Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · May 2009
Chronic kidney disease and cardiovascular risk in hypertensive type 2 diabetics: a primary care perspective.
Chronic kidney disease (CKD) is associated with poor renal and cardiovascular (CV) outcome, and early identification largely depends on the general practitioners' (GPs) awareness of it. Only a few studies have evaluated the prevalence of CKD in type 2 diabetes in primary care, and no studies are available on hypertensive diabetics. Thus, the aim of this study was to assess the prevalence of CKD and its association with CV morbidity in such a population. ⋯ This study shows that CKD is highly prevalent in hypertensive type 2 diabetic patients, where it is a strong predictor of CV adverse outcome. However, awareness of CKD by GPs is low. Equations for calculating estimated GFR should be included in the GPs' database in order to detect the presence of CKD and to improve CV outcome of such a high-risk population.
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Nephrol. Dial. Transplant. · May 2009
Prognostic value of elevated cardiac troponin I in ESRD patients with sepsis.
Elevated cardiac troponin (cTn) levels have been reported to predict adverse cardiovascular outcomes in asymptomatic ESRD patients. However, the prognostic value of elevated cTn levels associated with sepsis in ESRD patients is unknown. Therefore, this study aimed to elucidate the clinical implications of elevated cTnI levels in ESRD patients with sepsis. ⋯ This study showed that elevated cTnI levels were significantly associated with short- and long-term mortality in ESRD patients with sepsis. Therefore, elevated cTnI levels in these patients should not be overlooked and be followed for adverse outcomes.
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Nephrol. Dial. Transplant. · Apr 2009
Comparative StudySerum cystatin C in mouse models: a reliable and precise marker for renal function and superior to serum creatinine.
Serum creatinine (SCR) and blood urea nitrogen (BUN) determine the glomerular filtration rate (GFR) improperly in acute renal failure. Serum cystatin C (CYS) has the potential to be a more precise marker for GFR. The aim of this study was to compare the sensitivity of SCR, BUN and CYS with respect to the detection of acute renal failure in mice. ⋯ CYS can be used as a reliable and precise marker for renal function in mouse models. CYS is more sensitive than SCR, and it shows renal damage earlier than SCR and BUN.
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Nephrol. Dial. Transplant. · Mar 2009
Case ReportsSurvival after 5-h resuscitation attempt for hypothermic cardiac arrest using CVVH for extracorporeal rewarming.
Hypothermic cardiac arrest is associated with a high mortality despite advances in pre-hospital rescue, rewarming techniques and intensive care management. Prolonged resuscitation is justified and full neurological recovery has been described using various methods of extracorporeal rewarming (Vretenar DF, Urschel JD, Parrott JCW et al. Ann Thorac Surg 1994; 58: 895-898; Hughes A, Riou P, Day C. ⋯ Resuscitation guidelines suggest cardiopulmonary bypass (CPB) as the method of choice in cardiac arrest, but in practice availability is restricted (Soar J, Deakin CD, Nolan JP et al. Resuscitation 2005; 67: S135-S170). Continuous veno-venous haemofiltration (CVVH) is an alternative, but underutilized approach which warrants further consideration given its ease and wider availability.
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Nephrol. Dial. Transplant. · Mar 2009
Comparative StudyImpact of local circumstances on outcome of renal casualties in major disasters.
In the aftermath of earthquakes, the cumulative incidence of crush-induced acute kidney injury (AKI) is difficult to predict. Insight into factors determining this risk is indispensable to allow adequate logistical planning, which is a prerogative for success in disaster management. ⋯ The cumulative incidence of treated AKI related to number of deaths or victims might differ substantially among earthquakes. Many factors may affect the frequency of AKI: hampered rescue and transport possibilities; destroyed medical facilities on the spot; availability or not of sophisticated therapeutic possibilities and structure of the buildings might all have impacted on different cumulative incidence between Kashmir and Marmara.