1,720,984 research outputs found
INTERVENTIONAL ULTRASOUND: RENAL BIOPSY.
No full textThe study of renal biopsy by light microscopy, immunofluorescence and electron microscopy allowscorrect diagnosis andtherapy of acute and chronic renal diseases. The most important indications in clinical practice are numerous, as elevated serum creatinine, hematuria, nephritic or nephrotic syndrome and systemic diseases with renal dysfunction. The absolute contraindications are generally represented by uncontrolled bleeding diathesis, severe arterial hypertension, multiple renal cysts, renal mass, acute pyelonephritis, end-stage kidney disease with small kidneys. In the classic procedure of percutaneous renal biopsy the patient is in prone position, while in patients obese or with respiratory problems has been successfully used the supine anterolateral position. The technique has significantly improved by the introduction of automated-gun biopsy devices and real-time ultrasound guidance which allows visualization of the biopsy needle and its path during the procedure. The bleeding complications include silent hematoma detected only by post-biopsy imaging, macroscopic hematuria, large hematoma and blood loss requiring erythrocyte transfusion, arteriovenous fistula, pagekidney and, rarely, the need for emergent angiographic intervention or nephrectomy. The main finding of the literature is that a renal biopsy should be regarded as a safe and successful procedure, and the overall rate of major complications is very low if general contraindications are respected. The declining trend in the performance of renal biopsy by practicing nephrologists should be alarming, while the importance should be emphasized because the information provided by this procedure directly affects the care of nephropathic patients
Kidney biopsy in the elderly
No full textRenal biopsy continues to play an essential role in the clinical assessment of hematuria, proteinuria and kidney failure. Nonetheless, the indications for renal biopsy are still controversial. The best determination of the potential benefit of an invasive diagnostic procedure comes from the demonstration that knowledge of a specific diagnosis guides the selection of treatments that produce improved outcomes. The size of the aging population is growing. In the years between 1980 and 1997, an 18% increase occurred in the number of individuals more than 65 years of age in the USA, and a 73% increase of those more than 85 years of age. Elderly patients are surviving longer with both acute and chronic disease, they are adapting to functional limitations in positive ways and they are choosing life-prolonging treatments that were not available to this population in the past. Despite these changes, several authors discuss physician biases that influence care of the elderly, and they argue that criteria for diagnosis and treatment should be the same as in younger patients. Many of the diagnoses made are treatable, and when treated, the outcome improves. Although comparison of survival data for patients with the general population would have been informative, data showing that loss of renal function correlates with shortened survival imply that interventions that delay progression to end-stage renal disease should significantly impact mortality. Thus, a bias toward limited diagnosis based on age alone is not justified. Histology is essential to precisely characterize the glomerular diseases underlying nonspecific clinical pictures and to direct the best therapeutic strategies. Our experience supported by larger studies from the United States showed that native kidney biopsy is safe and essential for diagnosis of renal disease and to direct the best therapeutic strategies in elderly patients
IgA nephropathy in systemic lupus erythematosus.
No full textRenal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis in SLE patients has rarely been reported; we describe the case of a woman suffering from SLE and IgA nephropathy (IgAN). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory and histopathologic findings and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of renal biopsy in lupus patients with urinary alterations since a correct diagnosis would permit the most appropriate treatment to be started, thus avoiding unnecessary immunosuppressive treatments
Proteomic profile of plasma proteins eluted from Coupled Plasma Filtration-Adsorption (CPFA) sorbent resin cartridges in a swine model of sepsis
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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