Nephrology

Acute kidney injury (AKI) may develop as an outcome of general anaesthesia. Using a rat model, the present study demonstrated that hyperglycaemia, renin-angiotensin system, systemic and intra-renal inflammation are independently activated during general anaesthesia, each contributing to induction of AKI. If relevant in clinical practice, tight intraoperative control over these parameters might prevent AKI development during general anaesthesia.

Internal jugular vein (IJV) catheterization is often required to gain access for haemodialysis. The authors prospectively analyzed 323 patients who underwent IJV cannulation with real-time ultrasound guidance. They concluded that cannulation of IJV under real-time ultrasound guidance is very safe with high technical success rates.

This cross-sectional study of a South African dialysis cohort shows a relatively low prevalence of coronary artery and aortic calcification likely related to the younger age of patients. The main finding though is the significantly lower degree of vascular calcification in black patients compared with whites, which may result from genetic factors.

The management of hyperphosphataemia remains a challenge in people with chronic kidney disease, particularly those requiring dialysis. In this study, Wang et al. demonstrate the potential efficacy of activated charcoal at lowering phosphate and parathyroid hormone levels.

In this manuscript, the authors studied the long-term survival, mortality hazards and causes of death in patients receiving dialysis in Taiwanese children. They showed for the first time that there was no significant difference of paediatric ESRD patient survival between HD and PD treatment in Taiwan. The older paediatric ESRD patients had better survival than younger patients.

This study examined the impact of kidney dysfunction on coronary atherosclerosis by evaluating coronary atherosclerosis using the intravascular ultrasound (IVUS) with virtual histology before and after statin. The authors showed that decreased GFR is associated with expanded remodelling and a greater atheroma volume, particularly the fibro-fatty and fibrous volume.

In stable asymptomatic HD patients, highly sensitive TNT is persistently elevated above normal values and is not affected by dialysis. Highest values were evident in those with cardiovascular disease. It is recommended that in at risk individuals on HD, a baseline hsTNT should be measured for future comparison in an acute event.

These investigators examined the serum levels of advanced oxidation protein products (AOPP) in patients on haemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) in a cross-section study and tested AOPP as an independent risk factor for cardiovascular disease. The levels of AOPP were significantly elevated in both HD and CAPD patients compared to healthy controls. However, accumulation of AOPP was more significant in HD compared to CAPD patients. Only in HD patients, the AOPP levels exhibit an association with ischaemic heart disease.

Mesenchymal stem cells may provide a new therapeutic tool for the treatment of chronic kidney disease by rescuing deteriorating kidney function.

In this single-centre study, the effects of tonsillectomy on the progression of childhood IgA nephropathy were investigated. Patients who underwent tonsillectomy (n = 25) had a greater chance of remission compared to those that did not (n = 5). In addition, renal histology improved in 19 patients who underwent a repeat renal biopsy following tonsillectomy.