International urology and nephrology
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Comparative Study Clinical Trial
Renal biomarkers for assessment of kidney function in renal transplant recipients: how do they compare?
Accurate assessment of renal function is of key importance, given its prognostic value. However, gold standard measures are cumbersome, and serum creatinine itself is an insensitive predictor, especially in renal transplant recipients. Though GFR-estimating formulae have been relied upon, they do have their own limitations. ⋯ It appears that in renal transplant recipients NGAL correlates well with cystatin C and eGFR, most strongly with cystatin-based formula. Though this suggests potential use of NGAL as a screening test, its weaker diagnostic performance raises some concern about its clinical usefulness. Larger studies are needed to explore this further.
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Multicenter Study Comparative Study
Racial differences in restless legs symptoms and serum ferritin in an incident dialysis patient cohort.
Restless legs syndrome (RLS), a debilitating sleep disorder that is frequently reported by CKD patients on dialysis, may be more common in whites than in non-whites. Iron deficiency is associated with RLS, and serum ferritin is higher among African Americans compared to Caucasians in the general population. No prior studies have compared restless legs symptoms and serum ferritin levels of African-American and those of the Caucasian patients on dialysis. ⋯ Further study of racial and iron status relationships could advance the understanding of RLS pathophysiology, and RLS is an important patient outcome to monitor, as revised anemia and iron protocols are implemented in the clinical setting.
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Acute kidney injury (AKI) secondary to acute tubular necrosis (ATN) is common in critically ill patients, and causes significant morbidity and mortality. The underlying etiology of ATN can be divided into pure ischemic, pure nephrotoxic, and mixed causes. This post-hoc analysis of a prospective cohort study aimed to investigate whether the cause (pure vs. mixed) of ATN affects the short- and long-term outcome of critically-ill patients. ⋯ The cause of presumed ATN has a profound impact on short- as well as long-term outcomes of critically-ill patients with AKI requiring renal replacement therapy. The challenge for intensivists is to avoid further injury to the kidneys of these patients.