Assessment of individual kidney function in a dog with congenital anomalies of the urinary tract

2019 ◽  
Vol 7 (2) ◽  
pp. e000753
Author(s):  
Evelyn Heier ◽  
Christine Urban ◽  
Ahmed Abdellatif ◽  
Cetina Thiel ◽  
Reto Neiger
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Imaging Techniques ◽  
Chronic Kidney Disease Stage ◽  
Clinical Signs ◽  
Disease Stage ◽  
Ectopic Ureter ◽  
Renal Hypoplasia ◽  
The Right

A 21-month-old entire female labrador retriever was presented for polyuria, pollakiuria, haematuria and intermittent urinary incontinence. Clinical signs were absent during antibiotic treatment but reoccurred shortly after completion of a treatment course. Investigations detected bilaterally dilated ureters, right renal hypoplasia, left extramural ectopic ureter and right intramural ectopic ureter forming an ureterocoele. Blood tests revealed moderate renal azotaemia. 99mTc-DMSA (technetium-99m-dimercaptosuccinic acid) scintigraphy was used to quantify individual kidney function to carefully consider nephrectomy. The right kidney contributed to less than 2 per cent of the total kidney function. Individual kidney function assessed by 99mTc-DMSA scintigraphy was compared with CT-based renal parenchyma volume as an equivalent to kidney function. In this case both diagnostic imaging techniques resulted in similar individual kidney function percentages. A right-sided nephroureterectomy and a left-sided neoureterocystostomy were performed. Surgical treatment successfully resolved the clinical signs. After surgery the dog’s chronic kidney disease remained stable at International Renal Interest Society chronic kidney disease stage 3.

Functional joint models for chronic kidney disease in kidney transplant recipients

2021 ◽  
pp. 096228022110092
Author(s):  
Jianghu (James) Dong ◽  
Jiguo Cao ◽  
Jagbir Gill ◽  
Clifford Miles ◽  
Troy Plumb
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Kidney Disease ◽  
Kidney Function ◽  
Competing Risks ◽  
Chronic Kidney Disease Stage ◽  
Joint Model ◽  
Disease Stage ◽  
Joint Models ◽  
Disease Study

This functional joint model paper is motivated by a chronic kidney disease study post kidney transplantation. The available kidney organ is a scarce resource because millions of end-stage renal patients are on the waiting list for kidney transplantation. The life of the transplanted kidney can be extended if the progression of the chronic kidney disease stage can be slowed, and so a major research question is how to extend the transplanted kidney life to maximize the usage of the scarce organ resource. The glomerular filtration rate is the best test to monitor the progression of the kidney function, and it is a continuous longitudinal outcome with repeated measures. The patient’s survival status is characterized by time-to-event outcomes including kidney transplant failure, death with kidney function, and death without kidney function. Few studies have been carried out to simultaneously investigate these multiple clinical outcomes in chronic kidney disease stage patients based on a joint model. Therefore, this paper proposes a new functional joint model from this clinical chronic kidney disease study. The proposed joint models include a longitudinal sub-model with a flexible basis function for subject-level trajectories and a competing-risks sub-model for multiple time-to event outcomes. The different association structures can be accomplished through a time-dependent function of shared random effects from the longitudinal process or the whole longitudinal history in the competing-risks sub-model. The proposed joint model that utilizes basis function and competing-risks sub-model is an extension of the standard linear joint models. The application results from the proposed joint model can supply some useful clinical references for chronic kidney disease study post kidney transplantation.

scholarly journals Chronic hepatitis B in a woman with chronic kidney disease

2020 ◽  
Vol 4 (11) ◽  
pp. 710-713
Author(s):  
Kh.G. Omarova ◽  
◽  
V.V. Makashova ◽  
◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Chronic Hepatitis ◽  
Kidney Disease ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Antiviral Treatment ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Renal Hypoplasia ◽  
One Year

A 38-year-old woman was diagnosed with phase 2 chronic hepatitis B without delta-agent (HBeAg+) with a high biochemical and viral load and significant liver fibrosis (F2) five years after renal allotransplantation for a chronic kidney disease stage 5 resulting from a congenital urogenital abnormality (left renal hypoplasia). This woman was switched from lamivudine, the first-generation nucleoside analogue, that she received for 6 years, to entecavir (after a 4-year interval). However, the development of the resistance to entecavir forced to switch to tenofovir. A positive virological response was achieved as demonstrated by the lack of the isolation of hepatitis B virus (HBV) DNA one year after starting treatment. Yet, HBV is not detected. In addition, F2 fibrosis down-graded to F0 by the METAVIR score (as demonstrated by liver fibroelastometry). The woman is currently being followed-up. KEYWORDS: chronic hepatitis B, chronic kidney disease, renal allotransplantation, antiviral treatment, nucleoside analogues. FOR CITATION: Omarova Kh.G., Makashova V.V. Chronic hepatitis B in a woman with chronic kidney disease. Russian Medical Inquiry. 2020;4(11):710–713. DOI: 10.32364/2587-6821-2020-4-11-710-713.

scholarly journals Bardoxolone Methyl Improves Kidney Function in Patients with Chronic Kidney Disease Stage 4 and Type 2 Diabetes: Post-Hoc Analyses from Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes Study

2018 ◽  
Vol 47 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Melanie P. Chin ◽  
George L. Bakris ◽  
Geoffrey A. Block ◽  
Glenn M. Chertow ◽  
Angie Goldsberry ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Stage 4 ◽  
Ckd Stage ◽  
Post Hoc

Background: Increases in measured inulin clearance, measured creatinine clearance, and estimated glomerular filtration rate (eGFR) have been observed with bardoxolone methyl in 7 studies enrolling approximately 2,600 patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The largest of these studies was Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes (BEACON), a multinational, randomized, double-blind, placebo-controlled phase 3 trial which enrolled patients with T2D and CKD stage 4. The BEACON trial was terminated after preliminary analyses showed that patients randomized to bardoxolone methyl experienced significantly higher rates of heart failure events. We performed post-hoc analyses to characterize changes in kidney function induced by bardoxolone methyl. Methods: Patients in ­BEACON (n = 2,185) were randomized 1: 1 to receive once-daily bardoxolone methyl (20 mg) or placebo. We compared the effects of bardoxolone methyl and placebo on a post-hoc composite renal endpoint consisting of ≥30% decline from baseline in eGFR, eGFR <15 mL/min/1.73 m2, and end-stage renal disease (ESRD) events (provision of dialysis or kidney transplantation). Results: Consistent with prior studies, patients randomized to bardoxolone methyl experienced mean increases in eGFR that were sustained through study week 48. Moreover, increases in eGFR from baseline were sustained 4 weeks after cessation of treatment. Patients randomized to bardoxolone methyl were significantly less likely to experience the composite renal endpoint (hazards ratio 0.48 [95% CI 0.36–0.64]; p < 0.0001). Conclusions: Bardoxolone methyl preserves kidney function and may delay the onset of ESRD in patients with T2D and stage 4 CKD.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

1049-P: Preexisting Chronic Kidney Disease Stage 3 Does Not Reduce Glycemic Efficacy of Metformin in U.S. Veterans with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1049-P
Author(s):  
ELVIRA GOSMANOVA ◽  
DARREN E. GEMOETS ◽  
LAURENCE S. KAMINSKY ◽  
CSABA P. KOVESDY ◽  
AIDAR R. GOSMANOV
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage
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