Air pollution and kidney disease: Review of current evidence

Along with amazing technological advances, the industrial revolution of the mid-19th century introduced new sources of pollution. By the mid-20th century, the effects of these changes were beginning to be felt around the world. Among these changes, health problems due to environmental air pollution are increasingly recognized. At the beginning, respiratory and cardiovascular diseases were emphasized. However, accumulated data indicate that every organ system in the body may be involved, and the kidney is no exception. Although research on air pollution and kidney damage is recent, there is now scientific evidence that air pollution harms the kidney. In this holistic review, we have summarized the epidemiology, disease states and mechanisms of air pollution and kidney damage

HbA1c Is Related with Uremic Pruritus in Diabetic and Nondiabetic Hemodialysis Patients

WOS: 000310016300013PubMed: 21370992Objective: Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HD patients. In this study, we investigated the relationship between UP and HbA1c in HD patients. Methods: Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imaginable itch). Results: Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 +/- 13.5 years) were included. The VAS pruritus score was higher in diabetic patients compared with nondiabetic patients (4.7 +/- 2.8 vs. 3.0 +/- 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.637, p < 0.0001), intact parathyroid hormone (beta : +0.343, p : 0.017), HbA1c (beta : +0.310, p : 0.027), and Beck depression score (beta : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta: +0.486, p : 0.004), intact parathyroid hormone (beta : +0.302, p : 0.041), and HbA1c (beta : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.372, p : 0.001), intact parathyroid hormone (beta : +0.241, p : 0.008), HbA1c (beta : +0.227, p : 0.031), and Beck depression score (beta : +0.298, p : 0.003). Conclusions: In both diabetic and nondiabetic patients, HbA1c is closely related with pruritus in HD patients

Atherosclerotic renal artery disease and heart failure: questions in mind

WOS: 000279189400058PubMed: 2046669

Acinetobacter co-infection and coagulase-negative Staphylococcus: case report and literature review

WOS: 000277388400019PubMed: 20446794Continuous ambulatory peritoneal dialysis (CAPD) is a safe, convenient, and cost-effective therapy in end-stage renal disease. The major complication of peritoneal dialysis (PD) is peritonitis. Gram-positive cocci are isolated in majority of the episodes. Among gram-negative bacteria, Acinetobacter species have been reported in peritonitis, sometimes as a concomitant that may be asymptomatic and require no treatment. Little has been written about the clinical features and outcome of PD-related peritonitis caused by co-infection of Acinetobacter species with other pathogens. We herein present a case of peritonitis caused by co-infection with Acinetobacter species and coagulase-negative staphylococci, which resulted in patient dropout and mortality. We review the literature about Acinetobacter peritonitis and current treatment protocols.</

The independent relationship between creatinine clearance, microalbuminuria and circadian blood pressure levels in newly diagnosed essential hypertensive and type 2 diabetic patients

WOS: 000311267700012PubMed: 22795337Background and Objectives: Increased evidence suggests that apart from patients with increased albumin excretion and decreased glomerular filtration rate (GFR); there are also patients with type 2 diabetes with decreased GFR but without albuminuria. The exact pathophysiologic mechanisms regarding these clinical conditions are not known. We suggest that different blood pressure (BP) levels may be one the factors for these different clinical conditions. However, before labeling BP as a causative factor: one must show whether BP levels are different in these patients. Thus the current study was performed to analyze the relationship between creatinine clearance, microalbuminuria and circadian blood pressure levels in newly diagnosed essential hypertensive and type 2 diabetic patients. Methods: Medical history, physical examination, laboratory analysis and ambulatory blood pressure measurements (ABPMs) were analyzed. 24-h urine specimens were collected to measure creatinine clearance and albumin excretion Results: In total 216 patients were included which were divided into 4 groups: group 1 composed of 90 patients with normal GFR and without microalbuminuria (MA), group 2 composed of 50 patients with normal GFR and with MA, group 3 composed of 36 patients with decreased GFR and without MA and group 4 composed of 40 patients with both decreased GFR and MA. The ratio of dippers vs. non dippers was not different between group 1, group 2 and group 3 patients. However ratio of dippers was higher in group 1 when compared to group 4 (P: 0.003) and group 4 patients have an odds of 7.678 (CI: 1.657-35.576, P: 0.009) for non-dapping status when compared to patients in group 1. Conclusion: In conclusion, ABPM measurements were highest in patients with both decreased GFR and MA, whereas they are lowest in patients with normal GFR and normal UAE. (C) 2012 Elsevier Inc. All rights reserved

Data are cumulating about elevated troponin I levels in asymptomatic dialysis patients

WOS: 000287746500057PubMed: 2118929

Mean platelet volume is not a determinant of primary arteriovenous fistula failure in hemodialysis patients

WOS: 000299600400023PubMed: 2121838

Sudden cardiac death and mineral metabolism in chronic kidney disease

WOS: 000275573500018PubMed: 2022459

Urinary albumin excretion among nondipper hypertensive patients is closely related with the pattern of nondipping

WOS: 000281294600007PubMed: 20655503The relationship between 24-hour urinary albumin excretion (UAE) rate and the pattern of nondipping (isolated systolic nondipping, isolated diastolic nondipping, and both systolic and diastolic nondipping) is not known. Medical history, physical examination, laboratory analysis, and office and ambulatory blood pressure measurements were performed. Twenty-four hour urine specimens were collected to determine creatinine clearance and UAE. In total, 158 essential hypertensive patients (104 dippers, 54 nondippers) were included. Fourteen patients were isolated systolic nondippers, 7 patients were isolated diastolic nondippers, and 33 patients were both systolic and diastolic nondippers. Among nondipper patients, 17 had microalbuminuria and, among dipper patients, 9 had microalbuminuria (P < .0001). The median UAE of dippers was lower when compared with nondippers (5.25 mg/day vs.23 mg/day, P < .0001). The median UAE of isolated systolic nondippers, isolated diastolic nondippers, and both systolic and diastolic nondippers were 8.45 mg/day, 7.7 mg/day, and 25.5 mg/day, respectively (P = .001). Subgroup comparison of patients revealed that UAE was higher in patients with both systolic and diastolic nondippers when compared with dippers (P < .0001), isolated systolic nondippers (P = .001), and isolated diastolic nondippers (P = .017). Not only nondipping itself, but nondipping profile may be related with UAE in essential hypertensive patients. J Am Soc Hypertens 2010;4(4):196-202. (C) 2010 American Society of Hypertension. All rights reserved

Malnutrition-Inflammation Complex Syndrome in Kidney Transplant Recipients

WOS: 000283261700029PubMed: 2097002