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journal club
Takahashi et  al., on behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; and Stroke Council. (Circulation. 2022;146:e558–e568.)
Source: Kidney International - March 20, 2023 Category: Urology & Nephrology Tags: Journal Club Source Type: research

Should we liberalize potassium intake in CKD? No, we should not
Although a high dietary sodium (Na) intake has dominated our understanding of pathophysiology of hypertension, the moderating effects of a dietary potassium (K) intake on blood pressure (BP) are less appreciated. K depletion in normotensive men can increase BP,1 supplementation of K among normotensive women can modestly lower 24-hour ambulatory BP,2 and in those with untreated hypertension3 or among those with hypertension and hypokalemia provoked by diuretics, K supplementation can lower BP.4 A cluster randomized trial from 600 villages in China in people with a history of previous stroke (72.6%) or a history of hypertens...
Source: Kidney International - September 20, 2022 Category: Urology & Nephrology Authors: Rajiv Agarwal Tags: Controversies in Nephrology Source Type: research

Targeting TMEM16A-encoded Ca2+-activated Cl − channels: a new paradigm for antihypertensive therapy?
Hypertension is the leading risk factor for the development of heart diseases and stroke. Many hypertensive patients experience undesirable side effects to conventional antihypertensive pharmacotherapy. Cil et  al. documented the antihypertensive profile of a novel molecule, TMinh-23 (2-bromodifluoroacetylamino-5,6,7,8-tetrahydro-4H-cyclohepta[b]thiophene-3-carboxylic acid o-tolylamide), in the spontaneously hypertensive rat model of systemic hypertension. They showed that this agent reduces blood pressu re by inhibiting transmembrane member 16A–encoded calcium-activated chloride channels in vascular myocytes from resistance arteries.
Source: Kidney International - July 19, 2021 Category: Urology & Nephrology Authors: Normand Leblanc Tags: Commentary Source Type: research

Tubuloreticular inclusions in COVID-19-related collapsing glomerulopathy
A 79-year-old male of African ancestry, with a history of hemorrhagic stroke, monoclonal gammopathy of unknown significance and chronic kidney disease stage 3 due to hypertension was admitted to Bichat hospital on day 1 after the first symptom of COVID-19 (fever). SARS-CoV 2 PCR was positive on nasal swab. At admission urinary dipstick was normal and plasma creatinine was 224 μmol/L. On day 4 plasma albumin was at 29 g/L and proteinuria was 11.4 g per gram of urinary creatinine (80% of albumin).
Source: Kidney International - April 26, 2020 Category: Urology & Nephrology Authors: Fran çois Gaillard, Sophie Ismael, Aurélie Sannier, Hassan Tarhini, Thomas Volpe, Clarisse Greze, Marie Christine Verpont, Ilyass Zouhry, Christophe Rioux, François-Xavier Lescure, David Buob, Eric Daugas Tags: nephrology image Source Type: research

Tubuloreticular inclusions in COVID-19 –related collapsing glomerulopathy
A 79-year-old man of African ancestry, with a history of hemorrhagic stroke, monoclonal gammopathy of unknown significance, and stage 3 chronic kidney disease due to hypertension, was admitted to Bichat Hospital on day 1 after the first symptom of COVID-19 (fever). Severe acute respiratory syndrome coronavirus 2 polymerase chain reaction was positive on nasal swab. At admission, urinary dipstick was normal and plasma creatinine was 224 μmol/l. On day 4 plasma albumin was at 29 g/l and proteinuria was 11.4 g per gram of urinary creatinine (80% of albumin).
Source: Kidney International - April 26, 2020 Category: Urology & Nephrology Authors: Fran çois Gaillard, Sophie Ismael, Aurélie Sannier, Hassan Tarhini, Thomas Volpe, Clarisse Greze, Marie Christine Verpont, Ilyass Zouhry, Christophe Rioux, François-Xavier Lescure, David Buob, Eric Daugas Tags: Nephrology Image Source Type: research

Prevention and treatment of stroke in patients with chronic kidney disease: an overview of evidence and current guidelines
Chronic Kidney Disease (CKD) is strongly associated with an increased risk of stroke, small vessel disease, and vascular dementia. Common vascular factors for stroke, such as hypertension, diabetes, and atrial fibrillation, are more prevalent in CKD patients, accounting for this association. However, factors unique to these patients, such as uraemia, oxidative stress, mineral and bone abnormalities, as well as dialysis-related factors are also believed to contribute to risk. Despite improvements in stroke treatment and survival in the general population, the rate of improvement in patients with CKD, especially those who ar...
Source: Kidney International - October 17, 2019 Category: Urology & Nephrology Authors: Dearbhla M. Kelly, Peter M. Rothwell Tags: Review Source Type: research

The Case | Severe hypertension and hyperkalemia in a kidney transplant recipient
A 55-year-old man with a history of end-stage renal disease due to autosomal dominant polycystic kidney disease and bilateral nephrectomy without adrenalectomy underwent his first kidney transplantation after 6 years of hemodialysis. The patient had no history of donor-specific antibodies. The donor was described as a 69-year-old man with a history of active smoking and  aortic valvulopathy who died of a stroke without cardiac arrest or collapse. Maintenance immunosuppressive therapy consisted of low-dose tacrolimus and everolimus.
Source: Kidney International - July 19, 2019 Category: Urology & Nephrology Authors: Vincent Dupont, Charlotte Colosio, Marguerite Hureaux, Laetitia Mokri, Betoul Schvartz, Vincent Vuiblet, Antoine Braconnier, Rosa Vargas-Poussou, Philippe Rieu Tags: Make Your Diagnosis Source Type: research

Folic acid supplementation and chronic kidney disease progression
In contrast to prior studies demonstrating no benefit or even increased harm from B vitamin supplementation in patients with chronic kidney disease, a large randomized trial from China recently demonstrated small but statistically significant reductions in the risk of first stroke and chronic kidney disease progression with the addition of folic acid to enalapril in adults with hypertension. Differences in the study population and study intervention may explain these discordant results.
Source: Kidney International - November 21, 2016 Category: Urology & Nephrology Authors: Christina M. Wyatt, J. David Spence Tags: Nephrology Digest Source Type: research

Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension?
Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension? Kidney International 87, 1109 (June 2015). doi:10.1038/ki.2015.62 Authors: Christopher W McIntyre & David J Goldsmith
Source: Kidney International - May 29, 2015 Category: Urology & Nephrology Authors: Christopher W McIntyreDavid J Goldsmith Tags: brain injury hemodialysis leukoaraiosis myocardial stunning stroke Source Type: research