IGA nephropathy - Are intravenous steroid pulses more effective than oral steroids in relapse prevention?

Introduction: It is recommended that IgA nephropathy (IgAN) is treated with steroids when the glomerular filtration rate (GFR) is >50ml/min and proteinuria >1g/day. Few studies have been performed comparing the two accepted steroid regimens (1g/day methylprednisolone pulses for 3 consecutive days at the beginning of months 1, 3 and 5, followed by 0.5mg/kg prednisolone on alternate days vs.

Prognostic Factors of Human Immunodeficiency Virus-Infected Patients on Chronic Hemodialysis.

Background/aims: The number of human immunodeficiency virus (HIV)-infected patients on hemodialysis (HD) have increased, and their prognostic factors are still poorly clarified. The study aimed to identify factors that can influence the survival of HIV-infected patients on HD.

Methods: We performed a retrospective cohort study of 44 HIV-infected patients on HD.

Hypervolemia, hypoalbuminemia and mitral calcification as markers of cardiovascular risk in peritoneal dialysis patients.

Introduction: Mortality in patients with end-stage renal disease is higher than in the general population. This is linked to traditional and non-traditional cardiovascular (CV) risk factors, as well as with risk factors associated with end-stage renal disease itself. The aim of this study is to identify CV risk markers in patients beginning peritoneal dialysis (PD) and their association with CV events and CV mortality.

Changes in albumin-to-creatinine ratio at 12-month follow-up in patients undergoing renal denervation.

Introduction: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited.

Objective: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up.

Cinacalcet in peritoneal dialysis patients: one-center experience.

Introduction: Secondary hyperparathyroidism is the target of several therapeutic strategies, including the use of cinacalcet. Most studies were done only in hemodialysis patients, with few data from peritoneal dialysis patients.

Objective: The aim of our work was to evaluate the effectiveness of cinacalcet in secondary hyperparathyroidism in a one-center peritoneal dialysis patients.

Peritoneal dialysis is a reasonable option in patients with cardiovascular disease .

Introduction: Peritoneal dialysis (PD) has been proposed as a therapeutic option for patients with end-stage renal disease (ESRD) and cardiovascular (CV) disease. The study presented here aimed to compare incident PD patients with and without CV disease at baseline, in order to determine the impact of CV disease in the outcomes of long-term PD patients.

Methods: This is a prospective cohort study performed at a single PD unit where 112 consecutive incident patients admitted to the PD program during 5 years were studied.

Diabetic kidney disease: Is there a non-albuminuric phenotype in type 2 diabetic patients?

Background: Albuminuria was widely considered as the first clinical sign of diabetic kidney disease (DKD), which is why it has traditionally been used as a screening test for DKD. However, increasing evidence has shown that a significant number of type 2 diabetes mellitus (DM) patients have a decreased glomerular filtration rate (GFR) without significant albuminuria, known as non-albuminuric DKD (NA-DKD). The aim of this study was to determine the prevalence and the demographic and clinical characteristics of patients with NA-DKD.

Peritoneal dialysis as a successful treatment in patients with refractory congestive heart failure: a one-center experience.

Introduction: Ultrafiltration (UF) technique is a valuable alternative to pharmacological therapy in the treatment of patients with refractory congestive heart failure (HF). The aim of this study was to describe a single-center experience in the treatment of refractory HF patients with peritoneal dialysis (PD).

Methods: Retrospective study of 5 patients included in a single PD Unit, showing symptoms and signs of severe refractory congestive HF to optimal pharmacological therapy (NYHA class IV).

Results in Assisted Peritoneal Dialysis: A Ten-Year Experience.

Background/Aims. Peritoneal dialysis is a successful renal replacement therapy (RRT) for old and dependent patients. We evaluated the clinical outcomes of an assisted peritoneal dialysis (aPD) program developed in a Portuguese center.

Effect of the arteriovenous access for hemodialysis on subendocardial viability ratio, pulse pressure and hospitalizations.

Background: In some patients the potential benefits of the arteriovenous (AV) access over catheter for hemodialysis seem to be outweighed by global cardiovascular status deterioration.

Methods: We prospectively evaluated 44 pre-dialysis chronic kidney disease patients submitted to vascular access creation during a follow-up of 25 ± 9 months. We performed pulse wave analysis and biochemical assessment before and 2 months after AV access construction, and we registered premature vascular access thrombosis, and all-cause and cardiovascular hospitalizations throughout follow-up.

[Percutaneous thrombus aspiration in renal artery stenosis after renal transplantation].

We describe the case of a patient with chronic renal failure under hemodialysis for five years who, after renal transplantation, developed acute renal failure and hypertension refractory to medical therapy. Given the clinical and imaging (renal ultrasound and computed tomography) suspicion of renal artery graft thrombosis, invasive angiography was performed, which confirmed the diagnosis. The therapeutic approach consisted of percutaneous thrombus aspiration and subsequent balloon angioplasty of the entire artery, followed by stent implantation in a second procedure.

[Renal sympathetic denervation for treatment of resistant hypertension].

Hypertension is an important cardiovascular risk factor and although there have been many improvements in pharmacological treatment, a significant percentage of patients are still considered resistant. The authors describe two cases of radiofrequency renal sympathetic denervation that illustrate the feasibility of this new technique for the treatment of resistant hypertension. The procedure consists of the application of radiofrequency energy inside the renal arteries to ablate afferent and efferent sympathetic renal activity, which has been implicated in the pathophysiology of hypertension.

Serum creatinine values underestimate surgical risk.

Introduction: Renal insufficiency is associated with increased mortality and morbidity from cardiac surgery. Serum creatinine (SCr) values are routinely used for the assessment of renal dysfunction. However, this parameter can overestimate renal function, especially in low-weight and elderly patients, who can have normal creatinine values despite impaired renal function.

Acute renal toxic effect of amiodarone in rats.

Amiodarone is an antiarrhythmic drug now more frequently used after a number of years in which the use had been on the decline due to a number of studies which reported side effects such as chronic toxicity, primarily in the lungs, liver and thyroid glands. Additionally, in some patients an increase in serum creatinine was noted, however the effect of amiodarone on renal function had never been closely examined. Thus, the aim of our study was to analyse the effects of amiodarone on renal function in rats.