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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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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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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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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 II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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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...
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Acute Kidney Injury I: Introduction01:22

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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...
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Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock
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Renal Hypoxia in CKD; Pathophysiology and Detecting Methods.

Yosuke Hirakawa1, Tetsuhiro Tanaka1, Masaomi Nangaku1

  • 1Division of Nephrology, The University of Tokyo School of Medicine Hongo, Japan.

Frontiers in Physiology
|March 9, 2017
PubMed
Summary

Detecting renal hypoxia is key to treating chronic kidney disease (CKD). This review details methods for measuring kidney oxygen levels to guide hypoxia-related therapies for CKD patients.

Keywords:
BOLD-MRINrf2chronic kidney diseasehypoxiahypoxia-inducible factormicroelectrodephosphorescencepimonidazole

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Area of Science:

  • Nephrology
  • Physiology
  • Biomedical Engineering

Background:

  • Chronic kidney disease (CKD) is a significant global health issue.
  • CKD exacerbates renal hypoxia, creating a detrimental cycle that accelerates disease progression.
  • Hypoxia-inducible factor (HIF) activation and NF-E2-related factor 2 activation are potential therapeutic targets.

Purpose of the Study:

  • To review and describe current methods for detecting renal hypoxia.
  • To highlight the advantages and disadvantages of each detection technique.
  • To aid in the precise assessment of renal hypoxia for developing targeted CKD therapies.

Main Methods:

  • Review of existing literature on hypoxia detection techniques.
  • Analysis of methods including microelectrodes, pimonidazole immunohistochemistry, HIF activation detection, blood oxygen level-dependent (BOLD) MRI, and phosphorescence lifetime measurement.
  • Evaluation of techniques based on invasiveness, quantitative performance, and ability to measure intracellular vs. extracellular oxygen tension.

Main Results:

  • Microelectrodes offer quantitative data but are invasive and measure extracellular oxygen.
  • Pimonidazole adducts and HIF detection indicate intracellular oxygen but provide qualitative data.
  • BOLD MRI is non-invasive and quantitative but measures deoxyhemoglobin.
  • Phosphorescence lifetime measurement is quantitative but has toxicity and depth limitations.

Conclusions:

  • Accurate assessment of renal hypoxia is crucial for identifying patients who will benefit from hypoxia-oriented therapies.
  • Understanding the limitations of current detection methods is essential for advancing CKD treatment.
  • Further development of precise and minimally invasive hypoxia detection techniques is needed for effective CKD management.