reaction) and kidney damage.
What is the concern regarding gadolinium-based contrast agents?
At this time, only certain patients who receive GBCAs appear to be at an increased risk for developing a serious systemic fibrosing disease, NSF. The patients at risk are those with acute or chronic severe renal (kidney) insufficiency (glomerular filtration rate < 30 mL/min/1.73m2); or renal dysfunction due to the hepato-renal syndrome or in the perioperative liver transplantation period. In the hepato-renal syndrome or in the perioperative liver transplantation period, the risk applies to any severity of renal dysfunction.
A possible association between NSF and GBCAs was first reported in a May 29, 2006, press release from the Danish Medicines Agency (DMA) and the April 2006 report by Grobner et al in Nephrology, Dialysis and Transplantation (2006) Vol 21 (4):1104-1108 and following erratum (2006) 21(6): 1745.
Recent publications have provided additional important information implicating a role for GBCAs in the development of NSF among some patients. Researchers have found gadolinium in the tissue of patients with NSF (High et al, J Am Acad Dermatol 2007; 56 (1): 21-26). Also, a retrospective study with Omniscan in about 370 patients with severe renal insufficiency estimated the risk of NSF to be 4% (Marckmann et al, J Am Soc Nephrol 2006; 17: 2359-2362). A case-control study of the occurrence of nephrogenic fibrosing dermopathy (NFD) indicated that exposure to GBCA was
Injury to the glomerulus and the tubules presents the onset of Intra-renal failure (Matzke, 2011). Some of the frequent causes for Intra-renal failure are glomerulonephritis; pyelonephritis; and tubular injury. Post-renal failure develops from things like ureteroliths, tumors, or anatomic impediments. Opposite of the acute form, the chronic form has a slow onset that has no early stage symptoms. It is important to know that following an acute episode a chronic renal episode often follows, and at this juncture the damage is irreversible. Glomerulonephritis and pyelonephritis combined, has been reported to be the forerunner in as much as half the cases from acute to chronic renal failure. Diabetes mellitus, renal vascular disease, such as atherosclerosis, hypertension, polycystic kidney disease, drug damage, and nephrolith are all examples of other causes of CKD (Pradeep, 2014). Biopsies of kidneys that suffered with CKD reveal smaller kidneys with scarring on the tubules.
Finally, one article was found by conducting a search of the identified article’s reference section. This article was searched by title on the Cochrane database and was found useful to the clinical
Patient has underlying conditions: Obesity, Coronary Artery disease, Edema, Hypertensions, Dyslipidemia, Ischemia, and hx of quadruple Coronary Artery Bypass Graft.
We collected data on the disease status (like renal histology, duration of nephrotic syndrome, number of relapses) and treatment status (like immunosuppressive treatments used before RTX, number of courses of RTX) of the patients. RTX response was measured at 1, 3, 6, 12, 18 and 24 months post RTX therapy in terms of proteinuria, spot urine protein/creatinine ratio (Up/Uc) or creatinine clearance. Complete blood counts, lipid profile and serum albumin levels were monitored regularly.
Chronic kidney disease (CKD) is a common disorder and occurs in the elderly population. In younger patients, it
Other hiccups in the investigation included Angulo not questioning Winston and either of the teammates and neither did he obtain a sample of Winston’s DNA to try and match it with Kinsman’s toxicology report. There were allegations that the TPD helped FSU Athletics stay up to date about the investigation, by informing them of everything going on before the details of the case even reached the victim. Due to media speculations, TPD turned the case over to state attorney, Willie Meggs. Once the case was in the state attorney’s possession, Tim Jensen (Winston’s lawyer) made Winston’s teammates sign a document agreeing that they both witnessed what appeared to be consensual sex between Kinsman and Winston that night (Kinsman v. Winston, 2012).
The results also showed that patients in the treatment group had a lower risk of hospitalization for heart failure, progression of albuminuria, and loss of kidney function
Maine Nephrology follows the vision of The National Kidney Foundation which was established in 1950 by Ada DeBold in an effort to save the life of her young son. As a small child, he was diagnosed with pediatric nephrosis, a disease that causes the kidney to lose protein and in turn the body develops swelling. In the 1950’s this disease was debilitating and had more than a ninety percent mortality rate. In an effort to find a cure, a group of clinicians and researchers were put together to share their findings to develop
There is agreement in the cutoff values in this paper with that of Yamamoto et al. [14] however the differences in the sensitivity and specificity in the nephrographic phase may be attributed to the difference in the patient population between the studies. The results of this
Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,
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Chronic Kidney Disease (CKD) is among the leading causes of mortality throughout the world, and its prevalence and the health care costs resulting from it are considerable and increasing. CKD commonly is silent and asymptomatic until its late stages. Accordingly, CKD is diagnosed prior to symptomatic stage of kidney failure, resulting in delays in proper interventions and the emergence of adverse consequences in the CKD patients
One of the diseases is diabetes mellitus which is a major cause of renal failure. This disease can be defined as an increase of fasting blood glucose that is affected by a deficiency in insulin hormone. The normal range for glucose (fasting) in the blood is 2.8-6.0 mmol/L. It is classified into two groups, type 1 (insulin-dependent diabetes mellitus) and type 2 (non insulin-dependent diabetes mellitus). Stein (2008, p.6) points out that kidney failure happens most often when patients have suffered from diabetes mellitus for more than 10 years. According to United States Renal Data System (USRDS) report in 2007, approximately 44% of primary causes of renal failure is diabetes mellitus in the United States in 2005. Also, Stein (2008) indicates that 15% of dialysis patients are influenced by diabetes mellitus in the United Kingdom. Diabetes mellitus has negative affects throughout the kidneys where the increase of the range of blood sugar causes the damages to the cells in the kidneys. This leads to the presence of the glucose in the urine which is known as glycosuric.
bacterial urinary tract infection, which is the most common side effect, may occur.21 Other patients
Glomerulonephritis (GN), or the inflammation of glomeruli, is a leading cause of renal failure worldwide. Inflammation is characterized by vascular fragility, infiltration of leukocytes, and edema. Glomerular disease may manifest by three major syndromes: nephritic syndrome, nephrotic syndrome, and rapidly progressive glomerulonephritis (RPGN). Nephritic syndrome consists of sudden onset of hematuria, non-nephrotic range proteinuria (1.5 g/24 h), active sediment with red blood cell (RBC) casts or dysmorphic RBCs, acute renal failure, and hypertension. Nephrotic syndrome is characterized by heavy proteinuria (>3.5 g/24 h), edema, hypoalbuminemia, and hyperlipidemia. RPGN is characterized by active sediment (RBC casts and dysmorphic RBCs) and rapid development of acute renal failure usually over a period of weeks to months. Glomerulonephritis accounts for the majority of progressive renal disease in many parts of the world.