scholarly journals Maxillomandibular Deformity in a Canine with Fibrous Osteodystrophy Secondary to Chronic Kidney Disease

2019 ◽  
Vol 47 ◽  
Author(s):  
Stefabie Bressan Waller ◽  
Francisco Jucelio Correia Canuto ◽  
Paula Priscila Correia Costa ◽  
Eduarda Alexia Nunes Louzada Dias Cavalncanti ◽  
Guilherme Albuquerque De Oliveira Cavalcanti ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Investigation ◽  
Serological Test ◽  
Bone Matrix ◽  
Macrocytic Anemia ◽  
Abdominal Ultrasound ◽  
Symptomatic Therapy ◽  
Laboratory Findings ◽  
Mongrel Dog

Background: Cases of renal fibrous osteodystrophy are usually associated with nutritional causes, which of renal causes are considered uncommon in dogs. This disorder is characterized by the intense proliferation of fibrous connective tissue in bones, impairing bone stiffness. The aim of this study was to report a case of fibrous osteodystrophy secondary to chronic kidney disease in a canine with a "rubber jaw" facial deformity.Case: A 4-year-old male unneutered mongrel dog weighing 5.2 kg had a history of apathy, progressive weight loss and vomiting for one month, and polyuria and polydipsia for more than three months. In addition, the owner complained about the deformed appearance in the muzzle region of the animal, which was evidenced flexibility of the same, with a displacement of the mandible and maxilla on physical examination, similar to the "rubber jaw". Blood tests revealed macrocytic anemia, elevated total plasma proteins, and lymphopenia-associated neutrophilia, as well as hyperphosphatemia (24 mg/dL), uremia (283.6 mg/dL) and increased creatinine (8.6 mg/dL), ALT (143.2 UI/L) and alkaline phosphatase (3222.2 UI/L), while calcium (8.8 mg/dL) and albumin (1.9 g/dL) were decreased. A serological test for visceral leishmaniasis was also performed, which was negative. Abdominal ultrasound imaging revealed kidneys with alterations in tissue architecture, increased thickness and complete loss of cortico-medullary relationship, while the parathyroid gland was enlarged and spindle-shaped. Cranial radiography showed marked radiopacity of the bilateral maxillary bones, with destruction of the nasal, turbinate and frontal bones, as well as loosening of the teeth and destruction of the mandibular bone matrix, characterizing an aspect of “rubber jaw”. Based on the history, history and evidence of azotemia, hyperphosphatemia and loss of facial bone density, the diagnosis of fibrous osteodystrophy secondary to chronic kidney disease associated with hyperparathyroidism was concluded.Discussion: The clinical and laboratory findings reported in the present study were similar to those described in dogs with renal fibrous osteodystrophy associated with hyperparathyroidism. In the presence of azotemia, the patient was in stage 4 of chronic kidney disease which, despite investigating the infectious etiology, which was negative, remained unknown. Along with chronic kidney disease, the observation of hyperphosphatemia associated with hypokalemia contributed to the clinical investigation, whose pathophysiological mechanisms of this disorder were discussed in this study. The organic alterations observed in the patient's imaging examination coincided with the pathophysiological processes of renal fibrous osteodystrophy. The findings of renal and parathyroid alterations on ultrasound, as well as the damage to the bone matrix, maxillomandibular deformity and loss of bone support evidenced on cranial radiography, led to the conclusion of the diagnosis of renal fibrous osteodystrophy secondary to hyperparathyroidism. Despite the recommended symptomatic therapy, the patient died within 24 hours of hospitalization, and it was not possible to perform a necropsy. This report is highlighted by the occurrence of bone deformity at the maxillary and mandibular level, as a result of renal dysfunction in a young canine, alerting to the importance of complementary exams for proper diagnosis.

MO566THE BONE EXPRESSION OF WNT INHIBITORS IN THE EXPERIMENTAL MODEL OF EARLY CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Evdokia Bogdanova ◽  
Natalia Semenova ◽  
Olga Galkina ◽  
Irina Zubina ◽  
Olga Beresneva ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Experimental Model ◽  
Inorganic Phosphate ◽  
Molecular Mechanisms ◽  
Fibroblast Growth Factor 23 ◽  
Bone Matrix ◽  
Serum Levels ◽  
Chow Diet ◽  
Dickkopf 1

Abstract Background and Aims Molecular mechanisms implicated in the initial stages of inorganic phosphate (Pi) imbalance in chronic kidney disease (CKD) remain poorly understood.The aim of the study was to evaluate whether canonical Wnt pathway inhibitors (iWnt) involved in early response to Pi retention in CKD. Methods Mild CKD was induced by 3/4 nephrectomy (NE) in spontaneously hypertensive rats (SHR) fed rat chow diet containing 0.6 % phosphate. Controls were sham operated SHR (SO). Duration of experimental exposure (NE or SO) was 2 and 6 months. Serum levels of creatinine (Cr), inorganic phosphate (Pi), fractional Pi excretion (FEPi), intact parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), alfa-Klotho (KL), sclerostin (SOST) and Dickkopf-1 (DKK1) were measured. The following morphological characteristics by light microscopy of bone metaphysis and kidney tissues: the area of renal interstitial fibrosis (RF) (Masson's trichrome), bone matrix volume (MV), the active osteoblasts to trabecular cells number ratio (aOB/cells), eroded surface to bone surface ratio (ES/BS) (hematoxylin & eosin), and bone SOST and DKK1 proteins expression (by IHC) were analyzed and calculated quantitatively. Statistical comparisons among groups were performed using Mann–Whitney U-test and Kruskal-Wallis H-test. Results Serum Cr, RF and indices of Pi exchange in the experimental model corresponded to early CKD (Table). Pi elevated in NE6 suggestive for its renal retention. KL level decreased (Table) in all experimental groups vs control. No differences were observed in serum levels FGF23 (p=0.62) and PTH (p=0.63). Serum SOST and DKK1 levels were significantly higher in NE6 group compared to SO6 (Table). The bone SOST and DKK1 expression increased in NE6 compared to SO6 (Figure). aOB/cells were lower in NE2, SO6 and NE6 vs SO2 (all p-values<=0.041). ES/BS increased in NE2 (vs SO2) while being lowest in NE6 and SO6 animals (Table). SOST and DKK1 metaphyseal expression increased in NE6 compared to SO2, SO6, NE2 (Figure). Osteocyte SOST expression increased in SO6 compared to SO2 and NE2 without differences in later groups. Osteoblast SOST expression was also higher in SO6 vs SO2 (Figure). Conclusion Increased serum levels of sclerostin and Dickkopf-1 and their bone expression are apparent in early stages of experimental CKD associating with hyperphosphatemia. Alterations of bone resorption and osteoblast depopulation occurred before the increase of serum Pi likely reflecting incipient stages of renal Pi retention. These molecular and cellular events seem to be independent of systemic FGF23 and PTH response.

scholarly journals BARDET — BIEDL SYNDROME WITH CONGENITAL KIDNEY MALFORMATION IN A 14-YEAR-OLD GIRL

2019 ◽  
Vol 26 (3) ◽  
pp. 129-134
Author(s):  
Anna V. Burlutskaya ◽  
Natalia V. Savelyeva
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Development ◽  
Clinical Symptoms ◽  
Left Kidney ◽  
Hereditary Disease ◽  
Symptomatic Therapy ◽  
Excretory Function ◽  
Kidney Malformation ◽  
The Right

Aim. To show the variety and severity of the clinical symptoms of a rare hereditary disease — Вardet — Biedle syndrome — in a14-year-old girl. Materials and methods. We carried out a retrospective analysis of anamnestic data, the course of the disease, laboratory and instrumental data, as well as the therapy of a 14-year-old patient with Вardet-Вiedlе syndrome. Results. A 14-year-old patient with hereditary Вardet — Вiedlе syndrome (polydactyly, mental retardation, progressive obesity, pigment retinopathy) was found to have a congenital abnormality of kidney development — hypoplasia and dysplasia of the only right kidney complicated by chronic secondary pyelonephritis with the development of chronic kidney disease. Urine tests revealed leukocyturia, bacteriuria and proteinuria. The echo-signs of diffuse changes in the parenchyma of the right kidney were found during the ultrasound kidney examination. The left kidney was not determined. The conclusion of dynamic renal scintigraphy: the image of the left kidney is not reliably visualized (a sharp decrease in the function or absence of the kidney), the preserved filtration function and a moderate decrease in the excretory function of the right kidney. Intoxication syndrome, leukocyturia, bacteriuria and proteinuria were relieved against the background of antibacterial (Ceftriaxone) and symptomatic therapy. Conclusion. We have described a clinical case of the Вardet — Вiedlе syndrome with congenital kidney malformation (impaired function), but with the normal structure of the internal reproductive organs and sexual development. In the future, due to the development of chronic kidney disease, the patient should receive specialized nephrological care, as well as be observed by endocrinologist due to a high risk of developing type 2 diabetes mellitus.

scholarly journals An Adaptive Neuro-Fuzzy Expert System for Clinical Staging of Patients with Chronic Kidney Disease

2021 ◽  
Author(s):  
Bernard Andoh ◽  
Adebayo Felix Adekoya ◽  
Benjamin Asubam Weyori ◽  
Elliot Koranteng Tannor
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Medical History ◽  
Predictive Factors ◽  
Filtration Rate ◽  
Disease Model ◽  
Experimental Result ◽  
Laboratory Findings ◽  
Health Records

Abstract BackgroundChronic kidney disease (CKD) is a health complication faced by almost every nation, as Ghana is no exception. The Ghana Dialysis Service Foundation (DSF) indicated that an average of 12,000 kidney-failure cases is diagnosed among Ghanaians every year. An adequate diagnosis of suspected CKD will play a critical role in saving many lives. This study widens the predictive factors grouped as; personal lifestyle, laboratory findings, and medical history of a patient. The glomerulus filtration rate addresses the controversy of diagnosing CKD without considering aetiology.MethodsThe study adopted a structured, guided questionnaire to obtain the dataset from health records of 180 patients diagnosed with CKD. The Renal clinic of Komfo Anokye Teaching hospital gave access to the patients' health records following the clearance from the ethical committee in Kwame Nkrumah University of Science and Technology. The health records were categorized into Personal Lifestyle, Laboratory findings and Medical history. Eleven factors that influence the incidence of chronic kidney disease were identified and analyzed in this work. The developed model is based on a hybrid of Artificial Neural Network and Fuzzy logic (ANFIS) techniques.ResultsAn experimental result of the proposed predictive model recorded an average Root Mean Square Error of 0.85014 for training and 1.3983 for testing. The result showed a close relationship between the actual and predicted outcomes for the training and testing. The Modification of Diet for Renal Disease (MDRD) model is applied to the dataset to estimate the Glomerulus Filtration Rate to determine the stage of the Chronic Kidney Disease. The developed model (NANFIS) gave a better performance than the Modification of Diet for Renal Disease MODEL results.ConclusionsConsidering the aetiology that widens the predictive factors provides an improved perspective in predicting the stage of the disease. The Modification of Diet for Renal Disease model considers Age, race, sex and creatinine to determine the location of Chronic Kidney Disease. The increase in data would help to improve the performance of the developed model better.

scholarly journals Renal imaging in children with chronic kidney disease

2013 ◽  
Vol 53 (4) ◽  
pp. 193
Author(s):  
Wiwit Rahmawati ◽  
Heru Muryawan ◽  
Farah Prabowo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Ultrasound Imaging ◽  
Renal Cortex ◽  
Clinical Manifestations ◽  
Renal Ultrasound ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Renal Imaging ◽  
Echogenic Kidneys

Background Chronic kidney failure is a cause of death inchildren. Diagnosing chronic kidney disease is often made byclinical manifestations, laboratory findings and ultrasonographyor other imaging tests. Early detection of chronic kidney diseaseis needed for education and management of the disease.Objective To describe renal imaging findings and mortality inchildren with chronic kidney disease .Methods This was a cross-sectional study on children with kidneydiseases who were inpatients at Dr. Kariadi Hospital from January2008 to June 2011. Data were taken from medical records. Chronickidney disease was confirmed by clinical manifestations, laboratoryfindings, and radiologic imaging. Renal ultrasound findings weredetermined by the radiologist responsible at that time. Resultswere presented as ft:equency distributions.Results Of 37 chronic kidney disease cases, 27 were males and 10were females. Subjects' most common complaints were dyspnea (7out of 3 7) and edema (30 out of 3 7) . Renal ultrasound imaging ofsubjects with chronic kidney disease yielded the following findings:reduced cortico-medullary differentiation (30 out of 3 7), bilateralechogenic kidneys (21 out of 3 7), reduced renal cortex thickness(4 out of 37) and small-sized kidneys (4 out of 37) . Eight of the37 children died. These 8 subjects had the following radiologicimaging findin gs: both kidneys appeared small in size (4 out ofS),reduced 'renal cortex' thickness (4 out of 8), echogenic kidneys(6 out of 8), and reduced cortico-medullary differentiation (8out of8).Conclusion Renal ultrasound imaging of pediatric subjects withchronic kidney disease revealed findings of reduced corticomedullarydifferentiation, bilateral echogenic kidneys, reducedrenal cortex thickness, and small kidneys bilaterally.

scholarly journals Neurological Complications and Associated Risk Factors in Children Affected with Chronic Kidney Disease

Children ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 59
Author(s):  
Osama Safdar ◽  
Sulafa Sindi ◽  
Njood Nazer ◽  
Asmaa Milyani ◽  
Abdulrahman Makki
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Central Nervous System Involvement ◽  
Abdominal Ultrasound ◽  
Neurological Complications ◽  
Management Plan ◽  
University Hospital ◽  
Cystic Kidney Disease ◽  
Cystic Kidney ◽  
Micturating Cystourethrogram

To investigate the correlation between chronic kidney disease (CKD) and the development of neurological disease among pediatric patients in Saudi Arabia. The present retrospective study recruited patients admitted to King Abdulaziz University Hospital during 2018. We reviewed electronic records to collect data on essential demographics including age, gender, and nationality; history of prior CNS disease or related symptoms; results of neurological physical examination; and findings of radiological investigations such as abdominal ultrasound, dimercaptosuccinic acid scan, micturating cystourethrogram, diethylene triamine pentaacetic acid scan, brain computed tomography, and magnetic resonance imaging. The most commonly diagnosed renal pathologies were neurogenic bladder and cystic kidney disease. The most common neurological manifestation was seizure disorder. Males were more frequently affected with neurological sequelae than females. The prevalence of neurological disorders was higher in patients over two years old. The most frequently observed stage of chronic kidney disease was stage 5. Most children who were affected with a neurological disorder required hemodialysis as part of their management plan. Patients with chronic kidney disease are at a high risk of neurocognitive defects. The type of management and renal diagnosis are significant factors that should be considered when anticipating central nervous system involvement in the case of chronic kidney disease.

scholarly journals Drug Dosage Adjustment of Chronic Kidney disease Patients at Nephrology Ward in Tertiary Care Hospital of Nepal

2020 ◽  
Vol 2 (1) ◽  
pp. 41-50
Author(s):  
Sonu Pakhrin ◽  
Sumitra Shrestha ◽  
Renu Karki ◽  
Nirmal Raj Marasine ◽  
Rajendra Lama ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dose Adjustment ◽  
Dosage Adjustment ◽  
Tertiary Care ◽  
College Teaching ◽  
Drug Dosage ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Drug Dosage Adjustment

Background: Drug dosage adjustment is essential for chronic kidney disease patients (CKD) patients. If it is not done properly, this will lead to an increase in toxicity and a decrease in the effectiveness of therapy. The objective of the present study was to assess whether appropriate dosage adjustments were made in hospitalized CKD patients. Methods: A descriptive cross-sectional study was carried out among 80 CKD patients with stage II to V admitted in the nephrology ward of Chitwan Medical College Teaching Hospital, Nepal between 1st August to 30th November 2018. All patients with renal clearance ≤90 ml/min/1.73 m2 were included for the analysis. Data concerning patient’s clinical, medications and dosages, laboratory findings were extracted from the medical record section. Results: Total of 81 numbers of prescribed drugs was found in eighty hospitalized CKD patients. Twenty-seven were found requiring dose adjustment. Dose adjustment according to renal function was judged as necessary in 27 dose adjustment required drugs. Among these, 11 (40.7% of 27) drugs were considered appropriate in dosing, whereas 16 (59.3%) were found to be inappropriate. A total of 13 (81.3%) number of drugs were inappropriately adjusted in stage V patients. Conclusion: Dosing errors were the most frequently observed challenge in the patient hospitalized with CKD. This study also intensified the need for strong monitoring of drug therapy which will bear in achieving the better therapeutic outcomes that improve the quality of life and decrease the various problems associated with dosing error. 

scholarly journals Role of Serum Uromodulin in the Early Diagnosis of Chronic Kidney Disease

2021 ◽  
Vol 48 (1) ◽  
pp. 13-16
Author(s):  
D. Genov ◽  
A. Kundurdgiev ◽  
I. Ivanova ◽  
M. Nikolova ◽  
V. Pencheva ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Diagnosis ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Inverse Correlation ◽  
Abdominal Ultrasound ◽  
University Hospital

Abstract Background: The diagnosis of chronic kidney disease (CKD) is usually delayed, when significant functional renal impairment has already occurred. The diagnosis is complex and clinical and laboratory investigations play a crucial role. There are well-established markers of CKD – serum creatinine and cystatin C. However, the search for new reliable biomarkers that aid in the assessment of kidney function and predict the evolution of the disease is still in progress. Objective: To investigate the role of serum uromodulin (sUmod) as a marker for early diagnosis of renal impairment in patients with CKD. Materials and Methods: We investigated 70 patients, 28 male and 42 female, mean age 56.53 ± 11.753, with CKD in a prospective observational study. All patients were admitted to the Clinic of Nephrology at the “St. Ivan Rilski” University Hospital between April and November 2019. After obtaining written informed consent, laboratory blood and urine tests, abdominal ultrasound and sUmod investigations were performed in all patients. Results: Plasma uromodulin levels showed decrease with the increasing of the severity of renal impairment. sUmod displayed inverse correlation with serum creatinine (r = -0.467, p < 0.0001), cystatin C (r = -0.430, p < 0.0001) and urea (r = -0.495, p < 0.0001) and a positive correlation with eGFR (r = 0.628, p < 0.0001). Conclusion: The results of our study show that sUmod levels significantly correlate with all established laboratory parameters used for the evaluation of renal impairment. It can be used as a potential early biomarker for CKD diagnosis.

scholarly journals Osteoporosis in Patients with Chronic Kidney Disease

2020 ◽  
Vol 95 (2) ◽  
pp. 89-94
Author(s):  
Young Joo Kwon
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnostic Methods ◽  
Mineral Density ◽  
Anabolic Agents ◽  
Adynamic Bone Disease ◽  
Laboratory Findings ◽  
Turnover Markers ◽  
Adynamic Bone ◽  
Selection Of

Osteoporosis in chronic kidney disease (CKD) is also referred to as ‘CKD with low bone mineral density (BMD)’, because the cause of low BMD in CKD includes chronic kidney disease-mineral bone disorders (CKD-MBD) such as secondary hyperparathyroidism, osteomalacia, and adynamic bone disease. Diagnostic methods of osteoporosis in CKD include FRAX®, BMD, and bone turnover markers as well as CKD-MBD biochemical parameters- calcium, P, alkaline phosphatase, PTH, and 25(OH)D3. The management of osteoporosis in CKD prioritizes CKD-MBD management over selection of bone anti-resorptive agents or osteo-anabolic agents according to clinical and laboratory findings.

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