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Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Acute Kidney Injury V: Interprofessional Care01:20

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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...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Acute Kidney Injury VI: Nursing Management01:22

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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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Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Updated: Apr 3, 2026

Intravascular Delivery of Biologics to the Rat Kidney
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Interventions for renal vasculitis in adults.

Giles Walters1, Narelle S Willis, Jonathan C Craig

  • 1Department of Renal Medicine, The Canberra Hospital, Yamba Drive, Garran, ACT, Australia, 2605.

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Plasma exchange effectively reduces end-stage kidney disease in renal vasculitis patients. Continuous cyclophosphamide is preferred over pulse therapy to minimize relapse risk, with newer agents showing promise.

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Area of Science:

  • Nephrology
  • Immunology
  • Rheumatology

Background:

  • Renal vasculitis, a cause of rapidly progressive glomerulonephritis, presents with acute kidney injury, hematuria, and proteinuria.
  • Current treatments involve steroids, non-steroid agents, and plasma exchange, but optimal strategies require further clarification.
  • This review updates a previous 2008 analysis of renal vasculitis treatments.

Purpose of the Study:

  • To evaluate the efficacy and safety of all interventions for treating adult renal vasculitis.
  • To identify optimal treatment protocols and the role of novel therapies.

Main Methods:

  • Systematic search of the Cochrane Kidney and Transplant Specialised Register up to July 2015.
  • Inclusion of randomized controlled trials (RCTs) investigating any intervention for adult renal vasculitis.
  • Data extraction and quality assessment by two independent authors, with random-effects meta-analysis.

Main Results:

  • Thirty-one RCTs (2217 patients) were analyzed, with later studies showing improved quality.
  • Plasma exchange significantly reduced end-stage kidney disease risk at 3 and 12 months.
  • Continuous cyclophosphamide administration was associated with lower relapse rates compared to pulse therapy; azathioprine, mycophenolate mofetil, rituximab, methotrexate, and leflunomide demonstrated efficacy in induction or maintenance therapy.

Conclusions:

  • Plasma exchange is beneficial for severe acute kidney injury due to vasculitis.
  • Continuous oral cyclophosphamide is preferred over pulse therapy for induction to reduce relapse risk.
  • Rituximab and mycophenolate mofetil are effective induction agents, while azathioprine, methotrexate, and leflunomide are effective maintenance therapies, warranting further research into newer agents.