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Severe acute kidney injury due to oxalate crystal induced severe interstitial nephritis:A case report

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World Journal of nephrology 2024年第2期13卷 24-30页

作者： Maulik K Lathiya Praveen Errabelli Sasmit Roy Neeharik Mareedu Department of Emergency Medicine Mayo Clinic Health SystemEau ClaireWI 54703United States Department of nephrology Mayo Clinic Health SystemEau ClaireWI 54703United States Department of nephrology Centra Lynchburg General HospitalLynchburgVA 24551United States Department of nephrology UPMC Western MarylandCumberlandMD 21502United States

BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various *** medication-induced interstitial nephritis is common,occurrences due to non-pharmacological factors are *** report presents a case of severe AKI triggered by intratubular oxalate crystal deposition,leading to interstitial *** aim is to outline the case and its management,emphasizing the significance of recognizing uncommon causes of interstitial *** SUMMARY A 71-year-old female presented with stroke-like symptoms,including weakness,speech difficulties,and cognitive *** hypertension had been managed with hydrochlorothiazide(HCTZ)for over two *** admis-sion,severe hypokalemia and AKI were noted,prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial *** investigations,including kidney biopsy,confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying *** treatment,initial renal function showed minimal ***,with prednisolone therapy and supportive measures,her condition gradually improved,high-lighting the importance of comprehensive *** This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial *** occurrence of interstitial nephritis due to oxalate crystal deposition,especially without typical risk factors,emphasizes the need for vigilance in clinical practice.

关键词： Acute kidney injury Interstitial nephritis Oxalate crystal Hydrochlorothiazide Hypokalemia Case report

Effects of Transjugular Intrahepatic Portosystemic Shunt on Renal and Pulmonary Function in Hepatic Decompensation with and without Hepatorenal and Hepatopulmonary Syndromes:A Review

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Journal of clinical and Translational Hepatology 2024年第9期12卷 780-791页

作者： Ahmed H.Abdelwahed Moataz Aboeldahb George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA Department of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Cirrhosis is often characterized by decreased liver function,ranging from a compensated,typically asymptomatic phase to a decompensated phase characterized by the appearance of ascites or variceal bleeding,and ultimately hepatorenal syndrome(HRS)or hepatopulmonary syndrome(HPS).The latter two complications are associated with a poor prognosis and limited treatment *** cases of ascites or variceal bleeding resistant to medical therapy,transjugular intrahepatic portosystemic shunt(TIPS)is effective and *** blood by TIPS diverts portal blood to the systemic circulation,potentially increasing systemic blood volume and benefiting renal ***,TIPS could also divert nitric oxide to the systemic circulation,potentially worsening systemic hypotension and perfusion,which could be detrimental to renal *** evidence indicates that TIPS often improves renal function in patients with portal hypertension,with or without *** studies have shown persistently decreased renal function after ***,these data are insufficient to support a recommendation for the use of TIPS specifically for *** patients without pre-existing HPS,TIPS does not appear to significantly affect pulmonary gas *** of TIPS in HPS have been inconsistent;some studies have shown improvement,but effects were *** studies have shown a persistent decline in pulmonary function after *** evidence supports the need for large randomized controlled trials to investigate the beneficial effects of TIPS for *** pulmonary function data are less clear regarding TIPS for *** aim of the current report was to review the literature regarding the effects of TIPS on renal and pulmonary function in hepatic decompensation,with or without the development of HRS or HPS.

关键词： Cirrhosis Hepatorenal syndrome Hepatopulmonary syndrome Transjugular intrahepatic portosystemic shunt

Long-term outcomes of titanium-nitride-oxide coated stents and drug-eluting stents in acute coronary syndrome:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第5期16卷 293-305页

作者： Muhammad Ahmed Ali Fahim Afia Salman Hira Anas Khan Syed Muhammad Hasan Muskan FatimaBhojani Sarah Aslam Amna Zia Ul Haq Vishal Reddy Bejugam Beena Muntaha Nasir Wajiha Gul Abdul Moeed Abdelrahman S Abdalla Muhammad Majid Muhammad Sohaib Asghar Md Al Hasibuzzaman Department of Internal Medicine Dow University of Health SciencesKarachi 74200Pakistan Department of Internal Medicine North Central Bronx HospitalBronxNY 10467United States Department of Urology Center for Academic MedicineStanford University School of MedicinePalo AltoCA 33872United States Department of Cardiovascular Imaging Cleveland ClinicClevelandOH 44195United States division of nephrology and hypertension Mayo Clinic RochesterRochesterMN 55905United States Institute of Nutrition and Food Science University of DhakaDhaka 1000Bangladesh

BACKGROUND In severe cases of coronary artery disease,percutaneous coronary intervention provide promising *** stent used could be a drug-eluting stent(DES)or a titanium-nitride-oxide coated stent(TiNOS).AIM To compare the 5-year effectiveness and safety of the two stent *** The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines,and PubMed/MEDLINE,Scopus,and Cochrane Central were searched from inception till August *** outcomes were major adverse cardiac events(MACE),cardiac death,myocardial infarction(MI),cardiac death or MI,and ischemia-driven total lesion revascularization(ID-TLR).RESULTS Four randomized controlled trials(RCT),which analyzed a sum total of 3045 patients with acute coronary syndrome(ACS)after a median follow-up time of 5 years were *** statistically insignificant,an increase in the ID-TLR was observed in patients receiving TiNOSs vs *** addition,MI,cardiac death and MI,and definite stent thrombosis(DST)were significantly decreased in the TiNOS *** analysis revealed no significant results with meta-regression presenting non-ST elevated MI(NSTEMI)as a statistically significant covariate in the outcome of *** TiNOS was found to be superior to DES in terms of MI,cardiac death or MI,and DST outcomes,however,the effect of the two stent types on ID-TLR and MACE was not significant.A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.

关键词： Stents Drug-eluting Major adverse cardiac events All-cause death Meta-analysis

Cardiac evaluation of renal transplant candidates with heart failure

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World Journal of Transplantation 2024年第4期14卷 44-49页

作者： Amer Ashaab Belal Alfonso Hernandez Santos Jr Amir Kazory Department of Medicine Division of NephrologyUniversity of Florida College of MedicineGainesvilleFL 32610United States division of nephrology Hypertension and Renal TransplantationUniversity of FloridaGainesvilleFL 32608United States

Patients with advanced kidney disease are at elevated risk of developing heart failure and appropriate risk stratification is important to permit them to receive kidney *** American Heart Association and American College of Cardiology joint statement provides guidance on risk stratification for the major cause of heart failure for these patients in its recommendations for coronary heart *** we provide an overview of the available literature on risk strati-fication for nonischemic heart failure and functional heart disease states such as pulmonary *** of these options for optimizing these patients be-fore transplant include optimizing their volume status,often with more agg-ressive *** transplantation remains the treatment of choice for patients with advanced kidney disease and cardiac disease,the correction of the azotemic substances with kidney transplantation has been associated with imp-roved survival than remaining on dialysis *** findings in the studies reviewed here are expected to help clinicians refine current strategies for evalua-ting potential kidney transplant recipients.

关键词： Kidney transplantation Preoperative evaluation clinical practice guidelines Heart failure Pulmonary hypertension

Rhabdomyolysis-related acute kidney injury in patients with COVID- 19

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World Journal of Virology 2024年第3期13卷 76-81页

作者： Ahmet Murt Mehmet Riza Altiparmak Department of nephrology clinic Istanbul University-CerrahpasaCerrahpasa Medical FacultyIstanbul 34000Türkiye Department of Internal Medicine Division of NephrologyIstanbul UniversityIstanbul 34000Türkiye

BACKGROUND Viral and bacterial infections may be complicated by rhabdomyolysis,which has a spectrum of clinical presentations ranging from asymptomatic laboratory abnor-malities to life-threatening conditions such as renal *** viral injury as well as inflammatory responses may cause rhabdomyolysis in the course of coronavirus disease 2019(COVID-19).When presented with acute kidney injury(AKI),rhabdomyolysis may be related to higher morbidity and *** To compare rhabdomyolysis-related AKI with other AKIs during *** A total of 115 patients with COVID-19 who had AKI were evaluated *** patients had a definite diagnosis of rhabdomyolysis(i.e.,creatine kinase levels increased to>5 times the upper normal range with a concomitant increase in transaminases and lactate dehydrogenase).These patients were aged 61.0±19.1 years and their baseline creatinine levels were 0.87±0.13 mg/*** were treated according to national COVID-19 treatment *** were compared with patients with COVID-19 who had AKI due to other *** For patients with rhabdomyolysis,creatinine reached 2.47±1.17 mg/dL during follow-up in *** these patients,13.3%had AKI upon hospital admission,and 86.4%developed AKI during hospital *** peak C-reactive protein reached as high as 253.2±80.6 mg/L and was higher than in patients with AKI due to other reasons(Pclinical course.

关键词： Rhabdomyolysis Acute kidney injury COVID-19 SARS-CoV-2 Creatine kinase

Propofol sedation in routine endoscopy:A case series comparing target controlled infusion vs manually controlled bolus concept

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World Journal of Gastrointestinal Endoscopy 2024年第1期16卷 11-17页

作者： Riad Sarraj Lorenz Theiler Nima Vakilzadeh Niklas Krupka Reiner Wiest Department of Visceral Surgery and Medicine Inselspital University HospitalBern 3010Switzerland clinic for Anesthesia PerioperativeEmergency&Intensive Care MedicineKantonsspital AarauAarau 5001Switzerland Department of nephrology and hypertension University Hospital LausanneLausanne 1011Switzerland

BACKGROUND Many studies have addressed safety and effectiveness of non-anaesthesiologist propofol sedation(NAPS)for gastrointestinal(GI)endoscopy Target controlled infusion(TCI)is claimed to provide an optimal sedation regimen by avoiding under-or *** To assess safety and performance of propofol TCI sedation in comparison with nurse-administered *** Fouty-five patients undergoing endoscopy under TCI propofol sedation were prospectively included from November 2016 to May 2017 and compared to 87 patients retrospectively included that underwent endoscopy with *** were matched for age and endoscopic *** recorded time of sedation and endoscopy,dosage of medication and adverse *** There was a significant reduction in dose per time of propofol administered in the TCI group,compared to the NAPS group(8.2±2.7 mg/min vs 9.3±3.4 mg/min;P=0.046).The time needed to provide adequate sedation levels was slightly but significantly lower in the control group(5.3±2.7 min vs 7.7±3.3 min;P<0.001),nonetheless the total endoscopy time was similar in both *** differences between TCI and bolus-sedation was observed for mean total-dosage of propofol rate as well as adverse *** This study indicates that sedation using TCI for GI endoscopy reduces the dose of propofol necessary per minute of *** may translate into less adverse ***,further and randomized trials need to confirm this trend.

关键词： Sedation Endoscopy Propofol Target controlled infusion Non-anaesthesiologist propofol sedation Adverse event

Exome sequencing identifies a likely causative variant in 53%of families with ciliopathy-related features on renal ultrasound after excluding NPHP1 deletions

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Genes & Diseases 2024年第5期11卷 40-43页

作者： Konstantin Deutsch Verena Klambt Thomas M.Kitzler Tilman Jobst-Schwan Ronen Schneider Florian Buerger Steve Seltzsam Sherif El Desoky Jameela A.Kari Farkhanda Hafeez Maria Szczepanska Loai A.Eid Hazem S.Awad Muna Al-Saffar Neveen A.Soliman Velibor Tasic Camille Nicolas-Frank Kirollos Yousef Luca M.Schierbaum Sophia Schneider Abdul Halawi Izzeldin Elmubarak Katharina Lemberg Shirlee Shril Shrikant M.Mane Nancy Rodig Friedhelm Hildebrandt division of nephrology Department of PediatricsBoston Children’s HospitalHarvard Medical SchoolBostonMA 02215USA Department of Pediatric Gastroenterology Nephrology and Metabolic DiseasesCharite Universitatsmedizin BerlinBerlin 13353Germany Berlin Institute of Health at Charitee Universitatsmedizin Berlin BIH Biomedical Innovation AcademyBIH Charite Clinician Scientist ProgramBerlin 10178Germany Department of nephrology and hypertension FriedrichAlexander-Universitat Erlangen-NurnbergErlangen 91054Germany Department of Pediatrics Faculty of Medicine King Abdulaziz UniversityPediatric Nephrology Center of ExcellenceKing Abdulaziz University HospitalJeddah 21589Saudi Arabia Department of Pediatric nephrology The Children’s Hospital and Institute of Child HealthLahore 54000Pakistan Department of Pediatrics Faculty of Medical Sciences in ZabrzeMedical University of Silesia in KatowiceKatowice 40-752Poland Dubai Hospital and Al-Jalila Children’s Specialty Hospital Kidney Center of ExcellenceDubai 4545United Arab Emirates Department of Genetics and Genomics UAE UniversityAbu Dhabi 15551United Arab Emirates Department of Pediatrics Division of Genetics and GenomicsBoston Children’s HospitalHarvard Medical SchoolBostonMA 02215USA Department of Pediatrics Center of Pediatric Nephrology and TransplantationKasr Al Ainy School of MedicineCairo UniversityCairo 11562Egypt Egypt Center for Research and Regenerative Medicine(ECRRM) Cairo 11511Egypt Medical Faculty Skopje University Children’s HospitalSkopje 1000North Macedonia Department of Genetics Yale University School of MedicineNew HavenCT 06520USA

Nephronophthisis-related ciliopathies(NPHP-RC)represent one of the most common causes of chronic kidney disease in the first three decades of life and are characterized by a broad genetic and clinical heterogeneity.1 To date,more than 90 genes have been identified that cause autosomalrecessive NPHP-RC if mutated,accounting for up to 60%of cases.1 Among these,homozygous deletions of NPHP1 are the most common *** genes localize to primary cilia,basal bodies,or the centrosome and lead to a primary ciliary disruption if mutated,thereby causing a broad phenotypical spectrum.1 Patients that suffer from NPHP-RC can either have an isolated renal phenotype,such as polyuria,polydipsia,decreased urinary concentration ability,and secondary enuresis due to loss of tubular function,or present with extrarenal symptoms including retinal degeneration,cerebellar vermis hypoplasia,or hepatic *** are often diagnosed in early adolescence,reaching end-stage renal disease before 25 years of age,but early onset and rapidly progressive forms of NPHP-RC also exist.1 Renal ultrasound indicates kidneys of normal or reduced renal length with increased echogenicity and corticomedullary cysts.

关键词： degeneration urinary likely

Point-of-care ultrasound in nephrology:A private practice viewpoint

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World Journal of Methodology 2024年第4期14卷 30-42页

作者： Rajiv Sinanan Afsheen Moshtaghi Abhilash Koratala Arizona Kidney Disease and hypertension Centers PhoenixAZ 85016United States Department of Medicine Verde Valley Medical CenterCottonwoodAZ 86326United States division of nephrology Medical College of WisconsinMilwaukeeWI 53226United States

Point-of-care ultrasound(POCUS)is a limited ultrasound examination performed by the clinician at the bedside,emerging as a complement to physical examination across various medical *** the field of nephrology,its integration has been gradual,primarily limited to guiding procedures like temporary dialysis catheter placement or,in some cases,diagnostic kidney *** reality,the assessment of hemodynamic status at the bedside holds immense value for nephrologists,yet there exists limited awareness among practitioners regarding its *** there is a growing trend towards incorporating multiorgan POCUS training in fellowship programs,private practice nephrologists remain relatively *** discussion explores the untapped potential of POCUS as a valuable diagnostic tool in everyday nephrology practice,demonstrating its effectiveness in diverse clinical settings,ranging from medical wards to outpatient dialysis ***,we delve into the challenges hindering its widespread adoption and consider the future trajectory of this innovative approach.

关键词： Point-of-care ultrasound Bedside ultrasound nephrology Hemodynamics Cirrhosis Acute kidney injury

Small GTPases and cilia

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Protein & Cell 2011年第3期2卷 13-25页

作者： Yujie Li Jinghua Hu Department of nephrology and hypertension Mayo ClinicRochesterMinnesotaUSA Translational PKD Center Mayo ClinicRochesterMinnesotaUSA Department of Biochemistry and Molecular Biology Mayo ClinicRochesterMinnesotaUSA

Small GTPases are key molecular switches that bind and hydrolyze GTP in diverse membrane-and cytoskeletonrelated cellular ***,mounting evidences have highlighted the role of various small GTPases,including the members in Arf/Arl,Rab,and Ran subfamilies,in cilia formation and *** overlooked as an evolutionary vestige,the primary cilium has attracted more and more attention in last decade because of its role in sensing various extracellular signals and the association between cilia dysfunction and a wide spectrum of human diseases,now called *** we review recent advances about the function of small GTPases in the context of cilia,and the correlation between the functional impairment of small GTPases and *** of these cellular processes is of fundamental importance for broadening our view of cilia development and function in normal and pathological states and for providing valuable insights into the role of various small GTPases in disease processes,and their potential as therapeutic targets.

关键词： Small GTPase cilia ciliopathy