scholarly journals An unusual recurrent ileocolonic injury

2021 ◽  
Vol 84 (4) ◽  
pp. 662-664
Author(s):  
A Mansour ◽  
A Lakis ◽  
J Gallez ◽  
M Elkoulali ◽  
E Laterre ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Chronic Kidney Disease ◽  
Abdominal Pain ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Side Effect ◽  
Clinical Symptoms ◽  
Polystyrene Sulfonate ◽  
Potassium Binders ◽  
Initial Drug

Potassium binders (Kayexalate® and Sorbisterit®) are commonly used to treat hyperkaliemia. They are made of sodium or calcium polystyrene sulfonate. Their use is associated with multiple adverse effects including ileocolonic (or more rarely upper digestive tract) injuries which can lead to necrosis or perforations. This side effect is mostly seen in patients with chronic kidney disease or constipation. It presents with abdominal pain, diarrhea or hematochezia. The diagnosis is made when the histo-logical analysis of samples from the erythematous or ulcerated digestive wall finds polystyrene sulfonate crystals embedded in the mucosa. This diagnosis can be suspected by taking a careful initial drug inventory, if the clinician is aware of this rare but serious adverse effect. The lack of specificity of clinical symptoms and endoscopic lesions makes this inventory even more essential. Treatment is mainly supportive and requires cessation of the drug, while surgery is inevitable in the most severe cases.

scholarly journals Drug Induced Encephalopathy in Patients with Chronic Kidney Disease: A Case Series

2018 ◽  
Vol 8 (2) ◽  
pp. 172-176
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Tabassum Samad ◽  
Muhammad Abdur Rahim ◽  
Shudhanshu Kumar Saha ◽  
Sarwar Iqbal
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Side Effect ◽  
Case Series ◽  
Special Group ◽  
Drug Induced ◽  
Reduced Dose

Drug induced encephalopathy is an established side effect of many drugs when used in a higher dose. Though we do not encounter this side effect frequently in our day to day practice, yet with renal impairment this is not uncommon. Even with a reduced dose many of these can precipitate encephalopathy in this special group of patients. We are presenting here a series of seven such cases of drug induced encephalopathy in patients with renal impairment.Birdem Med J 2018; 8(2): 172-176

Adverse Effects of Proton Pump Inhibitors in Chronic Kidney Disease

2016 ◽  
Vol 176 (6) ◽  
pp. 866 ◽  
Author(s):  
Maria Fusaro ◽  
Sandro Giannini ◽  
Maurizio Gallieni
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump

scholarly journals Paraneoplastic glomerular disease: The struggle is real

2019 ◽  
Vol 3 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Pooja Amarapurkar ◽  
Salim Bou-Slaiman ◽  
Bianca Madrid ◽  
Marco Ladino
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Cancer Treatment ◽  
Side Effect ◽  
Kidney Injury ◽  
Glomerular Diseases ◽  
The Past ◽  
Underlying Malignancy ◽  
Paraneoplastic Diseases

Over the past decade, the relationships between various kidney disease and cancer have been established, but not fully elucidated. Development of acute kidney injury or chronic kidney disease as a side effect of cancer treatment is not uncommon. However, renal paraneoplastic diseases are rather unique and less known examples of the association between kidney disease and cancer. These conditions are of importance to the nephrologist as they may be the initial presentation of an underlying malignancy and may not respond to the usual therapies used for their non-paraneoplastic variants. This article will discuss the pathogenesis and challenges in management of paraneoplastic glomerular diseases.

scholarly journals A Whole Food Plant-Based Diet With a Novel Potassium-Binding Resin in a Patient With Advanced Chronic Kidney Disease

2020 ◽  
Vol 14 (6) ◽  
pp. 592-594
Author(s):  
Dario Manley-Casco ◽  
Paul Berkowitz
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Enzyme Inhibitor ◽  
Standard Of Care ◽  
Food Plant ◽  
Major Health Problem ◽  
Progression Of Kidney Disease ◽  
Standard Of Care Treatment ◽  
Potassium Binders ◽  
Potassium Binding

Chronic kidney disease (CKD) is a major health problem with substantial morbidity and mortality. Plant-based diets decrease the incidence of CKD and progression of kidney disease and help prevent and treat the important comorbidities of obesity, type 2 diabetes, hypertension, and cardiovascular disease. However, in patients with CKD, there is concern that a plant-based diet may contribute to life-threatening hyperkalemia. We present a patient with CKD secondary to hypertensive glomerulosclerosis that worsened despite standard of care treatment. Shared decision making was used to initiate a whole food plant-based diet along with a potassium-binding resin (Patiromer) to control the potassium levels. The patient was able to be maintained on the whole food plant-based diet and an angiotensin-converting enzyme inhibitor without the development of hyperkalemia. This case shows that patients with CKD may be able to enjoy the benefits of a whole food plant-based diet while decreasing the risk of hyperkalemia by using the new potassium binders.

Analysing the impact of a guideline for the use of new potassium binders for treatment of chronic hyperkalaemia to maximise inhibition of renin–angiotensin–aldosterone system (RAAS) within the general nephrology clinic?

2020 ◽  
Author(s):  
Priyank Patel ◽  
Andrew Frankel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Ckd Stage ◽  
The Mean ◽  
Potassium Binders ◽  
The Impact ◽  
Chronic Use

Abstract Background Renin–angiotensin–aldosterone system (RAAS) inhibitors provide significant cardiorenal benefits with improved long-term outcomes for patients. This is most significant for patients receiving maximal RAAS inhibition, but some patients are unable to tolerate this therapy because of hyperkalaemia. Recently published National Institute for Health and Care Excellence (NICE) technology appraisal guidance recommended using sodium zirconium cyclosilicate (SZC) and patiromer for patients with chronic kidney disease (CKD) stage 3b to 5 or heart failure with reduced ejection fraction, who are not taking an optimised dosage of RAAS inhibitor because of hyperkalaemia. Objective Determine the impact of a locally produced guideline on effective implementation of NICE recommendation for use of SZC or patiromer to help maximise inhibition of the renin–angiotensin–aldosterone system within the general nephrology clinic. Methods A local guideline to practically support the implementation of recommendations made by NICE in the chronic use of new potassium binders was produced. One hundred sequential patients in a general nephrology clinic with non-immune chronic kidney disease (CKD 3 to 5) had their electronic records reviewed. Those with an indication for RAAS inhibition were identified. Results Of the 100 consecutive patients audited, 46 were female and 54 were male. The mean age of these patients was 64 and the mean estimated glomerular filtration rate (eGFR) was 33. Sixty-eight patients had an indication for being on RAAS inhibition with only 10 on maximal doses. Of the remaining 58 patients, 26 (45%) were limited by hyperkalaemia. Of these 26 patients, 12 of these patients (46%) had hyperkalaemia associated with an episode of acute kidney injury (AKI). Therefore, 14% of patients attending a general nephrology clinic were identified suitable for SZC and patiromer. Conclusions A significant proportion (14%) of unselected patients attending a general nephrology clinic were not on optimum RAAS inhibition due to hyperkalaemia. These patients would meet the criteria established within a working guideline for the implementation of the chronic use of SZC or patiromer and are likely to attain prognostic long-term benefit by using these new potassium binders to maximise RAAS inhibition. This analysis has implications for renal centres across the UK.

Effects of low-dose meloxicam in cats with chronic kidney disease

2020 ◽  
pp. 1098612X2093575
Author(s):  
Kate KuKanich ◽  
Christopher George ◽  
James K Roush ◽  
Sherry Sharp ◽  
Giosi Farace ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Growth Factor ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Transforming Growth Factor Beta ◽  
Low Dose ◽  
Transforming Growth Factor ◽  
Joint Disease ◽  
Cystatin B

Objectives Meloxicam therapy may benefit cats with degenerative joint disease, and retrospective studies suggest it could slow kidney disease progression and increase survival. This study aimed to prospectively evaluate the renal effects of low-dose meloxicam treatment (0.02 mg/kg/day) over 6 months in cats with chronic kidney disease (CKD). Methods Twenty-one cats with stable International Renal Interest Society stage 2 or 3 CKD were recruited and randomized to placebo or meloxicam groups. Cats were evaluated at baseline and at 1, 3 and 6 months, including blood pressure, chemistry, symmetric dimethylarginine (SDMA), glomerular filtration rate (GFR), urinalysis, urine protein:creatinine ratio (UPC), urine transforming growth factor-beta (ß):creatinine ratio, urine clusterin, urine cystatin B and serum inosine. Results No statistical difference was observed in systolic blood pressure, blood urea nitrogen, creatinine, SDMA, GFR, urine transforming growth factor-ß:creatinine ratio, urine clusterin, urine cystatin B or serum inosine in cats receiving meloxicam vs placebo. Mean UPC was greater in the meloxicam group (0.33) than the placebo group (0.1) at 6 months ( P = 0.006). Four cats had meloxicam discontinued owing to potential (mainly gastrointestinal) adverse effects. Conclusions and relevance No decline in renal excretory function was observed when meloxicam was administered to cats with CKD. However, gastrointestinal adverse effects were observed, and cats that received meloxicam had greater proteinuria at 6 months than cats that received placebo. As proteinuria is associated with negative outcomes (progression of azotemia and hypertension) in cats with CKD, this finding suggests that meloxicam should be used with caution in cats with CKD and UPC monitored. Until further research is available, clinicians should weigh the risk of potential increased proteinuria against quality of life benefits when considering meloxicam for analgesia in cats with renal disease.

scholarly journals Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nam Ju Heo ◽  
Sang Youl Rhee ◽  
Jill Waalen ◽  
Steven Steinhubl
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Symptoms ◽  
Screening Program ◽  
Renal Involvement ◽  
Newly Diagnosed ◽  
Mortality And Morbidity ◽  
Increased Risk

Abstract Background Diabetes is an independent risk factor for atrial fibrillation (AF), which is associated with increases in mortality and morbidity, as well as a diminished quality of life. Renal involvement in diabetes is common, and since chronic kidney disease (CKD) shares several of the same putative mechanisms as AF, it may contribute to its increased risk in individuals with diabetes. The objective of this study is to identify the relationship between CKD and the rates of newly-diagnosed AF in individuals with diabetes taking part in a screening program using a self-applied wearable electrocardiogram (ECG) patch. Materials and methods The study included 608 individuals with a diagnosis of diabetes among 1738 total actively monitored participants in the prospective mHealth Screening to Prevent Strokes (mSToPS) trial. Participants, without a prior diagnosis of AF, wore an ECG patch for 2 weeks, twice, over a 4-months period and followed clinically through claims data for 1 year. Definitions of CKD included ICD-9 or ICD-10 chronic renal failure diagnostic codes, and the Health Profile Database algorithm. Individuals requiring dialysis were excluded from trial enrollment. Results Ninety-six (15.8%) of study participants with diabetes also had a diagnosis of CKD. Over 12 months of follow-up, 19 new cases of AF were detected among the 608 participants. AF was newly diagnosed in 7.3% of participants with CKD and 2.3% in those without (P < 0.05) over 12 months of follow-up. In a univariate Cox proportional hazard regression analysis, the risk of incident AF was 3 times higher in individuals with CKD relative to those without CKD: hazard ratios (HR) 3.106 (95% CI 1.2–7.9). After adjusting for the effect of age, sex, and hypertension, the risk of incident AF was still significantly higher in those with CKD: HR 2.886 (95% CI 1.1–7.5). Conclusion Among individuals with diabetes, CKD significantly increases the risk of incident AF. Identification of AF prior to clinical symptoms through active ECG screening could help to improve the clinical outcomes in individuals with CKD and diabetes.

Adverse Effects of Proton Pump Inhibitors in Chronic Kidney Disease

2016 ◽  
Vol 176 (6) ◽  
pp. 868
Author(s):  
Francesco Iannuzzella ◽  
Mattia Corradini ◽  
Sonia Pasquali
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump
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