Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 2015
Randomized Controlled Trial Comparative StudyPlasma S100A12 and soluble receptor of advanced glycation end product levels and mortality in chronic kidney disease Stage 5 patients.
Alterations in the advanced glycation end-products (AGE)-receptor of AGE (RAGE) system are linked to several chronic diseases, which may result from vascular damage. A high circulating level of the pro-inflammatory RAGE-ligand S100A12, also known as EN-RAGE, is thought to promote while a high level of soluble RAGE (sRAGE) is thought to protect against development of atherosclerotic cardiovascular disease (CVD). We evaluated circulating S100A12 and sRAGE in relation to clinical characteristics, nutritional status, inflammation and mortality risk in chronic kidney disease (CKD) Stage 5 patients starting on dialysis. ⋯ Plasma concentrations of sRAGE, S100A12 and the ratio S100A12/sRAGE, are markedly elevated in CKD 5 patients starting on dialysis as well as in CKD 3-4 patients and prevalent dialysis patients suggesting that these alterations are typical for patients with moderate or severe CKD. In CKD 5 patients, an increased concentration of S100A12 are associated with inflammation, comorbidities and increased mortality risk whereas no such associations were observed for sRAGE. These results suggest that while high plasma S100A12 is an independent predictor of increased mortality risk, sRAGE does not seem to be a valid risk marker in this patient population.
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Nephrol. Dial. Transplant. · Dec 2014
ReviewGlomerular haemodynamics, the renal sympathetic nervous system and sepsis-induced acute kidney injury.
To describe recent insights into glomerular haemodynamics in septic acute kidney injury (AKI). ⋯ Despite a long-standing paradigm that septic AKI is due to renal hypo-perfusion and associated ATN, experimental and human studies increasingly suggest that changes in the state of the glomerular and peri-glomerular micro-vasculature are a more likely additional explanation for this condition.
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Nephrol. Dial. Transplant. · Dec 2014
Multicenter StudyEnd-stage kidney disease due to Alport syndrome: outcomes in 296 consecutive Australia and New Zealand Dialysis and Transplant Registry cases.
Alport syndrome is a rare inheritable renal disease. Clinical outcomes for patients progressing to end-stage kidney disease (ESKD) are not well described. ⋯ Alport syndrome patients experienced comparable dialysis and renal transplant outcomes to matched non-Alport ESKD controls in the contemporary cohort due to relatively greater improvements in outcomes for non-Alport ESKD patients over time. Post-transplant anti-GBM disease was rare.
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Nephrol. Dial. Transplant. · Dec 2014
Multicenter StudyDesmopressin acetate (DDAVP)-associated hyponatremia and brain damage: a case series.
Desmopressin (DDAVP) is typically prescribed for central diabetes insipidus, von Willebrands disease and for enuresis. DDAVP-associated hyponatremia is a known complication of DDAVP therapy. The currently recommended treatment for this condition calls for discontinuing DDAVP as part of the initial therapy. This recommendation could lead to a water diuresis and potentially over-correction of the serum sodium. ⋯ Discontinuing DDAVP in a patient with symptomatic DDAVP-associated hyponatremia can lead to rapid correction of the serum sodium and resultant severe neurological injury. In contrast, continuing the medication while correcting DDAVP-associated hyponatremia may lead to better outcomes by avoiding over-correction of the serum sodium. Thus, an alternative approach that we propose is to continue DDAVP as part of the initial management of this disorder.
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Nephrol. Dial. Transplant. · Dec 2014
Prediction of membranous nephropathy recurrence after transplantation by monitoring of anti-PLA2R1 (M-type phospholipase A2 receptor) autoantibodies: a case series of 15 patients.
The predictive value of anti-M-type phospholipase A2 receptor (PLA2R1) autoantibodies for membranous nephropathy (MN) recurrence after renal transplantation remains controversial. ⋯ The monitoring of IgG4 anti-PLA2R1 titres during follow-up helps to predict MN recurrence, and a strong immunosuppressive treatment of anti-PLA2R1 positive patients may prevent recurrence.