American journal of kidney diseases : the official journal of the National Kidney Foundation
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Comparative Study
Rapid reversal of acute kidney injury and hospital outcomes: a retrospective cohort study.
Acute kidney injury (AKI), defined as an increment in serum creatinine level of 0.3 mg/dL or greater in 48 hours, is associated with poor outcomes. The prognosis associated with an increased creatinine level, either on admission or that develops in the hospital (ie, AKI), that rapidly returns to normal is not known. ⋯ An increase in serum creatinine level of 0.3 mg/dL or greater during 48 hours of hospitalization predicts outcomes even if the value returns to normal. Patients who present to the hospital with an increased creatinine level that returns rapidly to normal have outcomes approaching those with serum creatinine levels consistently in the normal range.
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Randomized Controlled Trial Comparative Study
Efficacy and safety of tacrolimus versus cyclosporine in children with steroid-resistant nephrotic syndrome: a randomized controlled trial.
To examine whether tacrolimus is more effective and safe than cyclosporine (CsA) in inducing remission in patients with steroid-resistant nephrotic syndrome (SRNS). ⋯ Tacrolimus or CsA in combination with low-dose steroids show similar efficacy in inducing remission in patients with SRNS. Therapy with tacrolimus is a promising alternative to CsA in view of the lower risk of relapses and lack of cosmetic side effects.
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Wegener granulomatosis classically involves the renal, respiratory, and ear, nose, and throat systems. Pulmonary hemorrhage is recognized as a severe respiratory complication. Untreated, the mortality rate approaches 90% at 2 years. ⋯ Kidney function improved, and pulmonary hemorrhage resolved after 5 plasma exchanges. Reintroduction of intravenous heparin and subsequently warfarin caused no further bleeding. We discuss the difficult management dilemma this combination of disease manifestations presents and review the current literature.
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Health literacy has been recognized as an important public health issue over the past decade. Low health literacy is a widespread problem in the general population, affecting over 90 million Americans. ⋯ Despite the increasing prevalence of chronic kidney disease (CKD) and the considerable interest in health literacy, there has been limited research examining the role of health literacy in individuals at all stages of CKD. This article examines the role of health literacy in kidney disease by reviewing early research on the topic, providing a conceptual model of the relationship between health literacy and health outcomes, and highlighting potential areas for future research on health literacy in CKD.
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Accelerated atherosclerosis in patients with chronic kidney disease (CKD) is still incompletely understood. Angiopoietin 1 (Ang-1) and Ang-2 are 55-kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. We aimed to study: (1) angiopoietin levels in patients treated by means of dialysis and kidney transplantation, (2) the association of altered angiopoietin levels with atherosclerosis, and (3) changes in altered levels after renal transplantation. ⋯ Circulating Ang-2 level was increased in patients treated with dialysis, although the mechanism is unknown. Kidney transplantation normalized circulating Ang-2 levels after 3 months. In addition, Ang-2 might be a mediator (and thus a marker) that accounts for accelerated atherosclerosis in dialysis patients.