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Related Concept Videos

Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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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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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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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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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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Related Experiment Video

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Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
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Cholemic nephropathy - Historical notes and novel perspectives.

Elisabeth Krones1, Marion J Pollheimer2, Alexander R Rosenkranz3

  • 1Research Unit for Experimental and Molecular Hepatology, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Austria.

Biochimica Et Biophysica Acta. Molecular Basis of Disease
|August 31, 2017
PubMed
Summary

Cholemic nephropathy, a kidney injury in liver disease, involves bile cast formation and tubular damage. Understanding its mechanisms and developing diagnostic and therapeutic strategies are crucial for patient outcomes.

Keywords:
Acute kidney injuryBile acidsBile cast nephropathyCholemic nephropathyLiver cirrhosis

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Area of Science:

  • Nephrology
  • Hepatology
  • Gastroenterology

Background:

  • Acute kidney injury (AKI) is prevalent in liver disease patients, increasing morbidity and mortality.
  • Beyond common causes, tubular toxicity from cholephiles (bile substances) can trigger AKI.
  • Cholemic nephropathy, or bile cast nephropathy, is an underestimated cause of renal dysfunction in cholestatic/jaundiced liver disease.

Purpose of the Study:

  • To review clinical and morphological features of cholemic nephropathy.
  • To discuss available preclinical models for studying this condition.
  • To explore potential pathomechanisms, including the role of bile acids.
  • To outline future diagnostic and therapeutic strategies.

Main Methods:

  • Literature review of clinical, morphological, and preclinical data.
  • Analysis of proposed pathomechanisms, focusing on bile acid toxicity.
  • Synthesis of current knowledge on diagnostic and therapeutic approaches.

Main Results:

  • Cholemic nephropathy is characterized by impaired renal function, bile cast formation, and distal nephron injury.
  • Pathophysiological mechanisms are not fully understood, and diagnostic criteria are lacking.
  • Bile acids are implicated as potential contributors to tubular toxicity.

Conclusions:

  • Cholemic nephropathy is a significant, though underestimated, cause of kidney dysfunction in liver disease.
  • Further research is needed to elucidate mechanisms and establish diagnostic/therapeutic guidelines.
  • Targeting bile acid pathways may offer future therapeutic avenues.