scholarly journals On the contribution of immune 42 mechanisms to the pathogenesis of diabetic nephropathy

1996 ◽  
Vol 42 (5) ◽  
pp. 42-47
Author(s):  
О. I. Kamayeva ◽  
V. V. Sura
Keyword(s):  
Renal Failure ◽  
Diabetic Nephropathy ◽  
Western Europe ◽  
Kidney Tissue ◽  
The United States ◽  
Chronic Hemodialysis ◽  
Patients With Diabetes ◽  
End Stage ◽  
The Cost

Diabetic nephropathy (NF) came first among all the specified causes of end-stage renal failure. Patients with type 1 diabetes mellitus (DM) make up more than half of all patients treated with chronic hemodialysis in the United States and Western Europe. Among patients with diabetes with terminal renal failure, 60% are people over 50 years old, so hemodialysis is not always prescribed. However, hemodialysis is increasingly used in elderly and senile patients; therefore, the proportion of patients with diabetes, especially type II diabetes, in hemodialysis centers will increase, significantly increasing the cost of treating diabetes. Currently, along with metabolic, hemodynamic and genetic theories, the role of immune disorders in the formation and progression of DNs is being discussed. The prerequisites for the formation of a hypothesis about the immune genesis of DNs were the frequent detection of increased levels of circulating immune complexes (CICs) and immunoglobulins in the blood, as well as deposits of immunoglobulins and complement in the kidney structures of patients with diabetes. However, among researchers there is no unanimity in the explanation of these facts. Many consider indisputably existing immune abnormalities inherent in DN as non-specific epiphenomes. The immune hypothesis of the pathogenesis of DN was formulated back in the 70s. The currently accumulated data suggest the participation of the immunocomplex mechanism in the development of DN. Immunofluorescence examination of the kidney tissue of patients with diabetes almost always reveals a luminescence of IgG, IgM, less often IgA, SZ and other complement fractions along the basal membranes of the glomeruli (BMC) and tubules of focal granular and linear in nature.

scholarly journals Hand osteomyelitis in arterial calcification, diabetes mellitus and end-stage renal failure: a comparison of 210 cases over 12 years

2021 ◽  
pp. 175319342098187
Author(s):  
Matthew Wyman ◽  
Dallan Dargan ◽  
Jennifer Caddick ◽  
Victoria Giblin
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Disease Free Survival ◽  
Arterial Calcification ◽  
Level Of Evidence ◽  
Free Survival ◽  
End Stage Renal Failure ◽  
Patients With Diabetes ◽  
End Stage ◽  
Steal Syndrome

We present 210 patients with hand osteomyelitis in 246 rays over 12 years, including detailed analysis of 29 patients in this cohort with digital artery calcification evident on plain X-ray. Overall 71 patients had diabetes mellitus and/or end-stage renal failure, including 28 of 29 patients with calcification. In the calcification group, 17 patients had ipsilateral arteriovenous fistulae, five had steal syndrome and 15 had digital ulceration or skin necrosis. Compared with 181 controls, patients with calcification had more affected bones, polymicrobial infections, surgical procedures, phalanges and digits amputated and had higher mortality at 1 year (12 of 29) and 5 years (20 of 29), as a result of comorbidities. Absence of calcification in 43 patients with diabetes and/or end-stage renal failure was associated with better outcomes on all the above parameters. Early amputation to maximize disease-free survival may be appropriate for patients with hand osteomyelitis and arterial calcification. Level of evidence: IV

scholarly journals Matching theory: kidney allocation

2013 ◽  
Vol 82 (1) ◽  
pp. 14-16
Author(s):  
Kyle Luong
Keyword(s):  
United States ◽  
Renal Failure ◽  
The United States ◽  
Matching Theory ◽  
Great Success ◽  
End Stage Renal Failure ◽  
Exchange Programs ◽  
The World ◽  
Paired Exchange ◽  
End Stage

Lloyd Shapley and Alvin E. Roth have recently been awarded the Nobel Prize in Economics for their work in matching theory. Although branching from the field of economics, matching theory has had many implications in the world of medicine. For example, the National Residency Matching Program in the United States is an application of matching theory. The focus of this article is the application of matching theory to kidney transplant allocation. Kidney transplantation is the best treatment for end stage renal failure. Unfortunately, the demand for kidneys exceeds supply. Kidney paired exchange programs, which have begun to garner great success in increasing the number of kidney transplants worldwide, base their foundations on matching theory. Overviewed in this paper will be how these programs were created and work, their successes, and some of the unique challenges and logistical obstacles they face.

scholarly journals Ideological foundations of modern political and legal institutional architectonics in Western Europe and the USA

2020 ◽  
pp. 107-118
Author(s):  
N.N. Ravochkin ◽  
◽  
Keyword(s):  
United States ◽  
Western Europe ◽  
The United States ◽  
Close Attention ◽  
Institutional Settings ◽  
The Usa ◽  
Management Institutions

The author examines the ideological foundations of political and legal institutional architectonics in Western Europe and the United States and presents its structure. Close attention is paid to the role of social ideas and the development of these issues in modern scientific directions. The author clarifies the principles of synthesis of ideal and institutional and shows three ways of ideological determination of political and legal institutional settings. The mutually conditioned nature of functioning of the system of ideological frameworks and management institutions is substantiated.

Skin Examination: An Important Diagnostic Tool in Renal Failure Patients

2018 ◽  
Vol 45 (1-3) ◽  
pp. 187-193 ◽  
Author(s):  
Karen M. Van de Velde-Kossmann
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
Genetic Disorders ◽  
The United States ◽  
Underlying Disease ◽  
Careful Examination ◽  
Common Skin ◽  
Important Diagnostic Tool ◽  
Stage Renal Disease ◽  
End Stage

Renal failure is common in the United States with an estimated prevalence of 660,000 treated end-stage renal disease patients in 2015 [<xref ref-type="bibr" rid="ref1">1</xref>]. Causes of renal failure are many, and complications from renal failure, underlying disease, and treatment are not infrequent. Examples of common skin manifestations include xerosis, pigmentary change, and nail dystrophies. Frequent disease-specific skin changes may be helpful in the diagnosis of primary disorders leading to renal disease or severity of disease including bullosis diabeticorum, sclerodactyly, or leukoctoclastic vasculitis. Some cutaneous changes, such as the multiple angiokeratomas of Fabry disease or the plexiform neurofibromas of neurofibromatosis, are pathognomonic of genetic disorders, which often lead to renal failure. Careful examination of the skin can provide crucial clues to diagnosis of renal failure causation and aid in monitoring complications.

Recent Advances in the Management of the Infant, Child, and Adolescent With Chronic Renal Failure

1990 ◽  
Vol 11 (9) ◽  
pp. 277-282
Author(s):  
Richard N. Fine
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Quarter Century ◽  
Irreversible Reduction ◽  
Age Limits ◽  
Stage Renal Disease ◽  
End Stage

The prognosis of the infant, child, or adolescent with chronic renal failure, defined as an irreversible reduction in glomerular filtration rate, has improved during the past quarter century because of the use of dialysis and renal transplantation. These have prolonged lives in previously fatal situations. Because the potential not only to sustain life but also to effect full rehabilitation exists with the introduction of these treatments, it is now imperative that the multisystem consequences of uremia be either minimized or totally avoided in the pediatric patient with chronic renal failure. The role of the pediatrician in managing the infant, child, or adolescent with chronic renal failure should be directed toward minimizing the potentially devastating consequences of uremia so that the patient is in optimal clinical condition when end stage renal disease occurs. INCIDENCE It is difficult to know the incidence and prevalence of chronic renal failure and end stage renal disease in children. Surveys in Europe and North America have been conducted to obtain precise information regarding these issues; not only have the definitions included in these surveys differed, but the upper and lower age limits defining pediatric patients have not been uniform. The available data suggest a prevalence of chronic renal failure of 18.5 per 1 million child population and an incidence of end stage renal disease of from 3 to 6 children per 1 million total population.

Transplantation

2020 ◽  
pp. 449-466
Keyword(s):  
Liver Transplantation ◽  
Renal Failure ◽  
Renal Transplantation ◽  
Cardiac Transplantation ◽  
Intestinal Transplantation ◽  
Postoperative Management ◽  
Mechanical Support ◽  
End Stage Renal Failure ◽  
End Stage

This chapter begins with an introduction to transplant surgery with its intriguing history and development as a specialty. The general principles of biological rejection are covered on a background of immunology and immunosuppression. Clinical transplants in children are detailed with the first and most well-established being renal transplantation . The causes of end-stage renal failure are listed with further details of preparation, the operation itself, and potential complications. Cardiac transplantation is fully discussed, including indications, contraindications, the role of mechanical support, surgery for the donor and the recipient, complications, and postoperative management. Liver transplantation is covered in detail, including listing for a transplant, choice of a suitable donor, the surgical procedure, and outcomes and complications. Finally, intestinal transplantation is covered with discussion on indications, potential complications, and outcomes.

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