Neutrophil gelatinase-associated lipocalin (NGAL): a promising biomarker of contrast-induced nephropathy after computed tomography.

Contrast-induced nephropathy (CIN) is a common cause of hospital-acquired acute kidney injury (AKI) and a source of significantly increased short- and long-term mortality. Studies of large cohorts have revealed that more than half of these cases are in subjects undergoing cardiac catheterization and intra-arterial coronary angiography, and nearly a third follow computed tomography (CT) scans. Neutrophil gelatinase-associated lipocalin (NGAL) represents an early predictive troponin-like biomarker for AKI.

Plasma neutrophil gelatinase-associated lipocalin (NGAL) as an early predictive marker of contrast-induced nephropathy in hospitalized patients undergoing computed tomography.

Background: Contrast-induced nephropathy (CIN) is a common cause of hospital-acquired acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL) represents a promising biomarker for AKI. Its role in the early diagnosis of CIN has already been examined in adults and children undergoing coronary angiography.

Treatment with oral paricalcitol in daily clinical practice for patients with chronic kidney disease stage 3-4: a preliminary study.

Background: Active vitamin D is an effective treatment for secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients often complicated by hypercalcaemia and hyperphosphataemia. Treatment with paricalcitol, a selective vitamin D receptor activator, has shown benefits by adequately reducing parathyroid hormone (PTH) levels with minimal changes in serum calcium (Ca) and phosphorus (P). The purpose of this study is to present data on the use of oral paricalcitol in real-life clinical practice in patients with CKD stage 3-4 and SHPT.

Use of electron-beam sterilized hemodialysis membranes is not associated with significant and persistent thrombocytopenia.

Significant thrombocytopenia following hemodialysis with electron-beam (e-beam) sterilized membranes has been recently reported in a large-scale Canadian study. However, the underlying mechanism and the clinical significance of this finding remain undetermined as yet. We prospectively evaluated for a 4-month period the thrombocytopenic effect of the e-beam sterilized dialyzers as compared to the steam sterilized ones in two groups of well-controlled hemodialysis patients.

Chronic kidney disease epidemiology collaboration equation accuracy in predicting peritoneal dialysis-delivered creatinine clearance.

Introduction: Measuring total (residual kidney plus peritoneal) creatinine clearance (CrCl) with 24-h urine and dialysate collections is recommended for peritoneal dialysis (PD) adequacy evaluation. Prediction equations applied in this instance could simplify the approach. Cockcroft-Gault and modification of diet in renal disease (MDRD) four (MDRD-4) and six (MDRD-6) variables equations have been tested in this setting, and conflicting results have been reported.

Encapsulating peritoneal sclerosis with favorable outcome in hemodialysis: an unusual case with a literature review.

Encapsulating peritoneal sclerosis is a rare condition of a poorly understood pathogenesis with recognized risk factors, such as medications, surgical interventions, systemic diseases, and malignancies. In endstage renal disease it has been associated with chronic peritoneal dialysis. We hereby report the case of a 59-year-old male hemodialysis patient, who was never treated with peritoneal dialysis and developed an unexplained massive ascites 4 months post laparoscopic cholecystectomy for gallstones.

New insights into uric acid effects on the progression and prognosis of chronic kidney disease.

Hyperuricemia is particularly common in patients with arterial hypertension, metabolic syndrome, or kidney disease. Its role, however, as a risk factor for both renal and cardiovascular outcomes and in the context of the well-established interrelationship between cardiovascular disease and chronic kidney disease (CKD) is debated. For decades high serum uric acid levels were mainly considered the result of renal dysfunction and not a true mediator of renal disease development and progression.

Lanthanum carbonate versus sevelamer hydrochloride: improvement of metabolic acidosis and hyperkalemia in hemodialysis patients.

Sevelamer hydrochloride (SH) has been reported to aggravate metabolic acidosis and hyperkalemia. This study was performed to evaluate acid-base status and serum potassium changes after replacing SH with lanthanum carbonate (LC) in hemodialysis patients. SH was prescribed for 24 weeks in 14 stable hemodialysis patients and replaced by LC in a similar treatment schedule.

IgA nephropathy in association with Crohn's disease: a case report and brief review of the literature.

A case of immunoglobulin A nephropathy (IgAN) complicating a 10-year history of biopsy-proven Crohn's disease in a 31-year-old man is described. The patient presented with mild proteinuria and impaired renal function in the setting of an exacerbation of Crohn's disease. Renal biopsy showed IgAN.

Effects of interleukin-6 on depression risk in dialysis patients.

Background/aims: Depression represents the most frequent psychiatric disorder in nephrology. Cytokines, and especially IL-6, were found to be elevated in depressed patients with normal renal function. The objective of this pilot study was to examine the relationship between depression and cytokines (IL-6, TNF-alpha, and IL-10) in patients with end-stage kidney disease (ESKD).

Inflammation and oxidative stress in end-stage renal disease patients treated with hemodialysis or peritoneal dialysis.

Purpose: The impact of different dialysis modalities on oxidative stress and inflammation and the factors implicated in this interrelationship have not been adequately studied. This study was designed to comparatively evaluate the effect of hemodialysis (HD) and peritoneal dialysis (PD) on oxidative stress and inflammatory biomarkers and to search for associated factors.

Methods: We studied 20 HD, 11 PD patients and 11 healthy controls.

Inflammatory syndrome in chronic kidney disease: pathogenesis and influence on outcomes.

Morbidity and mortality are markedly elevated in chronic kidney disease (CKD) patients as consequence of cardiovascular risk factors clustering. Non-traditional risk factors such as inflammation are far more prevalent in this population and contribute significantly to atherosclerosis and cardiovascular disease (CVD). CKD results in a chronic, low-grade inflammatory process that becomes evident even in the early stages of the disease.

Paricalcitol treatment of secondary hyperparathyroidism in hemodialysis patients on sevelamer hydrochloride: which dialysate calcium concentration to use?

Background: Optimal dialysate calcium concentration (DCa) has not been determined under less hypercalcemic vitamin D analogues and Ca-free phosphate (P) binders.

Methods: Twelve hyperparathyroidic hemodialysis patients under sevelamer hydrochloride were treated with paricalcitol in three periods (A, B and C) under DCa of 3.5, 3 and 2.

Inflammation and oxidative stress in patients on hemodiafiltration.

Background: Chronic inflammation and oxidative stress are common features in hemodialysis patients. However, research results on the long-term influence of hemodiafiltration (HDF) on oxidative stress and inflammation are limited.

Methods: We studied changes of inflammatory and oxidative stress biomarkers in 9 stable patients on post-dilution HDF for 9 months.

Long-term management of sevelamer hydrochloride-induced metabolic acidosis aggravation and hyperkalemia in hemodialysis patients.

Sevelamer hydrochloride use in hemodialysis patients is complicated by metabolic acidosis aggravation and hyperkalemia. Rare reports about a short-term correction of this complication have been published. The current authors investigated the long-term correction of metabolic acidosis and hyperkalemia in sevelamer hydrochloride-treated patients at doses adequate to achieve serum phosphate levels within K/DOQI recommendations.

Sleep-disordered breathing in nondialyzed patients with chronic renal failure.

The prevalence and significance of sleep-disordered breathing (SDB) in dialysis-independent chronic renal failure (CRF) remains unknown. We studied the presence of SDB in nondialyzed CRF patients. Diagnostic polysomnography was performed in consecutive stable nondialyzed CRF patients.