Various classes of targeted therapies have emerged in the last few years, which have revolutionized cancer treatment, and improved the prognosis and survival of cancer patients. Unfortunately, these agents have serious toxic effects on the kidneys. Some of the toxic effects are hypertension, acute kidney injury (AKI), and proteinuria. One interesting phenomenon that has emerged recently is pseudo-acute kidney injury due to the interference with the tubular secretion of creatinine by some of the targeted therapeutic agents. Understanding this physiology is needed to avoid unnecessary investigation and withholding of lifesaving chemo regimen. Alternative methods to assess renal function such as cystatin C-based estimated glomerular filtration rate (eGFR) can differentiate true AKI from pseudo-AKI. Here, we describe one such case of pseudo-AKI from cyclin-dependent kinase (CDK) 4/6 inhibitor, abemaciclib, which inhibits tubular secretion of creatinine. Using cystatin-C-based eGFR revealed pseudo-AKI in this case.
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http://dx.doi.org/10.3389/fneph.2024.1389562 | DOI Listing |
J Antimicrob Chemother
January 2025
Pharmacy Department, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Background: AUC-based dosing with validated Bayesian software is recommended as a good approach to guide bedside vancomycin dosing.
Objectives: To compare treatment and vancomycin-associated acute kidney injury (AKI) costs between Bayesian AUC-based dosing and conventional therapeutic drug monitoring (TDM) using steady-state plasma concentrations of vancomycin administered as continuous infusion in hospitalized non-critically ill patients with severe Gram-positive infection.
Methods: A cost-benefit analysis presented as a return on investment (ROI) analysis from a hospital perspective was conducted using a decision tree model (TDM versus AUC-based dosing) to simulate treatment cost (personnel, serum sampling and drug cost), vancomycin-associated AKI risk and cost up to 14 days.
Annu Rev Med
January 2025
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; email:
Hepatorenal syndrome-acute kidney injury (HRS-AKI) occurs in the setting of advanced chronic liver disease, portal hypertension, and ascites. HRS-AKI is found in ∼20% of patients presenting to the hospital with AKI, but it may coexist with other causes of AKI and/or with preexisting chronic kidney disease, thereby making the diagnosis challenging. Novel biomarkers such as urinary neutrophil gelatinase-associated lipocalin may be useful.
View Article and Find Full Text PDFInt J Surg
January 2025
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou; Chang Gung University, Taoyuan, Taiwan.
Background: Detecting kidney trauma on CT scans can be challenging and is sometimes overlooked. While deep learning (DL) has shown promise in medical imaging, its application to kidney injuries remains underexplored. This study aims to develop and validate a DL algorithm for detecting kidney trauma, using institutional trauma data and the Radiological Society of North America (RSNA) dataset for external validation.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Turkey.
Importance: This study addresses the characteristics, kidney replacement therapy (KRT) modalities, and outcomes in children diagnosed with crush syndrome following an earthquake in Turkey.
Objective: To analyze the associations of different KRT modalities with long-term dialysis dependency and length of stay (LOS) in the pediatric intensive care unit (PICU).
Design, Setting, And Participants: This multicenter, prospective, and retrospective cohort study was conducted across 20 PICUs in Turkey.
Trop Anim Health Prod
January 2025
College of Animal Sciences, Anhui Science and Technology University, Fengyang, 233100, China.
This study was aim to investigate the effects of lipoic acid (ALA) on performance, meat quality, serum biochemistry and antioxidant function of broilers under heat stress (HS). Two hundred1-day-old Cobb broilers were randomly divided into four treatment groups and each treatment consisted of 4 replicates of 10 broilers each. The treatment group adopts a 2 × 2 two-factor setting, which is divided into two diets (basic diet or 250 mg/kg ALA diet) and two temperatures (24 ± 1℃ or 33 ± 1℃).
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