Background and objectives: Crush injury, the most important trauma complication encountered in earthquake victims, occurs as a result of prolonged compression of muscle mass. Crush syndrome, resulting from crush injury, and acute kidney injury (AKI) are the most common causes of in-hospital deaths after earthquakes. The aim of this study is to convey our experience after the devastating Turkey-Syria earthquake and to identify the risk factors of crush syndrome and crush-related AKI.
Methods: Of the 1134 children admitted to the emergency department, 265 with crush injury were included the study. Demographic information, laboratory and clinical data of the patients were retrospectively analyzed.
Results: Mean age of the patients was 10.3 ± 4.9 years (134 females and 131 males). The median time spent under the rubble was 20 h. Crush syndrome developed in 135 (50.9%). Patients with crush syndrome were older and had higher body weight, respectively (p = 0.014, p = 0.044). Acute kidney injury was present in 157 (59.2%) patients. Thirty-two patients (12.1%) received kidney replacement therapy (KRT). The risk factors for the development of AKI Stage 3 were crush syndrome, abdominal trauma, and age.
Conclusion: This disaster taught us the importance of establishing in advance a national emergency disaster plan. Older pediatric earthquake victims with multiple trauma and severe crush syndrome should be closely followed-up for development of AKI and, if necessary, started on dialysis. Timely access to medical care, early fluid resuscitation, and effective use of dialysis treatment are essential.
{"title":"Pediatric crush-related acute kidney injury and risk factors: a single center experience.","authors":"Sevgin Taner, Ulas Ozdemir, Tugba Kandemir Gulmez, Sercin Güven, Neslihan Cicek, Emre Kelesoglu, Ilknur Arslan, Umit Celik","doi":"10.1007/s40620-024-02043-1","DOIUrl":"https://doi.org/10.1007/s40620-024-02043-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>Crush injury, the most important trauma complication encountered in earthquake victims, occurs as a result of prolonged compression of muscle mass. Crush syndrome, resulting from crush injury, and acute kidney injury (AKI) are the most common causes of in-hospital deaths after earthquakes. The aim of this study is to convey our experience after the devastating Turkey-Syria earthquake and to identify the risk factors of crush syndrome and crush-related AKI.</p><p><strong>Methods: </strong>Of the 1134 children admitted to the emergency department, 265 with crush injury were included the study. Demographic information, laboratory and clinical data of the patients were retrospectively analyzed.</p><p><strong>Results: </strong>Mean age of the patients was 10.3 ± 4.9 years (134 females and 131 males). The median time spent under the rubble was 20 h. Crush syndrome developed in 135 (50.9%). Patients with crush syndrome were older and had higher body weight, respectively (p = 0.014, p = 0.044). Acute kidney injury was present in 157 (59.2%) patients. Thirty-two patients (12.1%) received kidney replacement therapy (KRT). The risk factors for the development of AKI Stage 3 were crush syndrome, abdominal trauma, and age.</p><p><strong>Conclusion: </strong>This disaster taught us the importance of establishing in advance a national emergency disaster plan. Older pediatric earthquake victims with multiple trauma and severe crush syndrome should be closely followed-up for development of AKI and, if necessary, started on dialysis. Timely access to medical care, early fluid resuscitation, and effective use of dialysis treatment are essential.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peritoneal dialysis (PD) catheter malfunction commonly leads to the removal of the catheter and eventually to a transfer to hemodialysis. The most common cause is intraluminal obstruction caused by blood and fibrin clots. Recommended interventions include irrigation of the catheter with heparinized saline; if this method fails, thrombolytic agents may be used. Mechanical methods such as intraluminal brushing are also utilized, typically after medical treatment fails. Here, we present a case of a patient who developed an intraluminal blood clot that persisted despite attempts with intraluminal thrombolytic drugs and intraluminal brushing. To salvage the catheter, targeted thrombolysis was performed using an endoscopic retrograde cholangiopancreatography (ERCP) guidewire to reinforce the coiled PD catheter and puncture the clots. Additionally, a Swing Tip cannula was employed for direct injection of the thrombolytic agent. These interventions successfully preserved the catheter, resolving the clot and ensuring continued functionality.
腹膜透析(PD)导管故障通常会导致导管移除,最终转为血液透析。最常见的原因是血液和纤维蛋白凝块造成的管腔内阻塞。建议采取的干预措施包括用肝素化生理盐水冲洗导管;如果这种方法无效,可使用溶栓药物。通常在药物治疗无效后,还可使用机械方法,如腔内刷洗。在此,我们介绍了一例患者的病例,尽管尝试了腔内溶栓药物和腔内刷洗,但腔内血凝块依然存在。为了抢救导管,我们使用内镜逆行胰胆管造影(ERCP)导丝进行了有针对性的溶栓治疗,以加固盘绕的PD导管并穿刺血栓。此外,还使用了一个 Swing Tip 插管直接注射溶栓剂。这些干预措施成功地保留了导管,溶解了血栓并确保了导管的持续功能。
{"title":"Salvaging intraluminal peritoneal dialysis catheter obstruction from blood clot with a targeted thrombolytic agent: an innovation.","authors":"Pacharida Kinpayom, Athiphat Banjongjit, Piyaporn Towannang, Rungsun Rerknimitr, Talerngsak Kanjanabuch","doi":"10.1007/s40620-024-02075-7","DOIUrl":"https://doi.org/10.1007/s40620-024-02075-7","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) catheter malfunction commonly leads to the removal of the catheter and eventually to a transfer to hemodialysis. The most common cause is intraluminal obstruction caused by blood and fibrin clots. Recommended interventions include irrigation of the catheter with heparinized saline; if this method fails, thrombolytic agents may be used. Mechanical methods such as intraluminal brushing are also utilized, typically after medical treatment fails. Here, we present a case of a patient who developed an intraluminal blood clot that persisted despite attempts with intraluminal thrombolytic drugs and intraluminal brushing. To salvage the catheter, targeted thrombolysis was performed using an endoscopic retrograde cholangiopancreatography (ERCP) guidewire to reinforce the coiled PD catheter and puncture the clots. Additionally, a Swing Tip cannula was employed for direct injection of the thrombolytic agent. These interventions successfully preserved the catheter, resolving the clot and ensuring continued functionality.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1007/s40620-024-02052-0
Hajar Ztati, Alexandre Hertig, Anne Grunenwald
{"title":"A hot bath a day does not keep the nephrologist away.","authors":"Hajar Ztati, Alexandre Hertig, Anne Grunenwald","doi":"10.1007/s40620-024-02052-0","DOIUrl":"https://doi.org/10.1007/s40620-024-02052-0","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1007/s40620-024-02062-y
Gianmarco Lombardi, Valentina Votrico, Pietro Manuel Ferraro, Serena Tassi, Francesca Lissoni, Vittorio Ortalda, Giovanni Gambaro
Background: Numerous studies have explored the role of kidney replacement therapy (KRT) in phosphorus (P) control among prevalent hemodialysis (HD) patients. However, whether the reduction of P achieved during KRT affects parathyroid hormone (PTH) levels is still a matter of debate.
Methods: We conducted a retrospective observational study on the prevalent HD population at the Division of Nephrology, University Hospital of Verona, from January to December 2022. We Included clinically stable adult patients undergoing HD for over 6 months, with multiple recorded visits during the follow-up. Demographic, clinical, laboratory, and medication data were collected. Time-varying variables were updated at each study visit. The primary outcome of interest was PTH levels. The absolute intra-HD change in P (intra-HD ∆P), defined as the difference between pre- and post-HD P levels, served as the main exposure. Multivariable adjusted linear mixed models were used to investigate the relationship between intra-HD ∆P and PTH levels.
Results: A total of 211 patients contributed to 904 study visits. A significant and positive relationship was observed between intra-HD ∆P and pre-HD P (β = 0.76, 95% CI 0.75, 0.78, p < 0.001) and urea reduction ratio (β = 0.38, 95% CI 0.35, 0.41; p < 0.001). An increase in intra-HD ∆P was significantly and independently associated with low PTH levels (β = - 0.16, 95% CI - 0.30, -0.03; p = 0.020).
Conclusions: The extent of intra-HD P reduction significantly correlates with low PTH levels. Strategies focused on optimizing or enhancing depurative efficiency in KRT can exert a substantial impact on managing positive phosphorus balance and secondary hyperparathyroidism. The assessment of intra-HD P reduction may play a pivotal role in the management and follow-up of secondary hyperparathyroidism in HD patients.
背景:许多研究探讨了肾脏替代疗法(KRT)在控制血液透析(HD)患者血磷(P)方面的作用。然而,肾脏替代疗法期间实现的磷降低是否会影响甲状旁腺激素(PTH)水平仍是一个争论不休的问题:我们在 2022 年 1 月至 12 月期间对维罗纳大学医院肾内科的 HD 患病人群进行了一项回顾性观察研究。我们纳入了接受 HD 治疗超过 6 个月且临床情况稳定的成年患者,这些患者在随访期间接受了多次记录访视。我们收集了人口统计学、临床、实验室和药物数据。每次随访都会更新随时间变化的变量。主要研究结果是 PTH 水平。腹泻期间 P 的绝对变化(腹泻期间 ∆P),即腹泻前和腹泻后 P 水平之差,是主要的暴露指标。采用多变量调整线性混合模型来研究HD内ΔP与PTH水平之间的关系:共有 211 名患者参与了 904 次研究。观察到肝脏内∆P 与肝脏前 P 之间存在明显的正相关关系(β = 0.76,95% CI 0.75,0.78,p 结论:肝脏内∆P 的降低程度与肝脏前 P 的降低程度之间存在明显的正相关关系:HD 内 P 降低的程度与低 PTH 水平密切相关。在 KRT 中优化或提高去磷效率的策略可对控制正磷平衡和继发性甲状旁腺功能亢进症产生重大影响。评估血液透析过程中磷的减少程度可能会在血液透析患者继发性甲状旁腺功能亢进的管理和随访中发挥关键作用。
{"title":"Intradialytic serum phosphate variations are associated with low PTH levels.","authors":"Gianmarco Lombardi, Valentina Votrico, Pietro Manuel Ferraro, Serena Tassi, Francesca Lissoni, Vittorio Ortalda, Giovanni Gambaro","doi":"10.1007/s40620-024-02062-y","DOIUrl":"https://doi.org/10.1007/s40620-024-02062-y","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have explored the role of kidney replacement therapy (KRT) in phosphorus (P) control among prevalent hemodialysis (HD) patients. However, whether the reduction of P achieved during KRT affects parathyroid hormone (PTH) levels is still a matter of debate.</p><p><strong>Methods: </strong>We conducted a retrospective observational study on the prevalent HD population at the Division of Nephrology, University Hospital of Verona, from January to December 2022. We Included clinically stable adult patients undergoing HD for over 6 months, with multiple recorded visits during the follow-up. Demographic, clinical, laboratory, and medication data were collected. Time-varying variables were updated at each study visit. The primary outcome of interest was PTH levels. The absolute intra-HD change in P (intra-HD ∆P), defined as the difference between pre- and post-HD P levels, served as the main exposure. Multivariable adjusted linear mixed models were used to investigate the relationship between intra-HD ∆P and PTH levels.</p><p><strong>Results: </strong>A total of 211 patients contributed to 904 study visits. A significant and positive relationship was observed between intra-HD ∆P and pre-HD P (β = 0.76, 95% CI 0.75, 0.78, p < 0.001) and urea reduction ratio (β = 0.38, 95% CI 0.35, 0.41; p < 0.001). An increase in intra-HD ∆P was significantly and independently associated with low PTH levels (β = - 0.16, 95% CI - 0.30, -0.03; p = 0.020).</p><p><strong>Conclusions: </strong>The extent of intra-HD P reduction significantly correlates with low PTH levels. Strategies focused on optimizing or enhancing depurative efficiency in KRT can exert a substantial impact on managing positive phosphorus balance and secondary hyperparathyroidism. The assessment of intra-HD P reduction may play a pivotal role in the management and follow-up of secondary hyperparathyroidism in HD patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1007/s40620-024-02035-1
Xiujuan Zhao, Haiyan Xue, Chun Fu, Shu Li, Zhenzhou Wang, Ziyan Xiao, Jingjing Ye, Jie Cai, Yucun Yang, Qiong Zhao, Fengxue Zhu, Tianbing Wang, Wei Huang
Background: Acute kidney injury (AKI) is a common complication of traumatic hemorrhagic shock. The risk factors for AKI after traumatic hemorrhagic shock remain unclear. The aim of this study was to investigate the risk factors for AKI after traumatic hemorrhagic shock.
Methods: This was a ten-year retrospective cohort study of patients who experienced traumatic hemorrhagic shock between January 2013 and April 2023. Patient characteristics and clinical data were recorded for 417 patients. The outcome was the occurrence of AKI, defined as a serum creatinine increase of ≥ 0.3 mg/dL (≥ 26.5 μmol/L) within 48 h, or an increase to 1.5 times the baseline, or a urine volume of < 0.5 mL/(kg h.). Risk factors for AKI were tested by logistic regression models.
Results: The incidence of AKI after traumatic hemorrhagic shock was 29.3% (122/417 patients). Multivariable analysis revealed that the independent risk factors for AKI included age (OR, 1.048; 95% CI, 1.022-1.074; p < 0.001), B-type natriuretic peptide (OR, 1.002; 95% CI, 1.000-1.004; p = 0.041), sepsis (OR, 4.536; 95% CI, 1.651-12.462; p = 0.030) and acute myocardial injury (OR, 2.745; 95% CI, 1.027-7.342; p = 0.044). Road traffic accidents (OR, 0.202; 95% CI, 0.076-0.541; p = 0.001), mean arterial pressure (OR, 0.972; 95% CI, 0.950-0.995; p = 0.017), and base excess (OR, 0.842; 95% CI, 0.764-0.929; p = 0.001) were negatively correlated with AKI. The area under the receiver operating characteristic (ROC) curve for prediction by this model was 0.85 (95% CI, 0.81-0.90).
Conclusion: The incidence of AKI after traumatic hemorrhagic shock was 29.3% in our series. Indicators of blood perfusion, sepsis and acute myocardial injury may be independent risk factors for AKI after traumatic hemorrhagic shock. Early detection and effective intervention on these risk factors could reduce the occurrence of AKI and improve outcomes.
背景:急性肾损伤(AKI)是创伤性失血性休克的常见并发症:急性肾损伤(AKI)是创伤性失血性休克的常见并发症。创伤性失血性休克后 AKI 的风险因素仍不清楚。本研究旨在调查创伤性失血性休克后 AKI 的风险因素:这是一项为期十年的回顾性队列研究,研究对象为 2013 年 1 月至 2023 年 4 月期间经历过创伤性失血性休克的患者。研究记录了 417 名患者的特征和临床数据。研究结果为发生 AKI,定义为 48 小时内血清肌酐升高≥ 0.3 mg/dL(≥ 26.5 μmol/L),或升高至基线的 1.5 倍,或尿量结果:创伤性失血性休克后AKI的发生率为29.3%(122/417例患者)。多变量分析显示,AKI 的独立风险因素包括年龄(OR,1.048;95% CI,1.022-1.074;P 结论:创伤性失血性休克后 AKI 的发生率为 29.3%(122/417 例患者):在我们的系列研究中,创伤性失血性休克后的 AKI 发生率为 29.3%。血液灌流指标、脓毒症和急性心肌损伤可能是创伤性失血性休克后发生 AKI 的独立危险因素。及早发现并有效干预这些危险因素可减少 AKI 的发生,改善预后。
{"title":"Incidence and risk factors for acute kidney injury after traumatic hemorrhagic shock: A 10-year retrospective cohort study.","authors":"Xiujuan Zhao, Haiyan Xue, Chun Fu, Shu Li, Zhenzhou Wang, Ziyan Xiao, Jingjing Ye, Jie Cai, Yucun Yang, Qiong Zhao, Fengxue Zhu, Tianbing Wang, Wei Huang","doi":"10.1007/s40620-024-02035-1","DOIUrl":"https://doi.org/10.1007/s40620-024-02035-1","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication of traumatic hemorrhagic shock. The risk factors for AKI after traumatic hemorrhagic shock remain unclear. The aim of this study was to investigate the risk factors for AKI after traumatic hemorrhagic shock.</p><p><strong>Methods: </strong>This was a ten-year retrospective cohort study of patients who experienced traumatic hemorrhagic shock between January 2013 and April 2023. Patient characteristics and clinical data were recorded for 417 patients. The outcome was the occurrence of AKI, defined as a serum creatinine increase of ≥ 0.3 mg/dL (≥ 26.5 μmol/L) within 48 h, or an increase to 1.5 times the baseline, or a urine volume of < 0.5 mL/(kg h.). Risk factors for AKI were tested by logistic regression models.</p><p><strong>Results: </strong>The incidence of AKI after traumatic hemorrhagic shock was 29.3% (122/417 patients). Multivariable analysis revealed that the independent risk factors for AKI included age (OR, 1.048; 95% CI, 1.022-1.074; p < 0.001), B-type natriuretic peptide (OR, 1.002; 95% CI, 1.000-1.004; p = 0.041), sepsis (OR, 4.536; 95% CI, 1.651-12.462; p = 0.030) and acute myocardial injury (OR, 2.745; 95% CI, 1.027-7.342; p = 0.044). Road traffic accidents (OR, 0.202; 95% CI, 0.076-0.541; p = 0.001), mean arterial pressure (OR, 0.972; 95% CI, 0.950-0.995; p = 0.017), and base excess (OR, 0.842; 95% CI, 0.764-0.929; p = 0.001) were negatively correlated with AKI. The area under the receiver operating characteristic (ROC) curve for prediction by this model was 0.85 (95% CI, 0.81-0.90).</p><p><strong>Conclusion: </strong>The incidence of AKI after traumatic hemorrhagic shock was 29.3% in our series. Indicators of blood perfusion, sepsis and acute myocardial injury may be independent risk factors for AKI after traumatic hemorrhagic shock. Early detection and effective intervention on these risk factors could reduce the occurrence of AKI and improve outcomes.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-21DOI: 10.1007/s40620-024-02048-w
Erica Rosati, Gianfranco Di Giuseppe, Teresa Mezza, Pietro Manuel Ferraro
The tubular function of the kidney is very complex and is finely regulated by many factors. These include a variety of hormonal signaling pathways which are involved in the expression, activation and regulation of renal transporters responsible for the handling of electrolytes. Glucose-lowering drugs such as insulin and incretin-based therapies, exert a well-known renal protective role in diabetic kidney disease, mainly acting at the glomerular level. In the literature, several studies have described the effect of insulin and the incretin hormones on tubular transport. Most of these studies focused on the variations in excretion and clearance of sodium but did not extensively and systematically investigate the possible variations that these hormones may induce in the tubular regulation of all the other electrolytes, urea metabolism, acid-base balance and urinary pH. While insulin action on the kidney is very well-described, the renal tubular impact of incretin-based therapies is less consistent and the results available are scarce. To our knowledge, this is the first review summarizing the effects induced on renal tubules by insulin, glucagon-like peptide-1 (GLP-1) receptor agonists and serine protease dipeptidyl peptidase-4 (DPP4) inhibitors in both healthy and diabetic human subjects. This is significant because it highlights the existence of a renal-gut and pancreas axis which also has a direct tubular effect and enables a deeper understanding of renal physiology.
{"title":"The influence of insulin and incretin-based therapies on renal tubular transport.","authors":"Erica Rosati, Gianfranco Di Giuseppe, Teresa Mezza, Pietro Manuel Ferraro","doi":"10.1007/s40620-024-02048-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02048-w","url":null,"abstract":"<p><p>The tubular function of the kidney is very complex and is finely regulated by many factors. These include a variety of hormonal signaling pathways which are involved in the expression, activation and regulation of renal transporters responsible for the handling of electrolytes. Glucose-lowering drugs such as insulin and incretin-based therapies, exert a well-known renal protective role in diabetic kidney disease, mainly acting at the glomerular level. In the literature, several studies have described the effect of insulin and the incretin hormones on tubular transport. Most of these studies focused on the variations in excretion and clearance of sodium but did not extensively and systematically investigate the possible variations that these hormones may induce in the tubular regulation of all the other electrolytes, urea metabolism, acid-base balance and urinary pH. While insulin action on the kidney is very well-described, the renal tubular impact of incretin-based therapies is less consistent and the results available are scarce. To our knowledge, this is the first review summarizing the effects induced on renal tubules by insulin, glucagon-like peptide-1 (GLP-1) receptor agonists and serine protease dipeptidyl peptidase-4 (DPP4) inhibitors in both healthy and diabetic human subjects. This is significant because it highlights the existence of a renal-gut and pancreas axis which also has a direct tubular effect and enables a deeper understanding of renal physiology.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20DOI: 10.1007/s40620-024-02057-9
Frank Rutsch, Isidro B Salusky, Carlos R Ferreira
{"title":"Commentary on: The use of burosumab to treat autosomal-recessive hypophosphatemic rickets type 2: rationale and a first clinical experience.","authors":"Frank Rutsch, Isidro B Salusky, Carlos R Ferreira","doi":"10.1007/s40620-024-02057-9","DOIUrl":"https://doi.org/10.1007/s40620-024-02057-9","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20DOI: 10.1007/s40620-024-02064-w
Giorgina Barbara Piccoli, Massimo Torreggiani
{"title":"Inequalities in the access to kidney care, revisiting the country mouse and the city mouse.","authors":"Giorgina Barbara Piccoli, Massimo Torreggiani","doi":"10.1007/s40620-024-02064-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02064-w","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1007/s40620-024-02047-x
Eleni Stefanou, Christos Tountas, Emmanouil Ioannidis, Christo Kole
Cardiorenal syndrome refers to the interrelated dysfunction of the heart or kidney resulting in a cascade of feedback mechanisms, hemodynamic, neurohormonal, and immunological and/or biochemical feedback pathways causing damage in the other organ. Cardiorenal syndrome is categorized into five clinical subtypes depending on the perceived primary precipitant of organ injury and is associated with high morbidity and mortality. Therefore, the development of tools for the earliest identification of cardiorenal syndrome in hospitalized patients is of extremely high significance to ameliorate the prognosis and outcome of these patients. There is increasing interest in identifying molecules serving as biomarkers, reflecting hemodynamic changes, heart and kidney damage and/or dysfunction and oxidative stress-induced cell damage or changes in the extracellular matrix of both the heart and kidneys. Biomarkers provide important insights into the pathophysiology of cardiorenal syndrome and are invaluable tools to predict the decrease in renal function during cardiac dysfunction and vice versa. Based on the pathophysiological mechanisms of cardiorenal syndrome, we reviewed and evaluated the available literature on serum and urinary biomarkers as predictors of kidney and/or heart injury. In addition, heart- and kidney-specific biomarkers were also evaluated based on their reference to kidney and cardiac (dys)function respectively, and whether they would provide any prediction and prognostication of cardiorenal syndrome. In this article, we discuss the current knowledge on the pathophysiology of different types of cardiorenal syndrome, examine the clinical utility of candidate biomarkers in the early diagnosis of cardiorenal syndrome, and guide treatment by evaluating the respective roles of the involved pathophysiological pathways.
{"title":"Biomarkers in cardiorenal syndrome, a potential use in precision medicine.","authors":"Eleni Stefanou, Christos Tountas, Emmanouil Ioannidis, Christo Kole","doi":"10.1007/s40620-024-02047-x","DOIUrl":"https://doi.org/10.1007/s40620-024-02047-x","url":null,"abstract":"<p><p>Cardiorenal syndrome refers to the interrelated dysfunction of the heart or kidney resulting in a cascade of feedback mechanisms, hemodynamic, neurohormonal, and immunological and/or biochemical feedback pathways causing damage in the other organ. Cardiorenal syndrome is categorized into five clinical subtypes depending on the perceived primary precipitant of organ injury and is associated with high morbidity and mortality. Therefore, the development of tools for the earliest identification of cardiorenal syndrome in hospitalized patients is of extremely high significance to ameliorate the prognosis and outcome of these patients. There is increasing interest in identifying molecules serving as biomarkers, reflecting hemodynamic changes, heart and kidney damage and/or dysfunction and oxidative stress-induced cell damage or changes in the extracellular matrix of both the heart and kidneys. Biomarkers provide important insights into the pathophysiology of cardiorenal syndrome and are invaluable tools to predict the decrease in renal function during cardiac dysfunction and vice versa. Based on the pathophysiological mechanisms of cardiorenal syndrome, we reviewed and evaluated the available literature on serum and urinary biomarkers as predictors of kidney and/or heart injury. In addition, heart- and kidney-specific biomarkers were also evaluated based on their reference to kidney and cardiac (dys)function respectively, and whether they would provide any prediction and prognostication of cardiorenal syndrome. In this article, we discuss the current knowledge on the pathophysiology of different types of cardiorenal syndrome, examine the clinical utility of candidate biomarkers in the early diagnosis of cardiorenal syndrome, and guide treatment by evaluating the respective roles of the involved pathophysiological pathways.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1007/s40620-024-02053-z
Niloufar Ebrahimi, Mehrbod Vakhshoori, Fouad Chebib, Pranav S Garimella, Yasar Caliskan, Amir Abdipour, Sayna Norouzi
{"title":"Evaluating physician confidence and barriers in prescribing tolvaptan for ADPKD management: a comprehensive online survey study.","authors":"Niloufar Ebrahimi, Mehrbod Vakhshoori, Fouad Chebib, Pranav S Garimella, Yasar Caliskan, Amir Abdipour, Sayna Norouzi","doi":"10.1007/s40620-024-02053-z","DOIUrl":"https://doi.org/10.1007/s40620-024-02053-z","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}