- Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management. [Journal Article]
- NNephron 2017 Apr 26; 136(3)
- CONCLUSIONS: Decline in kidney function is limited under routine clinical management with monitoring of renal function and interventions including decision to continue or discontinue TDF.
- Kidney disease in patients with obesity: It is not always obesity-related glomerulopathy alone. [Journal Article]
- ORObes Res Clin Pract 2017 Apr 22
- CONCLUSIONS: Diverse kidney pathology superimposed on ORG is present in patients with obesity with varied clinical renal disease, some of which may be amenable for therapy. Kidney biopsy will assist in delineating these lesions for appropriate management and prognosis.
- Angiopoietin-like-4 and minimal change disease. [Journal Article]
- PlosPLoS One 2017; 12(4):e0176198
- CONCLUSIONS: Neither serum nor urine Angptl4 appear to be good biomarkers in MCD. Elevated urinary Angptl4 n glomerular disease appears to reflect the degree of proteinuria rather than any specific disease.
- Prevalence and predictors of thyroid functional abnormalities in newly diagnosed AL amyloidosis. [Journal Article]
- JIJ Intern Med 2017 Apr 24
- CONCLUSIONS: A significant proportion of patients with AL amyloidosis present with hypothyroidism, predominantly subclinical, which carries a survival disadvantage. Routine assessment of TSH in these patients is warranted.
- Tubular atrophy/interstitial fibrosis scores of Oxford classification combinded with proteinuria level at biopsy provides earlier risk prediction in lgA nephropathy. [Journal Article]
- SRSci Rep 2017 Apr 24; 7(1):1100
- The predictive effect of combining MEST with clinical data at biopsy on renal survival outcomes has not been investigated in patients with IgA nephropathy (IgAN). MEST of The Oxford classification of...
The predictive effect of combining MEST with clinical data at biopsy on renal survival outcomes has not been investigated in patients with IgA nephropathy (IgAN). MEST of The Oxford classification of IgAN and 24-hour urine proteinuia measured at enrollment. The primary outcome was a composite of either ESRD (eGFR to <15 ml/min per 1.73 m(2)), or a permanent reduction in eGFR to below 50% of the value at biopsy. 742 patients were enrolled and follow-up >3 years, and were divided into two groups according to eGFR levels at biopsy. Multivariable logistical regression revealed that proteinuria at biopsy (OR 5.307 (95% Cl 3.003 to 9.376) p = 0.000), tubular atrophy/interstitial fibrosis scores (T) in MEST (OR 3.915 (95%Cl 2.710 to 5.654) p = 0.000) were the two predictors of eGFR decline for IgAN patients. Kaplan-Meier survival curves show significant difference in renal survival outcome among each T scores groups at biopsy (T0, T1, T2) (P < 0.05) and proteinuria levels at biopsy (P < 0.05), individially. Patients with T2 combined proteinuria at biopsy have the worst renal survival outcome. In conclusion, T scores in MEST classification combined with proteinuria at biopsy could be one of the important early predictors for the renal survial outcomes in patients with IgAN.
- Early introduction of oral paricalcitol in renal transplant recipients. An open-label randomized study. [Journal Article]
- TITranspl Int 2017 Apr 24
- In stable renal transplant recipients with hyperparathyroidism, previous studies have indicated that vitamin D agonist treatment might have anti-proteinuric effects. Animal studies indicate possible ...
In stable renal transplant recipients with hyperparathyroidism, previous studies have indicated that vitamin D agonist treatment might have anti-proteinuric effects. Animal studies indicate possible anti-fibrotic and anti-inflammatory effects. Early introduction of paricalcitol in de-novo renal transplant recipients might reduce proteinuria and prevent progressive allograft fibrosis. We performed a single-centre, prospective, randomized, open-label trial investigating effects of paricalcitol 2μg/day added to standard care. Participants were included 8 weeks after engraftment, and followed for 44 weeks. Primary endpoint was change in spot urine albumin/creatinine ratio. Exploratory microarray analyses of kidney biopsies at study end investigated potential effects on gene expression. Secondary endpoints included change in glomerular filtration rate (GFR), pulse wave velocity (PWV) and endothelial function measured by peripheral arterial tonometry as reactive hyperemia index (RHI). Seventy-seven de-novo transplanted kidney allograft recipients were included, 37 receiving paricalcitol. Paricalcitol treatment lowered PTH-levels (p=0.01) but did not significantly reduce albuminuria (p=0.76), change vascular parameters (PWV; p=0.98, RHI; p=0.33) or influence GFR (p=0.57). Allograft gene expression was not influenced. To summarize, in newly transplanted renal transplant recipients paricalcitol reduced PTH and was well tolerated without negatively affecting kidney function. Paricalcitol did not significantly reduce/prevent albuminuria, improve parameters of vascular health or influence allograft gene expression. (ClinicalTrials. gov number NCT01694160 (2012/107D)) This article is protected by copyright. All rights reserved.
- Polycythemia, capillary rarefaction, and focal glomerulosclerosis in two adolescents born extremely low birth weight and premature. [Journal Article]
- PNPediatr Nephrol 2017 Apr 24
- CONCLUSIONS: Since kidney function was almost normal and fibrosis was not severe, we consider that the capillary rarefaction and polycythemia associated with elevated EPO levels were largely attributable to preterm birth and/or IUGR.
- Chronic Nephropathy from Dietary Hyperoxaluria: Sustained Improvement of Renal Function after Dietary Intervention. [Journal Article]
- CCureus 2017 Mar 20; 9(3):e1105
- A 56-year-old man with stable chronic kidney disease (CKD) for two years following a single episode of calcium oxalate urolithiasis developed progressive elevation of his serum creatinine concentrati...
A 56-year-old man with stable chronic kidney disease (CKD) for two years following a single episode of calcium oxalate urolithiasis developed progressive elevation of his serum creatinine concentration. Urinalysis revealed pyuria and white cell casts, a few red blood cells, minimal proteinuria, and no crystals. Urine culture was sterile. Gallium scintigraphy was consistent with interstitial nephritis. Proton pump inhibitor intake was discontinued, and a short course of oral corticosteroids was initiated. Percutaneous kidney biopsy, performed because of the continued deterioration of renal function to a minimum estimated glomerular filtration rate (eGFR) value of 15 mL/min per 1.73 m(2) and persistent pyuria, revealed deposition of oxalate crystals in the tubules and interstitium, pronounced tubular changes, and interstitial nephritis and fibrosis. Urinary oxalate excretion was very high, in the range usually associated with primary hyperoxaluria. However, investigations for primary or enteric hyperoxaluria were negative. He reported a diet based on various nuts high in oxalate content. Estimated oxalate content in the diet was, for years, approximately four times higher than that in the average American diet. The institution of a diet low in oxalates resulted in the rapid normalization of urinary oxalate excretion and urinary sediment and in the slow, continuous improvement of renal function to near normal levels (eGFR 59 mL/min/1.73 m(2)) before his death from a brain malignancy 3.5 years later. The manifestations of nephropathy secondary to dietary hyperoxaluria, including the urine findings, can be indistinguishable from other types of interstitial nephritis. The diagnosis of dietary hyperoxaluria requires careful dietary history and a kidney biopsy. Identifying dietary hyperoxaluria as the cause of CKD is important because the decrease in dietary oxalate intake without any other measures can lead to sustained improvement in renal function.
- Improvement in Nutritional Status in Patients With Chronic Kidney Disease-4 by a Nutrition Education Program With No Impact on Renal Function and Determined by Male Sex. [Journal Article]
- JRJ Ren Nutr 2017 Apr 20
- CONCLUSIONS: The NEP in NDD-CKD generally improved nutritional status as measured by PEW parameters, but individual poorer results indicated the need to pay special attention to female sex and low body mass index at the start of the program.
New Search Next
- Urine clusterin/apolipoprotein J is linked to tubular damage and renal outcomes in patients with type 2 diabetes mellitus. [Journal Article]
- CEClin Endocrinol (Oxf) 2017 Apr 23
- CONCLUSIONS: Urine clusterin reflects tubular damage in the early-stage of DKD. The increase of urine clusterin along with albuminuria could be an independent predictive marker for the progression of DKD in type 2 diabetes. This article is protected by copyright. All rights reserved.