Bisphosphonates for preventing bone disease in kidney transplant recipients: a meta-analysis of randomized controlled trials.

An estimated 60% of kidney transplant recipients have mineral bone disease and about 0.5% break their hip within the first year after transplantation. We conducted a systematic review of benefits and harms of bisphosphonates in kidney transplant recipients.

Severe lactic acidosis in critically ill patients with acute kidney injury treated with renal replacement therapy.

Purpose: Severe lactic acidosis (SLA) is frequent in intensive care unit (ICU) patients with acute kidney injury (AKI) treated with renal replacement therapy (RRT). The aim of the study is to describe the epidemiology of SLA in this setting.

Materials And Methods: An observational single-center cohort analysis was performed on AKI patients treated with RRT.

Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy.

Background: Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU). Among other variables, serum urea concentrations are recommended for timing of initiation of renal replacement therapy (RRT). The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI.

Epidemiology of infection in critically ill patients with acute renal failure.

Objectives: Critically ill patients with infection are at increased risk for developing acute renal failure (ARF), and ARF is associated with an increased risk for infection. Both conditions are associated with prolonged length of stay (LOS) and worse outcome; however, little data exist on the epidemiology of infection in this specific cohort. Therefore, we investigated the occurrence of infection in a cohort of critically ill patients with ARF treated with renal replacement therapy (RRT).

Health implications of antimicrobial resistance for patients with acute kidney injury and bloodstream infection.

Studies have produced conflicting findings on outcomes for patients with antimicrobial-resistant infection. This study evaluated whether infection with an antimicrobial-resistant organism affects outcome in critically ill patients with acute kidney injury treated with renal replacement therapy and whose clinical course is complicated with a nosocomial bloodstream infection. We found that infection with an antimicrobial-resistant organism did not adversely affect clinical outcome in this specific cohort, which already has a high mortality rate.

Diagnostic performance of combined specific urinary proteins and urinary flow cytometry in urinary tract pathology.

Background: Urinalysis comprises three techniques: urinary flow cytometry, test strip analysis and determination of specific urinary proteins. We investigated the diagnostic possibilities of combining these methods for a cohort of patients with a variety of well-documented urological and nephrological pathology.

Methods: Urinary samples from 407 in- and out-patients with nephrological or urological pathology were retrospectively included in our study.

Impact of iron sucrose therapy on leucocyte surface molecules and reactive oxygen species in haemodialysis patients.

Background: It has been suggested that iron increases oxidative stress and that an excess of iron contributes to cardiovascular disease and infections in haemodialysis patients. In the present study, the effects of parenterally administered iron on leucocyte surface molecule expression and the production of reactive oxygen species (ROS) were evaluated.

Methods: Ten chronic haemodialysis (HD) patients without iron overload were studied.

Outcome in critically ill medical patients treated with renal replacement therapy for acute renal failure: comparison between patients with and those without haematological malignancies.

Background: Starting renal replacement therapy (RRT) for acute renal failure in critically ill patients with haematological malignancies is controversial because of the poor outcome and high costs. The aim of this study was to compare the outcome between critically ill medical patients with and without haematological malignancies who received RRT for acute renal failure.

Methods: We retrospectively collected data on all consecutive patients who received RRT for acute renal failure at the Medical Intensive Care Unit (ICU) of a University Hospital between 1997 and 2002, and assessed the impact of the presence of a haematological malignancy on the survival within 6 months after ICU admission by Cox proportional hazard models.

Elevated cardiac troponin T in hemodialysis patients receiving more intravenous iron sucrose.

Elevated cardiac troponin T (cTnT) has been associated with shorter survival in hemodialysis patients. Moreover, intravenous (IV) iron treatment has been held responsible for oxidative stress and accelerated atherosclerosis in these patients. In the present study, we investigated the relationship between cTnT concentration, IV iron treatment, and parameters of iron status.

In vitro study of the potential role of guanidines in leukocyte functions related to atherogenesis and infection.

Background: The blunted immune response upon stimulation in chronic renal failure (CRF) is often coupled to a baseline inflammatory status which has been related to atherogenesis. Uremic biologic fluids and several specific uremic retention solutes alter cell-mediated immune responses, as well as the interaction of calcitriol with the immune system.

Methods: The present study evaluated the influence of different guanidino compounds on DNA synthesis, chemiluminescence production, and CD14 expression of undifferentiated and calcitriol-differentiated HL-60 cells.

Studies on dialysate mixing in the Genius single-pass batch system for hemodialysis therapy.

Background: The Genius single-pass batch system for hemodialysis contains a closed reservoir and dialysate circuit of 75 L dialysate. The unused dialysate is withdrawn at the top of the reservoir and the spent fluid is reintroduced into the container at the bottom. Although it has been claimed that both fractions remain unmixed during the dialysis session, no direct proof of this assumption has yet been provided.