Search results for "kidney"

The lady with a history of blood transfusion who developed palpable purpura and microhaematuria

1999

Stretching the boundaries for liver transplant in the 21st century.

2018

Given the high waiting list mortality, there is a clear need to identify strategies to increase the number of livers for transplantation. Some strategies require policy changes, whereas others depend on a better understanding of available opportunities. We divided the strategies to increase the number of livers for transplantation into two categories-those aiming to increase the use of organs considered to be of suboptimal quality, and those aiming to increase the use of organs considered to be of suboptimal size. Enough evidence suggests that, if considered in the context of other donor and recipient variables, grafts from elderly donors are a safe option. The severity of steatosis, and no…

SARS-CoV-2 vs. Hepatitis Virus Infection Risk in the Hemodialysis Population: What Should We Expect?

2021

Since the dramatic rise of the coronavirus infection disease 2019 (COVID-19) pandemic, patients receiving dialysis have emerged as especially susceptible to this infection because of their impaired immunologic state, chronic inflammation and the high incidence of comorbidities. Although several strategies have thus been implemented to minimize the risk of transmission and acquisition in this population worldwide, the reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence varies across studies but is higher than in the general population. On the contrary, the screening for hepatitis viruses (HBV and HCV) has seen significant improvements in recent years, with va…

Calciphylaxie : une complication grave et méconnue de l'insuffisance rénale chronique terminale. À propos de deux cas

2005

Calciphylaxis presents like subcutaneous lesions with livedo reticularis leading to necrotic and painful ulcers, predominantly in the lower limbs and the abdomen. They initially simulate dermohypodermitis. Biology reveals secondary hyperparathyroidism, phosphocalcic metabolism abnormalities and state of hypercoagulability. Histological signs are constant: calcifications in the media of small and sub-cutaneous arteries, intimal hyperplasia and intravascular thrombosis. This complication occurs in 4% of end-stage renal disease patients. Its prognostic is awful with a rate of mortality of 60% due to sepsis. Treatment is based upon the normalization of phosphocalcic rates and local debridement.

Effects of canagliflozin on serum potassium in people with diabetes and chronic kidney disease: the CREDENCE trial

2021

Abstract Aims  Hyperkalaemia is a common complication of type 2 diabetes mellitus (T2DM) and limits the optimal use of agents that block the renin–angiotensin–aldosterone system, particularly in patients with chronic kidney disease (CKD). In patients with CKD, sodium‒glucose cotransporter 2 (SGLT2) inhibitors provide cardiorenal protection, but whether they affect the risk of hyperkalaemia remains uncertain. Methods and results  The CREDENCE trial randomized 4401 participants with T2DM and CKD to the SGLT2 inhibitor canagliflozin or matching placebo. In this post hoc analysis using an intention-to-treat approach, we assessed the effect of canagliflozin on a composite outcome of time to eith…

Special Considerations for Antihypertensive Agents in Dialysis Patients

2010

Hypertension is present in most patients with end-stage renal disease and likely contributes to the premature cardiovascular disease in dialysis patients. Previous practice guidelines have recommended that, in patients on chronic dialysis, blood pressure (BP) should be reduced below 130/80 mm Hg. This is based on opinions but not strong evidence, since no concrete information exists about which BP values should be the parameter to follow and which should be the target BP values. The majority of the antihypertensive agents can be used in this population, but the pharmacokinetics altered by the impaired kidney function and dialyzability influence the appropriate dosage as well as the time and…

New Sub-Phenotyping of Subjects at High Risk of Type 2 Diabetes: What Are the Potential Clinical Implications?

2021

Prediabetes is defined as a condition of abnormal glucose metabolism, characterised by plasma glucose above normal range but not as high as required for the diagnosis of diabetes mellitus (DM). It represents a heterogeneous entity of intermediate glucose metabolism, including impaired fasting glucose, impaired glucose tolerance, and borderline glycated haemoglobin. Prediabetes is being increasingly recognised as an important metabolic state not only predisposing to a higher probability of future progression to DM, but also to an increased risk of different micro- and macrovascular complications. The recently proposed sub-phenotyping of individuals at increased risk of type 2 DM, which disti…

Heart failure and chronic kidney disease in a registry of internal medicine wards

2014

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were signific…

Exertional hematuria: definition, epidemiology, diagnostic and clinical considerations

2019

Abstract Exertional hematuria can be considered a subcategory of exercise-induced hematuria, characterized by painless appearance of erythrocytes in urine after recent physical exercise, not directly attributable to external traumatic injuries to the genitourinary system, and spontaneously resolving with rest. Although its frequency has enormous heterogeneity, depending on the athlete population, duration and intensity of exercise, technique used for identifying or quantifying hematuria and relative diagnostic thresholds, what clearly emerges from the scientific literature is that a certain degree of hematuria is commonplace after non-contact sports, especially running. This exertional hema…

Administration of Second-Generation Extracorporeal Shock Waves without Waterbath for Fragmentation of Extra- and Intrahepatic Bile Duct Stones

1990

First-generation extracorporeal shock-wave sources disintegrate 97% of kidney stones [1, 2]. Recently, in selected patients gallbladder and common bile duct stones were also treated. The technique available so far, however, requires immersion of the patient’s body in a tank of degassed water. The procedure is therefore inconvenient, time consuming, and relatively expensive. The high pressure of shocks (up to 1000 bar) generated by underwater spark discharge causes pain, and general anesthesia is necessary in most patients [3, 4].