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The role of gut-dependent molecule trimethylamine N-oxide as a novel target for the treatment of chronic kidney disease
AbstractTrimethylamine N-oxide (TMAO) is an intestinal uremic toxin molecule mainly excreted by the kidney. Therefore, the plasma TMAO concentration is significantly increased in chronic kidney disease (CKD) patients, and plasma TMAO can be cleared by dialysis. Furthermore, TMAO damage the kidney mainly through three mechanisms: oxidative stress, inflammation and endoplasmic reticulum stress. Clinical experiments have indicated that higher TMAO levels are strongly related to the elevated incidence and mortality of cardiovascular (CV) events in CKD patients. Moreover, experimental data have shown that high levels of TMAO di...
Source: International Urology and Nephrology - February 16, 2023 Category: Urology & Nephrology Source Type: research

A systematic review of the efficacy and safety of anticoagulants in advanced chronic kidney disease
CONCLUSION: Further studies are still required, some ongoing, in patients with advanced CKD (CrCl < 30 ml/min) to identify the safest and most effective treatment options for VTE and AF.PMID:36006608 | DOI:10.1007/s40620-022-01413-x
Source: Journal of Nephrology - August 25, 2022 Category: Urology & Nephrology Authors: Kathrine Parker John Hartemink Ananya Saha Roshni Mitra Penny Lewis Albert Power Satarupa Choudhuri Sandip Mitra Jecko Thachil Source Type: research

Major Adverse Renal and Cardiovascular Events following Intra-Arterial Contrast Media Administration in Hospitalized Patients with Comorbid Conditions
Conclusion: Intra-arterial administration using IOCM in at-risk patients is associated with lower rates of MARCE than the use of LOCM. This difference is especially apparent in patients with a combination of CKD 3 –4 and diabetes and in patients with CTO, providing real-world data validation with meaningful NNT in favor of IOCM.Cardiorenal Med
Source: Cardiorenal Medicine - August 12, 2021 Category: Urology & Nephrology Source Type: research

Ischemic stroke and purpuric dermatitis as COVID-19-related complications in a peritoneal dialysis patient
AbstractPatients on dialysis may have an elevated risk of severe coronavirus disease 2019 (COVID-19) and its complications due to their high prevalence of comorbidities. Here we describe the case of an 80-year-old male undergoing peritoneal dialysis with a moderate SARS-CoV-2 infection who developed a purpuric dermatitis and ischemic stroke after successful recovery from his bilateral pneumonia. Erythemato-papular lesions affecting trunk and lower limbs appeared 17  days after the onset of SARS-CoV-2 symptoms. These kind of lesions are an infrequent cutaneous manifestation of COVID-19. The pathology revealed a moderate pu...
Source: CEN Case Reports - November 17, 2020 Category: Urology & Nephrology Source Type: research

Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation.
CONCLUSIONS: In patients with kidney failure and nonvalvular atrial fibrillation, treatment with apixaban was not associated with a lower incidence of new stroke, transient ischemic attack, or systemic thromboembolism but was associated with a higher incidence of fatal or intracranial bleeding. PMID: 32444398 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 21, 2020 Category: Urology & Nephrology Authors: Mavrakanas TA, Garlo K, Charytan DM Tags: Clin J Am Soc Nephrol Source Type: research

Systematic DOACs oral anticoagulation in patients with atrial fibrillation and chronic kidney disease: the nephrologist's perspective.
Abstract Atrial fibrillation (AF) is highly prevalent among patients with chronic kidney disease (CKD), and also associated with unfavorable outcome. Anticoagulant therapy is the mainstep of management in such patients, aimed at reducing the high risk of systemic thromboembolism and especially of ischemic stroke, which is reportedly associated with increased mortality in CKD patients. Even though new direct oral anticoagulant agents (DOACs) proved to be effective in patients with non valvular chronic AF, and are therefore recommended by recent guidelines for their treatment, warfarin is currently used in more than...
Source: Journal of Nephrology - March 20, 2020 Category: Urology & Nephrology Authors: Ravera M, Bussalino E, Fusaro M, Di Lullo L, Aucella F, Paoletti E Tags: J Nephrol Source Type: research

Successful Peritoneal Dialysis Catheter Placement in a New End-Stage Renal Disease Patient with Combined Antiphospholipid Syndrome and Factor XI Deficiency.
We present the case of a 68-year-old woman with combined antiphospholipid syndrome and factor XI deficiency, with chronic prolongation of activated partial thromboplastin time that was not correctable with fresh-frozen plasma (FFP).The patient had a history of stroke, but was not on antiplatelet therapy because of mucocutaneous bleeding events. She had progressive renal failure attributed to her autoimmune disease, and a decision was made to pursue peritoneal dialysis (PD) when she reached end-stage kidney disease. She was admitted to the hospital the day before her planned PD catheter placement and was transfused with FFP...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - April 21, 2018 Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research

Stroke in patients with chronic kidney disease & #8230;: How do we approach and manage it ?
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - May 3, 2017 Category: Urology & Nephrology Authors: S Nayak-Rao MP Shenoy Source Type: research

Regulation of the epithelial Na+ channel by the mTORC2/SGK1 pathway
The epithelial Na+ channel (ENaC) is decisive for sodium reabsorption by the aldosterone-sensitive distal nephron (ASDN) of the kidney. ENaC is regulated by the serum- and glucocorticoid-inducible kinase 1 (SGK1), a kinase genomically upregulated by several hormones including glucocorticoids and mineralocorticoids. SGK1 is activated by the serine/threonine kinase mammalian target of rapamycin (mTOR) isoform mTORC2. SGK1 knockout (sgk1–/– mice) impairs renal Na+ retention during salt depletion. The mTOR catalytic site inhibitor, PP242, but not mTORC1 inhibitor rapamycin, inhibits ENaC, decreases Na+ flux in isol...
Source: Nephrology Dialysis Transplantation - January 25, 2016 Category: Urology & Nephrology Authors: Lang, F., Pearce, D. Tags: REVIEWS - BASIC SCIENCE AND TRANSLATIONAL NEPHROLOGY Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.
Source: Nephrology Dialysis Transplantation - February 23, 2015 Category: Urology & Nephrology Authors: Genovesi, S., Rossi, E., Gallieni, M., Stella, A., Badiali, F., Conte, F., Pasquali, S., Bertoli, S., Ondei, P., Bonforte, G., Pozzi, C., Rebora, P., Valsecchi, M. G., Santoro, A. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

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