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Hyperkalemia and the Use of New Potassium Binders a Single Center Experience from Vestfold Norway (The PotBind Study). 高钾血症和新型钾结合剂的使用——来自挪威Vestfold的单中心经验(PotBind研究)。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S401623
Thea Bjune, Thea Bjerkestrand Bøe, Stig Arne Kjellevold, Kristian Heldal, Sadollah Abedini

Purpose: Hyperkalemia is a common metabolic complication of chronic kidney disease (CKD) and is associated with several serious adverse events. We aimed to treat/prevent hyperkalemia using the new of potassium-binders, allowing maintained renin-angiotensin-aldosterone system inhibitors (RAASi) treatment in proteinuric CKD and/or congestive heart failure (CHF) patients.

Patients and methods: We conducted a retrospective cohort study in long-term users of potassium binders for chronic hyperkalemia. Patients aged 18 years and older, treated with potassium-binders and who met the reimbursement criteria and indication for RAASi treatment were included.

Results: Fifty-seven percent of the patients were males and mean age was 65 years. During the study period, no patients were admitted to hospital due to hyperkalemia after initiation of potassium binders. Potassium maximum values were significantly lower after treatment. Few patients reported major side effects, and discontinuation was mostly due to normokalemia. We found no significant changes in bicarbonate, serum creatinine or GFR stage after starting potassium binder treatment. All patients on RAASi treatment before initiating potassium-binders were retained on RAASi treatment.

Conclusion: New potassium binders in clinical practice are an easy and safe treatment with few side effects and good tolerance, that significantly lowers the risk of hyperkalemia. Furthermore, and most importantly, patients can be maintained on RAASi treatment.

目的:高钾血症是慢性肾脏疾病(CKD)常见的代谢并发症,并与一些严重的不良事件相关。我们的目标是使用新的钾结合剂治疗/预防高钾血症,允许维持肾素-血管紧张素-醛固酮系统抑制剂(RAASi)治疗蛋白尿CKD和/或充血性心力衰竭(CHF)患者。患者和方法:我们对长期使用钾结合剂治疗慢性高钾血症的患者进行了回顾性队列研究。患者年龄在18岁及以上,接受钾结合剂治疗,符合RAASi治疗的报销标准和适应症。结果:57%的患者为男性,平均年龄65岁。在研究期间,没有患者在使用钾结合剂后因高钾血症而入院。处理后钾最大值显著降低。很少有患者报告严重的副作用,停药主要是由于正常血钾。我们发现在开始钾结合剂治疗后,碳酸氢盐、血清肌酐或GFR分期没有显著变化。所有在开始钾结合剂治疗前接受RAASi治疗的患者都保留了RAASi治疗。结论:临床应用的新型钾结合剂治疗方法简便、安全、副作用少、耐受性好,可显著降低高钾血症的发生风险。此外,最重要的是,患者可以维持RAASi治疗。
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引用次数: 1
Survival Rates in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis. 老年患者持续非卧床腹膜透析的生存率。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S397555
Bach Nguyen, Quynh Thi Huong Bui, Phuong Que Tran

Purpose: The present study aimed at evaluating the survival rate, its associated factors, and the causes of death in elderly patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in Vietnam.

Patients and methods: This is a retrospective, observational study conducted among patients aged ≥65 years who underwent CAPD at Thong Nhat Hospital, Ho Chi Minh City, Vietnam, from April 2012 to December 2020. The Kaplan-Meier method was used to calculate the cumulative survival rate, and the Log rank test was used to analyze the factors associated with the survival rate of patients.

Results: This study enrolled a total of 68 patients with a mean age of 71.93 ± 7.44 years at the initiation of CAPD. The most common complication among kidney failure patients was diabetic nephropathy (39.71%). The rate of concomitant cardiovascular diseases was 58.82%. The average survival rate was 45.59 ± 4.01 months. Peritonitis was the most common factor causing death (31.25%), followed by cardiovascular diseases (28.12%) and malnutrition (25%). The factors that impacted the survival rate included concomitant cardiovascular diseases, low serum albumin (<35 g/dL), and an indication of CAPD due to exhausted vascular access for hemodialysis at baseline. The main factor associated with a shorter survival time was concomitant cardiovascular diseases.

Conclusion: It is necessary to improve the survival time beyond 5 years for elderly patients undergoing CAPD, especially for those with concomitant cardiovascular diseases. Besides the prevention of peritonitis, adequate measures to protect from cardiovascular diseases and malnutrition will reduce the mortality rate in patients on CAPD.

目的:本研究旨在评估越南接受连续动态腹膜透析(CAPD)的老年患者的生存率、相关因素和死亡原因。患者和方法:这是一项回顾性观察性研究,研究对象为2012年4月至2020年12月在越南胡志明市通艺医院接受CAPD治疗的年龄≥65岁的患者。累积生存率采用Kaplan-Meier法计算,Log rank检验分析影响患者生存率的相关因素。结果:本研究共纳入68例患者,CAPD开始时的平均年龄为71.93±7.44岁。肾衰竭患者最常见的并发症是糖尿病肾病(39.71%)。合并心血管疾病的发生率为58.82%。平均生存率为45.59±4.01个月。最常见的死亡原因是腹膜炎(31.25%),其次是心血管疾病(28.12%)和营养不良(25%)。影响生存率的因素包括合并心血管疾病、血清白蛋白水平低(结论:老年CAPD患者,特别是合并心血管疾病的患者,有必要提高5年以上的生存时间。除了预防腹膜炎外,预防心血管疾病和营养不良的适当措施将降低CAPD患者的死亡率。
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引用次数: 0
Real-Life Anemia Management Among Patients with Non-Dialysis-Dependent Chronic Kidney Disease in Three European Countries. 三个欧洲国家非透析依赖型慢性肾病患者的现实生活贫血管理
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S401598
Danilo Fliser, Maria Mata Lorenzo, Katherine Houghton, Claire Ainsworth, Martin Blogg, Elena González de Antona Sánchez, Jose Portoles

Background: Anemia is prevalent among patients with chronic kidney disease (CKD), yet current evidence indicates that treatment may not adhere to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. We aimed to document the management of patients with non-dialysis-dependent (NDD)-CKD receiving erythropoiesis-stimulating agent (ESA) therapy in Europe.

Methods: This retrospective, observational study extracted information from medical records in Germany, Spain, and the UK. Eligible patients were adults with NDD-CKD stages 3b-5 who initiated ESA therapy for anemia between January and December 2015. Anemia was defined as hemoglobin (Hb) <13.0 g/dL (males) or <12.0 g/dL (females). Data regarding ESA treatment, treatment response, concomitant iron therapy and blood transfusions were extracted up to 24 months post-ESA initiation, and data on CKD progression until abstraction date.

Results: Eight hundred and forty-eight medical records were abstracted. Approximately 40% received no iron therapy prior to ESA initiation. At ESA initiation, mean ± standard deviation Hb level was 9.8 ± 1.0 g/dL. Most patients received darbepoetin alfa, and switching between ESAs was rare (8.5% of patients). Concomitant intravenous and oral iron therapy was prescribed for 36% and 42% of patients, respectively, during initial ESA therapy. Mean Hb levels reached the target level (10-12 g/dL) within 3-6 months of ESA initiation. Hb, transferrin saturation, and ferritin levels were infrequently monitored from 3 months post-ESA initiation. Rates of blood transfusion, dialysis, and diagnosis of end-stage renal disease were 16.4%, 19.3%, and 24.6%, respectively. Rates of kidney transplant and death were 4.8% and 8.8%, respectively.

Conclusion: Among ESA-treated patients, ESA initiation was in accordance with KDIGO guidelines, but subsequent monitoring of Hb and iron deficiency were suboptimal.

背景:贫血在慢性肾脏疾病(CKD)患者中很普遍,但目前的证据表明,治疗可能不符合肾脏疾病:改善全球结局(KDIGO)指南。我们旨在记录欧洲非透析依赖(NDD)-CKD患者接受促红细胞生成剂(ESA)治疗的管理情况。方法:这项回顾性观察性研究从德国、西班牙和英国的医疗记录中提取信息。符合条件的患者是2015年1月至12月期间因贫血开始ESA治疗的成人NDD-CKD 3b-5期患者。将贫血定义为血红蛋白(Hb)。结果:共提取病历848份。大约40%的患者在ESA开始前没有接受过铁治疗。在ESA开始时,平均±标准差Hb水平为9.8±1.0 g/dL。大多数患者接受达贝泊汀治疗,在esa之间切换的患者很少(8.5%的患者)。在初始ESA治疗期间,分别有36%和42%的患者同时使用静脉和口服铁治疗。在ESA开始的3-6个月内,平均Hb水平达到目标水平(10-12 g/dL)。Hb、转铁蛋白饱和度和铁蛋白水平从esa启动后3个月开始不经常监测。输血率、透析率和终末期肾病诊断率分别为16.4%、19.3%和24.6%。肾移植率和死亡率分别为4.8%和8.8%。结论:在接受ESA治疗的患者中,ESA启动符合KDIGO指南,但随后的Hb和铁缺乏监测不理想。
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引用次数: 0
Genetic Susceptibility to Chronic Kidney Disease: Links, Risks and Management. 慢性肾脏疾病的遗传易感性:联系、风险和管理。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S363041
Hanny Sawaf, Tariku T Gudura, Sylvester Dorobisz, Dianne Sandy, Xiangling Wang, Shane A Bobart

Chronic kidney disease (CKD) is associated with significant morbidity and mortality worldwide. In recent years, our understanding of genetic causes of CKD has expanded significantly with several renal conditions having been identified. This review discusses the current landscape of genetic kidney disease and their potential treatment options. This review will focus on cystic kidney disease, glomerular disease with genetic associations, congenital anomalies of kidneys and urinary tract (CAKUT), autosomal dominant-tubulointerstitial kidney disease (ADTKD), inherited nephrolithiasis and nephrocalcinosis.

慢性肾脏疾病(CKD)在世界范围内与显著的发病率和死亡率相关。近年来,我们对CKD遗传原因的理解随着几种肾脏疾病的确定而显著扩大。这篇综述讨论了遗传性肾脏疾病的现状及其潜在的治疗方案。本文将重点综述囊性肾病、遗传相关性肾小球疾病、先天性肾脏和尿路异常(CAKUT)、常染色体显性-小管间质肾病(ADTKD)、遗传性肾结石和肾钙质沉着症。
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引用次数: 0
Survival Analysis and Its Predictors Among Hemodialysis Patients at Saint Paul Hospital Millennium Medical College and Myungsung Christian Medical Center in Addis Ababa, Ethiopia, 2021. 2021年埃塞俄比亚亚的斯亚贝巴圣保罗医院千年医学院和明成基督教医疗中心血液透析患者的生存分析及其预测因素
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S401022
Eyob Assefa Betiru, Ephrem Mamo, Dube Jara Boneya, Abebawork Adem, Dessie Abebaw

Background: Diabetes mellitus and hypertension are the most prominent conditions causing chronic kidney disease and eventually end-stage renal disease. Renal replacement therapy, particularly hemodialysis (HD), is the mainstay of treatment. The aim of this study is to assess the overall survival status of HD patients and potential survival predictors at Saint Paul hospital millennium medical college (SPHMMC) and Myungsung Christian Medical Center (MCM) in Addis Ababa, Ethiopia.

Methods: A retrospective cohort study was conducted on HD patients at SPHMMC and MCM general hospital from January 1, 2013 to December 30, 2020. Kaplan Meier, Log-rank, and Cox proportional regression models were used for the analysis. Estimated risks were reported as hazard ratios with 95% confidence intervals and P<0.05 was considered as having a significant association.

Results: A total of 128 patients were included in the study. Median survival time was 65 months. The predominant co-morbid condition was found to be diabetes mellitus with hypertension (42%). The total risk time for these patients was 143,617 person years. The overall incidence rate of death was 2.9 per 10,000 person years (95% CI=2.2-4). Patients who developed blood stream infection were 2.98-times more likely to die than those without infection. Those using an arteriovenous fistula were 66% less likely to die than those using a central venous catheter. Additionally, patients treated in a government-owned facility were 79% less likely to die.

Conclusion: The study identified that the median survival time of 65 months was comparable with developed nations. Significant predictors of death were found to be blood stream infection and type of vascular access. Government-owned treatment facilities showed better patient survival.

背景:糖尿病和高血压是引起慢性肾脏疾病和终末期肾脏疾病的最主要疾病。肾脏替代疗法,特别是血液透析(HD),是主要的治疗方法。本研究的目的是评估圣保罗医院千禧医学院(SPHMMC)和埃塞俄比亚亚的斯亚贝巴Myungsung基督教医疗中心(MCM) HD患者的总体生存状况和潜在的生存预测因素。方法:对2013年1月1日至2020年12月30日在SPHMMC和MCM总医院就诊的HD患者进行回顾性队列研究。采用Kaplan Meier、Log-rank和Cox比例回归模型进行分析。估计风险以95%置信区间的风险比报告。结果:研究共纳入128例患者。中位生存期为65个月。主要的合并症是糖尿病合并高血压(42%)。这些患者的总风险时间为143,617人年。总死亡率为2.9 / 10000人年(95% CI=2.2-4)。发生血流感染的患者的死亡率是没有感染的患者的2.98倍。使用动静脉瘘的患者比使用中心静脉导管的患者死亡率低66%。此外,在政府拥有的机构接受治疗的患者死亡率降低了79%。结论:该研究确定65个月的中位生存时间与发达国家相当。发现血流感染和血管通路类型是死亡的重要预测因子。政府拥有的治疗设施显示患者存活率更高。
{"title":"Survival Analysis and Its Predictors Among Hemodialysis Patients at Saint Paul Hospital Millennium Medical College and Myungsung Christian Medical Center in Addis Ababa, Ethiopia, 2021.","authors":"Eyob Assefa Betiru,&nbsp;Ephrem Mamo,&nbsp;Dube Jara Boneya,&nbsp;Abebawork Adem,&nbsp;Dessie Abebaw","doi":"10.2147/IJNRD.S401022","DOIUrl":"https://doi.org/10.2147/IJNRD.S401022","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus and hypertension are the most prominent conditions causing chronic kidney disease and eventually end-stage renal disease. Renal replacement therapy, particularly hemodialysis (HD), is the mainstay of treatment. The aim of this study is to assess the overall survival status of HD patients and potential survival predictors at Saint Paul hospital millennium medical college (SPHMMC) and Myungsung Christian Medical Center (MCM) in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on HD patients at SPHMMC and MCM general hospital from January 1, 2013 to December 30, 2020. Kaplan Meier, Log-rank, and Cox proportional regression models were used for the analysis. Estimated risks were reported as hazard ratios with 95% confidence intervals and <i>P</i><0.05 was considered as having a significant association.</p><p><strong>Results: </strong>A total of 128 patients were included in the study. Median survival time was 65 months. The predominant co-morbid condition was found to be diabetes mellitus with hypertension (42%). The total risk time for these patients was 143,617 person years. The overall incidence rate of death was 2.9 per 10,000 person years (95% CI=2.2-4). Patients who developed blood stream infection were 2.98-times more likely to die than those without infection. Those using an arteriovenous fistula were 66% less likely to die than those using a central venous catheter. Additionally, patients treated in a government-owned facility were 79% less likely to die.</p><p><strong>Conclusion: </strong>The study identified that the median survival time of 65 months was comparable with developed nations. Significant predictors of death were found to be blood stream infection and type of vascular access. Government-owned treatment facilities showed better patient survival.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"16 ","pages":"59-71"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/b5/ijnrd-16-59.PMC9983441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9100260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cranial versus Caudal Direction Technique of Native Percutaneous Kidney Biopsy: A Randomized Controlled Trial. 经皮肾活检的颅侧与尾侧技术:一项随机对照试验。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S400639
Solos Jaturapisanukul, Chutima Chavanisakun, Nontawat Benjakul, Tanun Ngamvichchukorn, Punnawit Laungchuaychok, Sathit Kurathong, Wanjak Pongsittisak

Background: Percutaneous kidney biopsy (PKB) is the gold standard for diagnosing various kidney diseases, but it can result in potential complications. This study aimed to compare kidney tissue adequacy and safety between the two biopsy techniques, including cranial direction (CN) and caudal direction (CD), of needle biopsy under real-time ultrasonogram guidance.

Methods: This single-center, prospective, single-blinded, randomized trial included patients undergoing native PKB from July 5, 2017, to June 30, 2019. Patients were randomized to the CN and CD groups. Adequacy and complications between the two groups were analyzed. All PKBs were performed under real-time ultrasonogram guidance with a 16-gauge kidney biopsy needle.

Results: A total of 107 participants were enrolled (53 in the CD group and 54 in the CN group). The CD group has more glomeruli than the CN group but with no statistical significance (16 versus 11, p = 0.0865). The CD group obtained more adequate kidney tissue samples than the CN group (69.8% versus 59.3%, p = 0.348). The number of inadequate glomeruli tissue sampling is similar in both groups (14 versus 15, respectively). Furthermore, the CN group had more adverse events, including Hb decline ≥10% after kidney biopsy, perinephric hematoma size ≥1 cm, hematuria, and the need for blood transfusion, than the CD group.

Conclusion: The CD technique of the percutaneous kidney biopsy in the native kidney has fewer complications and was possibly more effective than the CN technique.

背景:经皮肾活检(PKB)是诊断各种肾脏疾病的金标准,但它可能导致潜在的并发症。本研究旨在比较实时超声引导下两种肾组织活检技术(颅向活检(CN)和尾向活检(CD))的充分性和安全性。方法:这项单中心、前瞻性、单盲、随机试验纳入了2017年7月5日至2019年6月30日接受原生PKB治疗的患者。患者随机分为CN组和CD组。分析两组间的充分性及并发症。所有PKBs均在实时超声引导下用16号肾活检针进行。结果:共纳入107名参与者(CD组53名,CN组54名)。CD组肾小球多于CN组,但差异无统计学意义(16 vs 11, p = 0.0865)。CD组比CN组获得更多的肾组织样本(69.8%比59.3%,p = 0.348)。两组肾小球组织取样不足的数量相似(分别为14例和15例)。此外,与CD组相比,CN组有更多的不良事件,包括肾活检后Hb下降≥10%,肾周血肿大小≥1 cm,血尿和需要输血。结论:原肾经皮肾活检的CD技术并发症少,可能比CN技术更有效。
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引用次数: 0
Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches. 中东和非洲的慢性肾脏疾病管理:关注、挑战和新方法。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S363133
Saeed Al-Ghamdi, Ali Abu-Alfa, Turki Alotaibi, Ali AlSaaidi, Abdulkareem AlSuwaida, Mustafa Arici, Tevfik Ecder, Ahmed F El Koraie, Mohamed Ghnaimat, Mohamed H Hafez, Mohamed Hassan, Tarik Sqalli

The burden of chronic kidney disease (CKD) and other comorbidities, such as hypertension and diabetes, which increase the risk of developing CKD, is on the rise in the Middle East and Africa. The Middle East and Africa CKD (MEA-CKD) steering committee, comprising eminent healthcare specialists from the Middle East and Africa, was formed to identify and propose steps to address the gaps in the management of CKD in these regions. The current article lists the MEA-CKD steering committee meeting outcomes and evaluates the available evidence supporting the role of novel therapeutic options for patients with CKD. The need of the hour is to address the gaps in awareness and screening, early diagnosis, along with referral and management of patients at risk. Measures to bring about appropriate changes in healthcare policies to ensure access to all benefit-proven protective therapies, including novel ones, at community levels are also vital for reducing the overall burden of CKD on the healthcare system as well as governing bodies, especially in developing countries of the Middle East and Africa.

在中东和非洲,慢性肾脏疾病(CKD)和其他合并症(如高血压和糖尿病)的负担正在上升,这些合并症会增加患CKD的风险。中东和非洲CKD (MEA-CKD)指导委员会由来自中东和非洲的知名医疗保健专家组成,旨在确定并提出解决这些地区CKD管理差距的步骤。目前的文章列出了MEA-CKD指导委员会会议的结果,并评估了支持CKD患者新治疗方案作用的现有证据。当务之急是解决认识和筛查、早期诊断以及高危患者转诊和管理方面的差距。采取措施适当改变医疗保健政策,以确保在社区层面上获得所有经证实有益的保护性疗法,包括新疗法,对于减轻CKD对医疗保健系统和管理机构的总体负担也至关重要,特别是在中东和非洲的发展中国家。
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引用次数: 2
Erratum: Hyperkalemia and the Use of New Potassium Binders a Single Center Experience from Vestfold Norway (The PotBind Study) [Corrigendum]. 勘误:高钾血症和新钾结合剂的使用:来自挪威Vestfold的单中心经验(PotBind研究)[勘误]。
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.2147/IJNRD.S416069

[This corrects the article DOI: 10.2147/IJNRD.S401623.].

[更正文章DOI: 10.2147/IJNRD.S401623.]。
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引用次数: 0
Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges 多发性骨髓瘤轻链铸造肾病:患病率、影响和管理挑战
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2022-05-01 DOI: 10.2147/IJNRD.S280179
P. Menè, A. Stoppacciaro, S. Lai, F. Festuccia
Abstract “Cast nephropathy” (CN) is a pathological feature of myeloma kidney, also seen to a lesser extent in the context of severe nephrotic syndrome from non-haematological diseases. The name relates to obstruction of distal tubules by “casts” of luminal proteins concentrated by intensive water reabsorption resulting from dehydration or high-dose diuretics. Filtered proteins form complexes with endogenous tubular Tamm-Horsfall glycoprotein. The resulting gel further slows or stops luminal flow upon complete obstruction of distal convoluted tubules and collecting ducts. Thus, a tubular obstructive form of acute kidney injury (AKI) is a common consequence of CN. The pathogenesis of CN will be reviewed in light of recent advances in the understanding of monoclonal disorders of B lymphocytes, leading to the release of immunoglobulin components (free light chains, FLC) into the bloodstream and their filtration across the glomerular basement membrane. Treatment aiming at reduction of the circulating burden of FLC may help recovery of renal function in a fraction of these patients, besides filling the void between the onset of AKI, histopathological diagnosis, and full response to pharmacologic treatment.
“铸型肾病”(Cast nephropathy, CN)是肾髓瘤的一种病理特征,在非血液学疾病引起的严重肾病综合征中也有较少的表现。由于脱水或大剂量利尿剂引起的强水重吸收引起的管腔蛋白“流”阻塞远端小管。过滤后的蛋白与内源性管状tam - horsfall糖蛋白形成复合物。在远曲小管和集管完全阻塞时,所得凝胶进一步减缓或停止管腔血流。因此,肾小管梗阻性急性肾损伤(AKI)是CN的常见后果。CN的发病机制将根据最近对B淋巴细胞单克隆疾病的理解进行综述,B淋巴细胞单克隆疾病导致免疫球蛋白成分(自由轻链,FLC)释放到血液中并通过肾小球基底膜过滤。旨在减轻FLC循环负荷的治疗,除了填补AKI发病、组织病理学诊断和药物治疗完全应答之间的空白外,还可能有助于部分患者的肾功能恢复。
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引用次数: 1
Clinical Factors Associated with Serum Magnesium Concentration in Patients Undergoing Peritoneal Dialysis: A Single-Center Observational Study 腹膜透析患者血清镁浓度相关的临床因素:一项单中心观察研究
IF 2 Q2 UROLOGY & NEPHROLOGY Pub Date : 2022-05-01 DOI: 10.2147/IJNRD.S357130
S. Kaneko, S. Ookawara, Y. Morishita
Purpose Magnesium (Mg) is an essential element that is associated with various physiological functions, such as maintenance of blood pressure, muscle contraction, and nerve function. In patients undergoing hemodialysis, hypomagnesemia is associated with cardiovascular and all-cause mortality. However, in patients undergoing peritoneal dialysis (PD), clinical factors associated with Mg have not been fully investigated. Patients and Methods Clinical factors including anthropometric data, comorbidities, laboratory data, medications, and dialysis methods were collected from the medical records of patients undergoing PD. The associations of these factors with the serum Mg concentration were investigated by univariate and multivariate analyses. Results Sixty patients undergoing PD were investigated. The univariate analysis showed that the serum Mg concentration was significantly associated with treatment by hybrid PD (daily PD + once-weekly hemodialysis) (β = 0.264, P = 0.04), administration of phosphate binders (β = 0.294, P = 0.02), the serum C-reactive protein concentration (β = −0.318, P = 0.01), the serum potassium (K) concentration (β = 0.451, P < 0.01), and the serum intact parathormone concentration (β = −0.333, P = 0.01). The multivariate analysis using these factors showed an independent association between the serum Mg and K concentrations (β = 0.333, P = 0.01). Conclusion The serum Mg concentration was independently associated with the serum K concentration in patients undergoing PD.
目的镁(Mg)是一种与各种生理功能有关的必需元素,如维持血压、肌肉收缩和神经功能。在接受血液透析的患者中,低镁血症与心血管和全因死亡率相关。然而,在接受腹膜透析(PD)的患者中,与镁相关的临床因素尚未得到充分研究。患者和方法从PD患者的病历中收集临床因素,包括人体测量数据、合并症、实验室数据、药物和透析方法。通过单变量和多变量分析研究这些因素与血清镁浓度的关系。结果对60例帕金森病患者进行了调查。单因素分析显示,血清镁浓度与混合PD治疗(每日PD+每周血液透析一次)(β=0.264,P=0.04)、磷酸盐结合剂给药(β=0.294,P=0.02)、血清C反应蛋白浓度(β=-0.318,P=0.01)、血清钾(K)浓度(β=0.451,P<0.01)、,和血清完整甲状旁腺激素浓度(β=−0.333,P=0.01)。利用这些因素进行的多变量分析显示,血清Mg和K浓度之间存在独立相关性(β=0..333,P=0.001)。结论PD患者血清Mg浓度与血清K浓度独立相关。
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引用次数: 1
期刊
International Journal of Nephrology and Renovascular Disease
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