The American journal of the medical sciences
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Review Meta Analysis
Efficacy and safety of mTOR inhibitor therapy in patients with early-stage autosomal dominant polycystic kidney disease: a meta-analysis of randomized controlled trials.
The objective of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) to present a profound review and an objective appraisal of the efficacy and safety of the mammalian target of rapamycin (mTOR) inhibitor therapy in patients with autosomal dominant polycystic kidney disease (ADPKD). ⋯ Based on the current limited clinical trials, this study suggests that short-duration mTOR inhibitor therapy is relatively safe to slow down the increase in kidney volume in patients with early-stage ADPKD, but it has limited impact on slowing down the decrease in GFR.
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Anion gap metabolic acidosis (AGMA) is commonly encountered in medical practice. Acetaminophen-induced AGMA is, however, not widely recognized. ⋯ Recognition of this entity facilitated timely diagnosis and effective treatment. Given acetaminophen is commonly used over the counter medication, increased recognition of this adverse effect is of important clinical significance.
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Pleural effusions in ovarian hyperstimulation syndrome, whether transudative or exudative, can occur in up to 30% of cases. This disorder is always reversible but may have various clinical presentations and degrees of severity. Although assessing for risk factors to predict clinical severity is helpful, it is rare for ovarian hyperstimulation syndrome to present as a massive pleural effusion requiring emergent intervention. In this study, such a case is reported.
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Podocytes play an important role in the pathogenesis and progression of glomerulosclerosis. Various elements of the renin-angiotensin-aldosterone system can induce podocyte apoptosis. However, little is known about the direct effects of renin on podocytes. ⋯ The authors conclude that the effects of renin are mediated through the activation of rennin receptor and are independent of angiotensin II generation.
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Comparative Study
A comparison of acute kidney injury classifications in patients with severe sepsis and septic shock.
Acute kidney injury (AKI) is a common and serious complication in patients with severe sepsis and septic shock. AKI can be classified using the RIFLE (Risk, Injury, Failure, Loss and End-stage) and/or the Acute Kidney Injury Network (AKIN) criteria. The aim of this study was to determine which of the 2 systems better predicted 28-day mortality in patients with severe sepsis and septic shock. ⋯ The incidence of AKI in patients with sepsis and septic shock was slightly higher using AKIN than RIFLE criteria. However, using the AKIN criteria did not enhance the ability of AKI to predict 28-day mortality in such patients.