Nephrology
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The kidney is an organ highly susceptible to injury by regional tissue oxygen desaturation during hypoxic episodes. Transcutaneous monitoring of renal tissue oxygen saturation is therefore of increasing interest. The aim of the present study was to compare renal tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) during acute hypoxia in neonates directly on the kidney and transcutaneously. ⋯ There were pronounced and lower renaldirect rSO₂ readings when compared with those of renalskin rSO₂ with significant differences from 25 to 55 s after initiation of hypoxia. Changes of cerebralskin rSO₂ and renalskin rSO₂ were similar. Transcutaneous monitoring of renal tissue oxygen saturation may underestimate acute oxygen desaturation of the kidney during hypoxia in neonates.
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Letter Case Reports
Severe linezolid-induced lactic acidosis in a cirrhosis patient.
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Randomized Controlled Trial
Triple immunosuppressive therapy in steroid-resistant nephrotic syndrome children with tacrolimus resistance or tacrolimus sensitivity but frequently relapsing.
The treatment strategy for steroid-resistant nephrotic syndrome remains uncertain at present, especially in those with calcineurin inhibitor resistance or intolerance. To date, few studies have been published using multiple combination therapy of immunosuppressive reagents for children with calcineurin inhibitor-resistant or -intolerant nephrotic syndrome. ⋯ Triple-combination therapy with Pre + TAC + CTX/MMF/LEF is effective for short-term response and 1 year remission, without significant additional side-effects seen in children with steroid-resistant and tacrolimus-resistant or tacrolimus-sensitive but frequently relapsing nephrotic syndrome. Further study for evaluating long-term efficacy and safety of triple-combination therapy with Pre + TAC + CTX/MMF/LEF would be necessary for these patients.
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Review Meta Analysis
Effect of preoperative statin therapy on postoperative acute kidney injury in patients undergoing major surgery: systemic review and meta-analysis.
We aimed to examine the association between preoperative use of statins and postoperative acute kidney injury (AKI) in patients undergoing major surgery by performing a systemic review and meta-analysis. MEDLINE and EMBASE, from inception to April 2013, and the reference lists of related articles were searched for relevant studies. Trials comparing preoperative statin therapy with no preoperative statin in patients undergoing major surgery were included. ⋯ In patients undergoing major surgery, preoperative statin therapy could associate with a reduced risk for postoperative AKI. However, considerable heterogeneity existed among included studies. Future randomized trials were warranted for this critical clinical question.
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Meta Analysis
Relationship of cystatin-C change and the prevalence of death or dialysis need after acute kidney injury: a meta-analysis.
Cystatin-C (CysC) has been demonstrated as a sensitive and reliable biomarker to predict the onset of acute kidney injury (AKI). However, there are few studies concerned about the relationship between CysC and the outcomes of AKI. The aim of the present study was to determine whether CysC elevation prior to definite diagnosis of AKI is related to higher prevalence of death and dialysis need outcome. ⋯ Patients with CysC elevated prior to AKI diagnosis have higher risk to develop death and need dialysis during short- and long-term follow-up after AKI, thus having worse outcomes. This population deserves more careful observation and might benefit from more frequent follow-up visits in the clinic. Future work is needed to get a consensus cut-off value defining CysC elevation.