scholarly journals Reversal deterioration of renal function accompanied with primary hypothyrodism

2012 ◽  
Vol 69 (2) ◽  
pp. 205-208 ◽  
Author(s):  
Tamara Dragovic
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Thyroid Hormone ◽  
Kidney Function ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Elevated Serum ◽  
Electrolyte Balance ◽  
Hormone Substitution ◽  
Adequate Treatment

Introduction. Hypothyroidism is often accompanied with decline of kidney function, or inability to maintain electrolyte balance. These changes are usually overlooked in everyday practice. Early recognition of this association eliminates unnecessary diagnostic procedures that postpone the adequate treatment. Case report. Two patients with elevated serum creatinine levels due to primary autoimmune hypothyroidism, with complete recovery of creatinine clearance after thyroid hormone substitution therapy are presented. The first patient was a young male whose laboratory tests suggested acute renal failure, and the delicate clinical presentation of reduced thyroid function. The second patient was an elderly woman with a history of a long-term signs and symptoms attributed to ageing, including the deterioration of renal function, with consequently delayed diagnosis of hypothyroidism. Conclusion. Serum thyrotropin and thyroxin levels measurement should be done in all cases of renal failure with undefined renal desease, even if the typical clinical presentation of hypothyroidism is absent. Thyroid hormone assays sholud also be performed in all patients with chronic kidney disease whose kidney function is rapidly worsening.

Treatment of Patients with Multiple Myeloma Complicated by Renal Failure with Bortezomib - Based Regimens.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2739-2739 ◽  
Author(s):  
Maria Roussou ◽  
Efstathios Kastritis ◽  
Athanasios Anagnostopoulos ◽  
Erasmia Psimenou ◽  
Irini Grapsa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Median Time ◽  
Objective Response ◽  
Elevated Serum ◽  
Management Problem ◽  
Newly Diagnosed ◽  
Kinetics Of

Abstract Introduction: Renal failure is a common feature of multiple myeloma and a major management problem. There is limited data regarding the reversibility of renal failure, the kinetics of serum creatinine and the safety of novel agents, such as bortezomib, when administered to newly diagnosed or relapsed/refractory patients with renal failure. The purpose of our analysis was to assess the frequency of renal failure improvement and kinetics of serum creatinine in patients who received bortezomib-based regimens. Patients and methods: We evaluated 20 consecutive patients with newly diagnosed (n=7) or relapsed/refractory (n=13) multiple myeloma and renal failure, defined as a serum creatinine ≥ 2mg/dl. Patients’ median age was 66 years (range 43–88 years). Median serum creatinine was 3.8 mg/dl (range 2–11.9 mg/dl) and median creatinine clearance was 15.3 ml/min (range 6.4–33.3). Other features included hemoglobin <10gr/dl in 12 patients, platelets <100 × 109/l in 3 patients and elevated serum LDH in 9 patients. All patients received bortezomib plus dexamethasone alone or in combination with other agents, such as thalidomide, doxorubicin or melphalan. Reversibility of renal failure was defined as a sustained decrease of serum creatinine to <1.5 mg/dl and renal response was defined as ≥50% decrease of serum creatinine from its peak value. Results: Reversal of renal failure was documented in 35% of all patients and the median time to reversal was 23 days. Moreover, 9 patients (45%) had 50% decrease in serum creatinine and the median time to decrease was 34 days. Some decrease of creatinine was documented in 88% of patients. Among four patients who were on renal dialysis, 2 became independent of this procedure after the second and the third cycle of treatment. The objective response rate was 61% and the median progression free survival for responders was 12 months. Toxicities were similar to those seen in myeloma patients without renal failure who were treated with bortezomib-based regimens. Grade 3–4 neutropenia and thrombocytopenia were seen in 28% and 22% of patients respectively. One patient died of infection and bortezomib had to be discontinued in 4 patients due to grade III neurotoxicity. Conclusions: When bortezomib-based regimens are administered to myeloma patients with renal impairment their toxicity and efficacy are similar to those observed in patients with normal renal function. Moreover, these regimens are associated with rapid improvement of renal function in most patients and with reversal of renal failure in one-third of them.

scholarly journals Severity Renal Function Detection through Critical Changes Glomerular Filtration Rate in Hemodialysis Patients

Jurnal NERS ◽  
2017 ◽  
Vol 9 (1) ◽  
pp. 43 ◽  
Author(s):  
Martono Martono ◽  
Satino Satino
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Hemodialysis Patients ◽  
Quasi Experimental ◽  
Fi Ltration ◽  
Age And Sex

Introductions: Hemodialysis is often interpreted incorrectly. People assume that the action is an action that will cure the treatment of hemodialysis patients with renal failure after hemodialysis. The purpose of this study was to determine the ability of critical changes in renal glomerular fi ltration rate in patients with hemodialysis nursing care. Method: The design is quasi-experimental study carried out 2 times the observation that pre-test and post-test with a retrospective approach. The study population was all patients who underwent hemodialysis with a sample size of 33 respondents. Analysis of the research data using the paired t test. Result: The results of this study indicate that the glomerular fi ltration rate fi xing Hemodialysis towards better able to detect and prevent the severity of renal function as evidenced by the value of P = 0.031 for change 9.18. Discussion: Hemodialysis fi x glomerular fi ltration rate towards better able to detect and prevent the severity of renal function with the ability to take into account the age and sex and weight stability. All the patients with chronic renal failure in the terminal stage are expected to follow and adhere to regular hemodialysisprogram with regard stabilization weight, age, and sex in order to avoid the severity of kidney function worse.Keyword: Glomerular Filtration Rate, Hemodialysis, Severity of Kidney Function

scholarly journals Penyakit Ginjal Kronis pada Anjing dan Kucing: Manajemen Terapi dan Diet

2017 ◽  
Vol 35 (1) ◽  
pp. 16
Author(s):  
Yanuartono Yanuartono ◽  
Alfarisa Nururrozi ◽  
Soedarmanto Indarjulianto
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Renal Failure ◽  
Renal Function ◽  
Medication Management ◽  
Clinical Signs ◽  
Electrolyte Balance ◽  
Mucous Membranes

Chronic kidney disease is a progressive impairment of renal function and irreversible. The kidneys fail to maintain metabolism and fluid and electrolyte balance, causing uremia. This disease is a common problem in old cats and dogs that not detected by the owners up to 75 % of kidney function is damaged. Clinical signs vary as polyuria, polidipsi, anorexia, vomiting, weight loss, pale mucous membranes, mouth ulceration, halitosis and acute blindness. Chronic renal failure is not curable so that the necessary medication management and proper diet in orderto improve the quality of life and prolong the life of the animal.

scholarly journals The elevated serum urea : creatinine ratio in canine babesiosis in South Africa is not of renal origin

2006 ◽  
Vol 77 (4) ◽  
Author(s):  
M.P. De Scally ◽  
A.L. Leisewitz ◽  
R.G. Lobetti ◽  
P.N. Thompson
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Elevated Serum ◽  
Serum Urea ◽  
Canine Babesiosis ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Renal Origin

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.

Effect of elevated serum uric acid on cisplatin-induced acute renal failure

2007 ◽  
Vol 292 (1) ◽  
pp. F116-F122 ◽  
Author(s):  
Carlos A. Roncal ◽  
Wei Mu ◽  
Byron Croker ◽  
Sirirat Reungjui ◽  
Xiaosen Ouyang ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Uric Acid ◽  
Renal Injury ◽  
Elevated Serum ◽  
Urate Oxidase ◽  
Crystal Formation ◽  
Tubular Injury ◽  
Crystal Deposition

Marked hyperuricemia is known to cause acute renal failure via intrarenal crystal deposition. However, recent studies suggest mild hyperuricemia may have vasoactive and proinflammatory effects independent of crystal formation. We therefore tested the hypothesis that mild hyperuricemia might exacerbate renal injury and dysfunction in a model of cisplatin-induced acute renal failure in the rat. Cisplatin was administered to normouricemic and hyperuricemic rats (the latter generated by administering the urate oxidase inhibitor, oxonic acid). Recombinant urate oxidase (rasburicase) was administered in a third group to assess the effect of lowering uric acid on outcomes. Other control groups include normal rats and hyperuricemic rats without cisplatin-induced injury. Cisplatin induced injury of the pars recta (S3) segment of the proximal tubule in association with a mild monocyte infiltration. Hyperuricemic rats showed significantly greater tubular injury and proliferation with significantly greater macrophage infiltration and increased expression of monocyte chemoattractant protein-1. However, renal function was not different between normouricemic and hyperuricemic rats with cisplatin injury. Treatment with rasburicase reversed the inflammatory changes and lessened tubular injury with an improvement in renal function (relative to the hyperuricemic group). No intrarenal crystals were observed in any groups. These data provide the first experimental evidence that uric acid, at concentrations that do not cause intrarenal crystal formation, may exacerbate renal injury in a model of acute renal failure. The mechanism may relate to a proinflammatory pathway involving chemokine expression with leukocyte infiltration.

scholarly journals Efektivitas Relaksasi Benson Terhadap Kecemasan Pasien Yang Menjalani Hemodialisa

2021 ◽  
Vol 14 (1) ◽  
pp. 57-64
Author(s):  
Isnaini Nur Anisah ◽  
Arina Maliya
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Literature Review ◽  
Kidney Function ◽  
Therapeutic Option ◽  
Hemodialysis Patients ◽  
The Body ◽  
Electrolyte Balance ◽  
Long Time ◽  
Body Fluid Balance

Pendahuluan: Penyakit gagal ginjal merupakan gangguan fungsi ginjal yang terjadi saat tubuh tidak bisa mempertahankan metabolisme, keseimbangan cairan serta elektrolit sehingga menyebabkan terjadinya retensi urea dan sampah nitrogen dalam darah. Hemodialisa menjadi pilihan terapi untuk mengatasi gagal ginjal kronik. Hemodialisa dilakukan dengan alat khusus untuk mempertahankan fungsi ginjal dengan menyeimbangkan kadar elektrolit dan keseimbangan cairan tubuh. Hemodialisa yang dilakukan dalam waktu lama dapat menyebabkan gangguan pada aspek biologis maupun aspek psikologis bagi pasien hemodialisa. Sebanyak 48,6 % pasien hemodialisa mengalami gangguan kecemasan. Salah satu non-farmakologi terapi untuk mengurangi kecemasan yaitu relaksasi benson yang dilakukan selama 15-20 menit setiap pagi dan sore hari. Tujuan dari penelitian untuk mengetahui efektivitas relaksasi benson terhadap kecemasan pada pasien yang menjalani hemodialisa. Metode yang digunakan untuk penelitian ini adalah studi literature review dengan membandingkan beberapa literature dari penelusuran situs jurnal seperti Sciendirect, PubMed, Elsevier dan Google Schoolar Hasil Penelitian menunjukkan relaksasi benson yang dilakukan sehari 2 kali selama 15-20 menit efektif untuk mengatasi masalah kecemasan pada pasien yang melakukan hemodialiasa. Kesimpulan: relakasi benson efektif dan bekerja dengan baik dalam menurunkan kadar kecemasan pada pasien hemodialisa Kata Kunci : gagal ginjal kronik, Hemodialisa, Cemas, Relaksasi Benson. Abstract: Introduction: Kidney failure is a disorder of kidney function that occurs when the body cannot maintain metabolism, fluid and electrolyte balance, causing retention of urea and nitrogen waste in the blood. Hemodialysis is a therapeutic option for treating chronic renal failure. Hemodialysis is performed with special tools to maintain kidney function by balancing electrolyte levels and body fluid balance. Hemodialysis that is carried out for a long time can cause disturbances in biological and psychological aspects for hemodialysis patients. As many as 48.6% of hemodialysis patients experienced anxiety disorders. One of the non-pharmacological therapies to reduce anxiety is benson relaxation which is done for 15-20 minutes every morning and evening. The aim of this study was to determine the effectiveness of Benson relaxation on anxiety in patients undergoing hemodialysis. The method used for this research is a literature review study by comparing some literature from searching journal sites such as Sciendirect, PubMed, Elsevier and Google Schoolar. The results showed that Benson relaxation which is carried out twice a day for 15-20 minutes is effective in overcoming anxiety problems in patients with do regular hemodialysis. Conclusion: Benson Relaxation is effective and works well in reducing anxiety levels in hemodialysis patients Keywords: chronic renal failure, hemodialysis, anxiety, Benson Relaxation

Kidney function in viral hepatitis a

1985 ◽  
Vol 66 (3) ◽  
pp. 192-195
Author(s):  
Ya. Kh. Sadekova
Keyword(s):  
Renal Function ◽  
Viral Hepatitis ◽  
Kidney Function ◽  
Hepatitis A ◽  
Electrolyte Balance ◽  
Viral Hepatitis A

Changes in renal function and electrolyte balance in viral hepatitis have been noted by a number of researchers [2, 3, 5].

scholarly journals Use of an educational, audiovisual podcast to maximise safety with variable rate intravenous insulin infusions

2018 ◽  
Vol 7 (2) ◽  
pp. e000111 ◽  
Author(s):  
Hannah Tamara Field ◽  
Nicholas Woodier ◽  
Jenny Clayton ◽  
Piotr Plichta ◽  
Kuok Shern Teo
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Normal Renal Function ◽  
Severe Illness ◽  
Electrolyte Balance ◽  
Variable Rate ◽  
Safety Issues ◽  
Intravenous Insulin ◽  
Good Glycaemic Control ◽  
Hospitalised Patients

Variable rate intravenous insulin infusions (VRIII) are used to maintain stable blood glucose in hospitalised patients with diabetes who are unable to eat or have a severe illness where good glycaemic control is paramount. With VRIII it is important to prescribe an adequate substrate to avoid hypoglycaemia and maintain electrolyte balance. Traditionally the substrate would have been varied to achieve this; current guidelines advise varying the infusion rate rather than the type of substrate. The local hospital Trust updated their VRIII prescription chart to reflect the Joint British Diabetes Societies’ suggestions for inpatient care in October 2014. A local audit in January 2015 highlighted that 48% of patients on VRIII were prescribed the correct fluid as per the guideline. A questionnaire to assess prescriber knowledge regarding VRIII showed 40.4% of prescribers selected appropriate fluid for a patient with normal renal function and 11.5% of prescribers selected appropriate fluid for a patient with renal failure. An educational podcast was devised to explain the rationale behind appropriate fluid prescription with VRIII; this was shown to prescribers. Following the podcast, 75.8% of prescribers selected appropriate fluids for normal renal function and 54.5% for renal failure. Questionnaires were completed to assess prescriber knowledge prepodcast and postpodcast. Following the podcast, there was a significant increase in questionnaire scores, indicating improved prescriber knowledge surrounding VRIII. A reaudit of prescriptions for VRIII showed improvement in practice, where 63% of patients on VRIII were prescribed correct fluids. The use of a simple audiovisual podcast on VRIII led to a significant improvement in prescriber knowledge. Podcasts are an ideal medium to raise awareness around safety issues, including safe prescription of insulin. Further work will include the follow-up of participants to evaluate sustained knowledge and improvements of prescriptions in practice, with the overall aim of improving patient safety.

scholarly journals Lipoprotein(a) in Chronic Renal Failure

2009 ◽  
Vol 28 (2) ◽  
pp. 82-88
Author(s):  
Velibor Čabarkapa ◽  
Mirjana Đerić ◽  
Zoran Stošić ◽  
Vladimir Sakač ◽  
Sunčica Kojić-Damjanov ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Serum Concentration ◽  
Elevated Serum ◽  
Serum Levels ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Elevated Concentration ◽  
Lipoprotein A

Lipoprotein(a) in Chronic Renal Failure Cardiovascular diseases are the leading cause of mortality in patients with chronic renal failure. Among the parameters contributing to cardiovascular disease development is the elevated serum concentration of lipoprotein(a) diagnosed in these patients, especially in the terminal stage of CRF. However, an elevated concentration of lipoprotein(a) could influence the renal failure progression. The objective of this study is to examine the lipoprotein(a) serum levels in chronic renal failure, and to establish the relation between the stage of renal function preservation and the level of this lipoprotein. In this study 127 subjects were included, divided into three groups. The first group contained 42 subjects (15 females and 27 males) in different CRF stages, the second group contained 32 subjects (7 females and 25 males) on a chronic hemodialysis program, and the control group contained 53 subjects (22 females and 31 males) with regular renal function. The results obtained point to significantly higher frequency of hyper-Lp(a) lipoproteinaemia in dialysed patients compared to the control group, as well as significantly higher Lp(a) values in both groups of patients compared to the control group. It can be concluded that for the risk assessment of premature atherosclerotic changes, but also renal failure progression in patients with CRF, determination of the Lp(a) serum concentration is recommendable.

The Effect of Continuous Ambulatory Peritoneal Dialysis on Change in Serum Leptin

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 172-175 ◽  
Author(s):  
Dae Joong Kim ◽  
Dong Jin Oh ◽  
Bum Kim ◽  
Young Hee Lim ◽  
Woo-Heon Kang ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Serum Insulin ◽  
Elevated Serum ◽  
Mass Gain ◽  
Residual Renal Function ◽  
Serum Leptin ◽  
Basal Serum

Objective Elevated serum leptin can contribute to anorexia and poor nutrition in patients with chronic renal failure, because leptin is elevated in chronic renal failure patients with or without dialysis, especially in chronic ambulatory peritoneal dialysis (CAPO) patients. The aim of this study was to find whether leptin can be removed by peritoneal dialysis (PO) and to analyze factors that can affect serum leptin after start of CAPO by observing the change in serum leptin shortly after start of CAPO and its correlation with body mass index (BMI), with serum insulin, and with residual renal function. Design Twenty patients who started CAPO during the observation period were studied. Serum leptin was measured by radioimmunoassay before start of CAPO, 3 5 days after start of CAPO, and 1 month and 3 months after start of CAPO. Simultaneously, body weight, serum insulin, and residual renal function were measured. To compensate for the circardian rhythm of leptin, removal of leptin was assessed by measuring dialysate leptin divided by average serum leptin before and after a peritoneal equilibration test (PET). Results Leptin was eliminated by PO with a dialysateto-serum ratio of 0.16 ± 0.07, which was comparable to removal of β2-microglobulin (0.14 ± 0.06). The mean serum leptin concentrations did not decrease after 3 5 days of CAPO (8.4 ± 13.1 ng/mL → 11.9 ± 18.0 ng/mL) despite its removal by PO, and levels increased markedly to 189% of basal serum leptin 1 month after start of PO and to 260% of basal serum leptin 3 months after start of PO. Correlation coefficients (Spearman's p) between change of serum leptin and change of BMI, of serum insulin, of glomerular filtration rate (average of urine creatinine clearance and urine urea clearance) were 0.267 (p > 0.05, n = 20),0.441 (p > 0.05, n = 16),0.706 (p > 0.05, n = 8) respectively. Conclusion Leptin is removed by peritoneal dialysis. Serum leptin did not decrease in 5 days after the start of PO despite its removal by PO, but increased markedly thereafter, within 3 months after start of PO. We could not find a significant correlation between the change in leptin and the change in BMI. Factors other than fat-mass gain can stimulate leptin increase shortly after start of PO.

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