Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · May 2010
Using RIFLE criteria to evaluate acute kidney injury in brain-deceased kidney donors.
The limited supply of deceased donors for renal transplantation led to considering alternative strategies for making more organs available. One of these strategies is the use of donors with renal dysfunction, as this is usually a reversible condition. RIFLE (risk, injury, failure, loss and end-stage renal failure) criteria were developed to standardize the definition and severity of acute kidney injury (AKI) but have not been previously used in brain-deceased donors. We applied the RIFLE classification to evaluate renal function changes in our donor pool, in an attempt to know its influence in transplant outcome. ⋯ The RIFLE classification system offers us an opportunity to standardize and quantify renal injury in donors. Although >10% of brain-deceased donors can suffer AKI, these grafts can perform adequately. Hence, the development of AKI in donors cannot be an isolated criterion to discard kidney donation.
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Nephrol. Dial. Transplant. · May 2010
Case ReportsEffect of corticosteroids during ongoing drug exposure in pantoprazole-induced interstitial nephritis.
Acute interstitial nephritis (AIN) represents a significant cause of acute renal failure in hospital practice. An increasing number of drugs are known to cause AIN. Due to the lack of prospective, randomized clinical trials, the most effective management is still uncertain, especially the role of steroids in the resolution of interstitial nephritis remains to be further defined. ⋯ In spite of ongoing drug exposure, steroids led to almost complete resolution of the inflammatory infiltrates. Early diagnosis of interstitial nephritis by renal biopsy and identification of the causative drug and its withdrawal remains the mainstay of treatment. However, the additional use of steroids has the potential to eradicate inflammatory infiltrates more rapidly and completely and may thus be important to minimize subsequent chronic damage.
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Nephrol. Dial. Transplant. · Apr 2010
Multicenter StudyIncidence and outcome of patients starting renal replacement therapy for end-stage renal disease due to multiple myeloma or light-chain deposit disease: an ERA-EDTA Registry study.
Information on demographics and survival of patients starting renal replacement therapy (RRT) for end-stage renal disease (ESRD) due to multiple myeloma (MM) or light-chain deposit disease (LCDD) is scarce. The aim of this study was to describe the incidence, characteristics, causes of death and survival rates of RRT for ESRD due to MM or LCDD in the ERA-EDTA Registry. ⋯ The incidence of RRT for ESRD due to MM or LCDD has increased over the past 20 years in Europe. The median patient survival on RRT for MM and LCDD patients was 0.91 years, compared to 4.46 years for non-MM patients. These results suggest that dialysis, and in selected cases even transplantation, should be offered to MM and LCDD patients.
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Nephrol. Dial. Transplant. · Mar 2010
Review Meta AnalysisSodium bicarbonate for prevention of contrast-induced acute kidney injury: a systematic review and meta-analysis.
There have been conflicting reports on the use of intravenous administration of sodium bicarbonate for prevention of contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the use of sodium bicarbonate for prevention of CI-AKI. ⋯ The incidence of CI-AKI was higher than recently reported, and varied among study cohorts. We found a preventive effect of the use of sodium bicarbonate on the risk for CI-AKI, however, with borderline statistical significance. There was no effect on need for RRT or mortality. The relative low quality of the individual studies, heterogeneity and possible publication bias means that only a limited recommendation can be made in favour of the use of sodium bicarbonate.