Clinical and experimental nephrology
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Clin. Exp. Nephrol. · Feb 2013
ReviewNew strategy for the treatment of type 2 diabetes mellitus with incretin-based therapy.
Incretin-based therapy was first made available for the treatment of type 2 diabetes mellitus (T2DM) in the US in 2006 and in Japan in 2009. Four DPP-4 inhibitors and two GLP-1 analog/receptor agonists are currently available. ⋯ The protective effects of this therapy on vulnerable pancreatic β-cells and against micro/macroangiopathy in T2DM are also most welcome. Indications and/or contraindications for incretin-based therapy should be clarified by prospectively studying the experiences of Japanese T2DM patients undergoing this therapy in the clinical setting.
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Clin. Exp. Nephrol. · Feb 2013
Comparative StudyRelationship between total testosterone, cognitive function, depressive behavior, and sleep quality in chronic kidney disease patients not on dialysis.
Studies show that testosterone levels are associated with cognitive function, depression, and sleep quality in the general population. However, these relationships in chronic kidney disease (CKD) patients not on dialysis have not yet been evaluated before. ⋯ Total serum testosterone levels were independently associated with cognitive function and depressive behavior but not with sleep disorders in stage 3-5 CKD patients not on dialysis.
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Clin. Exp. Nephrol. · Feb 2013
Virological responses of pegylated interferon alpha-2a treatment in hemodialysis patients infected with hepatitis C.
Hepatitis C is the most frequently encountered hepatic disease in dialysis patients. Data related to pegylated interferon alfa-2a (Peg-IFN-α-2a) use in hemodialysis patients with hepatitis C virus (HCV) are limited. The aim of this study was to evaluate the efficacy of Peg-IFN-α-2a among these patients. ⋯ According to results of this study, patients achieved good sustained viral and biochemical response rates with Peg-IFN-α-2a treatment. Histology activity index may be a predictor for SVR; but large randomized controlled trials are needed. Weekly 135 mcg dose of Peg-IFN-α-2a for 48 weeks is an effective treatment in HCV-infected hemodialysis patients.
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Acute kidney injury (AKI) is characterized by a rapid decrease in kidney function and increased serum creatinine. The term acute renal failure (ARF) has been applied to such clinical manifestations. Despite several advances in the treatment of ARF, such as pharmacologic treatment and renal replacement therapy (RRT), the mortality rate among patients with ARF has changed little over the past four decades. ⋯ Therefore, in order to improve outcomes in ARF patients, a new concept of AKI has been proposed. Recently the paradigm shift from ARF to AKI has been received by the research and clinical communities. In this review we will discuss the therapeutic strategies for AKI and focus on its management with an emphasis on RRT.
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Positive fluid balance (FB) has been linked to adverse clinical outcomes. We performed this study to explore the relationship between perioperative fluid balance and acute kidney injury (AKI). ⋯ Positive FB was associated with increased incidence of AKI.