Journal of nephrology
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Journal of nephrology · Nov 2012
Establishing goals of volume management in critically ill patients with renal failure.
Volume management remains a challenging component of caring for the critically ill. Renal failure complicates fluid management. We sought to identify relationships between delta blood volume and physiology-based targets for both the adequacy of left ventricular filling (stroke volume index [SVI]) and preload dependency (stroke volume variability [SVV]) in patients undergoing dialysis in the intensive care unit. ⋯ Physiologic variables assessing cardiac performance (SVI) and preload responsiveness (SVV) provide simple yet meaningful targets when one is determining the best approach for volume management in critically ill patients undergoing dialysis.
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Journal of nephrology · Nov 2012
FK506 alleviates proteinuria in rats with adriamycin-induced nephropathy by down-regulating TRPC6 and CaN expression.
To investigate the roles of transient receptor potential cation channel 6 (TRPC6) and calcineurin (CaN) in proteinuria pathogenesis and the mechanism of action of the calcineurin inhibitor tacrolimus (FK506) in adriamycin-induced nephropathy. ⋯ These findings suggested that TRPC6 and CaN were up-regulated on mRNA and protein levels in adriamycin-induced rats. FK506 had a therapeutic effect on the progression of proteinuria and renal damage by down-regulating of TRPC6 and CaN in the renal tissues.
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Journal of nephrology · Sep 2012
Comparative StudyNational primary care guidelines for England: impact on chronic kidney disease prevention in South Asian populations.
This study evaluated the impact of national policy for kidney disease in primary care comparing South Asian (SA) and white European (WE) population groups. ⋯ Recording of indicators for diabetic kidney disease at diagnosis increased in both South Asians and white Europeans following introduction of national guidance to improve early detection and quality of care in the diabetic kidney disease care pathway.
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Journal of nephrology · Sep 2012
Case ReportsReversible acute encephalopathy with mutism, induced by calcineurin inhibitors after renal transplantation.
The incidence of neurotoxicity from calcineurin inhibitors varies by the organ transplanted. Akinetic mutism is characterized by the inability to perform voluntary movements and express language, without alterations in mental status. ⋯ We report a clinical case of a renal transplant patient in whom reversible acute encephalopathy and akinetic mutism developed. Brain lesions appeared on magnetic resonance imaging, and the condition resolved after the drug was withdrawn.
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Increasing age is considered one of the risk factors for hyponatremia. The concept of asymptomatic hyponatremia is not correct anymore as these patients have a greater risk for falls, bone fractures and attention impairment. The combination of old age and a fall is a common recipe for admission to a nursing home. ⋯ Even mild hyponatremia in the elderly should be considered a risk factor for falls. Correction of hyponatremia in the elderly may reduce morbidity and mortality, and at the same time, it has a huge impact on socioeconomic status.