scholarly journals A call to action to evaluate renal functional reserve in patients with COVID-19

2020 ◽  
Vol 319 (5) ◽  
pp. F792-F795
Author(s):  
Vincenzo Cantaluppi ◽  
Gabriele Guglielmetti ◽  
Sergio Dellepiane ◽  
Marita Marengo ◽  
Ravindra L. Mehta ◽  
...  
Keyword(s):  
Renal Function ◽  
Ventilatory Support ◽  
Kidney Tissue ◽  
Kidney Injury ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Therapeutic Approaches ◽  
Functional Reserve ◽  
Call To Action ◽  
Renal Functional Reserve

Coronavirus disease 2019 (COVID-19) poses an unprecedented challenge to world health systems, substantially increasing hospitalization and mortality rates in all affected countries. Being primarily a respiratory disease, COVID-19 is mainly associated with pneumonia or minor upper respiratory tract symptoms; however, different organs can sustain considerable (if not terminal) damage because of coronavirus. Acute kidney injury is the most common complication of COVID-19-related pneumonia, and more than 20% of patients requiring ventilatory support develop renal failure. Additionally, chronic kidney disease is a major risk factor for COVID-19 severity and mortality. All these data demonstrate the relevance of renal function assessment in patients with COVID-19 and the need of early kidney-directed diagnostic and therapeutic approaches. However, the sole assessment of renal function could be not entirely indicative of kidney tissue status. In this viewpoint, we discuss the clinical significance and potential relevance of renal functional reserve evaluation in patients with COVID-19.

scholarly journals Renal Functional Reserve Is Related to the Nondipping Phenotype and to the Exercise Heart Rate Response in Patients with Essential Hypertension and Preserved Renal Function

2020 ◽  
Vol 45 (5) ◽  
pp. 737-747
Author(s):  
Katerina Damianaki ◽  
Michel Burnier ◽  
Kyriakos Dimitriadis ◽  
Costas Tsioufis ◽  
Dimitrios Petras
Keyword(s):  
Heart Rate ◽  
Renal Function ◽  
Essential Hypertension ◽  
Vascular Reactivity ◽  
Stress Test ◽  
Kidney Injury ◽  
Exercise Heart Rate ◽  
Functional Reserve ◽  
Hypertensive Patients ◽  
Renal Functional Reserve

Background: Renal functional reserve (RFR), defined as the difference between stress and resting glomerular filtration rate (GFR), may constitute a diagnostic tool to identify patients at higher risk of developing acute kidney injury or chronic kidney disease. Blunted RFR has been demonstrated in early stages of hypertension and has been attributed to impaired vascular reactivity due to an overactive sympathetic nervous system (SNS). Objective: The purpose of this study was to investigate whether RFR correlates with other phenotypes expressing overactivity of the SNS in patients with essential hypertension and preserved renal function. Methods: Thirty-six patients with untreated essential hypertension and a GFR >60 mL/min/1.73 m2 were enrolled. The following parameters were measured: RFR, 24-h ambulatory blood pressure (BP) profile, a treadmill stress test, and an echocardiographic examination. Urine and venous samples were obtained at specific time points for the determination of clinical parameters, and both resting and stress GFR were calculated by using endogenous creatinine clearance for the measurement of RFR after an acute oral protein load (1 g/kg). Results: Twenty-one patients had a RFR <30 mL/min/1.73 m2 and 15 had a RFR above this cutoff. A nondipping pattern of 24-h BP was significantly more frequent in patients with low RFR (57.1 vs. 25.0%, p < 0.05 for systolic BP and 52.3 vs. 10.0%, p < 0.02 for diastolic BP). Moreover, patients with lower RFR values showed a blunted heart rate (HR) response to exercise during treadmill test (r = 0.439, p < 0.05). None of the echocardiographic parameters differed between the two groups of patients. Conclusions: In hypertensive patients with preserved GFR, reduced RFR is related to nondipping BP phenotype as well as to attenuated exercise HR response. Overactivity of the SNS may be a common pathway. Since loss of RFR may represent a risk factor for acute or chronic kidney injury, hypertensive patients with blunted RFR might need a more careful renal follow-up.

scholarly journals Current Concepts of Pediatric Acute Kidney Injury—Are We Ready to Translate Them into Everyday Practice?

2021 ◽  
Vol 10 (14) ◽  
pp. 3113
Author(s):  
Kinga Musiał
Keyword(s):  
Acute Kidney Injury ◽  
Surrogate Marker ◽  
Kidney Injury ◽  
Tubuloglomerular Feedback ◽  
Everyday Practice ◽  
Special Focus ◽  
Functional Reserve ◽  
Renal Functional Reserve ◽  
Acute Kidney Disease ◽  
Pediatric Acute Kidney Injury

Pediatric acute kidney injury (AKI) is a major cause of morbidity and mortality in children undergoing interventional procedures. The review summarizes current classifications of AKI and acute kidney disease (AKD), as well as systematizes the knowledge on pathophysiology of kidney injury, with a special focus on renal functional reserve and tubuloglomerular feedback. The aim of this review is also to show the state-of-the-art in methods assessing risk and prognosis by discussing the potential role of risk stratification strategies, taking into account both glomerular function and clinical settings conditioned by fluid overload, urine output, or drug nephrotoxicity. The last task is to suggest careful assessment of eGFR as a surrogate marker of renal functional reserve and implementation of point-of-care testing, available in the case of biomarkers like NGAL and [IGFBP-7] × [TIMP-2] product, into everyday practice in patients at risk of AKI due to planned invasive procedures or treatment.

scholarly journals Chickenpox Mimicking Monkeypox in Adult with Diabetes Mellitus and Acute Kidney Injury: Diagnosis and Management

2021 ◽  
Vol 33 (3) ◽  
pp. 213
Author(s):  
Maya Wardiana ◽  
Rahmadewi Rahmadewi ◽  
Dwi Murtiastutik ◽  
Sawitri Sawitri ◽  
Damayanti Damayanti
Keyword(s):  
Diabetes Mellitus ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Skin Lesions ◽  
World Health ◽  
Varicella Zoster ◽  
Intravenous Acyclovir ◽  
Acute Kidney Injury Diagnosis ◽  
Health Organization

Background: Chickenpox caused by the varicella-zoster virus (VZV) in diabetes mellitus patients might exhibit similar clinical features with monkeypox, caused by monkeypox virus (MPXV). In May 2019, Singapore notified World Health Organization (WHO) of one laboratory-confirmed case of monkeypox. Considering Singapore is located near Indonesia, awareness about the possibility of an outbreak in Indonesia should be raised. Purpose: To report a case of chickenpox mimicking monkeypox in an adult with diabetes mellitus and acute kidney injury. Case: A 51-year-old male with poorly controlled diabetes mellitus was suspected to have a chickenpox differential diagnosis with monkeypox. His chief complaint was multiple blisters on his body and vomiting. There was a history of feeding a monkey. From dermatological status on facial, trunk, and extremities there were multiple pleomorphic vesicles. Laboratory results showed elevated renal function. Polymerase chain reaction (PCR) examination using VZV as primer revealed a positive result in the range of 810 bp. He was treated with intravenous acyclovir for 3 days and oral acyclovir for 7 days then discharged with improvement in skin lesions and normal renal function. Discussion: Chickenpox in adult and diabetes mellitus patients can give severe clinical manifestation mimicking monkeypox. PCR has a significant role especially when diagnosis could not be established from the physical examination. Acyclovir can be given as the therapy. Conclusion: Adult and poorly controlled diabetes mellitus are important risk factors associated with the severity and complication of chickenpox. A careful diagnostic approach and management are needed.

scholarly journals Dynamic renal function testing by compartmental analysis: assessment of renal functional reserve in essential hypertension

2000 ◽  
Vol 15 (8) ◽  
pp. 1162-1169 ◽  
Author(s):  
Sabine Zitta ◽  
Kurt Stoschitzky ◽  
Robert Zweiker ◽  
Karl Oettl ◽  
Gilbert Reibnegger ◽  
...  
Keyword(s):  
Renal Function ◽  
Essential Hypertension ◽  
Compartmental Analysis ◽  
Functional Reserve ◽  
Renal Functional Reserve ◽  
Function Testing

Pre-transplant renal functional reserve and renal function after lung transplantation

2020 ◽  
Vol 39 (9) ◽  
pp. 970-974
Author(s):  
Faeq Husain-Syed ◽  
Fiorenza Ferrari ◽  
Horst-Walter Birk ◽  
Rolf Weimer ◽  
Claudio Ronco ◽  
...  
Keyword(s):  
Renal Function ◽  
Lung Transplantation ◽  
Functional Reserve ◽  
Renal Functional Reserve

scholarly journals RENAL FUNCTIONAL RESERVE IS RELATED TO THE NON-DIPPING PHENOTYPE AND TO THE EXERCISE HEART RATE RESPONSE IN PATIENTS WITH ESSENTIAL HYPERTESION AND A PRESERVED RENAL FUNCTION

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e34-e35
Author(s):  
Katerina Damianaki ◽  
Michel Burnier ◽  
Constantinos Tsioufis ◽  
Kyriakos Dimitriadis ◽  
Demetrios Vlahakos ◽  
...  
Keyword(s):  
Heart Rate ◽  
Renal Function ◽  
Heart Rate Response ◽  
Exercise Heart Rate ◽  
Functional Reserve ◽  
Renal Functional Reserve

Renoprotective Effects of Artesunate against Renal Ischemia-Reperfusion Injury in Rat Model

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Bassim I Mohammed ◽  
Najah R Hadi ◽  
Jabber Huda ◽  
Galal Elkilany ◽  
RB Singh
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Tissue Injury ◽  
Ischemia Reperfusion ◽  
Plasma Concentrations ◽  
Kidney Tissue ◽  
Kidney Injury ◽  
Renal Ischemia ◽  
Control Group ◽  
Tissue Concentrations

Renal ischemia-reperfusion (Renal I/R) leads to acute kidney injury (AKI),a major kidney disease associated with an increasing prevalence and high mortality rates. A variety of experimental models,both in vitro and in vivo,have been used to study the pathogenic mechanisms of ischemic AKI and to test reno-protective strategies. Aim: To study potential protective effects of artesunate on renal I/R injury. Renal I/R injury was unilaterally induced in adult (3 to 5 months) male Sprague-Dawely rats,whose weights ranged from 180 to 390 g. Thereafter,the animals were pre-treated with artesunate intra-peritoneally,and at the end of reperfusion sacrificed humanely. Plasma,serum and tissue samples were obtained for analysis. Plasma concentrations of NGAL (neutrophil gelatinase associated lipocalin),an iron-trafficking protein involved in multiple processes such as apoptosis,innate immunity and renal development,and tissue concentrations of IL-18 (Interleukin-18) were measured via ELISA analysis. Serum urea and creatinine were also measured in the samples. Artesunate improved renal ischemia reperfusion,including renal function and brought about reductions in inflammatory mediators and kidney tissue injury. Plasma concentrations of NGAL and tissue concentrations of IL-18 were significantly (p < 0.05) lower in the artesunatepretreated group than in the vehicle and control groups. Furthermore,serum concentrations of urea and creatinine were significantly (p < 0.05) decreased in the pretreated group as compared to the control group. Artesunate can significantly improve renal function following I/R through down-regulation of inflammatory parameters and NGAL expression. Furthermore,it could serve as a potential therapy in ischemia reperfusion-induced acute kidney injury.

scholarly journals Renal Functional Reserve and Renal Recovery after Acute Kidney Injury

2014 ◽  
Vol 127 (1-4) ◽  
pp. 94-100 ◽  
Author(s):  
Aashish Sharma ◽  
Marìa Jimena Mucino ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Functional Reserve ◽  
Renal Functional Reserve
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