821 results match your criteria Uremic Encephalopathy

A Novel Predictive Model for Hospital Survival in Patients who are Critically Ill with Dialysis-Dependent AKI: A Retrospective Single-Center Exploratory Study.

Kidney360 2022 Apr 25;3(4):636-646. Epub 2022 Jan 25.

Division of Nephrology, Georgetown University/Medstar Washington Hospital Center, Washington, DC.

Background: Mortality of patients who are critically ill with AKI initiated on RRT is very high. Identifying modifiable and unmodifiable clinical variables at dialysis start that are associated with hospital survival can help, not only in prognostication, but also in clinical triaging.

Methods: A retrospective observational study was conducted on patients with AKI-D who were initiated on RRT in the medical and surgical intensive care units (ICUs) of a high-acuity academic medical center from January 2010 through December 2015. Read More

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Epidemiology, Risk Factors and Etiology of Altered Level of Consciousness Among Patients Attending the Emergency Department at a Tertiary Hospital in Mogadishu, Somalia.

Int J Gen Med 2022 30;15:5297-5306. Epub 2022 May 30.

Emergency Department, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia.

Introduction: An altered level of consciousness (ALOC) means that the patient is not as awake, alert, or able to understand or react to the surrounding environment. The main purpose of this study was to investigate the epidemiology, risk factors, and etiology of altered levels of consciousness among patients attending the Emergency Department.

Methods: The study was conducted in the Mogadishu-Somali-Turkey Training and Research Hospital in Mogadishu, Somalia, as a prospective observational study. Read More

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Dialysis in disaster: Using continuous renal replacement therapy for end-stage renal disease patients, a pilot proof of concept study.

Am J Emerg Med 2022 May 11. Epub 2022 May 11.

Department of Pulmonary and Critical Care Medicine, Louisiana State University Health, Shreveport, LA, United States of America.

Introduction: Each dialysis session uses approximately 150 to 200 L of water. The winter storm that swept southwest USA saw an unprecedented disruption of water supplies due to which intermittent hemodialysis could not be performed for end-stage renal disease (ESRD) patients. We present 4 cases when continuous renal replacement therapy (CRRT) was utilized to provide urgent hemodialysis in hemodynamically stable, non-critically ill ESRD patients during this time of water supply crisis. Read More

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A rare endocrinological complication of chronic kidney disease.

Turk J Pediatr 2022 ;64(2):375-380

Divisions of Nephrology, Department of Pediatrics, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir.

Background: Chronic kidney disease (CKD) may lead to increase in serum levels of peptide hormones as a result of changes in peripheral metabolism. The pathogenesis of uremic hyperprolactinemia in CKD is not fully understood. Plasma prolactin levels are elevated in women, pubertal girls, and also in men with chronic kidney disease. Read More

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COVAN Leading to ESKD Despite Minimal COVID Symptoms.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221093888

Mount Sinai Hospital Center (Elmhurst), New York, NY, USA.

We report a case of dialysis dependence in a patient with COVID-19-associated nephropathy (COVAN) who had minimal respiratory manifestations. A 25-year-old man with a history of multiple sclerosis in remission presented with mild dyspnea due to COVID-19 pneumonia and was found to have rapidly worsening kidney function. He only required nasal cannula and was able to be weaned off within a few days. Read More

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The dopamine system: insights between kidney and brain.

Kidney Blood Press Res 2022 Apr 4. Epub 2022 Apr 4.

Background: Chronic kidney disease (CKD) is one of the most common diseases in adult age and it is typical of older adults. Recent data suggest that almost half of the elders have CKD. It is now clear that CKD is accompanied, in the early stages, by cognitive impairment, together with depression and subtle abnormalities in motor control (such as gait and balance alterations). Read More

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Insights into Concomitant Atrial Fibrillation and Chronic Kidney Disease.

Rev Cardiovasc Med 2022 Mar;23(3):105

Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, Hubei, China.

Chronic kidney disease (CKD) shows a high prevalence and is characterized by progressive and irreversible loss of renal function. It is also associated with a high risk of cardiovascular disease. The CKD population often suffers from atrial fibrillation (AF), which is associated with cardiovascular and all-cause mortality. Read More

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Metabolic Disorders Associated with Renal Disease in Horses.

Vet Clin North Am Equine Pract 2022 Apr 10;38(1):109-122. Epub 2022 Mar 10.

Littleton Equine Medical Center, 8025 South Santa Fe Drive, Littleton, CO 80120, USA. Electronic address:

This article overviews metabolic disorders associated with renal disease. Included is a discussion of the pathophysiology, clinical signs, and treatment of hyperchloremic metabolic acidosis associated with renal tubular acidosis. Conditions affecting the central nervous system including uremic encephalopathy and hyponatremic encephalopathy secondary to renal disease are presented. Read More

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Arsenic intoxication with renal failure managed with hemodialysis alone: A case report.

Drug Discov Ther 2022 ;16(1):49-51

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Arsenic has widespread use in agriculture, in alternative medicine and in treatment of certain malignancies, therefore it is vital to timely recognize and treat arsenic toxicity in a suspected patient. Hemodialysis conventionally is thought to play only a supportive role in managing arsenic toxicity but it can be life-saving when chelation is not possible or available. A middle-aged female with a history of non-dialysis-dependent chronic kidney disease (CKD) was brought to the emergency with altered sensorium. Read More

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Emotional and cognitive changes in chronic kidney disease.

Korean J Intern Med 2022 05 8;37(3):489-501. Epub 2022 Mar 8.

Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

Chronic kidney disease (CKD) leads to cognitive impairment and emotional changes. However, the precise mechanism underlying the crosstalk between the kidneys and the nervous system is not fully understood. Inflammation and cerebrovascular disease can influence the development of depression in CKD. Read More

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Case report: MRI findings of acute uremic encephalopathy in a 1-year-old boy.

BJR Case Rep 2021 Sep 14;7(5):20210057. Epub 2021 May 14.

Department of Neuroradiology, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom.

We present a 1-year-old boy who presented to the emergency department with a 7-day history of diarrhoea and vomiting. The initial renal function profile demonstrated a urea of 55 mmol l (normal range between 5 and 20 mmol l), creatinine 695 micromol/L (normal range between 62-106 micromol/L) and potassium 9.1 mmol l (normal range between 3. Read More

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September 2021

Adult-onset CblC deficiency: a challenging diagnosis involving different adult clinical specialists.

Orphanet J Rare Dis 2022 02 2;17(1):33. Epub 2022 Feb 2.

Department of Pediatrics, Città della Salute e della Scienza University Hospital, University of Torino, Piazza Polonia 94, 10126, Turin, Italy.

Background: Methylmalonic aciduria and homocystinuria, CblC type (OMIM #277400) is the most common disorder of cobalamin intracellular metabolism, an autosomal recessive disease, whose biochemical hallmarks are hyperhomocysteinemia, methylmalonic aciduria and low plasma methionine. Despite being a well-recognized disease for pediatricians, there is scarce awareness of its adult presentation. A thorough analysis and discussion of cobalamin C defect presentation in adult patients has never been extensively performed. Read More

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February 2022

Acute Acquired Metabolic Encephalopathy Based on Diffusion MRI: Note of an Error.

Korean J Radiol 2022 02;23(2):289

Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey.

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February 2022

Functional Analysis of Variants in Complement Factor I Identified in Age-Related Macular Degeneration and Atypical Hemolytic Uremic Syndrome.

Front Immunol 2021 5;12:789897. Epub 2022 Jan 5.

Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, Netherlands.

Complement factor I (FI) is a central inhibitor of the complement system, and impaired FI function increases complement activation, contributing to diseases such as age-related macular degeneration (AMD) and atypical hemolytic uremic syndrome (aHUS). Genetic variation in complement factor I () has been identified in both AMD and aHUS, with more than half of these variants leading to reduced FI secretion levels. For many of the variants with normal FI secretion, however, functional implications are not yet known. Read More

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February 2022

What is the impact of blood pressure on neurological symptoms and the risk of ESKD in primary and secondary thrombotic microangiopathies based on clinical presentation: a retrospective study.

BMC Nephrol 2022 01 20;23(1):39. Epub 2022 Jan 20.

Service of nephrology, department of medicine, CHUV and Université de Lausanne, Lausanne, Switzerland.

Background: The impact of blood pressure on neurological symptoms and risk of end-stage kidney disease (ESKD) is unknown in primary and secondary thrombotic microangiopathies (TMAs).

Methods: We measured baseline systolic (SBP) and diastolic (DBP) BP in consecutive 563 patients with adjudicated primary and secondary TMAs, and assessed its association with the risk of ESKD.

Results: Normal BP, grade 1, 2 and 3 hypertension were present in 243 (43. Read More

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January 2022

The Impact of Uremic Toxins on Alzheimer's Disease.

Curr Alzheimer Res 2022 ;19(2):104-118

Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland.

Alzheimer's disease (AD) is the most common type of dementia, pathologically characterized by the accumulation of senile plaques and neurofibrillary tangles. Chronic kidney disease (CKD) is highly prevalent in the elderly population closely associated with the occurrence of dementia. Recent epidemiological and experimental studies suggest a potential association of CKD with AD. Read More

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January 2022

"Is It Removed During Dialysis?"-Cognitive Dysfunction in Advanced Kidney Failure-A Review Article.

Front Neurol 2021 2;12:787370. Epub 2021 Dec 2.

Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Cognitive impairment is independently associated with kidney disease and increases in prevalence with declining kidney function. At the stage where kidney replacement therapy is required, with dialysis or transplantation, cognitive impairment is up to three times more common, and can present at a younger age. This is not a new phenomenon. Read More

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December 2021

Tacrolimus Induced Thrombotic Microangiopathy (TMA) Presenting as Acute Macular Neuroretinopathy.

Ocul Immunol Inflamm 2021 Dec 2:1-2. Epub 2021 Dec 2.

Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

This report highlights the association of tacrolimus use with acute macular neuroretinopathy (AMN). A 27-year-old woman, a known case of diffuse proliferative membranous glomerulonephritis, developed abnormal body movements, loss of consciousness, and blurring of vision in the left eye, after 3 months of starting tacrolimus. Blood investigations revealed anemia, thrombocytopenia, raised urea and creatinine levels, and raised LDH levels. Read More

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December 2021

Treatment of Shiga-Toxin Hus with Severe Neurologic Features with Eculizumab.

Case Rep Pediatr 2021 13;2021:8053246. Epub 2021 Nov 13.

University of Kansas, School of Medicine, Wichita, USA.

Hemolytic Uremic Syndrome (HUS) is a constellation of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Shiga toxin-producing - (STEC-) mediated HUS is a common cause of acute renal failure in children and can rarely result in severe neurological complications such as encephalopathy, seizures, cerebrovascular accidents, and coma. Current literature supports use of eculizumab, a monoclonal antibody that blocks complement activation, in atypical HUS (aHUS). Read More

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November 2021

Omega-3 Polyunsaturated Fatty Acid Attenuates Uremia-Induced Brain Damage in Mice.

Int J Mol Sci 2021 Oct 30;22(21). Epub 2021 Oct 30.

Department of Medical Science, Medical School, Chungnam National University, Daejeon 35015, Korea.

Although the cause of neurological disease in patients with chronic kidney disease (CKD) has not been completely identified yet, recent papers have identified accumulated uremic toxin as its main cause. Additionally, omega-3 polyunsaturated fatty acid (ω-3 PUFA) plays an important role in maintaining normal nerve function, but its protective effects against uremic toxin is unclear. The objective of this study was to identify brain damage caused by uremic toxicity and determine the protective effects of ω-3 PUFA against uremic toxin. Read More

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October 2021

Severe and Regionally Widespread Increases in Tissue Urea in the Human Brain Represent a Novel Finding of Pathogenic Potential in Parkinson's Disease Dementia.

Front Mol Neurosci 2021 22;14:711396. Epub 2021 Oct 22.

Centre for Advanced Discovery & Experimental Therapeutics, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.

Widespread elevations in brain urea have, in recent years, been reported in certain types of age-related dementia, notably Alzheimer's disease (AD) and Huntington's disease (HD). Urea increases in these diseases are substantive, and approximate in magnitude to levels present in uraemic encephalopathy. In AD and HD, elevated urea levels are widespread, and not only in regions heavily affected by neurodegeneration. Read More

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October 2021

Posterior Reversible Encephalopathy Syndrome Presenting Atypically as a Non-Convulsive Seizure.

Am J Case Rep 2021 Nov 5;22:e933667. Epub 2021 Nov 5.

Department of Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York City, NY, USA.

BACKGROUND Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy, is a neurotoxic state with multiple etiologies characterized by altered mental state, headaches, visual abnormalities, and seizures. This clinico-radiological syndrome is rare, and a high index of suspicion is needed to diagnose, provide adequate treatment, and prevent irreversible neurological sequelae. CASE REPORT We present a case of a woman with end-stage renal disease (ESRD) who presented with acute confusion and non-convulsive seizures and was later diagnosed with PRES. Read More

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November 2021

Uremic encephalopathy.

Kidney Int 2022 02 1;101(2):227-241. Epub 2021 Nov 1.

Nephrology Section, Department of Internal Medicine and Pediatrics, University Hospital, Ghent, Belgium.

Uremic encephalopathy encompasses a wide range of central nervous system abnormalities associated with poor kidney function occurring with either progressive chronic kidney disease or acute kidney injury. The syndrome is likely caused by retention of uremic solutes, alterations in hormonal metabolism, changes in electrolyte and acid-base homeostasis, as well as changes in vascular reactivity, blood-brain barrier transport, and inflammation. There are no defining clinical, laboratory, or imaging findings, and the diagnosis is often made retrospectively when symptoms improve after dialysis or transplantation. Read More

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February 2022

Chronic kidney disease and neurological disorders: are uraemic toxins the missing piece of the puzzle?

Nephrol Dial Transplant 2021 12;37(Suppl 2):ii33-ii44

Université Paris-Saclay, UVSQ, Inserm, Clinical Epidemiology Team, CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Villejuif, France.

Chronic kidney disease (CKD) perturbs the crosstalk with others organs, with the interaction between the kidneys and the heart having been studied most intensively. However, a growing body of data indicates that there is an association between kidney dysfunction and disorders of the central nervous system. In epidemiological studies, CKD is associated with a high prevalence of neurological complications, such as cerebrovascular disorders, movement disorders, cognitive impairment and depression. Read More

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December 2021

Indoleamine 2,3-dioxygenase-1, a Novel Therapeutic Target for Post-Vascular Injury Thrombosis in CKD.

J Am Soc Nephrol 2021 11;32(11):2834-2850

Renal Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts

Background: CKD, characterized by retained uremic solutes, is a strong and independent risk factor for thrombosis after vascular procedures . Urem ic solutes such as indoxyl sulfate (IS) and kynurenine (Kyn) mediate prothrombotic effect through tissue factor (TF). IS and Kyn biogenesis depends on multiple enzymes, with therapeutic implications unexplored. Read More

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November 2021

Utilization Pattern for Eculizumab Among Children With Hemolytic Uremic Syndrome.

Front Pediatr 2021 5;9:733042. Epub 2021 Oct 5.

Pediatrics, Pediatric Cardiology/Pediatric Critical Care, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, United States.

Hemolytic uremic syndrome (HUS) is a complex disease with multi-organ involvement. Eculizumab therapy is recommended for treatment of complement mediated hemolytic uremic syndrome (cHUS). However, there are few studies evaluating eculizumab therapy among children with HUS. Read More

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October 2021

Seizures in patients with kidney diseases: a neglected problem?

Nephrol Dial Transplant 2021 Oct 1. Epub 2021 Oct 1.

Hacettepe University, Faculty of Medicine, Department of Nephrology, Ankara, Turkey.

Nephrologists may encounter many systemic problems in their patients, including involvement of the neurological system and the development of seizures. Seizures are defined as abnormal neurological functions that cause overstimulation of neurons in the cerebral cortex or limbic system. Seizures may be focal or generalized depending on their origin and may have tonic, clonic, tonic-clonic, or myoclonic character depending on the level of involvement of the motor movements. Read More

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October 2021

Project extension for community healthcare outcomes improves care and treatment for multidrug-resistant tuberculosis patients in Tanzania.

Int J Mycobacteriol 2021 Apr-Jun;10(2):182-187

Division of Infectious Diseases, The ECHO Institute, University of New Mexico Health Sciences Centre, New Mexico, United States.

Background: Project Extension for Community Healthcare Outcomes (Project ECHO) is a telementoring, case based virtual community of practice training and education model connecting experts to primary care clinicians (PCCs). Project ECHO has good evidence for favorable treatment outcomes on wide range of diseases. Since 2017, Tanzania hosts multidrug resistant tuberculosis (MDR TB) ECHO with hub at Kibong'oto Infectious Diseases Hospital. Read More

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October 2021