Unexpected Impacts of a Commercial Weight Loss Diet on Kidney Function: A Case Report

Abstract Objectives As 42.4% of the United States is obese and recent estimates expect an obesity/overweight prevalence of approximately three-fourths of the population by 2030, Americans have become more invested in finding weight control solutions. Commercial weight-loss programs and diets have risen to fulfill this need. However, there continues to be a lack of clarity surrounding the longitudinal and adverse outcomes of the majority of these programs. This report discusses a likely link between the usage of a popular commercial weight loss diet and the development of impaired kidney function in a 68-year-old patient. Methods Upon routine laboratory testing, the patient was noted to have elevated creatinine levels and was referred to a hematologist-oncologist for a bone marrow biopsy for a suspected diagnosis of multiple myeloma, and to a nephrologist for a kidney biopsy. The patient had a peak creatinine level of 3.02 mg/dL (reference range 0.70–1.25 mg/dL) prior to the kidney biopsy, which showed prominent calcium oxalate deposits and tubular atrophy with interstitial fibrosis, virtually excluding multiple myeloma. This finding placed the patient at risk for loss of kidney function, if not addressed immediately. Upon further investigation, the patient admitted to using a Nutrisystem® diet, which was aiding him in his weight loss goals. Results After a trial of removing this diet from his lifestyle, the creatinine level of the patient substantially improved to 1.42 mg/dL within three months, demonstrating a gradual improvement in kidney function. Conclusions This case report shows the importance of taking commercial weight-loss interventions into consideration when generating clinical recommendations for patients and adds to the currently limited literature on the long-term outcomes of the Nutrisystem® diet. Our findings point to the need for more comprehensive research into the effects of these programs and diets. Funding Sources Not applicable.

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Onset of Ulcerative Colitis during a Low-Carbohydrate Weight-Loss Diet and Treatment with a Plant-Based Diet: A Case Report

The Permanente Journal ◽

10.7812/tpp/15-038 ◽

2015 ◽

Cited By ~ 1

Author(s):

Mitsuro Chiba

Keyword(s):

Ulcerative Colitis ◽

Weight Loss ◽

Case Report ◽

Weight Loss Diet ◽

Low Carbohydrate

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Clinical and financial implications of central venous catheters bloodstream infections in patients with multiple myeloma in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e20033 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e20033-e20033

Author(s):

Pool Tobar ◽

Luis F. Gonzalez Mosquera ◽

Diana D. Cardenas Maldonado ◽

Bernard Moscoso ◽

Alida I. Podrumar ◽

...

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Weight Loss ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

The United States ◽

Central Venous ◽

Predictors Of Mortality ◽

Poor Outcome

e20033 Background: Multiple Myeloma(MM) has an increased exposure to intravascular catheters due to the increased risk of severe infections and due to the route of treatment administration. Central Venous Catheter Bloodstream Infections(CVCBI) have significant mortality, imply a delay in treatment and increased cost as well. There is no prior report on the risk factors for poor outcome in MM patients that develop this complication. We aim to describe the predictors of mortality as well as the changes in cost that CVCBI implies. Methods: We retrieved adult patients with MM from the Nationwide Inpatient Sample database from 2016-2018. We used the ICD-10 codes to identify and compare patients who developed CVCBI with those that did not developed it. The main outcomes were hospital mortality and predictors of mortality. We computed the chi-squared test and the Mann-Whitney U-test. Mortality predictors are estimated using multivariate logistic regression and logistic fixed-effect methods to control for admission cohort and hospital time invariant characteristics. All analyses were performed using Stata Statistical Software version 14 (StataCorp, College Station, TX). Results: A total of 58,838 patients with MM were identified. The majority were white (63.5%), male (55.3%), with a median age of 70 (IQR 62-78). Most MM were not in remission (99.1%), followed by those in remission (1.3%) and relapse (0.3%). CVCBI was diagnosed in 264 (0.4%) of the MM patients. There was significantly higher mortality in the CVCBI group vs. the non-CVCBI group (8.7% vs. 5%; p < 0.01), longer LOS (10 vs. 5 days; p < 0.001), and higher median hospitalization cost (US$86,168 vs. US$43,511; p < 0.001). In the multivariable analysis, CVCBI was associated with higher mortality (OR: 1.69; CI 95%: 1.14-2.52; p < 0.001). Among patients with MM and CVCBI those that had achieved remission had a higher risk of death (OR: 2.87; CI 95%: 2.17-3.8; p < 0.001). Other variables associated with mortality were age > 65 (OR: 1.84; CI 95%: 1.59-2.15; p < 0.001), concomitant chronic heart failure (CHF) (OR: 1.46; CI 95%: 1.29-1.65; p < 0.001), chronic kidney disease (CKD) (OR: 1.43; CI 95%: 1.32-1.56; p < 0.001), and weight loss (OR: 2.31; CI 95%: 1.91-2.8; p < 0.001). When compared to medicare patients with higher mortality were more likely to be under medicaid(OR: 1.25; CI 95%: 1.02-1.55; p < 0.05) and private insurances(OR: 1.31; CI 95%: 1.15-1.49; p < 0.001). There was no significant association with sex, race/ethinicity or household income. Conclusions: In patients with Multiple Myeloma the development of Central Venous Catheter Bloodstream Infections was associated with a higher overall mortality, length of stay and cost of hospitalization. Age, CHF, CKD and weight loss were independent risk factors for poor outcome in this patient population. Further studies are required on developing strategies for the prevention of this complication.

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Barriers to Adherence to a Weight Loss Diet Using the Nominal Group Technique

Current Developments in Nutrition ◽

10.1093/cdn/nzaa059_014 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1297-1297

Author(s):

Angela De Leon ◽

James Roemmich ◽

Shanon Casperson

Keyword(s):

Weight Loss ◽

Nominal Group Technique ◽

The United States ◽

Nominal Group ◽

Female Population ◽

Weight Loss Diet ◽

Weight Loss Interventions ◽

Environmental Level ◽

Group Technique

Abstract Objectives At any given time, a large percentage of the female population, especially those of childbearing age, is engaged in some form of weight loss behavior. Although numerous weight loss plans and diets have been shown to achieve weight loss in the short term, the long-term maintenance of weight loss is modest at best. The identification of factors associated with difficulty adhering to a weight loss diet and sustaining weight loss maintenance is paramount to improving the long-term success of weight loss interventions. Methods As part of a study investigating the effects of dietary protein distribution on weight loss in women (N = 33; age = 33 ± 8; BMI = 36 ± 4), we conducted a series of nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight-loss diet. NGT generates a large number of unique responses to a specific research question, in this case, factors that make it hard to stick to a weight-loss diet. Responses from all NGT sessions were then aggregated and grouped into major themes to create an overall thematic framework of highest ranking responses. Results The major themes to emerge were individual- and environmental-level barriers. Individual-level themes rated the most highly by the groups were knowledge, cravings, emotions, habits, impatience, and willpower—specifically, knowing when to stop eating, being able to control cravings and emotional eating, and sustaining dietary lifestyle changes. The highest ranking environmental-level themes included family/social, time constraints, eating out, food being present, and cost. Events that bring people together, especially those centered around food and drink, and busy schedules were particularly challenging for women's efforts to stay “on track” with their weight control goals. Conclusions Our findings provide a rich depiction of the barriers that women find most salient in adhering to a weight-loss diet. These results highlight the importance of understanding the intricate interplay between individual- and environmental-level factors that make achieving and maintaining a healthy body weight difficult. This information can be used to inform the planning and implementation of behavioral weight-loss interventions in women. Funding Sources The United States Department of Agriculture, Agricultural Research Service and the North Dakota Beef Commission.

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Goodpasture's syndrome: Case report

Medicinski pregled ◽

10.2298/mpns0408391v ◽

2004 ◽

Vol 57 (7-8) ◽

pp. 391-395

Author(s):

Biljana Vuckovic ◽

Tatjana Ilic ◽

Igor Mitic ◽

Violeta Knezevic ◽

Slavenka Vodopivec ◽

...

Keyword(s):

Case Report ◽

Autoimmune Disease ◽

Kidney Disease ◽

Kidney Function ◽

Kidney Biopsy ◽

Pulmonary Hemorrhage ◽

Laboratory Findings ◽

Goodpasture's Syndrome ◽

Important Thing ◽

Goodpasture’S Syndrome

Introduction Goodpasture's syndrome is a rare, autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and production of anti-GBM (glomerular basement membrane) antibodies. The etiology of this syndrome is still unknown. Goodpasture's syndrome usually starts with pulmonary hemorrhage, which is followed by symptoms of kidney disease. Laboratory findings often include: anemia, microhematuria, proteinuria, increased levels of urea and creatinine and anti-GBM antibodies. Diagnosis of this syndrome can be established by presence of pulmonary hemorrhage, pulmonary radiography, kidney biopsy and positive result of circulating anti-GBM antibodies. Treatment of this syndrome should be initiated as soon as possible using a combination of cortocosteroids, cytostatics and plasmapheresis. Case report The first symptoms in a nineteen-year-old female patient were caused by anemia. Two months later she reported symptoms of pulmonary hemorrhage. At that point of time she already had renal insufficiency and was immediately hospitalized. The same day we started therapy with cortocosteroids, endoxan and plasmapheresis was initiated. Recovery of pulmonary function was obtained, but kidney function was lost. Discussion and Conclusions The most important thing in regard to Goodpasture's syndrome is quick diagnosis. Because of that, if patients report any kind of pulmonary hemorrhage, this syndrome must be considered. At that point of time, kidney function is usually not irreversibly damaged. The second important thing in Goodpasture's syndrome is that treatment must be very aggressive using a combination of immunosuppressives and plasmapheresis. This is the only chance for these patients to avoid hemodialysis or death.

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Delayed recovery of kidney function in a multiple myeloma patient treated with high cut-off hemodialysis: A case report

Acta Haematologica Polonica ◽

10.1016/j.achaem.2014.12.003 ◽

2015 ◽

Vol 46 (1) ◽

pp. 61-64

Author(s):

Katarzyna Kakareko ◽

Alicja Rydzewska-Rosolowska ◽

Tomasz Hryszko ◽

Beata Naumnik

Keyword(s):

Multiple Myeloma ◽

Case Report ◽

Kidney Function ◽

Myeloma Patient ◽

Multiple Myeloma Patient ◽

Delayed Recovery

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Progression of Monoclonal Gammopathy with Undetermined Significance to Multiple Myeloma Diagnosed by Kidney Biopsy: A Case Report

Case Reports in Nephrology and Dialysis ◽

10.1159/000439267 ◽

2015 ◽

Vol 5 (3) ◽

pp. 180-186 ◽

Cited By ~ 1

Author(s):

Jin Hae Kim ◽

Ji Won Kim ◽

Young Nam Kim ◽

Hye In Kim ◽

Jun Young Kim ◽

...

Keyword(s):

Multiple Myeloma ◽

Bone Marrow ◽

Renal Function ◽

Case Report ◽

Monoclonal Gammopathy ◽

Kidney Biopsy ◽

M Protein ◽

Tubular Proteinuria ◽

Risk Of Progression ◽

Undetermined Significance

Monoclonal gammopathy with undetermined significance (MGUS) carries a risk of progression to multiple myeloma, and progression is usually diagnosed with changes in M-protein or bone marrow biopsy. We report a case of 62-year-old female patient showing MGUS progression to multiple myeloma without significant changes in M-protein but diagnosed by kidney biopsy. During the follow-ups, azotemia and tubular proteinuria were aggravated without elevation of M-protein. Kidney biopsy showed intratubular and glomerular inclusions associated with plasma cell dysplasia. The progression of MGUS to multiple myeloma was diagnosed by this kidney biopsy. The patient's renal function and tubular proteinuria were markedly improved after chemotherapy.

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Adult heart procurement following circulatory determined death from a donor on venous-venous extracorporeal membrane oxygenation: A case report

Perfusion ◽

10.1177/02676591211055305 ◽

2021 ◽

pp. 026765912110553

Author(s):

Eyal R Nachum ◽

John Hogan ◽

Mohammed Osman ◽

Simon Messer ◽

Jennifer Baxter ◽

...

Keyword(s):

Case Report ◽

Ex Vivo ◽

The United States ◽

Postoperative Recovery ◽

Adverse Outcomes ◽

Ischemic Time ◽

Warm Ischemic Time ◽

Membrane Oxygenation ◽

The Right ◽

Circulatory Death

Donation after circulatory death in the context of heart transplants is attracting interest and becoming popular in clinical practice. Activity is growing in the United Kingdom, Australia, and the United States. We believe that a prolonged warm ischemic time (time from asystole to reperfusion of the heart on an ex vivo perfusion system) is a primary indicator of adverse outcomes. However, 1.5 liters of blood must be retrieved from the right atrium following sternotomy prolonging warm ischemic time. The patient in the following case report was supported by veno-venous extra-corporeal membrane oxygenation following drowning, further complicated by aspiration-related lung failure. Following circulatory death and a mandatory five-minute stand-off period, 1.5 liters of blood was drained from the circuit as sternotomy began. Surgeons then proceeded to direct procurement of the heart, aiming for least functional warm ischemic time. Following standard implantation, the patient’s postoperative recovery has been unremarkable to date.

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Accidental Ixazomib Overdose in a Patient With Multiple Myeloma

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211013230 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110132

Author(s):

Parth J. Sampat ◽

Maneesh Bisen ◽

Nimisha Srivastava ◽

Suman Rao ◽

Teresa Gentile

Keyword(s):

United States ◽

Multiple Myeloma ◽

Case Report ◽

Adverse Effects ◽

Proteasome Inhibitor ◽

Adverse Reactions ◽

Hematological Malignancy ◽

The United States ◽

Chemotherapeutic Agents ◽

To Come

Multiple myeloma is the second most common hematological malignancy. Ixazomib is the first oral proteasome inhibitor approved in the United States for the management of multiple myeloma who have received at least one prior treatment. The availability of oral chemotherapeutic agents for the management of multiple myeloma has made it easier for patients who do not have to come to the hospital for chemotherapy infusions. However, many barriers are associated with oral chemotherapy, and one of them is a misinterpretation of instruction which can have deleterious effects. In this case report, we present a case of a 69-year-old male with multiple myeloma who accidentally took ixazomib daily for 3 days instead of the weekly regimen and thus coming into the hospital with an overdose. In this report, we focus on the adverse effects associated with ixazomib toxicity and how to manage the adverse reactions. Although there is no antidote available for ixazomib, supportive care is very essential in these patients.

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