M A Perazella

..Cool dialysate and midodrine appear to improve intradialytic hemodynamics in patients with dialysis-associated hypotension, mainly through the preservation of CBV and CO, rather than significantly elevating PVR...

..Onco-Nephrology is a new area that is rapidly expanding and requires a close working relationship between oncologists and nephrologists...

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..We performed a systematic review to describe the effect in septic patients of direct hemoperfusion with PMX-F on outcomes of blood pressure, use of vasoactive drugs, oxygenation, and mortality reported in published studies...

..Therefore, therapies targeting both progression of chronic kidney disease and comorbidities such as cardiovascular disease are required to reduce mortality among these patients...

..Recognizing risk factors that increase renal vulnerability to drug-induced kidney disease is the first step in reducing the renal complications of drugs and toxins...

..This medication has been demonstrated to be effective and safe in the acute and chronic treatment of haemodialysis-associated hypotension in end stage renal disease patients...

..Agents recently described to induce an "osmotic nephrosis" include intravenous immunoglobulin and the plasma expander hydroxyethyl starch...

..Several therapies have no role in the prevention of RCIN and should be avoided. This review will provide an up to date examination of the current status of these issues as they relate to RCIN...

..Although urine microscopy is useful to differentiate AKI, its role in predicting adverse clinical outcomes has not been well described...

..This article reviews the current status of GBC agents as nephrotoxins and causes of NSF and provides opinions on how to use these agents in patients with underlying kidney disease...

..Urine microscopy is the oldest and one of the most commonly used tests for differential diagnosis of acute kidney injury (AKI), but its performance has not been adequately studied in the setting of AKI...

..Peritoneal dialysis clearance of gadolinium is poor, but aggressive peritoneal dialysis prescriptions have not been studied for gadolinium removal...

..These clinical practice guidelines should be individualized and considered in consultation with the ordering physician, radiologist, and nephrologist...

..Direct gadolinium activation of transglutaminases on these tissue fibroblast-like cells may also promote fibrosis...

..Finally, postrenal azotemia from structural or functional obstruction of the urinary tract also complicates therapy with a number of medications...

..Herlitz et al. confirm the nephrotoxicity of tenofovir in humans. They describe its clinical consequences, histopathologic findings, and its mitochondrial toxicity in HIV+ patients...

..We present two cases of acute renal failure complicating the course of therapy with celecoxib in patients with chronic renal insufficiency...

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..Finally, obstruction of the urinary system will rarely cause postrenal azotemia in patients infected with HIV...

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..A few therapies appear to be efficacious and well tolerated-carnitine, sertraline, and midodrine. This article reviews the various pharmacologic therapies used for IDH and makes recommendations for treatment of this difficult problem...

..Available clinical data on the renal effects of COX-2 selective inhibitors in humans also demonstrate nephrotoxic potential...

..This article reviews some of the classic nephrotoxic chemotherapeutic agents and focuses on examples of the clinical and histopathologic kidney lesions they cause as well as measures that may prevent or treat drug-induced nephrotoxicity...

..This will allow one to maximize the diagnostic efficiency while also limiting the adverse effects...

..We also touch on the COX-1/COX-2 selectivity of NSAIDs, the localization of COX enzymes in kidneys, and clinical studies examining the renal effects of selective COX-2 inhibitors...

..Transfusion was required in 1 patient while 6 patients had detectable bleeding and were hospitalized for observation. Outpatient CT-guided kidney biopsy provides adequate tissue and appears to be safe with very low complication rates...

..COX-2 inhibitors may thus have much the same renal risks that a standard NSAID does. Several clinical trials have already focused on the new drugs' renal effects...

..Management of established renal insufficiency includes volume repletion, dialytic support if necessary, adjustment of drug doses, and avoidance of further exposure to nephrotoxins...

..This paper will critically review the effect of PPIs on the kidney...

..However, this therapy did not reduce symptoms or interventions required for IDH. In addition, hypercalcemia complicated this therapy in 22% of the patients...

..However, many patients with kidney disease are exposed to GBC agents, yet they do not develop this devastating disorder...

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..Hence, it appears that intravenous epsilon-aminocaproic acid can also cause hyperkalemia in humans...

..We review the available data and draw conclusions about the relative benefits of modulating potassium balance versus nonrenal effects of aldosterone blockade in patients with cardiovascular disease...

..Arginine vasopressin (AVP), an endogenous hormone with vasopressor properties, may be inadequately secreted during episodes of intradialytic hypotension (IDH)...

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..We review the literature of renal syndromes associated with indinavir focusing on chronic progressive tubulointerstitial injury and speculate on risk factors and potential mechanisms of indinavir-induced renal injury...

..Finally, other less common adverse effects, although rare in most patients, should be recognized as such by physicians who prescribe rHuEPO...

..Only with greater awareness of kidney-disease manifestations and their implications in this particularly vulnerable population will we be able to achieve success in confronting this growing problem...

..Other hemodynamic parameters fared similarly, and coefficients of variation were all between 7 and 18%. CONCLUSION: We conclude that the Dynapulse 500 Guardian has adequate reliability indices in hemodialysis patients...

..In conclusion, it appears that sertraline has no additive effect on intradialytic haemodynamics to improve blood pressure in patients with DAH who are under therapy (with sodium modelling, cool dialysate and midodrine)...

..We present a case in which acute renal failure developed after therapy with tenofovir DF in a patient with HIV and stable chronic kidney disease...

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..Unfortunately there is a lack of a universally effective therapy. Resolution of acute kidney injury (AKI) appears to attenuate disease in most cases, while kidney transplantation has been associated with variable success...

..Treatment of toxicity includes hemodialysis to effectively remove propylene glycol. Prevention is best achieved by limiting the dose of propylene glycol infused...

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..The aim of the present review is to provide an update of the recent literature on causes and possible management of ESA-resistant anemia in CKD patients...

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..Recognition of drug-related nephrotoxicity will promote earlier resolution of acute kidney injury and reduce the development of chronic kidney disease...

..A case illustrating the typical clinical presentation of ARF after heart transplant will be presented and the clinical features will be reviewed...

..Theophylline, which reduces adenosine-mediated erythropoietin synthesis, is effective but may be associated with side effects.(ABSTRACT TRUNCATED AT 250 WORDS)..

..In particular, treatment with calcium EDTA chelation may benefit certain patients with chronic kidney disease by slowing the progression to end-stage renal disease...

..CONCLUSIONS: Intradialytic administration of amphotericin B was generally well tolerated. Our observations suggest that amphotericin B is effective and safe for outpatient intradialytic therapy when administered according to protocol...

..In contrast to scleroderma, inflammatory cells are generally absent. Corticosteroid therapy can be tried, but in our patient was of no benefit...

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..In particular, the authors review their effects on reductions in cardiovascular events and progression of chronic kidney disease, as well as the safety and tolerability of these agents...

..CONCLUSION: Intravenous iron is not associated with acute microbial growth in catheters or clinical infection. However, a trend towards increased catheter colonization following iron administration exists...

..In general, the prognosis for drug-induced AIN is good, and at least partial recovery of kidney function is normally observed. Early recognition is crucial because patients can ultimately develop chronic kidney disease...

..Herein, the pathophysiology of CHF, the beneficial role of aldosterone antagonists in this disease process, and potential adverse consequences of these agents are reviewed...

..However, other organs may be involved. We report a case of a young man who developed renal failure in the transplanted kidney. Renal biopsy demonstrated myointimal calcification in the renal arteries consistent with this diagnosis...

..Two patients received gadoversetamide and the third received gadodiamide. All 3 patients were treated early in their disease course with intravenous sodium thiosulfate and responded with improved skin changes and joint mobility...

..The efficacy and safety of dual RAS blockade in proteinuric renal diseases will be examined. Finally, recommendations for utilising combined therapy with ACE inhibitors and ARBs will be provided...

..More often, tests such as fractional excretion of sodium (FeNa) and fractional excretion of urea (FeUrea) are used to differentiate these two causes of acute kidney injury...

..We herein review and summarize clinical practice guidelines put forward by the National Kidney Foundation Working Group to aid physicians in the diagnosis and management of CKD...

..We discuss the initial management, diagnosis, and definitive therapy of this relatively rare type of pheochromocytoma...

..Available data suggest that ibandronate has a safe renal profile without evidence of nephrotoxicity, even in patients with abnormal baseline kidney function...

..Because falls occur frequently in the dialysis population, simple fall prevention may be one important way of protecting dialysis patients from the morbidity and mortality of hip fracture...

..Cryotherapy with the cryoballoon (cryoplasty) may represent a useful therapy for patients with intractable stenoses at or near the venous anastomosis of arteriovenous grafts...

..Renal biopsy showed acute interstitial nephritis. This is the first report of acute interstitial nephritis from atazanavir...

..We encountered a patient with Langerhans's histiocytosis who developed nephrotic syndrome and renal failure after pamidronate therapy. We describe the clinical and renal biopsy findings in this patient...

..Dysproteinemias are associated with protean renal manifestations, and renal disease may be the presenting manifestation...

..We conducted a systematic review of published trials to determine whether periprocedural extracorporeal blood purification prevents RCIN...

..Caution should be exercised when utilizing gadolinium as a contrast agent in patients with advanced CKD or ESRD...

..Practicing nephrologists should be aware of this issue, but should not hesitate to use IV iron in iron-deficient patients while avoiding the development of iron overload and administration of iron to patients who have active infection...

..A steady improvement in renal function subsequently was observed. Results of a repeated 24-hour urine oxalate collection performed 3 weeks later when kidney function had improved were within normal limits...

..3% of ICU patients requiring renal replacement therapy. Sepsis was a significant contributing factor. Overall mortality was between 30 and 42%, and was highest among those in RIFLE class F...

..This review focuses on the multitude of patterns of drug-induced renal failure due to tubulointerstitial disease...