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Acute pancreatitis as a complication of acute COVID-19 in kidney transplant recipients

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World Journal of Clinical Cases 2024年第6期12卷 1104-1110页

作者： Nikolina Basic-Jukic Ivana Juric Lea Katalinic Vesna Furic-Cunko Vibor Sesa Anna Mrzljak Department of nephrology Arterial HypertensionDialysis and TransplantationUniversity Hospital Centre ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia

BACKGROUND Acute pancreatitis is a rare extrapulmonary manifestation of coronavirus disease 2019(COVID-19)but its full correlation with COVID-19 infection remains *** To identify acute pancreatitis’occurrence,clinical presentation and outcomes in a cohort of kidney transplant recipients with acute *** A retrospective observational single-centre cohort study from a transplant centre in Croatia for all adult renal transplant recipients with a functioning kidney allograft between March 2020 and August 2022 to record cases of acute pancreatitis during acute *** were obtained from hospital electronic medical *** acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection was proven by a positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction on the nasopharyngeal *** Four hundred and eight out of 1432(28.49%)patients who received a renal allograft developed COVID-19 *** analyzed cohort included 321 patients(57%males).One hundred and fifty patients(46.7%)received at least one dose of the anti-SARS-CoV-2 vaccine before the *** hundred twenty-five(39.1%)patients required hospitalization,141(44.1%)developed pneumonia and four patients(1.3%)required mechanical *** included immunosuppression modification in 233 patients(77.1%)and remdesivir in 53 patients(16.6%),besides the other supportive *** the study cohort,only one transplant recipient(0.3%)developed acute pancreatitis during acute COVID-19,presenting with abdominal pain and significantly elevated pancreatic *** survived without complications with a stable kidney allograft *** Although rare,acute pancreatitis may complicate the course of acute COVID-19 in kidney transplant *** mechanism of injury to the pancreas and its correlation with the severity of the COVID-19 infection in kidney transplant recipients warrants further research.

关键词： Acute pancreatitis COVID-19 Kidney transplant Angiotensin-converting enzyme-2 receptor Immunosuppressive agents

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

Risk factors for cognitive impairment in patients with chronic kidney disease

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World Journal of Psychiatry 2024年第2期14卷 308-314页

作者： Xiao-Hui Wang Yong He Huan Zhou Ting Xiao Ran Du Xin Zhang Department of nephrology The Fifth Hospital of WuhanWuhan 430050Hubei ProvinceChina Department of nephrology The Central Hospital of Enshi Tujia and Miao Autonomous PrefectureEnshi 445000Hubei ProvinceChina

BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread *** To investigate the risk factors for concurrent cognitive dysfunction in patients with *** This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and *** Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive *** risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married *** The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.

关键词： Cognitive impairment Cognitive dysfunction Chronic kidney disease

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

Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease

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World Journal of nephrology 2024年第3期13卷 41-48页

作者： Anastasia Vagopoulou Panagiotis Theofilis Despina Karasavvidou Nasra Haddad Dimitris Makridis Stergios Tzimikas Rigas Kalaitzidis nephrology Department“C.Katsinas” General Hospital of Ptolemaida“Mpodosakeio”Ptolemaida 50200Greece Center for nephrology“G.Papadakis” General Hospital of Nikaia-Piraeus“Agios Panteleimon”Nikaia-Piraeus 18454Greece

BACKGROUND Flavonoids,the main class of polyphenols,exhibit antioxidant and antihypertensive *** To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease(CKD)stagesⅠ-Ⅳ.METHODS In this prospective,single-arm study,CKD patients with arterial hypertension and diabetes mellitus were *** demographic,clinical,and laboratory variables were *** received daily treatment with a phenol-rich dietary supplement for 3 *** pressure,arterial stiffness(carotidfemoral pulse wave velocity,central pulse pressure),and oxidative stress markers(protein carbonyls,total phenolic compound,total antioxidant capacity)were measured at baseline and at study *** Sixteen patients(mean age:62.5 years,87.5%male)completed the *** intervention,peripheral systolic blood pressure decreased significantly by 14 mmHg(P<0.001).Carotid-femoral pulse wave velocity decreased from 8.9 m/s(baseline)to 8.2 m/s(study end)(P<0.001),and central pulse pressure improved from 59 mmHg to 48 mmHg(P=0.003).Flavonoids also reduced oxidative stress markers including protein carbonyls(P<0.001),total phenolic compound(P=0.001),and total antioxidant capacity(P=0.013).CONCLUSION Flavonoid supplementation in CKD patients shows promise in improving blood pressure,arterial stiffness,and oxidative stress markers.

关键词： Flavonoids Chronic kidney disease Arterial stiffness Oxidative stress Carotid-femoral pulse wave velocity

The Impact of Finerenone on Changes in Pulse Wave Velocity, Arterial Pressure and Heart Related Deaths in Hemodialysis Patients—Study Perspective

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Open Journal of nephrology 2024年第2期14卷 216-225页

作者： Ljiljana Fodor Duric Bozidar Vujicic Tonko Gulin Matko Gulin School of Medicine University Catholica Croatica Zagreb Croatia Department for nephrology and Arterial hypertension Medikol Polyclinic Zagreb Croatia Department for nephrology Dialysis and Kidney Transplantation Clinical Hospital Center Rijeka Faculty of Medicine University of Rijeka Rijeka Croatia Department for nephrology and Dialysis Clinical Hospital Center Sisters of Charity Zagreb Croatia Faculty of Medicine University of Zagreb Zagreb Croatia Department for Radiology Clinical Hospital Center Sisters of Charity Zagreb Croatia

The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order of (research background), purpose/aim, method, results and conclusions. The introduction of the abstract and preface is rather lengthy, but the summary of the whole study and the presentation of the research background are not perfect (mainly because the logic of the context is not clear and orderly), so it will appear a bit messy. Hope to be able to modify (this has been mentioned in the preliminary opinion). Cardiovascular events (CVE) pose a significant threat to individuals with end-stage renal disease (ESRD), yet these patients are often excluded from cardiovascular clinical trials, leaving prognostic factors associated with CVE in ESRD patients largely unexplored. Recent human studies have demonstrated elevated circulating aldosterone levels in ESRD patients, correlating with left ventricular hypertrophy. Additionally, animal models have shown improvements in uremic cardiomyopathy with spironolactone therapy, prompting interest in assessing the efficacy of spironolactone or eplerenone in reducing mortality and improving cardiovascular function in dialysis patients. Clinicians have historically been cautious about prescribing mineralocorticoid receptor antagonists (MRAs) to congestive heart failure patients with chronic kidney disease (CKD) due to hyperkalemia risk. However, the emergence of finerenone, a novel MR antagonist with a favorable safety profile and lower hyperkalemia risk, has renewed interest in MRA therapy in this population. Heart disease, including coronary artery disease, hypertension, and left ventricular failure, is alarmingly prevalent in dialysis patients, contributing significantly to elevated mortality rates compared to the general population. Arterial stiffness, as indicated by pulse wave velocity (PWV), progressively worsens

关键词： Cardiovascular Risk Factors Finerenone Arterial Stiffness Heart Related Deaths Hemodialysis Patients

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

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

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