Journal of nephrology
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Journal of nephrology · Nov 2011
ReviewFerumoxytol: a new era of iron deficiency anemia treatment for patients with chronic kidney disease.
Ferumoxytol is a new product approved for intravenous use by the US Food and Drug Administration (FDA) in the treatment of iron deficiency anemia in adults with chronic kidney disease. This approval was based on data from 3 open-label, randomized, controlled clinical trials. In all of these trials, ferumoxytol was well tolerated, and hemoglobin levels were significantly increased compared with those achieved by orally administered iron. ⋯ In addition, it has demonstrated a greater T1 relaxation time than MRI gadolinium-contrast agents. Currently, the Ferumoxytol Compared to Iron Sucrose Trial (FIRST) has started. This is a multicenter randomized trial of ferumoxytol compared with iron sucrose for the treatment of iron deficiency anemia in adult subjects with chronic kidney disease, where intravenous ferumoxytol is being compared with other intravenous agents to evaluate the safety of ferumoxytol and assess changes in hemoglobin level.
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Journal of nephrology · Nov 2011
Preoperative left ventricular dysfunction predisposes to postoperative acute kidney injury and long-term mortality.
Both preoperative left ventricular dysfunction (LVD) and acute kidney injury (AKI) in the postoperative period are independently associated with mortality. We evaluated the prevalence and prognostic implications of AKI in a cohort of vascular surgery patients. ⋯ Patients with preoperatively LVD have an increased risk of developing AKI after vascular surgery. The occurrence of AKI in patients with LVD has an incremental predictive value toward cardiovascular mortality risk during long-term follow-up.
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Journal of nephrology · Sep 2011
ReviewDo HMG-CoA reductase inhibitors improve kidney function? The saga continues.
Several reviews have addressed the role of dyslipidemia in renal injury and the potential renal protective effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins). Experimental evidence in animals strongly supports the concept that statins may be renal protective. ⋯ A recent controlled study using rosuvastatin has cast some doubts on the renal protective effect of this drug. This article reviews the available evidence pro and con the renal protective effects of statins in human subjects.
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Journal of nephrology · Sep 2011
Multicenter Study Clinical TrialIron isomaltoside 1000: a new intravenous iron for treating iron deficiency in chronic kidney disease.
Patients with chronic kidney disease (CKD) often suffer from iron deficiency anemia necessitating treatment with intravenous iron. This study was designed to assess the safety of iron isomaltoside 1000 (Monofer) in CKD patients. The secondary objective was to assess its effect on iron deficiency anemia. ⋯ Iron isomaltoside 1000 was clinically well tolerated, safe and effective. This new intravenous iron may offer a further valuable choice in treating the anemia of CKD.
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Journal of nephrology · Sep 2011
ReviewAcute kidney injury in pregnancy: the thrombotic microangiopathies.
Acute kidney injury (AKI) is a rare but serious complication of pregnancy. Although prerenal and ischemic causes of AKI are most common, renal insufficiency can complicate several other pregnancy-specific conditions. ⋯ It is imperative to distinguish these conditions to make appropriate therapeutic decisions which can be lifesaving for the mother and fetus. Typically AFLP and HELLP improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for TTP.