Plasmapheresis in antiglomerular basement membrane disease: How much is enough?
PMID: 26709522 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 28, 2015 Category: Urology & Nephrology Authors: Relia N, Cheema Y, Tuazon J, Paprello J Tags: Clin Nephrol Source Type: research

Revisiting medullary tophi: a link between uric acid and progressive chronic kidney disease?
CONCLUSION: Medullary tophi appear to be far more likely to occur in CKD compared to no-CKD patients. This cross-sectional study cannot determine whether medullary tophi are a cause or consequence of CKD. However, given their location and bulk, it is possible that medullary tophi contribute to progression of established CKD by causing upstream nephron damage. PMID: 26709523 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 28, 2015 Category: Urology & Nephrology Authors: Ayoub I, Almaani S, Brodsky S, Nadasdy T, Prosek J, Hebert L, Rovin B Tags: Clin Nephrol Source Type: research

Fibrillary glomerulonephritis associated with limited scleroderma: a case report.
We present the case of a 56-year-old woman with limitedtype scleroderma and remote discoid lupus, evaluated for dipstick positive hematuria and preserved kidney function. Serologies were negative. Kidney biopsy revealed fibrillary GN. Her renal function and proteinuria remain stable 4 years after her initial diagnosis. This case is unusual both in its presentation and evolution, but mostly because it is the first reported case of fibrillary GN in association with limited type scleroderma. PMID: 26709524 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 28, 2015 Category: Urology & Nephrology Authors: Nakhoul GN, Simon JF Tags: Clin Nephrol Source Type: research

Diagnostic and management considerations for nephrolithiasis in the gravid patient.
Abstract Renal colic is recognized as one of the most common causes of nonobstetric hospitalization during pregnancy. Furthermore, both symptomatic urolithiasis and its management have been associated with preterm labor, markedly amplifying the "typical" concerns of either pregnancy or stone passage alone. As those specializing in the care of stone disease are likely to be involved in the management of suspected renal colic in the pregnant woman, it is imperative to be informed of strategies and pitfalls in the evaluation and treatment of urinary tract stones in this population. PMID: 26709525 [PubM...
Source: Clinical Nephrology - December 28, 2015 Category: Urology & Nephrology Authors: Hernandez N, Pais VM Tags: Clin Nephrol Source Type: research

The importance of sensitive screening for abnormal glucose metabolism in patients with IgA nephropathy.
Abstract AIM: To investigate the prevalence of abnormal glucose metabolism, insulin resistance (IR) and the related risk factors in IgA nephropathy (IgAN) patients. METHODS: We analyzed oral glucose tolerance test (OGTT) and clinical data of 107 IgAN patients and 106 healthy controls. Glucose metabolism, homeostasis model assessment of insulin resistance (HOMA-IR) and the insulin sensitivity index (ISI) of both groups were evaluated. RESULTS: The prevalence of abnormal glucose metabolism was significantly higher in the IgAN group than in the control group (41.12% vs. 9.43%, p
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Jia X, Pan X, Xie J, Shen P, Wang Z, Li Y, Wang W, Chen N Tags: Clin Nephrol Source Type: research

Meta-analysis of the efficacy and safety of nucleotide/nucleoside analog monotherapy for hepatitis B virus-associated glomerulonephritis.
CONCLUSIONS: HBV-GN proteinuria remission with elevated serum albumin, decreased HBV replication, and improved HBeAg clearance could be achieved using NA monotherapy. Furthermore, NA monotherapy may protect renal function in HBV-GN patients by preventing Scr elevation. PMID: 26636326 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Wang WN, Wu MY, Ma FZ, Sun T, Xu ZG Tags: Clin Nephrol Source Type: research

Development, validation, and implementation of a medication adherence survey to seek a better understanding of the hemodialysis patient.
CONCLUSIONS: Our study shows that, despite an intensive drug education program, almost one quarter of patients continue to have problems with taking medication and that traditional education around medications is insufficient. We propose that clinicians customize education to the patient-driven gaps in knowledge, in particular focusing on the education needed to empower patients to recognize which aspects of their care they can and should modify and which aspects require further clinician input. PMID: 26636327 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Battistella M, Fleites R, Wong R, Jassal SV Tags: Clin Nephrol Source Type: research

Acute kidney injury (AKI) outcome, a predictor of long-term major adverse cardiovascular events (MACE).
CONCLUSION: Complete renal recovery after an episode of AKI in patients with normal baseline kidney function is associated with a lower risk of long-term MACE when compared with those who did not fully recover. PMID: 26636328 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Omotoso BA, Abdel-Rahman EM, Xin W, Ma JZ, Scully KW, Arogundade FA, Balogun RA Tags: Clin Nephrol Source Type: research

Minimal change disease: an unusual presentation of marginal zone MALT lymphoma.
We report a 68-yearold male who presented with nephrotic range proteinuria as the first manifestation of underlying MZL, confirmed with standard set of investigations. Being a steroid non-responder, he was treated with rituximab demonstrating a marked response with resolution of proteinuria. However, he relapsed after 3 months. Upon relapse, a combination of rituximab and bendamustine (R-Benda) was initiated achieving sustained resolution of proteinuria. No additional treatment was administered and the proteinuria has remained in remission for over a year. PMID: 26636329 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Inayat F, Law JK, Myers-Gurevitch PM, Seshan SV, Perlman AS Tags: Clin Nephrol Source Type: research

A case of mistaken identity: fibrillary glomerulonephritis masquerading as crescentic anti-glomerular basement membrane disease.
We report a case of FGN in which the patient presented with a clinical pulmonary-renal syndrome and whose kidney biopsy showed> 90% crescents on light microscopy. Immunofluorescence microscopy showed pseudo-linear IgG and C3 staining of the glomerular capillary walls resulting in an initial diagnosis of crescentic glomerulonephritis of anti-glomerular basement membrane (anti-GBM) antibody etiology. Electron microscopy showed fibrillary deposits permeating the glomerular capillary walls, characteristic of FGN. Although dialysis dependent at presentation and anuric at discharge, the patient recovered adequate renal functi...
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Thomas JA, Vasin D, Lin M, Anderson AE, Alpers CE Tags: Clin Nephrol Source Type: research

Patient characteristics, disease burden, and medication use in stage 4 - 5 chronic kidney disease patients.
CONCLUSIONS: Comorbidity burdens and hospitalization rates were high for patients with advanced, non-dialysisrequiring CKD. While hyperparathyroidism and anemia were common, appropriate medication use was not optimal, suggesting opportunities for improved care. PMID: 26636331 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - December 4, 2015 Category: Urology & Nephrology Authors: Wetmore JB, Peng Y, Jackson S, Matlon TJ, Collins AJ, Gilbertson DT Tags: Clin Nephrol Source Type: research

Sodium polystyrene sulfonate for the treatment of acute hyperkalemia: a retrospective study.
CONCLUSION: Our results suggest a serum potassium reduction of less than 1 mEq/L after administration of SPS for the treatment of acute hyperkalemia. Additionally, this study offers some evidence that the use of SPS may be associated with harm. We further note the need for standardized guidelines for the treatment of hyperkalemia at our institution. PMID: 26587776 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 20, 2015 Category: Urology & Nephrology Authors: Hagan AE, Farrington CA, Wall GC, Belz MM Tags: Clin Nephrol Source Type: research

Acute bile nephropathy secondary to anabolic steroids.
This report supports the recently re-emerged concept of bile nephropathy cholemic ephrosis. PMID: 26587777 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 20, 2015 Category: Urology & Nephrology Authors: Alkhunaizi AM, ElTigani MA, Rabah RS, Nasr SH Tags: Clin Nephrol Source Type: research

Diagnosis of low bone mass in CKD-5D patients.
CONCLUSIONS: DXA and QCT provide nearly identical areal BMD measures at the hip. However, QCT t-scores are consistently higher than DXA t-scores resulting in less diagnosis of osteoporosis or osteopenia. DXA results showed acceptable diagnostic sensitivity and specificity for low bone volume by histology and can be used for diagnosis of osteopenia and osteoporosis in patients with CKD-5D. PMID: 26587778 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 20, 2015 Category: Urology & Nephrology Authors: Blomquist GA, Davenport DL, Mawad HW, Monier-Faugere MC, Malluche HH Tags: Clin Nephrol Source Type: research

Glomerular expression of matrix metalloproteinases in AL-amyloidosis and association with renal function at the time of kidney biopsy.
CONCLUSION: The findings of this study show increased glomerular expression of MMP-1 and MMP-3 in patients with AL-amyloidosis which is associated with worse renal function at the time of the kidney biopsy. Our results suggest an important role for MMP-1 and MMP-3 in the pathogenesis of renal damage in AL-amyloidosis. PMID: 26587779 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 20, 2015 Category: Urology & Nephrology Authors: Charitaki E, Kastritis E, Petraki C, Liapis K, Adamidis K, Apostolou T, Christodoulidou C, Nikolopoulou N, Terpos E, Nakopoulou L, Dimopoulos MA Tags: Clin Nephrol Source Type: research

Is the new GFR equation using inulin clearance a more accurate method for Asian patients?
Abstract Recently, a new glomerular filtration rate (GFR) equation for the Japanese population was proposed using measured inulin clearance. To expand its applicability to other Asian populations, we performed a comparative study in the Korean population. Inulin clearance was measured in 166 patients from seven participating medical centers in Korea. Patient's sera and urine were collected, and baseline clinical characteristics were measured to provide an estimated GFR (eGFR) by the Japanese GFR equation using inulin clearance (Japanese-GFR equation), the Modification of Diet in Renal Disease (MDRD) study equation...
Source: Clinical Nephrology - November 11, 2015 Category: Urology & Nephrology Authors: Kim BS, Lee YK, Choi HY, Choi SO, Shin SK, Ha SK, Lee KW, Kim YW, Kim YL, Yasuda Y, Imai E, Horio M, Tomino Y, Matsuo S, Lee HY Tags: Clin Nephrol Source Type: research

Associations of kidney injury markers with subclinical cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.
PMID: 26558369 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - November 11, 2015 Category: Urology & Nephrology Authors: Park M, Shlipak MG, Vittinghoff E, Katz R, Siscovick D, Sarnak M, Lima JA, Hsu CY, Peralta CA Tags: Clin Nephrol Source Type: research

Ertapenem-induced acute reversible peripheral neuropathy in chronic kidney disease: 3 case reports.
CONCLUSION: Ertapenem is potentially neurotoxic in patients with CKD even when it is given with renal adjusted doses according to recommendations. Although carbapenem-related neurotoxicity most commonly manifests as seizures, our series indicates that acute and reversible peripheral neuropathy can also develop. Clinicians administering ertapenem for patients with a GFR of
Source: Clinical Nephrology - November 11, 2015 Category: Urology & Nephrology Authors: Kara E, Sahin OZ, Ayaz T, Yildirim S, Sahutoglu T, Tufekci A Tags: Clin Nephrol Source Type: research

NxStage dialysis system-associated thrombocytopenia: a report of two cases.
We report the occurrence of thrombocytopenia in the first two patients of a newly established home hemodialysis program. The 2 patients switched from conventional hemodialysis using polysulfone electron-beam sterilized dialyzers to a NxStage system, which uses gamma sterilized polyehersulfone dialyzers incorporated into a drop-in cartridge. The thrombocytopenia resolved after return to conventional dialysis in both patients and recurred upon rechallenge in the patient who opted to retry NxStage. This is the first report of thrombocytopenia with the NxStage system according to the authors' knowledge. Dialysis-associated thr...
Source: Clinical Nephrology - November 2, 2015 Category: Urology & Nephrology Authors: Sekkarie M, Waldron M, Reynolds T Tags: Clin Nephrol Source Type: research

Neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio in evaluation of inflammation in end-stage renal disease.
Abstract OBJECTIVE: To evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and inflammation in end-stage renal disease (ESRD) patients on maintenance hemodialysis (HD). METHODS: 100 ESRD patients on maintenance HD (mean ± SD age: 52.3 ± 1.7 years, 52% were males) were included in this cross-sectional study. Data on patient demographics, dry weight, body mass index, duration of HD (months), etiology of ESRD, delivered dose of dialysis (spKt/V), complete blood count, blood biochemistry and inflammatory markers including hs-CRP (mg/L), TNF-&al...
Source: Clinical Nephrology - November 2, 2015 Category: Urology & Nephrology Authors: Ahbap E, Sakaci T, Kara E, Sahutoglu T, Koc Y, Basturk T, Sevinc M, Akgol C, Kayalar AO, Ucar ZA, Bayraktar F, Unsal A Tags: Clin Nephrol Source Type: research

Tumor induced osteomalacia: associated with elevated circulating levels of fibroblast growth factor-7 in addition to fibroblast growth factor-23.
Abstract Tumor induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and osteomalacia. Fibroblast growth factor (FGF)-23, a phosphatonin i.e., phosphaturia-promoting hormone, is commonly implicated in the pathogenesis of TIO. However, very limited information is available about the circulating levels and clinical significance of other phosphatonins that are expressed by TIO-associated tumors. In addition, identification of the primary tumor constitutes a frequent major challenge in the management of TIO. Here, we report a patient with the clinical ...
Source: Clinical Nephrology - November 2, 2015 Category: Urology & Nephrology Authors: Bansal S, Khazim K, Suri R, Martin D, Werner S, Fanti P Tags: Clin Nephrol Source Type: research

Comparison of albuminuria test and urine test strip in Japanese hypertensive patients: AVA-E study.
Abstract BACKGROUND: Albuminuria is thought to reflect generalized endothelial dysfunction. In hypertensive patients, albuminuria is related to the risk for cardiovascular disease (CVD) events. Thus, screening for albuminuria is critical for risk stratification in hypertensive patients. However, the actual state of albuminuria in Japanese patients without diabetes remains unclear due to insurance coverage. METHODS: The CLINITEK microalb creatinine test® is a urine test paper that can assess albumin excretion corrected for urine creatinine levels in only 60 seconds without any special equipment. The semi-q...
Source: Clinical Nephrology - October 7, 2015 Category: Urology & Nephrology Authors: Tani Y, Nakayama M, Terawaki H, Iseki K, Watanabe T Tags: Clin Nephrol Source Type: research

Clinicopathological features of membranoproliferative glomerulonephritis under a new classification.
CONCLUSIONS: Our study highlights the clinicopathological features of patients with biopsy proven MPGN with no known etiological factors and sheds some light on the incidence and outcomes of various categories of MPGN under the new criteria, including MPGN with "dominant C3" deposits, rapidly becoming a descriptive diagnosis. PMID: 26445002 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - October 7, 2015 Category: Urology & Nephrology Authors: Nargund P, Kambham N, Mehta K, Lafayette RA Tags: Clin Nephrol Source Type: research

Report of six kidney disease-associated Castleman's disease cases.
In conclusion, common diagnosis and treatment techniques are suitable for kidney disease-associated CD. However, treatment efficacy might be difficult to predict, and some cases may have poor prognosis with this treatment strategy. Therefore, additional studies investigating kidney disease-associated CD and treatment outcomes in larger patient populations are needed. PMID: 26445003 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - October 7, 2015 Category: Urology & Nephrology Authors: Sui Y, Zhao D Tags: Clin Nephrol Source Type: research

Efficacy of calcitriol in treating glucocorticoidinduced osteoporosis in patients with nephrotic syndrome: an open-label, randomized controlled study.
Abstract OBJECTIVE: To evaluate the efficacy and safety of calcitriol in the prevention and treatment of glucocorticoid-induced osteoporosis. METHODS: 66 patients treated with glucocorticoids (GC) for primary nephrotic syndrome (NS) were randomly assigned to 3 groups. Groups were designated as follows: calcitriol alone (n = 22), calcitriol plus calcium carbonate (n = 23), or calcium carbonate alone (n = 21). Serum markers of bone metabolism and bone mineral density (BMD) were tested at 3 different time points: the initiation of GC treatment (baseline), 12 weeks, and 24 weeks after the initiation of treatment....
Source: Clinical Nephrology - September 23, 2015 Category: Urology & Nephrology Authors: Chen Y, Wan JX, Jiang DW, Fu BB, Cui J, Li GF, Chen CM Tags: Clin Nephrol Source Type: research

Renal and prostate stones composition in alkaptonuria: a case report.
We describe the case of a 51-year-old man whose renal and prostate stones were analyzed by X-ray diffraction and infrared spectroscopy, respectively. We review the cases of alkaptonuria (AKU) patients reported in the literature for whom the composition of kidney or prostate stones was assessed with physical or chemical techniques. In this paper, we also discuss the advantages and drawbacks of the different methodologies. PMID: 26396096 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - September 23, 2015 Category: Urology & Nephrology Authors: Wolff F, Biaou I, Koopmansch C, Vanden Bossche M, Pozdzik A, Roumeguère T, Cotton F Tags: Clin Nephrol Source Type: research

Results from a safety cohort of patients with renal anemia receiving the biosimilar epoetinzeta: The PASCO I study.
CONCLUSION: The PASCO I study contributes significantly to current knowledge about the frequency of adverse events associated with the use of epoetin-ζ for the treatment of renal anemia and demonstrates a pattern of adverse events comparable with data for other existing epoetin products in Europe. PMID: 26396097 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - September 23, 2015 Category: Urology & Nephrology Authors: Dellanna F, Fluck RJ, Lonnemann G, Wild CA, Iwanowitsch A, Meissner R, Audhya P Tags: Clin Nephrol Source Type: research

Diagnostic impact of percutaneous renal biopsy.
CONCLUSIONS: In summary, PRB was found to be a safe procedure that confirmed the suspected clinical diagnosis in two thirds of patients. As one third of the histopathological analyses demonstrated a non-suspected disease, the biopsies were of major importance for the correct treatment of the patients. PMID: 26396098 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - September 23, 2015 Category: Urology & Nephrology Authors: Kitterer D, Gürzing K, Segerer S, Alscher MD, Amann K, Braun N, Latus J Tags: Clin Nephrol Source Type: research

Urinary liver-type fatty acid-binding protein predicts recovery from acute kidney injury.
Abstract OBJECTIVES: Despite significant advances in the epidemiology of acute kidney injury (AKI), there is no reliable method to predict renal recovery. Using acute kidney injury network (AKIN) criteria, we tested whether higher urinary L-FABP (uL-FABP) concentrations in the patients with AKIN stage 3 (AKIN3) after nephrology consultation would predict failure to recover. METHODS: This is a prospective cohort study of 114 patients with AKIN3 at WuXi People's Hospital from August 2011 to July 2014. The levels of serum creatinine, urine creatinine, and uL-FABP were obtained at the time of nephrology consultat...
Source: Clinical Nephrology - September 23, 2015 Category: Urology & Nephrology Authors: Wang L, Xue J, Chen C, Zhang Z, Deng Z, Sun Z, Xing C Tags: Clin Nephrol Source Type: research

Major bleeding in hemodialysis patients using unfractionated or low molecular weight heparin: a single-center study.
CONCLUSIONS: There is no difference in bleeding rates between hemodialysis patients treated with either UFH or LMWH for anticoagulation of the extracorporeal circuit. We believe that both heparins have similar safety profiles when used for extracorporeal anticoagulation and that bleeding risk should not determine the choice of anticoagulation. PMID: 26365216 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - September 14, 2015 Category: Urology & Nephrology Authors: Nadarajah L, Fan S, Forbes S, Ashman N Tags: Clin Nephrol Source Type: research

Peritonitis in children with automated peritoneal dialysis.
Abstract This is a retrospective study including 36 Saudi children who were on automated peritoneal dialysis (APD) at the Al-Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia during seven years. A total of 10 boys and 26 girls with end-stage renal disease (ESRD) received APD for a total of 731.75 months. 36 episodes of peritonitis occurred in 17 children (47%). The frequency of peritonitis was one episode per 20.3 treatment months. Catheters were changed in 3 patients (8%). Three patients were switched to chronic hemodialysis, while 4 underwent successful renal transplantation. Results revealed that 11 pat...
Source: Clinical Nephrology - September 14, 2015 Category: Urology & Nephrology Authors: Alharthi AA Tags: Clin Nephrol Source Type: research

The role of mast cells in AIN: friend, foe, bystander, or all of the above?
PMID: 26296036 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - August 23, 2015 Category: Urology & Nephrology Authors: Perazella MA Tags: Clin Nephrol Source Type: research

NephroPharmacology coming of age.
PMID: 26296037 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - August 23, 2015 Category: Urology & Nephrology Authors: Keller F, Czock D Tags: Clin Nephrol Source Type: research

Colchicine toxicity in renal patients - Are we paying attention?
We report two cases of colchicine toxicity marked by severe neuromyopathy in a diabetic with stage 4 chronic kidney disease (CKD) and a renal transplant recipient. Both patients presented with diarrhea, acute on chronic kidney injury and progressive muscle weakness while on colchicine for several weeks or longer. In addition to kidney disease, risk factors for colchicine toxicity included maintenance therapy with simvastatin in the first patient and cyclosporine in the second. Creatine phosphokinase (CPK) was elevated in both cases at presentation and neurophysiologic studies showed a pattern of severe myopathy with axonal...
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: Medani S, Wall C Tags: Clin Nephrol Source Type: research

BK virus-associated nephropathy with hydronephrosis in a patient with AIDS: a case report and literature review.
Abstract BK virus is ubiquitous worldwide, with infection usually occurring in early childhood. BK virus replicates prolifically under immunosuppressive conditions, causing inflammation along the genitourinary tract and progressing clinically to hemorrhagic cystitis, ureteral stenosis, and tubulointerstitial nephritis. Most BK virusassociated nephropathy occurs in renal allograft patients after kidney transplantation, although some case reports have described BK virus-associated nephropathy in the native kidney, particularly in patients with human immunodeficiency virus infection. Here we present the case of a 49-...
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: Jung SW, Sung JY, Park SJ, Jeong KH Tags: Clin Nephrol Source Type: research

Fibrillary glomerulonephritis masquerading as rapidly progressive glomerulonephritis with pseudo-linear glomerular basement membrane staining.
We report a case of a patient presenting with hypertensive crisis, nephrotic range proteinuria, and rapidly progressive glomerulonephritis (RPGN). The kidney biopsy demonstrates crescentic GN on light microscopy (LM) and strong pseudo-linear/globular glomerular basement membrane (GBM) staining for immunoglobulin G on immunofluorescence (IF), suggestive of anti-GBM disease. However, circulating anti-GBM antibodies were negative. Electron microscopy (EM) revealed fibrillary deposits in the GBM, confirming the diagnosis of FGN. Review of the literature revealed very few reported similar cases. It appears that severe hypertens...
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: El-Husseini A, Aycinena JC, George B, Jennings S, Cornea V, Sawaya BP Tags: Clin Nephrol Source Type: research

Early supplemented low-protein diet restriction for chronic kidney disease patients in Taiwan - A cost-effectiveness analysis.
Abstract BACKGROUND: Low-protein diet (LPD) together with supplementation with ketoanalogs (KA) is associated with slower decline of estimated glomerular filtration rate (eGFR) in chronic kidney disease (CKD). We compared potential clinical and economic outcomes of KA supplement initiation at eGFR 15 - 29 mL/min/1.73 m2 vs. eGFR
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: You JH, Ming WK, Lin WA, Tarn YH Tags: Clin Nephrol Source Type: research

Phenotypic heterogeneity in females with X-linked Alport syndrome.
CONCLUSIONS: The current case report demonstrates the importance of considering skewed X-inactivation in females who exhibit signs or symptoms of Xlinked disorders. PMID: 26249550 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: Allred SC, Weck KE, Gasim A, Mottl AK Tags: Clin Nephrol Source Type: research

IgA nephropathy with anti-neutrophil cytoplasmic antibody seropositivity.
CONCLUSIONS: These findings suggest not all ANCAs are involved in the pathology of IgAN. In patients with IgAN and ANCAs, identification of pathogenic vs. non-pathogenic ANCAs is recommended. PMID: 26249551 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: Huang X, Wang Y, Xie L, Zhang Y, Tang S, Yin S, Gao X, Cai J, Wang W, Zhang J, Zhao J, Huang Y, Li Y, Zhang J Tags: Clin Nephrol Source Type: research

Keratinized squamous metaplasia of the upper urinary tract resulting in recurrent renal colic.
We present a case of recurrent renal colic secondary to sloughing keratin debris from KSM. PMID: 26249552 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - August 7, 2015 Category: Urology & Nephrology Authors: Ghali F, Pattison E, Pais VM Tags: Clin Nephrol Source Type: research

Diagnostic accuracy of serum cystatin C in chronic kidney disease: a meta-analysis.
CONCLUSION: SCysC appears to be a good biomarker in the definition of CKD. However, its performance is different in subgroups restricted by clinical settings, race, and sCysC assay. PMID: 26200185 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - July 25, 2015 Category: Urology & Nephrology Authors: Wei L, Ye X, Pei X, Wu J, Zhao W Tags: Clin Nephrol Source Type: research

A case of acetaminopheninduced acute interstitial nephritis and other complications.
PMID: 26200186 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - July 25, 2015 Category: Urology & Nephrology Authors: Tang Y, Yang L, Tao Y, Qin W Tags: Clin Nephrol Source Type: research

Vitamin D therapy in chronic kidney disease: back to the future?
Abstract Deficiency of 1,25(OH)2 vitamin D is inevitable in CKD, and is part of a cascade of bone and mineral abnormalities that result in secondary hyperparathyroidism. The widespread acceptance of calcitriol therapy as the treatment paradigm, has resulted in an overall neglect of vitamin D deficiency, as defined by low serum 25(OH)D levels Recent research has greatly enhanced our understanding of the disordered vitamin D metabolism seen in CKD. Furthermore vitamin D has been implicated in numerous disease states, beyond its traditional role in regulating bone and mineral metabolism. Low serum 25(OH)D levels have...
Source: Clinical Nephrology - July 8, 2015 Category: Urology & Nephrology Authors: Damasiewicz MJ, Kerr PG, Polkinghorne KR Tags: Clin Nephrol Source Type: research

Coagulopathy and spontaneous hemorrhage in a patient with nephrotic syndrome.
We report a patient who presented with coagulopathy and recurrent spontaneous hemorrhage in association with nephrotic syndrome. The case highlights key diagnostic and therapeutic challenges and strategies: 1) work up to establish a unifying etiology for both nephrotic syndrome and the bleeding disorder; 2) decision making to obtain a tissue biopsy, select the site of biopsy and understand the relative yields for each site; 3) recognizing the risk and managing peri-procedural bleeding; and 5) developing a treatment strategy with the lowest risk of possible complications. Our patient underwent a kidney biopsy without any co...
Source: Clinical Nephrology - June 26, 2015 Category: Urology & Nephrology Authors: Gebregeorgis W, Pillai U, Mamdani H, Yang J, Rossi NF Tags: Clin Nephrol Source Type: research

Two cases of successful pregnancy in patients with Gitelman's syndrome.
We report two cases of successful pregnancies, after previous fetal loss, in patients with GS managed with aggressive oral and intravenous electrolyte repletion. These cases illustrate increased potassium and magnesium requirements over the course of the pregnancies and are notable due to the high doses of electrolytes required. They also demonstrate the possibility of successful pregnancy outcomes with frequent laboratory monitoring and aggressive titration of electrolyte replacement either orally or intravenously to maintain appropriate serum levels necessary to provide a suitable environment for fetal development. ...
Source: Clinical Nephrology - June 25, 2015 Category: Urology & Nephrology Authors: Waguespack DR, Kasekar R, Abdel-Kader K, Fissell RB Tags: Clin Nephrol Source Type: research

Effect of BMP7 on podocyte transdifferentiation and Smad7 expression induced by hyperglycemia.
Abstract OBJECTIVE: To investigate the effect of BMP7 on the transdifferentiation and Smad7 expression of podocytes induced by high glucose in vitro and to explore its possible protective mechanisms. METHODS: Mouse podocytes were cultured and divided into normal glucose group (NG), high glucose group (HG), mannitol group, NG+BMP7 group, and HG+BMP7 group. Real-time PCR and Western blot were applied respectively to detect the mRNA and protein expression levels of synaptopodin, desmin, and Smad7. RESULTS: The cells significantly up-regulated the mRNA and protein expression of desmin and reduced the express...
Source: Clinical Nephrology - June 24, 2015 Category: Urology & Nephrology Authors: Liu L, Fu W, Xu J, Shao L, Wang Y Tags: Clin Nephrol Source Type: research

Hyponatremia: incidence, risk factors, and consequences in the elderly in a home-based primary care program.
CONCLUSIONS: Hyponatremia is common in home-bound elderly patients and its persistence independently contributes to falls, fractures, and hospitalization but not mortality. Our study highlights a new association of hyponatremia with frailty and underscores the need to study time-dependent association of hyponatremia with epidemiological outcomes. PMID: 26042411 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - June 3, 2015 Category: Urology & Nephrology Authors: Ganguli A, Mascarenhas RC, Jamshed N, Tefera E, Veis JH Tags: Clin Nephrol Source Type: research

Keeping an eye on dialysis: the association of hemodialysis with intraocular hypertension.
We describe a patient with complicated diabetes mellitus, end-stage renal disease, and recent cataract surgery who developed severe intraocular hypertension during hemodialysis. We recommend increased awareness of the symptoms of intraocular hypertension and subsequent ophthalmologic surveillance in order to prevent long-term visual complications. PMID: 26042412 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - June 3, 2015 Category: Urology & Nephrology Authors: William JH, Gilbert AL, Rosas SE Tags: Clin Nephrol Source Type: research

Glycopeptide-specific drugmembrane interaction in continuous venovenous hemofiltration: an in vitro screening test.
PMID: 26042413 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - June 3, 2015 Category: Urology & Nephrology Authors: Sartori M, Zaragoza JJ, Sharma A, Zancato M, Ronco C Tags: Clin Nephrol Source Type: research

Rupture of an infectious pseudoaneurysm of the aortic arch in an end-stage renal failure patient with chronic hemodialysis.
Abstract In hemodialysis patients, vascular access infection remains a significant cause of morbidity and mortality. It has various complications, including bacterial endocarditis, spinal epidural abscess, osteomyelitis, septic arthritis, and septic pulmonary emboli. However, aortitis with infected pseudoaneurysm formation is very rare. Here, we report a case of necrotizing aortitis in a hemodialysis patient with an arteriovenous graft infection. PMID: 26042414 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - June 3, 2015 Category: Urology & Nephrology Authors: Chung S, Choi DE, Na KR, Lee KW Tags: Clin Nephrol Source Type: research