Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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Early initiation of dialysis: mortality and renal function recovery in acute kidney injury patients.
The decision of when to start dialysis in Acute Kidney Injury (AKI) patients with overt uremia is strongly established, however, when blood urea nitrogen (BUN) levels is < 100 mg/dL the timing of initiation of dialysis remains uncertain. ⋯ Lower mortality and higher renal function recovery rates were associated with early dialysis initiated at lower BUN levels in AKI patients.
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The recent RIFLE classification defines three degrees for severity of acute kidney injury (AKI): RISK, INJURY and FAILURE and was associated with mortality according to the grading of the severity of AKI, but little valued at prospective studies. ⋯ The severity of AKI according to RIFLE criteria was a risk marker for mortality in this population. The LRA group class Injury + Failure was associated with increased mortality when compared to the subgroup Without AKI + AKI that remained in Risk class even after adjustments for multiple variables.
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Hypokalemia is found in peritoneal dialysis (PD) patients. The problem may be severe and promote mortality. Several factors may trigger the hypokalemia in PD patients, such as preexisting malnutrition and the low protein and potassium food intake. ⋯ Low levels of serum potassium were associated to lower survival in PD patients and it seems to be related to malnutrition.
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Review Case Reports
[Crossed renal ectopia with fusion: report of two cases and review of the literature].
Renal ectopia is one of the most common renal abnormalities of kidney development. However, only a few cases of crossed fused renal ectopia have been reported in the literature. ⋯ We report two new cases of crossed renal ectopia with fusion diagnosed in a context of kidney stones and urinary tract infection and review the mechanism and clinical features of this abnormality. We believe that Nephrologist must be familiar with this abnormality of kidney development, as a number of complications may appear during follow-up.
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Comparative Study Clinical Trial
Uremic pruritus in hemodialysis patients: treatment with desloratidine versus gabapentin.
Uremic pruritus is common among dialysis patients. Effective treatments are not readily available. Early evidence with antihistamines and gabapentin indicate variable effects. ⋯ Desloratadine provides significant relief of uremic pruritus compared with no therapy. gabapentin has marginal efficacy. Desloratadine is better tolerated than gabapentin.