Medicine
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Mrs T, a 73-year-old lady, is seen regularly by the renal clinic. She has chronic kidney disease and is being readied for renal replacement therapy. Her most recent eGFR is 14mL/min. What stage CKD does Mrs T have? (1)Give three signs of chronic kidney disease you may find on examination. (3)Explain the basic principles of haemodialysis. (2)Give two complications of peritoneal dialysis. (2)Mrs T opts for renal transplantation and receives a cadaveric kidney. She will be on lifelong immunosuppressants.Organ rejection is a possible complication of renal transplantation. What time period determines whether the organ rejection is acute or chronic? (1)Mrs T is now seen annually by a dermatologist. Why is this? (1)
The kidneys
C. Simon Herrington in Muir's Textbook of Pathology, 2020
The estimated glomerular filtration rate (eGFR), a laboratory calculation taking into account the serum creatinine, age, sex, and race of the individual, is now the most common method of reporting renal function in adults. Using eGFR, there are five recognized stages of chronic kidney disease (CKD) ranging from CKD 1 (in which eGFR is normal but there is other evidence of kidney disease such as proteinuria, chronic glomerulonephritis, calculi, scarring, or polycystic kidneys) to CKD 5 (in which eGFR <15 mL/min per 1.73 m2 or the patient is undergoing chronic dialysis or has received a kidney transplant) (Table 14.1). Patients with stage 5 CKD are said to have ‘established renal failure’, a term that has replaced ‘end-stage renal failure’. Patients with stage 5 CKD who are being treated by dialysis or have a functioning kidney transplant are said to be on ‘renal replacement therapy’.
Small vessel vasculitis
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
Renal manifestations vary from isolated hematuria with or without proteinuria to hypertension. The more severe cases may manifest as nephrotic syndrome with significant proteinuria or as acute glomerulonephritis. Nephritis occurs within a mean period of 2 weeks after the diagnosis of HSP is made and usually within a month in the majority of cases. The risk factors for developing nephritis are age older than 8 years, abdominal pain, and recurrence of HSP disease. It is recommended that weekly urine analysis be done for the first 2 months [62]. The prognosis of HSP is dependent on the severity of renal involvement. This can lead to chronic kidney disease in a small proportion of patients, even as late as 20 years after diagnosis [63]. Renal disease can mimic poststreptococcal glomerulonephritis or SLE nephritis. The C3 levels are normal in HSP nephritis as opposed to those of SLE with nephritis. The rare complications of HSP include cerebral vasculitis [64], scrotal or testicular hemorrhage [65], and interstitial pulmonary hemorrhage [66]. HSP nephritis with pulmonary findings may mimic AAV.
Preventive and healing effect of high dosing grape seed flour on CKD patients of various stages and aetiologies
Published in Biomarkers, 2022
Wiem Bejaoui, Mohamed Mahmoudi, Kamel Charradi, Monia Abbes-Belhadj, Habib Boukhalfa, Mossadok Ben-Attia, Ferid Limam, Ezzedine Aouani
Chronic kidney disease (CKD) is a worldwide issue and a non-communicable disease and diabetes, hypertension, medications as non-steroidal anti-inflammatory drugs and antibiotics, or infection-induced renal toxicity are major causes of CKD in developed and many developing countries (Webster et al. 2017). Nonetheless diabetes-induced CKD is one of the most devastating complications in terms of patients’ quality of life and survival and diabetic kidney disease is the leading cause of CKD and end-stage renal disease (Yamazaki et al. 2021). CKD outcome is related to the severity of its pathological mechanisms, such as micro-vascular damage, oxidative and inflammation stresses, and fibrosis (Krolewski et al. 2017). The severity of CKD is generally quantified by a low serum creatinine-based glomerular filtration rate (GFR), reflecting excretory kidney function, and continuous proteinuria measured by the urinary albumin-to-creatinine ratio, which is a hallmark of kidney damage and an independent risk for the prediction of CKD worsening (Matsuoka-Uchiyama et al. 2022). At the present time there is no satisfactory treatment and management of CKD patients is limited to early detection or prevention, treatment of the underlying cause to slow down progression and counteract its comorbidities.
Icariin attenuates renal fibrosis in vivo and in vitro by inhibiting the Notch2/Hes-1 pathway
Published in Growth Factors, 2022
Qiaoqi Zhang, Lei Xie, Lin Jiang, Jiaqing Ni, Wenke Han, Xiuhua Mi, Ping Wang
Renal fibrosis is the pathological process pervasive to any ongoing chronic kidney injury or maladaptive repair, and is considered the underlying pathological process of chronic kidney disease (CKD) (Djudjaj and Boor 2019). Although renal fibrosis affects more than 10% of the population around the world, the incidence of patients with renal fibrosis is still on the rise steadily and there is no effective treatment (Yang, Dai, and Liu 2001). Chronic kidney disease (CKD) is caused by a variety of reasons and is a major factor in deaths throughout the world (Gouveia et al. 2016). Renal fibrosis is usually presented as the ultimate hallmark of CKD (Gewin 2018). Renal fibrosis is characterised as interstitial inflammation, extreme extracellular matrix (ECM) metabolism, and fibroblast accumulation (Magalhães et al. 2017). The degree of renal fibrosis severity is closely correlated with the level of renal insufficiency and a higher risk for renal failure (Bohle et al. 1996). Thus, research on the mechanisms of renal fibrosis is essential for finding novel therapeutic approaches.
Maximizing New Technologies to Treat Depression
Published in Issues in Mental Health Nursing, 2019
Veronica Decker, Michael Valenti, Vicki Montoya, Alla Sikorskii, Charles W. Given, Barbara A. Given
The number of people accessing online healthcare communities has been increasing over the past decade (Fox, 2011; Fox & Maeve, 2013; Grosberg, Grinvald, Reuveni, & Magnezi, 2016; Sudau et al., 2014). Social media websites, or mobile applications, provide a platform for online healthcare communities to share experiences of health, wellness, and illness as well as resources people found helpful in managing their symptoms. Online healthcare communities are accessible to people with physical limitations who may not be able to participate in face-to-face groups. Symptoms associated with chronic illness, such as pain accompanying arthritis or fatigue associated with advanced chronic kidney disease often result in some degree of physical limitation. Debilitating symptoms, as well as declining social contacts, are frequently coupled with social isolation and depression in older adults (Chen & Schulz, 2016). Social media provides a platform through which they may remain socially engaged, able to receive emotional support instrumental for the maintenance of positive mental health (Leigh-Hunt et al., 2017; Santini, Koyanagi, Tyrovolas, Mason & Haro, 2015).
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