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Documents  Reins - Maladies | enregistrements trouvés : 22

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Reins - Maladies ; Chirurgie

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The benefits of removing small (≤6 mm), asymptomatic kidney stones endoscopically is unknown. Current guidelines leave such decisions to the urologist and the patient. A prospective study involving older, nonendoscopic technology and some retrospective studies favor observation. However, published data indicate that about half of small renal stones left in place at the time that larger stones were removed caused other symptomatic events within 5 years after surgery.
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The benefits of removing small (≤6 mm), asymptomatic kidney stones endoscopically is unknown. Current guidelines leave such decisions to the urologist and the patient. A prospective study involving older, nonendoscopic technology and some retrospective studies favor observation. However, published data indicate that about half of small renal stones left in place at the ...

Reins - Maladies ; Chirurgie

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Patients with chronic kidney disease (CKD) have several pathophysiological alterations, including anemia, one of the first changes in CKD patients. More recently, researchers have observed that the intestinal microbiota alterations are also another complication in these patients. The most common treatment for anemia is oral (mainly ferrous sulfate) or intravenous iron supplementation. Despite being a necessary treatment, recent studies have reported that supplementation with oral iron may increase its availability in the intestine, leading to disturbance in the gut microbiota and also to oxidative stress in the enterocytes, which may change the permeability and the microbiota profile. Although it is a therapy routinely used in patients with CKD, supplementation with oral iron on the gut microbiota has been rarely studied in these patients. Thus, this review will discuss the relationship between iron and the gut microbiota and the possible effects of oral iron supplementation on gut microbiota in patients with CKD.
Patients with chronic kidney disease (CKD) have several pathophysiological alterations, including anemia, one of the first changes in CKD patients. More recently, researchers have observed that the intestinal microbiota alterations are also another complication in these patients. The most common treatment for anemia is oral (mainly ferrous sulfate) or intravenous iron supplementation. Despite being a necessary treatment, recent studies have ...

Vitamines dans l'alimentation humaine ; Microbiote ; Reins - Maladies

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Purpose: Antibiotics are frequently used in patients receiving intermittent or continuous renal replacement therapy (RRT). Continuous renal replacement may alter the pharmacokinetics (PK) and the ability to achieve PK/pharmacodynamic (PD) targets. Therapeutic drug monitoring (TDM) could help evaluate drug exposure and guide antibiotic dosage adjustment. The present review describes recent TDM data on antibiotic exposure and PK/PD target attainment (TA) in patients receiving intermittent or continuous RRT, proposing practical guidelines for performing TDM.

Methods: Studies on antibiotic TDM performed in patients receiving intermittent or continuous RRT published between 2000 and 2020 were searched and assessed. The authors focused on studies that reported data on PK/PD TA. TDM recommendations were based on clinically relevant PK/PD relationships and previously published guidelines.

Results: In total, 2383 reports were retrieved. After excluding nonrelevant publications, 139 articles were selected. Overall, 107 studies reported PK/PD TA for 24 agents. Data were available for various intermittent and continuous RRT techniques. The study design, TDM practice, and definition of PK/PD targets were inconsistent across studies. Drug exposure and TA rates were highly variable. TDM seems to be necessary to control drug exposure in patients receiving intermittent and continuous RRT techniques, especially for antibiotics with narrow therapeutic margins and in critically ill patients. Practical recommendations can provide insights on relevant PK/PD targets, sampling, and timing of TDM for various antibiotic classes.

Conclusions: Highly variable antibiotic exposure and TA have been reported in patients receiving intermittent or continuous RRT. TDM for aminoglycosides, beta-lactams, glycopeptides, linezolid, and colistin is recommended in patients receiving RRT and suggested for daptomycin, fluoroquinolones, and tigecycline in critically ill patients on RRT.
Purpose: Antibiotics are frequently used in patients receiving intermittent or continuous renal replacement therapy (RRT). Continuous renal replacement may alter the pharmacokinetics (PK) and the ability to achieve PK/pharmacodynamic (PD) targets. Therapeutic drug monitoring (TDM) could help evaluate drug exposure and guide antibiotic dosage adjustment. The present review describes recent TDM data on antibiotic exposure and PK/PD target ...

Antibiotiques ; Hémodialyse ; Reins - Maladies ; Médicaments - Usage

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Common causes of acute kidney injury (AKI) in the ICU setting include acute tubular necrosis (due to shock, hemolysis, rhabdomyolysis, or procedures that compromise renal perfusion), abdominal compartment syndrome, urinary retention, and interstitial nephritis. Treatment is geared toward addressing the underlying cause. Dialysis may be required if renal injury does not resolve. Early initiation of dialysis based on the stage of AKI alone has not been shown to provide a mortality benefit. Dialysis modalities are based on the dialysis indication and the patient’s clinical status. Providers should pay close attention to nutritional requirements and medication dosing according to renal function and dialysis modality.Management of Acute Kidney Injury/Renal Replacement Therapy in the Intensive Care Unit
Common causes of acute kidney injury (AKI) in the ICU setting include acute tubular necrosis (due to shock, hemolysis, rhabdomyolysis, or procedures that compromise renal perfusion), abdominal compartment syndrome, urinary retention, and interstitial nephritis. Treatment is geared toward addressing the underlying cause. Dialysis may be required if renal injury does not resolve. Early initiation of dialysis based on the stage of AKI alone has not ...

Hémodialyse ; Reins - Maladies

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- 448 p.
Cote : WJ300 Q4e 2019

Ouvrage d'une grande rigueur scientifique, L'essentiel sur la néphrologie et l'urologie aborde conjointement
les affections du rein et des voies urinaires. Adapté tout particulièrement à la méthode pédagogique éprouvée de l'apprentissage par problèmes (APP), il met l'accent sur les concepts physiopathologiques dominants, non sans avoir au préalable passé en revue l'anatomie, l'histologie, la physiologie, et exposé ensuite les principales démarches diagnostiques.
Cette quatrième édition constitue une mise à jour en profondeur, qui couvre notamment les nouvelles classifications en oncologie urologique ainsi que les nouveautés en matière de traitements des pathologies urologiques, de moyens d'investigation, de médicaments et de technologies. Le chapitre sur la lithiase urinaire a été réécrit pour tenir compte des plus récentes avancées, surtout en ce qui a trait au traitement.
Utile au praticien, mais conçu en premier lieu comme outil d'apprentissage pour l'étudiant en médecine, cet ouvrage de référence contient une mine d'informations permettant de comprendre les principaux symptômes et signes cliniques, biologiques, radiologiques et fonctionnels propres à l'appareil urinaire.
Ouvrage d'une grande rigueur scientifique, L'essentiel sur la néphrologie et l'urologie aborde conjointement
les affections du rein et des voies urinaires. Adapté tout particulièrement à la méthode pédagogique éprouvée de l'apprentissage par problèmes (APP), il met l'accent sur les concepts physiopathologiques dominants, non sans avoir au préalable passé en revue l'anatomie, l'histologie, la physiologie, et exposé ensuite les principales ...

Urologie ; Néphrologie ; Appareil urinaire - Maladies ; Reins - Maladies

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- xxiii, 630 p.
Cote : WJ18.2 L616n 2019

Néphrologie ; Reins - Maladies

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Objectives
The aims of the study were to evaluate the quality of the diet of nondialysis-dependent patients with chronic kidney disease and to investigate the impact of dietary counseling in the quality of the diet of these patients.

Methods
In the cross-sectional analysis, 3-day food records of 100 nondialysis-dependent patients with chronic kidney disease patients, in the first visit to the renal dietitians, were evaluated using the Diet Quality Index (DQI). Under-reporters were excluded. DQI is comprised by 10 components: 6 are food groups (fruits, vegetables, cereals, milk and dairy, meats and eggs, and legumes); 3 are nutrients (total fat, sodium, and cholesterol), and the last one is the diet variety. Each component is scored from 0 to 10, according to the adequacy of the Brazilian dietary guideline, and an overall score ranging from 0 (poor) to 100 (good) is obtained. In a subsample of 44 patients, a prospective analysis was performed to compare the DQI and its components before and after dietary counseling.

Results
The median DQI score was 68.6 (62.3-75.6; interquartile range), which means that most of the patients (92%) had a diet that “needs improvement” (DQI between 50 and 80 points). The DQI components with the lowest scores (lower adequacy) were sodium (0.0 [0.0-0.9]), dairy (3.9 [2.1-6.0]), and vegetables (6.0 [2.8-9.5]), whereas meat/egg, legumes, and cholesterol had the highest scores. Vegetables, legumes, and diet variety components were significantly lower in the lower tertiles of DQI. After a median follow-up of 25.0 (17.0-35.8) months comprising 6 (5-10) visits to the dietitian, energy, protein, and micronutrients intake were significantly reduced. The dietary counseling did not improve the overall DQI (after: 69.0 [69.0-74.8]; P = .95) and, a significant reduction in the score of legumes (from 10.0 [2.7-10.0] to 7.8 [4.7-10.0], P = .00) and diet variety (from 7.0 [5.3-10.0] to 6.0 [4.0-9.0], P = .02) components were observed.

Conclusion
The diet of this cohort of patients needs to be improved, particularly regarding vegetables, food variety, and sodium intake. Dietary counseling had no positive impact on the diet quality. This result highlights the importance of focusing the dietary counseling not simply on nutrient or food restriction but providing healthy food choices aiming to improve the overall diet quality of the patients.
Objectives
The aims of the study were to evaluate the quality of the diet of nondialysis-dependent patients with chronic kidney disease and to investigate the impact of dietary counseling in the quality of the diet of these patients.

Methods
In the cross-sectional analysis, 3-day food records of 100 nondialysis-dependent patients with chronic kidney disease patients, in the first visit to the renal dietitians, were evaluated using the Diet ...

Reins - Maladies ; Nutrition

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- xx, 1299 p.
Cote : WJ300 C737 2015

Néphrologie ; Reins - Maladies

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- xix, 647 p.
Cote : WJ18.2 N439 2012

Néphrologie ; Reins - Maladies

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- 169 p.
Cote : WJ301 F453r 2010

Reins - Maladies ; Reins - Maladies - Diagnostic

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Cote : WJ300 Q4e 2004

Publ. antérieurement sous le titre: Physiopathologie des maladies du rein et des voies urinaires

Urologie ; Néphrologie ; Appareil urinaire - Maladies ; Reins - Maladies

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Cote : WJ300 M421

0-683-30488-7

Reins - Maladies

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