Abstract:
:Skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin for prophylaxis against deep vein thrombosis. A preliminary diagnosis of calciphylaxis was made based on the classical distribution and macroscopic appearance of the ulceration in a patient with end-stage renal failure and secondary hyperparathyroidism. However skin biopsy showed complete absence of calcium deposits in the dermal microvasculature. The presence of extensive microthrombi within dermal vessels prompted serologic testing to detect a prothrombotic state. We identified the combined presence of heparin-dependent platelet activating (HIT) antibodies and functional protein S deficiency. To our knowledge this is the first reported case of a dialysis patient presenting with skin ulceration induced by heparin and protein S deficiency. This case highlights the importance of a skin biopsy and testing for a hypercoaguable state in patients with end-stage renal disease and skin ulceration. We suggest that HIT antibodies should be requested in all dialysis patients presenting with skin ulceration.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Denton MD,Mauiyyedi S,Bazari Hdoi
10.1159/000046263subject
Has Abstractpub_date
2001-07-01 00:00:00pages
289-93issue
4eissn
0250-8095issn
1421-9670pii
46263journal_volume
21pub_type
杂志文章abstract::Since it was first discovered in the early 1980s, the role of atrial natriuretic peptide (ANP) in the control of fluid and electrolyte balance and blood pressure has been extensively studied in both health and disease. We report here a study of ANP and its relationship to corresponding changes in right atrial pressure...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168797
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Living donor liver transplantation (LDLT) patients run the risk of developing acute kidney injury (AKI) and subsequent chronic kidney disease, affecting morbidity and mortality. Sevoflurane has anti-inflammation properties, and renal ischemia/reperfusion under sevoflurane anesthesia resulted in drastic impro...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000319623
更新日期:2010-01-01 00:00:00
abstract::A patient with progressive systemic sclerosis (PSS) involving skin, digit, esophagus, and lung developed the nephrotic syndrome and rapidly progressive renal insufficiency. Renal pathology revealed capillary collapse, cellular crescents, arteriolar hyaline deposition, and mesangial proliferation. On immunofluorescence...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167055
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND/AIMS:The shortage in organ supply has required the use of expanded criteria donors (ECD) for kidney transplantation. Current pre-transplant evaluations of ECD organs are based on histological, clinical or mixed criteria. This monocentric study investigates the predictivity of Karpinski's histological score o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000346257
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Evidence using real-world data is sparse regarding the effects of oral anticoagulants (OACs) among patients with kidney disease. The aim of this study was to investigate the effects of kidney disease on ischemic stroke (IS) or systemic embolism (SE) among patients taking OAC, using large-scale real-world d...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000509567
更新日期:2020-01-01 00:00:00
abstract::A renal transplant recipient with a remote history of end-stage renal disease due to postpartum hemolytic-uremic syndrome (HUS) presented with acute renal failure after having stable renal allograft function for 9 years. A diagnosis of thrombotic microangiopathy was made based on clinical and histologic findings at re...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169094
更新日期:1997-01-01 00:00:00
abstract::We have compared the renal effects of ioxitalamate, ioxaglate, and iopamidol in patients with chronic renal failure. Sixty consecutive patients with an estimated creatinine clearance (ECRCl) less than 60 ml/min were randomly assigned to receive either ioxitalamate, iopamidol, or ioxaglate. All patients received 500 cm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168328
更新日期:1991-01-01 00:00:00
abstract::This study was designed to evaluate beta-adrenergic responsiveness as assessed by the generation of cyclic AMP after the subcutaneous administration of epinephrine in 31 subjects: normal controls, patients with chronic renal insufficiency, hemodynamically stable patients on chronic acetate dialysis and hemodynamically...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167985
更新日期:1989-01-01 00:00:00
abstract::Hepcidin is a key regulator of iron metabolism. In this study, we examined whether measurement of hepcidin is useful in assessing recombinant human erythropoietin (rHuEPO) responsiveness in regular hemodialysis (HD) patients in a cross-sectional fashion. We examined the association between serum prohepcidin, a prohorm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000109968
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:More than 50% of American adolescents and adults report having used illicit drugs in their lifetime. We examined the association of lifetime opiate and cocaine use with reduced kidney function, albuminuria and rapid kidney function decline among urban-dwelling adults. METHODS:Our prospective cohort included...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000452348
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:It has been demonstrated that phosphate uptake through the type III sodium-dependent phosphate co-transporter, Pit-1, induced apoptosis of aortic vascular smooth muscle cells and endothelial cells in vitro. However, the apoptotic effects of high phosphate (HP) level in human peritoneal mesothelial cells (HPM...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000329081
更新日期:2011-01-01 00:00:00
abstract::Most pretransplant malignancies require a tumor-free waiting period before transplantation. End-stage renal disease (ESRD) patients have an increased risk of renal cell carcinoma (RCC), which is mostly detected from routine screening during pre-kidney transplant evaluation. RCC must be quiescent prior to kidney transp...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000365201
更新日期:2014-01-01 00:00:00
abstract::Five patients with the clinical patterns of Bartter's syndrome underwent a series of clearance studies in order to characterize the underlying tubule defect. Free water generation during maximal water diuresis (CH2O), expressed as percentage of the distal delivery (CH2O + CCl), was lower in the patients (72.5 +/- 3.2%...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168451
更新日期:1992-01-01 00:00:00
abstract:RATIONALE AND OBJECTIVE:In the Systolic Blood Pressure Intervention Trial, the possible relationships between acute kidney injury (AKI) and risk of major cardiovascular events and death are not known. STUDY DESIGN:Post hoc analysis of a multicenter, randomized, controlled, open-label clinical trial. SETTING AND PARTI...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000499574
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Pulmonary arterial hypertension (PAH) may lead to right heart failure and subsequently alter glomerular filtration rates (GFR). Chronic kidney disease (CKD, GFR <60 mL/min/1.73 m2) may also adversely affect PAH prognosis. This study aimed to assess how right heart hemodynamics was associated with reduced est...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487198
更新日期:2018-01-01 00:00:00
abstract::Acute hyperammonemia is an emergent cause of central nervous system dysfunction for which renal replacement therapy is advocated. We report the successful use of continuous venovenous hemodiafiltration in this metabolic emergency, and report the calculated ammonia clearances for both continuous venovenous hemofiltrati...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013400
更新日期:1998-01-01 00:00:00
abstract:AIM:To develop and assess a semiautomated method for segmenting and counting individual renal cysts from mid-slice MR images in patients with autosomal dominant polycystic kidney disease (ADPKD). METHODS:A semiautomated method was developed to segment and count individual renal cysts from mid-slice MR images in 241 su...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000358604
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK b...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000491552
更新日期:2018-01-01 00:00:00
abstract::Idiopathic diffuse crescentic glomerulonephritis without immune deposits is a variant of rapidly progressive glomerulonephritis which can account for up to 40% of crescentic nephritis. The prognosis may depend on both the severity of histological injury at presentation and the efficacy of treatment. Recent advances in...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167424
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP), which reflects chronic inflammation, is a strong predictor of cardiovascular mortality in hemodialysis patients. We investigated whether persistent elevation of CRP is associated with cardiac function and morphology in patients maintained on hemodialysis. METHODS:Predialysis high-s...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085585
更新日期:2005-05-01 00:00:00
abstract::The number of patients with end-stage renal disease undergoing kidney transplantation - both cadaveric and living-donor - continues to rise. With long-term graft survival relatively fixed, this trend means that increasing numbers of patients are returning to dialysis after graft loss. Most will never be retransplanted...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000342626
更新日期:2012-01-01 00:00:00
abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract::A patient with advanced chronic renal failure secondary to polycystic kidney disease suffered an episode of volume contraction during which his urinary sodium concentration fell to less than 5 mEq daily. Urine sodium excretion remained at this level when later in his course he became clinically volume expanded. The pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166535
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:There is continued and significant debate regarding the salient etiologies associated with graft loss and racial disparities in kidney transplant recipients. METHODS:This was a longitudinal cohort study of all adult kidney transplant recipients, comparing patients with early graft loss (<5 years) to those w...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000363393
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Inflammation and increased erythropoiesis stimulating agents (ESA) requirement are frequently associated in patients on dialysis. On-line hemodiafiltration (ol-HDF), putting together high levels of diffusion, and convection could improve both conditions. However, it is still not known which depurative compon...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000437171
更新日期:2015-01-01 00:00:00
abstract::Renal function and life expectancy can be improved by aggressive antihypertensive therapy in severe hypertension. However, most reports of severe hypertension and renal failure concern primary hypertensive states. 3 cases of primary renal disease, 1 glomerular, 1 obstructive and 1 of chronic pyelonephritis, are descri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166576
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:There has been an increasing incidence of hemodialysis (HD) due to old age and comorbid condition such as diabetes. In general, socioeconomic status (SES) is known as one of the most important risk factors for patient mortality and morbidity. Whether low SES is associated with poorer outcome in HD patients i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000512855
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND/AIM:Although clinical and immunological findings in steroid-sensitive nephrotic syndrome (SSNS) favor an immunopathogenesis, many issues remain unsolved. Comprehensive studies analyzing cellular and humoral immunity in SSNS are scarce, and few studies addressed the effect of steroids on immunological factors...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085357
更新日期:2005-03-01 00:00:00
abstract::The medical history of salt begins in ancient times and is closely related to different aspects of human history. Salt may be extracted from sea water, mineral deposits, surface encrustations, saline lakes and brine springs. In many inland areas, wood was used as a fuel source for evaporation of brine and this practic...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000168759
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:2009 influenza A has spread globally. Respiratory complications and renal failure have been the leading causes for hospitalization and critical illness. We describe the risk factors and complications of acute kidney injury (AKI) in patients with influenza A. METHODS:Observational study of adult patients tes...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000328386
更新日期:2011-01-01 00:00:00