Nephrology
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The aim of this study was to demonstrate the ability of widely used bioimpedance techniques to assess dry weight (DW) and to predict a state of normal hydration in haemodialysis patients whose post-dialysis weight had been gradually reduced from baseline in successive treatments over time. ⋯ WBM could be useful to predict a target range of normal hydration weight particularly for patients with substantial fluid overload. The cBIS provides an accurate reference for the estimation of DW so that combined use of cBIS and WBM is promising and warrants further studies.
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The incidence of end-stage kidney disease (ESKD) has been increasing worldwide, with increasing numbers of older people, people with diabetic nephropathy and indigenous people. We investigated the incidence of renal replacement therapy (RRT) in Australia and New Zealand (NZ) to better understand the causes of these effects. ⋯ Patterns of incident renal replacement therapy strongly reflect the prevalence of diabetes within these groups. In addition, other factors such as reduced risk of dying before reaching ESKD, and increased acceptance of older and sicker patients are also contributing to increases in incidence of RRT.
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Living kidney donation provides the best source of kidney graft. The mortality and morbidity rates are small but the long-term effects have not been studied. This is a report on our 29-year experience of living kidney donation. ⋯ Living kidney donors had reductions in GFR post uninephrectomy with subsequent improvement. A significant proportion developed HT and stage 3 CKD. Age at donation was a strong determinant of development of HT and stage 3 CKD.
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Vancomycin and teicoplanin are the two most used glycopeptides for the treatment of methicillin-resistant Staphylococcus aureus (MRSA). Vancomycin is suspected to have more nephrotoxicity but this has not been clearly established. The aim of this study was to assess its nephrotoxicity by a consensus definition of acute kidney injury (AKI): the risk (R), injury (I), failure (F), loss and end-stage renal disease (RIFLE) classification. ⋯ The study data suggest that vancomycin is associated with a higher likelihood of nephrotoxicity using the RIFLE classification.
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Uric acid (UA) is strongly associated with the confirmed chronic kidney disease (CKD) risk factors, such as hypertension, diabetes and metabolic syndrome (MS); however, whether higher UA is independently associated with CKD is still debatable. Other studies found that low UA level may reflect inadequate protection against oxidant-mediated stress; it is also unknown whether hypouricemia may have a harmful effect on the kidney. No studies have examined whether there is a J-shaped relationship between UA and incident CKD. ⋯ Hyperuricemia is a risk factor for CKD in Taiwan, future studies are still necessary to determine whether hypouricemia increases the risk of CKD.