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Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...

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Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury
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Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury

Published on: August 30, 2011

Renal insufficiency and failure.

Meletios A Dimopoulos1, Evangelos Terpos

  • 1Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece. mdimop@med.uoa.gr

Hematology. American Society of Hematology. Education Program
|January 18, 2011
PubMed
Summary
This summary is machine-generated.

Novel criteria define renal response in multiple myeloma patients. Treatments like bortezomib, thalidomide, and lenalidomide can improve kidney function, with specific criteria for assessing recovery.

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Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury
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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Published on: July 19, 2018

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Renal impairment is a frequent complication in multiple myeloma.
  • Existing classifications for chronic and acute kidney injury include MDRD, RIFLE, and AKIN criteria.
  • There is a need for standardized criteria to define renal reversibility in myeloma patients.

Purpose of the Study:

  • To propose novel criteria for defining renal reversibility in multiple myeloma patients.
  • To establish definitions for renal complete response (CRrenal), partial response (PRrenal), and minor response (MRrenal) based on sustained improvements in creatinine clearance (CRCL).
  • To review the efficacy of current multiple myeloma treatments on renal function.

Main Methods:

  • Defined novel criteria for renal response based on estimated glomerular filtration rate (eGFR) and creatinine clearance (CRCL) measurements.
  • Established specific thresholds for CRrenal, PRrenal, and MRrenal based on baseline and improved CRCL values.
  • Reviewed existing literature on the impact of bortezomib, thalidomide, and lenalidomide on renal function in multiple myeloma.

Main Results:

  • Renal complete response (CRrenal) is defined as sustained CRCL improvement from <50 mL/min to ≥60 mL/min.
  • Renal partial response (PRrenal) is defined as sustained CRCL improvement from <15 mL/min to 30-59 mL/min.
  • Renal minor response (MRrenal) involves sustained CRCL improvement from <15 mL/min to 15-29 mL/min or from 15-29 mL/min to 30-59 mL/min.
  • Bortezomib with high-dose dexamethasone improves renal function in most patients.
  • Lenalidomide, at reduced doses, can reverse renal impairment in a subset of patients.

Conclusions:

  • The proposed criteria provide a standardized framework for assessing renal response in multiple myeloma.
  • Bortezomib-based regimens are effective in improving renal function in myeloma patients with renal impairment.
  • Thalidomide and lenalidomide also demonstrate potential in managing renal complications, with lenalidomide showing efficacy in reversing impairment when doses are adjusted for renal function.