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Refining the Role of Simultaneous Liver Kidney Transplantation

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Journal of Clinical and Translational Hepatology 2018年第3期6卷 289-295页

作者： Sabiha M.Hussain Kalathil K.Sureshkumar division of Nephrology and hypertension Department of MedicineAllegheny General HospitalAllegheny Health NetworkPittsburghPAUSA

Adoption of the model for end-stage liver disease score by Organ Procurement and Transplant Network(OPTN)deceased donor liver allocation policy in 2002 has led to an increase in the number of simultaneous liver kidney(SLK)*** kidney function recovery following liver transplantation is difficult to predict,al ocation of the kidney for SLK trans-plantation thus far has not been based on much rationale and *** of OPTN policy towards SLK organ allocation has resulted in great variations among transplant centers regarding SLK *** use of kidneys towards SLK transplantation diverts deceased donor kidneys away from candidates awaiting kidney-alone *** OPTN/United Network of Organ Sharing has imple-mented medical eligibility criteria for adult SLK transplantation which also includes a concept of safety *** of the new policy is a move in a positive direction,providing consistency in our practice and evidence-based guidelines in selecting candidates for SLK *** policy needs to be monitored prospectively and modified based on new data that wil emerge over *** review outlines the literature on SLK transplantation and efforts towards developing rational policy on SLK organ allocation.

关键词： Liver kidney transplantation Graft survival MELD score Creatinine GFR

Kidney disease in non-kidney solid organ transplantation

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World Journal of Transplantation 2022年第8期12卷 231-249页

作者： Kurtis J Swanson division of Nephrology and hypertension University of MinnesotaMinneapolisMN 55414United States

Kidney disease after non-kidney solid organ transplantation(NKSOT)is a common post-transplant complication associated with deleterious *** disease,both acute kidney injury and chronic kidney disease(CKD)alike,emanates from multifactorial,summative pre-,peri-and post-transplant *** factors leading to kidney disease are shared amongst solid organ transplantation in addition to distinct mechanisms unique to individual transplant *** aim of this review is to summarize the current literature describing kidney disease in *** conducted a narrative review of pertinent studies on the subject,limiting our search to full text studies in the English *** disease after NKSOT is prevalent,particularly in intestinal and lung *** strategies in the peri-operative and post-transplant periods including proteinuria management,calcineurin-inhibitor minimization/sparing approaches,and nephrology referral can counteract CKD progression and/or aid in subsequent kidney after solid organ *** disease after NKSOT is an important consideration in organ allocation practices,ethics of *** disease after SOT is an incipient condition demanding further *** some truths have been revealed about this chronic disease,as we have aimed to describe in this review,continued multidisciplinary efforts are needed more than ever to combat this threat to patient and allograft survival.

关键词： Acute kidney injury Chronic kidney disease Solid organ transplant Native kidneys Calcineurin inhibitor toxicity Renal replacement therapy Kidney after solid organ transplant

The calcium sensing receptor: from calcium sensing to signaling

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Science China(Life Sciences) 2015年第1期58卷 14-27页

作者： ZHANG Chen MILLER Cassandra Lynn BROWN Edward M YANG Jenny J. Department of Chemistry Georgia State University Center for Diagnostics and Therapeutics Georgia State University division of Endocrinology Diabetes and HypertensionDepartment of MedicineBrigham and Women's Hospital

The Ca2+-sensing receptor(the Ca SR),a G-protein-coupled receptor,regulates Ca2+ homeostasis in the body by monitoring extracellular levels of Ca2+([Ca2+]o) and responding to a diverse array of *** in the Ca2+-sensing receptor result in hypercalcemic or hypocalcemic disorders,such as familial hypocalciuric hypercalcemia,neonatal severe primary hyperparathyroidism,and autosomal dominant hypocalcemic *** evidence suggests that the Ca SR plays multiple roles extending well beyond not only regulating the level of extracellular Ca2+ in the human body,but also controlling a diverse range of biological *** this review,we focus on the structural biology of the Ca SR,the ligand interaction sites as well as their relevance to the disease associated *** systematic summary will provide a comprehensive exploration of how the Ca SR integrates extracellular Ca2+ into intracellular Ca2+ signaling.

关键词： the Ca2+-sensing receptor(the Ca SR) Ca2+ signaling extracellular domain(ECD) Ca2+-binding sites

Albumin use in cirrhosis:a nephrology viewpoint on key considerations and cautionary notes

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 536-539页

作者： Abhilash Koratala Amir Kazory division of Nephrology Department of MedicineMedical College of WisconsinMilwaukeeWIUSA division of Nephrology Hypertension and Renal TransplantationUniversity of FloridaGainesvilleFLUSA

The constant need to reduce the variability of clinical practice and to improve the quality of care of the patients and their outcomes have led to the increasing emphasis on evidence-based *** there is a paucity of robust data on a specific topic or there are conflicting conclusions from available studies,clinical practice recommendations may prove helpful to fill the gap and assist with clinical *** are a variety of such recommendations,such as consensus statements,practice guidelines,and position statements,each with a specific set of methodology and *** statements are comprehensive documents meant to elucidate,justify,and recommend a particular approach to a clinical *** papers often present a detailed understanding of the issues in question,discuss the pros and cons of the available options,and provide the rationale for the position that is set *** other forms of clinical practice consensus,position statements innately provide information on the level of evidence and the strength of what the panel of experts agrees *** are several consensus group methods by which these statements can be *** is a systematic process to create and measure consensus,which is particularly well suited where input is required from a large number of geographically dispersed experts.

关键词： Cirrhosis hepatorenal albumin point-of-care ultrasound(POCUS) ultrasound

Point of care ultrasonography in onco-nephrology:A stride toward better physical examination

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World Journal of Nephrology 2023年第2期12卷 29-39页

作者： Bhavna Bhasin-Chhabra Abhilash Koratala division of Nephrology and hypertension Mayo ClinicScottsdaleAZ 85259United States division of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

Onco-Nephrology is an emerging subspecialty of Nephrology that focuses on a broad spectrum of renal disorders that can arise in patients with *** encompasses acute kidney injury(AKI),complex fluid,electrolyte,and acid-base disorders,as well as chronic kidney disease caused or exacerbated by cancer and/or its *** many such scenarios including AKI and hyponatremia,objective evaluation of hemodynamics is vital for appropriate *** of care ultrasonography(POCUS)is a limited ultrasound exam performed at the bedside and interpreted by the treating physician intended to answer focused clinical questions and guide *** to conventional physical examination,POCUS offers substantially higher diagnostic accuracy for various structural and hemodynamic *** this narrative review,we provide an overview of the utility of POCUS enhanced physical examination for the Onconephrologist supported by the current evidence and our experience-based opinion.

关键词： Point of care ultrasonography Onco-nephrology Acute kidney injury Hyponatremia Volume assessment

Atherosclerosis in elderly patients with renal insufficiency

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Journal of Geriatric Cardiology 2005年第3期2卷 143-156页

作者： Sandeep S.Soman division of Nephrology and hypertension Henry Ford Health System CFP-5DetroitMI 48202

IntroductionAs people age,cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease *** addition to lipid levels,diabetes,sedentary lifestyle,and genetic factors that are known risks for coronary disease,hypertension,and stroke - the quintessential cardiovascular (CV) diseases related to atherosclerosis within our society - advancing age unequivocally confers the major risk.(Fig.1) Mortality due to cardiovascular disease is more than any other disease and creates enormous costs for the health care *** main underlying problem in cardiovascular disease is atherosclerosis,a process that obstructs major arteries with lipid deposits and cell accumulation.1 Decreased kidney function (estimated GFR＜70 mL/min/1.73 m2) is an independent risk factor for cardiovascular disease and all-cause mortality in the general population.

关键词： Atherosclerosis in elderly patients with renal insufficiency CKD HDL LDL ESRD

Acute abdomen and ascites as presenting features of autosomal dominant polycystic kidney disease

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World Journal of Hepatology 2012年第12期4卷 394-398页

作者： Sanjay Chaudhary Qi Qian division of Nephrology and hypertension Department of MedicineMayo Clinic College of MedicineRochesterMN 55905United States

We describe a patient with sudden onset of abdominal pain and ascites,leading to the diagnosis of autosomal dominant polycystic kidney disease(ADPKD).Her presentation was consistent with acute liver cyst rupture as the cause of her acute illness.A review of literature on polycystic liver disease in patients with ADPKD and current management strategies are *** case alerts physicians that ADPKD could occasionally present as an acute abdomen;cyst rupture related to ADPKD may be considered in the differential diagnoses of acute abdomen.

关键词： Autosomal dominant polycystic kidney disease Acute abdominal pain Ascites Polycystic liver disease

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Genes & Diseases 2016年第4期3卷 252-256页

作者： Le Min division of Endocrinology Diabetes and HypertensionBrigham and Women’s Hospital221 Longwood AvenueBostonMA02115USA

Immune checkpoint inhibition against advance malignancies was named breakthrough discovery by the science magazine in *** numerous clinical studies,monoclonal antibodies against the immune checkpoints,CTLA4,PD1 and PD1 ligand PDL1 have shown promising tumor response in different type of metastatic *** adverse events are *** endocrine disorders,hypophysitis and thyroiditis are among the most common side effects associated with immune checkpoint inhibition ***,a very rare endocrine disorder occurs in about one tenth of the patients receiving anti-CTLA4 ***,on the other hand,is more commonly seen in patients receiving anti-PD1 *** addition,both thyroiditis and hypophysitis are common in patients receiving combination treatment with anti-CTLA4 and anti-PD1 *** time to onset of hypophysitis and thyroiditis is *** of the endocrine disorders occur within 12 weeks after initiation of the immune checkpoint inhibition *** can manifest as total anterior pituitary hormone deficiency or isolated pituitary hormone *** insipidus is *** and gonadotropin deficiencies may be reversible but ACTH deficiency appears *** can present as hypothyroidism or thyrotoxicosis followed by *** appears *** identifying the onset of hypophysitis and thyroiditis and proper management of these endocrine disorders will improve the quality of the life and the outcome of this novel immunotherapy.

关键词： Cancer Hypophysitis Immune checkpoint inhibition Immune-related adverse events Thyroiditis

Incidence of kidney stones in kidney transplant recipients:A systematic review and meta-analysis

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World Journal of Transplantation 2016年第4期6卷 790-797页

作者： Wisit Cheungpasitporn Charat Thongprayoon Michael A Mao Wonngarm Kittanamongkolchai Insara J Jaffer Sathick Tsering Dhondup Stephen B Erickson division of Nephrology and hypertension Department of Medicine Mayo Clinic

AIM To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients. METHODS A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a randomeffects model to estimate the incidence of kidney *** Twenty one studies with 64416 kidney transplant patients were included in the analyses to assess the incidence of kidney stones after kidney transplantation. The estimated incidence of kidney stones was 1.0%(95%CI: 0.6%-1.4%). The mean duration to diagnosis of kidney stones after kidney transplantation was 28 ± 22 mo. The mean age of patients with kidney stones was 42 ± 7 years. Within reported studies, approximately 50% of kidney transplant recipients with kidney stones were males. 67% of kidney stones were calcium-based stones(30% mixed CaO x/CaP, 27%CaO x and 10%CaP), followed by struvite stones(20%) and uric acid stones(13%).CONCLUSION The estimated incidence of kidney stones in patients after kidney transplantation is 1.0%. Although calcium based stones are the most common kidney stones aftertransplantation, struvite stones(also known as "infection stones") are not uncommon in kidney transplant recipients. These findings may impact the prevention and clinical management of kidney stones after kidney transplantation.

关键词： Nephrolithiasis Incidence Kidney stones Kidney transplantation Transplantation