- Acute Kidney Injury in Patients Receiving Systemic Treatment for Cancer: A Population-Based Cohort Study. [Journal Article]
- JNCIJ Natl Cancer Inst 2018 Nov 13
- CONCLUSIONS: Cancer-related AKI is common and associated with advanced stage, chronic kidney disease, diabetes, and concomitant receipt of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Risk is heightened in the 90 days after systemic therapy. Preventive strategies are needed to address the increasing burden of AKI in this population.
- Acute Flaccid Paralysis in an 11-Year-Old. [Journal Article]
- PEPediatr Emerg Care 2018 Nov 12
- Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and subsequent release of intracellular components into the systemic circulation. We report a case of rhabdomyolysis causing acute par...
Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and subsequent release of intracellular components into the systemic circulation. We report a case of rhabdomyolysis causing acute paralysis from underlying and unrecognized hypothyroidism in an 11-year-old girl. To date, publications of rhabdomyolysis secondary to hypothyroidism have been limited, especially in the pediatric population. Early intervention with intravenous fluids and levothyroxine led to resolution of our patient's symptoms and is overall important in preventing the serious sequela of rhabdomyolysis including renal failure, cardiac dysrhythmias, compartment syndrome, and disseminated intravascular coagulation.
- Long-term renal outcomes and mortality following renal injury among myocardial infarction patients treated by primary percutaneous intervention. [Journal Article]
- CACoron Artery Dis 2018 Nov 12
- CONCLUSIONS: Progression to AKD following an acute renal insult in STEMI is frequent and associated with worse survival and adverse long-term renal outcomes.
- Acute milk-alkali syndrome [Journal Article]
- EDEndocrinol Diabetes Metab Case Rep 2018 Oct 31; 2018(1)
- A 74-year-old woman presented with progressive lethargy, confusion, poor appetite and abdominal pain. She was found to have non-PTH-mediated severe hypercalcemia with renal failure and metabolic alka...
A 74-year-old woman presented with progressive lethargy, confusion, poor appetite and abdominal pain. She was found to have non-PTH-mediated severe hypercalcemia with renal failure and metabolic alkalosis. Extensive workup for hypercalcemia to rule out alternate etiology was unrevealing. Upon further questioning, she was taking excess calcium carbonate (Tums) for her worsening heartburn. She was diagnosed with milk-alkali syndrome (MAS). Her hypercalcemia and alkalosis recovered completely with aggressive hydration along with improvement in her renal function. High index of suspicion should be maintained and history of drug and supplements, especially calcium ingestion, should be routinely asked in patients presenting with hypercalcemia to timely diagnose MAS and prevent unnecessary tests and treatments.
- Case 19-2018: A 15-Year-Old Girl with Acute Kidney Injury. [Letter]
- NEJMN Engl J Med 2018 Nov 01; 379(18):e34
- Use of Renin Angiotensin System Blockers After Acute Kidney Injury: Balancing Tradeoffs. [Journal Article]
- JIMJAMA Intern Med 2018 Oct 27
- Association of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use With Outcomes After Acute Kidney Injury. [Journal Article]
- JIMJAMA Intern Med 2018 Oct 27
- CONCLUSIONS: Among patients with AKI, ACEI or ARB therapy appeared to be associated with lower mortality but a higher risk of hospitalization for a renal cause. These results suggest a potential benefit of ACEI or ARB use after AKI, but cautious monitoring for renal-specific complications may be warranted.
- Acute kidney injury post cardiac catheterization: Does vascular access route matter? [Journal Article]
- CCCurr Cardiol Rev 2018 Nov 12
- CONCLUSIONS: Transradial access offers several advantages to a patient at high risk of acute kidney injury undergoing cardiac catheterization. Further large studies are needed to establish this trend in the years ahead.
- Design of the Randomized, Placebo-Controlled Evolocumab for Early Reduction of LDL-Cholesterol Levels in Patients with Acute Coronary Syndromes (EVOPACS) Trial. [Journal Article]
- CCClin Cardiol 2018 Nov 12
- Statins lower low-density lipoprotein cholesterol (LDL-C) and improve clinical outcomes in patients with atherosclerotic cardiovascular disease (CVD). Patients with acute coronary syndromes (ACS) oft...
Statins lower low-density lipoprotein cholesterol (LDL-C) and improve clinical outcomes in patients with atherosclerotic cardiovascular disease (CVD). Patients with acute coronary syndromes (ACS) often do not achieve LDL-C targets despite potent statin treatment, and have a particularly high risk of early recurrent events. Evolocumab, a proprotein convertase subtilisin/kexin type (PCSK9)-inhibitor resulting in rapid, marked LDL-C reduction, has been studied in hypercholesterolemic subjects without CVD and stabilized patients with CVD; the feasibility, safety, and efficacy of this treatment initiated in the acute phase of ACS remain unknown. We report the design of Evolocumab for Early Reduction of LDL-Cholesterol Levels in Patients with ACS (EVOPACS), a phase-3, multicenter, randomized, double-blind, placebo-controlled trial to assess the feasibility, safety, and LDL-C-lowering efficacy of evolocumab on top of atorvastatin 40 mg in patients with ACS. The primary endpoint is percent change in LDL-C from baseline to 8 weeks. Secondary endpoints are adverse events and serious adverse events. Against a background of beneficial cardiovascular effects of statins beyond LDL-C lowering and in view of preclinical evidence of similar effects of PCSK9 inhibition, the study will also address a variety of exploratory endpoints including the change in C-reactive protein and other inflammatory biomarkers; platelet reactivity; and occurrence of contrast-induced acute kidney injury and myocardial injury in patients undergoing cardiac catheterization. An intracoronary imaging sub-study will assess the change from baseline in the lipid core burden index in non-culprit lesions, as assessed by serial near-infrared spectroscopy. Recruitment began in January 2018 and enrolment of 308 patients is planned. This article is protected by copyright. All rights reserved.
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- Clinical outcomes depending on acute blood pressure after cerebral hemorrhage. [Journal Article]
- ANAnn Neurol 2018 Nov 12
- CONCLUSIONS: Beneficial effects of lowering and maintaining SBP at 120-130 mmHg during the first 24 hours on clinical outcomes by suppressing hematoma expansion was somewhat offset by cardio-renal complications. This article is protected by copyright. All rights reserved.