Orthostatic hypotension in kidney pancreas transplant patients and its relation to preexisting autonomic neuropathy.

Objectives: Orthostatic hypotension is a known complication of pancreas transplant. This retrospective study of 25 kidney-pancreas transplant patients at our center was done to determine the incidence and course of postoperative orthostatic hypotension.

Materials And Methods: A chart review was done for all patients who received a kidney-pancreas transplant between January 1997 and December 2005.

Quantification of gadolinium in nephrogenic systemic fibrosis: re-examination of a reported cohort with analysis of clinical factors.

Background: Nephrogenic systemic fibrosis (NSF) has been associated with exposure to gadolinium-based contrast agent (GdCA) used in medical imaging.

Objective: We sought to quantify levels of gadolinium in affected skin of patients with NSF and correlate the levels to clinical and laboratory parameters.

Methods: Skin biopsy specimens were analyzed using inductively coupled plasma mass spectroscopy (ICP-MS) and the micrograms of gadolinium per gram (microg/g) of dry tissue were determined.

Successful pregnancy in a hemodialysis patient and marked resolution of her nephrogenic systemic fibrosis.

Nephrogenic systemic fibrosis (NSF) is a recently recognized clinicopathologic entity. It is believed to be related to exposure to gadolinium-containing magnetic resonance imaging agents with gadolinium deposition in the tissues, including skin and other organs. It mainly affects patients on dialysis therapy.

The effect of oral sodium phosphate drug products on renal function in adults undergoing bowel endoscopy.

Background: Oral sodium phosphate solution (OSPS) preparations are preferred cleansing agents for colonoscopy because of ease of use and excellent preparation quality. Besides causing acute renal failure in some patients, the high phosphorus content can potentially cause chronic kidney damage to patients undergoing colonoscopy.

Methods: We carried out a retrospective study on patients with creatinine levels in the normal range who had undergone colonoscopy or flexible sigmoidoscopy using OSPS preparation from January 1998 to February 2005 and followed them for 1 year to determine its effects on their renal function.

Effect of hepatitis C infection on anemia in hemodialysis patients.

Hepatitis C (HCV) infection is commonly seen in dialysis patients, but its long-term deleterious effects in these patients are unknown. We evaluated the effect of HCV infection on anemia in our hemodialysis population. This retrospective case control study was carried out from January 1999 to February 2007.

Allergic interstitial nephritis possibly related to sunitinib use.

Background: Sunitinib is an oral multitargeted inhibitor indicated for the treatment of renal cell carcinoma.

Objective: This report describes a case of allergic interstitial nephritis possibly related to this agent.

Case Summary: A 69-year-old female patient with a history of metastatic renal cell carcinoma after left radical nephrectomy presented to our nephrology clinic after completing 2 courses of sunitinib therapy.

Nephrogenic systemic fibrosis: a review of 6 cases temporally related to gadodiamide injection (omniscan).

Objectives: Nephrogenic systemic fibrosis (NSF) is a rare acquired disorder that was first recognized in 1997. Presented is a retrospective review of 6 cases of NSF diagnosed by skin biopsy in our institution during the past 4 years and their relationship to gadodiamide exposure.

Methods And Results: Patient age ranged from 23 to 71 years.

Transcatheter closure of atrial septal defect (secundum type): the role of echocardiography in evaluating interatrial defects.

Atrial septal defects are among the most common congenital heart defects seen in the adult population. The diagnosis is usually made in children and closure is attempted before they are school age. In other cases, where the diagnosis is missed until adulthood, atrial arrhythmias and congestive heart failure are commonly seen.

Venous thromboembolic disease presenting as inferior vena cava thrombus extending into the right atrium.

With increasing use of echocardiography, especially transesophageal echocardiography, the diagnosis of intracardiac masses has surged. Masses that are most commonly seen in the atrial chambers include thrombi due to atrial fibrillation, cardiac myxomas often located in the atria, and valvular vegetations of infective endocarditis. In this report we present a case of a patient who developed thrombus in the inferior vena cava that extended up to the right atrium and presented as an apparent intracardiac mass.

Aortic valve papillary fibroelastoma.

Papillary fibroelastomas are benign and rare tumors usually involving the cardiac valves. The diagnosis of this condition has gradually increased over the past few years. This is attributed to the increasing number of echocardiographic and transesophageal procedures that are currently performed.