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12. Evaluation of the correlation between computed tomography and anatomopathological findings in adult renal tumors

Abstract

[eng] Purpose: To evaluate the correlation between CT-scan findings in the diagnosis and extension workup of renal tumors to anatomical-pathology findings. Patients and method: This is a retro-spective, analytical, comparative and single center study over a period of 10 years, including all patients who had an extended total nephrectomy or partial nephrectomy indicated for a renal tumor with preoperative CT-scan and histopathological findings of the operative specimen. The parameters studied were: age, sex and CT-scan results and the results of the anatomical-pathology examination. Data analysis was done using the software SPSS. The threshold of significance was set at a P value of 0.05. Sensitivity, specificity, PPV, NPV for the variables studied were determined from the results of the CT-scan data and histopathological examination. Results: Forty-three patients were included with a sex-ratio of 0.8. The mean age was 43±16.9 years. In the 40 solid tumors and 3 cystic tumors suspected on CT-scan, histology had confirmed 40 malignant, 2 benign and 1 interstitial nephritis. CT-scan had a sensitivity of 100% and a PPV of 95.4%. CT-scan significantly overestimated tumor size for sizes less than 4 cm (p=0.01). For sizes between 4 and 10 cm, the size overestimation was not significant (p=0.13 and p=0.28). For sizes greater or equal than 10 cm, CT-scan underestimated size non-significantly (p=0.2). CT-scan had a high sensitivity to determine a solid or solid-cystic tumor mass but for cystic tumors it was not very sensitive but very specific. Comparing cTNM and pTNM classification, CT-scan had a specificity >90% to determine tumor size and extension except for tumors classified as T1 and T4. Conclusion: Our results show a high sensitivity and specificity of CT-scan in the diagnosis and extension of renal tumors., [spa] Objetivo: Evaluar la correlación entre los hallazgos de la TC en el diagnóstico y la extensión de los tumores renales con los hallazgos anatomopatológicos. Pacientes y método: Se trata de un estudio retrospectivo, analítico, comparativo y unicéntrico durante un periodo de 10 años, que incluye a todos los pacientes a los que se les realizó una nefrectomía total ampliada o una nefrectomía parcial indicada por un tumor renal con los hallazgos preoperatorios de la TC y los histopatológicos de la muestra operatoria. Los parámetros estudiados fueron: la edad, el sexo y los resultados de la TC y del examen anatomopatológico. El análisis de los datos se realizó con el programa informático SPSS. El umbral de significación se fijó en un valor P de 0,05. La sensibilidad, la especificidad, el VPP y el VPN de las variables estudiadas se determinaron a partir de los resultados de la TC y del examen histopatológico. Resultados: Se incluyeron 43 pacientes con una proporción de sexo de 0,8. La edad media era de 43±16,9 años. En los 40 tumores sóli-dos y 3 quísticos que se sospechaban en la TC, la histología había confirmado 40 malignos, 2 benignos y 1 nefritis intersticial. La TC tuvo una sensibilidad del 100% y un VPP del 95,4%. La TC sobrestimó significativamente el tamaño del tumor para los tamaños inferiores a 4 cm (p=0,01). Para tamaños entre 4 y 10 cm, la sobreestimación del tamaño no fue significativa (p=0,13 y p=0,28). Para tamaños mayores o iguales a 10 cm, el CT-scan subestimó el tamaño de forma no significativa (p=0,2). El CT-scan tuvo una alta sensibilidad para determinar una ma-sa tumoral sólida o sólida-quística pero para los tumores quísticos fue poco sensible pero muy específico. Comparando la clasificación cTNM y pTNM, el CT-scan tuvo una especificidad >90% para determinar el tamaño y la extensión del tumor, excepto para los tumores clasificados como T1 y T4. Conclusión: Nuestros resultados muestran una alta sensibilidad y especificidad del CT-scan e

Published
2023
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19. Evaluation of the correlation between computed tomography and anatomopathological findings in adult renal tumors

Author

Ndiaye, Modou, Sine, Babacar, Sarr, Alioune, Akpo, Geraud, Gaye, Abdou Majib, Kadiaké, Hawa, Ndour, Ndiaga Seck, Faye, Samba Thiapato, Sow, Ousmane, Zé-Ondo, Cyrille 1, Ndiath, Abdoulaye, Diaw, El Hadji Malick, Sow, Yaya, Diao, Babacar, and Ndoye, Alain Khassim

Subjects
Kidneys--Diseases, Health Sciences
Abstract

[eng] Purpose: To evaluate the correlation between CT-scan findings in the diagnosis and extension workup of renal tumors to anatomical-pathology findings. Patients and method: This is a retro-spective, analytical, comparative and single center study over a period of 10 years, including all patients who had an extended total nephrectomy or partial nephrectomy indicated for a renal tumor with preoperative CT-scan and histopathological findings of the operative specimen. The parameters studied were: age, sex and CT-scan results and the results of the anatomical-pathology examination. Data analysis was done using the software SPSS. The threshold of significance was set at a P value of 0.05. Sensitivity, specificity, PPV, NPV for the variables studied were determined from the results of the CT-scan data and histopathological examination. Results: Forty-three patients were included with a sex-ratio of 0.8. The mean age was 43±16.9 years. In the 40 solid tumors and 3 cystic tumors suspected on CT-scan, histology had confirmed 40 malignant, 2 benign and 1 interstitial nephritis. CT-scan had a sensitivity of 100% and a PPV of 95.4%. CT-scan significantly overestimated tumor size for sizes less than 4 cm (p=0.01). For sizes between 4 and 10 cm, the size overestimation was not significant (p=0.13 and p=0.28). For sizes greater or equal than 10 cm, CT-scan underestimated size non-significantly (p=0.2). CT-scan had a high sensitivity to determine a solid or solid-cystic tumor mass but for cystic tumors it was not very sensitive but very specific. Comparing cTNM and pTNM classification, CT-scan had a specificity >90% to determine tumor size and extension except for tumors classified as T1 and T4. Conclusion: Our results show a high sensitivity and specificity of CT-scan in the diagnosis and extension of renal tumors., [spa] Objetivo: Evaluar la correlación entre los hallazgos de la TC en el diagnóstico y la extensión de los tumores renales con los hallazgos anatomopatológicos. Pacientes y método: Se trata de un estudio retrospectivo, analítico, comparativo y unicéntrico durante un periodo de 10 años, que incluye a todos los pacientes a los que se les realizó una nefrectomía total ampliada o una nefrectomía parcial indicada por un tumor renal con los hallazgos preoperatorios de la TC y los histopatológicos de la muestra operatoria. Los parámetros estudiados fueron: la edad, el sexo y los resultados de la TC y del examen anatomopatológico. El análisis de los datos se realizó con el programa informático SPSS. El umbral de significación se fijó en un valor P de 0,05. La sensibilidad, la especificidad, el VPP y el VPN de las variables estudiadas se determinaron a partir de los resultados de la TC y del examen histopatológico. Resultados: Se incluyeron 43 pacientes con una proporción de sexo de 0,8. La edad media era de 43±16,9 años. En los 40 tumores sóli-dos y 3 quísticos que se sospechaban en la TC, la histología había confirmado 40 malignos, 2 benignos y 1 nefritis intersticial. La TC tuvo una sensibilidad del 100% y un VPP del 95,4%. La TC sobrestimó significativamente el tamaño del tumor para los tamaños inferiores a 4 cm (p=0,01). Para tamaños entre 4 y 10 cm, la sobreestimación del tamaño no fue significativa (p=0,13 y p=0,28). Para tamaños mayores o iguales a 10 cm, el CT-scan subestimó el tamaño de forma no significativa (p=0,2). El CT-scan tuvo una alta sensibilidad para determinar una ma-sa tumoral sólida o sólida-quística pero para los tumores quísticos fue poco sensible pero muy específico. Comparando la clasificación cTNM y pTNM, el CT-scan tuvo una especificidad >90% para determinar el tamaño y la extensión del tumor, excepto para los tumores clasificados como T1 y T4. Conclusión: Nuestros resultados muestran una alta sensibilidad y especificidad del CT-scan en el diagnóstico y la extensión de los tumores renales.

Published
2023

23. Research and development of a new kidney stone test

Abstract

La litiasi renal, també coneguda comunament com a càlculs renals o pedres al ronyó, es tracta d'una malaltia amb una incidència a l'alça i amb una taxa de recurrència molt elevada, ja que més del 50% dels pacients que han patit un episodi tornaran a formar un càlcul renal en un termini de 5 anys. Sabent això, l'estudi presentat té com a objectiu desenvolupar un projecte per a l'empresa Devicare sobre un nou test per a l'anàlisi de les pedres de ronyó, basat en un kit que permetrà recollir la pedra expulsada pel pacient, ser enviada al laboratori i que sigui analitzada. Gràcies a la combinació de microscòpia estereoscòpica, microscòpia electrònica d'escombrada amb microanàlisi per energia dispersiva de raigs-X i espectroscòpia d’infrarojos, s’aconsegueix un diagnòstic i tractament més específic, reduint les possibilitats de recurrència de la malaltia. Aquesta prova compta amb servei a domicili de recollida de la mostra i informes personalitzats tant per al pacient com per a l'uròleg, així com una futura implementació en una App per a telèfons mòbils. Després d'una anàlisi econòmica i considerant els paràmetres del VAN, TIR, WACC i el període de retorn, s'ha arribat a la conclusió que el projecte presentat és viable per a l' empresa ja que els resultats són coherents amb el que es considera viable en l'àmbit financer, La litiasis renal, también conocida comúnmente como cálculos renales o piedras en el riñón, se trata de una enfermedad con una incidencia al alza y con una tasa de recurrencia muy elevada, ya que más del 50% de los pacientes que han sufrido un episodio volverán a formar un cálculo renal en un plazo de 5 años. Sabiendo esto, el estudio presentado tiene como objetivo desarrollar un proyecto para la empresa Devicare sobre un nuevo test para el análisis de las piedras de riñón, basado en un kit que permitirá recoger la piedra expulsada por el paciente y ser enviada al laboratorio y que sea analizada. Gracias a la combinación de microscopía estereoscópica, microscopía electrónica de barrido con microanálisis por energía dispersiva de rayos-X y espectroscopia de infrarrojos, se consigue un diagnóstico y tratamiento más específico, reduciendo las posibilidades de recurrencia de la enfermedad. Dicha prueba cuenta con servicio a domicilio de recogida de la muestra e informes personalizados tanto para el paciente como para el urólogo, así como una futura implementación en una App para teléfonos móviles. Tras un análisis económico y considerando los parámetros del VAN, TIR, WACC y el periodo de retorno, se ha llegado a la conclusión que el proyecto presentado es viable para la empresa ya que los resultados son coherentes con lo que se considera viable en el ámbito financiero., Renal lithiasis, also commonly known as kidney stones, is a disease with a rising incidence and a very high recurrence rate, as more than 50% of patients who have suffered an episode will re-form a kidney stone within 5 years. Knowing this, the study presented aims to develop a project for the company Devicare on a new test for the analysis of kidney stones, based on a kit that will allow the stone expelled by the patient to be collected and sent to the laboratory for analysis. Thanks to the combination of stereo microscopy, scanning electron microscopy with energy dispersive X-ray microanalysis and infrared spectroscopy, a more specific diagnosis and treatment is achieved, reducing the chances of recurrence of the disease. This test includes a home service for sample collection and personalised reports for both the patient and the urologist, as well as a future implementation in a smartphone App. After an economic analysis and considering the parameters of NPV, IRR, WACC and payback period, it has been concluded that the project presented is viable for the company as the results are consistent with what is considered financially viable.

Published
2022

27. Diseño de una app de mHealth para el control de la hiperfosfatemia en enfermos renales crónicos

Abstract

Aquest projecte representa el disseny i desenvolupament dels primers passos per a la creació d'una aplicació software de mHealth per al control de la hiperfosfatèmia en malalts renals crònics. Basant-se en dades reals de l'Hospital de Bellvitge, s'ha desenvolupat el prototip d'un sistema per interactuar amb els afectats per aquesta patologia renal, enllaçant el problema a les noves tecnologies de mHealth. En aquesta memòria es descriuen totes les tecnologies utilitzades per a la realització d'el projecte, incloent-hi els llenguatges de programació utilitzats, les llibreries i les eines corresponents. S'exemplifica com les noves tecnologies basades en l'ús d'aplicacions mòbils o en entorns web poden millorar les comunicacions metge-pacient, contribuint també a controlar els nivells de lesmesures preses tradicionalment als pacients, reduint la despesa mèdica en fàrmacs i els ingressos hospitalaris a conseqüència de les complicacions d'aquesta malaltia. Utilitzant tècniques d'anàlisi de dades s'han desenvolupat una sèrie d'interfícies gràfiques de visualització que serviran com a primer pas i prova de concepte perquè, en un futur, els pacients puguin utilitzar aquestes eines juntament amb els doctors per tenir un major control sobre la seva malaltia ., Este proyecto concierne el diseño y desarrollo de los primeros pasos conducentes a la creación de una aplicación software de mHealth para el control de la hiperfosfatemia en enfermos renales crónicos. En base a datos reales del Hospital de Bellvitge, se ha desarrollado el prototipo de un sistema para interactuar con los afectados por esta patología renal, enlazando el problema a las nuevas tecnologías de mHealth. En esta memoria se describen todas las tecnologías utilizadas para la realización del proyecto, incluyendo los lenguajes de programación utilizados, las librerías y las herramientas correspondientes. Se ejemplifica cómo las nuevas tecnologías basadas en el uso de aplicaciones móviles o en entornos web pueden mejorar las comunicaciones médico-paciente, contribuyendo asimismo a controlar los niveles de las mediciones tradicionales tomadas a los pacientes, reduciendo el gasto médico en fármacos y los ingresos hospitalarios a consecuencia de las complicaciones de esta enfermedad. Utilizando técnicas de análisis de datos se han desarrollado una serie de interfaces gráficas de visualización que servirán como primer paso y prueba de concepto para que, en un futuro, los pacientes puedan utilizar estas herramientas junto con los doctores para tener un mayor control sobre su enfermedad., In this project, we have taken the first steps towards the design and development of an mHealth application for the control of hyperphosphatemia in chronic renal patients. From real clinical data from Bellvitge Hospital, we have developed the prototype of a system to interact with patients affected by this kidney pathology, linking it to mHealth technologies. In this report, we will highlight all the technologies used for the realization of the project, including the programming languages used, the libraries and corresponding tools. We thus expect to illustrate that new technologies based on the use of mobile applications or web environments can improve the doctor-patient communications and contribute to control the levels of traditional measurements taken from patients, reducing medical spending on drugs and hospital admissions as a result of the complications of this disease. Using data analytics, a series of graphical interfaces have been created that as a first step and proof of concept for the future development of a tool with which patients will be able to interact with doctors to gain greater control over their disease.

Published
2021

28. Circulating CD5L is associated with cardiovascular events and all-cause mortality in individuals with chronic kidney disease

Abstract

This study assessed the association of CD5L and soluble CD36 (sCD36) with the risk of a cardiovascular event (CVE), including CV death and all-cause mortality in CKD. We evaluated the association of CD5L and sCD36 with a predefined composite CV endpoint (unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular accident, congestive heart failure, arrhythmia, peripheral arterial disease [PAD] or amputation by PAD, aortic aneurysm, or death from CV causes) and all-cause mortality using Cox proportional hazards regression, adjusted for CV risk factors. The analysis included 1,516 participants free from pre-existing CV disease followed up for 4 years. The median age was 62 years, 38.8% were female, and 26.8% had diabetes. There were 98 (6.5%) CVEs and 72 (4.8%) deaths, of which 26 (36.1%) were of CV origin. Higher baseline CD5L concentration was associated with increased risk of CVE (HR, 95% CI, 1.17, 1.0–1.36), and all-cause mortality (1.22, 1.01–1.48) after adjusting for age, sex, diabetes, systolic blood pressure, dyslipidemia, waist circumference, smoking, and CKD stage. sCD36 showed no association with adverse CV outcomes or mortality. Our study showed for the first time that higher concentrations of CD5L are associated with future CVE and all-cause mortality in individuals with CKD, Peer Reviewed, Postprint (published version)

Published
2021

29. Nonlinear T-wave time warping-based sensing model for non-invasive personalised blood potassium monitoring in hemodialysis patients: a pilot study

Abstract

Background: End-stage renal disease patients undergoing hemodialysis (ESRD-HD) therapy are highly susceptible to malignant ventricular arrhythmias caused by undetected potassium concentration ([K+]) variations (¿[K+]) out of normal ranges. Therefore, a reliable method for continuous, noninvasive monitoring of [K+] is crucial. The morphology of the T-wave in the electrocardiogram (ECG) reflects ¿[K+] and two time-warping-based T-wave morphological parameters, dw and its heart-rate corrected version dw,c, have been shown to reliably track ¿[K+] from the ECG. The aim of this study is to derive polynomial models relating dw and dw,c with ¿[K+], and to test their ability to reliably sense and quantify ¿[K+] values. Methods: 48-hour Holter ECGs and [K+] values from six blood samples were collected from 29 ESRD-HD patients. For every patient, dw and dw,c were computed, and linear, quadratic, and cubic fitting models were derived from them. Then, Spearman’s (¿) and Pearson’s (r) correlation coefficients, and the estimation error (ed) between ¿[K+] and the corresponding model-estimated values (¿^[K+]) were calculated. Results and Discussions: Nonlinear models were the most suitable for ¿[K+] estimation, rendering higher Pearson’s correlation (median 0.77 =r= 0.92) and smaller estimation error (median 0.20 =ed= 0.43) than the linear model (median 0.76 =r= 0.86 and 0.30 =ed= 0.40), even if similar Spearman’s ¿ were found across models (median 0.77 =¿= 0.83). Conclusion: Results support the use of nonlinear T-wave-based models as ¿[K+] sensors in ESRD-HD patients., Peer Reviewed, Postprint (published version)

Published
2021

30. Fresh Air with Terry Gross, Monday, May 17, 2021: Interview with Carol Leonnig; Review of 'Notes of Grief.'

Abstract

Since its national debut in 1987, Fresh Air with Terry Gross has been a highly acclaimed and much adored weekday magazine among public radio listeners. Each week, nearly 4.8 million people turn to Peabody Award-winning host Terry Gross for insightful conversations with the leading voices in contemporary arts and issues. The renowned program reaches a global audience, with over 620 public radio stations broadcasting Fresh Air, and 3 million podcast downloads each week. Fresh Air has broken the mold of 'talk show' by weaving together superior journalism and intimate storytelling from modern-day intellectuals, politicians and artists alike. Through probing questions and careful research, Gross's interviews are lauded for revealing a fresh perspective on cultural icons and trends. Her thorough conversations are often complemented by commentary from well-known contributors. Fresh Air is produced at WHYY-FM in Philadelphia and broadcast nationally by NPR., (1.) CAROL LEONNIG is an investigative reporter for the Washington Post. She talks about her new book 'Zero Fail: The Rise and Fall of the Secret Service.' The book is based on years of reporting. LEONNIG finds that as an organization, the Secret Service is something of a mess. It's understaffed and underfunded, working with outdated technology and inadequate training, and burdened by a culture in which promotions are based on personal loyalty to competing bosses, and among its agents and supervisors, heavy drinking, frat boy behavior, and sexual harassment have been tolerated. (2.) MAUREEN CORRIGAN reviews Chimamanda Ngozi Adichie's essay-length book called Notes on Grief. It's an exploration of her grief after her father's sudden death.

Published
2021

31. Diseño de una app de mHealth para el control de la hiperfosfatemia en enfermos renales crónicos

Author

Martinez-Illescas Ruiz, Guillem, Universitat Politècnica de Catalunya. Departament de Llenguatges i Sistemes Informàtics, and Vellido Alcacena, Alfredo

Subjects
Informàtica::Aplicacions de la informàtica [Àrees temàtiques de la UPC], Kidneys--Diseases, Ciències de la salut::Medicina [Àrees temàtiques de la UPC], Ronyons--Malalties, Web applications, Entorno de control pacientes con hiperfosfatemia, Aplicacions web
Abstract

Aquest projecte representa el disseny i desenvolupament dels primers passos per a la creació d'una aplicació software de mHealth per al control de la hiperfosfatèmia en malalts renals crònics. Basant-se en dades reals de l'Hospital de Bellvitge, s'ha desenvolupat el prototip d'un sistema per interactuar amb els afectats per aquesta patologia renal, enllaçant el problema a les noves tecnologies de mHealth. En aquesta memòria es descriuen totes les tecnologies utilitzades per a la realització d'el projecte, incloent-hi els llenguatges de programació utilitzats, les llibreries i les eines corresponents. S'exemplifica com les noves tecnologies basades en l'ús d'aplicacions mòbils o en entorns web poden millorar les comunicacions metge-pacient, contribuint també a controlar els nivells de lesmesures preses tradicionalment als pacients, reduint la despesa mèdica en fàrmacs i els ingressos hospitalaris a conseqüència de les complicacions d'aquesta malaltia. Utilitzant tècniques d'anàlisi de dades s'han desenvolupat una sèrie d'interfícies gràfiques de visualització que serviran com a primer pas i prova de concepte perquè, en un futur, els pacients puguin utilitzar aquestes eines juntament amb els doctors per tenir un major control sobre la seva malaltia . Este proyecto concierne el diseño y desarrollo de los primeros pasos conducentes a la creación de una aplicación software de mHealth para el control de la hiperfosfatemia en enfermos renales crónicos. En base a datos reales del Hospital de Bellvitge, se ha desarrollado el prototipo de un sistema para interactuar con los afectados por esta patología renal, enlazando el problema a las nuevas tecnologías de mHealth. En esta memoria se describen todas las tecnologías utilizadas para la realización del proyecto, incluyendo los lenguajes de programación utilizados, las librerías y las herramientas correspondientes. Se ejemplifica cómo las nuevas tecnologías basadas en el uso de aplicaciones móviles o en entornos web pueden mejorar las comunicaciones médico-paciente, contribuyendo asimismo a controlar los niveles de las mediciones tradicionales tomadas a los pacientes, reduciendo el gasto médico en fármacos y los ingresos hospitalarios a consecuencia de las complicaciones de esta enfermedad. Utilizando técnicas de análisis de datos se han desarrollado una serie de interfaces gráficas de visualización que servirán como primer paso y prueba de concepto para que, en un futuro, los pacientes puedan utilizar estas herramientas junto con los doctores para tener un mayor control sobre su enfermedad. In this project, we have taken the first steps towards the design and development of an mHealth application for the control of hyperphosphatemia in chronic renal patients. From real clinical data from Bellvitge Hospital, we have developed the prototype of a system to interact with patients affected by this kidney pathology, linking it to mHealth technologies. In this report, we will highlight all the technologies used for the realization of the project, including the programming languages used, the libraries and corresponding tools. We thus expect to illustrate that new technologies based on the use of mobile applications or web environments can improve the doctor-patient communications and contribute to control the levels of traditional measurements taken from patients, reducing medical spending on drugs and hospital admissions as a result of the complications of this disease. Using data analytics, a series of graphical interfaces have been created that as a first step and proof of concept for the future development of a tool with which patients will be able to interact with doctors to gain greater control over their disease.

Published
2021

33. Restless legs syndrome in end stage renal disease patients undergoing hemodialysis

Author

Xiao Wei Lin, Ling Yan Ni, Jun Fang Zhang, Sheng-Han Kuo, William G. Ondo, Qing Yu, Hong Lei Yu, Meng Yao Qiu, and Yun Cheng Wu

Subjects
Male, medicine.medical_treatment, Anxiety, Hospital Anxiety and Depression Scale, urologic and male genital diseases, lcsh:RC346-429, Pittsburgh Sleep Quality Index, 0302 clinical medicine, Risk Factors, Prevalence, 030212 general & internal medicine, Restless legs syndrome, Sleep disorder, education.field_of_study, Depression, General Medicine, Middle Aged, Female, Hemodialysis, Alcohol, Research Article, Adult, Sleep Wake Disorders, China, medicine.medical_specialty, Hemodialysis--Patients, Population, End stage renal disease, 03 medical and health sciences, Kidneys--Diseases, Renal Dialysis, RLS, Restless Legs Syndrome, Internal medicine, mental disorders, medicine, Humans, Alcohol intake, ESRD, education, Dialysis, lcsh:Neurology. Diseases of the nervous system, Aged, business.industry, medicine.disease, Quality of Life, Kidney Failure, Chronic, Neurology (clinical), Sleep, business, 030217 neurology & neurosurgery
Abstract

Background The prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population. However, the associations of RLS within the ESRD population are inconsistent and RLS is usually neglected in dialysis centers, although it impairs the life quality among ESRD patients. We aim to investigate the prevalence of RLS in patients with ESRD undergoing maintenance hemodialysis and evaluate the risk factors of developing RLS and the effect of RLS on quality of life among ESRD patients. Methods ESRD patients undergoing maintenance hemodialysis in Shanghai General Hospital dialysis unit from July 2016 to October 2016 were enrolled in the study. RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). IRLSSG Severity Scale was used to evaluate the severity of RLS. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and Hospital Anxiety and Depression Scale (HADS) was used to estimate anxiety and depression. Serologic and historic variables were analyzed to determine predictors of RLS in the ESRD population. Results A total of 137 ESRD patients were enrolled. The prevalence of RLS among the ESRD patients was 20.44%. The risk of RLS was increased significantly in females (OR = 2.729, p = 0.032) and daily alcohol drinkers (OR = 4.716, p = 0.022). RLS increased the risks of sleep disorders (25/28, 89.3% vs 73/109, 67.0%, p = 0.02) and sedative hypnotics intake (7/28, 25.0% vs 10/109, 9.2%, p = 0.047) and impaired the sleep quality (7/109 vs 11/28, p = 0.001) according to PSQI sum scores. Conclusion A high RLS prevalence among the ESRD patients undergoing hemodialysis was confirmed. ESRD patients who are women and drinking alcohol have a higher risk of RLS. The sleep quality was significantly impaired and sleeping medication use was more common among the ESRD patients with RLS.

Published
2019

34. Circulating CD5L is associated with cardiovascular events and all-cause mortality in individuals with chronic kidney disease

Author

Angels Betriu, Maria Rosa Sarrias, Marcelino Bermudez-Lopez, José Maria Valdivielso, Elvira Fernández, Josep Franch-Nadal, Berta Soldevila, Per-Henrik Groop, Didac Mauricio, Maria Barranco-Altirriba, Núria Alonso, Esmeralda Castelblanco, Universitat Politècnica de Catalunya. Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, HUS Abdominal Center, Research Programs Unit, Department of Medicine, Per Henrik Groop / Principal Investigator, Clinicum, Nefrologian yksikkö, and CAMM - Research Program for Clinical and Molecular Metabolism

Subjects
Male, Aging, Cardiovascular system--Diseases, Informàtica::Automàtica i control [Àrees temàtiques de la UPC], PROGRESSION, 030204 cardiovascular system & hematology, GLOMERULAR-FILTRATION-RATE, 0302 clinical medicine, Risk Factors, Sistema cardiovascular--Malalties, Cause of Death, Chronic kidney disease, AIM, Myocardial infarction, MACROPHAGES, RISK, Receptors, Scavenger, 0303 health sciences, APOPTOSIS INHIBITOR, Biochemical markers, Middle Aged, 3. Good health, Cardiovascular Diseases, Marcadors bioquímics, Cardiology, Female, SOLUBLE CD36, Research Paper, medicine.medical_specialty, Ciències de la salut::Medicina [Àrees temàtiques de la UPC], Renal function, PLASMA SCD36, CD5L, Cardiovascular events, 03 medical and health sciences, cardiovascular events, Kidneys--Diseases, Internal medicine, Diabetes mellitus, medicine, Mortalitat, Humans, Renal Insufficiency, Chronic, Mortality, 030304 developmental biology, Aged, business.industry, Unstable angina, Cell Biology, medicine.disease, sCD36, mortality, Blood pressure, ATHEROSCLEROSIS, Gene Expression Regulation, Heart failure, 3121 General medicine, internal medicine and other clinical medicine, Ronyons--Malalties, 1182 Biochemistry, cell and molecular biology, business, Apoptosis Regulatory Proteins, Dyslipidemia, chronic kidney disease, Biomarkers, Kidney disease
Abstract

This study assessed the association of CD5L and soluble CD36 (sCD36) with the risk of a cardiovascular event (CVE), including CV death and all-cause mortality in CKD. We evaluated the association of CD5L and sCD36 with a predefined composite CV endpoint (unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular accident, congestive heart failure, arrhythmia, peripheral arterial disease [PAD] or amputation by PAD, aortic aneurysm, or death from CV causes) and all-cause mortality using Cox proportional hazards regression, adjusted for CV risk factors. The analysis included 1,516 participants free from pre-existing CV disease followed up for 4 years. The median age was 62 years, 38.8% were female, and 26.8% had diabetes. There were 98 (6.5%) CVEs and 72 (4.8%) deaths, of which 26 (36.1%) were of CV origin. Higher baseline CD5L concentration was associated with increased risk of CVE (HR, 95% CI, 1.17, 1.0-1.36), and all-cause mortality (1.22, 1.01-1.48) after adjusting for age, sex, diabetes, systolic blood pressure, dyslipidemia, waist circumference, smoking, and CKD stage. sCD36 showed no association with adverse CV outcomes or mortality. Our study showed for the first time that higher concentrations of CD5L are associated with future CVE and all-cause mortality in individuals with CKD. This research was supported by grants from the European Foundation for the Study of Diabetes (2014-EFSD-00914) Düsseldorf, Germany; the European Regional Development Fund; and the Carlos III National Institute of Health (PI14/1772) Madrid, Spain. CIBER for Diabetes and Associated Metabolic Diseases (CIBERDEM) and CIBER on Liver and Digestive Diseases (CIBEREHD) are an initiative of ISCIII, Madrid, Spain. The NEFRONA study is funded by a research grant from AbbVie, Lake County, Illinois.

Published
2021

37. Estudi de viabilitat tècnica i econòmica per una solució IoT per a malalts renals

Abstract

Cada vegada és més elevat el percentatge de població que contreu una malaltia d’insuficiència renal, moment a partir del qual els ronyons deixen de realitzar correctament les seves funcions i és necessari accedir a un trasplantament de ronyó o bé iniciar una teràpia renal substitutiva (TSR) per remeiar la pèrdua de funció renal. L’elecció de la TSR a la qual es sotmetrà el pacient, després d’una adequada i completa informació sobre els avantatges i inconvenients de les diferents modalitats existents, és completament lliure, a no ser que existeixi una contraindicació per alguna d’elles. Actualment, segons les dades d’IDESCAT de l’any 2016, dels 10.523 casos d’insuficiència renal a Catalunya, un 40,7% dels pacients escull la TSR de l’hemodiàlisi (HD) mentre que un 4% es decanta per la modalitat de la diàlisi peritoneal (DP). El document es centra en la teràpia renal de la DP, realitzada des del domicili del pacient, amb l’objectiu de promoure aquesta modalitat de tractament posant solució al punt feble que presenta: la falta de control i seguiment del malalt renal. Es proposa la incorporació de tecnologia IoT (Internet of Things) per establir un pont d’informació entre el domicili del pacient i l’hospital, permetent una monitorització a temps real. Les xifres de nous casos de malalts renals a Catalunya que inicien un TSR han augmentat un 29,2% en els últims 10 anys i el tractament de DP poc a poc augmenta la seva popularitat, passant de 197 usuaris l’any 2001 a 426 usuaris l’any 2016. La tendència a iniciar un TSR a edat avançada augmenta, de manera que la població contreu insuficiència renal a una major edat (actualment, un 69,4% dels malalts són majors de 60 anys), sent aquest sector de la població el que contempla amb més inseguretat la proposta de la DP. La solució que es planteja consisteix en monitoritzar els paràmetres necessaris per dur a terme un control adequat de l’estat del pacient -la temperatura corporal, la pressió sanguínia, el pes abans i després de l

Published
2018

38. Estudi de viabilitat tècnica i econòmica per una solució IoT per a malalts renals

Author

Ruiz Agut, Berta, Universitat Politècnica de Catalunya. Departament d'Enginyeria de Projectes i de la Construcció, and Cusidó Roura, Jordi

Subjects
Aplicacions mòbils, Internet of things, Kidneys--Diseases, Programari lliure, Internet de les coses, Ronyons -- Malalties, Mobile apps, Enginyeria de la telecomunicació::Radiocomunicació i exploració electromagnètica::Comunicacions mòbils [Àrees temàtiques de la UPC], Open source software, Enginyeria de la telecomunicació::Telemàtica i xarxes d'ordinadors::Internet [Àrees temàtiques de la UPC]
Abstract

Cada vegada és més elevat el percentatge de població que contreu una malaltia d’insuficiència renal, moment a partir del qual els ronyons deixen de realitzar correctament les seves funcions i és necessari accedir a un trasplantament de ronyó o bé iniciar una teràpia renal substitutiva (TSR) per remeiar la pèrdua de funció renal. L’elecció de la TSR a la qual es sotmetrà el pacient, després d’una adequada i completa informació sobre els avantatges i inconvenients de les diferents modalitats existents, és completament lliure, a no ser que existeixi una contraindicació per alguna d’elles. Actualment, segons les dades d’IDESCAT de l’any 2016, dels 10.523 casos d’insuficiència renal a Catalunya, un 40,7% dels pacients escull la TSR de l’hemodiàlisi (HD) mentre que un 4% es decanta per la modalitat de la diàlisi peritoneal (DP). El document es centra en la teràpia renal de la DP, realitzada des del domicili del pacient, amb l’objectiu de promoure aquesta modalitat de tractament posant solució al punt feble que presenta: la falta de control i seguiment del malalt renal. Es proposa la incorporació de tecnologia IoT (Internet of Things) per establir un pont d’informació entre el domicili del pacient i l’hospital, permetent una monitorització a temps real. Les xifres de nous casos de malalts renals a Catalunya que inicien un TSR han augmentat un 29,2% en els últims 10 anys i el tractament de DP poc a poc augmenta la seva popularitat, passant de 197 usuaris l’any 2001 a 426 usuaris l’any 2016. La tendència a iniciar un TSR a edat avançada augmenta, de manera que la població contreu insuficiència renal a una major edat (actualment, un 69,4% dels malalts són majors de 60 anys), sent aquest sector de la població el que contempla amb més inseguretat la proposta de la DP. La solució que es planteja consisteix en monitoritzar els paràmetres necessaris per dur a terme un control adequat de l’estat del pacient -la temperatura corporal, la pressió sanguínia, el pes abans i després de la sessió de tractament i el color de la solució de diàlisi- a partir de diferents sensors. L’ecosistema Fiware permetrà la comunicació entre els dispositius físics i la resta de components de Fiware, gestionarà i emmagatzemarà les dades registrades, brindarà mecanismes de seguretat i permetrà un anàlisi de les dades a temps real. Finalment, amb el suport d’una aplicació mòbil i d’una aplicació web –que poden ser fàcilment creades a partir de les interfícies de programació disponibles a la plataforma Fiware-, es permet la consulta dels paràmetres monitoritzats als pacients i metges. El cost de les TSR suposa un percentatge molt elevat del cost total del Servei de la Salut, el qual estaria interessat en la transició cap a la DP. S’ha estimat una reducció de costos de 31M per l’any 2016 si es produís una transició de la situació actual (4.279 casos d’HD i 426 de DP) a l’escenari on tots els potencials usuaris de DP duguessin a terme aquesta variant de tractament (4.418 casos de DP i 287 d’HD). Així doncs, el marge de benefici de la proposta d’incorporar IoT és ampli, arribant a una rendibilitat màxima de 13,5M.

Published
2018

39. Nefritis Lúpica: A propósito de un caso clínico

Author

Collado Montoliu, Paula, Fernández Donaire, Lidia, and Escoles Universitàries Gimbernat

Subjects
Kidneys--Diseases, Systemic lupus erythematosus, Lupus eritematós sistèmic, Ronyons--Malalties
Abstract

INTRODUCCIÓN: El Lupus Eritematoso Sistémico (LES) es una enfermedad crónica autoinmune y multifactorial caracterizada por la producción de autoanticuerpos, que van en contra del tejido sano provocando una inflamación de estos y su disfunción. La nefritis lúpica, en concreto, es una enfermedad de causa desconocida, consecuencia del LES, que se ha relacionado a causa factores genéticos, ambientales y hormonales. Afecta a la calidad de vida debido a las repercusiones fisiopatologicas por lo que el papel de enfermería debería de ser fundamental para estos pacientes. OBJETIVOS: Dar a conocer las necesidades que presenta una persona con LES a través de un plan de cuidados especifico e individualizado desde una perspectiva enfermera. METODOLOGÍA: Se ha desarrollado la metodología del caso clínico, mediante el Proceso Enfermero para obtener una visión integral de las necesidades de los pacientes con LES. Para la formulación y gestión de los problemas detectados se ha utilizado la taxonomía de NANDA-I. CONCLUSIONES: El escaso conocimiento acerca del LES y su tratamiento y cuidados por parte de enfermería genera importantes carencias de información por parte de los pacientes que la padecen; además, de miedo para sobrellevar una enfermedad que requiere cuidados para toda la vida. Una aproximación, el caso expuesto contribuye a dar recursos a las enfermeras para que el paciente pueda lograr una mejor calidad de vida y tener un empoderamiento de su propia salud. PALABRAS CLAVE: Lupus Eritematoso Sistémico, Nefritis Lúpica, Inmunosupresores, educación sanitaria, Diagnósticos NANDA-I, plan de cuidados enfermero, caso clínico. INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune and multifactorial disease characterized by the production of autoantibodies, which go against healthy tissue causing inflammation of these and their dysfunction. Lupus nephritis, in particular, is a disease of unknown cause, a consequence of SLE, which has been linked to genetic, environmental and hormonal factors. It affects the quality of life due to the pathophysiological repercussions, so the role of nursing should be fundamental for these patients. OBJECTIVES: To make known the needs of a person with SLE through a specific and individualized care plan from a nursing perspective. METHODOLOGY: The clinical case methodology has been developed, through the Nursing Care Process (PAE), to obtain a comprehensive vision of the needs of patients with SLE. For the formulation and management of the problems detected, the NANDA-I taxonomy has been used. CONCLUSIONS: The limited knowledge about SLE and its treatment and care by nursing, generates significant gaps in information on the part of patients who suffer from it; In addition, fear to cope with a disease that requires lifelong care. An approach, the case that is presented contributes to give resources to the nurses so that the patient can achieve a better quality of life and have an empowerment of their own health. KEY WORDS: Systemic Lupus Erythematosus, Lupus Nephritis, Immunosuppressants, health education, NANDA-I diagnoses, nursing care plan, clinical case. Grau en Infermeria

Published
2018

41. Prevalencia de acidosis renal distal en pacientes con litiasis de fosfato cálcico usando el test de la furosemida

Abstract

Introducción: Adultos con acidosis renal distal (ATRD) comunmente presentan litiasis urinarina y pH urinario alcalino (>6). Las litiasis de fosfato cálcico son las litiasis más comúnmente relacionadas con ATRD. El objetivo principal de este estudio es determinar la prevalencia de ATRD en pacientes con litiasis de fosfato cálcico y pH urinario alcalino usando el test de la furosemida. Materiales y métodos: Hemos seleccionado 40 pacientes, 17 hombres y 23 mujeres, entre 18 y 65 años con litiasis de fosfato cálcico y pH urinario alcalino tratadas en nuestro servicio. La edad, sexo, localización de la litiasis (bilateral o unilateral) y efectos adversos derivados del test de la furosemida fueron recogidos. Analizamos sexo y localización de litiasis mediate el test de chi-cuadrado, la edad fue analizada mediante el test de T de Student. Se consideró significación estadística p<0’05. Resultados: 15 pacientes (37’5%) fueron diagnosticados de ATRD con el test de la furosemida. La media de edad del grupo con ATRD fue 40’73, la edad del otro grupo fue 51’12 años (P<0’001). Todos los pacientes en el grupo de ATRD (15) presentaron litiasis bilateral (p<0’001). El grupo de ATRD fueron 10 mujeres y 5 hombres, no hubo diferencias con el grupo negativo para ATRD (p<0’342). Conclusión: Concluimos que la prevalencia de ATRD en nuestra muestra es de 37’5% usando el test de la furosemida y el test de la furosemida es seguro. Nuestros datos sugieren que las litiasis bilaterales y la edad joven pueden ser indicadores de DRTA., Introduction: Adults with distal renal acidosis (DRTA) commonly present urolithiasis and alkaline pH (>6). Calcium phosphate is the most common urolithiasis related with DRTA. The main objective of our study is to determine DRTA prevalence in patients with calcium phosphate lithiasis and alkaline pH (>6) using the furosemide test. Materials: We selected 40 patients, 17 men and 23 women, between 18 and 65 years old with calcium phosphate lithiasis and alkaline urine pH (>6) treated in our department. Age, sex, urolithiasis localization (unilateral or bilateral) and side effects by furosemide test were collected. We analysed sex and urolithiasis location with chi-squared test, age was analysed with T-test. We considered stadistical significance p<0’05. We performed the furosemide test for the DRTA diagnosis. It consists in the adminístration of 40 mg of furosemide orally. We performed a urine pH test before the furosemide administration to verify a urine pH higher than 6. In the following 3 hours after the furosemide administration we performed a urine pH test to each micturition. We considered a urine pH higher than 6 in all the urine tests diagnostic of DRTA. Results: 15 patients (37’5 %) were positive for DRTA with furosemide test (Figure 1). The mean age in DRTA group was 40,73 years, in the other group was 51,12 years, statistical significance was found (p<0’001) (Figure 2). All the patients (15) in the DRTA group presented with bilateral urolithiasis (p<0’001) (Figure 3). There were 10 women and 5 men in the DRTA group, no statistical significance was found (p<0’342). No side effects were reported with furosemide test. Conclusion: We conclude that the DRTA prevalence in our sample is 37’5% using furosemide test and the furosemide test is save. Our data suggest that bilateral urolithiasis and young age could be considered risk factors for DRTA.

Published
2017
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42. Prevalence of distal renal tubular acidosis in patients with calcium phosphate urolithiasis using furosemide test

Author

Guimerà, Jordi, Pieras, Enrique, Grases, Fèlix, Sabate, Arnau, Tubau, Valentí, and Pizá, Pedro

Subjects
Kidneys--Diseases, Health Sciences
Abstract

Introducción: Adultos con acidosis renal distal (ATRD) comunmente presentan litiasis urinarina y pH urinario alcalino (>6). Las litiasis de fosfato cálcico son las litiasis más comúnmente relacionadas con ATRD. El objetivo principal de este estudio es determinar la prevalencia de ATRD en pacientes con litiasis de fosfato cálcico y pH urinario alcalino usando el test de la furosemida. Materiales y métodos: Hemos seleccionado 40 pacientes, 17 hombres y 23 mujeres, entre 18 y 65 años con litiasis de fosfato cálcico y pH urinario alcalino tratadas en nuestro servicio. La edad, sexo, localización de la litiasis (bilateral o unilateral) y efectos adversos derivados del test de la furosemida fueron recogidos. Analizamos sexo y localización de litiasis mediate el test de chi-cuadrado, la edad fue analizada mediante el test de T de Student. Se consideró significación estadística p, Introduction: Adults with distal renal acidosis (DRTA) commonly present urolithiasis and alkaline pH (>6). Calcium phosphate is the most common urolithiasis related with DRTA. The main objective of our study is to determine DRTA prevalence in patients with calcium phosphate lithiasis and alkaline pH (>6) using the furosemide test. Materials: We selected 40 patients, 17 men and 23 women, between 18 and 65 years old with calcium phosphate lithiasis and alkaline urine pH (>6) treated in our department. Age, sex, urolithiasis localization (unilateral or bilateral) and side effects by furosemide test were collected. We analysed sex and urolithiasis location with chi-squared test, age was analysed with T-test. We considered stadistical significance p

Published
2017

43. Prevalencia de acidosis renal distal en pacientes con litiasis de fosfato cálcico usando el test de la furosemida

Author

Guimerà, Jordi, Pieras, Enrique, Grases, Fèlix, Sabate, Arnau, Tubau, Valentí, and Pizá, Pedro

Subjects
Kidneys--Diseases, Health Sciences
Abstract

Introducción: Adultos con acidosis renal distal (ATRD) comunmente presentan litiasis urinarina y pH urinario alcalino (>6). Las litiasis de fosfato cálcico son las litiasis más comúnmente relacionadas con ATRD. El objetivo principal de este estudio es determinar la prevalencia de ATRD en pacientes con litiasis de fosfato cálcico y pH urinario alcalino usando el test de la furosemida. Materiales y métodos: Hemos seleccionado 40 pacientes, 17 hombres y 23 mujeres, entre 18 y 65 años con litiasis de fosfato cálcico y pH urinario alcalino tratadas en nuestro servicio. La edad, sexo, localización de la litiasis (bilateral o unilateral) y efectos adversos derivados del test de la furosemida fueron recogidos. Analizamos sexo y localización de litiasis mediate el test de chi-cuadrado, la edad fue analizada mediante el test de T de Student. Se consideró significación estadística p6). Calcium phosphate is the most common urolithiasis related with DRTA. The main objective of our study is to determine DRTA prevalence in patients with calcium phosphate lithiasis and alkaline pH (>6) using the furosemide test. Materials: We selected 40 patients, 17 men and 23 women, between 18 and 65 years old with calcium phosphate lithiasis and alkaline urine pH (>6) treated in our department. Age, sex, urolithiasis localization (unilateral or bilateral) and side effects by furosemide test were collected. We analysed sex and urolithiasis location with chi-squared test, age was analysed with T-test. We considered stadistical significance p

Published
2017

44. Short telomere length is associated with renal impairment in Japanese subjects with cardiovascular risk

Author

Kazuomi Kario, Kazuo Eguchi, Satoshi Hoshide, Lawrence S. Honig, and Joseph H. Lee

Subjects
Male, lcsh:Medicine, Blood Pressure, Urine, 030204 cardiovascular system & hematology, Kidney, Biochemistry, Vascular Medicine, Stiffness, White Blood Cells, chemistry.chemical_compound, Endocrinology, 0302 clinical medicine, Japan, Animal Cells, Risk Factors, Medicine and Health Sciences, Medicine, lcsh:Science, Pulse wave velocity, Telomere Length, Multidisciplinary, Chromosome Biology, Middle Aged, Telomere, Telomeres, Cardiovascular Diseases, Creatinine, Hypertension, Physical Sciences, Cohort, Cardiology, Female, Cellular Types, Anatomy, Research Article, Chromosome Structure and Function, medicine.medical_specialty, Endocrine Disorders, Immune Cells, Immunology, Materials Science, Material Properties, Renal function, Pulse Wave Analysis, Chromosomes, 03 medical and health sciences, Vascular Stiffness, Kidneys--Diseases, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Mechanical Properties, Humans, Risk factor, Aged, Japanese--Health and hygiene, Blood Cells, business.industry, lcsh:R, Biology and Life Sciences, Cell Biology, Renal System, medicine.disease, chemistry, Metabolic Disorders, Arterial stiffness, lcsh:Q, business, Biomarkers, 030217 neurology & neurosurgery
Abstract

Introduction Short telomere length has been suggested to be associated with atherosclerotic changes in Western populations. We examined the relationships between leukocyte telomere length and cardiovascular and renal function in a Japanese cohort. Participants and methods We enrolled 770 subjects who each had at least one cardiovascular risk factor. The mean age was 59.5 ± 12.2 years; mean BMI was 25.1 ± 4.6 kg/m2. We measured leukocyte telomere length (LTL) by quantitative PCR (T/S ratio), and measured other biomarkers from blood and urine samples. In addition, we assessed surrogate markers of arterial stiffness, cardiovascular organ damage and kidney function, including flow-mediated vasodilation (FMD), pulse wave velocity (PWV), carotid artery augmentation index (CAAI), and urinary albumin creatinine ratio (UACR) and eGFR. Results Leukocyte telomere length (T/S ratio) was inversely associated with age (r = -0.194, P

Published
2017
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45. The Role of MAPK in Drug-Induced Kidney Injury

Author

Hilary Cassidy, Tara McMorrow, Craig Slattery, Séin O'Connell, Michael P. Ryan, Robert J. Radford, and Jennifer Slyne

Subjects
MAPK/ERK pathway, Kidney Disease, p38 mitogen-activated protein kinases, Cell, Review Article, Bioinformatics, Biochemistry, 03 medical and health sciences, Cellular and Molecular Neuroscience, Kidneys--Diseases, 0302 clinical medicine, Drug-Induced Kidney Injury, medicine, Mitogen-activated protein kinases, 030304 developmental biology, 0303 health sciences, Kidney, Kinase, business.industry, Cell Biology, medicine.disease, MapK, Drugs--Side effects, Cell biology, Cytosol, medicine.anatomical_structure, 030220 oncology & carcinogenesis, business, Kidney disease
Abstract

This paper focuses on the role that mitogen-activated protein kinases (MAPKs) play in drug-induced kidney injury. The MAPKs, of which there are four major classes (ERK, p38, JNK, and ERK5/BMK), are signalling cascades which have been found to be broadly conserved across a wide variety of organisms. MAPKs allow effective transmission of information from the cell surface to the cytosolic or nuclear compartments. Cross talk between the MAPKs themselves and with other signalling pathways allows the cell to modulate responses to a wide variety of external stimuli. The MAPKs have been shown to play key roles in both mediating and ameliorating cellular responses to stress including xenobiotic-induced toxicity. Therefore, this paper will discuss the specific role of the MAPKs in the kidney in response to injury by a variety of xenobiotics and the potential for therapeutic intervention at the level of MAPK signalling across different types of kidney disease. European Research Council

Published
2012
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46. Valoración y tratamiento en fisioterapia de la lumbalgia causada por una ptosis renal

Author

Díaz Villegas, Ricardo, Gatell Acheson, Oenone, Gómez Giménez, Pablo, Tutusaus Homs, Ricard, and Escoles Universitàries Gimbernat

Subjects
Fàscies (Anatomia), Kidneys--Diseases, Ronyons--Malalties, Fasciae (Anatomy), Backage, Lumbàlgia
Abstract

Las lumbalgias se encuentran entre las patologías más habituales que afectan a la población a nivel mundial, por este motivo, el impacto que tienen a nivel de gasto sanitario, económico y calidad de vida son muy elevados. Desafortunadamente en la mayoría de los casos se desconoce el origen de dicha patología y es etiquetada como dolor lumbar inespecífico. La experiencia clínica muestra una relación entre una afectación del sistema fascial renal y las lumbalgias de origen inespecífico. La ptosis renal o nefroptosis es una alteración de la posición del riñón que repercute, entre otras estructuras, sobre su sistema fascial relacionado con la zona lumbar. Debido a esta estrecha relación entre la zona lumbar y el sistema fascial-renal, con el apoyo de la experiencia clínica y la literatura científica disponible, se identifica la nefroptosis como causa de dolor lumbar. En este estudio se presenta la nefroptosis de manera amplia, con los métodos de diagnóstico y tratamiento disponibles en la literatura científica actual. Bajo la idea del abordaje de la nefroptosis para la resolución del dolor a nivel lumbar se propone un plan de actuación clínica elaborado a partir de la valoración y tratamiento en fisioterapia, basado en técnicas viscerales y miofasciales. Finalmente se discute esta propuesta de actuación como una opción acertada para las características de este grupo de pacientes, pero es necesario remarcar, como conclusión, que es necesaria la realización de estudios de calidad que demuestren la eficacia de la aplicación del plan de actuación. PALABRAS CLAVE : Nefroptosis, fascia renal, lumbalgias, riñón, dolor lumbar inespecífico Low back pain are among the most common diseases affecting the population worldwide, for this reason, the impact in terms of health, economic and quality of life cost are very high. Unfortunately, in most cases the origin of this disease is unknown and is labeled as unspecific low back pain. Clinical experience shows a relationship between an impairment of the renal fascial system and nonspecific low back pain. Renal ptosis or nephroptosis is an impairment of the kidney position affecting, among other structures, their fascial system related with the low back region. Because of this close relationship between the lower back and the fascial-renal system, supported by clinical experience and available scientific literature, nephroptosis is identified as a cause of low back pain. In this study, nephroptosis is broadly presented, including diagnostic methods and treatments available in the current scientific literature. Under the idea of nephroptosis treatment in order to eliminate lumbar pain, a clinical action plan is proposed, developed from physiotherapy assessment and treatment, and based on visceral and myofascial techniques. Finally, this proposed action is discussed as a successful option for the characteristics of this group of patients, but it is necessary to emphasize, in conclusion, that quality studies that demonstrate the effectiveness of the implementation of the action plan are necessary. KEYWORDS : Nephroptosis, renal fascia, low back pain, kidney, non-specific low back pain. Grau en Fisioteràpia

Published
2015

47. Vascular calcification and mineral bone disorder in chronic kidney disease

Author

Kinsella, Sinéad and Eustace, Joe

Subjects
Kidneys--Diseases, Mineral bone disorder, Chronic kidney disease, Hyperparathyroidism, Renal transplantation, Kidneys--Transplantation, Vascular calcification
Abstract

Chronic Kidney Disease (CKD), osteoporosis and mild hyponatremia are all prevalent chronic conditions that may coexist and are often under-recognized. Mineral-Bone Disorder begins early in the natural history of CKD and results in complex abnormalities of bone which ultimately confers a well-established increased risk of fragility fractures in End Stage Kidney Disease. Hyponatremia is a novel, usually renal mediated metabolic perturbation, that most commonly occurs independently of the stage of renal dysfunction but which may also predispose to increased fracture risk. The extent -if any- to which either early stages of renal dysfunction or the presence of hyponatremia contribute to fracture occurrence in the general population, independently of osteoporosis, is unclear. Renal transplantation is the treatment of choice for ESKD and although it restores endogenous renal function it typically fails to normalize either the long term cardiovascular or fracture risk. One potential mechanism contributing to these elevated long-term risks and to diminished Health Related Quality of Life is persistent, post-transplant hyperparathyroidism. In this study we retrospectively examine the association of renal function and serum sodium with Bone Mineral Density and fracture occurrence in a retrospective cohort of 1930 female members of the general population who underwent routine DXA scan. We then prospectively recruited a cohort of 90 renal transplant recipients in order to examine the association of post transplant parathyroid hormone (PTH) level with measures of CKD Mineral Bone Disorder, including, DXA Bone Mineral Density, Vascular Calcification (assessed using both abdominal radiography and CT techniques, as well as indirectly by carotid-femoral Pulse Wave Velocity) and Quality of Life (using the Short Form-12 and a PTH specific symptom score). In the retrospective DXA cohort, moderate CKD (eGFR 30-59ml/min/1.73m2) and hyponatremia (

Published
2013

48. β2 microglobulin and chronic allograft nephropathy

Author

Patricia B. Maguire, Kieran Wynne, Olwyn Johnston, Aisling O'Riordan, Hilary Cassidy, Tara McMorrow, Séin O'Connell, Michael P. Ryan, Peter J. Conlon, William M. Gallagher, and Gerard Cagney

Subjects
Proteomics, Pathology, Clinical Biochemistry, 030232 urology & nephrology, Urine, Kidney, Glomerulonephritis, Membranous, 0302 clinical medicine, Chronic allograft nephropathy, ROC, β2-microglobulin, CAN, Glomerulosclerosis, Focal Segmental, Blood proteins, Biochemical markers, food and beverages, Glomerulonephritis, Middle Aged, 3. Good health, 030220 oncology & carcinogenesis, Biomarker (medicine), Female, Kidney Diseases, Biological Markers, Adult, medicine.medical_specialty, Urinary system, Urology, Protein Array Analysis, 03 medical and health sciences, Kidneys--Diseases, medicine, Humans, Transplantation, Homologous, Clinical significance, SELDI-TOF MS, Mass spectrometry, Beta-2 microglobulin, business.industry, Renal transplantation, medicine.disease, Kidney Transplantation, Kidneys--Transplantation, Transplantation, Case-Control Studies, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, business, beta 2-Microglobulin, Software, Biomarkers
Abstract

Chronic allograft nephropathy (CAN) remains the leading cause of renal graft loss after the first year following renal transplantation. This study aimed to identify novel urinary proteomic profiles, which could distinguish and predict CAN in susceptible individuals. Experimental Design: The study included 34 renal transplant patients with histologically proven CAN and 36 patients with normal renal transplant function. High-throughput proteomic profiles were generated from urine samples with three different ProteinChip arrays by surface-enhanced laser-desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Following SELDI a biomarker pattern software analysis was performed which led to the identification of a novel biomarker pattern that could distinguish patients with CAN from those with normal renal function. Results: An 11.7 kDa protein identified as β2 microglobulin was the primary protein of this biomarker pattern, distinguishing CAN from control patients (ROC = 0.996). SELDI-TOF-MS comparison of purified β2 microglobulin protein and CAN urine demonstrated identical 11.7 kDa protein peaks. Significantly higher concentrations of β2 microglobulin were found in the urine of patients with CAN compared to the urine of normal renal function transplant recipients (p

Published
2011

49. Diabetes and kidney disease

Abstract

Information about diabetes and chronic kidney disease, stages 1-4. Resources for the Blind is part of the Office of Health Disparities Multilingual Library collection of health education materials.

Published
2012

50. Diabetes and kidney disease

Abstract

Information about diabetes and chronic kidney disease, stages 1-4. Resources for the Blind is part of the Office of Health Disparities Multilingual Library collection of health education materials.

Published
2012

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