intravenous pyelography is of little use in children with chronic renal insufficiency, we evaluated the usefulness of sup(99m)Tc-DTPA renogram in two children. The causes of the renal insufficiency presented were obstructive congenital anomalies and chronic pyelonephritis in one patient and polycystic kidneys in the other. As expected, intravenous pyelography poorly visualized in the upper urinary tracts of both the cases examined. Sup(99m)Tc-DTPA renogram gave us distinct image for the diagnosis of the kidneys and urinary tracts, and the individual renal functions were clarified as well. It was apparently superior to the combined use of sup(99m)Tc-DMSA renoscintigram and /sup 131/I-Hippuran renogram in both the imaging and functional evaluations. In such cases as are reported herein, sup(99m)Tc-DTPA renogram might be a useful alternative to several other diagnostic tests.

  13. Calcinosis Cutis, Renal Insufficiency and Low-Molecular-Weight Calcium Containing Heparins

    OpenAIRE

    2014-01-01

    Foi solicitada observação por Dermatologia de uma doente de 35 anos de idade, de raça negra, por 2 nódulos subcutâneos localizados na região paraumbilical direita e flanco direito com 2 semanas de evolução. Da história prévia, destaque para doença renal crónica em programa de hemodiálise e infeção pelo vírus da imunodeficiência humana (VIH-1). Ao exame objetivo observaram-se 2 nódulos bem delimitados, subcutâneos, sem alteração da coloração; à palpação, estes eram dolorosos, de consistê...

  14. [Efficacy of continuous ambulatory peritoneal dialysis in treatment of children with end-stage renal insufficiency].

    Science.gov (United States)

    Sahapozova, E; Ruso, B; Kuzmanovska, D; Tasić, V; Ristoska-Bojkoviska, N

    1998-01-01

    Three children (2 girls and 1 boy) with end-stage renal failure were put in program of continuous ambulatory peritoneal dialysis in the period of 2.5 years (January 1995-September 1997). The age of the children at the treatment onset was 5-12 years. One of three children died due to cardiovascular failure after six-month treatment. Two out of three children had a total of 8 episodes of peritonitis in the period of 37 months during the treatment with peritoneal dialysis. The incidence of peritonitis occurrence in our patients was one episode in 4 patients/months. Most frequent cause for peritonitis occurrence was Staphylococcus aureus in 50% of isolated bacteria. Obtained results in peritoneal equilibration test revealed that the transport and ultrafiltration rate of peritoneal membrane decreased after recurrent peritonitis episodes.

  15. Sublethal exposure from microcystins to renal insufficiency patients in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Soares, Raquel M; Yuan, Moucun; Servaites, Jerome C; Delgado, Alvimar; Magalhães, Valéria F; Hilborn, Elizabeth D; Carmichael, Wayne W; Azevedo, Sandra M F O

    2006-04-01

    In November 2001, a cyanobacterial bloom dominated by Microcystis and Anabaena occurred in the Funil Reservoir and the Guandu River, both of which supply drinking water to Rio de Janeiro, Brazil. Using ELISA, microcystins were detected at a concentration of 0.4 microg/L in the drinking water, whereas a concentration of 0.32 microg/L was detected in activated carbon column-treated water for use at the renal dialysis center of Clementino Fraga Filho Hospital (HUCFF) at the Federal University of Rio de Janeiro. A total of 44 hemodialysis patients who received care at this center were believed to be exposed. Initial ELISA analyses confirmed the presence of serum microcystin concentrations > or = 0.16 ng/mL in 90% of serum samples collected from these patients. Twelve patients were selected for continued monitoring over the following 2-month period. Serum microcystin concentrations ranged from < 0.16 to 0.96 ng/mL during the 57 days after documented exposure. ELISA-positive samples were found throughout the monitoring period, with the highest values detected 1 month after initial exposure. ESI LC/MS analyses indicated microcystins in the serum; however, MS/MS fragmentation patterns typical of microcystins were not identified. LC/MS analyses of MMPB for control serum spiked with MCYST-LR. and patient sera revealed a peak at retention time of 8.4 min and a mass of 207 m/z. These peaks are equivalent to the peak observed in the MMPB standard analysis. Taken together ELISA, LC/MS, and MMPB results indicate that these renal dialysis patients were exposed to microcystins. This documents another incident of human microcystin exposure during hemodialysis treatment.

  16. Retinopathy and the risk of cardiovascular disease in patients with chronic kidney disease (from the Chronic Renal Insufficiency Cohort study).

    Science.gov (United States)

    Grunwald, Juan E; Pistilli, Maxwell; Ying, Gui-Shuang; Maguire, Maureen; Daniel, Ebenezer; Whittock-Martin, Revell; Parker-Ostroff, Candace; Mohler, Emile; Lo, Joan C; Townsend, Raymond R; Gadegbeku, Crystal Ann; Lash, James Phillip; Fink, Jeffrey Craig; Rahman, Mahboob; Feldman, Harold; Kusek, John W; Xie, Dawei

    2015-11-15

    Patients with chronic kidney disease (CKD) experience other diseases such as cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess whether retinopathy predicts future CVD events in a subgroup of the participants of the Chronic Renal Insufficiency Cohort (CRIC) study. In this ancillary investigation, 2,605 participants of the CRIC study were invited to participate, and nonmydriatic fundus photographs were obtained in 1,936 subjects. Using standard protocols, presence and severity of retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed at a central photograph reading center by trained graders masked to study participant's information. Patients with a self-reported history of cardiovascular disease were excluded. Incident CVD events were adjudicated using medical records. Kidney function measurements, traditional and nontraditional risk factors, for CVD were obtained. Presence and severity of retinopathy were associated with increased risk of development of any CVD in this population of CKD patients, and these associations persisted after adjustment for traditional risk factors for CVD. We also found a direct relation between increased venular diameter and risk of development of CVD; however, the relation was not statistically significant after adjustment for traditional risk factors. In conclusion, the presence of retinopathy was associated with future CVD events, suggesting that retinovascular pathology may be indicative of macrovascular disease even after adjustment for renal dysfunction and traditional CVD risk factors. Assessment of retinal morphology may be valuable in assessing risk of CVD in patients with CKD, both clinically and in research settings.

  17. Drug Dosing in Patients with Renal Insufficiency in a Hospital Setting using Electronic Prescribing and Automated Reporting of Estimated Glomerular Filtration Rate

    DEFF Research Database (Denmark)

    Nielsen, Anita L.; Henriksen, Daniel Pilsgaard; Marinakis, Christianna;

    2014-01-01

    . We conclude that despite implementation of electronic prescribing and automated reporting of eGFR, patients with renal insufficiency may still be exposed to inappropriate drug use, with potential increased risk of adverse effects. Initiatives to reduce medication errors such as the use of electronic......GFR in the range of 10-49 ml/min/1.73m(2) were included. We identified 436 episodes with administration of renal risk drugs (prescribed to 183 patients): 410 drugs required dose adjustment according to the eGFR and 26 should be avoided. In total, the use or dosing of 66 (15%) of the 436 renal risk drugs...

  18. [Oxidative stress and chronic renal insufficiency: what can be a prophylactic approach?].

    Science.gov (United States)

    Cristol, J P; Maggi, M F; Bosc, J Y; Badiou, S; Delage, M; Vernet, M H; Michel, F; Castel, J; Canaud, B; Descomps, B

    1997-01-01

    Cardiovascular diseases represent the first cause of mortality in chronic renal failure patients treated by hemodialysis. Alterations in lipid metabolism and oxidative stress are recognized as vascular risk factors. Their corrections could be of interest for atherosclerosis prevention. In order to evaluate interest of an therapeutic intervention, we have analyzed oxidative metabolism in hemodialysis patients by determining the production of oxygen reactive species (ROS), the level of defense mechanisms, and the balance between nitric oxide (NO) and ROS, responsible for anti- or proxidant effects of NO. During dialysis sessions performed with cellulosic membrane (Cuprophan) an increase in hydroperoxide production by platelets was noted (12 HETE) (5.62 +/- 0.94 pg); similarly, superoxide anion (O2(0)-) production by monocytes (fluorescence index: 115 +/- 24) and by polynuclear cells (fluorescence index: 115 +/- 24) was enhanced. On the other hand, anti-oxidant defenses were significantly reduced with a decrease in RBC SOC activity (0.92 +/- 0.06 U/mg Hg) and in RBC vitamin E (0.7 +/- 0.07 mg/l) concentration. We have demonstrated a profound alteration in the L-arginine/NO pathway consequently to an accumulation of NO synthases inhibitors or activators. The necessity to reduce the production of ROS during dialysis sessions justifies the use of more biocompatible membranes, such as modified cellulosic or synthetic membranes, decreasing leucocyte activation. In addition, NO synthetase inhibitors can be preferentially eliminated by convection. Finally, a supplementation with an exogenous anti-oxidant, such as oral vitamin E (500 mg/day for 6 months) normalizes RBC vitamin E levels and concomitantly allows a decrease in MDA concentrations In conclusion, oxidative metabolism alterations observed in hemodialysis are multifactorial: preventive measures include the use of a more biocompatible material, the reequilibrium of the NO/ROS balance, and supplementation with

  19. Treatment-related changes in urinary excretion of high and low molecular weight proteins in patients with idiopathic membranous nephropathy and renal insufficiency.

    NARCIS (Netherlands)

    Buf-Vereijken, P.W.G. du; Wetzels, J.F.M.

    2006-01-01

    BACKGROUND: In patients with idiopathic membranous nephropathy, an increased urinary excretion of high (IgG) and low [beta(2)-microglobulin (beta(2)M), alpha(1)-microglobulin (alpha(1)M)] molecular weight proteins predicts prognosis and precedes renal insufficiency. We have studied the changes in th

  20. Ectopia renal cruzada con fusión, reflujo vesicoureteral y riñón ectópico afuncional:: informe de un caso Crossed renal ectopia with fusion, vesicoureteral reflux and dysfunctional ectopic kidney:: A case report

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2010-03-01

    Full Text Available Se presenta el caso de un niño cuyo ultrasonido materno-fetal de la semana 20 de la gestación no detectó alteraciones, pero el de la semana 23,6 mostró un riñón pélvico derecho. A los 22 días de nacido el ultrasonido renal mostró un riñón derecho de tamaño y posición normal y dilatación pélvica moderada, e inmediatamente por debajo del polo inferior de éste, un bolsón hidronefrótico que parecía corresponder a una ectopia renal cruzada con hidronefrosis grave. El padre padeció reflujo vesicoureteral derecho que desapareció espontáneamente. A pesar de la profilaxis con cefalexina, hubo una infección urinaria que se trató satisfactoriamente con ceftriaxona. Investigaciones ultrasonográficas y radioisotópicas arrojaron la existencia de una anomalía congénita dada por dilatación pélvica no obstructiva del riñón derecho, ectopia renal cruzada con fusión del riñón izquierdo afuncional y reflujo vesicoureteral bilateral, de grado II del riñón derecho y de grado V del izquierdo ectópico cruzado. A los 11 meses de edad se le realizó una lumbotomía y se comprobó la fusión del bolsón hidronefrótico con el polo inferior del riñón derecho. Se resecó el bolsón y se realizó una ligadura baja del uréter.This is the case of a child whose maternal-fetus ultrasound (US at twenty weeks pregnancy not detected alterations, but at the 23, 6 weeks it showed the presence of a right pelvic kidney. At twenty two days the renal US showed a right kidney with a normal size and location as well as a moderate pelvic dilation and immediately beneath its lower pole a hydronephrosis big sac in correspondence with a crossed renal ectopia with severe hydronephrosis. His father had right vesiculorectal reflux disappeared spontaneously. Despite the prophylaxis with Cephalexin there was a urinary infection adequately treated with Cephtriaxone. Ultrasonography and radioisotope researches demonstrated the presence of a congenital anomaly

  1. 肾功能不全对急性 ST 段抬高型心肌梗死患者住院期间预后的影响%Impact of Renal Insufficiency of Patients with Acute ST segment Elevation Myocardial Infarction on Prognosis in Duration of Hospital Stay

    Institute of Scientific and Technical Information of China (English)

    夏雪; 郑再星; 朱千里; 黄伟剑

    2015-01-01

    目的:探讨急性 ST 段抬高型心肌梗死(ST segment elevation myocardial infarction ,STEMI)合并肾功能不全(re-nal insufficiency ,RI)患者的临床特征,并分析肾功能不全对 STEMI 患者住院期间预后的影响。方法对温州医科大学附属第一医院2007年3月至2012年3月收治的950例急性 STEMI 患者资料进行回顾性分析,根据简化 MDRD(modifi-cation of diet in renal disease)方程计算患者的肾小球滤过率(estimated glomerular filtration rate ,eGFR),将患者分为肾功能正常组(eGFR ≥90ml・min -1・1.73m -2)、轻度 RI 组(60ml・min -1・1.73m -2≤ eGFR <90ml・min -1・1.73m -2)及中重度 RI 组(eGFR <60ml・min -1・1.73m -2)。分析 STEMI 合并 RI 患者的临床特征及对住院期间预后的影响。结果950例急性STEMI 患者中肾功能正常患者共444例(46.74%),轻度 RI 组351例(36.95%),中重度 RI 组155例(16.32%)。 RI 患者年龄更大,女性比例更高,吸烟、饮酒者更少,既往存在高血压病、糖尿病、高脂血症、陈旧性脑梗死患者比例更高,病程中出现心房颤动、Ⅱ/Ⅲ度房室传导阻滞更多(P<0.05)。同时 RI 患者更易合并冠状动脉三支病变及左主干、右冠状动脉、回旋支严重病变,但接受急诊冠状动脉血运重建比例更低(P<0.05)。多因素 Logistic 回归分析显示相对于肾功能正常组,中重度 RI 是 STEMI 患者住院期间出现心力衰竭(OR =2.25,95% CI :1.36~3.71)、心源性休克(OR =4.13,95% CI :1.52~11.22)的独立危险因素,而轻度 RI(OR =2.20,95% CI :1.27~6.70)及中重度 RI(OR =14.54,95% CI :6.12~34.53)均为住院期间出现全因死亡的的独立危险因素。结论肾功能不全是 STEMI 患者住院期间出现全因死亡、心源性休克和心力衰

  2. Use of sofosbuvir-based direct-acting antiviral therapy for hepatitis C viral infection in patients with severe renal insufficiency.

    Science.gov (United States)

    Hundemer, Gregory L; Sise, Meghan E; Wisocky, Jessica; Ufere, Nneka; Friedman, Lawrence S; Corey, Kathleen E; Chung, Raymond T

    2015-01-01

    Sofosbuvir-based direct-acting antiviral therapy revolutionized the treatment of hepatitis C virus (HCV) infection. However, sofosbuvir use is not approved for patients with severe renal insufficiency (estimated glomerular filtration (eGFR) rate below 30 ml/min) or end-stage renal disease (ESRD) based on concerns raised during premarket animal testing over hepatobiliary and cardiovascular toxicity in this population. We report the first published data on use of sofosbuvir-based regimens in patients with severe renal insufficiency and ESRD, focusing on clinical efficacy and safety. Six patients were treated with full dose sofosbuvir; three received sofosbuvir and simeprevir, two received sofosbuvir and ribavirin, and one received sofosbuvir, ribavirin, and interferon. Three of the patients had cirrhosis. On-treatment viral suppression was 100% and sustained virological response (SVR) rate at 12 weeks was 67%. One patient had to discontinue antiviral therapy early due to side effects. No hepatobiliary or cardiovascular toxicity was reported.

  3. Pregnancy in patients with chronic renal insufficiency at Hospital de Clínicas of Porto Alegre, Brazil.

    Science.gov (United States)

    Trevisan, Glaucia; Ramos, José Geraldo Lopes; Martins-Costa, Sérgio; Barros, Elvino José Guardão

    2004-01-01

    Chronic renal insufficiency (CRI) decreases reproductive capability. The biggest challenge in monitoring pregnant women with renal disease is to keep the intrauterine environment favorable to the fetus. One of the common prognosis in this kind of pregnancy involves premature birth, restricted growth and mental retardation. Also, the risk of developing complications is higher for the mother. This study focuses on evaluating CRI patients' clinical conditions during pregnancy, checking fetal development and birth and verifying the prevalence of CRI in pregnant women attended at Hospital de Clínicas of Porto Alegre-Brazil (HCPA). This is a retrospective study with both a control and an case group of pregnant women with CRI who delivered their babies at HCPA from 1989 to 1999. The case group is composed of pregnant women with CRI, while the control group was paired according to maternal and gestational ages and to the time of the delivery, which should be the same both in the experimental and in the control group. Among the criteria usually used to identify CRI, we chose the creatinine level higher than 1.5 mg/dL. Significance was established in 0.05%. Our results demonstrate that the prevalence of CRI was 6/10,000 births. Average maternal age was 28. Sixty five per cent of the patients, in both the groups, underwent prenatal monitoring, 40% presented preeclampsia, 48% presented urinary infection. Among the CRI complications, 48% of the cases presented anemia and 56% presented systemic hypertension. Average hematocrit was 24% while hemoglobin was 6.7 g/dL, which leads us to the conclusion that patients presented anemia during pregnancy. Average creatinine was 4.61 mg/dL. It is relevant that 64% of the CRI cases migrated to a substitutive renal therapy method. As for the fetus evolution in the case group, we confirmed the findings of previous studies, such as larger number of premature births (newborns younger than 36 weeks in 60% of the cases), larger number of

  4. Indispensable but insufficient role of renal D-amino acid oxidase in chiral inversion of NG-nitro-D-arginine.

    Science.gov (United States)

    Xin, Yan-Fei; Li, Xin; Hao, Bin; Gong, Nian; Sun, Wen-Qiang; Konno, Ryuichi; Wang, Yong-Xiang

    2010-06-01

    Unidirectionally chiral inversion of N(G)-nitro-D-arginine (D-NNA) to its L-enantiomer (L-NNA) occurred in rats, and it was blocked markedly (ca. 80%) by renal vascular ligation, and entirely (100%) by the D-amino acid oxidase (DAO) inhibitor sodium benzoate, suggesting that renal DAO is essential for the inversion. However, the doses of sodium benzoate administrated were extremely high (e.g., 400 mg/kg) due to its low potency. It is thus possible that sodium benzoate-mediated blockade of D-NNA inversion might be due to its nonspecific (or non-DAO-related) effects. In addition, after D-NNA was incubated with the pure enzyme of DAO in vitro without tissue homogenates, L-NNA was not produced, even though D-NNA was disposed. We propose that this occurred because D-NNA was first converted to its corresponding alpha-keto acid by DAO and then to L-NNA by transaminase(s); however, there was no direct evidence for this process. The goal of this study is to further elucidate the process of D-NNA chiral inversion both in vivo and in in vitro tissue homogenates by comparing mutant ddY/DAO(-/-) mice that lack DAO activity entirely compared to normal ddY/DAO(+/+) mice and Swiss mice. Furthermore, the ability to produce L-NNA from D-NNA-corresponding alpha-keto acids (N(G)-nitroguanidino-2-oxopentanoic acid) produced by porcine kidney-derived DAO (pkDAO) was also studied in the DAO inhibitor-pretreated rats. We found that D-NNA chiral inversion occurred in Swiss mice and ddY/DAO(+/+) mice both in vivo and in in vitro kidney homogenates, but not in ddY/DAO(-/-) mice, correlated to their DAO activities. The alpha-keto acid (N(G)-nitro-guanidino-2-oxopentanoic acid) from D-NNA was able to produce L-NNA, and subsequent vasoconstriction and pressor responses. These results indicate that the role of renal DAO is indispensible but insufficient for chiral inversion of D-NNA and other neutral and polar D-amino acids, and unidentified aminotransferase(s) are involved in a subsequent

  5. 50例儿童肾功能不全临床分析%Clinical Analysis for 50 Cases of Children with Renal Insufficiency

    Institute of Scientific and Technical Information of China (English)

    梁冰红

    2015-01-01

    Objective To explore the clinical and pathological features of renal insufficiency in children, and provide reference for clinical. Methods A retrospective analysis from January 2010 to December 2014 in our hospital 50 cases of chronic renal insuffi-ciency in children patients with the clinical data of 50 cases of children, etiology, clinical features, case analysis. Results In 50 patients with chronic renal insufficiency in children acquired glomerular disease in 33 cases, accounting for 66%. Congenital renal malformation in 12 cases, accounting for 24%. The children with chronic renal insufficiency the main clinical manifestations of re-nal anemia, hypertension, electrolyte disturbances, metabolic acidosis, growth retardation and infection. In 50 cases of chronic re-nal insufficiency patients had anemia, a negative relationship between hemoglobin and serum creatinine. Conclusion Children with renal insufficiency to obtain glomerulonephritis as the main cause of disease, renal dysfunction is more obvious, more severe ane-mia. Clinical on children with chronic kidney diseases such as alert the occurrence of renal insufficiency may be persistent anemi-a, with the degree of anemia to help assess the severity, renal insufficiency treatment as soon as possible, improve the quality of life.%目的:探究肾功能不全患儿的临床病理特点,为临床提供参考。方法回顾性分析2010年1月-2014年12期间在该院收治的50例儿童慢性肾功能不全患者的临床资料,对50例患儿的病因、临床特点,情况进行分析。结果①在50例儿童慢性肾功能不全的患者中,获得性肾小球疾病33例,占66%。先天性肾脏畸形12例,占24%。②儿童慢性肾功能不全主要临床表现为肾性贫血、高血压、电解质紊乱、代谢性酸中毒、生长发育迟缓和感染等。③50例慢性肾功能不全患儿均有贫血,血红蛋白与血肌酐呈负相关关系[结论过于笼统,没有针对结果。

  6. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency.

    Science.gov (United States)

    Mehta, Nandita; Gupta, Sunana; Sharma, Atul; Dar, Mohd Reidwan

    2015-01-01

    Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation. Regional anesthesia fulfills all the aforementioned criteria and aids in quick recovery and thus has been suggested to be a suitable alternative to general anesthesia for laparoscopic surgeries, particularly in patients who are at high risk while under general anesthesia or for patients unwilling to undergo general anesthesia. In conclusion, we report results of successful management with thoracic combined spinal epidural for laparoscopic cholecystectomy of a geriatric patient with ischemic heart disease with chronic obstructive pulmonary disease and renal insufficiency.

  7. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency

    Directory of Open Access Journals (Sweden)

    Mehta N

    2015-12-01

    Full Text Available Nandita Mehta, Sunana Gupta, Atul Sharma, Mohd Reidwan Dar Department of Anesthesiology and Intensive Care, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India Abstract: Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation. Regional anesthesia fulfills all the aforementioned criteria and aids in quick recovery and thus has been suggested to be a suitable alternative to general anesthesia for laparoscopic surgeries, particularly in patients who are at high risk while under general anesthesia or for patients unwilling to undergo general anesthesia. In conclusion, we report results of successful management with thoracic combined spinal epidural for laparoscopic cholecystectomy of a geriatric patient with ischemic heart disease with chronic obstructive pulmonary disease and renal insufficiency. Keywords: geriatric anesthesia, bupivacaine, segmental anesthesia, laparoscopic surgery

  8. Effect of Shenxinning decoction on ventricular remodeling in AT1 receptor-knockout mice with chronic renal insufficiency

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    Xuejun Yang

    2014-01-01

    Full Text Available Objective: To observe the efficacy of Shenxinning Decoction (SXND in ventricular remodeling in AT1 receptor-knockout (AT1-KO mice with chronic renal insufficiency (CRI. Materials and Methods: AT1-KO mice modeled with subtotal (5/6 nephrectomy were intervened with SXND for 12 weeks. Subsequently, blood urea nitrogen (BUN, serum creatinine (SCr, brain natriuretic peptide (BNP, echocardiography (left ventricular end-diastolic diameter, LVDD; left ventricular end-systolic diameter, LVDS; fractional shortening, FS; and ejection fraction, EF, collagen types I and III in the heart and kidney, myocardial mitochondria, and cardiac transforming growth factor-β1 (TGF-β1 of the AT1-KO mice were compared with the same model with nephrectomy only and untreated with SXND. Results: AT1-KO mice did not affect the process of CRI but it could significantly affect cardiac remodeling process. SXND decreased to some extent the AT1-KO mice′s BUN, SCr, BNP, and cardiac LVDD, LVDS, and BNP, improved FS and EF, lowered the expression of collagen type I and III in heart and kidney, increased the quantity of mitochondria and ameliorated their structure, and down-regulated the expression of TGF-β1. Conclusion: SXND may antagonize the renin-angiotensin system (RAS and decrease uremia toxins, thereby ameliorating ventricular remodeling in CRI. Furthermore, SXND has a mechanism correlated with the improvement of myocardial energy metabolism and the down-regulation of TGF-β1.

  9. Predictors of ertapenem therapeutic efficacy in the treatment of urinary tract infections (UTIs) in hospitalized adults: the importance of renal insufficiency and urinary pH.

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    Cunha, B A; Giuga, J; Gerson, S

    2016-04-01

    In hospitalized adults acute uncomplicated cystitis (AUC) and catheter associated bacteriuria (CAB) may be treated with oral antibiotics. With AUC or CAB due to extended spectrum ß-lactamase (ESBL) + Gram negative bacilli (GNB) physicians often use intravenous therapy, e.g., ertapenem. We reviewed our recent experience in hospitalized adults with AUC and CAB treated with ertapenem. Therapeutic efficacy of ertapenem was assessed by decreased pyuria/bacteriuria, and elimination of the uropathogen. The effectiveness of ertapenem in the presence of renal insufficiency (CrCl 3 days) in patients with decreased renal function and alkaline urinary pH. We reviewed 45 hospitalized adults with AUC or CAB to determine if renal insufficiency and or alkaline urinary pH affected ertapenem efficacy. In the 33 adult hospitalized patients with AUC and 12 with CAB, we found that ertapenem was consistently effective in eliminating the GNB bacteriuria. In hospitalized adults, the presence of renal insufficiency and acid urine, bacteriuria was eliminated in  3 days which has not been previously reported.

  10. Renal insufficiency is an independent predictor of in-hospital mortality for patients with acute myocardial infarction receiving primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Jian-ping LI; Mohetaboer MOMIN; Yong HUO; Chun-yan WANG; Yan ZHANG; Yan-jun GONG; Zhao-ping LIU; Xin-gang WANG; Bo ZHENG

    2012-01-01

    Objective:To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI),who were treated with emergency percutaneous coronary intervention (PCI).Methods:420 patients hospitalized in Peking University First Hospital,diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study.Estimated glomerular filtration rate (eGFR) was used as a measure of renal function.We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function.Results:There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m2)) (P<0.01).CKD (eGFR<60 ml/(min·1.73 m2)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032,odds ratio (OR) 4.159,95% confidence interval (CI) 1.127-15.346).Conclusions:Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.

  11. Phosphate binding reduces aortic angiotensin-converting enzyme and enhances nitric oxide bioactivity in experimental renal insufficiency.

    Science.gov (United States)

    Eräranta, Arttu; Törmänen, Suvi; Kööbi, Peeter; Vehmas, Tuija I; Lakkisto, Päivi; Tikkanen, Ilkka; Moilanen, Eeva; Niemelä, Onni; Mustonen, Jukka; Pörsti, Ilkka

    2014-01-01

    Disturbed calcium-phosphorus metabolism is associated with increased kidney angiotensin-converting enzyme (ACE) in experimental chronic renal insufficiency (CRI). However, information about the effects of phosphate binding and loading on vascular ACE is lacking. Fifteen weeks after 5/6 nephrectomy (NX), rats were placed on a phosphate-binding (NX+Ca, 3.0% Ca), phosphate-loading (NX+Pi, 1.5% Pi), or control diet for 12 weeks (NX and sham). Aortic ACE, blood pressure, plasma phosphate, and parathyroid hormone were increased in the NX and NX+Pi groups, but were reduced with phosphate binding. Endothelium-mediated relaxations of isolated mesenteric conduit artery rings to acetylcholine were impaired in the NX and NX+Pi groups, but did not differ from sham in NX+Ca rats. Experiments with nitric oxide (NO) synthase inhibition in vitro suggested that the NO-mediated component of acetylcholine response was lower in the NX and NX+Pi groups, but did not differ from sham in NX+Ca rats. In all NX groups, aortic endothelial NO synthase (eNOS) was reduced, while plasma and urine concentrations of NO metabolites were increased. Aortic nitrated proteins and calcification were increased in the NX and NX+Pi groups when compared with the NX+Ca and sham groups. Hypertension in the NX model of CRI was associated with reduced vasorelaxation, decreased eNOS, and increased ACE and nitrated proteins in the aorta. Phosphate binding with calcium carbonate enhanced vasorelaxation via endogenous NO and suppressed elevation of ACE and nitrated proteins, suggesting reduced vascular oxidative stress. Our findings support the view that correction of the calcium-phosphorus balance prevents CRI-induced vascular pathophysiology.

  12. Study on the Relationship between Stroke and Chronic Renal Insufficiency%脑卒中与慢性肾功能不全的关系研究

    Institute of Scientific and Technical Information of China (English)

    地里木拉提·阿不都拉; 杨莉; 热娜古丽·努尔; 孙岩; 桑晓红

    2012-01-01

    Objective To understand the condition of patients with stroke combined with renal insufficiency and to explore the relationship between stroke and chronic renal insufficiency. Methods Clinical data of 486 stroke patients firstly admitted to our hospital were retrospectively analyzed. The sex, age, ethnicity, disease history and carotid artery condition of the patients were observed. Kidney Disease Diet Adjustment Method was used to calculate glomerular filtration rate and the criteria of judging chronic renal insufficiency was glomerular filtration rate < with 60 ml·min-1·(1. 73 m) according to the staging standard of K/DOQI. The neurological deficit was assessed by Stroke Scale of U. S. National Institutes of Health. Results 121 out of the 486 patients had renal insufficiency, accounting for 24. 9% . The sex composition, history of primary hypertension and incidences of dyslipidemia, hyperuricemia, intimal thickening of the carotid artery and carotid artery plaque showed statistically significant differences between the renal insufficiency group and non-renal insufficiency group (P < 0. 05). The incidences of brain hemorrhage and non-lacunar infarction between renal insufficiency group and non-renal insufficiency group showed statistically significant differences (P <0. 05). The level of neurological deficit between patients with stroke combined with renal insufficiency and patients without renal insufficiency showed statistically significant difference (u = 3. 609, P = 0. 000). Conclusion The incidence of stroke combined with renal insufficiency is high, indicating chronic renal insufficiency is of great importance in predicting the prognosis of new stroke patients.%目的 了解脑卒中患者合并肾功能不全的情况,并探讨脑卒中与慢性肾功能不全的关系.方法 回顾性分析我院收治的486例首次入院的脑卒中患者的临床资料,观察患者性别、年龄、民族、既往史及颈动脉情况;采用肾脏疾病饮食调整

  13. Displasia renal multiquística: curso clínico y evaluación del riñón contralateral

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    Iris de Castaño

    2009-12-01

    Full Text Available Introducción: La displasia renal multiquística (DRM unilateral es una malformación frecuentemente encontrada en el ultrasonido obstétrico. En Colombia no existen publicaciones sobre las características clínicas y el comportamiento de esta enfermedad que permitan sugerir el tipo de estudios que se deben practicar en la fase inicial y en el seguimiento de estos niños.Objetivos: Describir las características clínicas de 40 pacientes con DRM unilateral con énfasis en la evaluación del riñón contralateral (RC con respecto a sus funciones, tamaño y frecuencia de malformación urológicas asociadas.Metodología: Estudio descriptivo de pacientes menores de 18 años con diagnósticos pre o postnatales de DRM unilateral, atendidos en la consulta externa de nefrología pediátrica del Hospital Infantil Club Noel entre julio de 1997 y diciembre de 2007.Resultados: Se encontraron 40 pacientes. En ellos 88% el diagnóstico se hizo antes de nacer; 55% eran de sexo masculino, con una edad promedio al ingreso de 2 meses (rangos, 1 y 42 meses. En el RC se descubrió hidronefrosis (HN en 2 casos (5% y reflujo vesicoureteral (RVU grados I yII en 3 casos (9%. El cálculo de la filtración glomerular fluctuó entre 81 ml/min/1.73 y 193 ml/min/1.73 (media, 105. Sólo uno de los 38 renogramas fue anormal e informó la presencia de una cicatriz renal. En el control ecográfico de 31 pacientes los quistes desaparecieron en 13 y persistían en 18, con una media de 60 meses (rango, 24 y 132 meses. El tiempo de seguimiento promedio fue 60 meses con un rango entre 15 y 132 meses.Conclusiones: En este grupo de pacientes se encontró buen pronóstico del RC: ninguno presentó disminución de la filtración glomerular y la frecuencia de malformaciones urológicas como la HN y el RVU fue muy baja. El ultrasonido renal (UR es indispensable en la evaluación inicial y seguimiento de los casos. Es recomendable practicar al comienzo un renograma, preferiblemente con 99

  14. Displasia renal multiquística: curso clínico y evaluación del riñón contralateral

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    Iris De Castaño

    2010-08-01

    Full Text Available Introducción: La displasia renal multiquística (DRM unilateral es una malformación frecuentemente encontrada en el ultrasonido obstétrico. En Colombia no existen publicaciones sobre las características clínicas y el comportamiento de esta enfermedad que permitan sugerir el tipo de estudios que se deben practicar en la fase inicial y en el seguimiento de estos niños. Objetivos: Describir las características clínicas de 40 pacientes con DRM unilateral con énfasis en la evaluación del riñón contralateral (RC con respecto a sus funciones, tamaño y frecuencia de malformación urológicas asociadas. Metodología: Estudio descriptivo de pacientes menores de 18 años con diagnósticos pre o postnatales de DRM unilateral, atendidos en la consulta externa de nefrología pediátrica del Hospital Infantil Club Noel entre julio de 1997 y diciembre de 2007. Resultados: Se encontraron 40 pacientes. En ellos 88% el diagnóstico se hizo antes de nacer; 55% eran de sexo masculino, con una edad promedio al ingreso de 2 meses (rangos, 1 y 42 meses. En el RC se descubrió hidronefrosis (HN en 2 casos (5% y reflujo vesicoureteral (RVU grados I yII en 3 casos (9%. El cálculo de la filtración glomerular fluctuó entre 81 ml/min/1.73 y 193 ml/min/1.73 (media, 105. Sólo uno de los 38 renogramas fue anormal e informó la presencia de una cicatriz renal. En el control ecográfico de 31 pacientes los quistes desaparecieron en 13 y persistían en 18, con una media de 60 meses (rango, 24 y 132 meses. El tiempo de seguimiento promedio fue 60 meses con un rango entre 15 y 132 meses. Conclusiones: En este grupo de pacientes se encontró buen pronóstico del RC: ninguno presentó disminución de la filtración glomerular y la frecuencia de malformaciones urológicas como la HN y el RVU fue muy baja. El ultrasonido renal (UR es indispensable en la evaluación inicial y seguimiento de los casos. Es recomendable practicar al comienzo un renograma, preferiblemente

  15. Utility of radioisotopic filtration markers in chronic renal insufficiency: Simultaneous comparison of sup 125 I-iothalamate, sup 169 Yb-DTPA, sup 99m Tc-DTPA, and inulin. The Modification of Diet in Renal Disease Study

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    Perrone, R.D.; Steinman, T.I.; Beck, G.J.; Skibinski, C.I.; Royal, H.D.; Lawlor, M.; Hunsicker, L.G. (National Institute of Diabetes, Digestive, and Kidney Diseases, Bethesda, MD (USA))

    1990-09-01

    Assessment of glomerular filtration rate (GFR) with inulin is cumbersome and time-consuming. Radioisotopic filtration markers have been studied as filtration markers because they can be used without continuous intravenous (IV) infusion and because analysis is relatively simple. Although the clearances of 99mTc-DTPA, 169Yb-DTPA, and 125I-iothalamate have each been compared with inulin, rarely has the comparability of radioisotopic filtration markers been directly evaluated in the same subject. To this purpose, we determined the renal clearance of inulin administered by continuous infusion and the above radioisotopic filtration markers administered as bolus injections, simultaneously in four subjects with normal renal function and 16 subjects with renal insufficiency. Subjects were studied twice in order to assess within-study and between-study variability. Unlabeled iothalamate was infused during the second half of each study to assess its effect on clearances. We found that renal clearance of 125I-iothalamate and 169Yb-DTPA significantly exceeded clearance of inulin in patients with renal insufficiency, but only by several mL.min-1.1.73m-2. Overestimation of inulin clearance by radioisotopic filtration markers was found in all normal subjects. No differences between markers were found in the coefficient of variation of clearances either between periods on a given study day (within-day variability) or between the two study days (between-day variability). The true test variability between days did not correlate with within-test variability. We conclude that the renal clearance of 99mTc-DTPA, 169Yb-DTPA, or 125I-iothalamate administered as a single IV or subcutaneous injection can be used to accurately measure GFR in subjects with renal insufficiency; use of the single injection technique may overestimate GFR in normal subjects.

  16. Hypertension Awareness, Treatment, and Control in Adults With CKD: Results From the Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Muntner, Paul; Anderson, Amanda; Charleston, Jeanne; Chen, Zhen; Ford, Virginia; Makos, Gail; O’Connor, Andrew; Perumal, Kalyani; Rahman, Mahboob; Steigerwalt, Susan; Teal, Valerie; Townsend, Raymond; Weir, Matthew; Wright, Jackson T

    2010-01-01

    Background A low rate of blood pressure control has been reported among patients with chronic kidney disease (CKD). These data were derived from population-based samples with a low rate of CKD awareness. Study Design Cross-sectional Setting & Participants Data from the baseline visit of the Chronic Renal Insufficiency Cohort (CRIC) study (n=3612) were analyzed. Participants with an estimated glomerular filtration rate of 20 to 70 ml/min/1.73m2 were identified from physician offices and review of laboratory databases. Outcomes Prevalence and awareness of hypertension, treatment patterns, control rates and factors associated with hypertension control. Measurements Following a standardized protocol, blood pressure was measured three times by trained staff and hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or self-reported antihypertensive medication use. Patients’ awareness and treatment of hypertension were defined using self-report and two levels of hypertension control were evaluated: systolic/diastolic blood pressure <140/90 mmHg and <130/80 mmHg. Results The prevalence of hypertension was 85.7%, and 98.9% of CRIC participants were aware of this diagnosis, 98.3% were treated with medications while 67.1% and 46.1% had their hypertension controlled to <140/90 mmHg and <130/80 mmHg, respectively. Of CRIC participants with hypertension, 15%, 25%, 26% and 32% were taking one, two, three and four or more antihypertensive medications, respectively. After multivariable adjustment, older patients, blacks, those with higher urinary albumin excretion were less likely while participants taking ACE-inhibitors and angiotensin receptor blockers were more likely to have controlled their hypertension to <140/90 mmHg and <130/80 mmHg. Limitations Data were derived from a single study visit. Conclusions Despite almost universal hypertension awareness and treatment in this cohort of patients with CKD, rates of

  17. Cost-effectiveness analysis of HLA-B5801 genotyping in the treatment of gout patients with chronic renal insufficiency in Korea.

    Science.gov (United States)

    Park, Dong-Jin; Kang, Ji-Hyoun; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Tae-Jong; Park, Yong-Wook; Park, Sung-Hwan; Lee, Shin-Seok

    2015-02-01

    Allopurinol-induced severe cutaneous adverse reactions (SCARs) are relatively rare but cause high rates of morbidity and mortality. Studies have shown that the HLA-B5801 allele and renal impairment are strongly associated with SCARs. Recent American College of Rheumatology guidelines recommend that, prior to treatment with allopurinol, the HLA-B5801 genotype of gout patients at high risk for SCARs, including Korean patients with chronic renal insufficiency, should be determined. However, whether such genotyping is cost-effective is unknown. This study evaluated the cost-effectiveness of HLA-B5801 genotyping for the treatment of gout in patients with chronic renal insufficiency in Korea. A decision analytical model over a time period of 12 months was employed to compare the cost and outcomes of treatment informed by HLA-B5801 genotyping with that of a conventional treatment strategy using a hypothetical cohort of gout patients with chronic renal insufficiency. Direct medical costs were obtained from real patients with SCARs from 2 tertiary hospitals. Outcomes were measured as a total expected cost and an incremental cost-effectiveness ratio. In the base model, the total expected cost and probability of continuation of gout treatment without SCARs for the conventional and HLA-B5801 screening strategies were $1,193 and 97.8% and $1,055 and 100%, respectively. The results were robust according to sensitivity analyses. Our model suggests that gout treatment informed by HLA-B5801 genotyping is less costly and more effective than treatment without genotyping, and HLA-B5801 genotyping could considerably reduce the occurrence of allopurinol-induced SCARs and related deaths. Copyright © 2015 by the American College of Rheumatology.

  18. Association of TGFβ1, TNFα, CCR2 and CCR5 gene polymorphisms in type-2 diabetes and renal insufficiency among Asian Indians

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    Gupta Arvind

    2007-04-01

    Full Text Available Abstract Background Cytokines play an important role in the development of diabetic chronic renal insufficiency (CRI. Transforming growth factor β1 (TGF β1 induces renal hypertrophy and fibrosis, and cytokines like tumor necrosis factor-alpha (TNFα, chemoattractant protein-1 (MCP-1, and regulated upon activation and normal T cell expressed and secreted (RANTES mediate macrophage infiltration into kidney. Over expression of these chemokines leads to glomerulosclerosis and interstitial fibrosis. The effect of MCP-1 and RANTES on kidney is conferred by their receptors i.e., chemokine receptor (CCR-2 and CCR-5 respectively. We tested association of nine single nucleotide polymorphisms (SNPs from TGFβ1, TNFα, CCR2 and CCR5 genes among individuals with type-2 diabetes with and without renal insufficiency. Methods Type-2 diabetes subjects with chronic renal insufficiency (serum creatinine ≥ 3.0 mg/dl constituted the cases, and matched individuals with diabetes of duration ≥ 10 years and normoalbuminuria were evaluated as controls from four centres in India. Allelic and genotypic contributions of nine SNPs from TGFβ1, TNFα, CCR2 and CCR5 genes to diabetic CRI were tested by computing odds ratio (OR and 95% confidence intervals (CI. Sub-analysis of CRI cases diabetic retinopathy status as dependent variable and SNP genotypes as independent variable in a univariate logistic regression was also performed. Results SNPs Tyr81His and Thr263Ile in TGF β1 gene were monomorphic, and Arg25Pro in TGF β1 gene and Δ32 polymorphism in CCR5 gene were minor variants (minor allele frequency A SNP of CCR5 gene has been observed and the allele 59029A seems to confer predisposition to development of diabetic CRI (OR 1.39; CI 1.04–1.84. In CRI subjects a compound group of genotypes "GA and AA" of SNP G>A -800 was found to confer predisposition for proliferative retinopathy (OR 3.03; CI 1.08–8.50, p = 0.035. Conclusion Of the various cytokine gene

  19. Relationship of hyperglycemia with endothelial function, renal function, lipidemic profile, and morphological changes of blood cells in patients with insufficient compensation of type 2 diabetes mellitus with hypertension

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    N. O. Pertseva

    2014-12-01

    Full Text Available Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. It has been established that in the insufficient glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis (up to r=+0.95 formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes.

  20. Suboptimal medical care of patients with ST-Elevation Myocardial Infarction and Renal Insufficiency: results from the Korea acute Myocardial Infarction Registry

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    Choi Joon

    2012-09-01

    Full Text Available Abstract Background The clinical outcomes of ST-segment elevation myocardial infarction (STEMI are poor in patients with renal insufficiency. This study investigated changes in the likelihood that patients received optimal medical care throughout the entire process of myocardial infarction management, on the basis of their glomerular filtration rate (GFR. Methods This study analyzed 7,679 patients (age, 63 ± 13 years; men 73.6% who had STEMI and were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR from November 2005 to August 2008. The study subjects were divided into 5 groups corresponding to strata used to define chronic kidney disease stages. Results Patients with lower GFR were less likely to present with typical chest pain. The average symptom-to-door time, door-to-balloon time, and symptom-to-balloon time were longer with lower GFR than higher GFR. Primary reperfusion therapy was performed less frequently and the results of reperfusion therapy were poorer in patients with renal insufficiency; these patients were less likely to receive adjunctive medical treatment, such as treatment with aspirin, clopidogrel, β-blocker, angiotensin-converting enzyme (ACE inhibitor/angiotensin-receptor blocker (ARB, or statin, during hospitalization and at discharge. Patients who received less intense medical therapy had worse clinical outcomes than those who received more intense medical therapy. Conclusions Patients with STEMI and renal insufficiency had less chance of receiving optimal medical care throughout the entire process of MI management, which may contribute to worse outcomes in these patients.

  1. Polypharmacy and Renal Failure in Nursing Home Residents: Results of the Inappropriate Medication in Patients with Renal Insufficiency in Nursing Homes (IMREN) Study.

    Science.gov (United States)

    Dörks, Michael; Herget-Rosenthal, Stefan; Schmiemann, Guido; Hoffmann, Falk

    2016-01-01

    Polypharmacy has become an emerging public health issue in recent years, since use of multiple medications or polypharmacy is beneficial for many conditions, but may also have negative effects like adverse drug reactions. The risk further increases in patients with chronic renal failure, a comorbidity very frequent in nursing home residents. Since more than 50% of all drugs were renally excreted, dose adjustments in patients with renal failure are required. To assess polypharmacy in German nursing homes, in particular in residents with renal failure. Multi-center cross-sectional study in 21 nursing homes in Bremen and Lower Saxony/Germany. Baseline data were analysed using descriptive statistics. Multivariable logistic regression model and 95% confidence intervals were used to study the association of renal failure and polypharmacy. Of all 852 residents, the analysis comprised those 685 with at least one serum creatinine value so that the estimated creatinine clearance could be calculated. Of those, 436 (63.6%) had a severe or moderate renal failure, defined as estimated creatinine clearance Polypharmacy (5-9 drugs) was found in 365 (53.3%) and excessive polypharmacy (≥10 drugs) in 112 (16.4%) residents. Diuretics and psycholeptics were the most commonly used drug classes. Severe renal failure (estimated creatinine clearance polypharmacy (OR: 2.8, 95% CI 1.4-5.7). Both, polypharmacy and renal failure are common in German nursing home residents and an association of both could be found. Further studies are needed to assess the appropriateness of polypharmacy in these patients.

  2. Evaluación nutricional de niños con insuficiencia renal aguda que reciben diálisis Nutritional assessment of children presenting with acute renal insufficiency and underwent to dialysis

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    Jorge Silva Ferrera

    2010-03-01

    Full Text Available INTRODUCCIÓN. La insuficiencia renal aguda se produce en horas o en algunos días, y durante su evolución se produce un deterioro del estado nutricional del paciente. El objetivo de este estudio fue caracterizar el estado nutricional de niños con esta enfermedad que requirieron terapias de reemplazo renal. MÉTODOS. Se realizó un estudio retrospectivo y transversal que incluyó a los pacientes ingresados por insuficiencia renal aguda en dos hospitales pediátricos de Santiago de Cuba entre diciembre de 2006 y diciembre de 2008. Se analizó edad, sexo, etiología, terapia de reemplazo renal, causa del uso de nutrición parenteral, evaluación nutricional según tablas cubanas de percentiles y parámetros antropométricos (edad, peso, talla y aporte de nutrientes parenterales. RESULTADOS. Eventos prerrenales fueron la causa de la insuficiencia renal aguda en el 44,4 % de los casos, y renales y posrenales, en el 33,4 y 22,2 %, respectivamente. Como método de depuración renal se utilizó la diálisis peritoneal en el 66,6 % de los casos y la hemodiálisis en los restantes pacientes. Las principales causas que motivaron la nutrición parenteral fueron las afecciones quirúrgicas, los estados hipercatabólicos, la hemorragia digestiva y la pancreatitis, en orden decreciente. Cuatro pacientes fueron evaluados como de bajo peso. CONCLUSIONES. El aporte promedio de proteínas y lípidos estuvo por debajo de los aportes nutricionales establecidos, y el aporte de kilocalorías fue superior a lo recomendado. Se deben mejorar estos parámetros en el tratamiento de estos pacientes.INTRODUCTION: Acute renal insufficiency appears in hours or in a few days and during its course there is a deterioration of patient nutritional status. The aim of present study was to characterize the nutritional status of children with this disease requiring renal replacement therapies. METHODS: A crossed-sectional and retrospective study was conducted including the patients

  3. Aortic insufficiency

    Science.gov (United States)

    ... page, please enable JavaScript. Aortic insufficiency is a heart valve disease in which the aortic valve does not close ... aortic insufficiency Images Aortic insufficiency References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  4. Renal Function Recovery with Total Artificial Heart Support.

    Science.gov (United States)

    Quader, Mohammed A; Goodreau, Adam M; Shah, Keyur B; Katlaps, Gundars; Cooke, Richard; Smallfield, Melissa C; Tchoukina, Inna F; Wolfe, Luke G; Kasirajan, Vigneshwar

    2016-01-01

    Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

  5. [Data collection about the case management of end-stage renal insufficiency. Feasibility study. Nephrology Epidemiologic and information Network (REIN)].

    Science.gov (United States)

    Stengel, B; Landais, P

    1999-01-01

    End-stage renal failure (ESRD) is an important public health issue, because of both the increasing number of patients requiring renal replacement therapy and the cost of treatment. The need for a reliable data system, capable of describing the patient care network as a whole, including dialysis or transplantation, has often been reiterated. The Direction Générale de la Santé (the French Department of Health) commissioned INSERM (the National Institute of Health and Medical Research) to "study the feasibility of different scenarios of data collection about ESRD patient care in order to meet the priority needs of health care administration, physicians, and researchers". Analysis of these needs allowed the goals to be defined: to provide an accurate picture of ESRD patient care in order to guide and evaluate health care policy, to inform clinicians, and to provide a tool for more focused special studies in renal research issues. Three scenarios were studied: the first would use data systems of both the government and the National Health Insurance system for planning health care services, upon EfG (The French Transplant Agency) network to evaluate transplantation, and upon a few regional registries for epidemiology and research; the second is based on repeated cross-sectional surveys; the third would rely upon the organization of an information system, the Renal Epidemiology and Information Network (REIN). Regional centers and a national coordinating office would register and follow-up ESRD patients, principally to evaluate health care supply and quality. The REIN database would also be a resource for research. The advantage of the first scenario is its low cost; its principal drawback is that evaluations will not be possible in the regions without registries. The second suggestion is inadequate. The last project would fulfil the goals that were defined. The REIN data system would be a true public health project of interest to all the participants and institutions

  6. Association analysis of ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 gene polymorphisms with chronic renal insufficiency among Asian Indians with type-2 diabetes

    Directory of Open Access Journals (Sweden)

    Gupta Arvind

    2010-03-01

    Full Text Available Abstract Background To determine association of nine single nucleotide polymorphisms (SNPs in ADP ribosyltransferase-1 (ADPRT1, aldo-keto reductase family 1 member B1 (AKR1B1, receptor for advanced glycation end-products (RAGE, glutamine:fructose-6-phosphate amidotransferase-2 (GFPT2, and plasminogen activator inhibitor-1 (PAI-1 genes with chronic renal insufficiency (CRI among Asian Indians with type 2 diabetes; and to identify epistatic interactionss between genes from the present study and those from renin-angiotensin-aldosterone system (RAAS, and chemokine-cytokine, dopaminergic and oxidative stress pathways (previously investigated using the same sample set. Methods Type 2 diabetes subjects with CRI (serum creatinine ≥3.0 mg/dl constituted the cases (n = 196, and ethnicity and age matched individuals with diabetes for a duration of ≥ 10 years, normal renal functions and normoalbuminuria recruited as controls (n = 225. Allelic and genotypic constitution of 10 polymorphisms (SNPs from five genes namely- ADPRT1, AKR1B1, RAGE, GFPT2 and PAI-1 with diabetic CRI was investigated. The genetic associations were evaluated by computation of odds ratio and 95% confidence interval. Multiple logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study epistatic interactions between SNPs in different genes. Results Single nucleotide polymorphisms -429 T>C in RAGE and rs7725 C>T SNP in 3' UTR in GFPT2 gene showed a trend towards association with diabetic CRI. Investigation using miRBase statistical tool revealed that rs7725 in GFPT2 was a perfect target for predicted miRNA (hsa miR-378 suggesting the presence of the variant 'T' allele may result in an upregulation of GFPT2 contributing to diabetic renal complication. Epistatic interaction between SNPs in transforming growth factor TGF-β1 (investigated using the same sample set and reported elsewhere and GFPT2 genotype was observed. Conclusions

  7. Immunohistochemical study of pathological alterations of peritoneum in patients with terminal renal insufficiency and on peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Trbojević-Stanković Jasna

    2011-01-01

    Full Text Available Background/Aim. During peritoneal dialysis (PD an exchange of substances between blood and dialysate takes place through specific histological structures of peritoneum. Peritoneal double-layered serous membrane has, so far, mostly been studied with electron microscopy on experimental animals. The aim of this study was to assess integrity of peritoneal tissue in end-stage renal disease (ESRD and PD patients using standard light microscopy and immunohistochemical methods. Methods. Peritoneal tissue biopsies were performed on 25 persons: 8 healthy donors during nephrectomy, 9 ESRD patients upon insertion of PD catheter, and 8 PD patients upon removal of the catheter for medical indications. The samples were fixed and prepared routinely for immunocytochemical staining by standardized streptavidin biotin AEC method using a LSAB2® HRP kit (Dako®, Denmark for collagen IV and analyzed by light microscopy. Results. We observed mesothelial detachment from lamina propria, duplicated basement membrane and much thicker blood vessel walls in ESRD and PD patients, compared to healthy subjects. Differences in histological structure, emphasized with immunostaining, indicated pathological alterations of peritoneal tissue in the renal patients. Conclusions. Imunohistochemistry can be used in studying histological alterations of peritoneal tissue in ESRD and PD patients. This method may indicate possible problems in filtration and secretion processes in this tissue.

  8. Phytochemical screening, and assessment of ameliorating effect of aqueous and ethanolic extracts of Gmelina arborea on drug induced hepatic and renal insufficiency in rats.

    Science.gov (United States)

    Anthony, Ogbonnaya Enyinnaya; Mbuh, Awah Francis; Emmanuel, Mounmbegna Philippe

    2012-04-01

    Phytochemical screening of stem bark and leaves of Gmelina arborea; and effect of aqueous and ethanolic extracts of Gmelina arborea stembark on hepatic and renal insufficiency in rats was assessed in this study. Phytochemical screening was carried out on the air-dried leaf, oven-dried leaf, air-dried stembark and oven-dried stembark samples. Sixty five (65) wister albino rats, (50.7-117.5 g) were divided into thirteen groups of five animals each. Three groups serve as Controls and were administered Cisplatin (5mg/kg b.w; i.p), Paracetamol (200mg/kg b.w; i.p) and Normal saline (0.002 ml/kg b.w; oral). Other groups were administered, either, cisplatin and extracts (1g/kg b.w; oral); Paracetamol and extracts (1g/kg b.w; oral); extracts alone; or drugs and combination of extracts. Animals were starved, 24 hours prior to sacrifice and sacrificed on the 9th day after commencement of treatment. Phytochemical screening results show the presence of alkaloid, flavonoid, tannin, saponin, cyanogenic glycoside, phytate, and carbohydrate. Saponin and carbohydrate were shown to be much higher in concentration than other phytochemicals. The percentage composition of cyanogenic glycoside and phytate were highest in air-dried stembark and oven-dried leaf samples, respectively. All the Gmelina arborea extracts and extract mixture administered to both paracetamol and cisplatin treated animals, significantly, lowers both the activities of the SGOT and SGPT, and the levels of serum creatinine and urea. When administered alone, the aqueous and ethanolic extracts show little or no sign of toxicity. Thus Gmelina arborea extracts may have ameliorating effect on hepatic and renal insufficiency caused by paracetamol and cisplatin respectively, and any inherent toxicity may be reduced or eliminated through adequate heat treatment.

  9. Convergence Insufficiency

    Science.gov (United States)

    ... from convergence insufficiency? Symptoms of convergence insufficiency include diplopia (double vision) and headaches when reading. Many patients ... another time or simply watched for symptoms of diplopia or headaches with near work. A patient who ...

  10. The CECARI Study: Everolimus (Certican®) Initiation and Calcineurin Inhibitor Withdrawal in Maintenance Heart Transplant Recipients with Renal Insufficiency: A Multicenter, Randomized Trial

    Science.gov (United States)

    Derthoo, David; Van Caenegem, Olivier; De Pauw, Michel; Nellessen, Eric; Duerinckx, Nathalie; Droogne, Walter; Vörös, Gábor; Meyns, Bart; Belmans, Ann; Janssens, Stefan; Vanhaecke, Johan

    2017-01-01

    In this 3-year, open-label, multicenter study, 57 maintenance heart transplant recipients (>1 year after transplant) with renal insufficiency (eGFR 30–60 mL/min/1.73 m2) were randomized to start everolimus with CNI withdrawal (N = 29) or continue their current CNI-based immunosuppression (N = 28). The primary endpoint, change in measured glomerular filtration rate (mGFR) from baseline to year 3, did not differ significantly between both groups (+7.0 mL/min in the everolimus group versus +1.9 mL/min in the CNI group, p = 0.18). In the on-treatment analysis, the difference did reach statistical significance (+9.4 mL/min in the everolimus group versus +1.9 mL/min in the CNI group, p = 0.047). The composite safety endpoint of all-cause mortality, major adverse cardiovascular events, or treated acute rejection was not different between groups. Nonfatal adverse events occurred in 96.6% of patients in the everolimus group and 57.1% in the CNI group (p < 0.001). Ten patients (34.5%) in the everolimus group discontinued the study drug during follow-up due to adverse events. The poor adherence to the everolimus therapy might have masked a potential benefit of CNI withdrawal on renal function.

  11. Impact of benazepril on contrast-induced acute kidney injury for patients with mild to moderate renal insufficiency undergoing percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    LI Xi-ming; CONG Hong-liang; LI Ting-ting; HE Li-jun; ZHOU Yu-jie

    2011-01-01

    Background The role of angiotensin-converting enzyme inhibitors (ACEI) in contrast-induced acute kidney injury (CI-AKI) is controversial. Some studies pointed out that it was effective in the prevention of CI-AKI, while some concluded that it was one risk for CI-AKI, especially for patients with pre-existing renal impairment. The purpose of this study was to assess the influence of benazepril administration on the development of CI-AKI in patients with mild to moderate renal insufficiency undergoing coronary intervention.Methods One hundred and fourteen patients with mild to moderate impairment of renal function were enrolled before coronary angioplasty, who were randomly assigned to benazepril group (n=52) and control group (n=62). In the benazepril group, the patients received benazepril tablets 10 mg per day at least for 3 days before procedure. CI-AKI was defined as an increase of≥25% in creatinine over the baseline value or increase of 0.5 mg/L within 72 hours of angioplasty.Results Patients were well matched with no significant differences at baseline in all measured parameters between two groups. The incidence of CI-AKI was lower by 64% in the benazepril group compared with control group but without statistical significance (3.45% vs. 9.68%, P=0.506). Compared with benazepril group, estimated glomerular filtration rate (eGFR) level significantly decreased from (70.64+16.38) ml·min-1·1.73 m-2 to (67.30+11.99) ml·min-1·1.73 m-2 in control group (P=0.038). There was no significant difference for the post-procedure decreased eGFR from baseline (△eGFR)between two groups (benazepril group (0.67+12.67) ml·min-1·1.73 m-2 vs. control group (-3.33±12.39) ml·min-1·1.73 m-2,P=0.092). In diabetic subgroup analysis, △eGFR in benazepril group was slightly lower than that in the control group, but the difference was not statistically significant.Conclusions Benazepril has a protective effect on mild to moderate impairment of renal function during

  12. 表现为肾功能不全甲状腺功能减退症2例%Renal Insufficiency Caused by Hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    宋丽娟; 曹赟赟; 潘秀萍

    2012-01-01

    目的:探讨甲状腺功能减退症引起肾功能异常的发病特点,进一步认识甲减引起肾功能不全的病因病机,减少误诊漏诊.方法:运用回顾性分析病例,通过对临床表现、治疗和疗效综合分析,得出临床结论.结果:甲状腺功能减退症以肾功能异常为特点,容易误诊漏诊,治疗甲减引起肾功能不全重在病因治疗.结论:甲状腺功能减退症引起肾功能异常经积极治疗可以治愈,在临床中应重视甲状腺功能减退引起的肾功能异常.%Objective:To study the renal disease caused by hypothyroidism, further understand the etiology and pathogenesis, reducing misdiagnosis and missed diagrosis. Methods: Retrospective analysis using case, Through to the clinical manifestations, treatment and curative effect of comprehensive analysis, the conclusion that clinical. Results : Hypothyroidism with abnormal kidney function, it is easy to. Be misdiagnosed missed hypothyroidism treatment cause renal insufficiency between etiology treatment. Conclusion: Hypothyroidism cause kidney function abnormal via active treatment can be cured, in clinical should pay attention to in the hypothyroidism cause renal abnormality.

  13. Urine Neutrophil Gelatinase-Associated Lipocalin and Risk of Cardiovascular Disease and Death in CKD: Results From the Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Liu, Kathleen D.; Yang, Wei; Go, Alan S.; Anderson, Amanda H.; Feldman, Harold I.; Fischer, Michael J.; He, Jiang; Kallem, Radhakrishna R.; Kusek, John W.; Master, Stephen R.; Miller, Edgar R.; Rosas, Sylvia E.; Steigerwalt, Susan; Tao, Kaixiang; Weir, Matthew R.; Hsu, Chi-yuan

    2015-01-01

    Background Chronic kidney disease is common and associated with increased cardiovascular disease risk. Currently, markers of renal tubular injury are not used routinely to describe kidney health and little is known about risk of cardiovascular events and death associated with these biomarkers independent of glomerular filtration—based markers (such as serum creatinine or albuminuria). Study Design Cohort study, Chronic Renal Insufficiency Cohort (CRIC) Study. Setting & Participants 3386 participants with estimated glomerular filtration rate of 20-70 mL/min/1.73 m2 enrolled from June 2003 through August 2008. Predictor Urine neutrophil gelatinase-associated lipocalin (NGAL) concentration. Outcomes Adjudicated heart failure event, ischemic atherosclerotic event (myocardial infarction, ischemic stroke or peripheral artery disease) and death through March 2011. Measurements Urine NGAL concentration measured at baseline with a two-step assay using chemiluminescent microparticle immunoassay technology on an ARCHITECT i2000SR (Abbott Laboratories). Results There were 428 heart failure events (during 16383 person-years of follow-up), 361 ischemic atherosclerotic events (during 16584 person-years of follow-up) and 522 deaths (during 18214 person-years of follow-up). In Cox regression models adjusted for estimated glomerular filtration rate, albuminuria, demographics, traditional cardiovascular disease risk factors and cardiac medications, higher urine NGAL levels remained independently associated with ischemic atherosclerotic events (adjusted HR for the highest [>49.5 ng/ml] vs. lowest [≤6.9 ng/ml] quintile, 1.83 [95% CI, 1.20-2.81]; HR, per 0.1-unit increase in log urine NGAL, 1.012 [95% CI, 1.001-1.023]), but not heart failure events or deaths. Limitations Urine NGAL was measured only once. Conclusions Among patients with chronic kidney disease, urine levels of NGAL, a marker of renal tubular injury, were independently associated with future ischemic atherosclerotic

  14. Prevalence and Prognostic Significance of Apparent Treatment Resistant Hypertension in Chronic Kidney Disease: Report From the Chronic Renal Insufficiency Cohort Study.

    Science.gov (United States)

    Thomas, George; Xie, Dawei; Chen, Hsiang-Yu; Anderson, Amanda H; Appel, Lawrence J; Bodana, Shirisha; Brecklin, Carolyn S; Drawz, Paul; Flack, John M; Miller, Edgar R; Steigerwalt, Susan P; Townsend, Raymond R; Weir, Matthew R; Wright, Jackson T; Rahman, Mahboob

    2016-02-01

    The association between apparent treatment resistant hypertension (ATRH) and clinical outcomes is not well studied in chronic kidney disease. We analyzed data on 3367 hypertensive participants in the Chronic Renal Insufficiency Cohort (CRIC) to determine prevalence, associations, and clinical outcomes of ATRH in nondialysis chronic kidney disease patients. ATRH was defined as blood pressure ≥140/90 mm Hg on ≥3 antihypertensives, or use of ≥4 antihypertensives with blood pressure at goal at baseline visit. Prevalence of ATRH was 40.4%. Older age, male sex, black race, diabetes mellitus, and higher body mass index were independently associated with higher odds of having ATRH. Participants with ATRH had a higher risk of clinical events than participants without ATRH-composite of myocardial infarction, stroke, peripheral arterial disease, congestive heart failure (CHF), and all-cause mortality (hazard ratio [95% confidence interval], 1.38 [1.22-1.56]); renal events (1.28 [1.11-1.46]); CHF (1.66 [1.38-2.00]); and all-cause mortality (1.24 [1.06-1.45]). The subset of participants with ATRH and blood pressure at goal on ≥4 medications also had higher risk for composite of myocardial infarction, stroke, peripheral arterial disease, CHF, and all-cause mortality (hazard ratio [95% confidence interval], (1.30 [1.12-1.51]) and CHF (1.59 [1.28-1.99]) than those without ATRH. ATRH was associated with significantly higher risk for CHF and renal events only among those with estimated glomerular filtration rate ≥30 mL/min per 1.73 m(2). Our findings show that ATRH is common and associated with high risk of adverse outcomes in a cohort of patients with chronic kidney disease. This underscores the need for early identification and management of patients with ATRH and chronic kidney disease.

  15. Preventive effects of anisodamine against contrast-induced nephropathy in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty

    Institute of Scientific and Technical Information of China (English)

    GENG Wei; XUE Ling; FU Xiang-hua; GU Xin-shun; WANG Yan-bo; WANG Xue-chao; LI Wei; JIANG Yun-fa; HAO Guo-zhen; FAN Wei-ze

    2012-01-01

    Background Anisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation.We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.Methods A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) of 60 ml-1 ·min-1.1.73 m-2 or less,who were undergoing coronary angiography or angioplasty,were randomly assigned to receive an infusion of either sodium chloride (control group,n=128) or anisodamine (treatment group,n=132).Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 μg · kg-1.min-1 from 12 hours before to 12 hours after coronary angiography or angioplasty,while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group.All patients received intravenous sodium chloride hydration.CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of >0.5 mg/dl within three days after contrast exposure.The primary end point was the incidence of CIN.The secondary end point was a 25% or greater reduction in eGFR.Results There were no significant differences between the two groups with regard to age,gender,risk factors,laboratory results,medications and interventions.The incidence of CIN was 9.8% (13/132) in the treatment group and 20.3% (26/128) in the control group (P <0.05).The secondary end point was 6.0% (8/132) in the treatment group and 16.4% (21/128) in the control group (P<0.05).Conclusion These results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.

  16. Riñón supernumerario

    OpenAIRE

    María del Pilar Quesada Marrero; Pilar Laborí Quesada; Elizabeth Leonarda Cárdenas Quao

    2014-01-01

    El riñón supernumerario es una anomalía congénita rara, en la cual existe un tercer riñón pequeño y rudimentario, con su cápsula propia y con una vascularización independiente a la del riñón del mismo lado. Se presenta el caso de un paciente del sexo masculino de 58 años de edad con la presencia de riñón supernumerario, el mismo se detectó como hallazgo accidental en la realización de una ecografía renal, como examen de rutina. Los exámenes diagnósticos utilizados fueron ecografía renal y tom...

  17. EVALUATION OF ODONTO-PERIODONTAL PARAMETERS IN PATIENTS WITH CHRONIC RENAL INSUFFICIENCY (IRC TREATED BY HEMODIALYSIS (HD

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    Cerasella Dorina Şincar

    2012-09-01

    Full Text Available The scope of the study was to evaluate the odontoperiodontal modifications observed in patients with renal pathology in terminal stage, installed as a result of several chronic systemic pathologies, subjected to either dialysis or transplants. Materials and method. The group of patients suffering from IRC included 42 persons (30 men and 12 women, with an average age of 42.6 ± 9.2 years, while the control group was formed of 88 patients (36 men and 52 women, with an average age of 41.3 ± 8.4 years. 28 patients with IRC were treated by HD – hemodialysis, 8 by DPAC – continuous ambulatory peritoneal dialysis, and 6 by CCPD – continuous assisted cycle of peritoneal dialysis. The investigation was developed in the Specialized Policlinics of the „Sf. Apostol Andrei” Urgency Hospital of Galaţi. Results and discussion. The distribution of dialysed patients affected with IRC according to the type of therapy applied is the following: the highest ratio – 59% – is recorded for the patients treated by hemodialysis, followed by those subjected to ambulatory continuous peritoneal dialysis (DPAC and by those with continuous cycle assisted by peritoneal dialysis (CCDP. A statistically significant association was observed between the number of teeth covered by dental plaque or scale and the number of elements with bleeding on probing (r = 0.543, P<0.001 and r = 0.568, P<0.001, respectively. Conclusions: The study shows that the dialysed patients suffering from IRC are more susceptible to periodontal diseases, comparatively with those without IRC, which shows that maintaining of an optimum oral hygiene is essential.

  18. Síndrome de lisis tumoral en un paciente con cáncer de riñón tratado con sunitinib Tumor lysis syndrome in a patient with a renal carcinoma treated with sunitinib

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    Ezequiel Rodríguez-Reimúndes

    2011-04-01

    Full Text Available El síndrome de lisis tumoral (SLT es un trastorno metabólico que ocurre como consecuencia de una destrucción celular masiva. Se caracteriza por la presencia de hiperuricemia, hiperfosfatemia, hipocalcemia e hiperkalemia, y predispone al desarrollo de insuficiencia renal aguda. En la mayoría de los casos el SLT ocurre luego de instaurarse un tratamiento antitumoral y es más frecuente en tumores de alto grado de malignidad y alta sensibilidad a la quimioterapia. Presentamos el caso de un paciente con diagnóstico de cáncer de riñón recidivado que presenta un SLT e insuficiencia renal aguda luego de iniciar tratamiento con sunitinib.The tumor mor lysis syndrome (TLS is a metabolic disorder resulting from a massive tumor breakdown. It is characterized by hyperuricemia, hyperphosphatemia, hypocalcemia and hyperkalemia and predisposes to acute renal failure. TLS usually occurs after the initiation of cytotoxic therapy and is more frequent in the case of neoplasias with a high proliferative rate or that are highly chemo-sensitive. We report the case of a man with a recurrent kidney cancer who presented with a TLS and acute renal failure after initiation of sunitinib.

  19. Imaging of insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, Christian [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)], E-mail: christian.krestan@meduniwien.ac.at; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)

    2009-09-15

    This review focuses on the occurrence, imaging and differential diagnosis of insufficiency fractures. Prevalence, the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures occur with normal stress exerted on weakened bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. Other conditions which affect bone turnover include osteomalacia, hyperparathyroidism, chronic renal failure and high-dose glucocorticoid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures, and to differentiate them from other bone lesions. Radiographs are still the most widely used imaging method for identification of insufficiency fractures, but sensitivity is limited, depending on the location of the fractures. Magnetic resonance imaging (MRI) is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures. Thin section, multi-detector computed tomography (MDCT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but limited specificity. The most important differential diagnosis is underlying malignant disease leading to pathologic fractures. Bone densitometry and clinical history may also be helpful in confirming the diagnosis of insufficiency fractures.

  20. Time-updated systolic blood pressure and the progression of chronic kidney disease: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Anderson, Amanda H; Yang, Wei; Townsend, Raymond R; Pan, Qiang; Chertow, Glenn M; Kusek, John W; Charleston, Jeanne; He, Jiang; Kallem, RadhaKrishna; Lash, James P; Miller, Edgar R; Rahman, Mahboob; Steigerwalt, Susan; Weir, Matthew; Wright, Jackson T; Feldman, Harold I

    2015-01-01

    Background Blood pressure (BP) is often inadequately controlled in patients with chronic kidney disease (CKD). Previous reports of the longitudinal association between achieved level of BP and end-stage renal disease (ESRD) have not incorporated time-updated BP with appropriate adjustment for known confounders. Objective To assess the association between baseline and time-updated systolic BP (SBP) with the progression of CKD. Design Observational, prospective cohort study (ClinicalTrials.gov identifier: NCT00304148) Setting Seven US clinical centers Patients Participants of the Chronic Renal Insufficiency Cohort (CRIC) Study (N=3,708) followed for a median (25th, 75th percentiles) of 5.7 (4.6, 6.7) years Measurements The mean of three seated SBP measurements were used as the visit-specific SBP. SBP was time-updated as the mean of that visit and all prior visits. Outcomes were ESRD and the composite renal endpoint of ESRD (dialysis or transplantation) or halving of the estimated glomerular filtration rate (eGFR). Analyses investigating baseline and time-updated SBP utilized traditional Cox proportional hazards models and marginal structural models, respectively. Results SBP was ≥130 mmHg at all study visits in 19.2% of participants, and ≥140 mmHg in 10.6%. The hazard ratio (95% confidence interval) for ESRD among participants with SBP 130–139 mmHg, compared to SBP <120 mmHg, was 1.46 (1.13–1.88) using only baseline data, and was 2.37 (1.48–3.80) using all available time-updated data. Among those with SBP ≥140 mmHg, corresponding hazard ratios were 1.46 (1.18–1.88) and 3.37 (2.26–5.03), respectively. Limitations SBP was measured once annually, and the CRIC Study cohort is not a random sample. Conclusions Among participants in the CRIC Study, time-updated SBP over 130 mmHg was more strongly associated with progression of CKD than analyses based on baseline SBP. Funding The CRIC Study is funded under cooperative agreements from the National Institute of

  1. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    Aynur Metin Terzibaşoğlu

    2004-12-01

    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  2. Can renal infarction occur after renal cyst aspiration? Case report.

    Science.gov (United States)

    Emre, Habib; Soyoral, Yasemin Usul; Tanik, Serhat; Gecit, Ilhan; Begenik, Huseyin; Pirincci, Necip; Erkoc, Reha

    2011-01-01

    Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.

  3. Adrenal insufficiency.

    Science.gov (United States)

    Li-Ng, Melissa; Kennedy, Laurence

    2012-10-01

    Adrenocortical insufficiency may arise through primary failure of the adrenal glands or due to lack of ACTH stimulation as a result of pituitary or hypothalamic dysfunction. Prolonged administration of exogenous steroids will suppress the hypothalamic-pituitary-adrenal axis, and hence cortisol secretion. We review briefly the causes, investigation, and treatment of adrenal insufficiency, and highlight aspects of particular relevance to patients with adrenal tumors.

  4. Race/Ethnicity and Cardiovascular Outcomes in Adults With CKD: Findings From the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic CRIC Studies.

    Science.gov (United States)

    Lash, James P; Ricardo, Ana C; Roy, Jason; Deo, Rajat; Fischer, Michael; Flack, John; He, Jiang; Keane, Martin; Lora, Claudia; Ojo, Akinlolu; Rahman, Mahboob; Steigerwalt, Susan; Tao, Kaixiang; Wolf, Myles; Wright, Jackson T; Go, Alan S

    2016-10-01

    Non-Hispanic blacks and Hispanics with end-stage renal disease have a lower risk for death than non-Hispanic whites, but data for racial/ethnic variation in cardiovascular outcomes for non-dialysis-dependent chronic kidney disease are limited. Prospective cohort. 3,785 adults with entry estimated glomerular filtration rates of 20 to 70mL/min/1.73m(2) enrolled in the CRIC (Chronic Renal Insufficiency Cohort) Study. Race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic). Cardiovascular outcomes (atherosclerotic events [myocardial infarction, stroke, or peripheral arterial disease] and heart failure) and a composite of each cardiovascular outcome or all-cause death. Multivariable Cox proportional hazards. During a median follow-up of 6.6 years, we observed 506 atherosclerotic events, 551 heart failure events, and 692 deaths. In regression analyses, there were no significant differences in atherosclerotic events among the 3 racial/ethnic groups. In analyses stratified by clinical site, non-Hispanic blacks had a higher risk for heart failure events (HR, 1.59; 95% CI, 1.29-1.95), which became nonsignificant after adjustment for demographic factors and baseline kidney function. In contrast, Hispanics had similar risk for heart failure events as non-Hispanic whites. In analyses stratified by clinical site, compared with non-Hispanic whites, non-Hispanic blacks were at similar risk for atherosclerotic events or death. However, after further adjustment for cardiovascular risk factors, medications, and mineral metabolism markers, non-Hispanic blacks had 17% lower risk for the outcome (HR, 0.83; 95% CI, 0.69-0.99) than non-Hispanic whites, whereas there was no significant association with Hispanic ethnicity. Hispanics were largely recruited from a single center, and the study was underpowered to evaluate the association between Hispanic ethnicity and mortality. There were no significant racial/ethnic differences in adjusted risk for atherosclerotic or heart

  5. Plant Protein Intake Is Associated with Fibroblast Growth Factor 23 and Serum Bicarbonate in Patients with CKD: The Chronic Renal Insufficiency Cohort Study

    Science.gov (United States)

    Scialla, Julia J.; Appel, Lawrence J; Wolf, Myles; Yang, Wei; Zhang, Xiaoming; Sozio, Stephen M.; Miller, Edgar R.; Bazzano, Lydia A.; Cuevas, Magdalena; Glenn, Melanie J.; Lustigova, Eva; Kallem, Radhakrishna R.; Porter, Anna C.; Townsend, Raymond R.; Weir, Matthew R.; Anderson, Cheryl A.M.

    2012-01-01

    Background Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD), due to lower bioavailability of phosphate and lower nonvolatile acid load. Study Design Observational cross-sectional study. Setting & Participants 2938 participants with chronic kidney disease and information on dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study. Predictors Percentage of total protein from plant sources (% plant protein) was determined by scoring individual food items from the National Cancer Institute Diet History Questionnaire (DHQ). Outcomes Metabolic parameters, including serum phosphate, bicarbonate (HCO3), potassium, and albumin, plasma fibroblast growth factor 23 (FGF23), and parathyroid hormone (PTH), and hemoglobin. Measurements We modeled the association between % plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes, body mass index, eGFR, income, smoking, total energy intake, total protein intake, 24 hour urinary sodium, use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers and use of diuretics. Results Higher % plant protein was associated with lower FGF23 (p=0.05) and higher HCO3 (p=0.01), but not with serum phosphate or PTH (p=0.9 and 0.5, respectively). Higher % plant protein was not associated with higher serum potassium (p=0.2), lower serum albumin (p=0.2) or lower hemoglobin (p=0.3). The associations of % plant protein with FGF23 and HCO3 did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5) or total protein intake (≤ 0.8 g/kg/d vs. >0.8 g/kg/d) (p-interaction > 0.10 for each). Limitations Cross-sectional study; Determination of % plant protein using the DHQ has not been validated. Conclusions Consumption of a higher percentage of protein from plant sources may lower FGF23 and raise HCO3 in patients with CKD. PMID:22480598

  6. Resultados clínicos de trasplantes de riñón en pacientes con enfermedad renal en etapa terminal secundaria a nefritis lupus, enfermedad poliquística renal y nefropatía diabética

    OpenAIRE

    John Fredy Nieto-Ríos; Lina María Serna-Higuita; Sheila Alexandra Builes-Rodriguez; Ricardo Cesar Restrepo-Correa; Arbey Aristizabal-Alzate; Catalina Ocampo-Kohn; Angelica Serna-Campuzano; Natalia Cardona-Díaz; Nelson Dario Giraldo-Ramirez; Gustavo Adolfo Zuluaga-Valencia

    2016-01-01

    Antecedentes:Pacientes con nefritis lúpica pueden progresar a enfermedad renal crónica terminal (10-22%); en estos pacientes el trasplante renal debe ser considerado como la terapia de elección. Objetivo: Evaluar los desenlaces clínicos de un grupo de pacientes con enfermedad renal crónica terminal por nefropatía lúpica, enfermedad renal poliquística y nefropatía diabética que fueron sometidos a trasplante renal en el Hospital Pablo Tobón Uribe.Métodos:Estudio retrospectivo, descriptivo, real...

  7. The characteristics of chronic renal insufficiency complicated with infection and the related factors%慢性肾功能不全并发感染的特征及相关因素

    Institute of Scientific and Technical Information of China (English)

    陈卫东; 张燕; 贾平

    2001-01-01

    目的探讨慢性肾功能不全患者并发感染的特征及相关因素。方法对我科1996年6月~2000年6月慢性肾功能不全并发感染的297例患者进行回顾性统计分析,并与同期因慢性肾功能不全住院未并发感染的211例患者比较。结果慢性肾功能不全易并发感染,感染率达58.46%,其发生与血白蛋白水平降低及外周血白细胞减少等因素相关,各组间比较差异有非常显著性(P<0.001),病原菌以革兰阴性杆菌为主,临床表现多不典型,好发部位主要是泌尿道和呼吸道。结论对慢性肾功能不全合并感染患者应提高患者抵抗力,改善营养状况,积极控制感染。%Objective To investigate the characteristics of chronic renal insufficiency complicated with infection and the related factors.Methods A retrospective statistic analysis of 297 cases of chronic renal insufficiency complicated with infection from June 1996 to June 2000 was made in comparison with 211 cases of chronic renal insufficiency without infection.Results Chronic renal insufficiency was easy to complicate with infection.The infection rate was up to 58.46%.The occurrence was related to the lowering of serum albumin level and peripheral white blood count.The difference between the two groups was significant (P<0.001).The pathogens were mainly Gram negative organisms.The clinical features were not typical in most cases.Common involved locations were obviously in urethral and respiratory tracts.Conclusion In the case of chronic renal insufficiency complicated with infection,It is important to give patients better nutrition,active control of infection and improve the of patients’ resistance.

  8. Resultados clínicos de trasplantes de riñón en pacientes con enfermedad renal en etapa terminal secundaria a nefritis lupus, enfermedad poliquística renal y nefropatía diabética

    Directory of Open Access Journals (Sweden)

    John Fredy Nieto-Ríos

    2016-04-01

    Full Text Available Antecedentes:Pacientes con nefritis lúpica pueden progresar a enfermedad renal crónica terminal (10-22%; en estos pacientes el trasplante renal debe ser considerado como la terapia de elección. Objetivo: Evaluar los desenlaces clínicos de un grupo de pacientes con enfermedad renal crónica terminal por nefropatía lúpica, enfermedad renal poliquística y nefropatía diabética que fueron sometidos a trasplante renal en el Hospital Pablo Tobón Uribe.Métodos:Estudio retrospectivo, descriptivo, realizado en un solo centro de trasplante renal, durante el período 2005-2013.Resultados:Se evaluaron 136 pacientes: 27 con nefritis lúpica (19.9%, 31 con enfermedad renal poliquística (22.8% y 78 con nefropatía diabética (57.4%. La supervivencia del injerto a uno, tres y cinco años fue de de 96.3%, 82.5% y 82.5% en nefropatía lúpica, 90%, 86% y 76.5% en enfermedad renal poliquística y 91.7%, 80.3% y 67.9% en nefropatía diabética respectivamente, sin diferencias estadísticas significativas (Long Rank test= 0.488. La tasa de recurrencia de nefritis lúpica posterior al trasplante renal fue de 0.94%/persona-año. Tener lupus vs diabetes o enfermedad renal poliquística no fue un factor de riesgo para disminución del tiempo de supervivencia del injerto (Hazard ratio= 1.43; 95% IC= 0.52-3.93.Conclusiones:Los pacientes enfermedad renal crónica terminal secundaria a nefritis lúpica, que son llevados a trasplante renal tienen tasas de éxito similar en cuanto a supervivencia del injerto y del paciente, al compararlos con otras enfermedades renales. La tasa de complicaciones y el riesgo de recurrencia de la nefropatía lúpica son bajos. El trasplante renal debe ser considerado como la terapia de elección para los pacientes con enfermedad renal crónica estadio terminal secundaria a nefritis lúpica.

  9. Association of N-Terminal Pro-B-Type Natriuretic Peptide with Left Ventricular Structure and Function in Chronic Kidney Disease (From the Chronic Renal Insufficiency Cohort [CRIC])

    Science.gov (United States)

    Mishra, Rakesh K.; Li, Yongmei; Ricardo, Ana C.; Yang, Wei; Keane, Martin; Cuevas, Magdalena; Christenson, Robert; DeFilippi, Christopher; Chen, Jing; He, Jiang; Kallem, Radhakrishna R.; Raj, Dominic S.; Schelling, Jeffrey R.; Wright, Jackson; Go, Alan S.; Shlipak, Michael G.

    2017-01-01

    We evaluated the cross-sectional associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cardiac structural and functional abnormalities in a cohort of chronic kidney disease (CKD) patients without clinical heart failure (HF), the Chronic Renal Insufficiency Cohort (n=3,232). Associations of NT-proBNP with echocardiographically determined left ventricular (LV) mass and LV systolic and diastolic function were evaluated by multivariable logistic and linear regression models. Reclassification of participants’ predicted risk of LV hypertrophy (LVH), systolic and diastolic dysfunction was performed using a category-free net reclassification improvement (NRI) index that compared a clinical model with and without NT-proBNP. The median (interquartile range) NT-proBNP was 126.6 pg/ml (55.5–303.7). The highest quartile of NT-proBNP was associated with nearly three-fold odds of LVH (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.8–4.0) and LV systolic dysfunction (2.7, 1.7–4.5) and two-fold odds of diastolic dysfunction (2.0, 1.3–2.9) in the fully adjusted models. When evaluated alone as a screening test, NT-proBNP functioned modestly for the detection of LVH (area under the curve, AUC 0.66) and LV systolic dysfunction (AUC 0.62), and poorly for the detection of diastolic dysfunction (AUC 0.51). However, when added to the clinical model, NT-proBNP significantly reclassified participants’ likelihood of having LVH (NRI 0.14, 95% CI 0.13–0.15; p<0.001) and LV systolic dysfunction (0.28, 0.27–0.30; p<0.001), but not diastolic dysfunction (0.10, 0.10–0.11; p=0.07). In conclusion, in this large CKD cohort without HF, NT-proBNP had strong associations with prevalent LVH and LV systolic dysfunction. PMID:23178053

  10. Relating circulating thyroid hormone concentrations to serum interleukins-6 and -10 in association with non-thyroidal illnesses including chronic renal insufficiency

    Directory of Open Access Journals (Sweden)

    Sabry Alaa A

    2008-01-01

    Full Text Available Abstract Background Because of the possible role of cytokines including interleukins (IL in systemic non-thyroidal illnesses' (NTI pathogenesis and consequently the frequently associated alterations in thyroid hormone (TH concentrations constituting the euthyroid sick syndrome (ESS, we aimed in this research to elucidate the possible relation between IL-6 & IL-10 and any documented ESS in a cohort of patients with NTI. Methods Sixty patients and twenty healthy volunteers were recruited. The patients were subdivided into three subgroups depending on their underlying NTI and included 20 patients with chronic renal insufficiency (CRI, congestive heart failure (CHF, and ICU patients with myocardial infarction (MI. Determination of the circulating serum levels of IL-6 and IL-10, thyroid stimulating hormone (TSH, as well as total T4 and T3 was carried out. Results In the whole group of patients, we detected a significantly lower T3 and T4 levels compared to control subjects (0.938 ± 0.477 vs 1.345 ± 0.44 nmol/L, p = 0.001 and 47.9 ± 28.41 vs 108 ± 19.49 nmol/L, p 2 = 0.338, p = 0.001 and not IL-10 was a predictor of low T3 levels with only a borderline significance for T4 (R2 = 0.082, p = 0.071. By subgroup analysis, the proportion of patients with subnormal T3, T4, and TSH levels was highest in the MI patients (70%, 70%, and 72%, respectively who displayed the greatest IL-6 and IL-10 concentrations (192.5 ± 45.1 ng/L & 122.95 ± 46.1 ng/L, respectively compared with CHF (82.95 ± 28.9 ng/L & 69.05 ± 44.0 ng/L, respectively and CRI patients (40.05 ± 28.9 ng/L & 30.4 ± 10.6 ng/L, respectively. Surprisingly, CRI patients showed the least disturbance in IL-6 and IL-10 despite the lower levels of T3, T4, and TSH in a higher proportion of them compared to CHF patients (40%, 45%, & 26% vs 35%, 25%, & 18%, respectively. Conclusion the high prevalence of ESS we detected in NTI including CRI may be linked to IL-6 and IL-10 alterations. Further

  11. Renal insufficiency associated with adefovir dipivoxil overdose%阿德福韦酯过量相关肾功能不全

    Institute of Scientific and Technical Information of China (English)

    马小艳; 蔡晧东

    2015-01-01

    1例69岁男性乙型肝炎肝硬化患者加入抗病毒治疗临床试验,基线血清肌酐89μmol/L,肌酐清除率为56 ml/min。给予拉米夫定100 mg/d口服。治疗48周,血清肌酐91μmol/L,肌酐清除率为54 ml/min。加服阿德福韦酯10 mg/d。3年后,患者血清肌酐升至113μmol/L,肌酐清除率为39 ml/min。考虑为阿德福韦酯相关肾功能不全。阿德福韦酯减量为10 mg,隔日1次,拉米夫定原剂量应用。6个月后复查,患者血清肌酐88μmol/L,肌酐清除率50 ml/min。%A 69-year-old patient with hepatitis B cirrhosis to join clinical trials of antiviral therapy. His baseline serum creatinine level was 89 μmol/L and creatinine clearance was 56 ml/min. He was given oral lamivudine 100 mg daily. His serum creatinine level was 91 μmol/L and creatinine clearance was 54 ml/min 48 weeks later. Adefovir dipivoxil 10 mg daily was added to the regimen. Three years later,the patient′s serum creatinine level increased to 113 μmol/L and creatinine clearance was 39 ml/min. He was considered as renal insufficiency due to adefovir dipivoxil. The dosage of adefovir dipivoxil was reduced to 10 mg once every other day and lamivudine was continued according to the original dose. Six months later,the patient′s serum creatinine level was 88 μmol/L and the creatinine clearance was 50 ml/min.

  12. Correlation analysis of homocystein and chronic heart failure combined with insufficient renal function%同型半胱氨酸与慢性心力衰竭合并肾功能不全的相关性分析

    Institute of Scientific and Technical Information of China (English)

    李剑平; 郭建浩

    2015-01-01

    Objective To explore the levels of homocystein (Hcy) in patients with chronic heart failure combined insuf-ficient renal function. Methods 58 patients with chronic heart failure in our hospital from June 2013 to June 2014 were selected as the research object.According to patient’s condition,all patients were divided into the chronic heart failure combined insufficient renal function group (n=28) and the chronic heart failure group (n=30).The left ventricular ejec-tion fraction (LVEF) was determined by cardiac ultrasound,the levels of plasma BNP were determined enzyme-linked immuno sorbent assay,the levels of plasma creatine were determined by enzymatic method. Results The proportion of patients of gradeⅢ and gradeⅣ in chronic heart failure and renal insufficiency group was higher than that in chronic heart failure group,the level of LVEF in chronic heart failure and renal insufficiency group was lower than that in chronic heart failure group,the levels of BNP and Hcy in peripheral blood of chronic heart failure and renal insufficien-cy group was higher than that in chronic heart failure group,with significant difference (P<0.05).The levels of plasma Hcy was positively correlated with the levels of plasma BNP and creatine,but negatively correlated with LVEF. Con-clusion Hcy is participated in the development of chronic heart failure concurrence insufficient renal function,which may be a potential target for patients with chronic heart failure combined renal dysfunction.%目的:探讨同型半胱氨酸(Hcy)在慢性心力衰竭并肾功能不全患者外周血中的表达。方法选取2013年6月~2014年6月本院心血管内科收治的58例慢性心力衰竭患者作为研究对象,根据患者病情分为慢性心力衰竭合并肾功能不全组(n=28)和慢性心力衰竭组(n=30)。分别予以心脏超声检测左室射血分数(LVEF),酶联免疫吸附法检测血浆脑钠肽(BNP)水平,酶法检测血浆肌酐水平。结果慢性心力衰竭并肾

  13. Growth hormone and the kidney: the use of recombinant human growth hormone (rhGH) in growth-retarded children with chronic renal insufficiency.

    Science.gov (United States)

    Fine, R N

    1991-04-01

    Hypothalamic production of growth hormone releasing hormone stimulates the anterior pituitary gland to release growth hormone (GH). The clinical manifestations of GH on tissues are either direct or are mediated by insulin-like growth factors (IGF). Both the somatic effects of GH and the renal manifestations of an increase in glomerular filtration rate and renal plasma flow are mediated by IGF. The increase in glomerular filtration rate/renal plasma flow that occurs with either exogenous or endogenous GH is not apparent in patients with chronic renal failure (CRF); therefore, it is unlikely that recombinant human growth hormone (rhGH) treatment of patients with CRF will result in glomerular hyperfiltration. Longitudinal studies are required to determine if the glomerulosclerosis and renal functional impairment occurring in GH and growth hormone releasing hormone transgenic mice occurs after rhGH treatment of growth-retarded uremic rats with GH resulted in an improvement in growth velocity. This led to preliminary studies in growth-retarded children with CRF by using rhGH. The acceleration of growth velocity was dramatic despite the fact that GH levels are elevated in uremia. The elevated IGF carrier proteins in uremic children may contribute to the growth retardation. Treatment with rhGH may be efficacious by stimulating a net increase in the free (unbound) IGF levels. Hyposecretion of GH may contribute to the failure to achieve optimal growth after successful renal transplantation. Treatment with rhGH may be efficacious in improving the growth velocity of renal allograft recipients.

  14. 轻度肾功能不全与急性冠状动脉综合征预后的相关性%The predictive value of mild renal insufficiency on the prognosis of patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    张建华; 徐岩; 陈旭华; 伍梦佐; 程自平; 陈斌

    2013-01-01

    目的 分析轻度肾功能不全对急性冠状动脉综合征患者(ACS)终点事件的预测价值.方法 按估算的肾小球滤过率(eGFR)水平不同,将552例ACS患者分为肾功能正常组(eGFR≥90ml·min-1·1.73 m-2)与轻度肾功能不全组(eGFR60~ <90 ml·min-1·1.73 m-2),前瞻性随访并分析轻度肾功能不全与ACS患者终点事件的相关性.结果 轻度肾功能不全组患者初级终点事件的发生率高于肾功能正常组[31例(12.6%)比15例(4.9%),P=0.001],次级终点事件的发生在两组间差异无统计学意义.初级终点事件中全因死亡[22例(8.9%)比7例(2.2%),P<0.001]及心源性死亡[16例(6.5%)比4例(1.3%),P=0.001]的发生率在轻度肾功能不全组较高,而非致死性卒中及心肌梗死的发生两组间差异无统计学意义.COX回归模型分析结果发现,轻度肾功能不全患者发生初级终点事件的相对危险度是肾功能正常患者的2.265倍(95% CI1.076 ~4.771,P=0.031),对各单独事件进一步分析表明轻度肾功能不全对全因死亡有预测价值(HR3.118,95% CI1.197~8.125,P=0.020).初级终点事件及全因死亡的Kaplan-Meier曲线显示,轻度肾功能不全组患者的初级终点事件(p=0.004)及全因死亡(P=0.001)的发生率高于肾功能正常组.结论 轻度肾功能不全对ACS患者的初级终点事件具有重要预测价值.%Objective To investigate the predictive value of mild renal insufficiency on the endpoint events in patients with acute coronary syndrome (ACS).Methods A total of 552 patients with ACS were enrolled in the present study.According to the levels of estimated glomerular filtration rate (eGFR),patients were divided into two groups,normal renal function (eGFR≥90 ml · min-1 · 1.73 m-2) and mild renal insufficiency (60≤eGFR <90 ml · min-1 · 1.73 m-2).The primary and secondary events were collected and analyzed through the present prospective follow-up study.Results The patients in mild renal

  15. Increased expression of HIF-1α, VEGF-A and its receptors, MMP-2, TIMP-1, and ADAMTS-1 at the venous stenosis of arteriovenous fistula in a mouse model with renal insufficiency

    Science.gov (United States)

    Misra, Sanjay; Shergill, Uday; Yang, Binxia; Janardhanan, Rajiv; Misra, Khamal D.

    2010-01-01

    Purpose A mouse model of renal insufficiency with arteriovenous fistula (AVF) and venous stenosis was created. We tested the hypothesis that there is increased gene expression of hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor- A (VEGF-A) and its receptors (VEGFR-1, -2), matrix metalloproteinase-2 (MMP-2), -9 (MMP-9), tissue inhibitor of metalloproteinase-1, -2 (TIMP-1, -2), and a disintegrin and metalloproteinase thrombospondin-1 (ADAMTS-1) at the venous stenosis. Materials and methods Nineteen male C57BL/6 mice underwent a left nephrectomy and a surgical occlusion of the right upper pole to induce renal insufficiency and characterized in eight mice. Twenty eight days later, an AVF (n=11) was created from the right carotid artery to ipsilateral jugular vein and the mice were sacrificed at day 7 (n=4) and day 14 (n=4). The outflow and control veins were removed for gene expression. Three mice were sacrificed at day 28 for histologic analysis. Results The mean serum blood urea nitrogen remained significantly elevated for 8 weeks when compared to baseline (P<0.05). By day 7, there was a significant increase in the expression of HIF-1α, VEGF-A, VEGFR-1, VEGFR-2, MMP-2, TIMP-1, and ADAMTS-1 at the outflow vein with HIF-1α and TIMP-1 being significantly elevated at day 14 (P<0.05). By day 28, the venous stenosis was characterized by a thickened vein wall and neointima. Conclusions A mouse model of renal insufficiency with AVF was developed which had increased expression of HIF-1α, VEGF-A, VEGFR-1, VEGFR-2, MMP-2, TIMP-1, and ADAMTS-1 at the outflow vein with venous stenosis by day 28. PMID:20598569

  16. Effect of Shenqi Fuzheng Injection on Chronic Renal Insufficiency Anemia%参芪扶正注射液对慢性肾功能不全贫血的影响

    Institute of Scientific and Technical Information of China (English)

    韩鸿雁

    2016-01-01

    目的:探讨参芪扶正注射液对慢性肾功能不全贫血的影响。方法整群选取2013年11月-2015年1月医院收治的慢性肾功能不全贫血患者138例随机分成两组各69例,对照组给予蔗糖铁注射液,观察组给予参芪扶正注射液,比较两组的治疗效果,RBC、WBC及Hb和不良反应。结果观察组治疗有效率为85.5%,对照组治疗有效率为65.2%(P0.05﹚。结论参芪扶正注射液治疗慢性肾功能不全贫血疗效满意,不良反应少,值得应用。%Objective To discuss the effect of shenqi fuzheng injection on chronic renal insufficiency anemia. Methods 138 cases of patients with chronic renal insufficiency anemia treated in our hospital from November 2013 to January 2015 were randomly divided into two groups with 69 cases in each, the control group were treated with iron sucrose injection, the ob-servation group were treated with shenqi fuzheng injection, the treatment effect, RBC , WBC, Hb and adverse reaction of the two groups were compared. Results The treatment effective rate was 85.5% in the observation group and 65.2% in the control group (P0.05﹚. Conclusion Shenqi fuzheng injection in treatment of chronic renal insufficiency anemia has a satisfactory curative effect and few adverse reactions, which is worth application.

  17. 急性心肌梗死患者肾功能状态及对预后的影响%The Relationsc of renal insufficiency and in-hospital prognosis in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    李超; 胡大一; 王建旗; 杨进刚; 孙艺红; 宋丽

    2012-01-01

    目的 探评价急性ST段抬高型心肌梗死(STEMI)患者入院即刻肾功能状态及对院内预后的影响.方法 多中心、前瞻性队列研究.入选自2005年12月至2007年1月,在发病后24小时内至北京市19家医院就诊的STEMI患者718例.入院即刻测定血清肌酐,根据改良的简化MDRD公式计算估计的肾小球滤过率(eGFR).分为肾功能正常组(eGFR≥90 ml/ (min·1.73m2)、轻度肾功能不全组(60ml/(min·1.73m2≤eGFR<90 ml/ (min·1.73m2)和中度肾功能不全组(eGFR<60 ml/ (min·1.73m2),比较三组的临床特点和院内死亡和心血管事件发生情况,采用多元Logistic回归分析影响STEMI患者院内死亡和主要心血管事件的危险因素.结果 718例患者中共有280例(39.0%)已经存在不同程度的肾功能不全(eGFR<90ml/min),其中61例(8.5%)为中度以上肾功能不全(eGFR<60ml/min).与肾功能正常组相比,轻度肾功能不全组和中度肾功能不全组患者年龄偏大(57±12)岁vs (66±13)岁vs (72±13)岁,P<0.01),女性比例多(16.9%vs 39.2% vs 48.3%,P<0.01),既往有高血压病(47.7% vs 59.8% vs 70.5%,P<0.01),心力衰竭(0% vs 2.7% vs 6.6%,P<0.01),脑卒中或一过性脑缺血(TIA)病史(8.9% vs 10.6% vs 19.3%,P<0.05),入院时心功能Killip≥Ⅱ级(34.7% vs 37.0% vs 65.5%,P<0.01)较多.院内病死率(1.4% vs 5.9% vs 22.9%,P<0.01)和心血管事件(18.0% vs 27.4% vs 63.9%,P<0.01)显著增高.多因素Logistic回归分析显示入院即刻肾功能不全是STEMI患者发生院内死亡和心血管事件的独立危险因素(OR值分别为3.870;95%CI:1.767-8.474,P<0.01和1.712;95%CI:1.217-2.408,P<0.01).结论 STEMI患者中肾功能不全发生率较高,院内死亡及心血管事件的发生率随肾功能恶化而增加,肾功能不全是院内死亡和心血管事件的独立危险因素.%Aim To investigate the association of renal insufficiency and in-hospital prognosis in

  18. Riñón supernumerario

    Directory of Open Access Journals (Sweden)

    María del Pilar Quesada Marrero

    2014-12-01

    Full Text Available El riñón supernumerario es una anomalía congénita rara, en la cual existe un tercer riñón pequeño y rudimentario, con su cápsula propia y con una vascularización independiente a la del riñón del mismo lado. Se presenta el caso de un paciente del sexo masculino de 58 años de edad con la presencia de riñón supernumerario, el mismo se detectó como hallazgo accidental en la realización de una ecografía renal, como examen de rutina. Los exámenes diagnósticos utilizados fueron ecografía renal y tomografía axial computarizada. El motivo de la presentación del caso está dado por la poca frecuencia de esta anomalía congénita

  19. Relative Incidence of ESRD Versus Cardiovascular Mortality in Proteinuric Type 2 Diabetes and Nephropathy : Results From the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) Database

    NARCIS (Netherlands)

    Packham, David K.; Alves, Tahira P.; Dwyer, Jamie P.; Atkins, Robert; de Zeeuw, Dick; Cooper, Mark; Shahinfar, Shahnaz; Lewis, Julia B.; Lambers Heerspink, Hiddo J.

    2012-01-01

    Background: Previous studies have shown that patients with chronic kidney disease, including those with diabetic nephropathy, are more likely to die of cardiovascular disease than reach end-stage renal disease (ESRD). This analysis was conducted to determine whether ESRD is a more common outcome tha

  20. Serum uric acid is a GFR-independent long-term predictor of acute and chronic renal insufficiency: the Jerusalem Lipid Research Clinic cohort study

    Science.gov (United States)

    Kark, Jeremy D.

    2011-01-01

    Background. Kidney disease is commonly accompanied by hyperuricemia. However, the contribution of serum uric acid (SUA) to kidney injury is debated. Our objective was to assess the long-term prediction of renal failure by SUA. Methods. Visit 2 participants in the Jerusalem Lipid Research Clinic cohort with normal baseline kidney function were followed for 24–28 years. SUA levels were assessed for associations with acute renal failure (ARF) and chronic renal failure (CRF) as defined by hospital discharge records, and mortality, ascertained through linkage with the national population registry. Results. Among 2449 eligible participants (1470 men, 979 women aged 35–78 years in 1976–79), SUA was positively linked with male sex, serum creatinine and components of the metabolic syndrome but was lower in smokers and in diabetic subjects. The 22- to 25-year incidence of hospital-diagnosed kidney failure (145 first events, 67% CRF) and the 24- to 28-year mortality (587 events) were higher in subject with hyperuricemia (>6.5 mg/dL in men and >5.3 mg/dL in women, reflecting the upper quintiles), independent of baseline kidney function and covariates. Hyperuricemia conferred adjusted hazard ratios of 1.36 (P = 0.003), 2.14 (P < 0.001) and 2.87 (P = 0.003) for mortality, CRF and ARF, respectively. Conclusions. SUA predicts renal failure incidence and all-cause mortality independently of demographic and clinical covariates. These results lend support to the undertaking of clinical trials to examine the effect of uric acid-lowering strategies on kidney outcomes. PMID:21220750

  1. 急性ST段抬高心肌梗死患者肾功能不全的发生率和预后价值%Incidence and prognostic value of renal insufficiency in patients with acute ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    曾汇庆; 郑海生

    2010-01-01

    目的 评估急性ST段抬高心肌梗死(STEMI)患者肾功能不全的发生率及其预后价值.方法 采用改良的简化肾脏病改良饮食(MDRD)方程估算.肾小球滤过率(GFR),以GFR133 μmol/L判断肾功能不全,则其漏诊率为42.6%(40/94).伴肾功能不全的STEMI患者年龄较大,陈旧性心肌梗死、血脂异常患病率高,Killip分级较高,入院时尿素氮(BUN)、Cr水平较高.用Logistic回归分析筛选出年龄、肾功能不全、未再灌注治疗是STEMI患者住院期间死亡的危险因素.伴肾功能不全的STEMI患者院内死亡的相对危险度为2.411(95%可信区间为1.249~4.656).结论 STEMI患者肾功能不全的发生率高,并且是STEMI患者住院期间死亡的危险因素.%Objective To evaluate the incidence and prognostic value of renal insufficiency in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods The glomerular filtration rate(GFR)was estimated with the modified abbreviated modification of diet in renal disease (MDRD)study equation.Renal insufficiency was defined as GFR133 μmol/L,renal insufficiency was unrecognized in 40 cases(42.6%)of them.The renal insufficiency was associated with elder,old myocardial infarction,dyslipidemia,higher Killip-grade,and higher level of blood urea nitrogen(BUN)and Cr.By the Logistic regression analysis,renal insufficiency and no reperfusion was the risk factor of in-hospital mortality.The mortality relative risk between the STEMI patients with renal insufficiency and those without renal insufficiency was2.411(95% confidence interval:1.249-4.656).Conclusion The incidence of renal insufficiency is higher in the patients with STEMI,and it is an independent predictor for in-hospital mortality.

  2. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim...

  3. RI scintigraphy in myasthenia gravis

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Yoshikazu; Miyamoto, Mariko (Tokyo Metropolitan Fuchu Hospital (Japan)); Maki, Masako; Yamazaki, Toshiro

    1982-10-01

    35 cases of myasthenia gravis were studied with RI scintigraphy. /sup 67/Ga-citrate was used in 34 patients and /sup 76/Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type.

  4. Analysis of antibiotic treatment on elderly patients with chronic renal insufficiency and bacterial infection%老年慢性肾功能不全合并细菌感染的抗生素治疗分析

    Institute of Scientific and Technical Information of China (English)

    陈振汉; 滕玲

    2013-01-01

    目的 探索应用抗生素治疗慢性肾功能不全失代偿期合并下呼吸道感染的老年患者的临床效果和对其肾功能的影响.方法 选取某院自2008年5月~2011年10月治疗的60例肾功能不全合并肺部感染的老年患者纳入观察组,同期选取60肾功能正常的老年下呼吸道感染的患者纳入对照组.两组患者应用头孢哌酮进行治疗,观察两组患者的总体治疗效果差异以及观察组患者治疗前后的肾功能血肌酐、尿素氮、尿酸、肌酐清除率水平差异.结果 观察组和对照组患者平均治疗时间分别为(10.15±3.23)d和(7.32±2.18)d,差异有统计学意义(P<0.05);两组患者的总体治疗效果差异无统计学意义(P>0.05),但痊愈率差异有统计学意义(P<0.05);观察组治疗前后患者的血肌酐、尿素氮、内生肌酐清除率水平与治疗前比较差异有统计学意义(P<0.05).结论 肾功能不全的老年患者一旦发生下呼吸道感染,应用抗生素治疗的难度增大,治疗过程中应密切留意患者的肾功能情况,并合理控制药物用量,一旦出现肾功能衰竭应立即停药,必要时进行血液透析.%OBJECTIVE To explore the clinical effect of antibiotic treatment on elderly patients with chronic renal insufficiency and bacterial infection,and its influence on the renal function.METHODS 60 elderly patients with chronic renal failure (the experimental group) and 60 elderly patients with normal renal function (the control group) were chosen,and all patients suffered from lower respiratory tract infection and were treated by Cefiazidime in our hospital from May 2008 to October 2011.The difference of clinical effect and renal function change before and after treatment were observed.RESULTS The average treatment time of experimental group and control group were (10.15 ± 3.23) d and (7.32 ± 2.18) d with a stastical difference (P < 0.05) ; There was no statistical difference in overall treatment

  5. Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program Ocorrência de crises epilépticas em pacientes com insuficiência renal crônica em programa dialítico regular

    Directory of Open Access Journals (Sweden)

    Fulvio Alexandre Scorza

    2005-09-01

    Full Text Available Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.Convulsões durante o tratamento dialítico podem constituir uma complicação da hemodiálise. Esse artigo descreve a ocorrência de crises em pacientes em estágio final de insuficiência renal crônica sob tratamento dialítico no Instituto de Nefrologia de Mogi das Cruzes, São Paulo, Brasil. Foram revistos os prontuários de 189 pacientes, com o objetivo de investigar a ocorrência de crises convulsivas durante o tratamento dialítico. Dos sete pacientes selecionados com história de crises, cinco concordaram em participar de nosso estudo. Três pacientes apresentaram crises generalizadas tônico-clônicas, um apresentou crise parcial com generalização subseqüente e um apresentou crise inclassificada. Três pacientes apresentaram crises apenas durante o processo dialítico (crise única sendo que um deles apresentou status epilepticus convulsivo. Os outros dois pacientes já haviam apresentado crises antes do início do tratamento dialítico. Nós concluímos que as crises

  6. 冠状动脉硬化性心脏病并发肾功能不全患者的药学监护%Pharmaceutical Care on Patients with Coronary Heart Disease and Renal Insufficiency

    Institute of Scientific and Technical Information of China (English)

    葛鹏程; 党大胜; 任天舒; 史国兵

    2014-01-01

    Objective To explore the pharmaceutical care plan of clinical pharmacist for elderly patients with coronary heart disease and renal insufficiency. Methods To develop the therapeutic schedule in cooperation with clinicians through clinical rounds, in order to offer specific pharmaceutical care and further develop individualized care plan during patient ' s hospitalization. Results Clinical pharmacists paid close attention to the indicators and adjusted administration time when the adverse reactions such as lower blood pressure, leukopenia, and deterioration of renal function occurred, and finally avoided further potential adverse reactions. Conclusion The incidence of adverse drug reactions were reduced, the safety and efficacy of drugs used were guaranteed, which can promote rational and effective use of drugs in clinic. The overall quality of healthcare was improved with pharmacist involvement.%临床药师通过临床查房,与临床医师共同对老年冠心病并发肾功能不全患者制定治疗方案,对患者用药进行具体化药学服务和制定个体化监护计划。当患者出现血压偏低、白细胞减少、肾功能恶化等不良反应时,临床药师密切监测相关指标,及时调整药物,避免了临床治疗中潜在的不良反应。临床药师积极参与临床的治疗过程,可减少药品不良反应的发生,确保在院期间用药的安全性及有效性,提高了整体治疗水平。

  7. 1例晚期小细胞肺癌合并肾功能不全患者的药学监护%Pharmaceutical care for advanced small cell lung cancer patient associated with renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    李萌; 雷嘉川; 戎佩佩; 杨健; 宋金春

    2016-01-01

    Objective To monitor the medication process of advanced lung cancer patients with renal insufficiency .Meth‐ods Pharmaceutical care ,pharmaceutical intervention and medication were offered according to the individual condition of pa‐tient with renal function based on pharmaceutical experience and related literature .Results The patient finished chemotherapy successfully without adverse reaction .Conclusion Clinical pharmacists should keep improving their knowledge and participat‐ing in first‐line clinical treatment activities;the patient‐centered hospital pharmacy service will be founded and the level of ra‐tional medication will be improved when doctors ,pharmacists and nurses could cooperate sincerely .%目的:监护肾功能不全晚期肺癌患者的用药过程。方法利用药学经验和查阅文献,针对患者肾功能个体化情况,为其提供药学监护、干预和用药教育。结果患者未出现不良反应,顺利完成本次化疗。结论临床药师需要完善知识储备,积极参与临床一线治疗;医、药、护精诚合作才能促进以患者为中心的医院药学服务模式的建立,提高临床合理用药水平。

  8. Comparison of clinical therapeutic effects between high-flux hemodialysis and conventional hemodialysis on renal insufficiency%高通量血液透析与常规血液透析的临床透析效果比较

    Institute of Scientific and Technical Information of China (English)

    杜娟; 谭峰

    2016-01-01

    Objective To compare the clinical therapeutic effects between high-flux hemodialysis and conventional hemodialysis on renal insufficiency,and to explore optimized dialysis method to treat renal insufficiency.Methods Sixty-four patients with renal insufficiency who were treated in our hospital from April 2013 to October 2014 were divided into observation group and control group according to different dialysis methods, with 32 patients in each group.The patients in observation group were treated by high -flux hemodialysis, however, the patients in control group were treated by conventional hemodialysis for three months.Before and after hemodialysis,the levels of blood urea nitrogen (BUN), blood creatinine (SCR), albumin ( ALb), and serum β2-M microspheres protein (β2-M), parathyroid hormone ( PTH) and serum electrolytes ( Na, K, CA, CL, P ) were detected, moreover, the adverse reactions after hemodialysis were observed and compared between two groups.Results After hemodialysis, the levels of Ur, Scr in both groups were significantly decreased, as compared with those before dialysis ( P 0.05).After dialysis the serum levels of Alp in control group were obviously decreased,as compared with those before dialysis,but there were no significant differences in observation group before and after dialysis ( P >0.05) .Before dialysis, there were no significant differences in the levels of β2-M and PTH between two groups ( P >0.05),however,after dialysis there were significant differences between two groups ( P 0.05) ,the levels of Ca were increased,as compared with those before dialysis,but there were no significant differences between two groups ( P >0.05).The infection rate after dialysis in observation group was 18.75%,which in control group was 46.87%,there was a significant difference between two groups ( P <0.05) .Conclusion The high-flux hemodialysis has not only filtration effects,but also can decrease obviously the levels ofβ2-M and PTH, meanwhile, the infection

  9. "Aprende a cuidar a tus riñones y ellos cuidaran de ti". Programa de educación para la salud dirigido a pacientes con Insuficiencia Renal Crónica (IRC)

    OpenAIRE

    2016-01-01

    La Enfermedad renal crónica (ERC) es una enfermedad crónica que avanza progresivamente. Según la tasa de filtrado glomerular (TFG), se pueden diferenciar 5 estadios dentro de la enfermedad. En el estadio 5, ya es demasiado tarde para trabajar desde la prevención, ya que la TFG, y con ella la función renal, ha disminuido tanto que la supervivencia de los pacientes entra en juego y es necesario iniciar una terapia renal sustitutiva, diálisis o trasplante renal. Los estadios 3 y 4...

  10. Etiological analysis of nosocomial infections in elderly patients with chronic renal insufficiency and treatment measures%老年慢性肾功能不全患者医院感染的病原学分析与治疗

    Institute of Scientific and Technical Information of China (English)

    朱瑶; 刘维波; 费景萍; 严旺

    2015-01-01

    OBJECTIVE To explore the etiological diagnosis of the elderly chronic renal insufficiency patients com‐plicated with nosocomial infections and put forward the treatment measures so as to provide guidance for the clini‐cal diagnosis and treatment .METHODS A total of 3 793 elderly patients with chronic renal insufficiency who were treated in the hospital from Apr 2006 to Mar 2014 were enrolled in the study ,then the body fluid specimens that were collected from the patients with nosocomial infections were cultured ,the drug susceptibility testing was per‐formed for the isolated pathogens ,and the prevalence of the nosocomial infections and the infection sites were sta‐tistically analyzed according to the clinical manifestations and laboratory examinations .RESULTS Of 3 793 pa‐tients ,201 had the nosocomial infections with the infection rate of 5 .30% ,of whom 57 .21% had urinary system infections and 20 .40% had the respiratory system infections .A total of 195 strains of pathogens have been isola‐ted ,including 125 (64 .10% ) strains of gram‐positive bacteria ,68 (34 .87% ) strains of gram‐negative bacteria , and 2 (1 .03% ) strains of fungi .The drug susceptibility rates of the Staphylococcus aureus ,Streptococcus pneu‐moniae ,and Staphylococcus epidermidis to vancomycin were 100 .00% ,the drug susceptibility rates to teicopla‐nin were more than 97 .00% ,and the drug susceptibility rates to penicillin and sulfamethoxazole‐trimethoprim were less than 18 .00% .The drug susceptibility rates of the Pseudomonas aeruginosa ,K lebsiella pneumoniae ,and Escherichia coli to imipenem and cefoperazone‐sulbactam were more than 90 .00% ,while the drug susceptibility rates to ampicillin were less than 4 .00% .CONCLUSION The gram‐positive bacteria are dominant among the pathogens causing the nosocomial infections in the elderly patients with chronic renal insufficiency .It is an effective way to formulate individualized treatment program based on the

  11. Cotidiano e trabalho: concepções de indivíduos portadores de insuficiência renal crônica e seus familiares Cotidiano y trabajo: concepciones de individuos portadores de insuficiencia renal crónica y sus familiares Daily life and work: conceptions of chronic renal insufficiency patients and their relatives

    Directory of Open Access Journals (Sweden)

    Ligia Carreira

    2003-12-01

    importantes. Consideramos que los profesionales de la salud se deben unir para buscar apoyo en familiares y en la sociedad en general para que estos individuos puedan ser inseridos en el mercado de trabajo cuando lo deseen y tengan condiciones para ello.This descriptive and exploratory research aimed to know the conceptions, attitudes and behaviors about work as reported by 16 chronic renal insufficiency patients and their relatives. Data were collected from April to August 2000 through semi-structured interviews. The results revealed that work is valued by all families as a source of health and financial resources, besides being important for individuals' character formation; that most CRI patients do not carry out any remunerated activities and, when they do, they count on the help and understanding of the boss and relatives. We conclude that CRI and its treatment do not directly or absolutely impede the realization of this kind of activity, but entail important limitations. We consider it is necessary for health professionals to join in the search for support by relatives and society, so that these people can be inserted in the labor market when they want to and are in the right conditions.

  12. Cuidado em situação de Doença Renal Crônica: representações sociais elaboradas por adolescentes Atención en situación de Enfermedad Renal Crónica: representaciones sociales de adolescentes Care in situation of Severe Renal Insufficiency: social representations elaborated by adolescent

    Directory of Open Access Journals (Sweden)

    Islane Costa Ramos

    2008-04-01

    Full Text Available O objetivo do estudo foi apreender as representações sociais dos adolescentes em relação ao cuidado em situação de Insuficiência Renal Crônica. Aplicou-se o teste de associação livre de palavras a 70 adolescentes e a entrevista semi-estruturada a oito adolescentes. Foram evocadas 1630 palavras a partir dos estímulos doença, saúde, diálise, cuidado de si, cuidado profissional e cuidado familiar. Das entrevistas foram construídos dois núcleos temáticos que trazem significações sobre o cuidado familiar e o cuidado profissional que influenciam nas formas de perceber e agir em relação ao cuidado à saúde. Conclui-se que a representação social do adolescente focaliza as significações do adoecimento e do cuidado, marcada pela indissociabilidade entre as práticas de cuidado e as relações psico-afetivas e sociais imbrincadas na sua vivência.El estudio tuvo como objetivo aprehender las representaciones sociales de los adolescentes en relación a la atención en situación de Insuficiencia Renal Crónica. Se utilizó la prueba de asociación libre de palabras y la entrevista estructura en parte. Fueron 1.630 palabras a partir de los estímulos enfermedad, salud, dialisis, atención de si, atención profesional y atención familiar. De las entrevistas fueron construídos dos grupos de temas que tuvieron significaciones sobre la atención familiar y la atención profesional com influjos en las maneras de percibir y además agir en relación a la atención a la salud. La representación social del adolescente observa las significaciones del adoecimiento y de la atención, señalada, todavía, por la indisociabilidad entre las prácticas de atención y las relaciones psicoafectivas y sociales que hay en su vivencia.The objective of the study was to apprehend the social representations of teenagers in relation to care in situation of Severe Renal Insufficiency. It was applied the test of free association of words to 70 teenagers

  13. [Sodium transport in chronic renal insufficiency].

    Science.gov (United States)

    Noé, D

    1985-03-24

    From an analysis of the literature covering the problem of sodium contribution in uraemic patients subjected to both conservative treatment and maintenance dialysis, it has been shown that excessive reduction in dietary sodium intake can be harmful unless it is justified by severe hypertension or oedema since it aggravates the state of uraemia. In these cases, the addition of a minimum controlled amount of hyposodic salt to an otherwise salt free diet is undoubtedly useful. The hyposodic salt, "Misura" manufactured by the company "Plasmon" was used in the dietary treatment of a series of patients subjected to mild restriction in dietary salt intake. Misura was well tolerated and well accepted thanks to its pleasing taste.

  14. Atherosclerosis in elderly patients with renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    Sandeep S. Soman

    2005-01-01

    @@ Introduction As people age,cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease mechanism.In addition to lipid levels,diabetes,sedentary lifestyle,and genetic factors that are known risks for coronary disease,hypertension,and stroke - the quintessential cardiovascular (CV) diseases related to atherosclerosis within our society - advancing age unequivocally confers the major risk.(Fig.1) Mortality due to cardiovascular disease is more than any other disease and creates enormous costs for the health care system.The main underlying problem in cardiovascular disease is atherosclerosis,a process that obstructs major arteries with lipid deposits and cell accumulation.1 Decreased kidney function (estimated GFR<70 mL/min/1.73 m2) is an independent risk factor for cardiovascular disease and all-cause mortality in the general population.2

  15. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  16. INTERMEDIATE SYNDROME: A TYPICAL PATTERN OF PRE-RENAL ACUTE RENAL FAILURE IN THE ELDERLY

    Directory of Open Access Journals (Sweden)

    Greloni G

    2004-01-01

    Full Text Available Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatible with parenchymal renal insufficiency (elevated urinary sodium, plasma urea and creatinine, but with a positive response to hydration. The main characteristics of the aged kidney that predispose to the development of an intermediate syndrome are: the vascular dysautonomy and reduced capability of sodium and water reabsorption. The intermediate syndrome is a typical pattern of pre-renal insufficiency in the elderly. RESUMEN: La insuficiencia renal aguda es frecuente en el anciano. Esto se debe por un lado a los cambios estructurales y funcionales propios del riñón senil, y por otro a la gran exposición que esta población tiene a la polifarmacia, y su reducida capacidad para metabolizar los medicamentos. En este reporte presentamos el caso de una mujer de 70 años que desarrolló una insuficiencia renal aguda secundaria a severa deshidratación, mostrando un patrón clínico y de laboratorio propio de un sindrome intermedio: laboratorios compatibles con una insuficiencia renal parenquimatosa (sodio urinario, uremia y creatininemia elevadas, pero con una respuesta favorable a la hidratación. Las principales características del riñón senil que predisponen al desarrollo del sindrome intermedio: son la disautonomía vascular y la reducida capacidad en la recuperación de sodio y agua El sindrome intermedio es un patrón típico de insuficiencia prerrenal en el anciano.

  17. Injection of recombinant Fc alpha RI/CD89 in mice does not induce mesangial IgA deposition

    NARCIS (Netherlands)

    van der Boog, PJM; van Kooten, C; van Zandbergen, G; Klar-Mohamad, N; Oortwijn, B; Bos, NA; van Remoortere, A; Hokke, CH; de Fijter, JW; Daha, MR

    2004-01-01

    Background. Earlier studies have suggested that complexes of the human IgA receptor FcalphaRI/CD89 with mouse IgA are pathogenic upon deposition in the renal mesangium. Transgenic mice expressing FcalphaRI/CD89 on macrophages/monocytes developed massive mesangial IgA deposition and a clinical

  18. Injection of recombinant Fc alpha RI/CD89 in mice does not induce mesangial IgA deposition

    NARCIS (Netherlands)

    van der Boog, PJM; van Kooten, C; van Zandbergen, G; Klar-Mohamad, N; Oortwijn, B; Bos, NA; van Remoortere, A; Hokke, CH; de Fijter, JW; Daha, MR

    2004-01-01

    Background. Earlier studies have suggested that complexes of the human IgA receptor FcalphaRI/CD89 with mouse IgA are pathogenic upon deposition in the renal mesangium. Transgenic mice expressing FcalphaRI/CD89 on macrophages/monocytes developed massive mesangial IgA deposition and a clinical pictur

  19. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  20. 慢性心力衰竭急性加重伴2型糖尿病肾功能不全患者应用糖皮质激素的临床分析%THE CLINICAL ANALYSIS OF GLUCOCORTICOID ON PATIENTS WITH ACUTE EXACERBATION OF CONGESTIVE HEART FAILURE,TYPE 2 DIABETES AND RENAL INSUFFICIENCY

    Institute of Scientific and Technical Information of China (English)

    甄宇治; 高延秋; 刘超; 刘刚; 籍振国; 刘坤申

    2011-01-01

    Objective To determine the clinical efficacy of glucocorticoid on patients with acute exacerbation of congestive heart failure, type 2 diabetes and renal insufficiency. Methods Prednisone was used in addition to traditional treatment in 13 patients with acute exacerbation of congestive heart failure,type 2 diabetes and renal insufficiency. Results Prednisone dramatically improved patients ' symptoms, clinical status, heart function and renal function ( i. e. the glomerular filtration rate ).Conclusion In patients with acute exacerbation of congestive heart failure, type 2 diabetes and renal insufficiency , glucocorticoid treatment could remarkably improve the renal function.%目的 探讨糖皮质激素对于慢性充血性心力衰竭急性加重伴2型糖尿病肾功能不全患者的治疗效果.方法 慢性心力衰竭急性加重伴2型糖尿病肾功能不全患者13例在常规治疗基础上加用糖皮质激素治疗.结果 加用糖皮质激素治疗后,13例患者临床症状均好转,心功能改善,肾功能改善,血肌酐下降,肾小球滤过率升高.结论 慢性心力衰竭急性加重伴2型糖尿病肾功能不全患者在常规治疗基础上加用糖皮质激素治疗,肾功能可得到明显改善.

  1. Clinical application of continuous renal replacement therapy for postoperative renal insufficiency in patient with severe heart valve disease%连续性肾脏替代治疗在重症心脏瓣膜病术后急性肾功能衰竭的临床应用

    Institute of Scientific and Technical Information of China (English)

    王松; 谢凯; 李红; 王琴; 谭君

    2013-01-01

    Objectives To evaluate clinical application the of continuous renal replacement therapy (CRRT) for postoperative renal insufficiency in patient with severe heart valve disease. Methods We retrospectively analyzed the clinical data of 27 patients (live group 15 cases, death group 12 cases) with severe heart valves diseases who got postoperative renal insufficiency and performed CRRT. Results Gender, age, the classification of preoperative heart function classification and extracorporeal circulation time has no significant difference (P<0. 05) between live group and death group. But the duration of AKI before CRRT(P<0. 05)and the time of urine volume<0. 5ml·kg-1·h-1 before CRRT (P<0. 05) in death group were significantly longer than that in live group. The serum creatinine of death group before CRRT is also significantly higher than live group (P<0. 05). The serum creatinine, blood urea nitrogen, mean arterial pressure, central venous blood pressure, K+ and blood HCO3- of all 27 patients after CRRT are statistically significant difference (P<0. 05) with those before CRRT. Conclusion CRRT is an important treatment to these patients with severe heart valve disease who got postoperative renal insufficiency. But the most important problem in this process is the recognition of AKI and early beginning of the therapy. It is suggested that early CRRT therapy is beneficial for reducing mortality rate of these patients.%目的 探讨连续性肾脏替代治疗(CRRT)在心脏瓣膜病术后出现急性肾功能衰竭的临床应用价值.方法 回顾性分析心脏瓣膜病术后合并急性肾功能衰竭行CRRT治疗的27例患者(存活组15例,死亡组12例)的临床资料,并进行统计分析.结果 死亡组CRRT距AKI时间和距尿量<0.5ml/Kg·h时间明显长于存活组(P<0.05),且死亡组CRRT开始前的血肌酐显著高于存活组(P<0.05).27例患者CRRT治疗前后血肌酐、尿素氮、平均动脉压、中心静脉压、血K+、血HCO3

  2. Midterm renal functions following acute renal infarction

    Directory of Open Access Journals (Sweden)

    Sakir Ongun

    2015-10-01

    Full Text Available The aim of this study was to explore clinical features of renal infarction (RI that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA only, whereas patients with atrial fibrillation (AF or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8% with RI had atrial fibrillation (AF as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9% had elevated serum lactate dehydrogenase (LDH, 18 patients (78.2% had leukocytosis, and 16 patients (69.5% had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m2 at admission and increased to 82.3 ± 23.4 mL/min/1.73 m2 at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  3. Midterm renal functions following acute renal infarction.

    Science.gov (United States)

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven

    2015-10-01

    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m(2) at admission and increased to 82.3 ± 23.4 mL/min/1.73 m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  4. Utilidad de la relación aclaramiento de creatinina - índice de resistencia de la ecografía Doppler renal como predictor de rechazo agudo en riñones trasplantados

    Directory of Open Access Journals (Sweden)

    R. Cobeñas

    2016-04-01

    Conclusión: La asociación IR mayor de 0,7 y Cl Cr 0-30 demostró ser útil para confirmar la posibilidad de rechazo renal agudo, al tener una buena especificidad (98,2% a pesar de su baja sensibilidad (53%.

  5. RIKEN RI Beam Factory project

    Energy Technology Data Exchange (ETDEWEB)

    Yano, Yasushige; Goto, Akira; Katayama, Takeshi [Institute of Physical and Chemical Research, Wako, Saitama (Japan)

    1997-03-01

    The RARF proposes `RIKEN RI Beam Factory` as a next facility-expanding project. The factory makes it the primary aim to provide RI (Radioactive Isotope) beams covering over the whole atomic-mass range with the world-highest intensity in a wide energy range up to several hundreds MeV/nucleon. These RI beams are generated by the fragmentation of high-intensity heavy-ion beams. For the efficient production heavy-ion energies will be boosted up to over 100 MeV/nucleon even for very heavy ions by a K2500-MeV superconducting ring cyclotron serving as a post accelerator of the existing K540-MeV ring cyclotron. A new type of experimental installation called `MUSES` (Multi-USe Experimental Storage rings) will be constructed as well. With MUSES, various types of unique colliding experiments will become possible. (author)

  6. Electrocardiographic Analysis of Hyperkalemia in Renal Insufficiency Patients on Pre-and Post-Hemodialysis%肾功能不全高钾患者透析前、后心电图分析

    Institute of Scientific and Technical Information of China (English)

    陈娟; 刘仁光

    2014-01-01

    目的:观测肾功能不全高钾患者血液透析前、后随血清钾离子浓度变化对应的心电图变化特点,为临床高钾血症诊断提供线索。方法选择我院50例诊断为肾功能不全并高钾血症进行血液透析的患者,观测:(1)血液透析前、后血清钾离子浓度;(2)心电图:血液透析前后心率、 P波时限、 PR间期、 QRS时限、 T波振幅、 T波时限、 QT间期。结果(1)透析前T波时限较透析后缩短(145.20±23.49) ms vs (180.00±22.86) ms,振幅较透析后增大(0.76±0.54) mV vs (0.43±0.36) mV,均P<0.05,且随着血钾增高T波高尖程度增加;(2)透析前P波时限、 PR间期和QRS时限均较透析后延长(112.50±15.33) ms vs (98.80±14.88) ms、(175.98±35.40) ms vs (157.34±22.73) ms和(104.00±20.85) ms vs (88.76±10.39) ms,均P<0.05,这些改变主要出现在中、重度高钾病例并随着血钾浓度增加而加重。结论进一步证实T波增高是高钾最先出现、常见的心电图表现;房内阻滞( P波增宽至消失)、室内阻滞( QRS增宽)和房室阻滞是中、重度高钾的心电图表现。%Objective To observe the corresponding different electrocardiogram (ECG) manifestations with changes of serum po-tassium levels in patients with renal insufficiency and hyperkalemia on pre-and post-hemodialysis ( HD) , providing diagnostic clues of hyperkalemia for the clinicians .Method A total of 50 cases of patients with renal insufficiency and hyperkalemia receiving hemodi-alysis in our hospital were selected.This study was preformed to evaluate the parameters such as serum potassium concentration and electrocardiographic findings including such factors as heart rate, P duration, PR interval, QRS duration, T amplitude and duration and QT intervals on pre-and post-hemodialysis respectively.Results (1) T wave duration on pre-HD was shorter than the post-HD (145.20±23.49 ) ms

  7. Primary Ovarian Insufficiency (POI)

    Science.gov (United States)

    ... insufficiency in the adolescent : Committee opinion no. 502. Obstetrics and Gynecology, 118 , 741–745. ... Search of Answers for Those Struggling With Infertility Study finds genetic clue to menopause-like condition ...

  8. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim...... of the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

  9. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  10. Riñón en herradura asociado a variantes anatómicas

    OpenAIRE

    David Rodríguez Palomo

    2009-01-01

    El riñón en herradura es una variante anatómica frecuente del sistema renal que normalmente cursa asintomático, sin embargo, la concomitancia de anormalidades congénitas en los pacientes portadores de esta variante puede desencadenar síntomas producto de complicaciones renales, cardiocirculatorias y varios tipos de neoplasias que tienden a la malignidad. Este trabajo describe la variante anatómica del riñón en herradura asociado a tres uréteres independientes con variante arteriovenosa de su ...

  11. 异常凝血酶原和唾液酸在慢性肾功能不全患者血清中的表达及临床意义%Serum expression of PIVKA-Ⅱand SA in patients with chronic renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    公帅; 孙桂荣; 刘明军; 席强; 彭冲; 孙晓岚

    2016-01-01

    目的:观察慢性肾功能不全对血清异常凝血酶原(PIVKA‐Ⅱ)和唾液酸(SA)水平的影响。方法用化学发光法和酶法分别检测127例慢性肾功能不全、32例肾功能正常肾脏疾病患者、57例体检健康者和120例肝细胞癌(HCC )患者血清PIV‐KA‐Ⅱ和SA水平。分别测定上述受试者血清尿素(Urea)和肌酐(Cr)水平,并估算肾小球滤过率值(eGFR)。结果健康对照组、肾功能正常疾病组和肾功能不全疾病组三组间血清PIVKA‐Ⅱ水平没有统计学差异(H=2.902,P>0.05),且明显低于 HCC组(U值分别为319.50、203.00、665.50,P均<0.001)。肾功能不全疾病组中各期之间血清 PIVKA -Ⅱ水平也没有统计学差异( H=3.991,P>0.05)。血清S A水平在健康对照组、肾功能正常疾病组和肾功能不全疾病组之间( H=63.685,P<0.001),以及在肾功能不全疾病组各期之间(H=64.689,P<0.001)均有统计学差异。血清SA水平与eGFR呈负相关(r=-0.705,P<0.001),与Urea、Cr水平呈正相关(r=0.599、0.704,P<0.001)。 HCC组血清SA水平较CKD1~4期均明显升高(U值分别为126.00、163.50、247.00、715.00,P均<0.001),较CKD5期无明显变化(U=419.00,P>0.05)。结论肾功能不全对血清 PIVKA‐Ⅱ表达无明显影响,但可明显提高血清SA的表达水平,并与肾功能损害程度密切相关。可见血清SA水平升高不仅对HCC及其他多种恶性肿瘤有辅助诊断价值,还可较好地反映慢性肾功能不全患者的肾功能状态。%Objective To investigate the impact of chronic renal insufficiency on serum levels of protein induced by vitamin K absence or antagonist‐Ⅱ(PIVKA‐Ⅱ) and sialic acid (SA) .MethodsThe levels of serum PIVKA‐Ⅱ ,SA ,urea and creatinine(Cr) were detected in 127 cases of chronic renal insufficiency ,32

  12. O Transplante renal sob a ótica de crianças portadoras de insuficiência renal crônica em tratamento dialítico: estudo de caso El transplante renal bajo la óptica de los niños que llevan la insuficiencia renal crónica en el tratamiento dialítico: estudio del caso The renal transplant under the optics of children with chronic renal insufficiency in dialysis treatment: study of case

    Directory of Open Access Journals (Sweden)

    Vanessa Grespan Setz

    2005-09-01

    Full Text Available INTRODUÇÃO: Para compreender quais são as implicações da doença crônica para a criança e seus familiares é necessário partir-se da premissa de que a doença crônica não pode ser curada e que a cura almejada pode se transformar em mito perigoso, que compromete todo o processo de desenvolvimento da criança. OBJETIVOS: Compreender o significado do transplante renal para crianças em tratamento dialítico e conhecer suas expectativas em relação a este tratamento. MÉTODO: Estudo qualitativo, utilizando o Estudo de Caso como método de investigação e os pressupostos de Mayeroff como referencial teórico-filosófico. Para coleta de dados foram utilizadas as técnicas de entrevista semi-estruturada e o Desenho-Estória com tema. Foram entrevistadas 15 crianças em tratamento dialítico e hemodialítico, com idades entre 6 e 16 anos que consentiram em participar do estudo RESULTADO: Da análise de conteúdo emergiram quatro categorias: Construindo o conhecimento sobre o transplante; Buscando entender a espera pelo transplante; Criando expectativas de mudanças; Em contato com a frustração. E do desenho-estória com tema a categoria: Desvelando os sentimentos através do desenho. Neste artigo apresentaremos os resultados referentes às questões semi-estruturadas que emergiram das falas dos sujeitos. CONCLUSÃO: O estudo possibilitou compreender que as crianças percebem a realização do transplante renal como a única possibilidade de voltarem a vivenciar uma vida normal.RESUMEN INTRODUCCIÓN: Para comprender cuales son las implicaciones de la enfermedad crónica para el niño y sus familiares és necessário partir del presupuesto de que la enfermedad crónica no puede ser curada y que la cura deseada puede se transformarse en un mito peligroso, que puede comprometer todo el proceso de desarrolo del niño. OBJETIVOS: Compreender el significado del transplante renal para los niños en tratamiento dialítico y conocer sus expectativas

  13. 'Jüri Rumm' : Kaks retroarvustust

    Index Scriptorium Estoniae

    1996-01-01

    Sisu: R. K. P. (Rasmus Kangro-Pool). 'Rummu Jüri' ekraanil (Päevaleht, 13. dets. 1929); J. J--k. (Juhan Jaik). 'Rummu Jüri'. Uus eesti film. (Postimees, 13. dets. 1929). Rets. film: Jüri Rumm. Stsenaariumi aluseks Hans Varessoo romaan 'Jüri Rumm' (Tln., 1908), stsenaariumi autor teadmata. Režissöör John Loop, operaator ja produtsent Konstantin Märska. Konstantin Märska Filmproduktsioon, 1929

  14. 小剂量多巴胺联合前列地尔治疗慢性肾功能不全的临床疗效分析%Analysis clinical effect of the low-dose dopamine combined with alprostadil for treatment of chronic renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    孙丽萍

    2013-01-01

      目的分析小剂量多巴胺联合前列地尔治疗慢性肾功能不全的疗效。方法将我院2010年3月-2012年12月90例慢性肾功能不全患者随机分为两组各45例,对照组患者给予常规治疗,观察组患者在此基础上加用小剂量多巴胺和前列地尔治疗。结果观察组24h尿蛋白量、内生肌酐清除率、血肌酐、尿素氮及疗效均优于对照组(P<0.05)。结论小剂量多巴胺联合前列地尔治疗慢性肾功能不全的疗效确切,能延缓疾病进展,值得临床推广。%Objective To analyze the effect of low-dose dopamine combined with alprostadil for treatment of chronic renal insufficiency. Methods 90 patients with chronic renal insufficiency in our hospital from March 2010 to December 2012 were randomly divided into observation group and control group. Observation group was given low-dose dopamine combined with alprostadil on the basis of general treatment therapy and control group was given general treatment therapy. Results The 24h urine protein quantity, endogenous creatinine clearancerate, serum creatinine, blood urea nitrogen, and the clinical effect in the observation group were significant better than those in the control group(P<0.05). Conclusions The low-dose dopamine combined with alprostadil for treatment of chronic renal insufficiency is efficacy, decrease in development. It is worthy to be popularized.

  15. Prevalência de anemia e insuficiência renal em portadores de insuficiência cardíaca não-hospitalizados Prevalencia de anemia e insuficiencia renal en portadores de insuficiencia cardiaca no hospitalizados Prevalence of anemia and renal insufficiency in non-hospitalized patients with heart failure

    OpenAIRE

    Francisco José Farias Borges dos Reis; André Maurício Souza Fernandes; Almir Galvão Vieira Bitencourt; Flávia Branco Cerqueira Serra Neves; André Yoichi Kuwano; Victor Hugo Pinheiro França; Cristiano Ricardo Bastos de Macedo; Cristiano Gonçalves da Cruz; Viviane Sahade; Roque Aras Júnior

    2009-01-01

    FUNDAMENTOS: Insuficiência cardíaca (IC) é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR) são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de ...

  16. Prevalência de anemia e insuficiência renal em portadores de insuficiência cardíaca não-hospitalizados Prevalencia de anemia e insuficiencia renal en portadores de insuficiencia cardiaca no hospitalizados Prevalence of anemia and renal insufficiency in non-hospitalized patients with heart failure

    OpenAIRE

    Francisco José Farias Borges dos Reis; André Maurício Souza Fernandes; Almir Galvão Vieira Bitencourt; Flávia Branco Cerqueira Serra Neves; André Yoichi Kuwano; Victor Hugo Pinheiro França; Cristiano Ricardo Bastos de Macedo; Cristiano Gonçalves da Cruz; Viviane Sahade; Roque Aras Júnior

    2009-01-01

    FUNDAMENTOS: Insuficiência cardíaca (IC) é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR) são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de ...

  17. Prevalência de anemia e insuficiência renal em portadores de insuficiência cardíaca não-hospitalizados Prevalencia de anemia e insuficiencia renal en portadores de insuficiencia cardiaca no hospitalizados Prevalence of anemia and renal insufficiency in non-hospitalized patients with heart failure

    Directory of Open Access Journals (Sweden)

    Francisco José Farias Borges dos Reis

    2009-09-01

    Full Text Available FUNDAMENTOS: Insuficiência cardíaca (IC é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de julho de 2003 a novembro de 2006. Anemia foi definida como níveis de hemoglobina abaixo de 13 mg/dl para homens e de 12 mg/dl para mulheres. A função renal foi avaliada por meio da taxa de filtração glomerular (TFG, calculada pela fórmula simplificada do estudo MDRD (Modification of Diet in Renal Disease. RESULTADOS: Dos trezentos e quarenta e cinco pacientes incluídos neste estudo, 26,4% (n = 91 tinham anemia e 29,6% tinham insuficiência renal moderada a grave (TFG FUNDAMENTO: La insuficiencia cardiaca (IC es una enfermedad común con alta tasa de mortalidad. La anemia y la insuficiencia renal (IR, encontradas frecuentemente en portadores de IC, son asociadas a mayor severidad de la enfermedad cardiaca y peor pronóstico. OBJETIVO: Evaluar la prevalencia de anemia e insuficiencia renal, así como la asociación entre esos dos cuadros, en portadores de IC no hospitalizados. MÉTODOS: Se observaron a pacientes seguidos en la clínica de IC de un hospital universitario de julio de 2003 a noviembre de 2006. Se definió la anemia como niveles de hemoglobina abajo de 13 mg/dl para varones y de 12 mg/dl para mujeres. La función renal se evaluó por medio de la tasa de filtración glomerular (TFG, calculada por la fórmula simplificada del estudio MDRD (Modification of Diet in Renal Disease. RESULTADOS: Teniendo en cuenta los trescientos y cuarenta y cinco pacientes incluidos en este estudio, el 26,4% (n = 91 tenía anemia y el 29

  18. Efeitos do exercício físico durante a hemodiálise em indivíduos com insuficiência renal crônica: uma revisão Effects of physical exercise during hemodialysis in patients with chronic renal insufficiency: a literature review

    Directory of Open Access Journals (Sweden)

    Regina Márcia Faria de Moura

    2008-01-01

    Full Text Available As principais alterações observadas em indivíduos com insuficiência renal crônica são anemia, hipertensão arterial sistêmica e atrofia muscular, que levam à baixa capacidade aeróbica e perda de força muscular. Assim, parte do tratamento desses indivíduos consiste em programas de exercício físico. O objetivo desta revisão da literatura foi documentar os efeitos agudos e as adaptações crônicas, cardiovasculares e musculares em indivíduos no estágio final da doença renal, submetidos a programas de exercício físico durante a hemodiálise. Foram selecionados artigos científicos nas bases eletrônicas Medline, Lilacs e PEDro, assim como no acervo de periódicos da biblioteca da Faculdade de Medicina da UFMG. Foram analisados 13 artigos envolvendo exercício físico aeróbico associado ou não a fortalecimento muscular durante a hemodiálise, variando quanto à intensidade, freqüência e duração da intervenção. A maioria demonstrou que exercícios físicos realizados durante a hemodiálise promovem efeitos benéficos na melhora da capacidade aeróbica, força muscular e no controle dos fatores de risco cardiovasculares, auxiliando a remoção dos solutos durante a hemodiálise. Embora o tema seja ainda pouco explorado, a literatura disponível evidencia benefícios do exercício durante a hemodiálise sobre a capacidade aeróbica e força muscular dos pacientes.Main alterations seen in patients with chronic renal insufficiency are anemia, systemic arterial hypertension, and muscular atrophy, which lead to low aerobic capacity and loss of muscle strength. Hence part of these patients treatment consists in programs of physical exercise. The purpose of this literature review was to assess muscle and cardiovascular acute effects and chronic adaptations in end-stage renal disease patients submitted to physical exercise during hemodialysis. After browsing through Medline, Lilacs and PEDro databases, as well as searching for

  19. Is there something special about cardiovascular abnormalities and sudden unexpected death in epilepsy among patients with chronic renal insufficiency in regular hemodialysis program? Existe algo de especial a respeito das anormalidades cardíacas e morte súbita e inesperada na epilepsia nos pacientes com insuficiência renal crônica no programa regular de hemodiálise?

    Directory of Open Access Journals (Sweden)

    Rui A. Gomes

    2009-06-01

    Full Text Available Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP, higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.Um dos principais fatores de risco para a morte súbita e inesperada na epilepsia (SUDEP é a alta freqüência de crises epilépticas. Seguindo este raciocínio, tem sido estabelecido que as crises epilépticas associadas à hemodiálise seja uma complicação do procedimento dialítico. Baseado neste fato, este estudo investigou uma possível associação entre anormalidades cardiovasculares e SUDEP nos pacientes com insuficiência renal crônica em um programa regular de hemodiálise. Para isto, um histórico médico retrospectivo de 209 pacientes foi revisado para avaliar a ocorrência de crises epilépticas e possíveis anormalidades no ECG durante o programa de diálise. Três pacientes apresentaram crises tônico-clonica generalizadas, um apresentou crise parcial com generalização secundária e um apresentou

  20. The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients

    Directory of Open Access Journals (Sweden)

    Kikuno Hanamura

    2012-01-01

    Full Text Available To evaluate the significance of the renal resistive index (RI as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD patients who underwent renal biopsy. RI increased as the CKD stage progressed and correlated with age, systolic blood pressure, estimated glomerular filtration rate (eGFR, and renal histological changes, including glomerulosclerosis, arteriolosclerosis, and tubulointerstitial damage. Prognostic evaluation with a median follow-up period of 38.5 months revealed that patients with RI≥0.7 (high RI group, n=39 had significantly poorer renal survival than those with RI<0.65 (normal RI group, n=120 and 0.65≤RI<0.7 (high-normal RI group, n=43. The patients in the high-normal RI group showed good response to steroids. However, in the high RI group, steroid therapy did not significantly improve renal survival. Of the clinical indices studied, RI≥0.7, hypertension, proteinuria, and low eGFR at diagnosis were independent risk factors for worsening renal dysfunction. In conclusion, RI in CKD patients was considered as a marker of renal function, histological damage, and renal prognosis, and a possible determinant of indication for steroids.

  1. Adrenal Insufficiency and Addison's Disease

    Science.gov (United States)

    ... People Who Were Treated with hGH Adrenal Insufficiency & Addison's Disease What is adrenal insufficiency? Adrenal insufficiency is an ... under “ How is adrenal insufficiency treated? ” What causes Addison’s disease? Autoimmune disorders cause most cases of Addison’s disease. ...

  2. Efficacy Analysis of 60 Cases of Senile Chronic Renal Insufficiency Combined with Infection Treated with Antibiotics%抗生素治疗老年慢性肾功能不全合并感染60例临床分析

    Institute of Scientific and Technical Information of China (English)

    滕玲; 覃建阳

    2012-01-01

    目的 探索抗生素治疗慢性肾功能不全失代偿期合并下呼吸道感染的老年患者的临床效果及其对肾功能影响.方法 选取2008年5月~2011年10月我院治疗的60例肾功能不全合并肺部感染老年患者,同期选取60例肾功能正常的老年下呼吸道感染患者作对照.应用头孢哌酮治疗后观察两组患者的总体疗效差异及治疗组患者治疗前后的肾功能情况差异.结果 治疗组和对照组患者的总体治疗效果比较,差异无统计学意义(P>0.05),但治愈率差异有统计学意义(P<0.05);治疗组治疗前后患者的血肌酐、尿素氮、内生肌酐清除率水平与治疗前比较,差异有统计学意义(P<0.05).结论 肾功能不全合并下呼吸道感染老年患者,治疗中应密切留意患者的肾功能,一旦出现肾功能衰竭应积极处理.%Objective To explore the clinical efficacy of antibiotics on chronic renal insufficiency at the compensatory stage combined with lower respiratory infection for the aged patients and the impacts on renal function. Methods From May 2008 to October 2011,60 aged patients with renal insufficiency combined with pulmonary infection were selected. In the same term, 60 aged patients with lower respiratory infection and normal renal function were selected as the control. After treated with cefoperazone, the difference in the total efficacy between two groups and the difference in renal function before and after treatment in the treatment group were observed. Results In comparison of the total efficacy for the patients between the treatment group and the control group, there was no statistical significant difference( P > 0.05 ), but the difference in the curative rate was significant statistically( P < 0. 05 ). In the treatment groups, the levels of creatinine( Cr ), urea nitrogen( BUN )and the endogenous creatinine clearance rate( CCr )were different significantly as compared with those before treatment P <0. 05

  3. 应用抗生素治疗老年慢性肾功能不全并细菌感染60例疗效分析%Clinical Effect of Antibiotics to Treat 60 Elderly Patients with Chronic Renal Insufficiency and Bacterial Infection

    Institute of Scientific and Technical Information of China (English)

    滕玲; 覃建阳

    2012-01-01

    目的 探索应用抗生素治疗慢性肾功能不全失代偿期合并下呼吸道感染的老年患者的临床效果和对其肾功能的影响.方法 选取我院自2008年5月~2011年10月我院治疗的60例肾功能不全合并肺部感染的老年患者纳入观察组,同期选取60肾功能正常的老年下呼吸道感染的患者纳入对照组.两组患者应用头孢哌酮进行治疗,观察两组患者的总体治疗效果差异以及观察组患者治疗前后的肾功能血肌酐、尿素氮、尿酸、肌酐清除率水平差异.结果 观察组和对照组患者平均治疗时间分别为(10.15±3.23)天和(7.32±2.18)天,差异有统计学意义(P<0.05);两组患者的总体治疗效果差异不明显(P>0.05),但痊愈率差异有统计学意义(P<0.05);观察组治疗前后患者的血肌酐、尿素氮、内生肌酐清除率水平与治疗前比较差异有统计学意义(P<0.05).结论 肾功能不全的老年患者一旦发生下呼吸道感染,应用抗生素治疗的难度增大,治疗过程中应密切留意患者的肾功能情况,并合理控制药物用量,一旦出现肾功能衰竭应立即停药,必要时进行血液透析.%Objective Explore the clinical effect of antibiotics to treat 60 elderly patients with chronic renal insufficiency and bacterial infection, and influence to the renal function. Methods Choosing 60 elderly patients with chronic renal failure and 60 elderly patients with normal renal function, all patients were suffered from lower respiratory tract infection, who were treated by Ceftazidime in our hospital from May 2008 to October 2011. Observe the difference of clinical effect and renal function change before and after treatment. Results The average treatment time of observation group and control group were(10.15±3.23) d and (7.32±2.18) d (P<0.05); There were no statistical means of overall treatment effect(P>0.05), but difference of cure rate between two groups was significant(P<0

  4. Fatores preditivos de diagnósticos de enfermagem em pacientes submetidos ao transplante renal Factores predictores de diagnósticos de enfermería en pacientes sometidos al trasplante de riñón Predisposing factors of nursing diagnoses in patients submitted to kidney transplantation

    Directory of Open Access Journals (Sweden)

    Jaqueline Galdino Albuquerque

    2010-02-01

    Full Text Available O objetivo do estudo foi identificar fatores preditores para diagnósticos de enfermagem de pacientes transplantados renais. Estudo transversal realizado em um hospital universitário com 58 pacientes submetidos ao transplante renal. Os dados foram coletados com um roteiro de entrevista e exame físico. Para análise dos dados foi utilizada a técnica de regressão logística considerando um nível de significância de 5%. Os fatores preditores identificados foram: Estado de Doença para o diagnóstico Fadiga; Procedência e Estado civil para Nutrição desequilibrada: mais do que as necessidades corporais; Tempo de diálise e Mudança relatada ou medida na acuidade sensorial para Percepção sensorial perturbada: auditiva; e Idade e Estado de doença para Percepção sensorial perturbada: visual.El objetivo del estudio fue identificar factores predictores de diagnósticos de enfermería de pacientes trasplantados de riñón. Estudio transversal realizado en un hospital universitario con 58 pacientes sometidos al trasplante de riñón. Los datos fueron recogidos con un guia dee entrevista y examen físico. Para el análisis de los datos fue utilizada la técnica de regresión logística considerando un nivel de significancia del 5%. Los factores predictores identificados fueron: Estado de Enfermedad para el diagnóstico Fatiga; Naturalidad y Estado civil para Desequilibrio nutricional: por exceso; Tiempo de diálisis y Cambio relatado o medido en la acuidad sensorial para Trastorno de la percepción sensorial: auditiva; y Edad y Estado de enfermedad para Trastorno de la percepción sensorial: visual.The purpose of this study was to identify predisposing factors of nursing diagnoses in patients submitted to kidney transplantation. A cross-sectional carried out in an academic hospital with 58 patients submitted to kidney transplantation. The data was collected with an interview script and physical examination. For data analysis was used the

  5. 慢性心力衰竭患者肝、肾功能不全发生率及其与心衰严重程度的关系%The incidence rate of liver and renal insufficiency in the patients with chronic cardiac failure and its relationship with heart failure severity

    Institute of Scientific and Technical Information of China (English)

    戴希友

    2014-01-01

    Objective:To explore the incidence rate of liver and renal insufficiency in the patients with chronic cardiac failure(CHF) and its relationship with heart failure severity.Methods:96 cases with CHF were selected.According to the NYHA heart function classification,they were randomly divided into cardiac function Ⅰ,Ⅱ,Ⅲ,Ⅳ group.The incidence rates of liver and renal insufficiency of each groups were respectively calculated.The changs of alanine aminotransferase(ALT)、 glomerular filtration rate(eGFR) level and the relationship with heart failure severity.Results:The incidence rates of liver and renal insufficiency in the patients with chronic cardiac failure were respectively 42.0% and 38.5% .With the rise of heart function classification,the incidence rate of liver and renal insufficiency was rised.With the continuous deterioration of heart function, serum ALT and eGFR concentration were gradually increased,and there was significant difference in 4 groups(P<0.05). Conclusion:The phenomenon of liver and renal insufficiency in the patients with chronic cardiac failure is quite common.The cardiac functional grading of patients is more higher.The liver and kidney function damage will be more serious.%目的:探讨慢性心力衰竭(CHF)患者肝、肾功能不全发生率及其与心衰严重程度的关系。方法:收治CHF患者96例,按照NYHA心功能分级随机分为心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级组,分别计算各组肝、肾功能不全发生率,探讨丙氨酸氨基转移酶(ALT)、肾小球滤过率(eGFR)水平的变化与心衰严重程度的关系。结果:慢性心衰患者肝、肾功能不全的发生率分别为42.0%、38.5%,并且随心功能分级的升高,肝、肾功能不全发生率也在升高;随着心功能的不断恶化,血清ALT、eGFR浓度也逐渐升高,且4组组间差异有统计学意义(P<0.05)。结论:慢性心衰患者中肝、肾功能不全的现象相当普遍,且患者心功能分级越

  6. Usefulness of resistive index on spectral Doppler ultrasonography in the detection of renal cell carcinoma in patients with end-stage renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Youn; Woo, Sung Min; Cho, Jeong Yeon; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Hwang, Sung Il; Lee, Hak Jong [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Moon, Min Hoan; Sung, Chang Kyu [Dept. of adiology, Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2014-04-15

    The aim of this study was to explore the usefulness of the resistive index (RI) on spectral Doppler ultrasonography (US) in the detection of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). Seventeen ESRD patients with kidneys in which renal masses were suspected in routine US were subjected. They underwent computed tomography scans and additional Doppler US for the characterization of the detected lesions. All underwent radical nephrectomy with the suspicion of RCC. Fourteen patients finally were included. RI measurements were conducted in the region of the suspected renal mass and the background renal parenchyma. The intra class correlation coefficient was used to assess the reproducibility of the RI measurement. A paired t-test was used to compare the RI values between the renal mass and the background renal parenchyma (P<0.05). The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma (0.41-0.65 vs. 0.75-0.89; P<0.001). The intrareader reproducibility proved to be excellent and good for the renal masses and the parenchyma, respectively (P<0.001). RI on spectral Doppler US is useful in detecting RCC in patients with ESRD. The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma.

  7. Effect observation of enteral nutrition“integration of medical care” for renal insufficiency patients in ICU%ICU肾功不全患者实施肠内营养“医护一体化”的效果观察

    Institute of Scientific and Technical Information of China (English)

    冯碧翠; 胡超娅; 夏蕊

    2014-01-01

    目的:探讨“医护一体化”在ICU对肾功能不全危重患者肠内营养支持的应用效果。方法58例诊断含“肾功能不全”的危重患者,随机分为研究组28例和对照组30例,其中对照组患者每日常规采用肠内营养乳剂(internal nutrition emulsion)持续胃管泵注补充能量;研究组采用“医护一体化”为患者制定个性化肠内营养支持方案。2周后对两组患者的肾功指标与肠内营养并发症发生率进行分析对比。结果两组患者经过治疗后,肾功指标均下降,研究组下降趋势较对照组明显,两组差异具有统计学意义(P<0.05);肠内营养并发症研究组发生率低于对照组,差异有统计学意义(P<0.05)。结论“医护一体化”在肾功能不全患者肠内营养支持中的实施具有促进患者疾病恢复和降低肠内营养并发症的作用,在临床有一定优势。%Objective To explore “integration of medical care” effects on enteral nutrition support for severe renal insufficiency patients in ICU.Methods A total of 58 ICU patients on diagnosis of renal insufficiency were randomly divided into the study group (n=28) and the control group (n=30). The control group was treated by internal nutrition emulsion from tube, while the study group received a personalized internal nutrition of “integration of medical care”. The two groups’ renal parameters and complication rate were compared after 2 weeks. Results Two groups’ renal functions both decreased, and the decline of the study group was more obvious than that of the control group. The difference was statistically significant (P<0.05). The incidence of enteral nutrition complications of the study group was lower than that of the control group, and the difference had statistical significance (P<0.05).Conclusion Integration of medical care for renal insufficiency patients can promote renal insufficiency patients’ recovery and reduces the complications, and

  8. Therapeutic effect and safety of half dose tirofiban combined PCI in patients with acute myocardial infarction complicated early renal insufficiency%半剂量替罗非班联合PCI对早期肾功能不全急性心肌梗死患者的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    沈冲; 方雪花; 赵炳朕; 余清; 马飞; 张伟; 高德全; 赵雪东

    2012-01-01

    目的:观察半剂量替罗非班联合经皮冠脉介入治疗(PCI)对合并早期肾功能不全急性心肌梗死(AMI)患者的疗效及安全性.方法:选择合并早期肾功能不全的AMI患者55例作为肾功能不全组,56例肾功能正常的AMI患者作为AMI对照组,两组均应用常规抗凝、抗血小板治疗,肾功能不全组于穿刺成功后开始应用半剂量替罗非班,AMI对照组全量应用替罗非班.比较两组间住院期主要不良心血管事件(MACE),出血、血小板减少发生率及对比剂肾病发生率的差异.结果:与AMI对照组比较,肾功能不全组3支病变比例(21.1%比43.6%)、术后肌酸激酶峰值浓度[(1863.1±86.7)IU/L比(2371.5±126.3)IU/L]明显升高(P均<0.05);两组术后TIMI 3级血流率、校正的TIMI计帧数和Blush 3级率未见显著性差异(P>0.05),术后2h心电图相关导联ST段下降幅度及住院期间的MACE发生率亦无显著性差异(P>0.05),出血事件发生率和血小板减少发生率亦无显著差异(P>0.05).对比剂肾病:AMI对照组无发生,肾功能不全组有3例发生(0%比5.45%,P<0.05).结论:合并早期肾功能不全的急性心肌梗死患者三支病变比例高,半剂量替罗非班联合PCI能有效再灌注心肌,降低住院心血管事件发生,未见明显出血及血小板减少发生率增加,但需警惕对比剂肾病的发生,术后应加强监测与干预.%To investigate therapeutic effect and safety of half dose tirofiban combined percutaneous coronary intervention (PCI) on patients with acute myocardial infarction (AMI) complicated early renal insufficiency. Methods: A total of 55 AMI patients with early renal insufficiency were enrolled as renal insufficiency group and 56 AMI patients with normal renal function were regard as AMI control group. Both groups received routine anticoagulant and antiplatelet therapy, renal insufficiency group received half dose tirofiban after successful puncture while AMI control group

  9. Riñón en herradura asociado a variantes anatómicas

    Directory of Open Access Journals (Sweden)

    David Rodríguez Palomo

    2009-03-01

    Full Text Available El riñón en herradura es una variante anatómica frecuente del sistema renal que normalmente cursa asintomático, sin embargo, la concomitancia de anormalidades congénitas en los pacientes portadores de esta variante puede desencadenar síntomas producto de complicaciones renales, cardiocirculatorias y varios tipos de neoplasias que tienden a la malignidad. Este trabajo describe la variante anatómica del riñón en herradura asociado a tres uréteres independientes con variante arteriovenosa de su hilio que constaa de cuatro arterias renales y tres venas renales, en un caso incidental de disección en el laboratorio de anatomía de la Escuela de Medicina de la Universidad de Costa Rica. Además, se presenta una revisión actualizada de la variante denominada riñón en herradura para brindar a los profesionales del área de la salud datos para su detección y diagnóstico, y poder asociarlo con las anormalidades congénitas descritas, con el fin de prevenir complicaciones en los pacientes.The horseshoe kidney is a common anatomical variation of de renal system that is often asymptomatic, however the concomitance with congenital abnormalities in these patients could result in the development of symptoms because of the renal or cardiovascular complications and renal tumors that arise predominantly as malignancies. This job describes the anatomic variations of a horseshoe kidney associated to three independent ureters and a hilium arteriovenous variant consistent in four renal arteries and three renal veins, an incidental dissection case found in the laboratory of Costa Rica’s University Medicine School. Moreover, an actualized literature review of the horseshoe kidney is presented so that health professionals could be able to detect it and diagnose it, and associate it with the congenital abnormalities described above to prevent its complications.

  10. Betahistine in vertebrobasilar insufficiency.

    Science.gov (United States)

    Kaźmierczak, Henryk; Pawlak-Osińska, Katarzyna; Kaźmierczak, Wojciech

    2004-01-01

    The aim of this study was to observe the usefulness of betahistine dihydrochloride--Betaserc--in therapy for vestibular disorders in patients with vertebrobasilar insufficiency. Two groups of patients, in each of which were 150 patients (mean age, 52.2 years), were tested on the basis of videonystagmography and stabilometry. Betaserc was administrated in two separate doses: 8 mg three times daily and 16 mg three times daily for 120-180 days (mean, 132 days). In every case before and after therapy, visuo-oculomotor and vestibulo-oculomotor reflexes were tested, and amplitude and velocity of the sway were measured during dynamic posturographic testing. After Betaserc treatment, pathological visuo-oculomotor reactions and pathological cervical test results disappeared in most cases: Smooth pursuit improved in 59.9% of cases and saccadic movements in 55.9% of patients, and cervical nystagmus disappeared in 62.2% of tested people. During stabilometry, mean and maximal platform amplitude and mean head velocity decreased as compared with results from tests performed before treatment. These observations were significant after the greater dose of Betaserc; nonetheless, improvement was noted after both doses. The usefulness of Betaserc in vertebrobasilar insufficiency was proved, 4-6 months' therapy was sufficient, and the effect on central compensation seemed to be most probable.

  11. El trasplante cadavérico de riñón en herradura. Reporte de dos casos

    OpenAIRE

    Gustavo Martínez-Mier; Stephen C Rayhill; Daniel A. Katz

    2005-01-01

    El número de pacientes en espera de un trasplante renal es elevado. La escasez de órganos demanda la exploración de fuentes alternativas como los riñones con anomalías anatómicas congénitas. Los riñones en herradura son la anomalía anatómica renal más común. Éstos pueden ser trasplantados en bloque o en forma separada posterior a su procuración cadavérica. La decisión de dividir un riñón en herradura depende de varios factores; los principales son el número, la posición de los vasos renales y...

  12. Effect of synchronous health education of family member on the quality of life in patients with chronic renal insufficiency%家属同步健康教育对慢性肾功能不全患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    汪春燕

    2014-01-01

    目的:探讨对家属实施同步教育在慢性肾功能不全患者治疗中的应用效果。方法:选取60例慢性肾功能不全患者,随机分为对照组和观察组,2组患者均接受常规教育,观察组家属实施同步教育。采用生活质量表( SF-36)进行问卷调查,比较2组患者生活质量。结果:2组患者健康教育后生活质量提高(P<0.01),而观察组生活质量各项评分均较对照组提高更明显(P<0.01)。结论:实施家属同步健康教育可明显改善慢性肾功能不全患者生存状态,增强自我护理知识和能力,促进患者更好地配合治疗和护理,提高生活质量。%Objective:To explore the effects of synchronous health education of family member on the quality of life in patients with chronic renal insufficiency. Methods:Sixty patients with chronic renal insufficiency were randomly divided into control group and observation group. All patients were educated with routine instruction,the observation group were additionally educated with synchronous health education of family member. The quality of life of two groups were analyzed by SF-36 scale. Results:After health education,the quality of life in all patients were significantly improved(P<0. 01),the improvement of the quality of life in observation group was significantly better than that in control group(P <0. 01). Conclusions:The synchronous health education of family member can significantly improve the living condition,strengthen the knowledge and self-care ability,promote better treatment and care and improve the quality of life of patients with chronic renal insufficiency.

  13. Peritoneal Dialysis in the Treatment of young Clinical Therapeutic Effect on Acute renal Insufficiency in Children after Cardiac Surgery%腹膜透析治疗低龄患儿心脏术后急性肾功能不全的临床疗效

    Institute of Scientific and Technical Information of China (English)

    陈磊; 赵永成; 万志坤; 查光彦

    2015-01-01

    Objective To investigate the peritoneal dialysis(PD)clinical curative effect in the treatment of acute renal insufficiency in children after cardiac surgery.Methods From 2009 March to 2013 May in our hospital treatment of children after cardiac surgery in children with acute renal insufficiency in 35 cases as the research object,and al patients were treated by surgical operation,the placement of peritoneal dialysis catheter. After 4~8 h in the beginning PD treatment,at the same time,with the strong heart diuresis,respiratory support and other comprehensive treatment. Results After the treatment of 0~6 h,7~12 h and the observation of the index before treatment,the difference was statisticaly significant(P<0.05).In 35 cases,32 cases were cured,the cure rate was 91.4%,3 cases of death. Conclusion Children after cardiac surgery complicated by acute renal insufficiency in application of peritoneal dialysis way to treatment,not only can timely stability in children with the disease,also can reduce the pain of patients.%目的:探讨腹膜透析(PD)治疗低龄小儿心脏术后急性肾功能不全的临床疗效。方法选取2009年3月至2013年5月在我院治疗的低龄小儿心脏术后急性肾功能不全患儿35例为研究对象,患儿均采用外科手术,放置腹膜透析管。在术后4~8 h内开始PD治疗,同时采用强心利尿、呼吸支持等综合治疗。结果治疗后0~6 h、7~12 h与治疗前各观察指标比较,差异均有统计学意义(均P<0.05)。35例患儿中,治愈32例,治愈率为91.4%,病死3例。结论低龄小儿心脏术后并发急性肾功能不全患儿应用腹膜透析的方式予以治疗,不仅可及时稳定患儿病情,还能减轻患儿痛苦。

  14. Renal arterial resistive index is associated with severe histological changes and poor renal outcome during chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Bigé Naïke

    2012-10-01

    Full Text Available Abstract Background Chronic kidney disease (CKD is a growing public health problem and end stage renal disease (ESRD represents a large human and economic burden. It is important to identify patients at high risk of ESRD. In order to determine whether renal Doppler resistive index (RI may discriminate those patients, we analyzed whether RI was associated with identified prognosis factors of CKD, in particular histological findings, and with renal outcome. Methods RI was measured in the 48 hours before renal biopsy in 58 CKD patients. Clinical and biological data were collected prospectively at inclusion. Arteriosclerosis, interstitial fibrosis and glomerulosclerosis were quantitatively assessed on renal biopsy in a blinded fashion. MDRD eGFR at 18 months was collected for 35 (60% patients. Renal function decline was defined as a decrease in eGFR from baseline of at least 5 mL/min/ 1.73 m2/year or need for chronic renal replacement therapy. Pearson’s correlation, Mann–Whitney and Chi-square tests were used for analysis of quantitative and qualitative variables respectively. Kaplan Meier analysis was realized to determine renal survival according to RI value using the log-rank test. Multiple logistic regression was performed including variables with p Results Most patients had glomerulonephritis (82%. Median age was 46 years [21–87], eGFR 59 mL/min/ 1.73m2 [5–130], percentage of interstitial fibrosis 10% [0–90], glomerulosclerosis 13% [0–96] and RI 0.63 [0.31-1.00]. RI increased with age (r = 0.435, p = 0.0063, pulse pressure (r = 0.303, p = 0.022, renal atrophy (r = −0.275, p = 0.038 and renal dysfunction (r = −0.402, p = 0.0018. Patients with arterial intima/media ratio ≥ 1 (p = 0.032, interstitial fibrosis > 20% (p = 0.014 and renal function decline (p = 0.0023 had higher RI. Patients with baseline RI ≥ 0.65 had a poorer renal outcome than those with baseline RI Conclusions Our results suggest that RI ≥ 0.65 is associated

  15. The resistive index is a marker of renal function, pathology, prognosis, and responsiveness to steroid therapy in chronic kidney disease patients.

    Science.gov (United States)

    Hanamura, Kikuno; Tojo, Akihiro; Kinugasa, Satoshi; Asaba, Kensuke; Fujita, Toshiro

    2012-01-01

    To evaluate the significance of the renal resistive index (RI) as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD) patients who underwent renal biopsy. RI increased as the CKD stage progressed and correlated with age, systolic blood pressure, estimated glomerular filtration rate (eGFR), and renal histological changes, including glomerulosclerosis, arteriolosclerosis, and tubulointerstitial damage. Prognostic evaluation with a median follow-up period of 38.5 months revealed that patients with RI ≥ 0.7 (high RI group, n = 39) had significantly poorer renal survival than those with RI histological damage, and renal prognosis, and a possible determinant of indication for steroids.

  16. Adrenal insufficiency: diagnosis and management.

    Science.gov (United States)

    Munver, Ravi; Volfson, Ilya A

    2006-01-01

    Adrenal insufficiency is a disorder characterized by hypoactive adrenal glands resulting in insufficient production of the hormones cortisol and aldosterone by the adrenal cortex. This disorder may develop as a primary failure of the adrenal cortex or be secondary to an abnormality of the hypothalamic-pituitary axis. Patients with adrenal insufficiency often are asymptomatic or they may present with fatigue, muscle weakness, weight loss, low blood pressure, and sometimes darkening of the skin. The presentation of adrenal insufficiency varies dramatically and poses a major diagnostic dilemma. This review focuses on the diagnosis and treatment of primary and secondary adrenal insufficiency.

  17. ri Talveti luulevalimik hispaania keeles

    Index Scriptorium Estoniae

    2003-01-01

    Talvet, Jüri. Elegia Estonia y otros poemas : [luulevalimik] / tõlkinud Jüri Talvet ja Albert Lázaro Tinaut ; järelsõna Janika Kronberg. Valencia : Palmart Capitelum, 2002; Vt. ka Eesti Päevaleht, 13. jaan., lk. 16

  18. ri Talveti luulevalimik hispaania keeles

    Index Scriptorium Estoniae

    2003-01-01

    Talvet, Jüri. Elegia Estonia y otros poemas : [luulevalimik] / tõlkinud Jüri Talvet ja Albert Lázaro Tinaut ; järelsõna Janika Kronberg. Valencia : Palmart Capitelum, 2002; Vt. ka Eesti Päevaleht, 13. jaan., lk. 16

  19. Fluoride-induced chronic renal failure.

    Science.gov (United States)

    Lantz, O; Jouvin, M H; De Vernejoul, M C; Druet, P

    1987-08-01

    Renal fluoride toxicity in human beings is difficult to assess in the literature. Although experimental studies and research on methoxyflurane toxicity have shown frank renal damage, observations of renal insufficiency related to chronic fluoride exposure are scarce. We report a case of fluoride intoxication related to potomania of Vichy water, a highly mineralized water containing 8.5 mg/L of fluoride. Features of fluoride osteosclerosis were prominent and end-stage renal failure was present. The young age of the patient, the long duration of high fluoride intake, and the absence of other cause of renal insufficiency suggest a causal relationship between fluoride intoxication and renal failure.

  20. SINDROME INTERMEDIO: UN PATRÓN TÍPICO DE INSUFICIENCIA RENAL AGUDA EN EL ANCIANO

    Directory of Open Access Journals (Sweden)

    Algranati L

    2004-01-01

    Full Text Available Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatible with parenchymal renal insufficiency (elevated urinary sodium, plasma urea and creatinine, but with a positive response to hydration. The main characteristics of the aged kidney that predispose to the development of an intermediate syndrome are: the vascular dysautonomy and reduced capability of sodium and water reabsorption. The intermediate syndrome is a typical pattern of pre-renal insufficiency in the elderly. RESUMEN: La insuficiencia renal aguda es frecuente en el anciano. Esto se debe por un lado a los cambios estructurales y funcionales propios del riñón senil, y por otro a la gran exposición que esta población tiene a la polifarmacia, y su reducida capacidad para metabolizar los medicamentos. En este reporte presentamos el caso de una mujer de 70 años que desarrolló una insuficiencia renal aguda secundaria a severa deshidratación, mostrando un patrón clínico y de laboratorio propio de un sindrome intermedio: laboratorios compatibles con una insuficiencia renal parenquimatosa (sodio urinario, uremia y creatininemia elevadas, pero con una respuesta favorable a la hidratación. Las principales características del riñón senil que predisponen al desarrollo del sindrome intermedio: son la disautonomía vascular y la reducida capacidad en la recuperación de sodio y agua El sindrome intermedio es un patrón típico de insuficiencia prerrenal en el anciano.

  1. Budesonide-related adrenal insufficiency.

    Science.gov (United States)

    Arntzenius, Alexander; van Galen, Louise

    2015-10-01

    Iatrogenic adrenal insufficiency is a potential harmful side effect of treatment with corticosteroids. It manifests itself when an insufficient cortisol response to biological stress leads to an Addisonian crisis: a life-threatening situation. We describe a case of a patient who developed an Addisonian crisis after inappropriate discontinuation of budesonide (a topical steroid used in Crohn's disease) treatment. Iatrogenic adrenal insufficiency due to budesonide use has been rarely reported. Prescribers should be aware of the resulting risk for an Addisonian crisis.

  2. SAMURAI spectrometer for RI beam experiments

    Science.gov (United States)

    Kobayashi, T.; Chiga, N.; Isobe, T.; Kondo, Y.; Kubo, T.; Kusaka, K.; Motobayashi, T.; Nakamura, T.; Ohnishi, J.; Okuno, H.; Otsu, H.; Sako, T.; Sato, H.; Shimizu, Y.; Sekiguchi, K.; Takahashi, K.; Tanaka, R.; Yoneda, K.

    2013-12-01

    A large-acceptance multiparticle spectrometer SAMURAI has been constructed at the RIKEN RI Beam Factory (RIBF) for RI beam experiments. It was designed primarily for kinematically complete experiments such as the invariant-mass spectroscopy of particle-unbound states in exotic nuclei, by detecting heavy fragments and projectile-rapidity nucleons in coincidence. The system consists of a superconducting dipole magnet, beam line detectors, heavy fragment detectors, neutron detectors, and proton detectors. The SAMURAI spectrometer was commissioned in March 2012, and a rigidity resolution of about 1/1500 was obtained for RI beams up to 2.4 GeV/c.

  3. SAMURAI spectrometer for RI beam experiments

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, T., E-mail: kobayash@lambda.phys.tohoku.ac.jp [Department of Physics, Tohoku University, Aoba, Sendai 980-8578 (Japan); Chiga, N. [Department of Physics, Tohoku University, Aoba, Sendai 980-8578 (Japan); Isobe, T. [RIKEN Nishina Center, Wako, Saitama 351-0198 (Japan); Kondo, Y. [Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551 (Japan); Kubo, T.; Kusaka, K.; Motobayashi, T. [RIKEN Nishina Center, Wako, Saitama 351-0198 (Japan); Nakamura, T. [Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551 (Japan); Ohnishi, J.; Okuno, H.; Otsu, H. [RIKEN Nishina Center, Wako, Saitama 351-0198 (Japan); Sako, T. [Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551 (Japan); Sato, H.; Shimizu, Y. [RIKEN Nishina Center, Wako, Saitama 351-0198 (Japan); Sekiguchi, K.; Takahashi, K. [Department of Physics, Tohoku University, Aoba, Sendai 980-8578 (Japan); Tanaka, R. [Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551 (Japan); Yoneda, K. [RIKEN Nishina Center, Wako, Saitama 351-0198 (Japan)

    2013-12-15

    A large-acceptance multiparticle spectrometer SAMURAI has been constructed at the RIKEN RI Beam Factory (RIBF) for RI beam experiments. It was designed primarily for kinematically complete experiments such as the invariant-mass spectroscopy of particle-unbound states in exotic nuclei, by detecting heavy fragments and projectile-rapidity nucleons in coincidence. The system consists of a superconducting dipole magnet, beam line detectors, heavy fragment detectors, neutron detectors, and proton detectors. The SAMURAI spectrometer was commissioned in March 2012, and a rigidity resolution of about 1/1500 was obtained for RI beams up to 2.4 GeV/c.

  4. Imaging of renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. E-mail: vladimir.jevtic@mf.uni-lj.si

    2003-05-01

    Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

  5. The progression of nutritional therapy and nutritional evaluation of child chronic renal insufficiency%儿童慢性肾功能不全的营养评估和营养治疗进展

    Institute of Scientific and Technical Information of China (English)

    姜明霞; 夏正坤

    2012-01-01

    营养治疗是慢性肾功能不全综合治疗的一个组成部分,患病儿童营养状况的好差不仅能影响治疗效果,而且还影响其生长发育.适量的蛋白质,充足的热量以及维生素和矿物质的供给,能延缓疾病的发展和减少并发症的发生.定期做营养评估,可为患病儿童营养治疗方案的调整提供依据.%Nutritional therapy is one part of combined therapy of chronic renal disease. The nutritional status is very important to growth and development of the children patients. The supplementation of appropriate amount of protein, abundant energy, vitamin and minerals can remission the development of disease and decrease the incidence of the complication. The regular nutritional evaluation can offer the basis of the adjustment of nutritional therapeutic schedule.

  6. The US color Doppler in acute renal failure.

    Science.gov (United States)

    Nori, G; Granata, A; Leonardi, G; Sicurezza, E; Spata, C

    2004-12-01

    Imaging techniques, especially ultrasonography and Doppler, can give an effective assistance in the differential diagnosis of acute renal failure (ARF). An resistance Index (RI) value >0.75 is reported as optimal in attempting differential diagnosis between acute tubular necrosis (ANT) and prerenal ARF. In hepatorenal syndrome (HRS) RIs is very increased. In some renal vasculitis, as nodose panarteritis (PN), hemolytic-uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), parenchymal perfusion is reduced and RI increased. In lupus nephritis the RI values are correlated with creatinine level and normal RI are considered as a good prognostic tool. In acute primitive or secondary glomerulonephritis (GN), RI value is normal, with diffuse parenchymal hypervascularization. In acute crescentic and proliferative GN and tubulo-interstitial disease, color Doppler (CD) and power Doppler (PD) reveal a decreased renal parenchymal perfusion, which correlates with increased RI values. In acute thrombosis of renal artery, US color Doppler (DUS) reveals either an absence of Doppler signal or a tardus-parvus pulse distal to the vascular obstruction. In this situation it is possible to visualize hyperthropic perforating vessels that redirect their flow from the capsular plexus to the renal parenchyma. In acute thrombosis of the renal vein Doppler analysis of parenchymal vessels reveals remarkable RI values, sometimes with reversed diastolic flow. In postrenal ARF an adjunct to the differentiation between obstruction and non obstructive dilatation can be found through RIs. Diagnostic criteria of obstruction as reported by literature are: RI>0.70 in the obstructed kidney and, mostly, a difference in RI between the 2 kidneys >0.06-0.1.

  7. Electron-beam-driven RI separator for SCRIT (ERIS) at RIKEN RI beam factory

    Science.gov (United States)

    Ohnishi, T.; Ichikawa, S.; Koizumi, K.; Kurita, K.; Miyashita, Y.; Ogawara, R.; Tamaki, S.; Togasaki, M.; Wakasugi, M.

    2013-12-01

    We constructed a radioactive isotope (RI) separator named ERIS (electron-beam-driven RI separator for SCRIT) for the SCRIT (Self-Confinement RI Target) electron scattering facility at RIKEN RI Beam Factory (RIBF). In ERIS, production rate of fission products in the photofission of uranium is estimated to be 2.2 ×1011 fissions/s with 30 g of uranium and a 1-kW electron beam. During the commissioning of ERIS, the mass resolution and overall efficiency, including ionization, extraction, and transmission, were found to be 1660 and 21%, respectively, using natural xenon gas. The preparation of uranium carbide (UC2) RI production targets is described from which a 132Sn beam was successfully separated in our first attempt at RI production.

  8. Domik Petra / Jüri Kuuskemaa

    Index Scriptorium Estoniae

    Kuuskemaa, Jüri, 1942-

    2006-01-01

    Kunstiajaloolane Jüri Kuuskemaa tutvustab Peeter I majamuuseumi Kadriorus. Maja ajaloost, sisustusest (mööbel, kunstiesemed). Keldriruumis eksponeeritud Salomon Zeltrechti ja tema abiliste poolt tehtud kivibüstidest

  9. [Söejoonistused] / Jüri Marran

    Index Scriptorium Estoniae

    Marran, Jüri, 1937-

    2005-01-01

    ri Marran on hariduselt füüsik ja kunstihariduse omandanud Melanie ja Erich Arraku ateljeekoolis. Lk. 1391 (Gravitatsioon), 1440 (Valgus), 1471 (Vastastikmõju), 1486 (Massenergia), 1519 (Valguse dualism), 1555 (Aja dilatatsioon)

  10. Richard Antiku kunstikiindumus / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2011-01-01

    Arvustus:Raamatu valgusel. Richard Antik 100. Artikleid ja bibliograafia. Koostanud Merike Kiipus ja Piret Noorhani. Tartu : Eesti Kirjandusmuuseum, 2001. Ka Richard Antiku tegevusest kollektsionääri, näitustekorraldaja, kunstikaupmehe ning kunstikriitikuna

  11. Richard Antiku kunstikiindumus / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2011-01-01

    Arvustus:Raamatu valgusel. Richard Antik 100. Artikleid ja bibliograafia. Koostanud Merike Kiipus ja Piret Noorhani. Tartu : Eesti Kirjandusmuuseum, 2001. Ka Richard Antiku tegevusest kollektsionääri, näitustekorraldaja, kunstikaupmehe ning kunstikriitikuna

  12. 急性脑梗死伴非瓣膜性心房颤动患者肾功能不全的影响因素分析%Analysis of influencing factors of renal insufficiency in acute cerebral infarction patients with non-valvular atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    董恺; 张倩; 俞志鹏; 丁建平; 宋海庆; 黄小钦

    2016-01-01

    retrospectively. Renal function was assessed by the estimated glomerular filtration rate (eGFR),eGFR 0. 05). (2)Multiple Logistic regression analysis showed that the age (≥65 years)was an independent risk factor for the occurrence of renal insufficiency in acute cerebral infarction patients with atrial fibrillation (OR,1. 147,95% CI 1. 087 -1. 209;P < 0. 01),and the histories of hypertension (OR,0. 870,95% CI 0. 362-2. 089;P = 0. 755),diabetes mellitus (OR,1. 078,95% CI 0. 403 -2. 883;P = 0. 882 ), and hyperlipidemia (OR,1. 666,95% CI 0. 645 - 4. 302;P = 0. 292 )were not associated with renal insufficiency in cerebral infarction patients with atrial fibrillation. Conclusions The incidence of renal insufficiency in cerebral infarction patients with atrial fibrillation is higher. Age (≥65 years)is an independent risk factor for renal insufficiency in this type of patients.

  13. Renal tubule cell repair following acute renal injury.

    Science.gov (United States)

    Humes, H D; Lake, E W; Liu, S

    1995-01-01

    Experimental data suggests the recovery of renal function after ischemic or nephrotoxic acute renal failure is due to a replicative repair process dependent upon predominantly paracrine release of growth factors. These growth factors promote renal proximal tubule cell proliferation and a differentiation phase dependent on the interaction between tubule cells and basement membrane. These insights identify the molecular basis of renal repair and ischemic and nephrotoxic acute renal failure, and may lead to potential therapeutic modalities that accelerate renal repair and lessen the morbidity and mortality associated with these renal disease processes. In this regard, there is a prominent vasoconstrictor response of the renal vasculature during the postischemic period of developing acute renal failure. The intravenous administration of pharmacologic doses of atrial natriuretic factor (ANF) in the postischemic period have proven efficacious by altering renal vascular resistance, so that renal blood flow and glomerular filtration rate improve. ANF also appears to protect renal tubular epithelial integrity and holds significant promise as a therapeutic agent in acute renal failure. Of equal or greater promise are the therapeutic interventions targeting the proliferative reparative zone during the postischemic period. The exogenous administration of epidermal growth factor or insulin-like growth factor-1 in the postischemic period have effectively decreased the degree of renal insufficiency as measured by the peak serum creatinine and has hastened renal recovery as measured by the duration of time required to return the baseline serum creatinine values. A similarly efficacious role for hepatocyte growth factor has also been recently demonstrated.

  14. Association of Renal Resistive Index, Renal Pulsatility Index, Systemic Hypertension, and Albuminuria with Survival in Dogs with Pituitary-Dependent Hyperadrenocorticism

    Directory of Open Access Journals (Sweden)

    Hung-Yin Chen

    2016-01-01

    Full Text Available An increased renal resistive index (RI and albuminuria are markers of target organ damage secondary to systemic hypertension. This study evaluated associations between systemic blood pressure (SBP, renal RI, pulsatility index (PI, and albuminuria in dogs with pituitary-dependent hyperadrenocorticism (PDH. Predictors of overall mortality were investigated. Twenty client-owned dogs with PDH and 20 clinically healthy client-owned dogs as matched controls were included. Incidence rates of systemic hypertension (SBP ≥ 160 mmHg, albuminuria, and increased renal RI (≥ 0.70 and PI (≥ 1.45 in the control group were 5%, 0%, 5%, and 0%, respectively, compared to 35%, 40%, 50%, and 35%, respectively, in the PDH group (P=0.001, P<0.001, P<0.001, and P=0.001, resp.. No association between systemic hypertension, renal RI, renal PI, and albuminuria was observed. PDH was the only predictor of albuminuria and increased renal RI. Survival was not affected by increased renal PI, systemic hypertension, or albuminuria. Increased renal RI (≥ 0.70 was the only predictor of overall mortality in dogs with PDH.

  15. Principais causas de insuficiência renal aguda em unidades de terapia intensiva: intervenção de enfermagem

    National Research Council Canada - National Science Library

    Eliandro deSouza Santos; Carina Martins daSilva Marinho

    2013-01-01

    ...: To identify the main causes of Acute Renal Insufficiency in patients admitted to an intensive care unit and to describe the nursing interventions to address the causes of Acute Renal Insufficiency in...

  16. Chronic renal disease in pregnancy.

    Science.gov (United States)

    Ramin, Susan M; Vidaeff, Alex C; Yeomans, Edward R; Gilstrap, Larry C

    2006-12-01

    The purpose of this review was to examine the impact of varying degrees of renal insufficiency on pregnancy outcome in women with chronic renal disease. Our search of the literature did not reveal any randomized clinical trials or meta-analyses. The available information is derived from opinion, reviews, retrospective series, and limited observational series. It appears that chronic renal disease in pregnancy is uncommon, occurring in 0.03-0.12% of all pregnancies from two U.S. population-based and registry studies. Maternal complications associated with chronic renal disease include preeclampsia, worsening renal function, preterm delivery, anemia, chronic hypertension, and cesarean delivery. The live birth rate in women with chronic renal disease ranges between 64% and 98% depending on the severity of renal insufficiency and presence of hypertension. Significant proteinuria may be an indicator of underlying renal insufficiency. Management of pregnant women with underlying renal disease should ideally entail a multidisciplinary approach at a tertiary center and include a maternal-fetal medicine specialist and a nephrologist. Such women should receive counseling regarding the pregnancy outcomes in association with maternal chronic renal disease and the effect of pregnancy on renal function, especially within the ensuing 5 years postpartum. These women will require frequent visits and monitoring of renal function during pregnancy. Women whose renal disease is further complicated by hypertension should be counseled regarding the increased risk of adverse outcome and need for blood pressure control. Some antihypertensives, especially angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, should be avoided during pregnancy, if possible, because of the potential for both teratogenic (hypocalvaria) and fetal effects (renal failure, oliguria, and demise).

  17. Repercussões da insuficiência renal crônica na capacidade de exercício, estado nutricional, função pulmonar e musculatura respiratória de crianças e adolescentes Consequences of chronic renal insufficiency on the exercise capacity, nutritional status, pulmonary function and respiratory musculature of children and adolescents

    OpenAIRE

    2008-01-01

    OBJETIVO: Avaliar a capacidade funcional, função pulmonar, musculatura respiratória e estado nutricional de crianças e adolescentes portadores de insuficiência renal crônica (IRC) em tratamento conservador. MÉTODOS: Este estudo foi realizado com 30 voluntários, divididos em dois grupos: Portadores de IRC em tratamento conservador (Grupo IRC) e grupo sem comprometimento da função renal (Grupo Controle). Os voluntários foram submetidos à avaliação fisioterapêutica, espirometria, avaliação de fo...

  18. Insufficiency fracture after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Huh, Seung Jae [Dept.of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    Insufficiency fracture occurs when normal or physiological stress applied to weakened bone with demineralization and decreased elastic resistance. Recently, many studies reported the development of IF after radiation therapy (RT) in gynecological cancer, prostate cancer, anal cancer and rectal cancer. The RT-induced insufficiency fracture is a common complication during the follow-up using modern imaging studies. The clinical suspicion and knowledge the characteristic imaging patterns of insufficiency fracture is essential to differentiate it from metastatic bone lesions, because it sometimes cause severe pain, and it may be confused with bone metastasis.

  19. Renal involvement in antiphospholipid syndrome.

    Science.gov (United States)

    Pons-Estel, Guillermo J; Cervera, Ricard

    2014-02-01

    Renal involvement can be a serious problem for patients with antiphospholipid syndrome (APS). However, this complication has been poorly recognized and studied. It can be present in patients who have either primary or systemic lupus erythematosus-associated APS. Clinical and laboratory features of renal involvement in APS include hypertension, hematuria, acute renal failure, and progressive chronic renal insufficiency with mild levels of proteinuria that can progress to nephrotic-range proteinuria. The main lesions are renal artery stenosis, venous renal thrombosis, and glomerular lesions (APS nephropathy) that may be acute (thrombotic microangiopathy) and/or chronic (arteriosclerosis, arterial fibrous intimal hyperplasia, tubular thyroidization, arteriolar occlusions, and focal cortical atrophy). APS can also cause end-stage renal disease and allograft vascular thrombosis. This article reviews the range of renal abnormalities associated with APS, and their diagnosis and treatment options.

  20. Nutrición y enfermedad renal

    OpenAIRE

    Iris de Castaño; Consuelo de Rovetto

    2007-01-01

    El riñón juega un papel importante en la regulación interna del organismo a través de las funciones excretoras, metabólicas y endocrinas. La insuficiencia renal aguda, IRA, se caracteriza por un rápido deterioro de la función renal con acumulación de productos nitrogenados como la urea y la creatinina y desequilibrio del agua y de los electrólitos. La falla renal crea un estado de desequilibrio metabólico proporcional a la perdida de la función renal. Dentro de los factores importantes para d...

  1. Dupplex doppler sonography in patients with medical renal diseases: correlation with clinical and histopathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Song, Soon Young; Koh, Byung Hee; Lee, Seung Chul; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Cho, On Koo; Park, Chan Hyun; Park, Moon Hyang [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To compare the RI (resistive index) of renal artery with serum creatinine level and histological change in 50 patients with renal parenchymal disease. To measure RI in each patient, Doppler studies were performed three times in each kidney at the level of the interlobar arteries, and the average value of RI was taken. The study was performed 1 -3 days after renal biopsy and the time interval between blood sampling for serum creatinine and duplex study was also 1 - 3 days. The RI of patients with renal disease was also correlated with patient's age, sex and serum creatinine level, and RI was also correlated with the degree of severity of glomerular, interstitial, and vascular change in the kidneys. Statistical analysis was performed using Student's t test and Pearson's correlation method. The RI of the normal control and renal disease group was 0.566{+-}0.037 and 0.584{+-}0.038, respectively with no statistical significance(p=0.444). In the group with renal disease, there was no significant correlation between RI and a patient's age, sex, and serum creatinine level(p>0.05). RI was not significantly different between predominantly glomerular disease (n=45) and nonglomerular or mixed disease(n=5)(p=0.558), and did not correlate with the severity of glomerular sclerosis, interstitial fibrosis, or atherosclerosis(p>0.05). The authors conclude that RI is not helpful for the diagnosis and differential diagnosis of renal parenchymal diseases and does not correlate with serum creatinine levels. In order to define the role of the RI, further clinical experience with more cases is required.

  2. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases

    OpenAIRE

    Bush, Lisabeth A.; Chew, Felix S.

    2015-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was foc...

  3. Riñón fetal hiperecogénico

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2011-12-01

    Full Text Available El hallazgo de riñones fetales hiperecogénicos es un problema de gran preocupación médica y de ansiedad familiar, porque casi siempre traduce una enfermedad renal importante. Cuando la hiperecogenicidad se acompaña de oligohidramnios, la mayoría de las veces estamos enfrentando una enfermedad poliquística; cuando no existe oligohidramnios, el diagnóstico probable es difícil. El objetivo de este reporte es la presentación de un niño con enfermedad poliquística autosómico recesiva. En los exámenes realizados a la madre, durante el embarazo, se encontró hiperecogenia renal y oligohidramnios. Se describe la evolución clínica, ultrasonográfica y gammagráfica de su enfermedad. Se revisa brevemente la literatura con relación al tema.

  4. Tüüri vioolakontserdi esiettekanne

    Index Scriptorium Estoniae

    2008-01-01

    24. okt. toovad Taanis Sonderborgis maailmaesiettekandele Erkki-Sven Tüüri Vioolakontserdi "Illuminatio" norra vioolamängija Lars Anders Tomter ja Lõuna- Jüütimaa Sümfooniaorkester, mida juhatab Vladimir Ziva. Evelyn Glennie ja New Jersey Sümfooniaorkester Neeme Järvi juhatusel esitavad 10. okt. USAs Newarkis ja 12. okt. New Brunswickis Tüüri 4. sümfoonia "Magma". Sellega seoses esineb Tüür loengutega oma loomingust järgmistes kõrgkoolides: New York Univerdity, Juilliard Scool of Music, Princeton University ja Montclair State University

  5. Electron-beam-driven RI separator for SCRIT (ERIS) at RIKEN RI beam factory

    Energy Technology Data Exchange (ETDEWEB)

    Ohnishi, T., E-mail: oonishi@ribf.riken.jp [RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198 (Japan); Ichikawa, S. [RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198 (Japan); Koizumi, K.; Kurita, K. [Department of Physics, Rikkyo University, Toshima, Tokyo 171-8501 (Japan); Miyashita, Y. [RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198 (Japan); Ogawara, R.; Tamaki, S.; Togasaki, M. [Department of Physics, Rikkyo University, Toshima, Tokyo 171-8501 (Japan); Wakasugi, M. [RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198 (Japan)

    2013-12-15

    Highlights: • We constructed a radioactive isotope separator, ERIS, for the SCRIT electron scattering facility at RIKEN RIBF. • ERIS uses a photofission of uranium to produce a radioactive isotope. • The commissioning of ERIS was perfromed using natural xenon gas. • A {sup 132}Sn beam was successfully separated in our first attempt at RI production. -- Abstract: We constructed a radioactive isotope (RI) separator named ERIS (electron-beam-driven RI separator for SCRIT) for the SCRIT (Self-Confinement RI Target) electron scattering facility at RIKEN RI Beam Factory (RIBF). In ERIS, production rate of fission products in the photofission of uranium is estimated to be 2.2 ×10{sup 11} fissions/s with 30 g of uranium and a 1-kW electron beam. During the commissioning of ERIS, the mass resolution and overall efficiency, including ionization, extraction, and transmission, were found to be 1660 and 21%, respectively, using natural xenon gas. The preparation of uranium carbide (UC{sub 2}) RI production targets is described from which a {sup 132}Sn beam was successfully separated in our first attempt at RI production.

  6. Neonatal Sepsis and Neutrophil Insufficiencies

    Science.gov (United States)

    Melvan, John Nicholas; Bagby, Gregory J.; Welsh, David A.; Nelson, Steve; Zhang, Ping

    2011-01-01

    Sepsis has continuously been a leading cause of neonatal morbidity and mortality despite current advances in chemotherapy and patient intensive care facilities. Neonates are at high risk for developing bacterial infections due to quantitative and qualitative insufficiencies of innate immunity, particularly granulocyte lineage development and response to infection. Although antibiotics remain the mainstay of treatment, adjuvant therapies enhancing immune function have shown promise in treating sepsis in neonates. This chapter reviews current strategies for the clinical management of neonatal sepsis and analyzes mechanisms underlying insufficiencies of neutrophil defense in neonates with emphasis on new directions for adjuvant therapy development. PMID:20521927

  7. [Adrenal mass and adrenal insufficiency].

    Science.gov (United States)

    Martínez Albaladejo, M; García López, B; Serrano Corredor, S; Alguacil García, G

    1996-12-01

    Primary adrenal insufficiency is a non frequent disease, that is declared in young adults and in the most of the cases is produced from an autoimmune mechanism or a tuberculous disease. The incidence of these forms in the different geographic areas is dependent of degree of irradication of the tuberculosis. We report the case of a patient with latent chronic adrenal insufficiency of tuberculous origin who was affected for an addisonian crisis during an intercurrent infectious disease, which permitted the diagnosis of the addisonian crisis, and Mal of Pott was moreover detected. Evolution with corticosteroid and specific treatment was very favorable.

  8. Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Starklint, Henrik; Petersen, J;

    1999-01-01

    To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI).......To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI)....

  9. Renovascular hypertension due to insufficient collateral flow in segmental artery occulusion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Y. H.; Lee, S. Y.; Kim, S. H.; Sohn, H. S.; Chung, S. K. [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2001-07-01

    We report a case in which a 33-year-old woman with renovascular hypertension due to insufficient collateral flow in segmental renal artery occlusion demonstrated abnormality on captopril renal scintigram. Baseline renal scintigram with DTPA showed normal perfusion and excretion in left kidney and captopril renal scintigram with DTPA showed a focal area of decreased perfusion and delayed clearance in lower half of left kidney, suggesting segmental renal artery stenosis. Selective left renal arteriography showed complete obstruction in proximal portion of anterior segmental artery with multiple small collateral vessels from posterior segmental artery and capsular artery and delayed opacification in lower half of left kidney. These findings are suggestive of segmental hypoperfusion due to insufficient collateral blood flow resulting to positive captopril response. Patient's blood pressure have been controlled well with ACE (angiotensin converting enzyme) inhibitor and calcium channel blocker for 2 year. Follow-up baseline renal scintigram with MAG3 showed normal perfusion and excretion in left kidney and captopril renal scintigram with MAG3 showed a focal area of decreased perfusion and delayed clearance in lower lateral portion of left kidney, which was smaller size than that of previous renal scintigram. And captopril renal scintigram with DMSA demonstrated a small area of decreased DMSA uptake on this lesion compared to baseline DMSA scintigram.

  10. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Urbania, Thomas H. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Ave., Box 0628, San Francisco, CA (United States); Kammen, Bamidele F.; Nancarrow, Paul A. [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Morrell, Rose Ellen [Children' s Hospital and Research Center Oakland, Department of Nephrology, Oakland, CA (United States)

    2009-02-15

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  11. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  12. Presence of pRI1:

    DEFF Research Database (Denmark)

    Migura, Lourdes Garcia; Hasman, Henrik; Jensen, Lars Bogø

    2009-01-01

    This study focused on the molecular characterization of a small cryptic, mobilizable plasmid (6038 bp) sequenced from an E. faecium 9631160-1 of poultry origin. Sequence analysis of pRI1 revealed seven open reading frames. pRI1 contained an IS 100% identical to ISEfa4. This insertion element...... disrupted a putative mobilization gene (mobA) which presented 99% similarity to the one described in plasmid pJS42 (NC_010291). pRI1 harbored a cluster of four coding sequences which exhibited a homology to those described in contig 658 (from nucleotide 8940 to nt 10515) of E. faecium DO. In addition, a rep...... almost identical to the repA from the pEFNP1 and pKQ10 plasmids from E. faecium was also identified. Presence of the pRI1 replication initiation gene (rep) was analyzed in a panel of 159 E. faecium isolates of human and animal origin from different European countries, of which 60 tested positive...

  13. Teel kriisist õigusriiki / Jüri Raidla

    Index Scriptorium Estoniae

    Raidla, Jüri, 1957-

    1990-01-01

    ri Raidla, justiitsminister (kinnitati 17. 04. 1990). Sündinud 1957. a. Pärnus, 1980. a. lõpetas Tartu Ülikooli õigusteaduskonna, kaitses 12. 02. 1987. a. Leningradi Ülikoolis väitekirja "Mehaaniliste transpordivahenditega kahju tekitamisest tulenevad kohustused"

  14. Migratsioonipoliitika innovatsiooni heaks / Jüri Pihl

    Index Scriptorium Estoniae

    Pihl, Jüri, 1954-

    2008-01-01

    Ilmunud ka: Narvskaja Gazeta 17. apr. lk. 6, Den za Dnjom 18. apr. lk. 19. Siseminister Jüri Pihli arvates võib kvalifitseeritud tööjõu puudus ohustada Eesti majanduse jätkusuutlikkust ja heaolu kasvu ning Eesti võiks heade spetsialistide otsingul vaadata ka Euroopa Liidust väljapoole

  15. 76 FR 59596 - Anchorage Regulations; Newport, RI

    Science.gov (United States)

    2011-09-27

    ... cruise ship visits to Newport and to improve navigation safety. DATES: Comments and related material..., Rhode Island, to better accommodate increasing cruise ship visits to Newport, and to improve navigation... years cruise ship visits to Newport, RI, have been more frequent. On occasion, there is a need to...

  16. Clinical aspects of cervical insufficiency

    NARCIS (Netherlands)

    Lotgering, F.K.

    2007-01-01

    Fetal loss is a painful experience. A history of second or early third trimester fetal loss, after painless dilatation of the cervix, prolapse or rupture of the membranes, and expulsion of a live fetus despite minimal uterine activity, is characteristic for cervical insufficiency. In such cases the

  17. ri Ratas : Tallinnasse rahvuspark! / Jüri Ratas ; interv. Ilmar Palli

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2005-01-01

    Tallinna uus linnapea Jüri Ratas rohelisest vööndist, keskkonnakaitsest, ohtlikest veostest, teede olukorrast, linna elukeskkonnast, asotsiaalide probleemist ning kohaliku omavalitsuse ja riigi koostööst

  18. ri Ratas : Tallinnasse rahvuspark! / Jüri Ratas ; interv. Ilmar Palli

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2005-01-01

    Tallinna uus linnapea Jüri Ratas rohelisest vööndist, keskkonnakaitsest, ohtlikest veostest, teede olukorrast, linna elukeskkonnast, asotsiaalide probleemist ning kohaliku omavalitsuse ja riigi koostööst

  19. ri Kraft / Jüri Kraft ; interv. Tiina Jõgeda

    Index Scriptorium Estoniae

    Kraft, Jüri, 1935-

    2004-01-01

    Autori meenutusi õpingutest Tartu Ülikooli majandusteaduskonnas, direktori ametist Sangaris ja Klementis, tööst kergetööstusministeeriumis ning ministrina. Lisatud Jüri Krafti olulisemad eluloolised andmed

  20. [Assessment and characteristics of chronic renal insufficiency in France].

    Science.gov (United States)

    Bongard, V; Dallongeville, J; Arveiler, D; Ruidavets, J-B; Cottel, D; Wagner, A; Ferrières, J

    2012-08-01

    Chronic kidney disease (CKD) is a major public health issue. In France, few studies have evaluated CKD prevalence. The objective of the MONA LISA study was to estimate and to characterize CKD in three representative cross-sectional surveys in subjects aged 35-74.9 years. CKD was defined as subjects having MDRD glomerular filtration rate lower than 60 mL/min/1.73 m(2). Prevalence of CKD in MONA LISA was standardized according to the French population. A multiple logistic regression analysis was performed in order to find independent factors associated to CKD. The French estimate of CKD prevalence was 8.2% (95% confidence interval: 7.4-8.9%), that is 2,454,548 (95% confidence interval: 2,215,080-2,664,082) subjects aged 35-74.9 years. Factors significantly and independently associated to CKD were older age, hypertension and dyslipidemias. In conclusion, the MONA LISA study evaluated for the first time in France CKD prevalence in subjects aged 35-74.9 years. This prevalence probably underestimates the real CKD size due to selection bias present in every representative cross-sectional survey. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  1. Clinical study on treatment of IgA nephropathy with renal insufficiency by corticosteroid, corticosteroid combined with cyclophosphamide and corticosteroid combined with mycophenolate mofetil%单纯激素、激素联合环磷酰胺和激素联合麦考酚酯治疗肾功能不全IgA肾病的临床研究

    Institute of Scientific and Technical Information of China (English)

    王伟铭; 贾晓媛; 潘晓霞; 沈平雁; 刘剑; 徐丽梨; 李娅; 王朝晖; 李晓

    2013-01-01

    Objective To investigate the clinical efficacy and safety of corticosteroid, corticosteroid combined with cyclophosphamide ( CTX) and corticosteroid combined with mycophenolate mofetil ( MMF) in IgA nephropathy (IgAN) with renal insufficiency. Methods Patients confirmed as primary IgAN by renal biopsy were selected, with chronic renal disease (CKD) of 3-4 stage and moderate renal lesions. Sixty patients were enrolled, and randomly received corticosteroid therapy (corticosteroid group, re =20), corticosteroid combined with CTX therapy (corticosteroid + CTX group, n=20) and corticosteroid combined with MMF therapy ( corticosteroid + MMF group, n = 20) . The 24 h urine protein, renal function parameters and adverse effect were observed during treatment. Results With the time of treatment, 24 h urine protein was gradually reduced in each group, and 24 h urine protein in corticosteroid group and corticosteroid + CTX group 3, 6 and 12 months after treatment and in corticosteroid + MMF group 12 months after treatment was significantly lower than the baseline (P 0. 05). Eight patients (8/20) in corticosteroid + MMF group suffered from serious pulmonary infection during treatment for 3 to 4 months, the baseline eGFR of whom was significantly lower than that of patients without serious pulmonary infection in corticosteroid + MMF group (P <0. 05). Conclusion Twenty-four hour urine protein can be significantly decreased with corticostsroid therapy, corticosteroid combined with CTX therapy and corticosteroid combined with MMF therapy in patients with IgAN and impaired renal function, and stable renal function can be maintained during treatment. Intensive follow-up should be carried out in the treatment with MMF due to the possibility of occurrence of serious pulmonary infection.%目的 观察单纯激素、激素联合环磷酰胺(CTX)、激素联合霉酚酸酯(MMF)治疗伴慢性肾功能不全原发性IgA肾病(IgAN)患者的临床效果和安全性.方法 选取经肾穿

  2. 血浆置换联合日间连续性血液滤过治疗肝衰竭并肾功能不全的护理%Nursing care of plasma exchange combined with daytime continuous ve-nous-venous hemofiltration in the treatment of liver failure accompanied with renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    李颖; 周莉; 陈占军; 郑素军; 段钟平

    2015-01-01

    Objective To summarize the nursing care of plasma exchange combined with daytime continuous venous-venous hemofiltration in liver failure patients accompanied with renal insufficiency. Methods 187 liver failure patients accompanied with renal insufficiency received plasma exchange combined with daytime continuous venous-venous hemofiltration in Artificial Liver Center, Beijing You'an Hospital Affiliated to Capital Medical University from January 2013 to May 2014 were selected as research objects. Liver and kidney function and blood coagulation indexes before and after treatment were compared. The nursing measures included the pretreatment conversation with patient, close observation, correct handling to adverse reactions with effective nursing intervention during treatment, health education and follow up after treatment. Results Alanine transaminase [(220.2±109.9) v s (366.4±153.3) U/L], aspartate transami-nase [(148.2±71.7) vs (219.8±90.0) U/L], total bilirubin [(283.0±78.2) vs (420.0±106.3)μmol/L], direct bilirubin [(141.5±38.1) vs (206.7±52.4)μmol/L], serum urea [(25.0±5.8) vs (28.8±5.6) mmol/L], creatinine [(176.6±38.6) vs (290.7±63.3)μmol/L] of patient after treatment was significantly lower than that before treatment respectively, albumin [(28.1±3.0) v s (26.6±3.1) g/L], prothrombin activity [(32.3±7.1)%v s (27.7±7.0)%] of patient after treatment was significantly higher than that before treatment respectively, with significantly statistical difference (P﹤ 0.01). Conclusion The combination of plas-ma exchange and daytime continuous venous-venous hemofiltration provides a good option for treatment of liver failure patients accompanied with renal insufficiency. Nurs-ing care support during the whole treatment proce-dures is the key of success.%目的:总结肝衰竭合并肾功能不全患者行血浆置换联合日间连续性血液滤过治疗的护理。方法选取首都医科大学附属北京佑安医院人工肝中心2013年1

  3. 不同肾造瘘管及固定方式对肾结石合并肾功能不全患者术后并发症的影Ⅱ向%Impacts of different nephrostomy tubes and their fixation ways on patients with nephrolithiasis complicated with renal insufficiency after percutaneous nephrolithotomy

    Institute of Scientific and Technical Information of China (English)

    陈亮; 李建兴; 杨波; 胡卫国; 黄晓波; 王晓峰

    2011-01-01

    Objective: To investigate impacts of different nephrostomy tubes and their fixation ways on patients with nephrolithiasis complicated with renal insufficiency after percutaneous nephrolithotomy. Methods: A total of 72 renal insufficiency patients were enrolled in this study, who were randomized into three groups with 24 patients in each group according to nephrostomy tube diameter and its fixation way: Group Ⅰ , I. E. Stretch group with 14 Fr silicon tube( Urevision) with balloon; Group Ⅱ , I. E. Not strech group with 14 Fr silicon tube( Urovision) with balloon; Group Ⅲ , I. E. Not strech group with 20Fr latex tube without balloon. The data collected included preoperative serum cretinine, hemoglobin value, midstream urine culture, stone volume, and operative time, and number of operative tract. It was also recorded that the change of hemoglobin between preoperation and 24 h or 72 h postoperation, presence of postoperative extravasation, systemic inflammatory respose syndrome, narcotic usage and blood transfusion. Results: There were no statistically significant differences among the three groups in terms of the incidence of postooperative extravasation(P = 0. 301), S1RS( P = 0. 099) and narcotic usage (P = 0. 898). In the aspects of the change of hemoglobin between preoperation and 24 h or 72 h postoperation, there were significant differences between group Ⅰ and group Ⅱ (P = 0. 001, P = 0. 009) or group Ⅲ ( P = 0.021, P= 0.003). No difference was found between groups Ⅱ and Ⅲ(P =0.989, P= 0.962). In the aspect of blood transfusion cases, group Ⅰ(1 case) <group Ⅲ (6 cases) < group Ⅱ (10 cases). The number of patients needing blood transfusion in group Ⅰ was significantly lower than that in group Ⅱ (P=0.002), but the differences between group Ⅲ and group Ⅰ (P=0.102) or group Ⅱ (P=0.221) were not statistically significant. Conclusion: It is worth recommending indwelling 14 Fr silicon nephrostomy tube with balloon oppressing the

  4. Diminished response to furosemide in I-123 Hippuran renal studies of renovascular hypertension caused by unilateral renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Flueckiger, F.M.; Fueger, G.F.; Einspieler, R.; Hausegger, K. (Department of Radiology, Graz (Austria))

    1990-09-01

    Dynamic I-123 Hippuran renal studies to measure furosemide response (FR) were performed in three groups of patients: (1) 57 patients with renovascular hypertension due to a poststenotic, ischemic kidney; (2) 23 patients with essential hypertension; and (3) 50 nonhypertensive patients with healthy kidneys (control group). FR was observed as renal parenchymal tracer washout within 10 minutes after the injection of 40 mg of furosemide. The retention index (RI) took into consideration the renal parenchymal tracer content before and 10 minutes after furosemide injection. In the control group, the FR was greater than 50% and the RI was less than 20. Patients with essential hypertension revealed no differences in the amounts of FR and RI compared with the control group. In renovascular hypertension, the FR was diminished and the RI was raised significantly. The values of FR and RI showed a good correlation to the degree of the renal artery stenosis before and after percutaneous transluminal angioplasty. It is concluded that the stimulation of diuresis with furosemide and its quantification represent an important additional step in the evaluation of dynamic I-123 Hippuran studies to detect renal ischemia.

  5. Growth failure in children with renal disease : incidence, pathophysiology, new perspectives with growth hormone therapy

    NARCIS (Netherlands)

    A.C.S. Hokken-Koelega (Anita)

    1994-01-01

    textabstractStunted growth is a serious problem for children with chronic renal insufficiency (CRI). Advances in the treatment of renal insufficiency, including dialysis and renal transplantation, have greatly improved the survival rate for these patients. Consequently the failure to grow has become

  6. Growth failure in children with renal disease : incidence, pathophysiology, new perspectives with growth hormone therapy

    NARCIS (Netherlands)

    A.C.S. Hokken-Koelega (Anita)

    1994-01-01

    textabstractStunted growth is a serious problem for children with chronic renal insufficiency (CRI). Advances in the treatment of renal insufficiency, including dialysis and renal transplantation, have greatly improved the survival rate for these patients. Consequently the failure to grow has become

  7. Rembrandt Kadrioru lossis / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2000-01-01

    Kadrioru lossi kuppelsaali tundmatu meistri laemaali maalimise ajalugu. Maali aluseks on Rembrandti maal "Diana suplus". Laemaal on maalitud Magdalena de Passe (1600-1638) vasegravüüri põhjal, mis on tehtud Rembrandti maalist. Rembrandt on lähtunud Antonio Tempesta (1555-1630) kahest gravüürist, viimane on lähtunud Otto van Veeni (1556-1629) maalist

  8. Streamlining the RI/FS process

    Energy Technology Data Exchange (ETDEWEB)

    Dumas, L.; Doss, R.C.

    1998-07-01

    In 1994, Pacific Gas and Electric Company (PG and E) contracted with CH2M HILL to manage remedial investigations and feasibility studies (RI/FS) at its former manufactured gas plant (MGP) sites in Chico, Willows, and Marysville, California. These three sites had similar histories, MGP-related contaminants, similar geologic settings, and geographically were close together. Recognizing the advantages that may be gained, both in time and money, by streamlining the RI/FS process, PG and E and CH2M HILL combined the sites into one project. From the start of the project, PG and E and CH2M HILL looked for an implemented changes to the RI/FS process to streamline the project. These changes included combining deliverables, linking field programs at the three sites, and negotiating bulk discounts on laboratory and other services by combining the work to be done at the three sites under one contract. CH2M HILL later proposed additional measures to streamline the project that were eventually adopted by both PG and E and the regulatory agencies. PG and E and CH2M HILL are currently working with the regulatory agencies to negotiate realistic measures to address contaminants in soil and groundwater, and are jointly preparing the FS with the regulatory agencies using a unique means of documentation.

  9. 腔内修复治疗合并慢性肾功能不全的急性B型主动脉夹层%Short-term results of endovascular aortic repair for patients with acute type B aortic dissection and chronic renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    潘旭东; 黄连军; 郑军; 刘永民; 马维国; 刘宁宁; 李建荣; 孙立忠

    2012-01-01

    Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P <0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7% versus 3.3%,P <0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year

  10. X-ray signals in renal osteopathy

    Energy Technology Data Exchange (ETDEWEB)

    Rieden, K.

    1984-10-01

    Chronic renal insufficiency is associated with metabolic disturbances which ultimately lead to typical, partly extremely painful changes in the skeletal system the longer the disease persists. Regular X-ray control of certain skeletal segments allows early detection of renal oesteopathy if the radiological findings described in this article are carefully scrutinised and interpreted.

  11. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  12. [Chronic respiratory insufficiency in France].

    Science.gov (United States)

    Chailleux, E; Boffa, C

    2001-05-31

    The data concerning the prevalence of chronic respiratory insufficiency (CRI) in France are scarce: in 1994 official numbers were 14,000 deaths due to chronic bronchitis, 2,000 due to asthma for a total number of 40,000 deaths with respiratory cause; the same year 27,000 new patients were compensated for chronic respiratory insufficiency by social security services. On January 1st 2000 the non-profit organizations was in charge of 21,500 patients with long term oxygen therapy and 10,500 with home ventilation, and the commercial companies respectively 30,000 and 6,000. Accordingly the total of patients treated at home for CRI is about 68,000. The repartition by cause of CRI, the characteristics of patients and the prognosis can be evaluated thanks to the ANTADIR observatory which collects medical data since 1981. Chronic obstructive pulmonary diseases (chronic bronchitis, emphysema, asthma, bronchiectasis) count for more than half of the total of cases. Other causes comprise pleuro-parietal diseases (tuberculosis sequelae, kyphoscoliosis), neuro-muscular diseases and interstitial lung diseases. CRI is a severe disease with a survival median of three years for chronic obstructive pulmonary diseases, and a prognosis slightly better for kyphoscoliosis and neuro-muscular diseases, and worse for pulmonary fibrosis.

  13. 临床药师参与癌痛伴肾功能不全患者止痛方案的实践与经验%Practice and experience in the participant of the clinical pharmacist in the treatment of cancer pain with renal insufficiency

    Institute of Scientific and Technical Information of China (English)

    伊佳; 侯幸赟; 黄立峰; 陈万生

    2016-01-01

    Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs .Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection ,dosage and adverse reaction monitoring .Results Physicians accepted suggestions from clinical pharmacists .The first day ,the morphine hydrochloride tablets were used for rapid titration . The next day doxycodone were used ,adding the morphine hydrochloride tablets when required .After the pain was controlled stability ,the transdermal fentanyl was used to alleviate the damage of kidney .Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treat-ment .%目的:探讨临床药师在止痛治疗中的作用,促进镇痛药更加规范的使用。方法临床药师通过参与癌痛伴肾功能不全患者止痛方案的制定,从药物的选择、给药剂量以及不良反应预计等方面,提出药学观点。结果医师采用了临床药师的建议,首日使用盐酸吗啡片进行快速滴定,次日起使用羟考酮缓释片控制背景疼痛,小剂量盐酸吗啡片控制爆发痛,在疼痛控制稳定后,改用芬太尼贴剂以减轻肾功能损害。结论临床药师参与到重度癌痛患者的治疗方案制定中,能提高患者用药安全性、合理性,提高临床治疗效果。

  14. Renal arteriography

    Science.gov (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  15. Outreach and Education with Europlanet 2020 RI

    Science.gov (United States)

    Heward, Anita R.; Barrosa, Mariana; Europlanet 2020 RI

    2016-10-01

    Since 2005, Europlanet has provided a framework to bring together Europe's widespread planetary science community. The project has evolved through a number of phases, and currently comprises a Research Infrastructure (RI) funded through the European Commission's Horizon 2020 program, as well as a self-sustaining membership organization. Launched in September 2015, Europlanet 2020 RI provides support, services, access to facilities, new research tools and a virtual planetary observatory. Europlanet 2020 RI's outreach and education program aims to engage members of the public, schools, teachers, policy makers and industrial partners across Europe with planetary science and the opportunities that it provides for innovation, inspiration and job creation. Europlanet's outreach and education activities are led by Science Office Ltd, a Portuguese-based SME, and a network of partners spread across nine countries including University College London, the University of Leiden, University of Latvia, Vilnius University, the Institute of Accelerating Systems and Applications, the Observatoire de Paris, CAB-INTA and the Austrian Space Forum.Europlanet supports educators and outreach providers within the planetary science community by organizing meetings, best practice workshops and communication training sessions, offering a seed-funding scheme for outreach activities, and awarding an annual prize for public engagement. Europlanet is also developing its own education and outreach resources, including an animation on 'Jupiter and its Icy Moons' (the first in a series of video "shorts") and kits for hands-on comparative planetology activities. The Europlanet Media Centre uses traditional and social media channels to communicate newsworthy results and activities to diverse audiences in Europe and worldwide. Using tools like Google Hangouts, the project connects planetary researchers directly with the public and school groups. In addition, Europlanet engages with policy makers in the

  16. Radio Meteors Observations Techniques at RI NAO

    Science.gov (United States)

    Vovk, Vasyl; Kaliuzhnyi, Mykola

    2016-07-01

    The Solar system is inhabited with large number of celestial bodies. Some of them are well studied, such as planets and vast majority of big asteroids and comets. There is one group of objects which has received little attention. That is meteoroids with related to them meteors. Nowadays enough low-technology high-efficiency radio-technical solutions are appeared which allow to observe meteors daily. At RI NAO three methodologies for meteor observation are developed: single-station method using FM-receiver, correlation method using FM-receiver and Internet resources, and single-station method using low-cost SDR-receiver.

  17. Insufficient Sleep Is a Public Health Epidemic

    Science.gov (United States)

    ... this? Submit Button Past Emails CDC Features Insufficient Sleep Is a Public Health Problem Language: English Español ( ... insufficient sleep is an important public health concern. Sleep-Related Unhealthy Behaviors The Behavioral Risk Factor Surveillance ...

  18. Doppler sonographic renal resistance index and resistance index ratio in children and adolescents with unilateral hydronephrosis

    Energy Technology Data Exchange (ETDEWEB)

    Brkljacic, Boris [Department of Radiology, University Hospital ' ' Dubrava' ' , Av. G. Suska 6, 10000 Zagreb (Croatia); Kuzmic, Andrea Cvitkovic; Dmitrovic, Romana [Department of Pediatric Nephrology, Children' s Hospital, Klaiceva 16, 10000 Zagreb (Croatia); Rados, Marko [Department of Radiology, University Hospital Center, Kispaticeva 12, 10000 Zagreb (Croatia); Vidjak, Vinko [Department of Radiology, University Hospital ' ' Merkur' ' , Zajceva 19, 10000 Zagreb (Croatia)

    2002-11-01

    The aim of this study was to evaluate Doppler renal resistance index (RI) and RI ratio (RIR) in differentiating between obstructive and nonobstructive hydronephrosis in children and adolescents. The RI and RIR were measured in 32 healthy examinees (control group) and 29 patients with unilateral hydronephrosis. Ten patients had acute obstruction caused by a ureteric stone. Seven had obstructive hydronephrosis due to uretero-pelvic junction (UPJ) obstruction. Twelve patients had nonobstructive hydronephrosis. In controls the mean RI{+-}S.D. was 0.615{+-}0.04, and RIR 1.045{+-}0.033. In children with acute obstruction RI was 0.692{+-}0.035 and RIR 1.148{+-}0.037. In UPJ obstruction RI was 0.631{+-}0.054 and RIR 1.059{+-}0.047. In nonobstructive dilatation RI was 0.61{+-}0.038 and RIR 1.043{+-}0.042. The RI and RIR differences were statistically significant between controls and patients with acute colic (p<0.01), and between patients with acute obstruction and with nonobstructive hydronephrosis (p<0.01). In detecting acute obstruction RI{>=}0.70 was found to have a 70% sensitivity and a 92% specificity. The RIR{>=}1.10 was found optimal to distinguish obstructive from nonobstructive dilatation (sensitivity 90%, specificity 83%). Both RI and RIR are significantly elevated in patients with acute obstruction. Renal Doppler seems to be useful in children and adolescents for the detection of acute renal obstruction, although it cannot differentiate chronic obstruction due to the UPJ obstruction and nonobstructive renal collecting system dilatation. (orig.)

  19. Luteal insufficiency in first trimester

    Directory of Open Access Journals (Sweden)

    Duru Shah

    2013-01-01

    Full Text Available Luteal phase insufficiency is one of the reasons for implantation failure and has been responsible for miscarriages and unsuccessful assisted reproduction. Luteal phase defect is seen in women with polycystic ovaries, thyroid and prolactin disorder. Low progesterone environment is created iatrogenically due to interventions in assisted reproduction. Use of gonadotrophin-releasing hormone analogs to prevent the LH surge and aspiration of granulosa cells during the oocyte retrieval may impair the ability of corpus luteum to produce progesterone. Treatment of the underlying disorder and use of progestational agents like progesterone/human chorionic gonadotrophin have been found to be effective in women with a history of recurrent miscarriage. There has been no proved beneficial effect of using additional agents like ascorbic acid, estrogen, prednisolone along with progesterone. Despite their widespread use, further studies are required to establish the optimal treatment. Literature review and analysis of published studies on luteal phase support.

  20. Renal parenchymal histopathology predicts life-threatening chronic kidney disease as a result of radical nephrectomy.

    Science.gov (United States)

    Sejima, Takehiro; Honda, Masashi; Takenaka, Atsushi

    2015-01-01

    The preoperative prediction of post-radical nephrectomy renal insufficiency plays an important role in the decision-making process regarding renal surgery options. Furthermore, the prediction of both postoperative renal insufficiency and postoperative cardiovascular disease occurrence, which is suggested to be an adverse consequence caused by renal insufficiency, contributes to the preoperative policy decision as well as the precise informed consent for a renal cell carcinoma patient. Preoperative nomograms for the prediction of post-radical nephrectomy renal insufficiency, calculated using patient backgrounds, are advocated. The use of these nomograms together with other types of nomograms predicting oncological outcome is beneficial. Post-radical nephrectomy attending physicians can predict renal insufficiency based on the normal renal parenchymal pathology in addition to preoperative patient characteristics. It is suggested that a high level of global glomerulosclerosis in nephrectomized normal renal parenchyma is closely associated with severe renal insufficiency. Some studies showed that post-radical nephrectomy severe renal insufficiency might have an association with increased mortality as a result of cardiovascular disease. Therefore, such pathophysiology should be recognized as life-threatening, surgically-related chronic kidney disease. On the contrary, the investigation of the prediction of mild post-radical nephrectomy renal insufficiency, which is not related to adverse consequences in the postoperative long-term period, is also promising because the prediction of mild renal insufficiency might be the basis for the substitution of radical nephrectomy for nephron-sparing surgery in technically difficult or compromised cases. The deterioration of quality of life caused by post-radical nephrectomy renal insufficiency should be investigated in conjunction with life-threatening matters.

  1. ri Talveti luulepiiriületamised / Jüri Talvet ; intervjueerinud Rein Veidemann

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    2010-01-01

    IX Moncayo luulefestivalist Aragoonias 10. aug. 2010 ja Jüri Talveti luule tõlgetest: Del sueno, de la nieve / tõlkinud Albert Lázaro Tinaut (Olifante, 2010) ; Of Snow, of Soul / tõlkinud H. L. Hix (Guernica, 2010)

  2. Construction of rare-RI ring at RIKEN RI Beam Factory

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Y., E-mail: yamaguch@ribf.riken.jp [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Wakasugi, M.; Uesaka, T. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Ozawa, A.; Abe, Y. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Institute of Physics, University of Tsukuba, Ibaraki305-8571 (Japan); Fujinawa, T.; Kase, M.; Komiyama, M.; Kubo, T.; Kumagai, K.; Maie, T. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Nagae, D. [Institute of Physics, University of Tsukuba, Ibaraki305-8571 (Japan); Ohnishi, J. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Suzaki, F. [Department of Physics, Saitama University, Saitama 338-8570 (Japan); Tokuchi, A. [Pulsed Power Japan Laboratory Ltd., Shiga 525-0032 (Japan); Watanabe, Y.; Yoshida, K.; Yamada, K. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); Yamaguchi, T. [Department of Physics, Saitama University, Saitama 338-8570 (Japan); Yamasawa, H. [RIKEN Nishina Center, RIKEN, Saitma 351-0198 (Japan); and others

    2013-12-15

    An isochronous mass spectroscopy system using a newly constructed storage ring named the “rare-RI ring” is expected to be implemented at the RIKEN Nishina Center to determine the masses of short-lived rare nuclei including those in the r-process region with a relative precision of the order of 10{sup -6} even for only one particle. In an isochronous storage ring, the mass is determined by measuring the revolution time of each nucleus. Our rare-RI ring consists of six magnetic sectors, and each sector consists of four bending magnets. To precisely optimize the isochronous conditions of the circulating particles for large acceptance, we install ten trim coils to half of the bending magnets. A fast-response and fast-charging kicker system enables selective and efficient injection of the produced rare nuclei into the ring one by one, along with facilitating efficient extraction of the circulating particles for time-of-flight measurement. Construction of the rare-RI ring was begun in the middle of the fiscal year 2012 at the RIKEN RI Beam Factory, and the ring is expected to be fully functional by 2015.

  3. ri Talveti luulepiiriületamised / Jüri Talvet ; intervjueerinud Rein Veidemann

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    2010-01-01

    IX Moncayo luulefestivalist Aragoonias 10. aug. 2010 ja Jüri Talveti luule tõlgetest: Del sueno, de la nieve / tõlkinud Albert Lázaro Tinaut (Olifante, 2010) ; Of Snow, of Soul / tõlkinud H. L. Hix (Guernica, 2010)

  4. ri Palmi uppunud tšello / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2002-01-01

    ri Palmist, tema loomingust kunstniku ja kirjanikuna. J. Palmi eluajal viimasest näitusest "Tallinna tuled", mida saatis kunstniku tekst "Kui mõista, siis mõista õigesti". J. Palmi ja Pavel Filonoviga (1883-1941) juhtunu sarnasusest

  5. Renal Vascular Resistive Index in Chronic Kidney Disease-relationship between RI and Pathology and Other Factors%慢性肾脏疾病肾内动脉阻力指数的影响因素及其与病理学的关系

    Institute of Scientific and Technical Information of China (English)

    李乾; 王彬; 张惠; 邵玉红

    2013-01-01

    目的 分析肾内动脉阻力指数(resistive index,RI)与慢性肾脏疾病(chronic kidney disease,CKD)的病理类型的关系,及可能影响RI的因素.方法 超声测定189例CKD患者的RI,记录性别、年龄、肾脏长度、血肌酐(μmol/L)、血压(mmHg)、24 h尿蛋白(g/24 h)、肾脏病理.根据血肌酐值计算肾小球滤过率(estimated glomerular filtration rate,eGFR).结果 RI与eGFR和年龄显著相关(P<0.05),而与血压、肾脏长度、尿蛋白均无显著相关.IgA肾病组与非IgA肾病组的RI无显著差异(P>0.05).在肾功能类似的各组中,IgA肾病组与非IgA肾病组的RI值无显著差异(P均>0.05).结论 CKD患者中,RI值在区分患者病理类型的作用有限.RI超声测定的RI值与肾脏形态、血压、尿蛋白等指标无明显关联,而与肾功能和年龄有关,RI值随eGFR的降低而增高,在临床工作中是监测CKD患者肾功能进展的有潜在价值的影像学指标.

  6. Rare-RI ring for mass measurements at RIBF

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Akira [Institute of Physics, University of Tsukuba, Ibaraki 305-8571 (Japan)

    2014-05-02

    The rare-RI (radioactive isotope) ring at the RIKEN RI Beam Factory is described. The main purpose of the rare-RI ring is to measure the mass of short-lived rare RI. In the rare-RI ring, the mass is determined by measuring the revolution time of each nucleus based on isochronous mass spectrometry. The rare-RI ring consists of six magnetic sectors, and each sector consists of four dipole magnets. To precisely optimize the isochronous conditions of the circulating particles for large acceptance, we install 10 trim coils to half of the dipole magnets. Individual injection system enables efficient injection of the produced rare RI into the ring one by one. With facilitating efficient extraction of the circulating particles, time-of-flight measurements can be performed to the each rare RI. Construction of the rare-RI ring was begun in the middle of the fiscal year 2012, and the ring is expected to be fully functional by 2015, when we can start the mass measurements for unknown masses.

  7. Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology

    Science.gov (United States)

    Khosroshahi, Hamid Tayebi; Sarbaz, Yashar; Shakeri Bavil, Abolhassan

    2017-01-01

    At the present time, imaging guided renal biopsy is used to provide diagnoses in most types of primary and secondary renal diseases. It has been claimed that renal biopsy can provide a link between diagnosis of renal disease and its pathological conditions. However, sometimes there is a considerable mismatch between patient renal outcome and pathological findings in renal biopsy. This is the time to address some new diagnostic methods to resolve the insufficiency of conventional percutaneous guided renal biopsy. Nanotechnology is still in its infancy in renal imaging; however, it seems that it is the next step in renal biopsy, providing solutions to the limitations of conventional modalities.

  8. Genetics of primary ovarian insufficiency.

    Science.gov (United States)

    Rossetti, R; Ferrari, I; Bonomi, M; Persani, L

    2017-02-01

    Primary ovarian insufficiency (POI) is characterized by a loss of ovarian function before the age of 40 and account for one major cause of female infertility. POI relevance is continuously growing because of the increasing number of women desiring conception beyond 30 years of age, when POI prevalence is >1%. POI is highly heterogeneous and can present with ovarian dysgenesis and primary amenorrhea, or with secondary amenorrhea, and it can be associated with other congenital or acquired abnormalities. In most cases POI remains classified as idiopathic. However, the age of menopause is an inheritable trait and POI has a strong genetic component. This is confirmed by the existence of several candidate genes, experimental and natural models. The variable expressivity of POI defect may indicate that, this disease may frequently be considered as a multifactorial or oligogenic defect. The most common genetic contributors to POI are the X chromosome-linked defects. Here, we review the principal X-linked and autosomal genes involved in syndromic and non-syndromic forms of POI with the expectation that this list will soon be upgraded, thus allowing the possibility to predict the risk of an early age at menopause in families with POI.

  9. Kidney in systemic diseases El riñón en las enfermedades sistémicas

    Directory of Open Access Journals (Sweden)

    Aldo Luis González Pérez

    Full Text Available Renal function alterant, sodium and water retention with intravascular volume expansion, and augmentation of the cardiac preload are closely related to the main causes of mortality and morbidity in patients suffering from symptomatic cardiac insufficiency. A review of the renal function alterant in congestive cardiac insufficiency and chronic liver diseases is carried out in this bibliographical revision. Important therapeutic aspects of the patients suffering from cardiac insufficiency considering its renal function alterant are also presented.
    Entre las causas principales de mortalidad y morbilidad en pacientes con insuficiencia cardiaca sintomática, se encuentran las relacionadas con alteraciones de la función renal y retención de sodio y agua, con expansión del volumen intravascular y aumento de la precarga cardiaca. En este trabajo se realiza una revisión de las alteraciones renales en la insuficiencia cardiaca congestiva y hepatopatías crónicas. Además, se presentan aspectos terapéuticos importantes de pacientes con insuficiencia cardiaca, considerando sus alteraciones renales.

  10. Renal scar formation after urinary tract infection in children

    OpenAIRE

    2012-01-01

    Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephrop...

  11. 临床药师参与1例慢性肾功能不全伴尿路感染的治疗实践%A treatment practice of a clinical pharmacist participating in 1 case of chronic renal insufficiency with urinary tract infection

    Institute of Scientific and Technical Information of China (English)

    刘俊; 安益国; 杨冬梅; 周光树; 张圣雨

    2013-01-01

    目的 通过临床药师参与1例慢性肾功能不全伴尿路感染的治疗实践,探讨药师在合理用药中发挥的作用.方法 临床药师积极参与了该患者的抗感染,控制高血压,纠正贫血,抗凝的治疗实践,针对患者的治疗方案,药品的选择、剂量、相互作用、不良反应、注意事项等提出了一些合理化的建议,同时对患者实施了药学监护,健康教育和用药教育.结果 临床药师参与治疗实践,提高了临床治疗效果.患者住院用药期间无相关不良反应发生,出院时尿路感染已经控制,血压平稳,无电解质紊乱,病情控制尚可.结论 临床药师参与临床药物治疗,为病人提供个体化药学服务,可使用药更合理、有效和经济;临床药师只有参与临床实践与临床医师密切配合,才能有助于更好地开展临床药学服务工作,更好地为病人服务.%Objective To investigate the role of a pharmacist in rational drug use by participating in 1 case of chronic renal insufficiency with urinary tract infection treatment practice. Methods The clinical pharmacist actively participated in the patient' s treatment practice of anti-infection,high blood pressure controlling,anemia correction,and anticoagulation,and also proposed reasonable suggestions according to the patient s treatment practice on drug selection, dosage, interactions, adverse reactions and points for attention, meanwhile implement pharmaceutical care, health education and drug education for the patient at the same time. Results The clinical pharmacist s participating in the treatment practice helped improve the clinical treatment effect. There was no relevant adverse reaction during the patient s hospitalization. And his urinary tract infection had been controlled, with smooth blood pressure, and normal electrolyte after his hospital discharge. Conclusion The clinical pharmacist s participation in clinical drug therapy for patients provides individualized service

  12. ri Naela rahakotti prantsatas miljon krooni / Aigi Viira

    Index Scriptorium Estoniae

    Viira, Aigi

    2009-01-01

    Tallinna Ülikooli tantsukompositsiooni dotsent Jüri Nael sai Eesti haridus- ja teadusministeeriumilt miljonikroonise stipendiumi doktoriõpinguteks Londonis Royal Holloway University's. Jüri Nael pühendub Londonis õppides sellele, mis jääb teatri ja tantsu vahele ehk füüsilisele teatrile, täpsemalt – füüsilisele eksperimentaalteatrile

  13. 76 FR 50770 - Submission for Review: Financial Resources Questionnaire (RI 34-1, RI 34-17, and RI 34-18) and...

    Science.gov (United States)

    2011-08-16

    ... documentation, may be obtained by contacting the Retirement Services Publications Team, Office of Personnel... Benefits Premiums Underpaid (RI 34-18), collects detailed financial information for use by OPM to...

  14. Näitus "Sajand eesti puugravüüri klotsidel" / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2007-01-01

    Eesti Rahvusraamatukogus 15. I-3. II eksponeeritud ja rahvusraamatukogu kollektsioonist koostatud näitusest "Sajand eesti puugravüüri klotsidel: 1840-1940". Järgmistest kunstnikest ja nende töödest: Aleksander Otto Gern, Bogdan Gottlieb Friedrich Kally, August Daugell, Hermann Eduard Hartmann, Eduard Magnus Jakobson, Mart Pukits, Andres Kuusk, Karl Friedrich Schnell, Anton Suurkask (1873-1965), Arkadio Laigo, Hando Mugasto, Eduard Järv, Richard Kaljo, Ott Kangilaski, Ants Puks (1918-?), Salome Trei

  15. TrueFISP MR imaging to determine the influence of hemodialysis on the myocardial functional parameters in patients with terminal renal insufficiency; TrueFISP-MR-Bildgebung zur Bestimmung des Einflusses der Haemodialyse auf myokardiale Funktionsparameter bei Patienten mit terminaler Niereninsuffizienz

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, U.; Fenchel, M.; Kraft, A.; Tomaschko, K.; Stauder, N.; Claussen, C.D.; Miller, S. [Tuebingen Univ. (Germany). Radiologische Klinik; Wolf, S.; Risler, T. [Tuebingen Univ. (Germany). Medizinische Klinik

    2004-03-01

    Purpose: To assess the characteristic signs of uremic cardiomyopathy in patients with chronic renal failure (CRF) in comparison with healthy volunteers and to determine changes of left ventricular (LV) functional parameters in patients undergoing hemodialysis (HD). Methods and Materials: Using a 1.5 T Magnetron Sonata system (Siemens, Erlangen), cardiac MR imaging was performed on 26 patients (20 men, 6 women, mean age 54.7 years) and 14 volunteers (8 men, 6 women, mean age 27.7 years). Single-slice true FISP sequences (TR 3.2 ms, TE 1.6 ms, flip angel 58 , matrix 256 x 208, slice thickness 5 mm) were used to obtain contiguous short axis slices covering the whole left ventricle. Patients were examined before and immediately afte HD. Cardiodynamic parameters end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass (MM), cardiac output (CO) were calculated using the modified Simpson's rule (Argus Software, Siemens). Patient data were compared to reference values taken from healthy volunteers. Results: As a consequence of HD, significant differences (p<0.01) were observed for EDV (150+47 ml/114+49 ml), ESV (71+46 ml/60+56 ml), SV (79+25 ml/57+27 ml) and CO (3.6+1.0 l/min x m{sup 2}/2.6+1.1 l/min x m{sup 2}). Although EF (56+15%/53+18%) was decreased after HD, values did not differ significantly (p>0.05). MM (148+47 g/148+52 g) and myocardial mass index (80.7{+-}27.4 g/m{sup 2}/80.1{+-}9.1 g/m{sup 2}) did not change before and after HD. In all patients, signs of LV-hypertrophy (LVH) and increased CO were diagnosed compared to reference values. In 8 of 26 patients, additional pathology, such as valvular dysfunction or global cardiac insufficiency, was detected. Conclusion: Cardiac MRI is an accurate tool to identify uremic cardiomyopathy in patients with chronic renal failure undergoing HD. LV functional parameters could be monitored reliably. [German] Zielsetzung: Die vorliegende Studie an Patienten mit

  16. The International Scoring System (ISS) for multiple myeloma remains a robust prognostic tool independently of patients' renal function.

    Science.gov (United States)

    Dimopoulos, M A; Kastritis, E; Michalis, E; Tsatalas, C; Michael, M; Pouli, A; Kartasis, Z; Delimpasi, S; Gika, D; Zomas, A; Roussou, M; Konstantopoulos, K; Parcharidou, A; Zervas, K; Terpos, E

    2012-03-01

    The International Staging System (ISS) is the most widely used staging system for patients with multiple myeloma (MM). However, serum β2-microglobulin increases in renal impairment (RI) and there have been concerns that ISS-3 stage may include 'up-staged' MM patients in whom elevated β2-microglobulin reflects the degree of renal dysfunction rather than tumor load. In order to assess the impact of RI on the prognostic value of ISS, we analyzed 1516 patients with symptomatic MM and the degree of RI was classified according to the Kidney Disease Outcomes Quality Initiative-Chronic Kidney Disease (CKD) criteria. Forty-eight percent patients had stages 3-5 CKD while 29% of patients had ISS-1, 38% had ISS-2 and 33% ISS-3. The frequency and severity of RI were more common in ISS-3 patients. RI was associated with inferior survival in univariate but not in multivariate analysis. When analyzed separately, ISS-1 and ISS-2 patients with RI had inferior survival in univariate but not in multivariate analysis. In ISS-3 MM patients, RI had no prognostic impact either in univariate or multivariate analysis. Results were similar, when we analyzed only patients with Bence-Jones >200 mg/day. ISS remains unaffected by the degree of RI, even in patients with ISS-3, which includes most patients with renal dysfunction.

  17. Exocrine pancreatic insufficiency following esophagectomy.

    Science.gov (United States)

    Huddy, J R; Macharg, F M S; Lawn, A M; Preston, S R

    2013-08-01

    Weight loss following esophagectomy is a management challenge for all patients. It is multifactorial with contributing factors including loss of gastric reservoir, rapid small bowel transit, malabsorption, and adjuvant chemotherapy. The development of a postoperative malabsorption syndrome, as a result of exocrine pancreatic insufficiency (EPI), is recognized in a subgroup of patients following gastrectomy. This has not previously been documented following esophageal resection. EPI can result in symptoms of flatulence, diarrhea, steatorrhea, vitamin deficiencies, and weight loss. It therefore has the potential to pose a significant level of morbidity in postoperative patients. There is some evidence that patients with proven EPI (fecal elastase-1 PERT). We observed symptoms compatible with EPI in a subgroup of patients following esophagectomy. We hypothesized that this was contributing to malabsorption and malnutrition in these patients. To investigate this, fecal elastase-1 was measured in postoperative patients, and in those with proven EPI, a trial of PERT was commenced in combination with specialist dietary education. At routine postoperative follow-up, which included assessment by a specialist dietitian, those patients with symptoms suggestive of malabsorption were given the opportunity to have their fecal elastase-1 measured. PERT was then offered to patients with fecal elastase-1 less than 200 μg/g (EPI) as well as those in the 200-500 μg/g range (mild EPI) with more severe symptoms. Fecal elastase-1 was measured in 63 patients between June 2009 and January 2011 at a median of 4 months (range 1-42) following surgery. Ten patients had fecal elastase-1 less than 200 μg/g, and all had failed to maintain preoperative weight. All accepted a trial of PERT. Nine (90%) had symptomatic improvement, and seven (70%) increased their weight. Thirty-nine patients had a fecal elastase-1 in the 200-500 μg/g range. Twelve were given a trial of PERT based on level of

  18. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication

    Directory of Open Access Journals (Sweden)

    Chang Kyu Sung

    2016-01-01

    Full Text Available Purpose: The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI by using an electrical circuit model to simulate renal blood flow. Methods: In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Results: Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. Conclusion: This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  19. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication)

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chang Kyu [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Bong Soo [Dept. of Radiological Science, College of Health Science, Yonsei University, Wonju (Korea, Republic of); Kim, Seung Hyup [Dept. of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI) by using an electrical circuit model to simulate renal blood flow. In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research) and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  20. Characterization of Three New Glutaredoxin Genes in the Arbuscular Mycorrhizal Fungus Rhizophagus irregularis: Putative Role of RiGRX4 and RiGRX5 in Iron Homeostasis

    Science.gov (United States)

    Tamayo, Elisabeth; Benabdellah, Karim; Ferrol, Nuria

    2016-01-01

    Glutaredoxins (GRXs) are small ubiquitous oxidoreductases involved in the regulation of the redox state in living cells. In an attempt to identify the full complement of GRXs in the arbuscular mycorrhizal (AM) fungus Rhizophagus irregularis, three additional GRX homologs, besides the formerly characterized GintGRX1 (renamed here as RiGRX1), were identified. The three new GRXs (RiGRX4, RiGRX5 and RiGRX6) contain the CXXS domain of monothiol GRXs, but whereas RiGRX4 and RiGRX5 belong to class II GRXs, RiGRX6 belongs to class I together with RiGRX1. By using a yeast expression system, we observed that the newly identified homologs partially reverted sensitivity of the GRX deletion yeast strains to external oxidants. Furthermore, our results indicated that RiGRX4 and RiGRX5 play a role in iron homeostasis in yeast. Gene expression analyses revealed that RiGRX1 and RiGRX6 were more highly expressed in the intraradical (IRM) than in the extraradical mycelium (ERM). Exposure of the ERM to hydrogen peroxide induced up-regulation of RiGRX1, RiGRX4 and RiGRX5 gene expression. RiGRX4 expression was also up-regulated in the ERM when the fungus was grown in media supplemented with a high iron concentration. These data indicate the two monothiol class II GRXs, RiGRX4 and RiGRX5, might be involved in oxidative stress protection and in the regulation of fungal iron homeostasis. Increased expression of RiGRX1 and RiGRX6 in the IRM suggests that these GRXs should play a key role in oxidative stress protection of R. irregularis during its in planta phase. PMID:26900849

  1. Characterization of Three New Glutaredoxin Genes in the Arbuscular Mycorrhizal Fungus Rhizophagus irregularis: Putative Role of RiGRX4 and RiGRX5 in Iron Homeostasis.

    Directory of Open Access Journals (Sweden)

    Elisabeth Tamayo

    Full Text Available Glutaredoxins (GRXs are small ubiquitous oxidoreductases involved in the regulation of the redox state in living cells. In an attempt to identify the full complement of GRXs in the arbuscular mycorrhizal (AM fungus Rhizophagus irregularis, three additional GRX homologs, besides the formerly characterized GintGRX1 (renamed here as RiGRX1, were identified. The three new GRXs (RiGRX4, RiGRX5 and RiGRX6 contain the CXXS domain of monothiol GRXs, but whereas RiGRX4 and RiGRX5 belong to class II GRXs, RiGRX6 belongs to class I together with RiGRX1. By using a yeast expression system, we observed that the newly identified homologs partially reverted sensitivity of the GRX deletion yeast strains to external oxidants. Furthermore, our results indicated that RiGRX4 and RiGRX5 play a role in iron homeostasis in yeast. Gene expression analyses revealed that RiGRX1 and RiGRX6 were more highly expressed in the intraradical (IRM than in the extraradical mycelium (ERM. Exposure of the ERM to hydrogen peroxide induced up-regulation of RiGRX1, RiGRX4 and RiGRX5 gene expression. RiGRX4 expression was also up-regulated in the ERM when the fungus was grown in media supplemented with a high iron concentration. These data indicate the two monothiol class II GRXs, RiGRX4 and RiGRX5, might be involved in oxidative stress protection and in the regulation of fungal iron homeostasis. Increased expression of RiGRX1 and RiGRX6 in the IRM suggests that these GRXs should play a key role in oxidative stress protection of R. irregularis during its in planta phase.

  2. Fc gamma RI blockade and modulation for immunotherapy.

    Science.gov (United States)

    Wallace, P K; Keler, T; Guyre, P M; Fanger, M W

    1997-01-01

    Splenectomy and corticosteroids are the treatment of choice for patients with immune thrombocytopenic purpura (ITP). However, for the 10%-15% of patients who do not respond to conventional therapy, high-dose i.v. IgG can induce life-saving transient responses. The benefits of i.v. IgG have been attributed to Fc receptor blockade; however, the involvement of the individual Fc receptors for IgG (Fc gamma R) in ITP remain to be more completely defined. Recently a mAb, designated mAb H22, which recognizes an epitope on Fc gamma RI (CD64) outside the ligand-binding domain, was humanized. Because mAb H22 is a human IgG1 and Fc gamma RI has a high affinity for human IgG1 antibodies, we predicted that mAb H22 would bind to the Fc gamma RI ligand-binding site through its Fc domain and to its external Fc gamma RI epitope through both Fab domains. These studies demonstrate that mAb H22 blocked Fc gamma RI-mediated phagocytosis of opsonized red blood cells more effectively than an irrelevant IgG. Moreover, cross-linking Fc gamma RI with mAb H22 down-modulated Fc gamma RI expression on monocytes, an effect seen within 2 h.

  3. Pregnancy in women with renal disease. Yes or no?

    Science.gov (United States)

    Edipidis, K

    2011-01-01

    Women with renal disease who conceive and continue pregnancy, are at significant risk for adverse maternal and fetal outcomes. Although advances in antenatal and neonatal care continue to improve these outcomes, the risks remain proportionate to the degree of underlying renal dysfunction.The aim of this article, is to examine the impact of varying degrees of renal insufficiency on pregnancy outcome, in women with chronic renal disease and to provide if possible, useful conclusions whether and when, a woman with Chronic Kidney Disease (CKD), should decide to get pregnant.This article, reviews briefly the normal physiological changes of renal function during pregnancy, and make an attempt to clarify the nature and severity of the risks, in the settings of chronic renal insufficiency and end stage renal disease, including dialysis patients and transplant recipients.

  4. Hypothalamic functions in patients with pituitary insufficiency

    NARCIS (Netherlands)

    Borgers, A.J.F.

    2013-01-01

    The main objective of this thesis is to increase our understanding of hypothalamic (dys)function in patients with pituitary insufficiency. This goal is driven by the clinical experience of persisting symptoms in patients adequately treated for pituitary insufficiency. We focus primarily on patients

  5. [Amyotrophic lateral sclerosis and respiratory insufficiency].

    Science.gov (United States)

    Siirala, Waltteri; Korpela, Jaana; Vuori, Arno; Saaresranta, Tarja; Olkkola, Klaus T; Aantaa, Riku

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a disease causing degeneration of motor neurons, without any curative treatment. The most common cause of death is respiratory arrest due to atrophy of the respiratory musculature. ALS-associated respiratory insufficiency differs in mechanism from the more common causes of dyspnea, such as diseases of pulmonary or cardiac origin. Recognizing the respiratory insufficiency can be challenging for a clinician. It should be possible to predict the development of respiratory insufficiency in order to avoid leaving the treatment decisions concerning respiratory insufficiency to emergency services. Noninvasive ventilatory support can be used to alleviate the patient's dyspnea. It is actually recommended as the first-line treatment of ALS-associated respiratory insufficiency.

  6. Safety and efficacy of bortezomib-melphalan-prednisone-thalidomide followed by bortezomib-thalidomide maintenance (VMPT-VT) versus bortezomib-melphalan-prednisone (VMP) in untreated multiple myeloma patients with renal impairment.

    Science.gov (United States)

    Morabito, Fortunato; Gentile, Massimo; Mazzone, Carla; Rossi, Davide; Di Raimondo, Francesco; Bringhen, Sara; Ria, Roberto; Offidani, Massimo; Patriarca, Francesca; Nozzoli, Chiara; Petrucci, Maria Teresa; Benevolo, Giulia; Vincelli, Iolanda; Guglielmelli, Tommasina; Grasso, Mariella; Marasca, Roberto; Baldini, Luca; Montefusco, Vittorio; Musto, Pellegrino; Cascavilla, Nicola; Majolino, Ignazio; Musolino, Caterina; Cavo, Michele; Boccadoro, Mario; Palumbo, Antonio

    2011-11-24

    We assessed efficacy, safety, and reversal of renal impairment (RI) in untreated patients with multiple myeloma given bortezomib-melphalan-prednisone-thalidomide followed by bortezomib-thalidomide (VMPT-VT) maintenance or bortezomib-melphalan-prednisone (VMP). Exclusion criteria included serum creatinine ≥ 2.5 mg/dL. In the VMPT-VT/VMP arms, severe RI (estimated glomerular filtration rate [eGFR] ≤ 30 mL/min), moderate RI (eGFR 31-50 mL/min), and normal renal function (eGFR > 50 mL/min), were 6%/7.9%, 24.1%/24.9%, and 69.8%/67.2%, respectively. Statistically significant improvements in overall response rates and progression-free survival were observed in VMPT-VT versus VMP arms across renal cohorts, except in severe RI patients. In the VMPT group, severe RI reduced overall survival (OS). RI was reversed in 16/63 (25.4%) patients receiving VMPT-VT versus 31/77 (40.3%) receiving VMP. Multivariate analysis showed male sex (P = .022) and moderate RI (P = .003) significantly predicted RI recovery. VMP patients achieving renal response showed longer OS. In both arms, greater rates of severe hematologic adverse events were associated with RI (eGFR < 50 mL/min), however, therapy discontinuation rates were unaffected. VMPT-VT was superior to VMP for cases with normal renal function and moderate RI, whereas VMPT-VT failed to outperform VMP in patients with severe RI, although the relatively low number of cases analyzed preclude drawing definitive conclusions. VMPT-VT had no advantage in terms of RI reversal over VMP.

  7. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  8. ri Kaljundi soovitab liikuda välisturgudele / Jüri Kaljundi

    Index Scriptorium Estoniae

    Kaljundi, Jüri, 1974-

    2005-01-01

    AS-i MicroLinki Eesti turundus- ja müügijuht vastab küsimustele, mis puudutavad tema lahkumist personaliotsingufirmast CV-Online, CV-Online'i laienemist, tööle asumist AS-i Microlink Eesti, alluvate värbamist ning ettevõtte omamise eeliseid võrreldes palgatööga. Lisad: Edu võtmed; Jüri Kaljundi. Kommenteerib MicroLinki nõukogu liige Allan Martinson: Vaga vesi, sügav põhi

  9. The Role of Oxygen Free Radicals in Acute Renal Failure Complicating Obstructive Jaundice: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Serdar Yüceyar

    1998-01-01

    Full Text Available Oxydant injury is considered to be an important mechanism in the pathophysiology of acute renal failure. It has been thought that decrease in extracellular and intracellular fluid and endotoxemia seen in obstructive jaundice may cause an increase in production of oxygen free radicals and impairment in antioxydant defense mechanism. This study is designed to investigate the possible role of oxydant injury in renal failure seen in jaundiced patients. In this study, 28 rats were divided into four groups: Control(C (N=7; Renal ischemia (RI (N=7; Obstructive jaundice+renal ischemia (OJ+RI (N=7; Obstructive jaundice (OJ (N=7. All groups were compared with each other according to renal failure findings and enzyme activities, such as Xanthine oxidase (XOD, Superoxide Dismutase (SOD and Catalase in renal cortex and Glutathione Peroxidase (GSH-Px, in blood at 3rd day after ischemia and reperfusion. Renal failure findings monitored by blood urea and creatinine levels, seemed more evident in OJ+RI than RI group (p <0.05. When compared with RI, in OJ+RI group, increase in XOD activity at 3rd day was statistically significant [0.259 ±0.01 U/g (tissue and 0.362±0.03 U/g (tissue respectively] (p <0.05. SOD and GSH-Px activities of each ischemic group at 3rd day were decreased compared to non-ischemic groups. This fall was significant (p <0.05. But there was no statistical difference between jaundiced and non-jaundiced groups. Alterations in catalase activities also had no statistical significance.

  10. Effects of initiating chronic renal replacement therapy in children, now and later in life: Data from the LERIC cohort and ERA-EDTA Registry

    NARCIS (Netherlands)

    J.L. Vogelzang

    2015-01-01

    This thesis describes the most important results of LERIC (Late Effects of Renal Insufficiency in Children), a very a long-term follow-up study to the late somatic and psychosocial consequences of renal insufficiency in children. LERIC is a comprehensive study to evaluate the late effects of renal i

  11. Cervical insufficiency and cervical cerclage.

    Science.gov (United States)

    Brown, Richard; Gagnon, Robert; Delisle, Marie-France; Gagnon, Robert; Bujold, Emmanuel; Basso, Melanie; Bos, Hayley; Brown, Richard; Cooper, Stephanie; Crane, Joan; Davies, Gregory; Gouin, Katy; Menticoglou, Savas; Mundle, William; Pylypjuk, Christy; Roggensack, Anne; Sanderson, Frank; Senikas, Vyta

    2013-12-01

    Objectif : La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d’un cerclage pourrait s’avérer souhaitable. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d’un vocabulaire contrôlé (p. ex. « uterine cervical incompetence ») et de mots clés appropriés (p. ex. « cervical insufficiency », « cerclage », « Shirodkar », « cerclage », « MacDonald », « cerclage », « abdominal », « cervical length », « mid-trimester pregnancy loss »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en janvier 2011. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Recommandations 1. Les femmes qui sont enceintes ou qui planifient connaître une grossesse devraient faire l’objet d’une évaluation visant les facteurs de

  12. Renal infarction in a patient with pulmonary vein thrombosis after left upper lobectomy.

    Science.gov (United States)

    Manabe, Shun; Oshima, Yasuko; Nakano, Marie; Fujii, Teruhiro; Maehara, Takamitsu; Nitta, Kosaku; Hatano, Michiyasu

    2014-05-01

    A 43-year-old male experienced renal infarction (RI) following left upper lobectomy for lung cancer. The patient complained of acute-onset severe left flank pain on the 14th postoperative day. A contrast-enhanced computed tomography (CT) of the abdomen revealed RI by a large wedge-shaped defect in the left kidney. A chest CT scan located the thrombus in the stump (a blind-ended vessel) of the left superior pulmonary vein. Therefore, thromboembolic RI caused by pulmonary vein thrombosis was suspected. Anticoagulation therapy was initiated with heparin and warfarin to treat RI and to prevent further embolic episodes. Two months later, pulmonary vein thrombosis had resolved without the appearance of additional peripheral infarction. This case emphasizes the need to consider thrombus in the stump of the pulmonary vein as a cause of RI.

  13. Enfermedad glomeruloquística en dos perros con insuficiencia renal

    OpenAIRE

    Elizabeth Morales Salinas; Luis Ignacio Montesinos Ramírez; Luis Enrique García Ortuño; Augusto César Núñez Díaz; Linda Abril Camacho González

    2008-01-01

    Se describen dos casos de enfermedad glomeruloquística renal (EGQR) en perros con insufi ciencia renal. En los análisis de laboratorio de ambos animales se encontró hiperazotemia renal con anemia no regenerativa secundaria, asociada con insufi ciencia renal crónica. Las lesiones macroscópicas en los riñones de dichos perros fueron similares: se observaron múltiples pequeños quistes de 1 mm de diámetro en promedio, localizados principalmente en la corteza renal. En el examen histopatológico de...

  14. Estimation of glomerular filtration rate with different background region of interest for renography in severe renal insufficiency patients%肾动态显像中不同本底的选取在重度肾功能不全患者肾小球滤过率的评估

    Institute of Scientific and Technical Information of China (English)

    杜晓英; 朱阳军; 李林法; 何强; 陈江华

    2008-01-01

    Objective To evaluate the improvement of diagnostic accuracy with background region of interest(ROI)rectification for 99mTc-DTPA renography in patients with GFR≤plasma sampling method). Methods Thirty-three patients(age>20 years,male/female=13/20)dose of 111 MBq/0.5 ml of 99mTc-DTPA was injected into an antecubital vein.The background ROI was selected below the kidney(Gates method,method a)or around the kidney(method b),then these two different GFR(GFRa,GFRb)were automatically estimated by computer.Meanwhile,3 ml blood samples were collected 2 h and 4 h after injection respectively,and radioactivity of 1 ml plasma was measured.GFR was calculated by dual plasma sampling method(GFRp)and the results were all standardized with the body surface area.The accuracies and correlations of GFRa and GFRb were compared to GFRp respectively. Results The correlation coefficients were ra=0.602 and rb=0.834.The median of difference of GFRa and GFRb was 8.33,-4.41.The median of absolute difference of GFRa and GFRb was 8.33,4.49.The accuracies within±15%,±30%and±50%of GFRa were 24.2%,30.3%and 48.5%,and those of GFRb were 33.3%,51.5%and 81.8%.Conclusion The background ROI around kidney can obviously improve the diagnostic accuracy of 99mTc-DTPA renography in patients with severe renal insufficiency.%目的 以99mTc-DTPA血浆清除率为标准,评价在重度肾功能不全[GFR≤30 ml·min-1·(1.73 m2)-1]患者GFR的评估中,本底矫正在提高99mTc-DTPA肾动态显像检查准确性中的价值.方法 选择重度慢性肾脏病患者33例,年龄均>20岁,男性/女性=13/20,平均Scr334 μmol/L,诊断均符合美国NKF-K/DOQI关于慢性肾脏病定义.排除肾功能急性恶化因素、水肿、肢体缺如及心功能不全.分别检测患者身高、体质量.常规99mTc-DTPA肾动态功能显像,采用双肾下极(传统Gates法,a法)及肾周环形勾画法(b法)获取图像本底,并分别由计算机自动计算GFR值(GFRa和GFRb).于注射后2 h、4 h各抽血4

  15. Pealinlased olid aktiivsemad valijad / Jüri Ratas

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2007-01-01

    Ilmunud ka: Stolitsa, 14. märts 2007, lk. 2. Tallinna linnapea Jüri Ratas parlamendivalimiste tulemustest. Vt. samas: Kes Tallinnast riigikokku valiti?; Riigikogu valimise tulemused Tallinnas: diagramm

  16. [Mihai Eminescu luulefestivalil osales Jüri Talvet

    Index Scriptorium Estoniae

    2014-01-01

    Mihai Eminescu luulefestivalil esitleti mahukat tõlkeantoloogiat "Antologia poeziei universal de astăzi" (Craiova: Editura Europa”, 2014), mille on koostanud Ion Deaconescu. Antoloogias on ka Jüri Talveti luulet

  17. Literature as a nation's emotional memory / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1998-01-01

    Bibliograafia, lk. 134-135. Autorist lk. 387. Juri Lotmani semiosfääri tõlgendamisest: "süntagmaatilised" struktuurid ja "perifeersed" kultuurid. Ka Friedebert Tuglase "Kalevipoja"-kriitikast ning Lydia Koidula ja Juhan Liivi luuletustest

  18. Pealinlased olid aktiivsemad valijad / Jüri Ratas

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2007-01-01

    Ilmunud ka: Stolitsa, 14. märts 2007, lk. 2. Tallinna linnapea Jüri Ratas parlamendivalimiste tulemustest. Vt. samas: Kes Tallinnast riigikokku valiti?; Riigikogu valimise tulemused Tallinnas: diagramm

  19. President vabastas Jüri Sakkarti kohtuniku ametist / Tanel Mazur

    Index Scriptorium Estoniae

    Mazur, Tanel, 1971-

    2010-01-01

    President Toomas Hendrik Ilves kirjutas 9. veebruaril 2010 alla otsusele vabastada Jüri Sakkart Viru Maakohtu kohtuniku ametist tema enda soovil. Kaitsepolitsei on J. Sakkarti kuriteokahtlustusega kinni pidanud

  20. Eurosib tuleb Eestisse laia teenustehulgaga / Jüri Ader

    Index Scriptorium Estoniae

    Ader, Jüri

    2005-01-01

    Venemaa viie juhtiva logistikafirma hulka kuuluva Eurosib SPb-TS-i Tallinna esinduse juhataja Jüri Ader vahendab peakorteri vastuseid küsimustele, mis puudutavad Eurosibi plaane ja teenuseid Eestis. Lisa: Eurosib leiab rakenduse 9000 raudteevagunile

  1. [Mihai Eminescu luulefestivalil osales Jüri Talvet

    Index Scriptorium Estoniae

    2014-01-01

    Mihai Eminescu luulefestivalil esitleti mahukat tõlkeantoloogiat "Antologia poeziei universal de astăzi" (Craiova: Editura Europa”, 2014), mille on koostanud Ion Deaconescu. Antoloogias on ka Jüri Talveti luulet

  2. Genetics Home Reference: Léri-Weill dyschondrosteosis

    Science.gov (United States)

    ... disorder of bone growth. Affected individuals typically have shortening of the long bones in the arms and ... features of Léri-Weill dyschondrosteosis can include increased muscle mass (muscle hypertrophy); bowing of a bone in ...

  3. Literature as a nation's emotional memory / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1998-01-01

    Bibliograafia, lk. 134-135. Autorist lk. 387. Juri Lotmani semiosfääri tõlgendamisest: "süntagmaatilised" struktuurid ja "perifeersed" kultuurid. Ka Friedebert Tuglase "Kalevipoja"-kriitikast ning Lydia Koidula ja Juhan Liivi luuletustest

  4. Helilooja Jüri Dmitrievi loominguline õhtu / Vladislav Horuzhenko

    Index Scriptorium Estoniae

    Horuzhenko, Vladislav

    2006-01-01

    Viiuldajast, pianistist ja heliloojast Jüri Dmitrievist. Loomingulisest õhtust 8. okt. Pärnu raekojas Pärnumaa Rahvakultuuri Keskseltsi korraldatava projekti "Inimesed Pärnumaa kultuurimaastikul" raames

  5. Ühest avastamata illustreeritud raamatust / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2011-01-01

    Erick, Françoise. Heute / ill. Sergei Slastnikov. Tallinn : Tallinna Eesti Kirjastus-Ühisus, 1926. S. Slastnikovi puugravüüris illustratsioonidest, tema kunstialastest kirjutistest ja puugravüüri kasutuselevõtust eesti raamatukunstis

  6. Ühest avastamata illustreeritud raamatust / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2011-01-01

    Erick, Françoise. Heute / ill. Sergei Slastnikov. Tallinn : Tallinna Eesti Kirjastus-Ühisus, 1926. S. Slastnikovi puugravüüris illustratsioonidest, tema kunstialastest kirjutistest ja puugravüüri kasutuselevõtust eesti raamatukunstis

  7. President vabastas Jüri Sakkarti kohtuniku ametist / Tanel Mazur

    Index Scriptorium Estoniae

    Mazur, Tanel, 1971-

    2010-01-01

    President Toomas Hendrik Ilves kirjutas 9. veebruaril 2010 alla otsusele vabastada Jüri Sakkart Viru Maakohtu kohtuniku ametist tema enda soovil. Kaitsepolitsei on J. Sakkarti kuriteokahtlustusega kinni pidanud

  8. Neurosarcoidosis-associated central diabetes insipidus masked by adrenal insufficiency.

    Science.gov (United States)

    Non, Lemuel; Brito, Daniel; Anastasopoulou, Catherine

    2015-01-22

    Central diabetes insipidus (CDI) is an infrequent complication of neurosarcoidosis (NS). Its presentation may be masked by adrenal insufficiency (AI) and uncovered by subsequent steroid replacement. A 45-year-old woman with a history of NS presented 2 weeks after abrupt cessation of prednisone with nausea, vomiting, decreased oral intake and confusion. She was diagnosed with secondary AI and intravenous hydrocortisone was promptly begun. Over the next few days, however, the patient developed severe thirst and polyuria exceeding 6 L of urine per day, accompanied by hypernatraemia and hypo-osmolar urine. She was presumed to have CDI due to NS, and intranasal desmopressin was administered. This eventually normalised her urine output and serum sodium. The patient was discharged improved on intranasal desmopressin and oral prednisone. AI may mask the manifestation of CDI because low serum cortisol impairs renal-free water clearance. Steroid replacement reverses this process and unmasks an underlying CDI.

  9. Szathmári, a great documentary artist

    Directory of Open Access Journals (Sweden)

    Ionescu, Adrian-Silvan

    2014-01-01

    Full Text Available Carol Pop de Szathmári was born in Cluj, Transylvania, on 11 January 1812. His talent for painting shone out from an early age. Being a passionate traveller, Szathmári journeyed through Europe and often crossed the Carpathian Mountains to visit Wallachia and its capital, Bucharest, where he eventually settled in 1843. An accomplished landscape and portrait painter, at ease with both watercolours and oil paints, Szathmári obtained commissions from the wealthy Wallachian boyars. Szathmári kept up constant, good relations with the successive ruling princes of Wallachia for whom he painted portraits and various other compositions. By 1848, Szathmári began to experiment with photography. The outbreak of the Russian-Ottoman War in late June 1853 saw the Romanian principalities occupied by the Russian army. In April 1854, Szathmári filled a van with his cameras and glass plates and went to the Danube to document the fighting between the Russian and Turkish armies.The result of Szathmári's bravery and hard work was a photographic album. His album, containing some two hundred images, became famous due to its presentation at the 1855 Paris World's Fair and Szathmári was awarded the Second Class Medal for his work.From that time on, photography, painting and lithography were always closely connected in Szathmári's career. In 1864 he became a member of the Société Française de Photographie in Paris and in 1870 of the one in Vienna. In 1863, he was appointed Court Painter and Photographer, a position he held for the rest of his life. In that capacity, he followed his patron, Prince Carol I, on the battlefield during the Russian-Romanian-Ottoman War of 1877, which was waged south of the Danube. Alongside martial compositions and albums, Szathmári had long been attracted by folk types and produced a large series of pictures of peasants, gypsies, postillions, merchants and artisans. He toured the fairs and the crowded streets of the town in search

  10. ri Lina kui tegelikkusele osutav Patagoonia šamaan / Jüri Lina ; intervjueerinud Ingrid Peek

    Index Scriptorium Estoniae

    Lina, Jüri, 1949-

    2011-01-01

    2.-5. juunini Tallinnas kinos Sõprus toimuva festivali "Hallo, Kosmos!" raames 2. juunil esilinastuvast Jüri Lina filmist "Täitmatu Uroboros. Massoonide salakaval taktika", tema uuringute põhjusest. Festivali "Hallo, Kosmos!" kavast

  11. ri Lina kui tegelikkusele osutav Patagoonia šamaan / Jüri Lina ; intervjueerinud Ingrid Peek

    Index Scriptorium Estoniae

    Lina, Jüri, 1949-

    2011-01-01

    2.-5. juunini Tallinnas kinos Sõprus toimuva festivali "Hallo, Kosmos!" raames 2. juunil esilinastuvast Jüri Lina filmist "Täitmatu Uroboros. Massoonide salakaval taktika", tema uuringute põhjusest. Festivali "Hallo, Kosmos!" kavast

  12. Pancreatic insufficiency secondary to abdominal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dookeran, K.A.; Thompson, M.M.; Allum, W.H. (Leicester Royal Infirmary (United Kingdom). Dept. of Surgery)

    1993-02-01

    Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author).

  13. Trasplante renal en bloque de donantes pediátricos

    Directory of Open Access Journals (Sweden)

    Pedro Méndez-Chacón

    2005-03-01

    Full Text Available Objetivo: Determinar la aceptación de ambos riñones de donantes pediátricos para utilizarlos como trasplante renal en bloque. Material y Métodos: La edad de los seis donantes varió entre 14 meses y 10 años. La causa de muerte fue el traumatismo encefalocraneano. La edad de los seis receptores osciló entre 15 y 48 años con peso menor de 50 kg. Ambos riñones fueron removidos en bloque. La técnica operatoria de los trasplantes consistió en la anastomosis término lateral del segmento aórtico y vena cava inferior del donante a los vasos ilíacos del receptor; ambos uréteres fueron anastomosados por separado a la vejiga. El implante fue localizado en una de las fosas ilíacas. Resultados: Los injertos en bloque funcionaron inmediatamente. Cuatro de los seis receptores cursaron con función renal adecuada a cuatro años promedio de seguimiento. Uno de los injertos en bloque se perdió por rechazo vascular severo y otro por indisciplina a la medicación inmunosupresora. Las series ecográficas de los riñones revelaron incremento de tamaño hasta en 55% de su dimensión original al tercer mes del trasplante. Conclusión: Se recomienda que los riñones procedentes de donantes menores de tres años de edad sean utilizados como trasplante en bloque y riñones de donantes mayores de tres años como trasplante renal simple. Se demuestra que es posible trasplantar exitosamente riñones en bloque de niños muy pequeños en receptores mayores, según experiencia inédita en nuestro medio.

  14. Manual ventilation therapy and aggressive potassium supplementation in the management of respiratory failure secondary to severe hypokalaemia in a cat with exocrine pancreatic insufficiency.

    Science.gov (United States)

    Daste, Thomas; Dossin, Olivier; Reynolds, Brice S; Aumann, Marcel

    2014-04-01

    A domestic shorthair cat was referred for progressive muscle weakness and dyspnoea. The cat had a 2-month history of severe weight loss, small intestinal diarrhoea, polyphagia and polyuria/polydipsia. Biochemical analysis and venous blood gas evaluation revealed severe hypokalaemia [1.7 mmol/l; reference interval (RI): 3.5-5.1 mmol/l] and hypoventilation (partial pressure of carbon dioxide = 68 mmHg; RI: 34-38 mmHg). Aggressive potassium supplementation was initiated. The cat was manually ventilated until serum potassium increased to 3 mmol/l. A diagnosis of exocrine pancreatic insufficiency (EPI) was made based on clinical signs and serum feline trypsin-like immunoreactivity (0.1 μg/l; RI: 12-82 μg/l). Medical management of the EPI resulted in clinical recovery.

  15. Changes of renal blood flow after ESWL: Assessment by ASL MR imaging, contrast enhanced MR imaging, and renal resistive index

    Energy Technology Data Exchange (ETDEWEB)

    Abd Ellah, Mohamed, E-mail: dr_m_hamdy2006@hotmail.co [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Kremser, Christian, E-mail: christian.kremser@i-med.ac.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Pallwein, Leo, E-mail: leo.pallwein-prettner@uki.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Aigner, Friedrich, E-mail: friedrich.Aigner@uki.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Schocke, Michael, E-mail: michael.schocke@i-med.ac.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Peschel, Reinhard, E-mail: reinhard.peschel@uki.a [Innsbruck Medical University, Urology Dept., Anich St. 35, 6020 Innsbruck (Austria); Pedross, Florian, E-mail: florian.pedross@i-med.ac.a [Innsbruck Medical University, Medical Statistics Dept., Anich St. 35, 6020 Innsbruck (Austria); Pinggera, Germar-Michael, E-mail: germar.pinggera@uki.a [Innsbruck Medical University, Urology Dept., Anich St. 35, 6020 Innsbruck (Austria); Wolf, Christian, E-mail: christian.wolf@bkh-reutte.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Alsharkawy, Mostafa A.M., E-mail: drmostafamri@yahoo.co [Assiut University, Radiology Dept., Assiut (Egypt); Jaschke, Werner, E-mail: werner.jaschke@i-med.ac.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria); Frauscher, Ferdinand, E-mail: ferdinand.frauscher@uki.a [Innsbruck Medical University, Radiology Dept., Anich St. 35, 6020 Innsbruck (Austria)

    2010-10-15

    The annual incidence of stone formation is increased in the industrialised world. Extracorporeal shockwave lithotripsy is a non-invasive effective treatment of upper urinary tract stones. This study is aimed to evaluate changes of renal blood flow in patients undergoing extracorporeal shock wave lithotripsy (ESWL) by arterial spin labeling (ASL) MR imaging, contrast enhanced dynamic MR imaging, and renal resistive index (RI). Thirteen patients with nephrolithiasis were examined using MR imaging and Doppler ultrasound 12 h before and 12 h after ESWL. ASL sequence was done for both kidneys and followed by contrast enhanced MR imaging. In addition RI Doppler ultrasound measurements were performed. A significant increase in RI (p < 0.001) was found in both treated and untreated kidneys. ASL MR imaging also showed significant changes in both kidneys (p < 0.001). Contrast enhanced dynamic MR imaging did not show significant changes in the kidneys. ESWL causes changes in RI and ASL MR imaging, which seem to reflect changes in renal blood flow.

  16. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  17. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  18. Urinary potassium excretion, renal ammoniagenesis, and risk of graft failure and mortality in renal transplant recipients1-3

    NARCIS (Netherlands)

    Eisenga, Michele F.; Kieneker, Lyanne M.; Soedamah-Muthu, Sabita S.; Berg, Van Den Else; Deetman, Petronella E.; Navis, Gerjan J.; Gans, Reinold O.B.; Gaillard, Carlo A.J.M.; Bakker, Stephan J.L.; Joosten, Michel M.

    2016-01-01

    Background: Renal transplant recipients (RTRs) have commonly been urged to limit their potassium intake during renal insufficiency and may adhere to this principle after transplantation. Importantly, in experimental animal models, low dietary potassium intake induces kidney injury through stimula

  19. Riñón fetal hiperecogénico Hyperechogenic fetal kidney

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2011-12-01

    Full Text Available El hallazgo de riñones fetales hiperecogénicos es un problema de gran preocupación médica y de ansiedad familiar, porque casi siempre traduce una enfermedad renal importante. Cuando la hiperecogenicidad se acompaña de oligohidramnios, la mayoría de las veces estamos enfrentando una enfermedad poliquística; cuando no existe oligohidramnios, el diagnóstico probable es difícil. El objetivo de este reporte es la presentación de un niño con enfermedad poliquística autosómico recesiva. En los exámenes realizados a la madre, durante el embarazo, se encontró hiperecogenia renal y oligohidramnios. Se describe la evolución clínica, ultrasonográfica y gammagráfica de su enfermedad. Se revisa brevemente la literatura con relación al tema.The finding of hyperechogenic fetal kidneys is a problem of a great medical concern and of family anxiety, because of almost always it expresses an important renal disease. When hyper-echogenicity is accompanied by oligohydramnios, usually we are facing a polycystic disease; where there are not oligohydramnios the potential diagnosis is difficult. The objective of present paper is the presentation of a child presenting with recessive autosomal polycystic disease. En examinations performed in the mother during pregnancy, it was found a renal hyperechogeny and oligohydramnios. The clinical evolution, ultrasonography and scintigraphy of its disease is described and a brief review of literature in relation to thus subject is reviewed.

  20. Insufficient insulin administration to diabetic rats increases substrate utilization and maintains lactate production in the kidney

    OpenAIRE

    Laustsen, Christoffer; Lipsø, Hans Kasper Wigh; Østergaard, Jakob Appel; Nørregaard, Rikke; Flyvbjerg, Allan; Pedersen, Michael; Palm, Fredrik; Ardenkjær-Larsen, Jan Henrik

    2014-01-01

    Abstract Good glycemic control is crucial to prevent the onset and progression of late diabetic complications, but insulin treatment often fails to achieve normalization of glycemic control to the level seen in healthy controls. In fact, recent experimental studies indicate that insufficient treatment with insulin, resulting in poor glycemic control, has an additional effect on progression of late diabetic complications, than poor glycemic control on its own. We therefore compared renal metab...

  1. Renal function and risk of myocardial infarction in an elderly population: The Rotterdam study

    NARCIS (Netherlands)

    J.J. Brugts (Jasper); A.M. Knetsch (Anneke); F.U.S. Mattace Raso (Francesco); A. Hofman (Albert); J.C.M. Witteman (Jacqueline)

    2005-01-01

    textabstractBackground: Renal insufficiency is a risk factor for cardiovascular disease in patients with renal disease or coronary heart disease; however, it is unknown whether renal function is an independent predictor of cardiovascular disease in the general population. Methods: We investigated wh

  2. Riigi äriühingu juhtorgani liige: kas ametiisik või ärijuht? / Jüri Raidla, Toomas Vaher, Kristel Urke

    Index Scriptorium Estoniae

    Raidla, Jüri, 1957-

    2017-01-01

    Riigi äriühingu põhijoontest, riigi äriühingu juhtorgani liikme kohustustest ja nõuetest juhtorgani liikmetele. Riigi äriühingute juhtorganite liikmete pidamisest ametiisikuteks korruptsioonivastase seaduse § 2 lõike 1 ja karistusseadustiku § 288 lõike 1 mõttes. Sisaldab asjakohast kohtupraktikat

  3. [Membranous nephropathy associated to autoimmune thyroiditis, chronic pancreatitis and suprarrenal insufficiency].

    Science.gov (United States)

    Merino, J L; Fernández Lucas, M; Teruel, J L; Valer, P; Moreira, V; Arambarri, M; Ortuño, J

    2004-01-01

    A 33 year old female was admitted to the hospital to study aedema and bocio, A nephrotic syndrome was diagnosed and the renal biopsy demonstrated membranous glomerulonephritis, stage II. She was also diagnosed of Hashimoto's autoinmmune thyroiditis: TSH (41.5 uUl/ml), T4 (0.07 ng/dl), antithyroglobuline (1/2560) and antimicrosome (1/6400). Four year latter she was diagnosed of autoinmmune pancreatitis, without evidence of diabetes mellitus or exocrine pancreatic insufficiency. Eight years latter she was diagnosed of primary autoimmune suprarrenal insufficiency: basal cortisol: 2.7 mcg/dl, post ACTH estimulated cortisol: 5.6 mcg/dl, antinuclear antibody (1/160) and antiparietal (1/320). We present a pluriglandular autoimmune syndrome with membranous glomerulonephritis, thyroiditis, pancreatitis and suprarrenal insufficiency. To the best of our knowledge this complex syndrome has not been previously described.

  4. Nutrition and renal disease.

    Directory of Open Access Journals (Sweden)

    Iris de Castaño

    2009-11-01

    Full Text Available Kidney plays an important roll in body homeostasis through excretory, metabolic and endocrine functions. Kidneys filter fluids and solutes and reabsorbed water , electrolytes an minerals. Urine volume and solute excretion are adjusted to keep composition of the extracellular space, serum osmolarity and intravascular volume in constant balance. Kidneys also regulate acid base equilibrium, hormone metabolism and excretion and amino acid concentration. Vitamin D hydroxylation takes place in the kidney, this is the active form of this vitamin, which inhibits PTH. In addition they produce erythropoietin which control hemoglobin concentration in erythrocytes. When renal insufficiency develops, and glormerular filtration rate is between 50 to 75% of normal, this functions are decreased .When renal function is less than 10%, this functions ceased. In children small changes in water, solute, acid base, calcium and phosphorus can alter normal growth and development. If kidneys can not maintain internal equilibrium, specific nutrients should be used. Compensation should be done according to age, type or renal disease and level of glomerular filtration rate.

  5. A case of human intramuscular adrenal gland transplantation as a cure for chronic adrenal insufficiency.

    Science.gov (United States)

    Grodstein, E; Hardy, M A; Goldstein, M J

    2010-02-01

    Intramuscular endocrine gland transplantation has been well described as it pertains to parathyroid autotransplantation; however, transplantation of the adrenal gland is less well characterized. While adrenal autotransplantation in the setting of Cushing's disease has been described, intramuscular adrenal allotransplantation as a cure for adrenal insufficiency to our knowledge has not been previously carried out. Current treatment for adrenal insufficiency leaves patients without diurnal variation in cortisol release and susceptible to the detrimental effects of chronic hypercortisolism. We describe here the case of a 5-year-old girl with renal failure who had adrenal insufficiency following fulminant meningococcemia that led to requirements for both stress-dose steroid and mineralocorticoid replacement. Ten months after the onset of her disease, she received a simultaneous renal and adrenal gland transplant from her mother. The adrenal gland allograft was morselized into 1 mm(3) segments and implanted into three 2 cm pockets created in her rectus abdominis muscle. Three years after surgery, her allograft remains fully functional, responding well to adrenocorticotropin hormone stimulation and the patient does not require any steroid or mineral-corticoid supplementation. We believe this case represents the first description of successful functional intramuscular adrenal allograft transplantation with long-term follow up as a cure for adrenal insufficiency.

  6. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  7. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  8. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  9. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  10. Diagnosis and management of adrenal insufficiency.

    Science.gov (United States)

    Bancos, Irina; Hahner, Stefanie; Tomlinson, Jeremy; Arlt, Wiebke

    2015-03-01

    Adrenal insufficiency continues to be a challenge for patients, their physicians, and researchers. During the past decade, long-term studies have shown increased mortality and morbidity and impaired quality of life in patients with adrenal insufficiency. These findings might, at least partially, be due to the failure of glucocorticoid replacement therapy to closely resemble physiological diurnal secretion of cortisol. The potential effect of newly developed glucocorticoid drugs is a focus of research, as are the mechanisms potentially underlying increased morbidity and mortality. Adrenal crisis remains a threat to lives, and awareness and preventative measures now receive increasing attention. Awareness should be raised in medical teams and patients about adrenal insufficiency and management of adrenal crisis to improve clinical outcome.

  11. [Oral cavity pathology by renal failure].

    Science.gov (United States)

    Maĭborodin, I V; Minikeev, I M; Kim, S A; Ragimova, T M

    2014-01-01

    The analysis of the scientific literature devoted to organ and tissue changes of oral cavity at the chronic renal insufficiency (CRI)is made. The number of patients in an end-stage of CRI constantly increases and patients receiving renal replacement therapy including hemodialysis, peritoneal dialysis or renal transplantation will comprise an enlarging segment of the dental patient population. Owing to CRI and its treatment there is a set of changes of teeth and oral cavity fabrics which remain even in a end-stage. Renal replacement therapy can affect periodontal tissues including gingival hyperplasia in immune suppressed renal transplantation patients and increased levels of bacterial contamination, gingival inflammation, formation of calculus, and possible increased prevalence and severity of destructive periodontal diseases. Besides, the presence of undiagnosed periodontitis may have significant effects on the medical management of the patients in end-stage of CRI.

  12. [Pregnancy in patients with underlying renal disease].

    Science.gov (United States)

    Golshayan, D; Mathieu, C; Burnier, M

    2007-03-07

    Pregnancy has generally been regarded as very high risk in women with chronic renal insufficiency. In this review, we describe the physiologic changes in systemic and renal haemodynamics during pregnancy, as well as the nature and severity of possible maternal and foetal complications in the setting of underlying renal disease. The risks are proportional to the degree of functional renal impairment, the presence or not of proteinuria and/or arterial hypertension at the time of conception, and are related to the type of underlying nephropathy or systemic disease in the mother. Furthermore, if the renal disease has been diagnosed before pregnancy, a better planning of the moment of conception, as well as a tight follow-up, allow for a better maternal and obstetrical outcome.

  13. Minimally invasive treatments for perforator vein insufficiency.

    Science.gov (United States)

    Kuyumcu, Gokhan; Salazar, Gloria Maria; Prabhakar, Anand M; Ganguli, Suvranu

    2016-12-01

    Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources. Advantages and disadvantages of each modality and knowledge on these treatments are required to adequately address perforator venous disease.

  14. [Pediatric emergency: adrenal insufficiency and adrenal crisis].

    Science.gov (United States)

    Martínez, Alicia; Pasqualini, Titania; Stivel, Mirta; Heinrich, Juan Jorge

    2010-04-01

    Adrenal insufficiency is defined by impaired secretion of adrenocortical hormones. It is classified upon the etiology in primary and secondary. Rapid recognition and therapy of adrenocortical crisis are critical to survival. Patients often have nonspecific symptoms: anorexia, vomiting, weakness, fatigue and lethargy. They are followed by hypotension, shock, hypoglicemia, hyponatremia and hyperkalemia. All patients with adrenal insufficiency require urgent fluid reposition, correction of hypoglycemia and glucocorticoid replacement, in order to avoid serious consequences of adrenal crisis. After initial crisis treatment, maintenance dose of corticoids should be indicated. Mineralocorticoids replacement, if necessary, should also be initiated.

  15. Schedule Optimization Study, Hanford RI/FS Program

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-01

    A Schedule Optimization Study (SOS) of the US Department of Energy (DOE) Hanford Site Remedial Investigation/Feasibility Study (RI/FS) Program was conducted by an independent team of professionals from other federal agencies and the private sector experienced in environmental restoration. This team spent two weeks at Hanford in September 1992 examining the reasons for the lengthy RI/FS process at Hanford and developing recommendations to expedite the process. The need for the study arose out of a schedule dispute regarding the submission of the 1100-EM-1 Operable Unit RI/FS Work Plan. This report documents the study called for in the August 29, 1991, Dispute Resolution Committee Decision Statement. Battelle's Environmental Management Operations (EMO) coordinated the effort for DOE's Richland Field Office (RL).

  16. Asynchronous Bilateral Renal Infarction and Thrombophilia With Associated Gene Mutations in a 43-Year-Old Man: A Case Report.

    Science.gov (United States)

    Zhou, Xu-Jie; Liu, Li-Jun; Chen, Min; Zhou, Fu-De

    2016-04-01

    Renal infarction (RI) is frequently misdiagnosed or diagnosed late because of its rarity and nonspecific clinical presentation, which may result in irreversible damage to the renal parenchyma or increase the risk of other embolic events affecting additional organs. Multiple causal mechanisms and cases of idiopathic RI have been reported, but the causal factors are not clear in most cases.Here, we report the case of a patient with heterochronic bilateral RI caused by thrombophilia. Although he had several risk factors for hypercoagulation disorders, two gene mutations-MTHFR 677 C>T and PLG 1858G>A-were identified by genome sequencing of the entire exome. The findings suggest the possibility of a synergistic relationship between the two gene mutations.Thus, screening for gene mutations may provide additional clues for clarifying the cause of RI and thrombophilia.

  17. AMH as Predictor of Premature Ovarian Insufficiency

    DEFF Research Database (Denmark)

    Lunding, Stine Aa; Aksglæde, Lise; Anderson, Richard A

    2015-01-01

    CONTEXT: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women...

  18. Surgical strategy for mild ischemic mitral insufficiency

    Institute of Scientific and Technical Information of China (English)

    GU Cheng-xiong; WEI Hua; YU Yang

    2010-01-01

    @@ To the Editor: We read with the interest the article by FAN Hong-guang and colleagues~1 having obtained outstanding early and long-term clinical outcomes of left ventricular restoration for the patients with postinfarction ventricular aneurysm and low left ventricular ejection fraction (LVEF) of mean 37.7%. We would like to comment on surgical strategy for mild ischemic mitral insufficiency.

  19. Tarlov Cyst Causing Sacral Insufficiency Fracture.

    Science.gov (United States)

    Puffer, Ross C; Gates, Marcus J; Copeland, William; Krauss, William E; Fogelson, Jeremy

    2017-06-01

    Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg. There was no recent history of spine or pelvic trauma. These symptoms prompted her initial emergency department evaluation, and imaging demonstrated a large Tarlov cyst with an associated sacral insufficiency fracture. She was noted to have a normal neurological examination notable only for an antalgic gait. She was taken to surgery via a posterior approach and the cyst was identified eccentric to the left. The cyst was fenestrated and the nerve roots identified. Given her large area of bone erosion and insufficiency fractures, fixation of the sacroiliac joints was deemed necessary. Fusion was extended to the L5 vertebral body to buttress the fixation. She tolerated the procedure well and was discharged from the hospital on postoperative day 3. Tarlov cysts of the sacrum can lead to significant bone erosion and subsequent insufficiency fractures, requiring fenestration and in some cases, complex sacropelvic fixation.

  20. [Chronic respiratory insufficiency and the elderly patient].

    Science.gov (United States)

    Cobarzan, Daniel

    2012-01-01

    Chronic respiratory failure is a complex entity of varied etiology and physio-pathological mechanisms. It is mainly characterised by the respiratory system's difficulty in ensuring correct aeration at rest, resulting initially in insufficient oxygenation of arterial blood. Treatment is adapted to each etiology and aims to compensate for respiratory failure and to ensure the oxygenation of the organism.

  1. Primary Ovarian Insufficiency: Genes, hormones, and beyond

    NARCIS (Netherlands)

    Janse, F.

    2012-01-01

    Primary ovarian insufficiency (POI) is characterized by amenorrhea in association with postmenopausal follicle-stimulating hormone (FSH) levels in women younger than 40 years. POI affects 1% of women and greatly influences a woman’s fertility potential and her overall health. The exact cause of POI

  2. Renal teratogens.

    Science.gov (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  3. 76 FR 18811 - Submission for Review: Letter Reply To Request for Information (RI 20-64), Former Spouse Survivor...

    Science.gov (United States)

    2011-04-05

    ... MANAGEMENT Submission for Review: Letter Reply To Request for Information (RI 20-64), Former Spouse Survivor Annuity Election (RI 20-64A), Information on Electing a Survivor Annuity for Your Former Spouse (RI 20-64B... Reply to Request for Information, RI 20-64, and Former Spouse Survivor Annuity Election, RI 20-64A....

  4. Nationwide Trends and Variations in Urological Surgical Interventions and Renal Outcome in Patients with Spina Bifida.

    Science.gov (United States)

    Wang, Hsin-Hsiao S; Lloyd, Jessica C; Wiener, John S; Routh, Jonathan C

    2016-04-01

    Bladder dysfunction in patients with spina bifida can lead to significant morbidity due to renal insufficiency. Indications for surgery vary among institutions and the impact is unclear. We examined trends and variations in urological interventions and chronic renal insufficiency in patients with spina bifida. We reviewed NIS (Nationwide Inpatient Sample) for all patients with spina bifida treated from 1998 to 2011. We used ICD-9-CM codes to identify urological surgery and chronic renal insufficiency. We calculated the Spearman correlation coefficients between rates of spina bifida related bladder surgeries and rates of chronic renal insufficiency outcomes by state. Linear regression models were fitted to investigate the associations between rates of spina bifida related surgery and chronic renal insufficiency across treatment years. We identified 427,616 spina bifida hospital admissions. Mean patient age was 26 years and 56% of patients were female. Of the admissions 35,249 (8%) were for chronic renal insufficiency and 11,078 (3%) were for surgery. During the study period chronic renal insufficiency rates doubled from 6% to 12% and surgery rates decreased from 2.0% to 1.8%. There was a moderately weak inverse association between surgery and chronic renal insufficiency rates with time (r = -0.3, p = 0.06) and by state (r = -0.3, p = 0.04). On multivariate analysis higher rates of surgery were associated with the state in which the patient was treated (p spina bifida related surgery (p = 0.67). We observed a temporal and geographic trend toward decreasing urological surgery and increasing chronic renal insufficiency rates in spina bifida and a wide variation in urological surgical rates among states. Further study is needed to determine the factors behind these trends and variations in spina bifida management. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Sarcoidose renal

    Directory of Open Access Journals (Sweden)

    AQUINO MARIA ENEDINA CLAUDINO DE

    2001-01-01

    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  6. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  7. Practical uses of a quantitative renal scintillation camera study. [/sup 131/I tracer techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bueschen, A.J.; Lloyd, L.K.

    1976-10-01

    A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported to illustrate its usefulness with renal tumors, neurogenic bladders, pyelonephritis, nephrolithiasis, congenital anomalies, and renal insufficiency.

  8. Mida me Tallinnas teinud oleme / Jüri Ratas

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2006-01-01

    Tallinna linnapea Jüri Ratas annab ülevaate linnavalitsuse tegevusest esimese saja päeva jooksul. Linnavalitsuse tegevust hindavad Tallinna volikogu Isamaaliidu fraktsiooni esimees Toomas Tõniste, volikogu Reformierakonna esimees Keit Pentus ja volikogu sotsiaaldemokraatide fraktsiooni aseesimees Hannes Rumm

  9. Rahvus, "glokaalsus" ja eesti kirjandusdiskursus aastatuhandevahetusel / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    2001-01-01

    Bibliogr. joonealustes märkustes. Artikli aluseks on rahvusvahelisel konverentsil "Cultural Identity and Its Glocal Manifestations" (Joensuu, 14.-16. IX 2000) peetud ingliskeelne ettekanne. Artikkel on ilmunud ka kogumikus: Talvet, Jüri. Tõrjumatu äär. Tartu : Ilmamaa, 2005, lk. 31-45

  10. Tartu kui märk / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1996-01-01

    Ilmus algkujul hispaania keeles Sevillas Andaluusia Semiootikaassotsiatsiooni ajakirja Discurso Tartu semiootikakoolkonnale pühendatud erinumbris (nr. 8, 1993). Ilmunud ka kogumikus: Talvet, Jüri. Ameerika märkmeid, ehk, Kaemusi Eestist. Tartu : Ilmamaa, 2000, lk. 62-71, pealk.: Tartu vaim

  11. Sonya Smith ja telenovela-äri / Tiina Lepiste

    Index Scriptorium Estoniae

    Lepiste, Tiina

    2006-01-01

    Telenovelade ärist ja fenomenist. Ka Venetsueela päritolu näitlejannast Sonya Smithist seriaalis "Armastuse jõud". Sama: Teleleht, 17. Jul. 2006, nr. 28, lk. 6-7 : ill pealkirjaga "Seebiäri vohab ja õitseb"

  12. Eesti keeles ilmus Sandor Cso̤ri "Piiririkkuja"

    Index Scriptorium Estoniae

    2008-01-01

    Cso̤ri, Sandor. Piiririkkuja : esseid / [ungari keelest tõlkinud ja toimetanud Edvin Hiedel ; järelsõna: Béla Javorszky. Tallinn] : Eesti Keele Sihtasutus, 2007. Esitlus oli 22. apr. Vt. ka Looming, nr. 5, 2008, lk. 792

  13. Mida me Tallinnas teinud oleme / Jüri Ratas

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2006-01-01

    Tallinna linnapea Jüri Ratas annab ülevaate linnavalitsuse tegevusest esimese saja päeva jooksul. Linnavalitsuse tegevust hindavad Tallinna volikogu Isamaaliidu fraktsiooni esimees Toomas Tõniste, volikogu Reformierakonna esimees Keit Pentus ja volikogu sotsiaaldemokraatide fraktsiooni aseesimees Hannes Rumm

  14. Hispaania kirjanduse elav keha / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1996-01-01

    Keha ja kehatus hispaania kirjanduses (Cervantese Dulcinea, Sancho Panza, don Quijote) ja maailmakirjanduses esinevate tegelaskujude näiteil : Ka Tõnu Õnnepalu Joonatanist romaanis 'Hind'. Ilmunud ka kogumikus: Talvet, Jüri. Tõrjumatu äär. Tartu : Ilmamaa, 2005, lk. 469-473

  15. ri Reinvere "Reekviemi" Saksamaa esiettekanne / foto: Aaron Nace

    Index Scriptorium Estoniae

    2009-01-01

    modernne ja müstiline helitöö, kirjutatud sooloflöödile, episoodilisele neljale meeshäälele ja loetud tekstile, koos spetsiaalselt teose jaoks austraalia filmirežissööri Catherine Jarvis'e tehtud filmiga on pilk eestlaste ning eestluse minevikku, teose esmaettekanne toimus 23. märtsil 2009 Helsingis

  16. ZeroDegree spectrometer at RIKEN RI Beam Factory

    Science.gov (United States)

    Kubo, Toshiyuki; Ohnishi, Tetsuya; Takeda, Hiroyuki; Fukuda, Naoki; Kameda, Daisuke; Kusaka, Kensuke; Yoshida, Atsushi; Yoshida, Koichi; Ohtake, Masao; Inabe, Naohito; Yanagisawa, Yoshiyuki; Tanaka, Kanenobu

    2009-10-01

    At RI Beam Factory (RIBF) [1] at RIKEN Nishina Center, a variety of fast rare isotope (RI) beams are produced using the BigRIPS in-flight separator [2] for studies of exotic nuclei. The beam line following BigRIPS is designed to work as a forward spectrometer named ZeroDegree, so that it can be used for reaction studies with RI beams. The ZeroDegree spectrometer consists of two dipoles and six superconducting quadrupole triplets, of which designs are essentially the same as those of BigRIPS. It analyzes and indentifies projectile reaction residues, often in coincidence with gamma rays, and can be operated in different optics modes, depending on experimental requirements. The ZeroDegree spectrometer has recently been commissioned and used for a series of full-dress RI-beam experiments. Overview and status of the ZeroDegree spectrometer will be reported.[4pt] [1] Y. Yano: Nucl. Instr. and Meth. B 261 (2007) 1009. [0pt] [2] T. Kubo: Nucl. Instr. and Meth. B 204 (2003) 97 and T. Ohnishi et al.: J. Phys. Soc. Japan, 77 (2008) 083201.

  17. Eduard Vääri : [Wiedemanni keeleauhinna laureaat 2001

    Index Scriptorium Estoniae

    2005-01-01

    Sisu: Kogu elu eesti keele kaitsel : [F. J. Wiedemanni keeleauhinna vastuvõtmisel peetud kõne alusel] ; Laks, Meinhard. Liivi rannarahva lipp : [luuletus] = Livõ rńdarouv plaga / liivi keelde tõlkinud Eduard Vääri

  18. Äri domeeninimedega kogub Ameerikas hoogu / Margus Mihkels

    Index Scriptorium Estoniae

    Mihkels, Margus

    2006-01-01

    2005. aastal müüdi Ameerikas 5851 domeeninime ja nimeäri käive ulatus 29 miljoni USA dollarini. 2006. aasta esimese kolme kuu jooksul on ajakirja Domain Name Journal andmetel müüdud 1949 veebiaadressi 14,2 miljoni dollari eest

  19. Maurice Riès et ses fils

    Directory of Open Access Journals (Sweden)

    Lukian Prijac

    2004-12-01

    Full Text Available Maurice Riès [1858-1945], originaire de Marseille, arrive à Aden en 1876 comme employé de César Tian. Très vite, il s'impose dans l'entreprise et devient l'associé de son patron en 1891. M. Riès est le dernier associé d'Arthur Rimbaud, et est avant-tout un négociant spécialiste du commerce yéménite et plus particulièrement du café qu'il exporte en Europe. Mais c'est aussi un diplomate et dès 1897, il devient l'agent consulaire de France à Aden. Cette gérance, il l'effectue en collaboration avec ses fils Paul et Adolphe Riès jusqu'en 1920. Les Riès par leurs actions commerciales et diplomatiques surent contribuer au renom de la France au Yémen mais aussi dans la région (mer Rouge, péninsule Arabique et corne de l'Afrique, région où ils sont toujours présents aujourd'hui.

  20. Tartu kui märk / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1996-01-01

    Ilmus algkujul hispaania keeles Sevillas Andaluusia Semiootikaassotsiatsiooni ajakirja Discurso Tartu semiootikakoolkonnale pühendatud erinumbris (nr. 8, 1993). Ilmunud ka kogumikus: Talvet, Jüri. Ameerika märkmeid, ehk, Kaemusi Eestist. Tartu : Ilmamaa, 2000, lk. 62-71, pealk.: Tartu vaim

  1. Dopustimo li ubistvo radi iskusstva? / Jüri Arrak

    Index Scriptorium Estoniae

    Arrak, Jüri, 1936-

    2005-01-01

    Artiklite "Kas kunsti nimel võib tappa?", "Sõnavõtt Eesti kultuurikonverentsil" ning "Muust ja sitast" tõlked Jüri Arraku esseekogumikust "Võsa, aas ja mägi" (Tallinn, 2003). Mõtteid kunsti nimel tapmise lubatavusest seoses taani shokikunstniku B. Norgaardi näitusega "Uus Euroopa" Tallinnas. Usu osast ja vaimsusest kunstis. Kriitikat seoses ekskrementide demonstreerimisega kunstina

  2. Sonya Smith ja telenovela-äri / Tiina Lepiste

    Index Scriptorium Estoniae

    Lepiste, Tiina

    2006-01-01

    Telenovelade ärist ja fenomenist. Ka Venetsueela päritolu näitlejannast Sonya Smithist seriaalis "Armastuse jõud". Sama: Teleleht, 17. Jul. 2006, nr. 28, lk. 6-7 : ill pealkirjaga "Seebiäri vohab ja õitseb"

  3. Võrguäri Eestis kiratseb / Indrek Kald

    Index Scriptorium Estoniae

    Kald, Indrek, 1974-

    2004-01-01

    Autor otsib põhjusi, miks tänavuse Interneti-kaupluste edetabeli koostamiseks saatis oma äritulemused vaid viis võrgukauplust. Zebra Infosüsteemide tegevjuhi Peeter Tamme arvamus e-äri kiratsemise põhjuste kohta

  4. Hispaania kirjanduse elav keha / Jüri Talvet

    Index Scriptorium Estoniae

    Talvet, Jüri, 1945-

    1996-01-01

    Keha ja kehatus hispaania kirjanduses (Cervantese Dulcinea, Sancho Panza, don Quijote) ja maailmakirjanduses esinevate tegelaskujude näiteil : Ka Tõnu Õnnepalu Joonatanist romaanis 'Hind'. Ilmunud ka kogumikus: Talvet, Jüri. Tõrjumatu äär. Tartu : Ilmamaa, 2005, lk. 469-473

  5. Võrguäri Eestis kiratseb / Indrek Kald

    Index Scriptorium Estoniae

    Kald, Indrek, 1974-

    2004-01-01

    Autor otsib põhjusi, miks tänavuse Interneti-kaupluste edetabeli koostamiseks saatis oma äritulemused vaid viis võrgukauplust. Zebra Infosüsteemide tegevjuhi Peeter Tamme arvamus e-äri kiratsemise põhjuste kohta

  6. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  7. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  8. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  9. Effective management of regulator RI/FS comments

    Energy Technology Data Exchange (ETDEWEB)

    Wolinsky, S.M.; Lojek, D.; George, R.D.; Houser, S.M.; Strimbu, M.J.

    1995-12-31

    This paper describes a successful strategy that facilitates regulatory approval of CERCLA documents required by compliance agreement and CERCLA, based on the experience of Operable Unit 1, Waste Storage Area, of the Fernald Environmental Management Project (FEMP). This strategy, which has become the site standard at the FEMP, was instrumental in obtaining regulator approval of the OU1 RI and FS, and early approval of the Record of Decision during a very tight compliance agreement-driven schedule. This strategy can be applied at any DOE Superfund site, especially where there is need to recover lost schedule, an incentive to meet milestones early, a need to improve the relationship between the DOE and the regulators, or where the regulatory agencies have historically provided a large volume of comments on CERCLA documents. The strategy focuses on early identification and resolution of issues relating to draft RI/FS documents, as raised in regulatory agency review comments. This pro-active strategy has the potential for schedule and cost savings, as well as for improved communication between DOE and the regulators. The strategy includes preparation of a separate comment response document, integration of comment responses with RI/FS documents, development of a database of agency comments and their resolution, and sharing lessons learned with preparers of subsequent RI/FS documents. The paper provides background on the FEMP and describes the FEMP comment response strategy; DOE and regulator interface; the Sitewide Comment Database; networked electronic file management; the process for classifying, analyzing, and responding to comments; integration with base RI/FS documents; and a conclusion.

  10. Structure of RiVax: a recombinant ricin vaccine

    Energy Technology Data Exchange (ETDEWEB)

    Legler, Patricia M. [Naval Research Laboratories, 4555 Overlook Avenue, Washington, DC 20375 (United States); Brey, Robert N. [Soligenix Inc., 29 Emmons Drive, Suite C-10, Princeton, NJ 08540 (United States); Smallshaw, Joan E.; Vitetta, Ellen S. [UT Southwestern Medical Center at Dallas, 6000 Harry Hines Boulevard, Dallas, TX 75390-8576 (United States); Millard, Charles B., E-mail: charles.b.millard@us.army.mil [US Army Medical Research and Materiel Command, Frederick, MD 21702-5012 (United States); Naval Research Laboratories, 4555 Overlook Avenue, Washington, DC 20375 (United States)

    2011-09-01

    The X-ray crystal structure (at 2.1 Å resolution) of an immunogen under development as part of a ricin vaccine for humans is presented and structure-based analysis of the results was conducted with respect to related proteins and the known determinants for inducing or suppressing the protective immune response. RiVax is a recombinant protein that is currently under clinical development as part of a human vaccine to protect against ricin poisoning. RiVax includes ricin A-chain (RTA) residues 1–267 with two intentional amino-acid substitutions, V76M and Y80A, aimed at reducing toxicity. Here, the crystal structure of RiVax was solved to 2.1 Å resolution and it was shown that it is superposable with that of the ricin toxin A-chain from Ricinus communis with a root-mean-square deviation of 0.6 Å over 258 C{sup α} atoms. The RiVax structure is also compared with the recently determined structure of another potential ricin-vaccine immunogen, RTA 1–33/44–198 R48C/T77C. Finally, the locations and solvent-exposure of two toxin-neutralizing B-cell epitopes were examined and it was found that these epitopes are within or near regions predicted to be involved in catalysis. The results demonstrate the composition of the RiVax clinical material and will guide ongoing protein-engineering strategies to develop improved immunogens.

  11. Idiopathic renal infarction in a previously healthy active duty soldier.

    Science.gov (United States)

    Eickhoff, Christa; Mei, Jian M; Martinez, Jorge; Little, Dustin

    2014-02-01

    Renal infarction (RI) is rare, and usually occurs in patients with associated comorbidities. The majority of reported cases have presented with laboratory abnormalities, most notably leukocytosis and elevated lactate dehydrogenase (LDH). A 50-year-old active duty white male nonsmoker without medical history presented with flank pain. Urinalysis, complete blood count, LDH, and serum creatinine were normal. Contrast-enhanced computed tomography of the abdomen and pelvis showed a right-sided RI. The patient was admitted to the hospital and anticoagulated. Laboratory values remained normal, and a comprehensive workup failed to reveal an etiology for his RI. RI is rare, and affected patients often present with symptoms similar to more common conditions such as lumbago or nephrolithiasis. Elevated LDH may be a clue to the diagnosis, but unlike 92% of the reviewed cases, our patient presented with a normal value. This case suggests that clinicians should consider RI in patients with persistent symptoms for whom more common causes of flank pain have been excluded; including in nonsmoking patients without apparent risk factors for infarction who present with a normal LDH and no leukocytosis.

  12. [Postoperative respiratory insufficiency and its treatment].

    Science.gov (United States)

    Kösek, V; Wiebe, K

    2015-05-01

    The development of a postoperative respiratory insufficiency is typically caused by several factors and include patient-related risks, the extent of the procedure and postoperative complications. Morbidity and mortality rates in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are high. It is important to have consistent strategies for prevention and preoperative conditioning is essential primarily for high-risk patients. Treatment of established postoperative lung failure requires early tracheotomy, protective ventilation (tidal volume 6 ml/kg body weight), elevated positive end expiratory pressure (PEEP, 10-20 mmH2O), recurrent bronchoscopy and early patient mobilization. In critical cases an extracorporeal lung assist is considered to be beneficial as a bridge to recovery and for realizing a protective ventilation protocol. Different systems with separate indications are available. The temporary application of a lung assist allows thoracic surgery to be performed safely in patients presenting with insufficient respiratory function.

  13. Novel insights into adrenal insufficiency in childhood.

    Science.gov (United States)

    Levy-Shraga, Y; Pinhas-Hamiel, O

    2014-12-01

    Adrenal insufficiency (AI) is a rare disease in childhood and adolescence that results from disruption in the hypothalamic-pituitary-adrenal axis. Pediatricians should be familiar with this entity since acute adrenal crisis is a life-threatening condition that requires immediate treatment. In the early stages of AI, the clinical manifestations may be subtle and non-specific; thus, they are frequently unrecognized. The main therapeutic approach in all forms of adrenal insufficiency is glucocorticoid replacement; the dose should be titrated appropriately to avoid under or overtreatment. Patient and family education is particularly important, to enable adjustment of dosage replacement therapy during stress and to prevent crisis. This article summarizes the current knowledge of AI and provides new insights on its management in children.

  14. Enfermedad Renal Poliquística

    OpenAIRE

    Cena Rivero, Pedro; Castillo Andrade, Rocío Elizabeth; Baquero Cadena, Silvia Marcela; Espinel Jara, Viviana Margarita

    2014-01-01

    La enfermedad renal poliquística es conocida por sus siglas en inglés como PKD (Policistyc Kidney Disease) y se caracteriza por el desarrollo de quistes epiteliales en ambos riñones, los que van aumentando progresivamente en tamaño y en número, hasta desplazar el parénquima, con la consecuente aparición de la falla funcional. Es una enfermedad de origen genético, multisistémica, de inicio tardío en la forma autosómica dominante y de inicio temprano si es recesiva. La PKD se produce por mut...

  15. Chronic Heroin Dependence Leading to Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Gautam Das

    2014-01-01

    Full Text Available Opioids have been the mainstay for pain relief and palliation over a long period of time. They are commonly abused by drug addicts and such dependence usually imparts severe physiologic effects on multiple organ systems. The negative impact of opioids on the endocrine system is poorly understood and often underestimated. We describe a patient who developed severe suppression of the hypothalamic-pituitary adrenal (HPA axis leading to secondary adrenal insufficiency due to long standing abuse of opioids.

  16. Tallinna linnapea Jüri Ratas : Keskerakond ei ole maffia! / Jüri Ratas ; interv. Urmo Soonvald

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2005-01-01

    Tallinna linnapea Jüri Ratas vastab küsimustele, mis puudutavad Rein Ratase Tallinna Vee nõukogu liikmeks määramist, K-kohukse reklaami seost Keskerakonna valimiskampaaniaga, linnapeaks saamist, koostööd teiste poliitikutega, Edgar Savisaare osa Tallinna linna juhtimises

  17. Tallinna linnapea Jüri Ratas : Keskerakond ei ole maffia! / Jüri Ratas ; interv. Urmo Soonvald

    Index Scriptorium Estoniae

    Ratas, Jüri, 1978-

    2005-01-01

    Tallinna linnapea Jüri Ratas vastab küsimustele, mis puudutavad Rein Ratase Tallinna Vee nõukogu liikmeks määramist, K-kohukse reklaami seost Keskerakonna valimiskampaaniaga, linnapeaks saamist, koostööd teiste poliitikutega, Edgar Savisaare osa Tallinna linna juhtimises

  18. Euroopa äriühingu mudel ja selle rakendamine finantssektori äriühingute poolt / Ingrid Ulst

    Index Scriptorium Estoniae

    Ulst, Ingrid, 1977-

    2005-01-01

    SE (Euroopa äriühingu) mudeli olemusest ja SE regulatsiooni olulisematest aspektidest, põgusalt Nordea Bank AB praegusest grupistruktuurist ja võimalikust restruktureerimisest. Lisatud tabel: Nordea Bank AB olulisemad grupiettevõtted ja järelevalve (01/01/2004)

  19. ri Kraft : Eesti eksport nõuab Euroopa Liitu minekut / Jüri Kraft ; interv. Sulev Oll

    Index Scriptorium Estoniae

    Kraft, Jüri, 1935-

    2003-01-01

    Kahe kergetööstusettevõtte, Sangari ja Mivari nõukogu esimees, endine ENSV kergetööstusminister Jüri Kraft leiab, et kui Eesti ei astu EL-i ja loobub soodsast ekspordivõimalusest, kordub Eestis 1990. aastate alguse olukord

  20. Euroopa äriühingu mudel ja selle rakendamine finantssektori äriühingute poolt / Ingrid Ulst

    Index Scriptorium Estoniae

    Ulst, Ingrid, 1977-

    2005-01-01

    SE (Euroopa äriühingu) mudeli olemusest ja SE regulatsiooni olulisematest aspektidest, põgusalt Nordea Bank AB praegusest grupistruktuurist ja võimalikust restruktureerimisest. Lisatud tabel: Nordea Bank AB olulisemad grupiettevõtted ja järelevalve (01/01/2004)

  1. Conduct protocol in emergency: Acute adrenal insufficiency

    Directory of Open Access Journals (Sweden)

    Adil Bachir Fares

    Full Text Available Summary Introduction: Acute adrenal insufficiency or addisonian crisis is a rare comorbidity in emergency; however, if not properly diagnosed and treated, it may progress unfavorably. Objective: To alert all health professionals about the diagnosis and correct treatment of this complication. Method: We performed an extensive search of the medical literature using specific search tools, retrieving 20 articles on the topic. Results: Addisonian crisis is a difficult diagnosis due to the unspecificity of its signs and symptoms. Nevertheless, it can be suspected in patients who enter the emergency room with complaints of abdominal pain, hypotension unresponsive to volume or vasopressor agents, clouding, and torpor. This situation may be associated with symptoms suggestive of chronic adrenal insufficiency such as hyperpigmentation, salt craving, and association with autoimmune diseases such as vitiligo and Hashimoto's thyroiditis. Hemodynamically stable patients may undergo more accurate diagnostic methods to confirm or rule out addisonian crisis. Delay to perform diagnostic tests should be avoided, in any circumstances, and unstable patients should be immediately medicated with intravenous glucocorticoid, even before confirmatory tests. Conclusion: Acute adrenal insufficiency is a severe disease that is difficult to diagnose. It should be part of the differential diagnosis in cases of hypotensive patient who is unresponsive to vasoactive agents. Therefore, whenever this complication is considered, health professionals should aim specifically at this pathology.

  2. Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Nazma Akter

    2015-03-01

    Full Text Available Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 μg ACTH (adrenocorticotropic hormone stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist.

  3. Usefulness of the renal resistive index to predict an increase in urinary albumin excretion in patients with essential hypertension.

    Science.gov (United States)

    Miyoshi, K; Okura, T; Tanino, A; Kukida, M; Nagao, T; Higaki, J

    2017-01-01

    Microalbuminuria is a risk factor for cardiovascular events and death in hypertensive patients. Patients who are expected to increase albuminuria need strict blood pressure control. In the present study, we assessed the association between the renal resistive index (RI) and future increases in albuminuria in patients with essential hypertension. Sixty-six patients with essential hypertension were included in the study. Univariate and multivariate logistic regression analyses were used to identify the factors, including renal RI, that were significant independent determinants of increased in urinary albumin excretion (UAE), defined as an increase of >50% in the urinary albumin-to-creatinine ratio over 2 years. Receiver operator characteristics curve analysis was used to select the optimal cut-off point that predicted an increase in UAE. RI was the only significant variable that predicted the increase in UAE, with the optimal cut-off value of renal RI that predicted this increase being 0.71 (sensitivity 52.4% and specificity 84.4%). Renal RI is associated with the future increase in albuminuria in patients with essential hypertension.

  4. The rise, fall, and possible resurrection of renal denervation.

    Science.gov (United States)

    Gulati, Rajiv; Raphael, Claire E; Negoita, Manuela; Pocock, Stuart J; Gersh, Bernard J

    2016-04-01

    Renal denervation has a chequered history. Dramatic reductions in blood pressure after denervation of the renal arteries were observed in early trials, but later trials in which denervation was tested against a sham procedure produced neutral results. Although a sound pathophysiological basis exists for interruption of the renal sympathetic nervous system as a treatment for hypertension, trial data to date are insufficient to support renal denervation as an established clinical therapy. In this Perspectives article, we summarize the currently available trial data, device development, and trials in progress, and provide recommendations for future trial design.

  5. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions

    OpenAIRE

    Edward Khawam; Bachir Abiad; Alaa Boughannam; Joanna Saade; Ramzi Alameddine

    2015-01-01

    Great discrepancies are often encountered between the distance fixation and the near-fixation esodeviations and exodeviations. They are all attributed to either anomalies of the AC/A ratio or anomalies of the fusional convergence or divergence amplitudes. We report a case with pseudoconvergence insufficiency and another one with pseudoaccommodative convergence excess. In both cases, conv./div. excess and insufficiency were erroneously attributed to anomalies of the AC/A ratio or to anomalies ...

  6. LMWH in cancer patients with renal impairment - better than warfarin?

    Science.gov (United States)

    Bauersachs, Rupert M

    2016-04-01

    Venous thromboembolism (VTE) is one of the leading causes of death in cancer patients, which are known to have a 5- to 7-fold increased risk for VTE. The anticoagulant treatment of VTE in cancer patients is less effective with a three-fold increased risk of VTE recurrence compared to non-cancer patients, and it is less safe with more than double rates of major bleeding. Compared to vitamin-K antagonists (VKA), long-term secondary prevention with low molecular weight heparin (LMWH) has been shown to reduce the risk of recurrent VTE in cancer-associated thrombosis (CAT), and therefore, current international guidelines recommend the use of LMWH over VKA. With increasing age, cancer prevalence and VTE incidence increase while renal function decreases. Anti-cancer treatment may impair renal function additionally. Therefore, renal insufficiency is a frequent challenge in CAT patients, which is associated with a higher risk of both bleeding and recurrent VTE. Both VKA and LMWH may be associated with less efficacy and higher bleeding risk in renal insufficiency. Unfortunately, there is a lack of prospective data on renal insufficiency and CAT. A recent sub-analysis from a large randomized controlled trial shows that the bleeding risk in patients with severe renal insufficiency in CAT is not elevated with the use of LMWH compared to VKA while efficacy is maintained. In addition, LMWH treatment has several practical advantages over VKA, particularly in patients with CAT while they are receiving anti-cancer treatment.

  7. Nooruslik kaupmeheemand kavatseb äri laiendada / Hille Tänavsuu

    Index Scriptorium Estoniae

    Tänavsuu, Hille, 1941-2014

    2006-01-01

    Vt. ka Postimees : na russkom jazõke 23. märts lk. 8. Tallinnas Vana-Kalamaja tänaval paikneva Alma Äri omanik Alma Sooäär avas oma esimese poe enam kui 15 aastat tagasi Nõmmel, praegu plaanib poeomanik majapidamistarvete äri laiendamist. Kaart: Alma Äri

  8. Äriühingute vastastikune tunnustamine ja asukohavahetus Euroopa Liidus / Andres Vutt

    Index Scriptorium Estoniae

    Vutt, Andres, 1969-

    2007-01-01

    Äriühingute vastastikuse tunnustamise põhimõtetest ja võimalustest, kuidas saab Euroopa Liidus muuta äriühingu asukohta ühest riigist teise ning mida tuleb Eestil seoses sellega arvestada. Äriühingute asukohavahetusest Euroopa Kohtu lahendites. Artikkel on valminud ETF-i grandi 6747 abil

  9. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases.

    Science.gov (United States)

    Bush, Lisabeth A; Chew, Felix S

    2008-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was focally increased T2 signal on MRI and a small, triangular ridge or cortical beak on radiographs. The lesion was initially thought to represent a metastasis, but after the patient returned with a transverse femoral shaft fracture through the ridge following minimal trauma, MRI and biopsy of the lesion failed to show any evidence of tumor. We suggest that this fracture is similar to the low-energy proximal femoral shaft fractures recently reported in postmenopausal women who have received oral bisphosphonates for osteoporosis. Suppression of bone turnover may play a role in the development of these fractures.

  10. Normal Doppler velocimetry of renal vasculature in Persian cats.

    Science.gov (United States)

    Carvalho, Cibele F; Chammas, Maria C

    2011-06-01

    Renal diseases are common in older cats. Decreased renal blood flow may be the first sign of dysfunction and can be evaluated by Doppler ultrasound. But previous studies suggest that the resistive index (RI) has a low sensitivity for detecting renal disease. Doppler waveforms of renal and intrarenal arteries demonstrate decreased blood flow before there are any changes in the RI. The purpose of this study was to evaluate the normal Doppler flowmetrics parameters of renal arteries (RAs), interlobar arteries (IAs) and abdominal aorta (AO) in adult healthy, Persian cats. Twenty-five Persian cats (13 females and 12 males with mean age of 30 months and an age range 12-60 months) with normal clinical examinations and biochemical tests and normal systemic blood pressure were given B-mode ultrasonographies in order to exclude all nephropathies, including polycystic kidney disease. All measurements were performed on both kidneys. Both kidneys (n=50) were examined by color mapping of the renal vasculature. Pulsed Doppler was used to examine both RAs, the IAs at cranial, middle and caudal sites, and the AO. The RI was calculated for all of the vessels. Early systolic acceleration (ESA) of RA and IA was obtained with Doppler spectral analysis. Furthermore, the ratio indices between RA/AO, and IA/RA velocities were calculated. The mean values of peak systolic velocity (PSV) and the diameter for AO were 53.17±13.46 cm/s and 0.38±0.08 cm, respectively. The mean RA diameter for all 50 kidneys was 0.15±0.02 cm. Considering the velocimetric values in both RAs, the mean PSV and RI that were obtained were 41.17±9.40 cm/s and 0.54±0.07. The RA had a mean ESA of 1.12±1.14 m/s(2) and the calculated upper limit of the reference value was 3.40 m/s(2). The mean renal-aortic ratio was 0.828±0.296. The IA showed PSV and RI values of 32.16±9.33 cm/s and 0.52±0.06, respectively. The mean ESA of all IAs was 0.73±0.61 m/s(2). The calculated upper limit of the reference value was 2.0m

  11. Determination and its significance of the ratio of urine microalbumin to urine cretinine in patients with nephrolithiasis complicated with renal insufficiency%肾结石合并肾功能不全患者围手术期尿微量白蛋白与尿肌酐比值检测及意义

    Institute of Scientific and Technical Information of China (English)

    陈亮; 李建兴; 黄晓波; 杨波; 王佳; 王晓峰

    2011-01-01

    Objective: To investigate the significance of change of urine microalbumin/urine cretinine (mALB/Ucr) in nephrolithiasis patients with renal dysfunction (experimental group) before and after percutaneous nephrolithotomy (PCNL). Methods: mALB/Ucr value and serum cretinine (Scr) value were analyzed in 21 nephrolithiasis patients with renal dysfunction before PCNL, and 1, 7, 30 and 90 days after PCNL. Operative time and the number of tract were recorded and analyzed in the experimental group. The same work was done in 27 nephrolithiasis patients with normal renal function (control group) before surgery. Results: The levels of mALB/ Ucr in experimental group patients before PCNL were significantly higher than those in control group (P <0. 001) . The levels of mALB /Ucr between 7 days after operation and 30 days (P=0.054) or 90 days (P=0.062) after operation were not statistically significant. The levels of Scr of 30 days after operation in experimental group were lower than those of 7 days after surgery (P<0.001 ) ; But they were not statistically significant compared with those of 90 days after surgery (P =0. 106). The mALB/Ucr difference between before PCNL and 7 days after PCNL (ΔmALB/Ucr) was positively correlated to the number of operation tract ( r =0.486 ,P =0. 030) , but it was not correlated to operation time ( r = 0. 323 , P = 0. 129 ). The ΔmALB/Ucr was not correlated to Scr difference between before PCNL and 7 days after PCNL ( r =0. 323 , P =0. 153 ). Actually the ΔmALB/ Ucr was correlated to Scr difference between before PCNL and 30 days (r =0. 632, P =0.002) , or 90 days ( r =0. 476 , P =0. 003 ) after PCNL. Conclusion: The damage to kidney filtration of experimental group was more severe than that of control group. The mALB/Ucr or Scr level of experimental group trends to be stable in 7 or 30 days after operation. Increasing operation tracts ( less than 3 tracts) can help to restore kidney filtration function. A reliable assessment, of a long

  12. Nutrición y enfermedad renal

    Directory of Open Access Journals (Sweden)

    Iris de Castaño

    2007-03-01

    Full Text Available El riñón juega un papel importante en la regulación interna del organismo a través de las funciones excretoras, metabólicas y endocrinas. La insuficiencia renal aguda, IRA, se caracteriza por un rápido deterioro de la función renal con acumulación de productos nitrogenados como la urea y la creatinina y desequilibrio del agua y de los electrólitos. La falla renal crea un estado de desequilibrio metabólico proporcional a la perdida de la función renal. Dentro de los factores importantes para disminuir la progresión de la insuficiencia renal crónica, IRC, están el control de la proteinuria y el control de la hipertensión arterial. Algunos pacientes no alcanzan a ingerir de manera voluntaria los requerimientos calóricos y de volumen adecuados y necesitan soporte con alimentación enteral con sonda nasogástrica o nasoyeyunal con bombas de infusión.

  13. Trasplante renal Kidney transplant

    Directory of Open Access Journals (Sweden)

    P. Martín

    2006-08-01

    Full Text Available El trasplante renal es la terapia de elección para la mayoría de las causas de insuficiencia renal crónica terminal porque mejora la calidad de vida y la supervivencia frente a la diálisis. El trasplante renal de donante vivo es una excelente alternativa para el paciente joven en situación de prediálisis porque ofrece mejores resultados. El tratamiento inmunosupresor debe ser individualizado buscando la sinergia inmunosupresora y el mejor perfil de seguridad, y debe adaptarse a las diferentes etapas del trasplante renal. En el seguimiento del trasplante renal hay que tener muy en cuenta los factores de riesgo cardiovascular y los tumores puesto que la muerte del paciente con injerto funcionante es la segunda causa de pérdida del injerto tras el primer año del trasplante. La función alterada del injerto es un factor de mortalidad cardiovascular independiente que requerirá seguimiento y control de todas sus complicaciones para retrasar la entrada en diálisis.The kidney transplant is the therapy of choice for the majority of the causes of chronic terminal kidney insufficiency, because it improves the quality of life and survival in comparison with dialysis. A kidney transplant from a live donor is an excellent alternative for the young patient in a state of pre-dialysis because it offers the best results. Immunosuppressive treatment must be individualised, seeking immunosuppressive synergy and the best safety profile, and must be adapted to the different stages of the kidney transplant. In the follow-up to the kidney transplant, cardiovascular risk factors and tumours must be especially taken into account, given that the death of the patient with a working graft is the second cause of loss of the graft following the first year of the transplant. The altered function of the graft is a factor of independent cardiovascular mortality that will require follow-up and the control of all its complications to postpone the entrance in dialysis.

  14. Influencias nutricionales sobre las capacidades gluconeogénica y glucolítica de corteza renal de rata

    OpenAIRE

    García Salguero, Leticia.

    2013-01-01

    Se ha puesto de manifiesto la importancia de la corteza renal en el mantenimiento de los niveles de glucosa sanguínea. El riñón es capaz de adaptar el metabolismo de carbohidratos ante diferentes situaciones nutricionales. Así cuando hay un aporte excesivo de carbohidratos en la dieta el riñón responde disminuyendo la gluconeogénesis e incrementando la glucólisis igual que ocurre en el hígado. En el ayuno los cambios que tienen lugar en la corteza renal siguen una dirección opuesta

  15. Influencias nutricionales sobre las capacidades gluconeogénica y glucolítica de corteza renal de rata

    OpenAIRE

    García Salguero, Leticia

    2013-01-01

    Se ha puesto de manifiesto la importancia de la corteza renal en el mantenimiento de los niveles de glucosa sanguínea. El riñón es capaz de adaptar el metabolismo de carbohidratos ante diferentes situaciones nutricionales. Así cuando hay un aporte excesivo de carbohidratos en la dieta el riñón responde disminuyendo la gluconeogénesis e incrementando la glucólisis igual que ocurre en el hígado. En el ayuno los cambios que tienen lugar en la corteza renal siguen una dirección opuesta

  16. Renal mass biopsy--a renaissance?

    Science.gov (United States)

    Lane, Brian R; Samplaski, Mary K; Herts, Brian R; Zhou, Ming; Novick, Andrew C; Campbell, Steven C

    2008-01-01

    Advances in our understanding of the natural history and limited aggressive potential of many small renal masses, expanding treatment options and the integration of molecular factors into prognostic and therapeutic algorithms have stimulated renewed interest in percutaneous renal mass biopsy. A comprehensive literature review was performed using MEDLINE/PubMed to evaluate the indications, techniques, complications and efficacy of renal mass biopsy. Reported techniques of renal mass biopsy vary widely with different modes of radiographic guidance, needle size, number of cores and pathological analyses. Percutaneous renal mass biopsy with 2 or 3 cores using 18 gauge needles may improve diagnostic accuracy without increasing morbidity. Serious complications of percutaneous biopsy are rare and the minor complication rate in recent series has been less than 5%. The reported rate of technical failure of renal mass biopsy due to insufficient material was about 9% before 2001 and 5% in more recent studies. The likelihood of indeterminate or inaccurate pathological findings has decreased from 10% to 4% when comparing clinical studies before and since 2001. Currently a total success rate of greater than 90% is attainable using renal mass biopsy with standard histopathological analysis. Recent studies demonstrated that combining immunohistochemical and molecular analyses may further improve renal mass biopsy accuracy. Research on expanded analysis of percutaneous renal mass biopsy specimens should remain a top priority. Enhanced renal mass biopsy should not change treatment in most patients with small renal masses, who should be treated with surgical excision. However, future clinical algorithms will likely incorporate enhanced biopsy in situations in which decision making is more challenging.

  17. [Treatment of renal anemia with erythropoietin].

    Science.gov (United States)

    Spustova, V; Kovac, A

    1999-08-01

    During the last decade, a considerable amount of new information has accumulated regarding therapy optimalization of renal anaemia with recombinant human erythropoietin (EPO). Key question involved is EPO hyporesponsiveness caused by absolute or functional iron deficiency. Most controversial issue in the treatment of renal anaemia in patients with chronic renal insufficiency is the definition of optimal target haemoglobin. Many questions about optimizing EPO therapy were considered at the 2nd European Epoetin Symposium which was held in April 1998 on Crete. Discussion was devoted also to revision of a draft version of the European Best Practice Guidelines for the Management of Anaemia in Patients with Chronic Renal Failure. The presented review is on summary of new insights presented at the symposium. (Ref. 85.)

  18. Efficacy of recombinant human brain natriuretic peptide on acute heart failure with renal function insufficiency%重组人脑钠肽治疗急性心力衰竭合并肾功能不全的近期疗效观察

    Institute of Scientific and Technical Information of China (English)

    卢鑫; 胡桃红; 谢晓春; 刘胜林; 李慧君; 张玮; 王晶

    2014-01-01

    Objective To analyze the efficacy of recombinant human brain natriuretic peptide (rhBNP) treating congestive heart failure complicated with renal failure.Methods A retrospective analysis of 105 cases of heart failure and renal failure patients were randomly divided into two groups:group rhBNP (55 cases,on the basis of conventional therapy plus rhBNP) and routine treatment group (50 cases,treated with routine therapy).The effect of recombinant human brain natriuretic peptide [0.007 5 μg/(kg · min) micro pump intravenous infusion,once a day,each lasting approximately 10 hours,7 days for a course of treatment] was recorded before treatment,7 days and 3 months after treatment,including left ventricular ejection fraction,left ventricular end diastolic volume,left ventricular systolic end diastolic volume,24 hour urine volume,blood urea nitrogen,serum creatinine,serum cystatin C,NT-proBNP and creatinine clearance rate.Results Compared with routine therapy group after 7 days,NT-proBNP[(1 516 ±432)ng/L vs (4 951 ± 1 314)ng/L],the left ventricular ejection fraction[(46.9 ±6.8)% vs (30.6 ± 2.5) %],left ventricular end diastolic diameter [(50 ± 3) mm vs (57 ± 5) mm],left ventricular end systolic diameter [(35 ±6)mm vs (43 ±3)mm],24 hours urine volume [(975 ± 172) ml vs (786 ± 143)ml],urea nitrogen [(7.3 ± 2.3)mmol/L vs (12.9 ± 3.2)mmol/L],serum creatinine [(93 ± 8)μmol/L vs (234 ± 69) μmol/L],glomerular filtration rate [(46 ±6)ml/min vs (34 ±3)ml/min],serum cystatin C[(1.4 ± 0.1)mg/L vs (3.2 ± 1.9)mg/L] had significant differences between the two groups (P < 0.05).Conclusion The recombinant human brain natriuretic peptide is safe and can improve the renal function in chronic heart failure.%目的 观察重组人脑钠肽(rhBNP)治疗心力衰竭合并肾功能不全的近期疗效.方法 回顾性分析心力衰竭合并肾功能不全的患者105例,根据不同治疗分为2组,常规治疗组50例,给予常规治疗;rhBNP组55例,常规治疗

  19. Genetic transformation of Begonia tuberhybrida by Ri rol genes.

    Science.gov (United States)

    Kiyokawa, S; Kikuchi, Y; Kamada, H; Harada, H

    1996-04-01

    We have developed an Agrobacterium -mediated transformation system for commercial Begonia species. The leaf explants of Begonia semperflorens, Begonia x hiemalis and B. tuberhybrida were inoculated with Agrobacterium tumefaciens LBA4404 harboring a binary vector pBI121 which contains rolA, B and C genes of an agropine type Ri plasmid (pRiA4b). Kanamycin resistant shoots of B. tuberhybrida were obtained on MS agar medium supplemented with 0.1 mg/l NAA, 0.5 mg/l BA, 500 mg/l claforan and 100 mg/l kanamycin. These shoots exhibited GUS activity and Southern analysis showed a single copy insertion into the genome. When the transgenic plants were transferred to soil, they displayed the phenotype specific to the transgenic plants by A. rhizogenes such as dwarfness, delay of flowering, and wrinkled leaves and petals.

  20. Ping-pong champion with adrenal insufficiency

    OpenAIRE

    2009-01-01

    A 62-year-old Japanese man, a bronze medal winner in the World Championship of table tennis when in his 20s, was diagnosed with secondary adrenocortical insufficiency due to isolated adrenocorticotropic hormone (ACTH) deficiency, and steroid administration was started. About 1 year after the diagnosis, he took part in a table tennis championship which was open to those 40 years or older. He took 10 mg hydrocortisone after breakfast as usual, played 10 matches, each of which took 20–30 min, an...

  1. News in Pathogenesis of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Mazuchova J

    2016-08-01

    Full Text Available This review article is concentrating on the news in the pathophysiology of chronic venous insufficiency (CVD. Despite ongoing progress in understanding the molecular aspects of CVD the exact mechanism of its development remains unclear. Many different factors may play role in the pathogenesis of CVD, including changes in hydrostatic pressure, valvular incompetence, increased capillary permeability, endothelial dysfunction, activation of leukocytes, deep venous obstruction, capillary microthrombosis, ineffective function of calf muscle pump, biochemical and structural changes in the vessel wall, extracellular matrix alteration, and several other mechanisms. A better understanding of the pathophysiology is an important step in the finding of new potential treatment.

  2. Radiocontrast-induced renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Misson, R.T.; Cutler, R.E.

    1985-05-01

    Review of the literature concerning contrast-induced renal dysfunction shows that the currently used agents are remarkably safe with careful patient selection. Clinically apparent kidney failure after their use is essentially nonexistent in those without preexistent renal insufficiency. The incidence rises rapidly in those with azotemia from any cause, however, and diabetic persons with nephropathy are perhaps at special risk. Vigorous volume expansion is possibly effective as a preventive measure and may attenuate adverse effects in those in whom postcontrast dysfunction occurs. New agents are becoming available. It is not yet known if these will prove safer or cost-effective. They have some experimentally demonstrated and theoretical advantages over the presently used agents. 58 references, 1 figure, 2 tables.

  3. Moskvast tuli Eestisse Hõbe-Jüri / Kristiina Davidjants

    Index Scriptorium Estoniae

    Davidjants, Kristiina, 1974-

    2004-01-01

    Moskvas lõppes XXVI rahvusvaheline filmifestival. Festivali programmi kuulus ka Renee Reinumäe, Jaak Kilmi noortefilm, mis sai žürii eripreemia, Hõbedase Püha Jüri. Peapreemia sai venelase Dmitri Meshijevi "Omad". Noorte lootustandvate režissööride programmis oli huvitav prantslase Christophe Honoré "Minu ema". Lisatud auhinnatute nimekiri ning nimekiri "Eesti filmide tähtsamaid autasusid"

  4. Kolonel Jüri Kadaku uus missioon / Virkko Lepassalu

    Index Scriptorium Estoniae

    Lepassalu, Virkko, 1971-

    2009-01-01

    Eesti ja Aserbaidžaani suhetest ning kohalikust poliitilisest olukorrast. Kohalike oludega tuttav kaitsejõudude erukoloneli ja praeguse Euroülikooli professori Jüri Kadaku hinnangul on Eesti ettevõtjatel kõige otstarbekam teha investeeringuid ehitusmaterjalide müüki ja IT-sektorisse. Lisa: Ühe akna printsiip; Kuhu investeerida?. Lisatud foto: Mehed mustas: president Alijev ja president Ilves 13. jaanuaril Bakuus

  5. Uudised : Fääri ooper Tallinnas. Sigur Ros Tallinnas

    Index Scriptorium Estoniae

    2008-01-01

    10.-12. septembrini mängitakse Tallinnas Kultuurikatlas fääri helilooja Sunleif Rasmusseni ooperit "Hullu mehe aias", lavastajaks Robert Annus. 23. augustil annab Rock Cafés kontserdi Islandi eksperimentaalrocki ansambel Sigur Ros, kes esitleb oma viiendat albumit "Med sud i eyrum vid spilum endalaust" (mida võiks tõlkida "Mängime lõppematult, sumin kõrvus"

  6. Uudised : Fääri ooper Tallinnas. Sigur Ros Tallinnas

    Index Scriptorium Estoniae

    2008-01-01

    10.-12. septembrini mängitakse Tallinnas Kultuurikatlas fääri helilooja Sunleif Rasmusseni ooperit "Hullu mehe aias", lavastajaks Robert Annus. 23. augustil annab Rock Cafés kontserdi Islandi eksperimentaalrocki ansambel Sigur Ros, kes esitleb oma viiendat albumit "Med sud i eyrum vid spilum endalaust" (mida võiks tõlkida "Mängime lõppematult, sumin kõrvus"

  7. USA kahepaiksest mängust / Jüri Lina

    Index Scriptorium Estoniae

    Lina, Jüri, 1949-

    2000-01-01

    Sama artikkel on ilmunud ka Eesti 2000 : sõltumatu almanahh ühiskonna ja vaimuelu küsimustes nr. 4 ja nr. 6. Autori väitel on USA muu hulgas huvitatud maakera rahvastiku drastilisest vähendamisest, seepärast ongi pärast Teist maailmasõda kunstlikult lõkkele puhutud sadu sõjalisi konflikte. Lisatud Jüri Lina lühielulugu lk. 23

  8. Prevalence of Renal Tuberculosis in Patients With Chronic Renal Failure Prior toDialysis, Associated with Constitutional Symptoms

    Directory of Open Access Journals (Sweden)

    Mona Hosny

    2001-09-01

    Full Text Available ot yet on dialysis, were included in the renal failure: -: D.M. is a predispasing fact!"# # + $ %-­ proliferative glomerulonephritis as it is the most common cause in Egypt for renal failure. Their "# $ +%ars. Constitutional and urogenital symptoms were a guide to choose patients included in the study. For all patients the following was done: Complete urine analysis, Acid-Fast Bacilli (AFB in urine; Tuberculin test, chest X-Ray, Plain urinary tract, CT of (Kidneys ­ ureter ­ bladder and PCR of Mycobacterium Tuberculosis in urine using Gen-Probe Amplification test. &" '%(" %" '%(" %*+tests mentioned above. " %''" %with a total #'this study. We conclude that Diabetes Mellitus is a risk factor for renal Tuberculosis, but also chronic renal insufficiency in itself is another risk factor but to a lesser extent than DM. There was no significant statistical difference between chronic renal insufficiency due to diabetic nephropathy and chronic renal insufficiency due to membrano proliferative glomerulonephritis as regards renal Tuberculosis which was detected essentially by PCR of TB in urine. Compared to normal group, there were significant statistical differences in all parameters that were measured, between normal group and the other two groups together and separately.

  9. Renal Cysts

    Science.gov (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  11. COLOR DOPPLER ULTRASONOGRAPHY APPEARANCES OF RENAL VEIN THROMBOSIS AND ITS DIAGNOSTIC VALUE

    Institute of Scientific and Technical Information of China (English)

    Sheng Cai; Guang-xi Zhong; Jian-chu Li; Yu Xia; Hui-jun Li; Yu-xin Jiang

    2007-01-01

    Objective To evaluate color Doppler ultrasonography (CDU) appearances of renal vein thrombosis (RVT) and its diagnostic value.Methods Ten patients with RVT were analyzed retrospectively. Renal structure, distributions of intrarenal flow signals, echogenicity, and flow fullness in main renal veins were observed with CDU. Resistance index (RI) was recorded from the waveforms of segmental or interlobar renal artery.Results Ten kidneys in nine patients were confirmed to have thrombus within the main renal veins, and one patient was confirmed to have thrombus within the small intrarenal veins. The appearances of the main renal vein thrombosis included full of solid echogenicity or strip echogenicity and complete or partial filling defect within the main renal veins, and absent or a few intrarenal venous flow signals in 70% of kidneys involved. The appearances of intrarenal vein thrombosis included obscure renal structure and no venous flow signal within the involved part of the kidneys. Reverse diastolic flow in the intrarenal artery had only a sensitivity of 36% (4/11) ; in other 7 kidneys without intrarenal arterial reverse diastolic flow, increased RI (mean, 0.84; range, 0.74-0.96) was found.Conclusion CDU is helpful for rapid clinical diagnosis and follow-up of RVT, and therefore can be the first imaging modality of choice for RVT.

  12. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  13. Inflammatory manifestations of experimental lymphatic insufficiency.

    Directory of Open Access Journals (Sweden)

    Raymond Tabibiazar

    2006-07-01

    Full Text Available BACKGROUND: Sustained lymph stagnation engenders a pathological response that is complex and not well characterized. Tissue inflammation in lymphedema may reflect either an active or passive consequence of impaired immune traffic. METHODS AND FINDINGS: We studied an experimental model of acute post-surgical lymphedema in the tails of female hairless, immunocompetent SKH-1 mice. We performed in vivo imaging of impaired immune traffic in experimental, murine acquired lymphatic insufficiency. We demonstrated impaired mobilization of immunocompetent cells from the lymphedematous region. These findings correlated with histopathological alterations and large-scale transcriptional profiling results. We found intense inflammatory changes in the dermis and the subdermis. The molecular pattern in the RNA extracted from the whole tissue was dominated by the upregulation of genes related to acute inflammation, immune response, complement activation, wound healing, fibrosis, and oxidative stress response. CONCLUSIONS: We have characterized a mouse model of acute, acquired lymphedema using in vivo functional imaging and histopathological correlation. The model closely simulates the volume response, histopathology, and lymphoscintigraphic characteristics of human acquired lymphedema, and the response is accompanied by an increase in the number and size of microlymphatic structures in the lymphedematous cutaneous tissues. Molecular characterization through clustering of genes with known functions provides insights into processes and signaling pathways that compose the acute tissue response to lymph stagnation. Further study of genes identified through this effort will continue to elucidate the molecular mechanisms and lead to potential therapeutic strategies for lymphatic vascular insufficiency.

  14. The chronic cerebrospinal venous insufficiency syndrome.

    Science.gov (United States)

    Zamboni, P; Galeotti, R

    2010-12-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure. Restenosis rate was found out elevated in the IJVs, but negligible in the AZ. However, PTA seems to positively influence clinical and QoL parameters of the associated MS and warrants further randomized control trials.

  15. DNA-guided hepatitis B treatment: Viral load is insufficient with few exceptions

    Institute of Scientific and Technical Information of China (English)

    Pankaj Jain

    2009-01-01

    In DNA-guided hepatitis B treatment, viral load is insufficient, and requires other viral markers for treatment of hepatitis B patients as in patients with acute exacerbation of chronic hepatitis B, end-stage renal disease on dialysis, human immunodeficiency virus co-infected patients. There are exceptions to this rule:a residual level hepatitis B virus (HBV) DNA at 24 wk predicts beneficial outcome and reduced resistance at 1 year. The genotypic viral resistance to antiviral agents and occult HBV infection can be determined by HBV-DNA levels.

  16. High serum enalaprilat in chronic renal failure

    DEFF Research Database (Denmark)

    Elung-Jensen, T; Heisterberg, J; Kamper, A L

    2001-01-01

    in patients with GFR ACE activity below the reference range. The ACE genotype did not influence the results. Additional pharmacokinetic studies were done in nine patients in whom GFR was 23 (10-42)ml/minute/1.73 m2. The median clearance of enalaprilat was 28 (16......BACKGROUND: Most angiotensin-converting enzyme (ACE) inhibitors and their metabolites are excreted renally and doses should hence be reduced in renal insufficiency. We studied whether the dosage of enalapril in daily clinical practice is associated with drug accumulation of enalaprilat in chronic...

  17. [Bilateral renal infarction after discontinuation of anticoagulant therapy].

    Science.gov (United States)

    Lavoignet, Charles-Éric; Le Borgne, Pierrick; Ugé, Sarah; Veneziano, Rinaldo; Brunhuber, Claudia; Kam, Claire; Bilbault, Pascal

    2016-07-01

    Acute renal infarction is an uncommon and often under diagnosed condition mostly because of misleading symptoms. Accurate data regarding clinical presentation, laboratory tests, diagnostic and treatment are lacking. Detection is often delayed or missed because of non-specific clinical presentation. The mechanisms of acute renal infarction are various, mainly embolic or thrombotic. Abdominal CT scan remains the most valuable exam to confirm the diagnosis. Therapeutic guidelines for the treatment of renal embolism have not been well established. The standard treatment strategy includes anticoagulation with or without thrombolysis. Despite the uncertainty regarding management, the renal outcome remains favorable. Some patients do develop some degree of renal insufficiency during the acute episode. We report here the case of a 73-year-old woman with bilateral acute renal infarction after discontinuation of anticoagulant therapy.

  18. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  19. 77 FR 5581 - Submission for Review: Financial Resources Questionnaire (RI 34-1, RI 34-17) and Notice of Amount...

    Science.gov (United States)

    2012-02-03

    ... Resources Questionnaire (RI 34-1), Financial Resources Questionnaire--Federal Employees' Group Life Insurance Premiums Underpaid (RI 34-17), collects detailed financial information for use by OPM to determine... published in the Federal Register on August 16, 2011 at Volume 76 FR 50770 allowing for a 60-day...

  20. [Determining the aortic and renal hemodynamic effects of propofol on rabbits using Doppler ultrasonography].

    Science.gov (United States)

    Apan, Alpaslan; Karadeniz Bilgili, M Yasemin; Cağlayan, Fatma

    2004-03-01

    The hemodynamic effects of propofol-fentanyl anesthesia were known to reduce arterial pressure and heart rate. We aimed to determine the effects of propofol-fentanyl anesthesia on renal artery blood flow and aorta by using Doppler ultrasonography on an animal model. The study was conducted on 8 male New Zaeland White strain rabbits. The initial aortic and renal hemodynamic measurements were determined on animals using ketamin anesthesia. Later the right femoral arteries were cannulated for determining arterial blood pressure and pulse oximetry was followed from the ear. Propofol 5-7 mg/kg with fentanyl 1-2 microg/kg was injected via the ear vein. Doppler parameters (RI, RI, Vmax, Vmin) of the renal artery and aorta were determined after the anesthesia. According to the basal measurements, arterial blood pressure and breath rates declined significantly (27% and 53% respectively, p<0.05); however there were no statistical alteration of aortic and renal artery Doppler parameters. Anesthesia induced by propofol-fentanyl did not induce a statistically significant difference in Doppler parameters obtained from the renal artery and aorta. It is clinically important to know that determining the changes in RI and PI during the postoperative period is not related to the propofol-fentanyl anesthesia.

  1. Doppler spectrum analysis to diagnose rejection during posttransplant acute renal failure.

    Science.gov (United States)

    Merkus, J W; Hoitsma, A J; van Asten, W N; Koene, R A; Skotnicki, S H

    1994-09-15

    During posttransplant acute renal failure (ARF), the diagnosis of allograft rejection constitutes a major problem. We evaluated the value of Doppler ultrasonography in identifying grafts at risk of rejection during ARF. In 184 recipients of a renal allograft, Doppler examinations were performed on the first and fifth postoperative day. Doppler spectra were quantitatively analyzed with a user-written computer program. Doppler findings were not used in clinical decision making. ARF was defined as a diuresis cadaveric grafts (n = 123), while living related donor grafts (n = 20) showed a lower RI (0.55 +/- 0.07; P 4 days (n = 24), RI was not significantly different (0.63 +/- 0.07 vs. 0.68 +/- 0.15; NS). However, the acceleration time of the systolic deflection of the spectrum waveform (Tmax) was shorter in grafts with ARF > 4 days (86 +/- 47 msec vs. 128 +/- 39 msec; P 4 days (n = 24) showed a Tmax or = 90 msec, only 2 rejections occurred (negative predictive value, 13/15 = 87%). For the RI (> 0.85), positive predictive value was 4/5 = 80% and negative predictive value (RI identification of patients at risk for rejection and in the timing of allograft biopsy during ARF. Persistently short Tmax values on the fifth day after transplantation perform better in identifying grafts at risk of rejection than high RI values.

  2. [Transcranial electrostimulation in chronic cerebral vascular insufficiency].

    Science.gov (United States)

    Voropaev, A A; Mochalov, A D

    2006-01-01

    The method of transcranial electrostimulation (TCES) has been used for treatment of 68 patients with chronic cerebral vascular insufficiency, stages I and II. A treatment course included 7 daily procedures. The influence of TCES was evaluated clinically, by EEG, transcranial ultrasonic Doppler study and hemodynamic indices in arteries and veins as well as by expression of trait and state anxiety. All the parameters were compared to those of the control group which was treated using conventional methods. TCES resulted in normalization of cerebral vascular reactivity, a decrease of venous circulation disturbances, positive influence on cerebral blood flow and EEG parameters, that corresponded to global improvement of the patients' state, regress of cephalgic syndrome and reduction of trait and state anxiety. The method is simple and safety and can be recommended for wide application including outpatient setting.

  3. Caracterización de la función renal en perros

    OpenAIRE

    Pedro Pablo Martínez Padua

    2012-01-01

    Mediante filtración, reabsorción y excreción, los riñones mantienen la homeostasis en los organismos vivos. Los perros con lesiones renales tienen afectados estos procesos, que alteran la homeostasis. Ello da como resultado cuadros de insuficiencia renal. Se evaluaron parámetros que estiman la filtración, reabsorción y excreción renal en tres grupos de perros, referentes a concentración sérica de creatinina, relación proteína-creatinina urinaria, clearance de creatinina, excreción fraccionada...

  4. Plan de cuidados en una paciente con insuficiencia renal aguda. Caso Clínico

    OpenAIRE

    Delgado-Hito, Pilar; Romero García, Marta

    1999-01-01

    La Insuficiencia Renal Aguda puede definirse como una reducción o cese brusco de la función renal. Debido a la importancia del riñón en el mantenimiento del medio extracelular, la disminución aguda de la función renal afectará muchos, en realidad, la mayoría de los sistemas orgánicos. Los síntomas de presentación, curso clínico y complicaciones son manifestaciones de estos...

  5. Improving Forecast Skill by Assimilation of AIRS Cloud Cleared Radiances RiCC

    Science.gov (United States)

    Susskind, Joel; Rosenberg, Robert I.; Iredell, Lena

    2015-01-01

    ECMWF, NCEP, and GMAO routinely assimilate radiosonde and other in-situ observations along with satellite IR and MW Sounder radiance observations. NCEP and GMAO use the NCEP GSI Data Assimilation System (DAS).GSI DAS assimilates AIRS, CrIS, IASI channel radiances Ri on a channel-by-channel, case-by-case basis, only for those channels i thought to be unaffected by cloud cover. This test excludes Ri for most tropospheric sounding channels under partial cloud cover conditions. AIRS Version-6 RiCC is a derived quantity representative of what AIRS channel i would have seen if the AIRS FOR were cloud free. All values of RiCC have case-by-case error estimates RiCC associated with them. Our experiments present to the GSI QCd values of AIRS RiCC in place of AIRS Ri observations. GSI DAS assimilates only those values of RiCC it thinks are cloud free. This potentially allows for better coverage of assimilated QCd values of RiCC as compared to Ri.

  6. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  7. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  8. Analysis of the New Zealand Black contribution to lupus-like renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Drake, C.G.; Rozzo, S.J.; Hirschfeld, H.F.; Smarnworawong, N.P. [National Center for Immunology and Respiratory Medicine, Denver, CO (United States); Palmer, E. [Basel Institute of Immunology, Basel (Switzerland); Kotzin, B.L. [National Jewish Center for Immunology and Respiratory Medicine, Denver, CO (United States)]|[Univ. of Colorado Health Sciences Center, Denver, CO (United States)

    1995-03-01

    F{sub 1} progeny of New Zealand Black (NZB) and New Zealand White (NZW) mice spontaneously develop an autoimmune process remarkably similar to human systemic lupus erythematosus. Previous studies have implicated major genetic contributions from the NZW MHC and from a dominant NZB gene on chromosome 4. To identify additional NZB contributions to lupus-like disease, (NZB x SM/J)F{sub 1} x NZW backcross mice were followed for the development of severe renal disease and were comprehensively genotyped. Despite a 50% incidence of disease significant associations between the presence of the NZB genotype and disease were noted on chromosomes 1, 4, 7, 10, 13, and 19. The data indicated that multiple NZB genes, in different combinations, contribute to severe renal disease, and that no single gene is required. To further investigate this NZB contribution, NZB x SM/J (NXSM) recombinant inbred (RI) strains were crossed with NZW mice, and F{sub 1} progeny were analyzed for the presence of lupus-like renal disease. Interestingly, nearly all of the (RI x NZW)F{sub 1} cohorts studies expressed some level of disease. Five RI strains generated a high incidence of disease, similar to (NZB x NZW)F{sub 1} mice, and nearly one-half of the cohorts developed disease at intermediate levels. Only two cohorts demonstrated very little disease, supporting the conclusion that multiple genes are capable of disease induction. Experiments correlating the genotypes of these RI strains with their ability to generate disease revealed that none of the disease-associated loci defined by the backcross analysis were present in all five RI strains that generated disease at high levels. Overall, both the backcross data and RI analysis provide additional support for the genetic complexity of lupus nephritis and uphold the conclusion that heterogeneous combinations of contributing NZB genes seem to operate in a threshold manner to generate the disease phenotype. 31 refs., 3 figs., 2 tabs.

  9. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  10. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  11. High Fat High Cholesterol Diet (Western Diet Aggravates Atherosclerosis, Hyperglycemia and Renal Failure in Nephrectomized LDL Receptor Knockout Mice: Role of Intestine Derived Lipopolysaccharide.

    Directory of Open Access Journals (Sweden)

    Siddhartha S Ghosh

    Full Text Available A high fat meal, frequently known as western diet (WD, exacerbates atherosclerosis and diabetes. Both these diseases are frequently associated with renal failure. Recent studies have shown that lipopolysaccharide (LPS leaks into the circulation from the intestine in the setting of renal failure and after WD. However, it is not clear how renal function and associated disorders are affected by LPS. This study demonstrates that circulatory LPS exacerbates renal insufficiency, atherosclerosis and glucose intolerance. Renal insufficiency was induced by 2/3 nephrectomy in LDL receptor knockout mice. Nx animals were given normal diet (Nx or WD (Nx+WD. The controls were sham operated animals on normal diet (control and WD (WD. To verify if LPS plays a role in exaggerating renal insufficiency, polymyxin (PM, a known LPS antagonist, and curcumin (CU, a compound known to ameliorate chronic kidney disease (CKD, was given to Nx animals on western diet (Nx+WD+PM and Nx+WD+CU, respectively. Compared to control, all other groups displayed increased circulatory LPS. The Nx+WD cohort had the highest levels of LPS. Nx group had significant renal insufficiency and glucose intolerance but not atherosclerosis. WD had intense atherosclerosis and glucose intolerance but it did not show signs of renal insufficiency. Compared to other groups, Nx+WD had significantly higher cytokine expression, macrophage infiltration in the kidney, renal insufficiency, glucose intolerance and atherosclerosis. PM treatment blunted the expression of cytokines, deterioration of renal function and associated disorders, albeit not to the levels of Nx, and was significantly inferior to CU. PM is a non-absorbable antibiotic with LPS binding properties, hence its beneficial effect can only be due to its effect within the GI tract. We conclude that LPS may not cause renal insufficiency but can exaggerate kidney failure and associated disorders following renal insufficiency.

  12. High Fat High Cholesterol Diet (Western Diet) Aggravates Atherosclerosis, Hyperglycemia and Renal Failure in Nephrectomized LDL Receptor Knockout Mice: Role of Intestine Derived Lipopolysaccharide.

    Science.gov (United States)

    Ghosh, Siddhartha S; Righi, Samuel; Krieg, Richard; Kang, Le; Carl, Daniel; Wang, Jing; Massey, H Davis; Sica, Domenic A; Gehr, Todd W B; Ghosh, Shobha

    2015-01-01

    A high fat meal, frequently known as western diet (WD), exacerbates atherosclerosis and diabetes. Both these diseases are frequently associated with renal failure. Recent studies have shown that lipopolysaccharide (LPS) leaks into the circulation from the intestine in the setting of renal failure and after WD. However, it is not clear how renal function and associated disorders are affected by LPS. This study demonstrates that circulatory LPS exacerbates renal insufficiency, atherosclerosis and glucose intolerance. Renal insufficiency was induced by 2/3 nephrectomy in LDL receptor knockout mice. Nx animals were given normal diet (Nx) or WD (Nx+WD). The controls were sham operated animals on normal diet (control) and WD (WD). To verify if LPS plays a role in exaggerating renal insufficiency, polymyxin (PM), a known LPS antagonist, and curcumin (CU), a compound known to ameliorate chronic kidney disease (CKD), was given to Nx animals on western diet (Nx+WD+PM and Nx+WD+CU, respectively). Compared to control, all other groups displayed increased circulatory LPS. The Nx+WD cohort had the highest levels of LPS. Nx group had significant renal insufficiency and glucose intolerance but not atherosclerosis. WD had intense atherosclerosis and glucose intolerance but it did not show signs of renal insufficiency. Compared to other groups, Nx+WD had significantly higher cytokine expression, macrophage infiltration in the kidney, renal insufficiency, glucose intolerance and atherosclerosis. PM treatment blunted the expression of cytokines, deterioration of renal function and associated disorders, albeit not to the levels of Nx, and was significantly inferior to CU. PM is a non-absorbable antibiotic with LPS binding properties, hence its beneficial effect can only be due to its effect within the GI tract. We conclude that LPS may not cause renal insufficiency but can exaggerate kidney failure and associated disorders following renal insufficiency.

  13. Emergency intervention therapy for renal vascular injury

    Institute of Scientific and Technical Information of China (English)

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; WANG Zhi-jun; DUAN Feng; SONG Peng

    2009-01-01

    Objective: To evaluate the efficacy and safety of the interventional techniques in the treatment of renal vascular injury.Methods: A total of 16 patients with renal vascular injuries were treated by superselective arterial embolization.The renal injuries resulted from renal biopsy in 7 patients,endovascular intervention in 2.percutaneous puncture and pyelostomy in 2.local resection of renal tumor in 1 and trauma in 4.With regards to clinical manifestations,there was hemorrhagic shock in 8 patients,severe flank pain in 14,and hematuria in 14.CT and ultrasonography confmued that 15 Patients had perirenal hematoma.The embolization was performed with microcoils in 13 and standard stainless steel coils in 3 patients,associated with polyvinyl alcohol particles (PVA) in 9,and gelfoam particles in 6 cases.Results: Renal angiogram revealed arteriovenous fistula in renal parenchyma in 9 cases,pseudoaneurysm in 3 and extravasation of contrast media in 4.The arterial embolization was successful in all 16 cases in a single session.The angiography at the end of therapy showed that abnormal vessels had disappeared without other major intrarenal arterial branch occlusion.In 13 patients with hemodynamical compromise,blood loss-related symptoms were immediately relieved after blood transfusion.In 14 patients with severe flank pain,the pain was progressively relieved.Hematuda ceased in 14 patients 2-14 days after the embolization procedures.The renal function was impaired after the procedure in 6 cases,in which preoperative renal insufficiency was exacerbated in 3 and developed new renal dysfunction in 3.2 of whom received hemodialysis.The ultrasonography showed that perirenal hematoma was gradually absorbed within 2.6 mortths after the procedure.A11 patients were followed up in 6-78 months (mean,48 months).Six patients died of primary diseases (5 cases of renal failure and multiple organ failure and 1 case of malignant tumor).Ten patients survived without bleeding and further

  14. THE UBV(RI){sub C} COLORS OF THE SUN

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez, I. [McDonald Observatory and Department of Astronomy, University of Texas at Austin, 1 University Station, C1400 Austin, TX 78712-0259 (United States); Michel, R.; Schuster, W. J. [Observatorio Astronomico Nacional, Universidad Nacional Autonoma de Mexico, Apartado Postal 877, Ensenada, B.C., CP 22800 (Mexico); Sefako, R.; Van Wyk, F. [South African Astronomical Observatory, P.O. Box 9, Observatory 7935, Cape Town (South Africa); Tucci Maia, M. [UNIFEI, DFQ-Instituto de Ciencias Exatas, Universidade Federal de Itajuba, Itajuba MG (Brazil); Melendez, J. [Departamento de Astronomia do IAG/USP, Universidade de Sao Paulo, Rua do Matao 1226, Sao Paulo, 05508-900 SP (Brazil); Casagrande, L. [Max-Planck-Institut fuer Astrophysik, Karl-Schwarzschild-Str. 1, Postfach 1317, D-85741 Garching (Germany); Castilho, B. V. [Laboratorio Nacional de Astrofisica/MCT, Rua Estados Unidos 154, 37504-364 Itajuba, MG (Brazil)

    2012-06-10

    Photometric data in the UBV(RI){sub C} system have been acquired for 80 solar analog stars for which we have previously derived highly precise atmospheric parameters T{sub eff}, log g, and [Fe/H] using high-resolution, high signal-to-noise ratio spectra. UBV and (RI){sub C} data for 46 and 76 of these stars, respectively, are published for the first time. Combining our data with those from the literature, colors in the UBV(RI){sub C} system, with {approx_equal} 0.01 mag precision, are now available for 112 solar analogs. Multiple linear regression is used to derive the solar colors from these photometric data and the spectroscopically derived T{sub eff}, log g, and [Fe/H] values. To minimize the impact of systematic errors in the model-dependent atmospheric parameters, we use only the data for the 10 stars that most closely resemble our Sun, i.e., the solar twins, and derive the following solar colors: (B - V){sub Sun} = 0.653 {+-} 0.005, (U - B){sub Sun} = 0.166 {+-} 0.022, (V - R){sub Sun} = 0.352 {+-} 0.007, and (V - I){sub Sun} = 0.702 {+-} 0.010. These colors are consistent, within the 1{sigma} errors, with those derived using the entire sample of 112 solar analogs. We also derive the solar colors using the relation between spectral-line-depth ratios and observed stellar colors, i.e., with a completely model-independent approach, and without restricting the analysis to solar twins. We find (B - V){sub Sun} = 0.653 {+-} 0.003, (U - B){sub Sun} = 0.158 {+-} 0.009, (V - R){sub Sun} = 0.356 {+-} 0.003, and (V - I){sub Sun} = 0.701 {+-} 0.003, in excellent agreement with the model-dependent analysis.

  15. Branchio-oto-renal syndrome caused by partial EYA1 deletion due to LINE-1 insertion

    DEFF Research Database (Denmark)

    Morisada, Naoya; Rendtorff, Nanna Dahl; Nozu, Kandai

    2010-01-01

    A 7-year-old Japanese girl with conductive deafness and preauricular fistulae developed proteinuria. She had renal insufficiency, and ultrasound revealed bilateral small kidneys. These findings indicated that she had branchio-oto-renal (BOR) syndrome. In the present patient, we identified, by using...

  16. Are angiotensin converting enzyme inhibitors superior to beta blockers in retarding progressive renal function decline?

    NARCIS (Netherlands)

    vanEssen, GG; Apperloo, AJ; Rensma, PL; Stegeman, CA; Sluiter, WJ; deZeeuw, D; deJong, PE

    1997-01-01

    We questioned the superiority of angiotensin converting enzyme (ACE) inhibitors to beta blocking drugs with regard to renal function outcome in patients with mild to moderate renal insufficiency and normal to moderately elevated blood pressure (BP). We therefore studied 89 patients in a prospective

  17. Eesti estamp sisepaguluses : graafikatriennaal / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2004-01-01

    Graafikute grupinäitused G-galeriis (kuraator Loit Jõekalda, osalevad Vive Tolli, Vello Vinn, Silvi Liiva, Raul Meel, Mare Vint, Jüri Kass, Ülle Marks, Maria-Kristiina Ulas) kuni 25. IX, Aatriumi galeriis kuni 23. IX, Soome Instituudis kuni 30. IX, Vappu Thurlowi kureeritud näitus "Lähenemised" Estonia kontserdisaalis kuni 15. X, Virge Jõekalda näitus "Vaikus" Ungari Instituudis kuni 27. IX, Loit Jõekalda näitus "Must ja valge" galeriis 36 kuni 19. IX

  18. Intramuscular lorazepam in catatonia in patients with acute renal failure: a report of two cases.

    Science.gov (United States)

    Huang, Chao-En; Huang, Tiao-Lai

    2010-01-01

    Cases of catatonia in patients with renal failure have been rarely reported. In this report, we describe two renal-insufficient patients with catatonia who had a good response to intramuscular lorazepam whereby the catatonic symptoms were relieved. Case 1 involved a patient with end-stage renal disease and severe pneumonia related respiratory failure. He responded well to intramuscular lorazepam (total dose, 4 mg) whereby the catatonia was elieved. Case 2 involved a patient with alcoholic liver cirrhosis and rhabdomyolysis-related acute renal failure. He showed great improvement with intramuscular lorazepam (2 mg) whereby the catatonia was subsequently relieved. This report demonstrates that intramuscular lorazepam is safe, effective and rapid in relieving catatonia associated with renal function impairment. Neither of the patients had a recurrence of catatonia during a period of 6- months follow-up. In conclusion, intramuscular lorazepam may play an important role in the treatment of catatonia associated with renal insufficiency.

  19. Síndrome de lisis tumoral en un paciente con cáncer de riñón tratado con sunitinib

    Directory of Open Access Journals (Sweden)

    Ezequiel Rodríguez-Reimúndes

    2011-04-01

    Full Text Available El síndrome de lisis tumoral (SLT es un trastorno metabólico que ocurre como consecuencia de una destrucción celular masiva. Se caracteriza por la presencia de hiperuricemia, hiperfosfatemia, hipocalcemia e hiperkalemia, y predispone al desarrollo de insuficiencia renal aguda. En la mayoría de los casos el SLT ocurre luego de instaurarse un tratamiento antitumoral y es más frecuente en tumores de alto grado de malignidad y alta sensibilidad a la quimioterapia. Presentamos el caso de un paciente con diagnóstico de cáncer de riñón recidivado que presenta un SLT e insuficiencia renal aguda luego de iniciar tratamiento con sunitinib.

  20. Monitoring of renal hemodynamics during acute hemorrhagic shock with Doppler ultrasonic imaging: an experimental study

    Directory of Open Access Journals (Sweden)

    Rui-hong LIU

    2015-07-01

    Full Text Available Objective To evaluate the value of color Doppler flow imaging (CDFI and pulsed-wave Doppler (PWD in monitoring renal hemodynamics in rabbits with acute hemorrhagic shock. Methods The experimental model of acute hemorrhagic shock was reproduced in 16 normal New Zealand white rabbits by controlled exsanguination which was divided into 4 different grades: normal (100% MAP, mild (70% MAP, moderate (50% MAP, and severe (40% MAP. The right kidney of the experimental animal was examined by gray-scale ultrasound (2DUS, CDFI and PWD. The structure of the right kidney was observed with 2DUS. CDFI was used to monitor the change in right renal hemodynamics along with the progression of shock. The hemodynamic parameters of main renal artery (MRA, segmental renal artery (SRA and interlobar renal artery (IRA were measured by PWD, including the peak systolic velocity (Vmax, minimum diastolic velocity (Vmin and resistive index (RI. Results The animal model of hemorrhagic shock was successfully reproduced in 16 healthy New Zealand rabbits, of which 14 rabbits survived at the end of the experiment, and 2 died of severe shock. The mean arterial pressure (MAP declined, while the respiratory rate and heart rate increased as the circulation changed from normal to severe shock (P<0.05. Observation of the right renal structure by 2DUS revealed no obvious changes after bleeding in different degrees. CDFI showed a gradually reduced distribution of blood flow in renal hemodynamics along with the progression of hemorrhagic shock. Vmax and Vmin declined gradually, while RI intensity increased as the hemorrhagic shock progressed from minor to severe. There was statistically significant difference in RI intensity between different grades of shock (P<005. Conclusion CDFI and PWD can quantitatively assess the renal hemodynamics during acute hemorrhagic shock, so it can be used as a noninvasive monitoring tool in the diagnosis and treatment of hemorrhagic shock. DOI: 10

  1. Mechanism of anti-FcαRI monoantibody treatment%抗IgA Fc受体抗体的作用机制

    Institute of Scientific and Technical Information of China (English)

    刘春蓓; 秦卫松

    2011-01-01

    Anti-FcaRI antibody treatment has been reported in recent years to be effective in controlling inflammatory and kidney diseases,such as immune related and nonimmune related renal disease. Inhibitory immunoreceptor tyrosine-based activation motifs (ITAMi) have been found to be involved in the mechanism of treatment other than activating effects, but mechanisms of inhibitory signaling are poorly understood. New evidence of low avidity ligation of the ITAM-associated FcaRI explained how ITAM broadly inhibits heterologous receptors, which involves translocation of receptor and the associated inhibitory Src homology 2( SH2) domain-containing phosphatase-1 (SHP-1) to membrane lipid rafts,coloealization of activating receptors with FcaRI and SHP-1 and trafficking to an inhibitory intracellular compartment termed the inhibisome. Thus, ITAM suppressive signals subvert the activating function of rafts to promote incorporation of receptors into supramolecular domains where signaling molecules are deactivated by SHP-1. These results provided new evidence for anti- FcaRI antibody therapy in the treatment of renal disease.%体外实验和动物实验证实,抗IgA Fc受体I(FcαRI)单抗具有抑制炎症信号通路,治疗感染性疾病、改善免疫及非免疫相关肾脏疾病肾组织病变等作用.虽然早有研究证实抗FcαRI单抗的疗效与FcαRI中抑制性免疫受体酪氨酸激活基序(immunoreceptor tyrosine-based activation motifs,ITAM)介导的抑制性信号(ITAMi)有关,但直到近期ITAMi的分子机制才被阐明,即低亲和性配体或单克隆抗体与FcαRI结合后可促使FcαRI移位及含Src同源结构域2(Src homology 2,SH2)的酪氨酸磷酸酶1(SHP-1)在细胞膜脂质结构中募集,激活性受体与FcαRI等受体及SHP-1在细胞脂筏上的共区域化促进了大分子抑制体的形成,在SHP-1的作用下激活信号被抑制.这一机制的明确为IgA FcαRI单抗治疗肾脏疾病提供了新的理论依据.

  2. Insufficient insulin administration to diabetic rats increases substrate utilization and maintains lactate production in the kidney.

    Science.gov (United States)

    Laustsen, Christoffer; Lipsø, Kasper; Ostergaard, Jakob Appel; Nørregaard, Rikke; Flyvbjerg, Allan; Pedersen, Michael; Palm, Fredrik; Ardenkjær-Larsen, Jan Henrik

    2014-12-01

    Good glycemic control is crucial to prevent the onset and progression of late diabetic complications, but insulin treatment often fails to achieve normalization of glycemic control to the level seen in healthy controls. In fact, recent experimental studies indicate that insufficient treatment with insulin, resulting in poor glycemic control, has an additional effect on progression of late diabetic complications, than poor glycemic control on its own. We therefore compared renal metabolic alterations during conditions of poor glycemic control with and without suboptimal insulin administration, which did not restore glycemic control, to streptozotocin (STZ)-diabetic rats using noninvasive hyperpolarized (13)C-pyruvate magnetic resonance imaging (MRI) and blood oxygenation level-dependent (BOLD) (1)H-MRI to determine renal metabolic flux and oxygen availability, respectively. Suboptimal insulin administration increased pyruvate utilization and metabolic flux via both anaerobic and aerobic pathways in diabetic rats even though insulin did not affect kidney oxygen availability, HbA1c, or oxidative stress. These results imply direct effects of insulin in the regulation of cellular substrate utilization and metabolic fluxes during conditions of poor glycemic control. The study demonstrates that poor glycemic control in combination with suboptimal insulin administration accelerates metabolic alterations by increasing both anaerobic and aerobic metabolism resulting in increased utilization of energy substrates. The results demonstrate the importance of tight glycemic control in insulinopenic diabetes, and that insulin, when administered insufficiently, adds an additional burden on top of poor glycemic control.

  3. Sphingosine-1-phosphate lyase mutations cause primary adrenal insufficiency and steroid-resistant nephrotic syndrome

    Science.gov (United States)

    Prasad, Rathi; Hadjidemetriou, Irene; Meimaridou, Eirini; Buonocore, Federica; Saleem, Moin; Hurcombe, Jenny; Bierzynska, Agnieszka; Barbagelata, Eliana; Bergadá, Ignacio; Cassinelli, Hamilton; Das, Urmi; Krone, Ruth; Hacihamdioglu, Bulent; Sari, Erkan; Yesilkaya, Ediz; Storr, Helen L.; Clemente, Maria; Fernandez-Cancio, Monica; Camats, Nuria; Ram, Nanik; Achermann, John C.; Van Veldhoven, Paul P.; Guasti, Leonardo; Braslavsky, Debora; Guran, Tulay; Metherell, Louise A.

    2017-01-01

    Primary adrenal insufficiency is life threatening and can present alone or in combination with other comorbidities. Here, we have described a primary adrenal insufficiency syndrome and steroid-resistant nephrotic syndrome caused by loss-of-function mutations in sphingosine-1-phosphate lyase (SGPL1). SGPL1 executes the final decisive step of the sphingolipid breakdown pathway, mediating the irreversible cleavage of the lipid-signaling molecule sphingosine-1-phosphate (S1P). Mutations in other upstream components of the pathway lead to harmful accumulation of lysosomal sphingolipid species, which are associated with a series of conditions known as the sphingolipidoses. In this work, we have identified 4 different homozygous mutations, c.665G>A (p.R222Q), c.1633_1635delTTC (p.F545del), c.261+1G>A (p.S65Rfs*6), and c.7dupA (p.S3Kfs*11), in 5 families with the condition. In total, 8 patients were investigated, some of whom also manifested other features, including ichthyosis, primary hypothyroidism, neurological symptoms, and cryptorchidism. Sgpl1–/– mice recapitulated the main characteristics of the human disease with abnormal adrenal and renal morphology. Sgpl1–/– mice displayed disrupted adrenocortical zonation and defective expression of steroidogenic enzymes as well as renal histology in keeping with a glomerular phenotype. In summary, we have identified SGPL1 mutations in humans that perhaps represent a distinct multisystemic disorder of sphingolipid metabolism. PMID:28165343

  4. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  5. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  6. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions.

    Science.gov (United States)

    Khawam, Edward; Abiad, Bachir; Boughannam, Alaa; Saade, Joanna; Alameddine, Ramzi

    2015-01-01

    Great discrepancies are often encountered between the distance fixation and the near-fixation esodeviations and exodeviations. They are all attributed to either anomalies of the AC/A ratio or anomalies of the fusional convergence or divergence amplitudes. We report a case with pseudoconvergence insufficiency and another one with pseudoaccommodative convergence excess. In both cases, conv./div. excess and insufficiency were erroneously attributed to anomalies of the AC/A ratio or to anomalies of the fusional amplitudes. Our purpose is to show that numerous factors, other than anomalies in the AC/A ratio or anomalies in the fusional conv. or divergence amplitudes, can contaminate either the distance or the near deviations. This results in significant discrepancies between the distance and the near deviations despite a normal AC/A ratio and normal fusional amplitudes, leading to erroneous diagnoses and inappropriate treatment models.

  7. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions

    Directory of Open Access Journals (Sweden)

    Edward Khawam

    2015-01-01

    Full Text Available Great discrepancies are often encountered between the distance fixation and the near-fixation esodeviations and exodeviations. They are all attributed to either anomalies of the AC/A ratio or anomalies of the fusional convergence or divergence amplitudes. We report a case with pseudoconvergence insufficiency and another one with pseudoaccommodative convergence excess. In both cases, conv./div. excess and insufficiency were erroneously attributed to anomalies of the AC/A ratio or to anomalies of the fusional amplitudes. Our purpose is to show that numerous factors, other than anomalies in the AC/A ratio or anomalies in the fusional conv. or divergence amplitudes, can contaminate either the distance or the near deviations. This results in significant discrepancies between the distance and the near deviations despite a normal AC/A ratio and normal fusional amplitudes, leading to erroneous diagnoses and inappropriate treatment models.

  8. N-acetylcysteine infusion reduces the resistance index of renal artery in the early stage of systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Edoardo ROSATO; Rosario CIANCI; Biagio BARBANO; Ginevra MENGHI; Antonietta GIGANTE; Carmelina ROSSI; Enrico M ZARDI; Antonio AMOROSO; Simonetta PISARRI; Felice SALSANO

    2009-01-01

    Aim: To evaluate resistance index (RI) changes in renal artery after N-acetylcysteine infusion in patients with systemic sclerosis. Methods: In an open-label study 40 patients with systemic sclerosis (SSc) were treated with N-acetylcysteine (NAC) iv infusion over 5 consecutive hours, at a dose of 0.015g·kg~(-1)·h~(-1).Renal haemodynamic effects were evaluated by color Doppler examination before and after NAC infusion. Results: NAC infusion significantly reduced RI in a group of sclerodermic patients with early/active capillaroscopic pattern, modified Rodnan Total Skin Score (mRTSS)14 and severe-end stage score to the vascular domain of DSS. In patients with reduction of RI after NAC infusion, diffusion capacity for carbon monoxide mean value was significantly higher than in those patients with an increase of RI. No significant differences in renal blood flow were found between patients with different subsets of SSc. Conclusion: In patients with low disease severity NAC ameliorates vascular renal function.

  9. Premature ovarian insufficiency: Pathogenesis and management

    Directory of Open Access Journals (Sweden)

    Anna J Fenton

    2015-01-01

    Full Text Available The term premature ovarian insufficiency (POI describes a continuum of declining ovarian function in a young woman, resulting in an earlier than average menopause. It is a term that reflects the variable nature of the condition and is substantially less emotive than the formerly used "premature ovarian failure" which signaled a single event in time. Contrary to the decline in the age of menarche seen over the last 3-4 decades there has been no similar change in the age of menopause. In developed nations, the average age for cessation of menstrual cycles is 50-52 years. The age is younger among women from developing nations. Much has been written about POI despite a lack of good data on the incidence of this condition. It is believed that 1% of women under the age of 40 years and 0.1% under the age of 30 years will develop POI. Research is increasingly providing information about the pathogenesis and treatments are being developed to better preserve ovarian function during cancer treatment and to improve fertility options. This narrative review summarizes the current literature to provide an approach to best practice management of POI.

  10. Adrenal insufficiency in patients with decompensatedcirrhosis

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Adrenal reserve depletion and overstimulation of thehypothalamus-pituitary-adrenal (HPA) axis are causesfor adrenal insufficiency (AI) in critically ill individuals.Cirrhosis is a predisposing condition for AI in cirrhotics aswell. Both stable cirrhotics and liver transplant patients(early and later after transplantation) have been reportedto present AI. The mechanisms leading to reducedcortisol production in cirrhotics are the combination oflow cholesterol levels (the primary source of cortisol), theincreased cytokines production that overstimulate andexhaust HPA axis and the destruction of adrenal glandsdue to coagulopathy. AI has been recorded in 10%-82%cirrhotics depending on the test used to evaluate adrenalfunction and in 9%-83% stable cirrhotics. The similarityof those proportions support the assumption that AI isan endogenous characteristic of liver disease. However,the lack of a gold standard method for AI assessmentand the limitation of precise thresholds in cirrhoticsmake difficult the recording of the real prevalence of AI.This review aims to summarize the present data overAI in stable, critically ill cirrhotics and liver transplantrecipients. Moreover, it provides information about thecurrent knowledge in the used diagnostic tools and thepossible effectiveness of corticosteroids administration incritically ill cirrhotics with AI.

  11. Pregnancies associated with primary adrenal insufficiency.

    Science.gov (United States)

    Fux Otta, Carolina; Szafryk de Mereshian, Paula; Iraci, Gabriel Santino; Ojeda de Pruneda, María Rosa

    2008-10-01

    To provide a framework for the clinical presentation, evolution, treatment, and outcome of the unusual association between primary adrenal insufficiency (AI) during pregnancy and life-threatening complications for the mother and fetus. Case reports. Pregnant women with AI treated in the Endocrine and Diabetes Department, Hospital Universitario de Maternidad y Neonatología, Córdoba, Argentina. Three pregnant women with AI. Review of hospital records. Clinical, laboratory features, treatment, and outcome. Two women with AI were diagnosed before conception, and one was diagnosed during gestation. Two of the cases were associated with other autoimmune diseases. Two newborns were born with signs of fetal distress, and one passed away hours later. Poor outcome was related to low compliance with treatment. AI is often overlooked during pregnancy because of its rarity and pregnancy-like symptoms. Nevertheless, other autoimmune diseases, hyponatremia, metabolic acidosis, nausea and vomiting, and orthostatic hypotension that does not improve with usual treatment or persists after first trimester should evoke a diagnosis of AI. If diagnosis and treatment are properly managed, pregnancy, labor, and delivery may occur without complications. If not, AI is associated with high maternal and fetal morbidity and mortality.

  12. Prevention Of Chronic Renal Diseases

    Directory of Open Access Journals (Sweden)

    Fejzi Alushi

    2011-10-01

    Full Text Available It is easier to prevent a disease than to cure it. This postulate is a foundation stone of the contemporary medicine, furthermore its mission. The Chronic Kidney Diseases (CKD, amongst them the Chronic Pyelonephrites (CP and the mass kidney reduction  take an important  place in human pathologies in general, and in particular in renal ones. The Chronic Pyelonephrites  are chronic renal pathologies, which on one side are of various causes and on the other side are multi systemic. At the same time they tend, earlier or later, depending on their course, to bring the patient towards the Chronic Kidney Insufficiency  in stage of uremia, consequently in need of substitution therapies e.g. dialysis, peritoneum dialysis or transplant. It is worthy to emphasize that from the prevention and correct cure of CP make profit the patients, the family, the state and in the last analyses  the entire society, because in that way the budget expense destined for the fore going substitution cures, dialysis, peritoneum dialysis or transplant, is considerably  reduced. The same should be mentioned  in relation to the CP and the mass kidney reduction, speaking about our country, which are still at the first place as the very cause of Chronic Kidney  Insufficiencies (CRI, later on advancing toward uremia and terminal uremia along with its grave consequences. In general  the very foundation of the CP is on  the  infections of urinary roads, in particular on the complicated ones, among them it should be mentioned-congenital kidney anomalies, renal calculosis  so much present in our country, and pathologies of segment or vesical-ureteral reflux, and rarely the pathologies of prostate.

  13. Early Onset of Tenofovir-Induced Renal Failure: Case Report and Review of the Literature

    OpenAIRE

    Patel, Shilpa M.; Zembower, Teresa R.; Frank Palella; Kanwar, Yashpal S.; Ahya, Shubhada N.

    2007-01-01

    Tenofovir is an acyclic nucleotide analogue reverse transcriptase inhibitor that is commonly prescribed as part of a highly active antiretroviral therapy (HAART) regimen in HIV-infected patients. Although it is generally well tolerated, renal insufficiency has been associated with its use. We report a biopsy-proven case of acute renal failure that developed within weeks of initiating a HAART regimen containing tenofovir, and review the literature with specific attention to cases of renal fail...

  14. Power doppler sonography in early renal transplantation: Does it differentiate acute graft rejection from acute tubular necrosis?

    Directory of Open Access Journals (Sweden)

    Haytham M Shebel

    2014-01-01

    Full Text Available To evaluate the role of power Doppler in the identification and differentiation bet-ween acute renal transplant rejection and acute tubular necrosis (ATN, we studied 67 live donor renal transplant recipients. All patients were examined by spectral and power Doppler sono-graphy. Assessment of cortical perfusion (CP by power Doppler was subjective, using our grading score system: P0 (normal CP; homogenous cortical blush extending to the capsule, P1 (reduced CP; cortical vascular cut-off at interlobular level, P2 (markedly reduced CP; scattered cortical color flow at the interlobar level. Renal biopsies were performed during acute graft dysfunction. Pathological diagnoses were based on Banff classification 1997. The Mann- Whitney test was used to test the difference between CP grades with respect to serum creatinine (SCr, and resistive index (RI. For 38 episodes of acute graft rejection grade I, power Doppler showed that CP was P1 and RI ranging from 0.78 to 0.89. For 21 episodes of acute graft rejection grade II, power Doppler showed that CP was P1, with RI ranging from 0.88 to >1. Only one case of grade III rejection had a CP of P2. Twelve biopsies of ATN had CP of P0 and RI ranging from 0.80 to 0.89 There was a statistically significant correlation between CP grading and SCr (P <0.01 as well as between CP grading and RI (P <0.05. CP grading had a higher sensitivity in the detection of early acute rejection compared with RI and cross-sectional area measurements. We conclude that power Doppler is a non-invasive sensitive technique that may help in the detection and differentiation between acute renal transplant rejection and ATN, particularly in the early post-transplantation period.

  15. Evaluation of ischemic cerebrovascular disorders by RI angiography

    Energy Technology Data Exchange (ETDEWEB)

    Matsumori, Kuniaki; Beppu, Toshio; Nakayama, Kenji; Saito, Motoyoshi; Aoki, Nobuo; Tokiwa, Kaichi; Tasei, Yukimitsu

    1984-11-01

    In evaluating the hemodynamic status of the brain in patients with ischemic cerebrovascular disorders, the use of an invasive method may occasionally be precluded by patient's old age and the presence of complications. In such an instance we electively use RI angiography with sup(99m)Tc-HSA as a less invasive method of evaluating cerebral hemodynamics. This procedure was performed in a total of 30 patients at our department, 22 inpatients with ischemic cerebrovascular disorders and 8 with headache who served as controls. Time activity curves constructed from RI angiograms thus obtained were classified into 5 types according to their pattern. The pattern of time activity curve had no correlation with the size of infarcted area but was found to correlate with the length of time elapsing from the onset (disease stage) and hence was thought to be of prognostic value. The mean transit time, half time and appearance time to peak time were estimated for each type of time activity curve. However, values of these parameters for any type of the curve were not significantly different from control values. It was thus considered that comparing the curves, as they were, from the healthy and affected sides of the patient's brain was the simplest and most useful method of understanding the existing status of ischemic cerebrovascular disorders. (author).

  16. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate.

    Science.gov (United States)

    Damkjaer, M; Wang, T; Brøndum, E; Østergaard, K H; Baandrup, U; Hørlyck, A; Hasenkam, J M; Smerup, M; Funder, J; Marcussen, N; Danielsen, C C; Bertelsen, M F; Grøndahl, C; Pedersen, M; Agger, P; Candy, G; Aalkjaer, C; Bie, P

    2015-08-01

    The tallest animal on earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension-related damage. We hypothesized that a species-specific evolutionary adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal interstitial hydrostatic pressure (RIHP) was assessed by inserting a needle into the medullary parenchyma. Doppler ultrasound measurements provided renal artery resistive index (RI). Hormone concentrations as well as biomechanical, structural and histological characteristics of vascular and renal tissues were determined. GFR averaged 342 ± 99 mL min(-1) and ERPF 1252 ± 305 mL min(-1) . RIHP varied between 45 and 140 mmHg. Renal pelvic pressure was 39 ± 2 mmHg and renal venous pressure 32 ± 4 mmHg. A valve-like structure at the junction of the renal and vena cava generated a pressure drop of 12 ± 2 mmHg. RI was 0.27. The renal capsule was durable with a calculated burst pressure of 600 mmHg. Plasma renin and AngII were 2.6 ± 0.5 mIU L(-1) and 9.1 ± 1.5 pg mL(-1) respectively. In giraffes, GFR, ERPF and RI appear much lower than expected based on body mass. A strong renal capsule supports a RIHP, which is >10-fold that of other mammals effectively reducing the net filtration pressure and protecting against the high MAP. © 2015 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  17. Aliskiren-associated acute renal failure with hyperkalemia.

    Science.gov (United States)

    Venzin, R M; Cohen, C D; Maggiorini, M; Wüthrich, R P

    2009-03-01

    We report the first case of acute renal failure with hyperkalemia associated with the recently marketed direct renin inhibitor aliskiren. To optimize blood pressure control, the antihypertensive medication of a 76-year-old hypertensive female patient was changed from the angiotensin II receptor antagonist irbesartan to aliskiren. Spironolactone was continued, as serum creatinine and potassium levels were initially normal. Two weeks later the patient presented with acute oliguric renal failure, symptomatic hyperkalemia and metabolic acidosis, necessitating emergency dialytic treatment. Unrecognized pre-existing renal insufficiency (CKD Stage 2 - 3) and the continuation of spironolactone were identified as predisposing risk factors.

  18. Renal tuberculosis

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    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  19. Renale Osteopathie

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    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  20. Drugs of abuse and renal disease.

    Science.gov (United States)

    Bakir, A A; Dunea, G

    1996-03-01

    The complications of drug abuse encompass a spectrum of glomerular, interstitial, and vascular diseases. They comprise the heroin-associated nephropathy seen in African-American intravenous drug addicts, which, however, has given way in the 1990s to HIV-associated nephropathy. Infections with methicillin-resistant Staphylococcus aureus may cause acute glomerulonephritis by releasing bacterial superantigens. Hepatitis C has supplanted hepatitis B and may give rise to membranoproliferative glomerulonephritis and cryoglobulinemia. Addicts who inject drugs subcutaneously ('skin popping') may develop amyloidosis. Cocaine causes rhabdomyolysis, severe hypertension, occasionally renal failure in the absence of rhabdomyolysis, and may hasten progression to uremia in patients with underlying renal insufficiency. 'Ecstasy', an amphetamine-like recreational drug, has caused acute renal failure, electrolyte disturbances, and malignant hypertension. In Belgium and some other European countries, women taking Chinese herbs in a slimming regimen have developed a severe and irreversible interstitial fibrosis that is assuming epidemic proportions.

  1. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  2. Inflammatory mediators in mastitis and lactation insufficiency.

    Science.gov (United States)

    Ingman, Wendy V; Glynn, Danielle J; Hutchinson, Mark R

    2014-07-01

    Mastitis is a common inflammatory disease during lactation that causes reduced milk supply. A growing body of evidence challenges the central role of pathogenic bacteria in mastitis, with disease severity associated with markers of inflammation rather than infection. Inflammation in the mammary gland may be triggered by microbe-associated molecular patterns (MAMPs) as well as danger-associated molecular patterns (DAMPs) binding to pattern recognition receptors such as the toll-like receptors (TLRs) on the surface of mammary epithelial cells and local immune cell populations. Activation of the TLR4 signalling pathway and downstream nuclear factor kappa B (NFkB) is critical to mediating local mammary gland inflammation and systemic immune responses in mouse models of mastitis. However, activation of NFkB also induces epithelial cell apoptosis and reduced milk protein synthesis, suggesting that inflammatory mediators activated during mastitis promote partial involution. Perturbed milk flow, maternal stress and genetic predisposition are significant risk factors for mastitis, and could lead to a heightened TLR4-mediated inflammatory response, resulting in increased susceptibility and severity of mastitis disease in the context of low MAMP abundance. Therefore, heightened host inflammatory signalling may act in concert with pathogenic or commensal bacterial species to cause both the inflammation associated with mastitis and lactation insufficiency. Here, we present an alternate paradigm to the widely held notion that breast inflammation is driven principally by infectious bacterial pathogens, and suggest there may be other therapeutic strategies, apart from the currently utilised antimicrobial agents, that could be employed to prevent and treat mastitis in women.

  3. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  4. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  5. Obesity-Mediated Autophagy Insufficiency Exacerbates Proteinuria-induced Tubulointerstitial Lesions

    Science.gov (United States)

    Yamahara, Kosuke; Kume, Shinji; Koya, Daisuke; Tanaka, Yuki; Morita, Yoshikata; Chin-Kanasaki, Masami; Araki, Hisazumi; Isshiki, Keiji; Araki, Shin-ichi; Haneda, Masakazu; Matsusaka, Taiji; Kashiwagi, Atsunori; Maegawa, Hiroshi

    2013-01-01

    Obesity is an independent risk factor for renal dysfunction in patients with CKDs, including diabetic nephropathy, but the mechanism underlying this connection remains unclear. Autophagy is an intracellular degradation system that maintains intracellular homeostasis by removing damaged proteins and organelles, and autophagy insufficiency is associated with the pathogenesis of obesity-related diseases. We therefore examined the role of autophagy in obesity-mediated exacerbation of proteinuria-induced proximal tubular epithelial cell damage in mice and in human renal biopsy specimens. In nonobese mice, overt proteinuria, induced by intraperitoneal free fatty acid–albumin overload, led to mild tubular damage and apoptosis, and activated autophagy in proximal tubules reabsorbing urinary albumin. In contrast, diet-induced obesity suppressed proteinuria-induced autophagy and exacerbated proteinuria-induced tubular cell damage. Proximal tubule-specific autophagy-deficient mice, resulting from an Atg5 gene deletion, subjected to intraperitoneal free fatty acid–albumin overload developed severe proteinuria-induced tubular damage, suggesting that proteinuria-induced autophagy is renoprotective. Mammalian target of rapamycin (mTOR), a potent suppressor of autophagy, was activated in proximal tubules of obese mice, and treatment with an mTOR inhibitor ameliorated obesity-mediated autophagy insufficiency. Furthermore, both mTOR hyperactivation and autophagy suppression were observed in tubular cells of specimens obtained from obese patients with proteinuria. Thus, in addition to enhancing the understanding of obesity-related cell vulnerability in the kidneys, these results suggest that restoring the renoprotective action of autophagy in proximal tubules may improve renal outcomes in obese patients. PMID:24092929

  6. La lepra y el riñón

    Directory of Open Access Journals (Sweden)

    Gerzain Rodríguez

    1999-03-01

    Full Text Available A review is made of leprosy's effect on the kidneys when related to secondary phenomena, such as precipitation within glomerules of antigen-antibody complexes, or fibrillar proteins resulting from chronic inflamation orto complications dueto polychemotherapy against the leprosy bacillus, ¡.e. not being due to M. Ieprae presence within the renal nerves or parenchyma. The following circumstances have been described: a defects in urine concentration and acidification; b acute and chronic interstitial nephritis; c acute renal failure; d systemic secondary or reactive amyloidosis; and e glomerulonephritis. It is also pointed out that leprosy is not a contraindication for renal transplant, because the disease (having already been cured may not become active again, or, if it does, or erupts because of the irnmunosuppression needed to maintain the transplant, can be controlled with availble polychemotherpy.

  7. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Robert Marcovich

    2003-06-01

    Full Text Available Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

  8. Tissue elasticity quantification by acoustic radiation force impulse for the assessment of renal allograft function.

    Science.gov (United States)

    He, Wan-Yuan; Jin, Yun-Jie; Wang, Wen-Ping; Li, Chao-Lun; Ji, Zheng-Biao; Yang, Cheng

    2014-02-01

    Acoustic radiation force impulse (ARFI) quantification, a novel ultrasound-based elastography method, has been used to measure liver fibrosis. However, few studies have been performed on the use of ARFI quantification in kidney examinations. We evaluated renal allograft stiffness using ARFI quantification in patients with stable renal function (n = 52) and those with biopsy-proven allograft dysfunction (n = 50). ARFI quantification, given as shear wave velocity (SWV), was performed. The resistance index (RI) was calculated by pulsed-wave Doppler ultrasound, and clinical and laboratory data were collected. Morphologic changes in transplanted kidneys were diagnosed by an independent pathologist. Mean SWV was more significantly negatively correlated with estimated glomerular filtration rate (eGFR) (r = -0.657, p renal allograft dysfunction were 72.0% and 86.5% (cutoff value = 2.625), respectively. The latter values were better than those of RI, which were 62.0% and 69.2% (cutoff value = 0.625), respectively. The coefficient of variation for repeat SWV measurements of the middle part of transplanted kidney was 8.64%, and inter-observer agreement on SWV was good (Bland-Altman method, ICC = 0.890). In conclusion, tissue elasticity quantification by ARFI is more accurate than the RI in diagnosing renal allograft function.

  9. "Petrified ears" with idiopathic adult-onset pituitary insufficiency

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    Yashpal Gogate

    2012-01-01

    Full Text Available "Petrified ears" or calcification of auricular cartilage is an uncommonly reported condition. The most common causes of this phenomenon are local trauma, frost bite, and inflammation. Adrenal insufficiency is the most frequent systemic disease associated with auricular calcification. We present a case of idiopathic adult-onset pituitary insufficiency with hypocortisolism and bilateral auricular calcification. Recognition of the association between auricular calcification and adrenal insufficiency can be an important step toward the identification of a life-threatening cortisol deficiency.

  10. Effect of NADPH oxidase inhibitor-apocynin on the expression of Src homology-2 domain-containing phosphatase-1 (SHP-1 exposed renal ischemia/reperfusion injury in rats

    Directory of Open Access Journals (Sweden)

    Zhiming Li

    2015-01-01

    Full Text Available This study was designed to evaluate whether NADPH oxidase inhibitor (apocynin preconditioning induces expression of Src homology-2 domain-containing phosphatase-1 (SHP-1 to protect against renal ischemia/reperfusion (I/R injury (RI/RI in rats. Rats were pretreated with 50 mg/kg apocynin, then subjected to 45 min ischemia and 24 h reperfusion. The results indicated that apocynin preconditioning improved the recovery of renal function and nitroso-redox balance, reduced oxidative stress injury and inflammation damage, and upregulated expression of SHP-1 as compared to RI/RI group. Therefore our study demonstrated that apocynin preconditioning provided a protection to the kidney against I/R injury in rats partially through inducing expression of SHP-1.

  11. Early respiratory insufficiency in the ALS patient: a case study.

    Science.gov (United States)

    Houseman, Gail; Kelley, Mary

    2005-08-01

    Respiratory insufficiency is a problem that develops in nearly all people diagnosed with amyotrophic lateral sclerosis (ALS). Noninvasive positive pressure ventilation (NIPPV) is the treatment of choice for ALS patients with respiratory insufficiency. Forced vital capacity (FVC) is the test most commonly used to qualify ALS patients for NIPPV; however, some research suggests FVC may not be the best tool to measure early respiratory insufficiency in all patients with ALS. This case study introduces an ALS patient who had normal FVC results, symptoms of respiratory insufficiency, and abnormal nocturnal oximetry. After NIPPV initiation, the patient reported improved sleep and less daytime fatigue, which he associated with the start of NIPPV treatment.

  12. Chronic cerebrospinal venous insufficiency: current perspectives

    Directory of Open Access Journals (Sweden)

    Simka M

    2014-03-01

    Full Text Available Marian Simka Department of Nursing, College of Applied Sciences, Ruda Slaska, Poland Abstract: This review summarizes the research to date on chronic cerebrospinal venous insufficiency (CCSVI. CCSVI was initially defined as a clinical syndrome comprising stenoses of the internal jugular and/or azygos veins, characterized by collateral venous outflows and reduced cerebral blood flow, and was found primarily in patients with multiple sclerosis. However, the published evidence on CCSVI is very discordant. Catheter venography studies gave a regular picture, with the majority of patients with multiple sclerosis presenting with demonstrable outflow abnormalities in the veins draining the central nervous system. The prevalence of these lesions was over 50%, and even higher (about 90% when more liberal definition of an abnormality or intravascular sonography was used. Further, the results of magnetic resonance venography studies have been quite consistent, in that stenoses of the internal jugular veins have been found in 25%–70% of patients with multiple sclerosis. In contrast, Doppler sonography studies have revealed CCSVI in 0% to 100% of patients. The research is currently suggesting that CCSVI is not a single entity, but rather a group of different anatomic and functional venous abnormalities. Regarding venous outflow from the brain, a patient can present either with diminished inflow to the internal jugular veins resulting from decreased cerebral circulation or with externally compressed or hypoplastic internal jugular veins or stenotic jugular valves. Considering these many faces of CCSVI, it becomes more comprehensible as to why the results of the studies, especially those utilizing Doppler sonography, have been so discordant. Not only were investigators using different diagnostic modalities and distinct protocols, but they were not looking for the same pathology. Since these abnormalities were indeed differently prevalent in patients and

  13. PEMBERITAAN PENCALONAN RUHUT SITOMPUL MENJADI KETUA KOMISI III DPR RI (Analisis Framing Pemberitaan Pencalonan Ruhut Sitompul Menjadi Ketua Komisi III DPR RI Di Surat Kabar Harian Sindo)

    OpenAIRE

    Barus, B M Vikana Nove Riahta

    2014-01-01

    Penelitian ini mengkaji pemberitaan tentang pencalonan nama Ruhut Sitompul untuk menjadi pimpinan baru di Komisi III DPR RI di Surat Kabar Harian Sindo khususnya biro Yogya. Sehingga, rumusan masalah dari penelitian ini adalah bagaimana surat kabar harian Sindo mengemas pemberitaan pencalonan Ruhut Sitompul menjadi ketua komisi III DPR RI. Berangkat dari cara pengemasan atau pembingkaian media terhadap berita ini, penelitian kemudian menggunakan model framing milik Zhongdang Pan dan Gerald M....

  14. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  15. RIKEN RI Beam Factory - Recent Results and Perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Motobayashi, T. [RIKEN Nisina Center, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan)

    2010-03-01

    The new facility of the RIKEN RI Beam Factory (RIBF) is dedicated to provide beams of unstable nuclei very far from the stability valley. It started operation at the end of 2006 after 10 years construction. Three newly-built cyclotrons boost the energy up to 345 MeV/nucleon for various heavy-ion beams accelerated by pre-existed accelerators, a linac (RILAC) and a ring cyclotron (RRC), which have been operated in 20 years. The first experiment in the year 2007, production of new neutron-rich palladium isotopes, was followed by the first experiment of secondary reactions at the end of 2008. The capability in producing nuclei far from the stability is exceeding the one of any other facilities in the world, and will reach the level where about 1000 unknown isotopes can be created. Several new experimental installations are planned or being constructed.

  16. CCD $UBV(RI)_{C}$ Photometry of Twenty Open Clusters

    CERN Document Server

    Oralhan, Inci Akkaya; Schuster, William J; Michel, Raúl; Chavarría, Carlos

    2014-01-01

    Fundamental astrophysical parameters have been derived for 20 open clusters (O\\!Cs) using CCD~$U\\!BV\\!(RI)_C$ photometric data observed with the 84~cm telescope at the San Pedro M\\'artir National Astronomical Observatory, M\\'exico. The interstellar reddenings, metallicities, distances, and ages have been compared to the literature values. Significant differences are usually due to the usage of diverse empirical calibrations and differing assumptions, such as concerning cluster metallicity, as well as distinct isochrones which correspond to differing element-abundance ratios, internal stellar physics, and photometric systems. Different interstellar reddenings, as well as varying reduction and cluster-membership techniques, are also responsible for these kinds of systematic differences and errors. The morphological ages, which are derived from the morphological indices ($\\delta V$ and $\\delta 1$) in the CM diagrams, are in good agreement with the isochrone ages of 12 O\\!Cs, those with good red clump (RC) and re...

  17. Endurance test on IR rig for RI production

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Heung June; Youn, Y. J.; Han, H. S.; Hong, S. B.; Cho, Y. G.; Ryu, J. S

    2000-12-01

    This report presents the pressure drop, vibration and endurance test results for IR rig for RI production which were desigened and fabricated by KAERI. From the pressure drop test results, it is noted that the flow rate through the IR rig corresponding to the pressure drop of 200 kPa is measured to be about 3.12 kg/sec. Vibration frequency for the IR rig ranges from 13 to 17 Hz. RMS(Root Mean Square) displacement for the IR rig is less than 30 {mu}m, and the maximum displacement is less than 110{mu}m. These experimental results show that the design criteria of IR rig meet the HANARO limit conditions. Endurance test results show that the appreciable fretting wear for the IR rig does not occur, however tiny trace of wear between contact points is observed.

  18. Renal scar formation after urinary tract infection in children.

    Science.gov (United States)

    Park, Young Seo

    2012-10-01

    Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects reflux-associated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

  19. Renal scar formation after urinary tract infection in children

    Directory of Open Access Journals (Sweden)

    Young Seo Park

    2012-10-01

    Full Text Available Urinary tract infection (UTI is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during