Nephrology News

Resistance to RAAS Inhibitors Not Easily Improved

Patients who show a poor response to a certain dose and medication also show a poor response to higher doses and other RAAS inhibitors or NSAIDs, meta-analysis shows.
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RCC Subtypes Affect Post-Surgery Cancer-Related Mortality Risk

Patients with papillary versus clear cell renal cell carcinoma have a 24% decreased risk of dying from their cancer.
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Drug Combo Promising for HCV Infection in Patients With Advanced CKD

Researchers report a high rate of sustained virologic response after 12 weeks of treatment with a ribavirin-free co-formulation of glecaprevir and pibrentasvir.
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Ask Well: How Do People Die From Diabetes?


Photo
Credit Stuart Bradford

Q. How do people die from diabetes?

A. People who have diabetes cannot regulate their blood sugar levels and if the disease isn’t tightly controlled, blood sugar can spike to abnormally high levels, a condition called hyperglycemia, or dip below normal, a condition called hypoglycemia. Both conditions are potentially life-threatening and can lead to coma and death if not promptly treated.

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Drug Combo Promising for HCV Infection in Patients With Advanced CKD

Researchers report a high rate of sustained virologic response after 12 weeks of treatment with a ribavirin-free co-formulation of glecaprevir and pibrentasvir.
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RCC Subtypes Affect Post-Surgery Cancer-Related Mortality Risk

Patients with papillary versus clear cell renal cell carcinoma have a 24% decreased risk of dying from their cancer.
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Serum Uromodulin May Predict CKD Development

Uromodulin may be a novel predictive serum biomarker.
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New type of diabetes caused by a genetic mutation

Scientific research at the ULB Center for Diabetes Research and the Erasmus Hospital of the ULB leads to the identification of a new type of diabetes caused by a mutation in the gene RFX6.

Scientists from the ULB Center for Diabetes Research and the Erasmus Hospital of the ULB, together with colleagues at the University of Exeter (UK), University of Helsinki (Finland) and Kyoto University (Japan), have identified a new type of diabetes caused by a mutation in the gene RFX6.

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CKD Risk Lower With Partial Nephrectomy

In a study, partial nephrectomy was associated with a 66% lower risk for stage 4 or higher CKD versus radical nephrectomy.
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Low Protein Diet With Keto Analogues May Prevent SHPT

Dialysis patients treated with a low protein diet with keto analogues had lower levels of parathyroid hormone than those on a normal diet, meta-analysis shows.
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CKD Risk Lower With Partial Nephrectomy

In a study, partial nephrectomy was associated with a 66% lower risk for stage 4 or higher CKD versus radical nephrectomy.
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Study Links Subclinical CAC to Nephrolithiasis

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Study Identifies Possible Way to Reduce Kidney Discard Rate

Limiting cold ischemia times could increase the use of renal allografts donated from patients after death from cardiovascular causes, researchers say.
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Recurrent UTIs Worsen Kidney Transplant Outcomes

Kidney transplant recipients who experience recurrent urinary tract infections are at increased risk of graft failure and death.
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High Rates of Infective Endocarditis Found Among ESRD Patients

Hemodialysis patients had higher rates of infective endocarditis than peritoneal dialysis and kidney transplant patients.
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Glycolate oxidase deficiency in a patient with congenital hyperinsulinism and unexplained hyperoxaluria

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ConclusionsThe results lead to the conclusion that this baby has two unrelated autosomal recessive conditions, CHI and GO deficiency, and also hyperoxaluria of unknown aetiology. Deficiency of GO is a very rare disorder with only two previously published cases. It is considered to be an essentially benign inborn error of metabolism. The present case is unique in that GO deficiency is associated with persistent hyperoxaluria.

CONCLUSION: These results confirm the therapeutic versatility of our approach. However, to the extent that its synergistic efficacy is dependent on the ability to achieve both a lethal photothermal effect and the thermally-controlled release of a sufficient amount of antibiotic, they also demonstrate the importance of carefully designing appropriate antibody and antibiotic combinations to achieve the desired therapeutic synergy. PMID: 29025325 [PubMed - as supplied by publisher]

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Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls

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ConclusionsUrine biomarkers, particularly NGAL, can aid in the diagnosis of UTI among febrile infants. The results suggest that in infants with fever and high NGAL, UTI is most likely, whereas in infants with fever and low NGAL, other causes of fever should be looked for.

Conclusion In this PMS, the safety and efficacy profiles of canagliflozin in elderly patients with T2DM were obtained in the clinical settings in Japan, and the drug was well tolerated and effective in improving glycemic control. PMID: 29025285 [PubMed - as supplied by publisher]

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Rabbit anti-human thymocyte immunoglobulin for the rescue treatment of chronic antibody-mediated rejection after pediatric kidney transplantation

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ConclusionsIn this small series of patients, rATG appears a promising treatment for unresponsive cAMR. Further evaluation, including earlier introduction of rATG, is warranted.

Surgeons at a Georgia hospital won't perform procedure because child's father, who is a 110 percent match, served time in prison

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The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome

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AbstractBackgroundLow serum levels of total 25-hydroxycholecalciferol (25(OH)D) occur in nephrotic syndrome (NS). We aimed to assess the effects of vitamin D3 and calcium supplementation on 25(OH)D levels, bone mineralization, and NS relapse rate in children with steroid-sensitive NS.MethodsA randomized controlled trial (RCT) was performed in children with steroid-sensitive NS. The treatment group received vitamin D3 (60,000  IU orally, weekly for 4 weeks) and calcium supplements (500 to 1,000 mg/day for 3 months) after achieving NS remission. Blood samples for bone biochemistry were taken during relapse (T0), after 6 weeks (T1) and 6 months (T2) of randomization, whereas a lumbar DXA scan was performed at T0 and T2. Renal ultrasound was performed after study completion in the treatment group and in all patients with hypercalciuria.ResultsOf the 48 initial recruits, 43 patients completed the study. Post-intervention, 25(OH)D levels showed significant improvements in the treatment group compared with controls at T1 (p 

Conclusions: The time course in this patient strongly suggests that the nephrotic syndrome occurred as an adverse drug reaction to nivolumab treatment. If during nivolumab treatment renal insufficiency, hypoalbuminemia, or proteinuria develops, further analysis for a possible nephrotic syndrome is warranted for early detection and treatment of this life-threatening complication.

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Characteristics of hypertension in premature infants with and without chronic lung disease: a long-term multi-center study

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AbstractBackgroundMany causes for neonatal hypertension in premature infants have been described; however in some cases no etiology can be attributed. Our objectives are to describe such cases of unexplained hypertension and to compare hypertensive infants with and without chronic lung disease (CLD).MethodsWe reviewed all cases of hypertension in premature infants referred from 18 hospitals over 16  years. Inclusion criteria were hypertension occurring at

CONCLUSION: In light of recent studies, lasting bilateral mydriasis may not always be considered a decisive factor for non-escalation of treatment, as variability among TBI patients and outcomes has been demonstrated. Wide decompressive craniectomy is viable for controlling refractory intracranial hypertension in hemodynamically stable patients. PMID: 29026665 [PubMed]

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