Abstract:
BACKGROUND:Osmotic demyelination syndrome (ODS) is a complication generally associated with overly rapid correction of hyponatremia. Traditionally, nephrologists have been trained to focus solely on limiting the correction rate. However, there is accumulating evidence to suggest that the prevention of ODS is beyond achieving slow correction rates. METHODS:We (1) reviewed the literature for glial intracellular protective alterations during hyperosmolar stress, a state presumed equivalent to the rapid correction of hyponatremia, and (2) analyzed all available hyponatremia-associated ODS cases from PubMed for possible contributing factors including correction rates and concurrent metabolic disturbances involving hypokalemia, hypophosphatemia, hypomagnesemia, and/or hypoglycemia. RESULTS:In response to acute hyperosmolar stress, glial cells undergo immediate extracellular free water shift, followed by active intracellular Na(+), K(+) and amino acid uptake, and eventual idiogenic osmoles synthesis. At minimum, protective mechanisms require K(+), Mg(2+), phosphate, amino acids, and glucose. There were 158 cases of hyponatremia-associated ODS where both correction rates and other metabolic factors were documented. Compared with the rapid correction group (>0.5 mmol/L/h), the slow correction group (≤0.5 mmol/L/h) had a greater number of cases with concurrent hypokalemia (49.4 vs. 33.3 %, p = 0.04), and a greater number of cases with any concurrent metabolic derangements (55.8 vs. 38.3 %, p = 0.03). CONCLUSION:Glial cell minimizes volume changes and injury in response to hyperosmolar stress via mobilization and/or utilization of various electrolytes and metabolic factors. The prevention of ODS likely requires both minimization of correction rate and optimization of intracellular response during the correction phase when a sufficient supply of various factors is necessary.
journal_name
Clin Exp Nephroljournal_title
Clinical and experimental nephrologyauthors
Pham PM,Pham PA,Pham SV,Pham PT,Pham PT,Pham PCdoi
10.1007/s10157-014-1021-ysubject
Has Abstractpub_date
2015-06-01 00:00:00pages
489-95issue
3eissn
1342-1751issn
1437-7799pii
10.1007/s10157-014-1021-yjournal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:The etiology of hemodialysis (HD)-induced hypotension and hypertension remains speculative. There is mounting evidence that endothelin-1 (ET-1) may play a vital role in these hemodynamic changes. We examined the possible role of intradialytic changes of ET-1 in the pathogenesis of hypotension and rebound hyp...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0065-2
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Two randomized, double-blind, placebo-controlled trials (EPPIC-1 and EPPIC-2) investigated the efficacy and safety of AST-120, an oral spherical carbon adsorbent, in adults with chronic kidney disease (CKD). While the benefit of adding AST-120 to standard therapy was not supported by these trials, we perform...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s10157-017-1447-0
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Children with nephrotic syndrome (NS) have hyperlipidemia, which may lead to endothelial dysfunction. This study evaluated endothelial function and structural atherosclerosis in NS children with disease duration more than 2 years, by assessment of brachial artery flow-mediated dilatation (FMD) and carotid in...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-014-0958-1
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Dotinurad, a novel selective urate reabsorption inhibitor, exerts a serum uric acid-lowering effect by selectively inhibiting urate transporter 1 (URAT1) in patients with hyperuricemia. It is generally known that the progression of renal dysfunction is associated with a reduction in the serum uric acid-lower...
journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章
doi:10.1007/s10157-019-01825-3
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Data regarding renal disease in the elderly (age ≥65 years old) and very elderly (age ≥80 years old) Japanese are extremely limited. The aim of this study was to examine the causes of renal disease and their clinical presentations in elderly patients who underwent renal biopsy. DESIGN, SETTIN...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-012-0673-8
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Tolvaptan slowed the rates of total kidney volume (TKV) growth and renal function decline over a 3-year period in patients with autosomal dominant polycystic kidney disease (ADPKD) enrolled in the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes (TE...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-020-02009-0
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND:Maxacalcitol (22-oxacalcitriol; OCT) is a novel vitamin D analogue. In previous clinical studies, OCT was administered three times a week to hemodialysis patients with refractory secondary hyperparathyroidism (2HPT), in whom it acted by inhibiting parathyroid hormone secretion, as well as causing mildly elev...
journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章
doi:10.1007/s10157-004-0283-1
更新日期:2004-06-01 00:00:00
abstract::Dyslipidemia is an established risk factor for atherosclerotic disease, such as stroke and ischemic heart disease, and is often detected in patients with chronic kidney disease (CKD). The role of dyslipidemia in CKD progression, however, is not well understood. CKD patients are heterogeneous and may include those who ...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,评审
doi:10.1007/s10157-013-0891-8
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) eventually progresses to end-stage renal disease (ESRD). However, risk factors associated with CKD progression have not been well characterized in Japanese patients with CKD who are less affected with coronary disease than Westerners. METHODS:A large-scale, multicenter, prospect...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10157-016-1309-1
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Hypertension is a risk factor common to both chronic kidney disease and cardiovascular disease. Nicorandil is widely used for the treatment of angina. We investigated the benefits of nicorandil with respect to renal dysfunction in Dahl salt-sensitive hypertensive (DS) rats. METHOD:DS rats were fed a high-sa...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-014-0998-6
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:A close correlation has been shown between tubulointerstitial (TI) injury and the outcome of renal dysfunction, and nuclear factor-kappaB (NFkappaB) has been shown to play a key role in proteinuria-induced TI injury. To explore the molecular mechanisms of the proteinuria-induced TI injury further, we have an...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0038-5
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:We previously reported a significant increase in plasma TGF-beta1 in patients with chronic renal failure (CRF). Progression of CRF may be caused by persistent renal production of TGF-beta1. In CRF rat models, an oral carbonic absorbent (AST-120) reduces the expression of the TGF-beta1 gene in the kidney, and...
journal_title:Clinical and experimental nephrology
pub_type: 临床试验,杂志文章
doi:10.1007/s10157-006-0441-8
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Depression is common in chronic kidney disease (CKD) patients and associated with significant increase in morbidity and mortality. In recent years, a relationship between vitamin D deficiency and depression has been shown. The aim of this study is to investigate the relationship between 25-hydroxy (OH) vitam...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-019-01794-7
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Creatinine clearance (Ccr) overestimates glomerular filtration rate (GFR) due to the tubular secretion of creatinine. It is known that fractional excretion of creatinine (FE-Cr) increases with decreasing GFR. Association of serum albumin level with the tubular secretion of creatinine was also reported previo...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-013-0841-5
更新日期:2014-06-01 00:00:00
abstract::Waldenström's macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström's macroglobulinemia present in 8-18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with ri...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0042-9
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Achieving a normal final adult height (FH) remains a challenge in the field of pediatric kidney transplantation (KTx). To examine the optimal approach to assuring normal FH following KTx, we retrospectively examined the post-transplant growth and FH of pediatric KTx recipients. METHODS:Since the relevant fa...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-013-0842-4
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Recent evidence indicates that both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) are more useful than the measurement of office blood pressure for evaluating cardiovascular risks in subjects with hypertension. The major advantage of ABPM over HBPM is the ability to me...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-009-0192-4
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome. METHODS:Twenty-nine patients with nephrotic syndrom...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-017-1387-8
更新日期:2017-10-01 00:00:00
abstract::A 34-year-old man who had been on dialysis for about 6 years, and had acquired renal cystic disease, received a renal transplantation. However, in spite of the success of the transplantation, one area without cyst regression was observed in the original kidney. Therefore, carcinoma was suspected and nephrectomy was pe...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s101570300013
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Skin and soft tissue infection (SSTI) is the most common of infectious diseases with high morbidity and mortality. However, the clinical characteristics of SSTI in patients with nephrotic syndrome (NS), especially in those patients who received immunosuppressive therapy, are still lacking. The present study w...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-020-01893-w
更新日期:2020-09-01 00:00:00
abstract::Acute kidney injury (AKI) is a threatening medical condition associated with poor outcomes at different settings. The development of standardized diagnostic criteria and new biomarkers addressed significant clinical impacts of AKI and the need for an early AKI detection, respectively. There have been some breakthrough...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,评审
doi:10.1007/s10157-020-01920-w
更新日期:2020-11-01 00:00:00
abstract::A 69-year-old woman presented with unusual electron microscopic findings. The patient was admitted to ascertain the cause of her persistent proteinuria, and kidney biopsy was performed. While light microscopic findings and immunofluorescence study suggested membranous nephropathy, electron microscopic study showed mic...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-008-0089-7
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:The current (2012) histological classification of immunoglobulin A nephropathy was established using a case-control study of 287 patients. However, the risk of progression to end-stage renal disease (ESRD) has not been validated for the previous (2002) classification. This study aimed to determine whether th...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-013-0848-y
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a major global problem and is also associated with a decreased health-related quality of life (HRQOL). The aim of this study was to evaluate measured HRQOL based on the new CKD classification including proteinuria stage, and the effect of measured HRQOL on CKD progression and ...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-013-0901-x
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Adenosine monophosphate (AMP)-activated protein kinase (AMPK), as a sensor of cellular energy status, has been known to play an important role in the pathophysiology of diabetes and its complications. As AMPK is also expressed in podocytes, it is possible that podocyte AMPK would be an important contributing...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-012-0649-8
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Myeloid-derived suppressor cells (MDSCs) have been identified as immunosuppressive cells in tumor-related inflammation. However, the pathogenesis of MDSCs for autoimmune disease has not been investigated as yet. The aim of this study was to address whether MDSCs contribute to autoimmune organ injury in lupus-...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-010-0309-9
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The appropriate blood pressure target to prevent end-stage renal disease (ESRD) is controversial. METHODS:We examined the association between systolic blood pressure (SBP) changes and ESRD incidence in 69,575 participants from the Okinawa general population aged ≥ 20 years who underwent health check-ups in ...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-019-01771-0
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:In the tubular cells of patients with polycystic kidney disease (PKD), a reduced intracellular Ca(2+) level accelerates cell proliferation, resulting in cyst formation. Thus, whether calcium channel blockers (CCB) are useful for the treatment of hypertension in patients with PKD is questionable. METHODS:Thi...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章
doi:10.1007/s10157-010-0329-5
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:There is no obvious evidence regarding biological variation of procalcitonin (PCT) levels in hemodialysis (HD) patients without infections. The aim of this study was to determine the within- and between-person biological variation of PCT levels in HD patients without infections. METHODS:A multicenter, prosp...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10157-018-1639-2
更新日期:2019-03-01 00:00:00
abstract::Endothelial dysfunction due to the reduced bioavailability of nitric oxide (NO) is involved in the course of atherosclerotic cardiovascular disease as well as chronic kidney disease (CKD). NO is synthesized from L-arginine via the action of NO synthase, which is blocked by endogenous L-arginine analogues such as asymm...
journal_title:Clinical and experimental nephrology
pub_type: 杂志文章,评审
doi:10.1007/s10157-007-0471-x
更新日期:2007-06-01 00:00:00