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Uremia/Uremic Syndrome
Published in Charles Theisler, Adjuvant Medical Care, 2023
Uremia is defined as elevated concentrations of urea, creatinine, and other nitrogenous end products of metabolism in the blood that are normally excreted by the kidneys into the urine. It is a serious condition and when left untreated can lead to death. Uremia occurs after the kidneys are damaged (chronic kidney disease) and cannot filter the blood normally. Symptoms include itchy skin, nausea, loss of appetite, weight loss, leg cramps, and fatigue. Common causes of chronic kidney disease are hypertension, polycystic kidney disease, diabetes (DM1 and DM2), glomerulitis, some cancers, and recurrent kidney stones or infections. Complications of untreated uremia can be seizures, coma, bleeding, cardiac arrest, and death.
Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Chronic renal failure may be caused by anything that results in the kidneys functioning abnormally. The most common causes are diabetic nephropathy, hypertensive nephrosclerosis, and glomerulopathies, which can be primary or secondary. Primary glomerulopathies include focal segmental glomerulosclerosis, idiopathic crescentic glomerulonephritis, IgA nephropathy, membranoproliferative glomerulonephritis, and membranous nephropathy. Systemic diseases that may cause secondary glomerulopathies include amyloidosis, diabetes mellitus, Goodpasture syndrome, granulomatosis with polyangiitis, hemolytic-uremic syndrome, mixed cryoglobulinemia, postinfectious glomerulonephritis, and systemic lupus erythematosus. Metabolic syndrome with hypertension and type 2 diabetes mellitus is an increasingly common cause of kidney damage.
Diabetes
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
The combination of high blood glucose and high blood pressure can damage the main renal artery as well as the tiny blood vessels inside the kidneys, which interferes with the filtration process. Useful substances, such as water and protein, are not fullysaved and waste products may not be properly excreted, so we feel unwell. Signs of kidney damage are protein in the urineblood in the urineswollen ankles, feet and handsfeeling tired, short of breath and nauseous(Diabetes UK, 2020c)
Incidence and risk factors for recurrent focal segmental glomerulosclerosis after kidney transplantation: a meta-analysis
Published in Renal Failure, 2023
Jiang Bai, Tianxiang Zhang, Yan Wang, Jiajing Cao, Zihui Duan, Linghui Ji, Yun Zhou, Chuan Hao, Qiang Guo
No curative therapies exist for the treatment of FSGS, and a significant proportion (40–70%) of patients with FSGS advance to kidney failure within 10–20 years after diagnosis, making FSGS one of the most common primary glomerular diseases leading to kidney failure requiring dialysis, along with diseases such as diabetic nephropathy and hypertensive nephrosclerosis [8,9]. In cases of kidney failure, kidney transplantation is usually the therapy of choice. However, primary FSGS recurrence occurs in 40%–60% of patients after kidney transplantation and varies widely depending on the study population, diagnostic criteria, and follow-up duration [10]. Patients with FSGS recurrence have a 52 percent 5-year graft survival rate compared to 83 percent in patients without FSGS recurrence, which significantly impairs the quality of life and places a heavy burden on families [10].
Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial
Published in Annals of Medicine, 2022
Yin-Chin Wang, Ming-Jiuh Wang, Chih-Yuan Lee, Chien-Chia Chen, Ching-Tang Chiu, Anne Chao, Wing-Sum Chan, Meng-Kun Tsai, Yu-Chang Yeh
End-stage kidney disease remains a global health concern; patients undergoing dialysis experience a lower quality of life and suffer increased morbidity and mortality. Kidney transplantation is the definitive treatment for patients on dialysis. However, ischemia-reperfusion injury to the transplanted kidneys may affect their postoperative function after kidney transplantation [1,2]. Moreover, renal microcirculation is a key issue related to acute and chronic kidney diseases [3]. Renal microvascular dysfunction includes alterations in endothelial barrier permeability, exaggerated inflammation, and impairment of endothelium-dependent vasorelaxation [3]. Our previous study revealed the alteration of sublingual microcirculatory dysfunction in patients on dialysis, and the severity of this alteration was lower in patients who receive a kidney transplant [4]. Surgical stress may affect the pre-existing microcirculatory dysfunction of patients undergoing kidney transplantation.
Actual drug-related harms in residential aged care facilities: a narrative review
Published in Expert Opinion on Drug Safety, 2022
Sheraz Ali, Colin M. Curtain, Luke RE. Bereznicki, Mohammed S. Salahudeen
Acute kidney injury is an abrupt decrease in kidney function, occurring within hours and resulting in the accumulation of urea and other metabolic waste products and the dysregulation of extracellular volume and electrolytes [51]. RACF residents are at high risk for acute kidney injury owing to age-related changes in kidney structure and function [51]. Handler et al. reported that 30% (n = 38) of older residents usually experience acute kidney injury within 100 days of admission to RACFs [51]. The occurrence of a drug-related acute kidney injury is often due to the use of diuretics, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, antibiotics, and non-steroidal anti-inflammatory drugs [51]. Clinical information systems using computerized alerts may help in the early detection of complications associated with acute kidney injury, as predicting acute kidney injury from underlying risk factors is challenging in older people [51]. Although acute kidney injury is well-studied in the acute care setting, evidence related to drug-induced acute kidney injury in RACFs is limited. Future research is needed to determine if deprescribing some renally-eliminated medications can positively impact the incidence and progression of acute kidney injury in older people living in RACFs.