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Urinary kidney injury Molocule-1 Level in Preterm Neonates with Respiratory Distress Syndrome

Open Journal of Pediatrics 2016年第1期6卷 1-9页

作者： Maha Youssef Manal Abdelsalam Radwa Saeed Alshimaa Mohamed Department of Pediatrics Faculty of Medicine (Girls) Al-Azhar University Cairo Egypt Department of Clinical Pathology Faculty of Medicine (Girls) Al-Azhar University Cairo Egypt

Background: Despite recent advances in perinatal and neonatal care in respiratory distress syndrome (RDS) prevention and treatment, a considerable number of these neonates suffer from acute kidney injury (AKI), and it is associated with poor outcome as an independent risk factor. KIM-1 mRNA and protein are expressed at a low level in normal kidney but are increased in post ischemic kidney. Aim: The aim is to detect the value of urinary KIM-1 measurement as an early predictor marker of acute kidney injury in preterm neonates with respiratory distress syndrome. Patients and methods: The study included 30 preterm newborn with (RDS) ≤36 weeks during the period from October 2014 to March 2015. Also the study included 30 apparently healthy newborn ≤36 weeks as controls. They were selected from NICU of Manshiate Elbakry hospital Cairo, Egypt. uKIM-1 along with serum creatinine levels and eGFR were assessed in days 1 of life for both groups and in day 3 for cases. Results: In day one of life, we found a significant increase in uKIM-1 levels in preterm newborn with RDS compared to their controls (2.88 ± 1.01 ng/ml and 0.95 ± 0.52 ng/ml respectively (p = 0.001)). There is no significant difference between both groups regarding serum creatinine and eGFR. In day 3 of life, preterm with RDS had significant decrease in uKIM-1 levels compared to day 1 of life with significant increase in non-survivor compared to survivor group ( 2.30 ± 1.56 ng/ml and 1.30 ± 0.90 ng/ml respectively (p = 0.03)). The sensitivity and specificity of uKIM-1 and serum creatinine was calculated (100.00%, 86.67% and 33.33%;95.00%) respectively. Conclusion: Preterm neonate with RDS is at high risk of developing AKI. Early and serial uKIM-1 measurements can be used as a non-invasive indicator of kidney injury in premature newborn with RDS.

关键词： Premature Respiratory Distress Syndrome Urinary kidney injury Molocule-1 acute kidney injury

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Nephrotoxicity in cancer treatment:An overview

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World Journal of Clinical Oncology 2020年第4期11卷 190-204页

作者： Maria Luísa Cordeiro Santos Breno Bittencourt de Brito Filipe Antonio FranÇa da Silva Anelise Costa dos Santos Botelho Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029094BahiaBrazil

Anticancer drug nephrotoxicity is an important and increasing adverse drug event that limits the efficacy of cancer *** kidney is an important elimination pathway for many antineoplastic drugs and their metabolites,which occurs by glomerular filtration and tubular *** agents,both conventional cytotoxic agents and molecularly targeted agents,can affect any segment of the nephron including its microvasculature,leading to many clinical manifestations such as proteinuria,hypertension,electrolyte disturbances,glomerulopathy,acute and chronic interstitial nephritis,acute kidney injury and at times chronic kidney *** clinician should be alert to recognize several factors that may maximize renal dysfunction and contribute to the increased incidence of nephrotoxicity associated with these drugs,such as intravascular volume depletion,the associated use of nonchemotherapeutic nephrotoxic drugs(analgesics,antibiotics,proton pump inhibitors,and bonetargeted therapies),radiographic ionic contrast media or radiation therapy,urinary tract obstruction,and intrinsic renal *** of patients at higher risk for nephrotoxicity may allow the prevention or at least reduction in the development and severity of this adverse ***,the aim of this brief review is to provide currently available evidences on oncologic drug-related nephrotoxicity.

关键词： acute kidney injury Cancer Chemotherapy Conventional cytotoxic agents Molecularly targeted agents Nephrotoxicity

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Role of Fluid Management on Renal Failure in Hospitalized COVID-19 Patients

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Open Journal of Nephrology 2021年第2期11卷 230-241页

作者： Angelie Santos Hillary Grainer Joseph Scarano Majed Samarneh Department of Internal Medicine St. John’s Riverside Hospital New York USA

Introduction: The reported incidence of AKI with COVID-19 varies from 0.5% to 22%. Several mechanisms were postulated as a cause of AKI in patients infected with COVID-19. The appropriate management of AKI in patients with COVID-19 remains unclear at this time. One point of absolute importance, is the consideration of volume status. Given the paucity of knowledge with regards to the role of different strategies for fluid management during an episode of AKI in patients with COVID-19, this retrospective study aims to compare renal outcome and overall prognosis in patients who received conservative versus liberal fluid management. Methods: This is a single-center retrospective observational cohort study at a community hospital in Westchester County, NY. All adult patients who tested positive for the COVID-19 infection by PCR testing of a nasopharyngeal swab and were hospitalized from March 22, 2020 to May 25, 2020 are eligible. Among those identified with AKI, patients were divided into two groups: conservative fluid administration versus liberal fluid administration. Results: Of the 136 patients, 84 (61.76%) were admitted to the ICU, with 60% of patients under the conservative fluid strategy and 40% receiving liberal fluid management. On the other hand, 52 (38.23%) patients were admitted on the medical floors, with more patients (67.31%) receiving liberal fluid management. Discussion: In our cohort of 136 patients with COVID-19 respiratory illness and AKI, there was a significant difference in renal outcome, in terms of improvement of renal function in patients receiving liberal fluid management (55.07%) versus conservative fluid management (16.41%, p ≤ 0.001), with more patients in the liberal group having lower peak creatinine before levels improved. This, as well, was associated with improvement in oxygenation, characterized by improvement in respiratory status, facilitating weaning of oxygen suppl

关键词： acute kidney injury COVID-19 Fluid Management

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Gα12 Regulates Interleukin-8 Expression after Epithelial Cell injury

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Open Journal of Pathology 2016年第3期6卷 154-161页

作者： Alexandra K. Kim Barrett Richard Ilene Boucher Wanfeng Yu Tianqing Kong Bradley M. Denker Renal Division Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA Brigham and Women’s Hospital Boston MA USA

acute kidney injury (AKI) is common in hospitalized patients and is strongly correlated with increased morbidity, mortality, and prolonged hospitalization. However, signals that determine whether injured tissues following AKI will repair or fibrose and lead to chronic kidney disease (CKD) are not well defined. Numerous cytokines are activated at various times after injury and recruit inflammatory cells. Interleukin-8 (IL-8) is upregulated following activation of Gα12 by H2O2, a reactive oxygen species (ROS). Herein, we study this occurrence in vitro and in vivo. IL-8 was measured by ELISA in Gα12-silenced (si-Gα12) and inducible QLα12 (constitutively active Gα12) Madin-Darby Canine kidney (QLα12-MDCK) cell lines after H2O2/catalase cell injury. QLα12- and si-Gα12 MDCK cells showed time-, agonist- and Gα12-dependent increases in IL-8 mRNA and protein. Gα12-silenced MDCK cells demonstrated lower IL-8 expression and blunted IL-8 increases. In transgenic mice (QLα12γGTCre+, proximal tubule Qα12 expression) ischemia reperfusion injury led to significant upregulation of CXCL-1 (IL-8 homologue) at 48 hours that was not observed in Gα12 knockout mice. Macrophages in renal cells from these mice were imaged by immunofluorescent microscopy and QLα12γGTCre+ showed increased macrophage infiltration. We demonstrate that IL-8 is a critical link between H2O2 stimulated Gα12 and renal injury. Gα12 activation led to increased IL-8 expression, a potent mediator of inflammation after injury. Future studies targeting Gα12 for inhibition after injury may blunt the IL-8 response and allow for organ recovery.

关键词： Gα12 Interleukin-8 acute kidney injury Inflammation Fibrosis

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Rhabdomyolysis with different etiologies in childhood

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World Journal of Clinical Pediatrics 2017年第4期6卷 161-168页

作者： Demet Alaygut Meral Torun Bayram Belde Kasap Alper Soylu Mehmet Türkmen Salih Kavukcu Department of Pediatric Nephrology Dokuz Eylul University Faculty of Medicine

AIM To investigate different etiologies and management of the rhabdomyolysis in *** Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment. RESULTS Average diagnosis ages of eight cases were 129(24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection(pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase Ⅱ deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis(Meyer-Betz syndrome).CONCLUSION It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive.

关键词： Rhabdomyolysis Children Etiology acute kidney injury Treatment Hemodialysis

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Non-Hodgkin’s Lymphoma Associated with Metastatic Lung Cancer: Case Report

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Advances in Lung Cancer 2021年第3期10卷 40-47页

作者： Miriam Viviane Baron Gabriela Di Lorenzo Garcia Scherer Célia Regina Martins Korzenieski Julia Braga da Silveira Carolina Boeira Soares Carina Marangoni Marcus Vinicius de Mello Pinto Aline Ronis Sampaio Alexandre Gomes Sancho Esteban Fortuny Pacheco Felice Picariello Joice Nedel Ott Isabel Cristina Reinheimer Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Cristine Brandenburg Danielle de Mello Florentino Patrícia Froes Meyer Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Celulare Institute Rio de Janeiro Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FMABC) S&#227 o Paulo Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Federal University of Ceará (UFC) Fortaleza Brazil Uniredentor University Rio de Janeiro Brazil Centro Universitário do Rio Grande do Norte Natal RN Brazil

Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-Hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-Hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-Hodgkin’s lymphoma.

关键词： acute kidney injury Febrile Neutropenia Sepsis Chemotherapy

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Evidence based review of management of cardiorenal syndrome type 1

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World Journal of Methodology 2021年第4期11卷 187-198页

作者： Leong Tung Ong Faculty of Medicine University of MalayaKuala Lumpur 50603Wilayah Persekutuan Kuala LumpurMalaysia

Cardiorenal syndrome(CRS)type 1 is the development of acute kidney injury in patients with acute decompensated heart *** often results in prolonged hospitalization,a higher rate of rehospitalization,high morbidity,and high *** pathophysiology of CRS is complex and involves hemodynamic changes,neurohormonal activation,hypothalamic-pituitary stress reaction,inflammation,and ***,there is limited evidence or guideline in managing CRS type 1,and the established therapeutic strategies mainly target the symptomatic relief of heart *** review will discuss the strategies in the management of CRS type *** clinical studies have been included in this review that include different treatment strategies such as nesiritide,dopamine,levosimendan,tolvaptan,dobutamine,and *** strategies for CRS type 1 are derived based on the current *** recognition and treatment of CRS can improve the outcomes of the patients significantly.

关键词： Cardiorenal syndrome Heart failure acute kidney injury Renal insufficiency Management

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Risk factors of prolonged recovery after Fontan operation

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South China Journal of Cardiology 2015年第4期16卷 201-207页

作者：王晗张崇健罗丹东朱卫中曾嵘熊卫萍陈寄梅庄建 Department of Cardiac Surgery Guangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences

Background With low rates of mortality and morbidity, Fontan procedure has become the preferred approach for patients with univentricular heart disease. However, risk factors associated with prolonged postoperative recovery still remain uncertain. Methods Data on all patients admitted to the surgical intensive care unit （SICU） after a Fontan procedure from Jan 2010 to December 2014 were retrospectively analyzed. We excluded all patients who were expired. The study cohort was further divided into a prolonged recovery group that includ- ed patients with 〉75% ile for duration of SICU stay and mechanical ventilation, and a normal recovery group which included all other patients. A multivariable logistic regression model was used to compare demographic and physiological variables between the prolonged and normal recovery groups. Results There were 164 Fon- tan operations performed and 159 patients in the study cohort. Groups were similar in demographic characteris- tics, preoperative hemodynamic parameters, and operative and immediate postoperative managements. A Fenes- trated Fontan procedure was present in 133 （83.6%）. The external Fontan procedure was present in 124 （78.0%）. Within the study population, 41 （25.8%） patients met criteria for prolonged recovery. Univariate risk factors for prolonged recovery included acute kidney injury （AKI, P=0.001）, preoperative prothrombin time and internation- al normalized ratio （P=0.02 and 0.018）, immediate postoperative red blood cell （RBC）, hematocrit, neutrophil and platelet （P=0.019, 0.006, 0.019, and 0.043）, and postoperative nosocomial infection, incision infection, blood urea nitrogen, and creatinine （P=0.011, 0.016, 0.014, and 0.005）. In a multivariable model, the independent risk factors for prolonged recovery after the Fontan operation were postoperative AKI （OR 1.753, 95% CI 1.238, 2.484） and postoperative higher RBC （OR 1.667, 95% CI 1.110, 2.503）. Fenestrated procedure might be a protec- tive factor （OR 0.355, 95% CI

关键词： Fontan, risk factors acute kidney injury cohort study

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Prevention Strategies of Contrast Medium Induced Nephropathy (CIN): A Review of the Current Literature

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Open Journal of Nephrology 2016年第3期6卷 98-110页

作者： Marco Di Serafino Rosa Severino Carmen Scavone Matilde Gioioso Valeria Coppola Raffaela Brigida Francesco Lisanti Rosario Rocca Enrico Scarano Radiology Department San Carlo Hospital Potenza Italy Emergency Department San Carlo Hospital Potenza Italy

Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hospitalization, cost increase and, above all, an unfavourable short- and long-term prognosis. Here, the authors discuss about the contrast medium induced nephropathy prevention strategies, from the identification of patients at risk and drugs potentially nephrotoxic, to the hydration with possible administration of drugs that appeared to be, in some contexts, nephron-protective, and finally we analyze the radiological procedure aimed at the correct choice of type and administration modality of the contrast medium according to current literature.

关键词： Contrast Medium acute kidney injury Hydration

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Proximal Iliac Artery Stenosis in Allograft Renal Transplant, a Diagnostic beyond Echo-Doppler, Treatment Approach

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Open Journal of Nephrology 2021年第3期11卷 295-303页

作者： Douze Makenzi Agustin Carreno Diego Catarovich Hourmant Marie Yvonne Praile Martin Alberto Carero Sanchez De la Nieta Maiberi Maldonado Antonio Pinar Makhoul Martin Mond Victoria General Hospital of Ciudad Real Ciudad Real Spain Centre Hospitalier Universitaire de Nantes Nantes France Centre Hospitalier de Mouscron Mouscron Belgium

Background: Transplant Renal Artery Stenosis (TRAS) is a well-known vascular complication after a kidney transplant. It is associated with premature renal failure, uncontrolled hypertension, and allograft loss. However, Proximal Iliac Artery Stenosis to a kidney Transplant (Prox-TRAS) is an uncommon cause of vascular graft complication leading to acute renal failure and refractory hypertension with a less incidence around and only a few cases reports have been described in the medical literature. Methods: We reviewed the medical record of kidney transplant recipients of the General Hospital of Ciudad Real, Spain, from March 2008 to March 2019. We identified all cases (260) with the diagnosis of renal vascular hypertension by imaging studies. Of those 260 renal vascular stenoses, five (5) were diagnosed with proximal iliac artery stenosis through Angio-CT and arteriography. We performed an analysis of clinical parameters and evolution. Results: Prox-TRAS was diagnosed in 5 of the 260 patients who presented acute or progressive allograft dysfunction with refractory hypertension, with an incidence rate of 1.4%. In 4 of them (1.1%), we had to resort to another imaging test, angio-CT, arteriography, as the echo-doppler was unable to identify the abnormalities. Hypertension was a constant finding along with impaired renal function (100%);with respect to Prox-TRAS, its onset was later (12 - 60 months) after transplantation. An increase in TA (140 ± 10 and 80.7 ± 7 to 160 ± 18 and 85 ± 7 mmHg, p-0.009) was observed. There was an increase in the use of hypotensive drugs (2.1 ± 1.1 and 4.3 ± 1, p-0.003). Similarly, in all cases, a worsening of basal creatinine from 0.9 to 0.1 ± to 1.2 ± (P × 0.004) was also observed. Prox-TRAS was a cause of the increase in both creatinine and TA (140 ± 10 and 80.7 ± 7 to 160 ± 18 and 85 ± 7 mmHg, P 0.009). All cases were treated by Percutaneous transluminal

关键词： acute kidney injury Hypertension Renal Transplant Renovascular Disease Chronic kidney Disease

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