Journal of nephrology
-
Journal of nephrology · Feb 2015
Review Meta AnalysisUrine interleukin-18 in prediction of acute kidney injury: a systemic review and meta-analysis.
Interleukin-18 (IL-18) mediates ischemic acute tubular necrosis; it has been proved as a rapid, reliable, and affordable test marker for the early detection of acute kidney injury (AKI), but its predictive accuracy varies greatly. ⋯ Urine IL-18 holds promise as a biomarker in the prediction of AKI but has only moderate diagnostic value.
-
Journal of nephrology · Nov 2013
ReviewBlood pressure measurement in children: which method? which is the gold standard.
The burden of hypertension has become increasingly prevalent in children. Hypertension that begins in childhood can carry on into adulthood, therefore early detection, accurate diagnosis and effective therapy of high blood pressure may improve long-term outcomes of children and adolescents. As far as pediatric hypertension is concerned, doubts still persist about the right instruments, modalities and standards of reference that should be used in routine practice. ⋯ Moreover, we specifically address the main characteristics of different modalities for blood pressure measurement in children, focusing on practical aspects. The latest international guidelines and appropriate standards of reference for office, ambulatory and home blood pressure data collection are presented. As clinicians are being faced with a greater number of children with hypertension, they should be aware of these peculiarities.
-
Acute kidney injury (AKI) is associated with significant morbidity, mortality, and health care costs. In spite of significant advances in health-care technology over the past few years, the incidence of AKI appears to be increasing over time. Elderly subjects represent the segment of the general population in which the incidence of AKI has been increasing the most. ⋯ In the last few years, several studies have suggested new biomarkers that may help the physician to better define AKI overall and in elderly patients in particular. The prevention of AKI is a crucial consideration in the management of elderly patients, since they are at high risk of developing AKI and in this particular population AKI is associated with significantly increased morbidity and mortality. Improved awareness, aiming for early detection, and implementation of preventive strategies, might lead to a decreased incidence of AKI and better outcomes in elderly patients.
-
Journal of nephrology · Jan 2012
ReviewAcute renal failure in the elderly: epidemiology and clinical features.
Structural and functional alterations affecting the aging kidney predispose to an increased risk of acute renal failure (ARF) in the elderly. This is a common problem becoming more relevant because of an increase in life expectancy. The epidemiology of ARF in the elderly is far from being well assessed, because of the lack of uniform definition criteria, variable etiology, coexistence of several comorbidities, and the various clinical settings and geographic areas where the condition is managed, with a higher incidence in developed regions where elderly patients predominate. ⋯ Although in elderly patients the more frequent forms of AKI are functional or obstructive, parenchymal AKI, such as acute tubular necrosis and contrast-induced nephropathy, still frequently occur. Elderly patients with chronic renal disease (CKD) who develop AKI are at high risk for mortality, and are prone to non-recovery from AKI and progression to more advanced stages of CKD and even to end-stage renal disease. Panels of AKI biomarkers are likely to improve early diagnosis and treatment, thus reducing morbidity and mortality of older patients from this condition in the future.
-
Journal of nephrology · Nov 2011
ReviewFerumoxytol: a new era of iron deficiency anemia treatment for patients with chronic kidney disease.
Ferumoxytol is a new product approved for intravenous use by the US Food and Drug Administration (FDA) in the treatment of iron deficiency anemia in adults with chronic kidney disease. This approval was based on data from 3 open-label, randomized, controlled clinical trials. In all of these trials, ferumoxytol was well tolerated, and hemoglobin levels were significantly increased compared with those achieved by orally administered iron. ⋯ In addition, it has demonstrated a greater T1 relaxation time than MRI gadolinium-contrast agents. Currently, the Ferumoxytol Compared to Iron Sucrose Trial (FIRST) has started. This is a multicenter randomized trial of ferumoxytol compared with iron sucrose for the treatment of iron deficiency anemia in adult subjects with chronic kidney disease, where intravenous ferumoxytol is being compared with other intravenous agents to evaluate the safety of ferumoxytol and assess changes in hemoglobin level.