The levels of total homocysteine in serum is positively associated with the presence of microalbuminuria.
1. Glomerular disease in children has good response and complete remission with steroids, predicts a good long-term prognosis.
2. There was a slower decline in glomerular filtration rate (using creatinine clearances) in the patients given enalapril compared with placebo. The demonstration of a protective effect of enalapril on renal function in normotensive patients underscores the potential usefulness of these drugs in the preservation of glomerular filtration rate in patients with type 2 diabetes.
Pancreas transplantation can reverse the lesions of diabetic nephropathy. However, more than 5 years of normoglycemia are required.
3. Overall, survival of both patients and kidney with antineutrophil cytoplasm antibody (ANCA)-associated crescentic GN has improved markedly in the last 2 decades with the use of corticosteroids and cyclophosphamide
4. Finding of renal dysfunction after exposure to ACE inhibitors is a sensitive detector of severe renovascular disease in patients at risk.
5. Henoch-Schonlein purpura (HSP) – Most patients with HSP and renal involvement have a good prognosis.
6. Serum levels of prostate-specific antigen (PSA) have been used as a tool for the early detection of prostatic cancer. One of the limitations of this test has been the lack of specificity of PSA levels in the range of 4 to 10 ng/mL PSA is present in serum in a bound form, but it is also present as free PSA. It has been postulated that measurements of these two moieties of PSA in serum may help to discriminate between cancer of the prostate and prostatitis or benign hyperplasia of the prostate.
7. Sickle cell disease is an inherited disorder. Chronic progressive renal insufficiency has emerged as a major cause of death. The development of the nephrotic syndrome and focal segmental glomerulosclerosis usually precedes the development of renal insufficiency in these patients.
8. Angiotensin II modulates the expression of transforming growth factor b (TGF-b). Ying and Sanders reported that an increase in dietary salt intake, by increasing the synthesis of TGF-b, may directly promote the development of glomerulosclerosis.
9. Ginsburg et al. examined the effect of estrogen replacement therapy on the lipoprotein profile of postmenopausal women with ESRD. Total cholesterol increased with estradiol treatment, caused by a rise in HDL cholesterol without changes in LDL cholesterol. There was a slight decrease in the levels of triglycerides.
10. A decrease in sodium intake contributed to a safe, effective, and feasible therapy for hypertension in older individuals.
11. Blood pressure increased with alcohol consumption. Also, left ventricular mass index increased with alcohol intake.
12. Bradykinin has a role in the decrease of blood pressure observed after the administration of ACE inhibitors. This raises the question as to whether the new antagonists of the angiotensin II receptor are as potent in controlling blood pressure as ACE inhibitors.
13. It has been shown that hepatitis C virus (HCV) is transmissible by organ transplantation. HCV infection at the time of referral for transplantation is associated with an increased risk of death. Nevertheless, they conclude that transplantation probably has a more beneficial than adverse effect on long-term survival. Thus, HCV-positive status alone is not a contraindication for renal transplantation.
Hematocrit levels in excess of 0.51 may develop in 5% to 17% of renal transplant recipients within 2 years of the operation. Erythrocytosis of any etiology enhances the risk of thromboembolic events. ACE inhibitors have been shown to be safe and effective in the treatment of posttransplant polycythemia.
14. In transplanted kidneys, one of two forms of vascular disease may be found: (1) arteriosclerosis of arteries and arterioles, or (2) sclerosis of the glomeruli.
15. Peritoneal dialysis in this study seems to be an appropriate modality of renal replacement therapy in the elderly. A new modality of hemodialysis, nocturnal hemodialysis is conducted at home for 8 to 10 hours.
16. In a related study, 85 patients undergoing peritoneal dialysis for ESRD caused by diabetic nephropathy, the use of erythropoietin was associated with a greater risk of peripheral vascular events.
17. Patients with moderate or severe renal insufficiency have a decreased sensitivity to the hypoglycaemic effects of insulin.
18. Administration of 1,25-dihydroxyvitamin D3 has been shown also to improve insulin secretion and sensitivity to the hormone in peripheral tissues.
19. There is a need to be cautious in prescribing ACE inhibitors for patients at risk for the development of renal stones.