Severe, Symptomatic Hypocalcemia due to Denosumab Administration: Treatment and Clinical Course.

Denosumab is a receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor used in the treatment of osteoporosis. Blockade of RANK ligand prevents osteoclastic resorption of bone, but in doing so impairs the parathyroid hormone (PTH)-driven maintenance of serum calcium. A subsequent elevation of PTH remains active at sites other than bone, potentially lowering serum phosphate by inhibiting proximal tubular reabsorption.

Case Report of Spontaneous Remission of Biopsy-Proven Idiopathic Immune Complex-Mediated Membranoproliferative Glomerulonephritis.

Membranoproliferative glomerulonephritis (MPGN) is a histopathologic diagnosis causing microscopic hematuria, nephrotic range proteinuria, and chronic renal failure. Current understanding divides pathogenesis into two broad categories: immune complex mediated and complement mediated (now termed C3 glomerulopathy). The term idiopathic immune complex-mediated MPGN would apply to a patient without an identifiable source of immune complex production and no evidence of C3 glomerulopathy.

[The prevalence of incidentaloma--asymptomatic thyroid nodules in the Tricity (Gdansk, Sopot, Gdynia) population].

Introduction: The increased sensitivity of imaging devices raised number of incidentally discovered lesions in various organs of the human body. Thyroid gland is one of them. Reported prevalence of ultrasonographically detected thyroid nodules (incidentalomas) in general population ranges from 5.

Improved urea reduction ratio and Kt/V in large hemodialysis patients using two dialyzers in parallel.

Delivered dose of hemodialysis (HD) in large patients with end-stage renal disease is often less than adequate. Fourteen chronic HD patients with weights greater than 80 kg participated in a prospective, cross-over study comparing urea reduction ratio (URR +/- SEM) and the fractional clearance index for urea (eKt/V(urea) +/- SEM) on a single polysulfone dialyzer for a control (HDC) period of 4 weeks versus clearances obtained with two dialyzers in parallel during an intervention (HDP) period of 4 weeks. Clearance of the surrogate middle molecule iohexol (C(Io)) was also measured.

Hemodialysis access stenosis: early detection with color Doppler US.

Purpose: To evaluate color Doppler ultrasound (US) in detection of subclinical stenosis of hemodialysis access grafts and fistulas.

Materials And Methods: Doppler US was performed in 40 consecutive patients with no clinical or laboratory findings of hemodialysis access dysfunction. To assess the presence and percentage of stenosis, the maximum systolic blood velocity and velocity ratios were measured and the US images were assessed visually.

Neuroendocrine alterations in the somatotropic and lactotropic axes in uremic men.

To investigate the pathophysiology of altered growth hormone (GH) and prolactin secretion in endstage renal disease, we sampled blood at 10-min intervals for 24 h and applied deconvolution analysis to calculate hormone half-lives and pulsatile secretion rates. Two-site immunoradiometric assays were employed to quantitate presumptively intact GH and prolactin in nine middle-aged men with chronic renal failure and 14 gender-, age-, body weight- and community-matched controls. We observed that the half-lives of endogenous GH and prolactin were prolonged significantly in uremia: for GH, control 17 +/- 1.

Evidence for attenuation of hypothalamic gonadotropin-releasing hormone (GnRH) impulse strength with preservation of GnRH pulse frequency in men with chronic renal failure.

To investigate the nature of putative disturbances in pulsatile gonadotropin (LH) secretion in men with chronic renal failure, we undertook blood sampling at 10-min intervals for 24 h in 9 hemodialysis-dependent uremic men and 16 community- and age-matched controls. Serum LH concentrations were measured in a 2-site immunoradiometric assay, which does not cross-react with free alpha or LH beta-subunit and correlates well with an in vitro Leydig cell bioassay. Deconvolution analysis was applied to calculate the number, amplitude, mass, and duration of spontaneous LH release episodes and simultaneously estimate the half-life of endogenous LH in each subject.

Flurbiprofen-associated acute tubulointerstitial nephritis.

We report a case of biopsy-proven acute tubulointerstitial nephritis associated with a second course of flurbiprofen, a nonsteroidal anti-inflammatory drug of the propionic acid class. The clinical presentation and course was consistent with acute tubulointerstitial nephritis due to these agents.

Neuroendocrine alterations in the somatotrophic axis in chronic renal failure.

Both secretion and metabolic clearance of GH in health and disease are subject to regulation by an array of metabolic, nutritional, physical activity, age, and body composition cues. Moreover, both GH and its mediators (e.g.

Risk factors in idiopathic renal vasculitis and glomerulonephritis.

In this retrospective study, we analyzed clinical laboratory, and pathologic variables to determine their value in predicting survival and survival free of renal failure for 170 consecutive patients with idiopathic renal vasculitis and glomerulonephritis evaluated during a 15 year period. Of the 170 patients, 108 had focal segmental necrotizing glomerulonephritis alone (FSNGN), 33 had FSNGN and small-artery vasculitis, and 29 had FSNGN and medium-sized artery vasculitis. Considerable overlap of clinical, laboratory, and pathologic findings existed among the three groups.