Nephron
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Complete remission (CR) and partial remission (PR) are beneficial to the long-term outcome of patients with idiopathic membranous nephropathy (iMN). However, we are lacking in studies that evaluate the clinical predictors of response to treatment with prednisone plus cyclophosphamide (CP). The objectives of the study are to identify clinical factors that could predict clinical remission or relapse in patients with iMN who were treated with prednisone plus i.v. CP therapy. ⋯ Patients with low proteinuria at baseline and high reduction of proteinuria at month 3 of treatment with CP were more likely to achieve remission and CR. The presence of only a PR may act as a useful predictor of relapse after completion of CP therapy.
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The glomerular filtration rate (GFR) is the most important measure of kidney function and chronic kidney disease (CKD). This study aims to validate commonly used equations for estimated GFR (eGFR) based on creatinine (cr), cystatin C (cys), β-trace protein (BTP), and β2-microglobulin (B2M) in older adults. ⋯ This study confirms that it is reasonable to use equations incorporating cystatin C and creatinine in older patients across a wide spectrum of GFR. However, the results call into question the use of creatinine alone below mGFR 45 mL/min/1.73 m2. B2M and BTP do not demonstrate additional value in eGFR determination in older adults.
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Both acute kidney injury (AKI) requiring dialysis and thrombocytopenia are very common and have been independently associated with mortality and morbidity in critically ill patients. Thrombocytopenia is an independent risk factor for AKI and also a marker of disease severity. There is a paucity of literature on the prevalence, incidence, and outcome of thrombocytopenia in patients receiving continuous renal replacement therapy (CRRT). We aimed at identifying the impact of thrombocytopenia on patients in the intensive care unit (ICU) with AKI requiring CRRT. ⋯ Thrombocytopenia is very common in ICU patients who are on CRRT, and both thrombocytopenia prior to the start of CRRT and severe thrombocytopenia developing after the initiation of CRRT significantly impact patient survival. Future large-scale prospective studies will help to explore the role of platelet in prognostication of outcome among CRRT patients.
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Incidence of acute kidney injury (AKI), requiring dialysis, is on the rise globally and is associated with high mortality and morbidity. ⋯ This study gives a comprehensive summary of renal outcomes and mortality after a single episode of AKI requiring RRT. The findings of the study confirm that dialysis-dependent AKI is associated with increased length of hospital stay, high mortality and loss of renal function long term, emphasizing the importance of recognition, classification and prevention of AKI.
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Review Meta Analysis
Effect of ultrafiltration versus intravenous furosemide for decompensated heart failure in cardiorenal syndrome: a systematic review with meta-analysis of randomized controlled trials.
Ultrafiltration is an adjunctive treatment for decompensated heart failure patients with cardiorenal syndrome. The efficacy and safety of ultrafiltration in the patient cohort are still unknown. ⋯ Ultrafiltration is a safe and effective strategy in the treatment of cardiorenal syndrome without increasing the risk of renal deterioration.