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Drug-Induced Kidney Injury
Drug-Induced Nephropathy

Presentation

Pseudo-renal failure clinical presentation • increase in SCr OR BUN (not both) • no decrease in actual kidney function hemodynamically mediated renal failure clinical presentation • increase in SCr • decrease in GFR • happens w/in days of drug initiation [quizlet.com]

Bhatt’s presentation, Dr. Michelle L. [mdedge.com]

Presents a multi-disciplinary and international approach to critical renal care for a thorough and integrated presentation of how to care for critically ill patients with renal disease or complications. [books.google.de]

A special case of recurrent gross hematuria: Answers J Tu, C Chen, H Li, M Chu, H Geng - Pediatric Nephrology, 2017 - Springer Wilson's disease (WD) is an autosomal recessive disorder, and has a variety of presentations. [scholar.google.it]

Its pathophysiological mechanism remains speculative and is possibly modulated according to the risk factor(s) and clinical presentation of the patients. [eurekaselect.com]

Treatment

Changes in renal function associated with tenofovir disoproxil fumarate treatment, compared with nucleoside reverse-transcriptase inhibitor treatment. Clin Infect Dis. 2005;40(8):1194–8. PubMed CrossRef 42. Coca S, Perazella MA. [springermedizin.de]

The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol 1997;50:683-691. 4.Song F, Altman DG, Glenny AM, Deeks JJ. [annals.org]

The risk of developing hypertension was maximally elevated (OR, 1.7) after >5 years of treatment with HAART, compared with the risk among HIV-infected patients who did not receive treatment (OR, 0.79) [ 44 ]. [academic.oup.com]

Conservative prevention indication there is no specific therapy for contrast-induced nephropathy and thus prevention is the best treatment modality using other imaging modalities that do not require contrast if clinically possible using decreased doses [step2.medbullets.com]

The treatment arm received a 20 ng/kg/min PGE 1 intravenous infusion for 6 hours before and after the administration of contrast media. Controls received only 0.9% sodium chloride solution for routine hydration. [clinicaladvisor.com]

Prognosis

Prognosis of Acute Renal Failure In-Hospital Evolution Of the patients who presented ARF, 22.2% (n=8) required renal replacement therapy at admission. Continuous veno-venous hemofiltration was employed in all these patients. [revespcardiol.org]

[…] primary chronic kidney disease diabetic nephropathy with renal insufficiency multiple myeloma contrast amount causes of decreased renal perfusion ( e.g., hypovolemia) Pathogenesis contrast media results in acute tubular necrosis via unknown mechanisms Prognosis [step2.medbullets.com]

[…] low: as above medium: Cr 110-130 μmol/L or CrCl high: Cr 130-200 μmol/L or CrCl renal transplant, dehydration or hypotension low: not possible medium: even if their renal function is normal high: Cr 130-200 μmol/L or CrCl 30-60 mL/min Treatment and prognosis [radiopaedia.org]

Course Prevention References: [1] [2] [3] [4] [5] [6] Stages Stages of acute kidney injury according to KDIGO There are several classifications for staging AKI and assessing the prognosis. [amboss.com]

The histologic classification scheme used in idiopathic AAV to predict clinical prognosis ( 8 ) has not been validated in drug-associated AAV. Figure 1. [cjasn.asnjournals.org]

Etiology

While sometimes this is easy and relatively straightforward, often the clinician faces a difficult challenge distinguishing these two etiologies of kidney disease. [ncbi.nlm.nih.gov]

Etiology Prerenal ( ∼ 60% of cases) Any condition leading to decreased renal perfusion : Hypovolemia (e.g., burns, pancreatitis, diuretics ) Hypotension (e.g., sepsis, dehydration ) Renal vasoconstriction or stenosis (e.g., hepatorenal syndrome ) NSAIDs [amboss.com]

Etiology of AKI The etiology of AKI has changed over the last 10-20 years from primary renal disease (hemolytic uremic syndrome, glomerulonephritis) to the renal complications of systemic illness or associated treatment (sepsis, cardiac disease, oncologic [chikd.org]

Additional Drug-Induced Etiologies of MN. [cjasn.asnjournals.org]

Epidemiology

The new epidemiology of HIV-related kidney disease. J AIDS Clin Res. 2012;S4:1–6. This article describes the changing epidemiology of HIV in both the pre and post- cART era. [springermedizin.de]

Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure. [books.google.de]

Renal failure secondary to acute tubular necrosis: epidemiology, diagnosis, and management. Chest. 2005;128:2847-2863. 3. Uchino S. The epidemiology of acute renal failure in the world. Curr Opin Crit Care. 2006;12:538-543. 4. Hilton R. [uspharmacist.com]

Introduction Clinical definition acute kidney injury soon (24-48 hours) after contrast media administration Epidemiology incidence dependent on the presence or absence of risk factors among patients with no risk factors, the risk of contrast nephropathy [step2.medbullets.com]

Research Research in the epidemiology of DIKD has been limited. The lack of consensus definitions has led to variability in the incidence of DIKD. [bmcnephrol.biomedcentral.com]

Pathophysiology

Its pathophysiological mechanism remains speculative and is possibly modulated according to the risk factor(s) and clinical presentation of the patients. [eurekaselect.com]

In this report, we describe a case of crystalglobulin-induced nephropathy and discuss its pathophysiology and the differential diagnosis of paraprotein-induced crystalline nephropathy. [mayoclinic.pure.elsevier.com]

Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure. [books.google.de]

Typical pathophysiological features include glomerular injury, proteinuria, renal fibrosis and inflammatory cell infiltration, making this model attractive as an in vivo drug screening system. [creative-biolabs.com]

Immunosuppressant-induced nephropathy: pathophysiology, incidence and management. Drug Saf. 1999;21(6):471–488. 12. Perazella MA. Drug-induced nephropathy: an update. Expert Opin Drug Saf. 2005;4(4):689–706. 13. Markowitz GS, Perazella MA. [aafp.org]

Prevention

Clinical trials for the prevention of CIN have largely employed small oral doses of NAC in stable outpatient populations. [annals.org]

The drug had also shown promise in small preliminary studies for the prevention of periprocedural myocardial infarction in patients undergoing coronary stenting. [mdedge.com]

AND THERAPEUTIC COMPOSITIONS FOR DRUG INDUCED NEPHROPATHY AND HEPATITIS (FR) COMPOSITIONS PREVENTIVES ET THERAPEUTIQUES POUR NEPHROPATHIES ET HEPATITES D'ORIGINE MEDICAMENTEUSE Abstract: (EN) Novel agents for relieving drug-induced nephropathy and acute [patentscope.wipo.int]

The PREVENT (Preventive Strategies of Renal Insufficiency in Patients with Diabetes Undergoing Intervention or Arteriography) trial in 2011 showed similar efficacy of normal saline and sodium bicarbonate hydration in prevention of CIN in patients with [cancertherapyadvisor.com]

Preventive and therapeutic compositions for drug induced nephropathy and hepatitis Info Publication number EP0997150A4 EP0997150A4 EP98907207A EP98907207A EP0997150A4 EP 0997150 A4 EP0997150 A4 EP 0997150A4 EP 98907207 A EP98907207 A EP 98907207A EP 98907207 [google.com]

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