Our own Exposure to CONTRASTENHANCED VOIDING UROSONOGRAPHY

In 2012, Kidney Disease Improving Global Outcomes (KDIGO) published a guideline on the classification and management of acute kidney injury (AKI). The guideline was derived from evidence available through February 2011. Since then, new evidence has emerged that has important implications for clinical practice in diagnosing and managing AKI. In April of 2019, KDIGO held a controversies conference entitled Acute Kidney Injury with the following goals determine best practices and areas of uncertainty in treating AKI; review key relevant literature published since the 2012 KDIGO AKI guideline; address ongoing controversial issues; identify new topics or issues to be revisited for the next iteration of the KDIGO AKI guideline; and outline research needed to improve AKI management. Here, we present the findings of this conference and describe key areas that future guidelines may address.Transplantation for children with end-stage kidney disease confers clear survival, health, and health economic benefits. Access to transplantation and graft survival has been clearly shown to be affected by macroeconomic and patient-level factors in adults. This commentary explores the findings and implications of the "Results in the ESPN/ERA-EDTA Registry Suggest Disparities in Access to Kidney Transplantation but Little Variation in Graft Survival of Children Across Europe" study by Bonthuis et al., including key priorities in future research.Tertiary lymphoid tissues are peripheral foci of immune activity that develop in kidneys and other peripheral organs in the context of chronic inflammation. In this issue of Kidney International, Sato and colleagues present a detailed characterization of tertiary lymphoid tissues in mouse and human kidneys in the context of acute kidney injury, chronic pyelonephritis, aging, and chronic kidney disease, showing the importance of nontraditional roles of B cells in the inflamed kidney microenvironment.Borderline T cell-mediated rejection is a diagnostic category of the Banff schema that uses a lower diagnostic threshold. read more Subclinical borderline T cell-mediated rejection detected by surveillance sampling is not entirely benign. Studies demonstrate increased rates of late rejection, progressive nephron loss, functional impairment, donor-specific antibody formation, and allograft failure. It can be conceptualized as a failure to control the cellular alloimmune response. Mixed results are reported for its treatment, and randomized controlled trials are needed.microRNAs play prominent regulatory roles by inducing target mRNA degradation or translational repression. Several studies have highlighted the power of microRNAs as biomarkers and potential mechanistic mediators of human kidney disease. Small RNA deep sequencing libraries can be generated from minute amounts of formalin-fixed paraffin-embedded tissues including specific tissue regions. Such analyses have unique advantages and may complement analyses of fresh kidney specimens to advance tissue functional genomics-based precision medicine for human kidney disease.The kidneys are the gatekeepers of phosphate balance, and loss of kidney function causes a profound disturbance of mineral metabolism. Patients with chronic kidney disease suffer from an excessive cardiovascular disease risk with a high morbidity and mortality. Current therapies aimed at reducing total phosphate body load are insufficient, and novel strategies are urgently needed. In this issue, Tsuboi and colleagues provide evidence for the use of a novel phosphate transporter inhibitor to reduce intestinal phosphate absorption.
We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2, a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province.
A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression.
A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index of these patients was 25 kg/m². White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia -19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.Tumors are often polyclonal and are therefore heterogenous in their genomic and molecular profiles, which contributes to drug resistance and treatment failure. The methods used to detect these heterogenous differences in tumor samples are critical, but findings have been hindered by methodological inability to detect low-frequency subclones in bulk DNA. Chang et al. (2020) have addressed some of these methodological issues.There is excitement in the air for patients with vitiligo. For the first time in decades, we have early case studies showing that targeted therapies can repigment vitiliginous skin, and well-powered clinical trials are underway. However, at the time of this writing, there is no Food and Drug Administration-approved drug for vitiligo. In a randomized clinical trial by Khemis et al. report negative results on a randomized clinical trial testing the combination of apremilast, a phosphodiesterase 4 inhibitor, and narrowband-ultraviolet B versus placebo and narrowband-ultraviolet B in patients with nonsegmental vitiligo. The results of this trial are a reminder that clinical management of vitiligo is challenging at best, even when combining anti-inflammatory and/or immunomodulating agents with repigmenting agents. However, these negative trials are critical in improving our understanding of this complex and disfiguring disease.