Database : MEDLINE
Search on : Uremia [Words]
References found : 19894 [refine]
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  1 / 19894 MEDLINE  
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[PMID]: 29505147
[Au] Autor:Alrifai MW; Mulherin DP; Weinberg ST; Wang L; Lehmann CU
[Ad] Address:Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
[Ti] Title:Parenteral Protein Decision Support System Improves Protein Delivery in Preterm Infants: A Randomized Clinical Trial.
[So] Source:JPEN J Parenter Enteral Nutr;42(1):219-224, 2018 Jan.
[Is] ISSN:1941-2444
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Management of neonatal parenteral protein intake for preterm infants is challenging and requires daily modifications of the dose to account for the infant's postnatal age, birth weight, current weight, and the volume and protein concentration of concurrent enteral nutrition. The objective of this study was to create and evaluate the Parenteral Protein Calculator (PPC), a clinical decision support system to improve the accuracy of protein intake for preterm infants who require parenteral nutrition (PN). MATERIALS AND METHODS: We integrated the PPC into the computerized provider order entry system and tested it in a randomized controlled trial (routine or PPC). Infants were eligible if they were ≤3 days old, had a birth weight ≤1500 g, and had no inborn error of metabolism. The primary outcome was the appropriate total protein intake, defined as target protein dose ±0.5 g/kg. RESULTS: We randomly allocated 42 infants for 221 PN days in the control group and 211 in the PPC group. Total protein intake in the PPC group was more accurate as compared with the control group (appropriate protein dosing: odds ratio = 5.8; 95% CI, 2.7-12.4). Absolute deviation from protein target was 0.41 g/kg (0.24-0.58) lower in the PPC group. CONCLUSION: The PPC improved appropriate protein dosing for premature infants receiving PN. Further studies are needed to test whether clinical decision support systems will reduce uremia and improve growth and to replicate similar findings in the cases of other PN nutrients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1002/jpen.1034

  2 / 19894 MEDLINE  
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[PMID]: 29516412
[Au] Autor:Kovalcíková A; Gyurászová M; Vavrincová-Yaghi D; Vavrinec P; Tóthová L; Boor P; Sebeková K; Celec P
[Ad] Address:Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Sasinkova 4, 841 01, Bratislava, Slovakia.
[Ti] Title:Oxidative stress in the brain caused by acute kidney injury.
[So] Source:Metab Brain Dis;, 2018 Mar 07.
[Is] ISSN:1573-7365
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uremic encephalopathy is a severe complication of renal failure. The underlying pathogenesis is unknown although several mechanisms have been suggested. Renal failure causes oxidative stress leading to cardiovascular complications. It has been suggested as the potential mediator of uremic encephalopathy as well, but it is largely unknown whether brain tissue itself undergoes oxidative damage in uremia. The aim of our experiment was to analyze oxidative stress markers in different brain regions in an animal model of acute kidney injury (AKI). AKI was induced by ischemia-reperfusion injury in male Wistar rats. Urine was collected in metabolic cages after 24 h. Samples of plasma and several brain regions were collected after 48 h. Markers of lipid peroxidation, protein oxidation and total antioxidant capacity were assessed. Renal failure was confirmed by high plasma creatinine, urea and urinary albumin to creatinine ratio. Our data confirmed increased systemic oxidative stress in the AKI group with plasma concentrations of markers of oxidative damage being twice as high compared to the sham-operated control group. No effect was seen in the urine. In the hippocampus, lipid and protein oxidation was higher, while antioxidant capacity was lower in the rats with AKI. Lipid oxidation markers in the frontal cortex were higher by 33%. No differences to controls were found in the cerebellum and hypothalamus. In conclusion, our results indicate that AKI leads to oxidative stress in the brain, especially in the hippocampus and in the frontal cortex. This kidney-brain crosstalk mediated by increased oxidative stress might explain some of the symptoms of uremic encephalopathy. The causes and consequences of oxidative damage observed in the brain during AKI remain to be elucidated.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1007/s11011-018-0204-8

  3 / 19894 MEDLINE  
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[PMID]: 29444901
[Au] Autor:Sirich TL; Meyer TW
[Ad] Address:Department of Medicine, Veterans Affairs Palo Alto Healthcare System and Stanford University, Palo Alto, California tsirich@stanford.edu.
[Ti] Title:Intensive Hemodialysis Fails to Reduce Plasma Levels of Uremic Solutes.
[So] Source:Clin J Am Soc Nephrol;13(3):361-362, 2018 Mar 07.
[Is] ISSN:1555-905X
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:EDITORIAL
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.2215/CJN.00950118

  4 / 19894 MEDLINE  
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[PMID]: 29401336
[Au] Autor:Glaser J; Zeman J; Noble S; Fernandez N
[Ad] Address:Naval Medical Research Unit San Antonio, Combat Casualty Care Directorate, 3650 Chambers Pass JBSA Fort Sam Houston, San Antonio, TX 78234.
[Ti] Title:CAVH in the Combat Environment: A Case Report and Lessons Learned in Southern Afghanistan.
[So] Source:Mil Med;183(1-2):e167-e171, 2018 Jan 01.
[Is] ISSN:1930-613X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Acute kidney injury is a common complication of both civilian and military trauma. The lack of dedicated resources restrict dialysis in the forward setting. We report a case of a combat polytrauma and renal failure, using continuous arteriovenous hemofiltration to clear uremia and remove volume, allowing for ventilator liberation and safe disposition. Materials and Methods: The patient presented with traumatic lower extremity injuries and abdominal wounds and developed acute post-traumatic renal failure. Using available supplies, the patient was cannulated for continuous arteriovenous hemofiltration. Aggressive fluid and electrolyte management accomplished specific goals of ventilator liberation and clearance of uremia. Results: Over 48 h, blood urea nitrogen was reduced from 101 mg/dL to 63 mg/dL. Creatinine was reduced from 8.2 mg/dL to 4.7 mg/dL. Acute respiratory distress syndrome was improved reducing P:F (PaO2:FiO2) ratio from 142 to 210. The patient was extubated and transferred safely. Conclusions: The ability to perform acute dialysis can be lifesaving. Although resource constrained, we created a dialysis system in the forward environment with a filter and universally available equipment. This represents the first described use of continuous arteriovenous hemofiltration at the NATO Role 3 hospital in Afghanistan. This technique represents another potential tool for deployed trauma teams to improve care.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1093/milmed/usx017

  5 / 19894 MEDLINE  
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[PMID]: 29507008
[Au] Autor:Wolley M; Jardine M; Hutchison CA
[Ad] Address:Department of Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
[Ti] Title:Exploring the Clinical Relevance of Providing Increased Removal of Large Middle Molecules.
[So] Source:Clin J Am Soc Nephrol;, 2018 Mar 05.
[Is] ISSN:1555-905X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Dialysis technologies have continued to advance over recent decades; however, these advancements have not always been met with improved patient outcomes. In part, the high morbidity and mortality associated with dialysis have been attributed to a group of uremic toxins, which are described as "difficult to remove." With a new generation of hemodialysis membranes now making meaningful clearance of these molecules possible, it is an apt time to review the clinical relevance of these middle molecules. Our review describes the developments in membrane technology that enable the removal of large middle molecules (molecular mass >15 kD) that is limited with high-flux dialysis membranes. Of the known 58 middle molecules, a literature search identified 27 that have molecular mass >15 kD. This group contains cytokines, adipokines, hormones, and other proteins. These molecules are implicated in chronic inflammation, atherosclerosis, structural heart disease, and secondary immunodeficiency in the literature. Single-center safety and efficacy studies have identified that use of these membranes in maintenance dialysis populations is associated with limited loss of albumin and increased clearance of large middle molecules. Larger, robustly conducted, multicenter studies are now evaluating these findings. After completion of these safety and efficacy studies, the perceived clinical benefits of providing clearance of large middle molecules must be assessed in rigorously conducted, randomized clinical studies.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  6 / 19894 MEDLINE  
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[PMID]: 29495444
[Au] Autor:Muñoz-Castañeda JR; Pendón-Ruiz de Mier MV; Rodríguez M; Rodríguez-Ortiz ME
[Ad] Address:Nephrology Service, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofía, University of Córdoba, 14004 Córdoba, Spain. juanr.munoz.exts@juntadeandalucia.es.
[Ti] Title:Magnesium Replacement to Protect Cardiovascular and Kidney Damage? Lack of Prospective Clinical Trials.
[So] Source:Int J Mol Sci;19(3), 2018 Feb 27.
[Is] ISSN:1422-0067
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Patients with advanced chronic kidney disease exhibit an increase in cardiovascular mortality. Recent works have shown that low levels of magnesium are associated with increased cardiovascular and all-cause mortality in hemodialysis patients. Epidemiological studies suggest an influence of low levels of magnesium on the occurrence of cardiovascular disease, which is also observed in the normal population. Magnesium is involved in critical cellular events such as apoptosis and oxidative stress. It also participates in a number of enzymatic reactions. In animal models of uremia, dietary supplementation of magnesium reduces vascular calcifications and mortality; in vitro, an increase of magnesium concentration decreases osteogenic transdifferentiation of vascular smooth muscle cells. Therefore, it may be appropriate to evaluate whether magnesium replacement should be administered in an attempt to reduce vascular damage and mortality in the uremic population In the present manuscript, we will review the magnesium homeostasis, the involvement of magnesium in enzymatic reactions, apoptosis and oxidative stress and the clinical association between magnesium and cardiovascular disease in the general population and in the context of chronic kidney disease. We will also analyze the role of magnesium on kidney function. Finally, the experimental evidence of the beneficial effects of magnesium replacement in chronic kidney disease will be thoroughly described.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Process

  7 / 19894 MEDLINE  
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[PMID]: 29490976
[Au] Autor:Wang K; Kestenbaum B
[Ad] Address:Division of Nephrology, Department of Medicine and.
[Ti] Title:Proximal Tubular Secretory Clearance: A Neglected Partner of Kidney Function.
[So] Source:Clin J Am Soc Nephrol;, 2018 Feb 28.
[Is] ISSN:1555-905X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The secretion of small molecules by the proximal tubules of the kidneys represents a vital homeostatic function for rapidly clearing endogenous solutes and medications from the circulation. After filtration at the glomerulus, renal blood flow is directed through a network of peritubular capillaries, where transporters of the proximal tubules actively secrete putative uremic toxins and hundreds of commonly prescribed drugs into the urine, including protein-bound substances that cannot readily cross the glomerular basement membrane. Despite its central physiologic importance, tubular secretory clearance is rarely measured or even estimated in clinical or research settings. Major barriers to estimating tubular solute clearance include uncertainty regarding optimal endogenous secretory markers and a lack of standardized laboratory assays. The creation of new methods to measure tubular secretion could catalyze advances in kidney disease research and clinical care. Differences in secretory clearance relative to the GFR could help distinguish among the causes of CKD, particularly for disorders that primarily affect the tubulointerstitium. As the primary mechanism by which the kidneys excrete medications, tubular secretory clearance offers promise for improving kidney medication dosing, which is currently exclusively on the basis of filtration. The differing metabolic profiles of retained solutes eliminated by secretion versus glomerular filtration suggest that secretory clearance could uniquely inform uremic toxicity, refine existing measures of residual kidney function, and improve prediction of cardiovascular and kidney disease outcomes. Interdisciplinary research across clinical, translational, and laboratory medicine is needed to bring this often neglected kidney function into the limelight.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher

  8 / 19894 MEDLINE  
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[PMID]: 29482271
[Au] Autor:De Santo NG; Quarto E; Phillips ME; de Pascale C; Di Iorio BR
[Ad] Address:Emeritus Professor of Nephrology, University of Campania Luigi Vanvitelli, Naples, Italy.
[Ti] Title:Carmelo Giordano (1930-2016): uremia therapy by low protein alimentation and sorbents.
[So] Source:G Ital Nefrol;35(Suppl 70):29-37, 2018 Feb.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Data-Review

  9 / 19894 MEDLINE  
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[PMID]: 29444477
[Au] Autor:Simões-Silva L; Araujo R; Pestana M; Soares-Silva I; Sampaio-Maia B
[Ad] Address:i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Portugal; Faculty of Medicine, University of Porto, Portugal.
[Ti] Title:The microbiome in chronic kidney disease patients undergoing hemodialysis and peritoneal dialysis.
[So] Source:Pharmacol Res;, 2018 Feb 11.
[Is] ISSN:1096-1186
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Chronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate. Also, dietary adaptations are mandatory in both therapies. This revision explores the impact of HD or PD therapies on human microbiome. HD and PD appear to be associated with different changes in the gut microbiome, for example a decrease in Proteobacteria relative abundance in HD patients and increase in PD patients. Both therapies may also have an impact on the human microbiome beyond the gut, leading to increased relative abundance of specific bacteria in the blood microbiome of HD patients and increased relative abundance of other bacteria in the peritoneal microbiome of PD patients. HD and PD catheter biofilms may also play an important role in the changes observed in these microbiomes. A more interdisciplinary approach is needed to further clarify the role of microbial groups other than bacteria in all body habitats to allow the complete understanding of the impact of HD or PD on the microbiome of CKD patients. Moreover, strategies that promote a healthy balance of the human microbiome on these patients should be explored.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher

  10 / 19894 MEDLINE  
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[PMID]: 29304096
[Au] Autor:Gravesen E; Lerche Mace M; Nordholm A; Hofman-Bang J; Hruska K; Haagen Nielsen C; Kjær A; Olgaard K; Lewin E
[Ad] Address:Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
[Ti] Title:Exogenous BMP7 in aortae of rats with chronic uremia ameliorates expression of profibrotic genes, but does not reverse established vascular calcification.
[So] Source:PLoS One;13(1):e0190820, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Hyperphosphatemia and vascular calcification are frequent complications of chronic renal failure and bone morphogenetic protein 7 (BMP7) has been shown to protect against development of vascular calcification in uremia. The present investigation examined the potential reversibility of established uremic vascular calcification by treatment of uremic rats with BMP7. A control model of isogenic transplantation of a calcified aorta from uremic rats into healthy littermates examined whether normalization of the uremic environment reversed vascular calcification. Uremia and vascular calcification were induced in rats by 5/6 nephrectomy, high phosphate diet and alfacalcidol treatment. After 14 weeks severe vascular calcification was present and rats were allocated to BMP7, vehicle or aorta transplantation. BMP7 treatment caused a significant decrease of plasma phosphate to 1.56 ± 0.17 mmol/L vs 2.06 ± 0.34 mmol/L in the vehicle group even in the setting of uremia and high phosphate diet. Uremia and alfacalcidol resulted in an increase in aortic expression of genes related to fibrosis, osteogenic transformation and extracellular matrix calcification, and the BMP7 treatment resulted in a decrease in the expression of profibrotic genes. The total Ca-content of the aorta was however unchanged both in the abdominal aorta: 1.9 ± 0.6 µg/mg tissue in the vehicle group vs 2.2 ± 0.6 µg/mg tissue in the BMP7 group and in the thoracic aorta: 71 ± 27 µg/mg tissue in the vehicle group vs 54 ± 18 µg/mg tissue in the BMP7 group. Likewise, normalization of the uremic environment by aorta transplantation had no effect on the Ca-content of the calcified aorta: 16.3 ± 0.6 µg/mg tissue pre-transplantation vs 15.9 ± 2.3 µg/mg tissue post-transplantation. Aortic expression of genes directly linked to extracellular matrix calcification was not affected by BMP7 treatment, which hypothetically might explain persistent high Ca-content in established vascular calcification. The present results highlight the importance of preventing the development of vascular calcification in chronic kidney disease. Once established, vascular calcification persists even in the setting when hyperphosphatemia or the uremic milieu is abolished.
[Mh] MeSH terms primary: Bone Morphogenetic Protein 7/pharmacology
Gene Expression Regulation/drug effects
Uremia/drug therapy
Vascular Calcification/drug therapy
[Mh] MeSH terms secundary: Animals
Aorta/drug effects
Aorta/metabolism
Bone Morphogenetic Protein 7/therapeutic use
Chronic Disease
Fibrosis
Male
Phosphates/blood
Rats
Real-Time Polymerase Chain Reaction
Uremia/genetics
X-Ray Microtomography
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Bone Morphogenetic Protein 7); 0 (Phosphates)
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[Js] Journal subset:IM
[Da] Date of entry for processing:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190820


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