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Severe Renal Failure (severe + renal_failure)
Selected AbstractsAcid-base balance of cats with chronic renal failure: effect of deterioration in renal functionJOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2003J. Elliott In a previous cross-sectional study of feline chronic renal failure (CRF), metabolic acidosis was identified in 52·6 per cent of animals with severe renal failure (plasma creatinine concentration > 400 umol/litre). The aim of this longitudinal study was to determine whether metabolic acidosis preceded or accompanied a deterioration in renal function in cats with CRF. Data were analysed from 55 cats with CRF that had been followed longitudinally for at least four months. Twenty-one cases showed deterioration in renal function over the period of the study, as evidenced by significant rises in their plasma creatinine concentrations and decreases in bodyweight. In five of the 21 cases, acidaemia accompanied the deterioration in renal function. Only one of these cats had evidence of metabolic acidosis before renal function deterioration. One other case developed metabolic acidosis without a rise in plasma creatinine concentration. These data suggest that biochemical evidence of metabolic acidosis does not generally occur until late in the course of feline CRF. [source] Gadolinium and nephrogenic systemic fibrosis: Association or causation (Review Article)NEPHROLOGY, Issue 3 2008JAGADEESH KURTKOTI SUMMARY: With widespread availability of magnetic resonance imaging (MRI), it has become standard practice for patients with severe renal impairment or previous severe reactions to iodine-containing contrast media to receive gadolinium-based MRI contrast agents instead of traditional radiographic contrast agents, particularly for magnetic resonance angiography. However, there is growing concern about the use of gadolinium contrast agents in the presence of severe renal insufficiency, because of increasing reports of nephrogenic fibrosing dermopathy (NFD)/nephrogenic systemic fibrosis (NSF), associated with the exposure to certain gadolinium-containing contrast agents. In this review we explore the causal link between gadolinium exposure and NSF, using an established system of epidemiological criteria proposed by Bradford Hill. Though the current evidence makes gadolinium a strong suspect as an aetiologic agent for NSF in the presence of severe renal failure, the die is not cast yet. At this stage there needs to be cautious approach to the use of gadolinium-containing contrast agents in the presence of severe renal failure (glomerular filtration rate <30 mL/min per 1.73 m2). [source] Pediatric cardiac transplant: Results using a steroid-free maintenance regimenPEDIATRIC TRANSPLANTATION, Issue 1 2003H. Leonard Abstract: We report on survival, rejection, lymphoma and renal function following cardiac transplant using a steroid-free maintenance immunosuppressive regimen. We have performed 73 cardiac transplants in 71 children under 16 yr of age in the last 12 yr. There were eight perioperative and four late deaths giving actuarial survival of 88, 88, 85 and 70% at 1, 2, 5 and 10 yr, respectively. A total of 11 (15.3%) children had one episode of rejection (grade 3) in the first 6 months; one died and one was re-transplanted because of rejection. There was only one episode of late rejection (8 yr post-transplant) because of low drug levels in a patient with lymphoma and sepsis. This patient did not survive. Three other children (5.6%) also developed lymphoma and recovered but one died subsequently of graft failure. Four children have developed severe renal failure (glomerular filtration rate GFR <30 mL/min/m2). Two have not survived and one is expected to commence dialysis soon. The remainder have mild to moderate renal impairment. We report excellent survival and low rejection rates without use of long-term steroids. However the doses of cyclosporin used have had a significant effect on renal function in many cases. [source] Pharmacokinetic profile of a modified release formulation of trimetazidine (TMZ MR 35 mg) in the elderly and patients with renal failureBIOPHARMACEUTICS AND DRUG DISPOSITION, Issue 4 2003J. Barré Abstract Objectives , To study the effect of age and renal function on the pharmacokinetic profile of a modified release tablet of trimetazidine (TMZ MR 35 mg) administered twice daily. Methods, Study 1: Twelve healthy elderly subjects (CLcreat 72±8 ml/min, 72±4 years mean±SD) and eight young volunteers (CLcreat 134±18 ml/min, 25±8 years) received TMZ MR 35 mg b.i.d. (eight doses). Study 2: eight patients with severe renal failure (CLcreat. 17±5 ml/min, 54±10 years), five patients with moderate renal failure (CLcreat. 39±6 ml/min, 54±15 years) and eight volunteers (CLcreat. 104±17 ml/min, 53±9 years) received TMZ MR 35 mg b.i.d. (patients: ten doses, volunteers: eight doses). Serial blood and urine samples were obtained following administration of the last dose in each study. TMZ plasma and urine concentrations were determined by gas chromatography (NPD-detector). The resulting data were analysed using standard non-compartmental pharmacokinetic methods. Results, Study 1: Elimination half-life of TMZ was significantly longer and renal clearance significantly lower in the elderly subjects. Study 2: In patients with either moderate or severe renal failure, exposure (AUC0,24) was significantly increased and renal clearance (CLR) was significantly decreased. Significant correlations were observed between CLcreat and CLR (r=0.94) and between CLcreat and AUC0,24 (r=,0.94). Conclusion , With repeated administration of TMZ MR 35 mg b.i.d., a decrease in CLcreat is directly related to a decrease in CLR and results in an increase in exposure to TMZ. Copyright © 2003 John Wiley & Sons, Ltd. [source] Serum creatinine is an inadequate screening test for renal failure in ischemic stroke patientsACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009G. Piñol-Ripoll Objective,,, Serum creatinine (SCr) level is the most commonly used screening test for renal function, but its concentration is affected by factors other than glomerular filtration rate (GFR). We hypothesized that SCr would underestimate the degree of renal failure in ischemic stroke patients. Material and methods,,, We conducted a prospective study of 273 patients admitted to our institution for ischemic stroke within a year. GFR was calculated using the Cockcroft,Gault formula (CG). Patients were grouped according to the SCr with stages of renal failure according to CG values. Results,,, Of the 273 patients studied, 231 had normal SCr. Of this group 46.8% (108), 24.7% (57) and 4 (1.7%) had mild, moderate and severe renal failure according to GFR estimation. Among patients with normal SCr, abnormal CG values were identified in 86.2% (150) , 65 years old, 33.3% (19) <65 years old, 69% (89) in men and 78.4% (80) in women. An SCr greater than 1.7 mg/dl had only a sensitivity of 14.7%. Conclusions,,, This study documents the substantial prevalence of significantly abnormal renal function among patients with normal-range SCr. Routine estimation of GFR be preferred to SCr as a screening method for the early detection of renal impairment in stroke patients. [source] | ||||||||||