Journal of nephrology
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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.
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Journal of nephrology · Feb 2015
Pericarditis in uremic patients: serum albumin and size of pericardial effusion predict drainage necessity.
Pericardial effusion in uremic patients (UPE) was first described by R. Bright in 1836. It is generally agreed that patients require emergency pericardial drainage when tamponade signs are present, but in patients with no tamponade the optimal timing for drainage remains unclear. ⋯ In this first study reporting UPE drainage risk factors, all large UPE required drainage even when extra-renal epuration intensification or medical treatment were tried. This suggests that large UPE should be drained without delay. For small and moderate UPE, size of effusion on echocardiography does not predict drainage requirement but serum albumin level does.
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Journal of nephrology · Oct 2014
Randomized Controlled Trial Multicenter Study Comparative StudyThe extent of informed decision-making about starting dialysis: does patients' age matter?
A growing number of elderly patients with end-stage renal disease start dialysis. We examined elderly (≥65 years) patients' views about their decision-making experience after starting dialysis in comparison with patients aged 50-64 years, and patients ≤49 years. ⋯ Informed decision-making is significantly poorer in patients aged 65 years or older than in younger patients. Clinicians should communicate clearly about the benefits and burdens of dialysis to older adults and provide an opportunity for them to understand the significant trade-offs that dialysis may require.
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Journal of nephrology · Aug 2014
Comparative Study Observational StudyAccuracy of the estimation of glomerular filtration rate within a population of critically ill patients.
Accuracy of glomerular filtration rate (GFR) estimates has been questioned and several authors recommend routine use of measured renal creatinine clearance (CLCR) as a surrogate of GFR in the intensive care unit (ICU). Our purpose was to compare estimates of GFR using Cockroft-Gault (CG), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease Study (MDRD) equations with 8h-CLCR, within a population of critically ill patients with a wide range of measured CLCR. ⋯ Estimates of GFR using CG, CKD-EPI and MDRD formulae are flawed in the critically ill with normal sCr, significantly underestimating renal function in those with ARC and overestimating it in those with normal or decreased 8h-CLCR. Globally, the population exhibited ARC on more than half of the ICU admission days.
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Journal of nephrology · Apr 2014
Suppressive effects of iron overloading on vascular calcification in uremic rats.
Medial vascular calcification is a specific complication in chronic kidney disease (CKD) patients although its pathogenesis is poorly understood. The administration of iron (Fe), generally used for the treatment of anemia in CKD patients, induces oxidative stress. Fe loading possibly affects the progress of vascular calcification in uremia. We investigated the effect of Fe on vascular calcification and its mechanism in uremic rats. ⋯ Fe suppressed the development of vascular calcification through the prevention of Pit-1 and vascular smooth muscle cell osteoblastic transdifferentiation.