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  1. Article ; Online: Risk factors associated with short- and long-term kidney injury in children with post infectious glomerulonephritis.

    Matsell, Douglas G / Cojocaru, Dan / Catapang, Marisa

    Pediatric nephrology (Berlin, Germany)

    2023  Volume 38, Issue 10, Page(s) 3309–3315

    Abstract: Background: Post infectious glomerulonephritis (PIGN) is the most common form of acute glomerulonephritis in children. The objective of this study was to evaluate the risk factors for kidney injury in children with PIGN referred to a tertiary care ... ...

    Abstract Background: Post infectious glomerulonephritis (PIGN) is the most common form of acute glomerulonephritis in children. The objective of this study was to evaluate the risk factors for kidney injury in children with PIGN referred to a tertiary care center.
    Methods: This was a retrospective cohort study. The primary outcome was acute kidney injury (AKI) at initial presentation; secondary outcome was composite kidney injury, defined as reduced estimated glomerular filtration rate (eGFR), proteinuria, or hypertension at last follow-up. Binary logistic regression defined risk factors associated with the primary and secondary outcomes.
    Results: We identified 125 PIGN cases with a mean age of 8.3±3.5 years at presentation and 252 ± 501 days of follow-up. Sixty-six percent (79/119) presented with AKI and 57% (71/125) were admitted to hospital. Shorter time to seeing a nephrologist (OR 6.7, 95%CI 1.8-24.6), nadir C3 < 0.12 g/L (OR 10.2, 95%CI 1.9-53.7), starting an antihypertensive medication (OR 7.6, 95%CI 1.8-31.3), and nephrotic range proteinuria (OR 3.8, 95%CI 1.2-12.4) were independent risk factors for AKI when adjusted for each other. At last follow-up 35% (44/125) of the cohort had the composite outcome, with older age at presentation (OR 1.2, 95%CI 1.04-1.4) and nadir C3 < 0.17 g/L (OR 2.6, 95%CI 1.04-6.7) being independent risk factors when adjusted for AKI.
    Conclusion: PIGN is an important cause of AKI in children and adolescents. The severity of initial illness is associated with the extent of kidney injury in both the short- and longer-term. Findings will help identify cases requiring lengthier surveillance. A higher resolution version of the Graphical abstract is available as Supplementary information.
    MeSH term(s) Adolescent ; Child ; Humans ; Child, Preschool ; Retrospective Studies ; Kidney ; Glomerulonephritis/complications ; Glomerulonephritis/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/complications ; Proteinuria/etiology ; Proteinuria/complications ; Risk Factors
    Language English
    Publishing date 2023-05-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-023-06000-1
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  2. Article ; Online: Predicting outcomes in children with congenital anomalies of the kidney and urinary tract.

    Matsell, Douglas G / Catapang, Marisa / Becknell, Brian

    Pediatric nephrology (Berlin, Germany)

    2023  Volume 38, Issue 10, Page(s) 3407–3415

    Abstract: Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the most frequent causes of childhood chronic kidney disease (CKD). Using a large CAKUT cohort, we sought to identify the predictors of CKD and to develop a prediction model ... ...

    Abstract Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the most frequent causes of childhood chronic kidney disease (CKD). Using a large CAKUT cohort, we sought to identify the predictors of CKD and to develop a prediction model that informs a risk-stratified clinical pathway.
    Methods: This was a retrospective cohort study including cases with multicystic dysplastic kidneys (MCDK), unilateral kidney agenesis (UKA), kidney hypoplasia (KH), and posterior urethral valves (PUV). We identified risk factors for CKD (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m
    Results: We identified 452 eligible cases of CAKUT with 22% developing CKD. Strongest associations with CKD included primary diagnosis (OR 3.5, 95% CI 2.6-4.6), preterm delivery (OR 2.3, 95% CI 1.2-4.4), non-kidney anomalies (OR 1.8, 95% CI 1.1-3), first eGFR<90 (OR 8.9, 95% CI 4.4-18.1), small kidney size (OR 9, 95% CI 4.9-16.6), and additional kidney anomalies (OR 1.6, 95% CI 1.2-2.8). PUV (OR 4.7, 95% CI 1.5-15.3), first eGFR <90 (OR 4.4, 95% CI 2-9.7), and kidney length to body length ratio <7.9 (OR 4.2, 95% CI 1.9-9.2) were independent predictors of CKD. The regression model had a prediction accuracy of 80% and a prediction probability c-statistic of 0.81.
    Conclusion: Using a large combined CAKUT cohort we identified risk factors for CKD. Our prediction model provides the first steps towards a risk-stratified clinical pathway. A higher resolution version of the Graphical abstract is available as Supplementary information.
    MeSH term(s) Infant, Newborn ; Child ; Humans ; Retrospective Studies ; Kidney/abnormalities ; Urinary Tract/abnormalities ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/etiology
    Language English
    Publishing date 2023-05-03
    Publishing country Germany
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-023-05992-0
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  3. Article ; Online: Hypertension in children with congenital anomalies of the kidney and urinary tract.

    Taha, Khalid / Catapang, Marisa / Becknell, Brian / Matsell, Douglas G

    Pediatric nephrology (Berlin, Germany)

    2023  Volume 39, Issue 4, Page(s) 1185–1192

    Abstract: Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of childhood chronic kidney disease (CKD). We hypothesized that hypertension varies across CAKUT categories and increases the risk of CKD.: Methods: ... ...

    Abstract Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of childhood chronic kidney disease (CKD). We hypothesized that hypertension varies across CAKUT categories and increases the risk of CKD.
    Methods: This was a retrospective cohort study and included cases with a multicystic dysplastic kidney (MCDK, n = 81), unilateral kidney agenesis (UKA, n = 47), kidney hypoplasia (KH, n = 130), and posterior urethral valves (PUV, n = 75). Hypertension was defined as systolic or diastolic blood pressure ≥ 95
    Results: Sixty-two (19%) out of 333 cases developed hypertension, with significant difference according to CAKUT type. Patients with smaller kidney size (7.7 vs. 8.3, p = 0.045), kidney anomalies in addition to the primary diagnosis (aCAKUT) (53 vs. 38%, p = 0.03), proteinuria (46 vs. 12%, p < 0.001), and CKD (51 vs. 23%, p < 0.001) were more likely to develop hypertension. When adjusted for kidney size, the diagnoses of PUV (OR 10.9, 95%CI 3.0, 40.5), UKA (OR 6.4, 95%CI 1.6, 24.9) and KH (OR 4.2, 95%CI 1.1, 16.1), and aCAKUT (OR 2.1, 95%CI 1.2, 3.9) were independent risk factors for hypertension. Hypertension increased the risk of developing CKD by twofold (HR 1.9, 95%CI 1.19, 2.94).
    Conclusion: Hypertension is common in children with CAKUT and increases the risk of CKD. These findings will aid in the development of a standardized clinical pathway for the care of hypertensive children with CAKUT.
    MeSH term(s) Child ; Humans ; Retrospective Studies ; Kidney/abnormalities ; Urinary Tract/abnormalities ; Hypertension/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/etiology ; Urogenital Abnormalities ; Vesico-Ureteral Reflux
    Language English
    Publishing date 2023-11-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-023-06207-2
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  4. Article ; Online: Predicting outcomes and improving care in children with congenital kidney anomalies.

    Matsell, Douglas G / Catapang, Marisa

    Pediatric nephrology (Berlin, Germany)

    2020  Volume 35, Issue 10, Page(s) 1811–1814

    MeSH term(s) Biomarkers ; Child ; Humans ; Kidney ; Kidney Diseases ; Urinary Tract
    Chemical Substances Biomarkers
    Language English
    Publishing date 2020-07-08
    Publishing country Germany
    Document type Editorial ; Comment
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-020-04677-2
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  5. Article ; Online: Kidney length standardized to body length predicts outcome in infants with a solitary functioning kidney.

    Matsell, Douglas G / Bao, Carol / White, Teagan Po / Chan, Ella / Matsell, Eli / Cojocaru, Dan / Bajno, Lydia / Catapang, Marisa

    Pediatric nephrology (Berlin, Germany)

    2022  

    Abstract: Background: Infants with a solitary functioning kidney (SFK) are at risk for chronic kidney injury (CKI). Lack of compensatory kidney growth (CKG) is associated with CKI, but measuring CKG is challenging since it is typically reported relative to normal ...

    Abstract Background: Infants with a solitary functioning kidney (SFK) are at risk for chronic kidney injury (CKI). Lack of compensatory kidney growth (CKG) is associated with CKI, but measuring CKG is challenging since it is typically reported relative to normal kidneys. This study aims to (1) standardize SFK growth in infants, (2) investigate the relationship between standardized kidney length and clinical outcomes, and (3) use these results to develop a risk-based prediction model and local clinical pathway for SFK care.
    Methods: This was a quality improvement study of 166 infants with an SFK. Linear regression was used to assess kidney growth from 0 to 180 days of life. Univariate binary regression analysis was used to identify kidney length to body length thresholds associated with the development of CKI, defined as the composite outcome of chronic kidney disease (eGFR < 60 mL/min/1.73 m
    Results: Kidneys grew in length from 0 to 180 days, and growth was constant when standardized to body length. Over follow-up, infants with a baseline kidney length to body length ≤ 0.088 were more likely to experience CKI than the rest of the cohort (27 vs. 8%, p = 0.04). Kidney length to body length ≤ 0.088 was also significantly associated with CKI development (OR 4.17, 95% CI 1.14-15.28, p = 0.04).
    Conclusions: In this study, kidney length to body length ratio was a stable CKG metric over 0-180 days, and a baseline ratio ≤ 0.088 was a risk factor for CKI. Results will aid in developing a practical, point-of-care risk assessment tool, and overarching risk-stratified clinical pathway for infants with an SFK. A higher resolution version of the Graphical abstract is available as Supplementary information.
    Language English
    Publishing date 2022-04-12
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-022-05544-y
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  6. Article ; Online: Outcomes of solitary functioning kidneys-renal agenesis is different than multicystic dysplastic kidney disease.

    Matsell, Douglas G / Bao, Carol / Po White, Teagan / Chan, Ella / Matsell, Eli / Cojocaru, Dan / Catapang, Marisa

    Pediatric nephrology (Berlin, Germany)

    2021  Volume 36, Issue 11, Page(s) 3673–3680

    Abstract: Background: Multicystic dysplastic kidney (MCDK) disease and unilateral renal agenesis (URA) are well-known causes of a solitary functioning kidney (SFK) and are associated with long-term kidney injury. The aims of this study were to characterize the ... ...

    Abstract Background: Multicystic dysplastic kidney (MCDK) disease and unilateral renal agenesis (URA) are well-known causes of a solitary functioning kidney (SFK) and are associated with long-term kidney injury. The aims of this study were to characterize the natural history of SFK at our center, define the risk factors associated with chronic kidney injury, and identify distinguishing features between URA and MCDK that predict outcome.
    Methods: This was a retrospective cohort study of 230 SFK patients. We compared MCDK (n=160) and URA (n=70) according to clinical features at diagnosis and kidney outcomes over follow-up. Univariate and multivariate binary regression analysis was used to determine independent risk factors for chronic kidney injury, defined as the composite outcome of hypertension, proteinuria, or chronic kidney disease (eGFR <60 mL/min/1.73m
    Results: URA had a higher prevalence of comorbid genetic syndromes (15 vs. 6%, p=0.04), non-renal anomalies (39 vs. 11%, p<0.001), and congenital anomalies of the kidney and urinary tract (CAKUT) (51 vs. 26%, p<0.001) than MCDK. Over follow-up, URA experienced more hypertension (19 vs. 3%, p=0.002), proteinuria (12 vs. 3%, p=0.03), and the composite outcome (19 vs. 6%, p=0.003) than MCDK. Independent risk factors for chronic kidney injury included CAKUT (OR 5.01, p=0.002) and URA (OR 2.71, p=0.04).
    Conclusions: In our population, URA was more likely to have associated syndromes or anomalies, and to have worse outcomes over time than MCDK. URA diagnosis was an independent risk factor for chronic kidney injury. Our results will be used to develop a standardized clinical pathway for SFK management. A higher resolution version of the Graphical abstract is available as Supplementary information.
    MeSH term(s) Congenital Abnormalities/epidemiology ; Follow-Up Studies ; Humans ; Kidney/abnormalities ; Kidney Diseases/congenital ; Kidney Diseases/epidemiology ; Multicystic Dysplastic Kidney/epidemiology ; Retrospective Studies ; Risk Factors ; Solitary Kidney/epidemiology
    Language English
    Publishing date 2021-05-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-021-05064-1
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  7. Article ; Online: Dietary intakes of children with nephrotic syndrome.

    Polderman, Nonnie / Cushing, Meredith / McFadyen, Kirsten / Catapang, Marisa / Humphreys, Robert / Mammen, Cherry / Matsell, Douglas G

    Pediatric nephrology (Berlin, Germany)

    2021  Volume 36, Issue 9, Page(s) 2819–2826

    Abstract: Background: Our multidisciplinary clinical pathway for treatment of childhood nephrotic syndrome (NS) was established with the goal of standardizing local clinical practice. This descriptive study aimed to assess nutrient intakes of children with newly ... ...

    Abstract Background: Our multidisciplinary clinical pathway for treatment of childhood nephrotic syndrome (NS) was established with the goal of standardizing local clinical practice. This descriptive study aimed to assess nutrient intakes of children with newly diagnosed NS compared with nutrition goals defined by our pathway.
    Methods: Our pathway includes evidence-based recommendations that target daily intakes during corticosteroid induction therapy: energy (Estimated Energy Requirements (EER) × Sedentary Physical Activity (PA)), sodium (1 mg/kcal), calcium (Dietary Reference Intake (DRI) + 500 mg elemental calcium), and vitamin D (DRI +800-1000 IU). After dietitian-led education at initial diagnosis, 3-day food records were completed at 4 weeks post-diagnosis. Daily nutrient intakes were compared to pathway targets and DRIs.
    Results: Thirty-six children (median age 4.8 years, 44% female) with newly diagnosed NS submitted food records. Mean energy and sodium intakes were 103±22% and 99±53% of pathway targets, respectively. Fourteen (39%) children exceeded pathway sodium recommendations, with four (11%) exceeding them by greater than 50%. Seven (19%) children met DRI for calcium, while six (17 %) met pathway targets for calcium. No children met DRI for vitamin D from diet alone; and only one met the target with supplementation.
    Conclusions: This is the first study to describe dietary intakes of children with newly diagnosed NS. Our clinical pathway targets for energy and sodium were achievable; however, calcium and vitamin D intakes fell short of pathway guidelines and DRIs. Prescription of supplemental calcium and vitamin D may be needed to achieve target intakes of calcium and vitamin D.
    MeSH term(s) Calcium ; Calcium, Dietary ; Child, Preschool ; Diet ; Eating ; Energy Intake ; Female ; Humans ; Male ; Nephrotic Syndrome/drug therapy ; Nutritional Requirements ; Sodium ; Vitamin D ; Vitamins
    Chemical Substances Calcium, Dietary ; Vitamins ; Vitamin D (1406-16-2) ; Sodium (9NEZ333N27) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2021-03-30
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-021-05055-2
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  8. Article ; Online: Induction prednisone dosing for childhood nephrotic syndrome: how low should we go?

    Sibley, Matthew / Roshan, Abishek / Alshami, Alanoud / Catapang, Marisa / Jöbsis, Jasper J / Kwok, Trevor / Polderman, Nonnie / Sibley, Jennifer / Matsell, Douglas G / Mammen, Cherry

    Pediatric nephrology (Berlin, Germany)

    2018  Volume 33, Issue 9, Page(s) 1539–1545

    Abstract: Background: Historically, children with nephrotic syndrome (NS) across British Columbia (BC), Canada have been cared for without formal standardization of induction prednisone dosing. We hypothesized that local historical practice variation in induction ...

    Abstract Background: Historically, children with nephrotic syndrome (NS) across British Columbia (BC), Canada have been cared for without formal standardization of induction prednisone dosing. We hypothesized that local historical practice variation in induction dosing was wide and that children treated with lower doses had worse relapsing outcomes.
    Methods: This retrospective cohort study included 92 NS patients from BC Children's Hospital (1990-2010). We excluded secondary causes of NS, age < 1 year at diagnosis, steroid resistance, and incomplete induction due to early relapse. We explored cumulative induction dose and defined dosing quartiles. Relapsing outcomes above and below each quartile threshold were compared including total relapses in 2 years, time to first relapse, and proportions developing frequently relapsing NS (FRNS) or starting a steroid-sparing agent (SSA).
    Results: Cumulative prednisone was widely distributed with approximated median, 1st, and 3rd quartile doses of 2500, 2000, and 3000 mg/m
    Conclusions: Results strongly justify our development of a standardized, province-wide NS clinical pathway to reduce practice variation and minimize under-treatment. The lowest induction prednisone dosing threshold to minimize future relapsing risks is likely between 2000 and 2500 mg/m
    MeSH term(s) Adolescent ; British Columbia ; Child ; Child, Preschool ; Critical Pathways/standards ; Female ; Follow-Up Studies ; Glucocorticoids/administration & dosage ; Humans ; Infant ; Male ; Nephrotic Syndrome/complications ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/urine ; Practice Patterns, Physicians'/standards ; Prednisone/administration & dosage ; Proteinuria/diagnosis ; Proteinuria/drug therapy ; Proteinuria/etiology ; Proteinuria/urine ; Recurrence ; Remission Induction/methods ; Retrospective Studies ; Time Factors ; Treatment Outcome
    Chemical Substances Glucocorticoids ; Prednisone (VB0R961HZT)
    Language English
    Publishing date 2018-05-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-018-3975-6
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  9. Article ; Online: Indications for kidney biopsy in idiopathic childhood nephrotic syndrome.

    Alshami, Alanoud / Roshan, Abishek / Catapang, Marisa / Jöbsis, Jasper J / Kwok, Trevor / Polderman, Nonnie / Sibley, Jennifer / Sibley, Matt / Mammen, Cherry / Matsell, Douglas G

    Pediatric nephrology (Berlin, Germany)

    2017  Volume 32, Issue 10, Page(s) 1897–1905

    Abstract: Background: Most cases of childhood nephrotic syndrome (NS) are due to minimal change disease (MCD), while a minority of children have focal segmental glomerulosclerosis (FSGS) and an unfavorable clinical course, requiring a kidney biopsy to confirm ... ...

    Abstract Background: Most cases of childhood nephrotic syndrome (NS) are due to minimal change disease (MCD), while a minority of children have focal segmental glomerulosclerosis (FSGS) and an unfavorable clinical course, requiring a kidney biopsy to confirm diagnosis. We hypothesized that clinical characteristics at diagnosis and initial response to corticosteroid treatment accurately predict FSGS and can be used to guide consistent practice in the indications for kidney biopsy.
    Methods: This was a case control study (1990-2012). Inclusion criteria included age 1-17 years, meeting the diagnostic criteria for NS, and having biopsy-proven FSGS or MCD. Clinical characteristics at diagnosis included age, kidney function [estimated glomerular filtration rate (eGFR)], hypertension, hematuria, nephritis (reduced eGFR, hematuria, hypertension), and response to steroids.
    Results: From a total of 169 children who underwent kidney biopsy for NS we included 65 children with MCD and 22 with FSGS for analysis. There were no significant between-group differences in age, sex, or eGFR at the time of diagnosis. The FSGS group had a higher proportion of hypertension (40 vs. 15%; p = 0.02), hematuria (80 vs. 47%; p = 0.01), and nephritis (22 vs. 2%; p = 0.004) and was more likely to be steroid resistant after 6 weeks of treatment than the MCD group (67 vs. 19%; p < 0.001). As predictors of FSGS, hematuria had a high sensitivity of 0.80 [95% confidence interval (CI) 0.56-0.93] and low specificity of 0.53 (95% CI 0.39-0.66), nephritis had a low sensitivity of 0.22 (95% CI 0.07-0.48) and high specificity of 0.98 (95% CI 0.88-0.99), and steroid resistance had a low sensitivity of 0.67 (95% CI 0.43-0.85) and high specificity of 0.81 (95% CI 0.68-0.90). The combination of steroid resistance after 6 weeks of therapy and/or nephritis at diagnosis yielded the optimal sensitivity and specificity at 0.80 (95% CI 0.56-0.93) and 0.75 (95% CI 0.60-0.86), respectively, confirmed by the highest receiver operator characteristic area under the curve of 0.77.
    Conclusion: Steroid resistance after 6 weeks of therapy and/or nephritis at initial presentation is an accurate predictor of FSGS in children with NS and will be used as the indication for kidney biopsy in our newly developed clinical pathway. This approach will maximize the yield of diagnostic FSGS biopsies while minimizing the number of unnecessary MCD biopsies.
    MeSH term(s) Adolescent ; Age Factors ; Biomarkers/analysis ; Biopsy ; Case-Control Studies ; Child ; Child, Preschool ; Drug Resistance ; Female ; Glomerular Filtration Rate ; Glomerulosclerosis, Focal Segmental/complications ; Glomerulosclerosis, Focal Segmental/diagnosis ; Glomerulosclerosis, Focal Segmental/drug therapy ; Glomerulosclerosis, Focal Segmental/pathology ; Glucocorticoids/pharmacology ; Glucocorticoids/therapeutic use ; Humans ; Infant ; Kidney/pathology ; Kidney/physiopathology ; Male ; Nephrosis, Lipoid/complications ; Nephrosis, Lipoid/diagnosis ; Nephrosis, Lipoid/pathology ; Nephrotic Syndrome/diagnosis ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/etiology ; Nephrotic Syndrome/pathology ; Patient Selection ; Prognosis ; ROC Curve ; Treatment Outcome
    Chemical Substances Biomarkers ; Glucocorticoids
    Language English
    Publishing date 2017-05-24
    Publishing country Germany
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-017-3687-3
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  10. Article: An Evidence-Based Systematic Review of Chlorophyll by the Natural Standard Research Collaboration

    Ulbricht, Catherine / Bramwell, Rebecca / Catapang, Marisa / Giese, Nicole / Isaac, Richard / Le, Thuy-Duong / Montalbano, Julie / Tanguay-Colucci, Shaina / Trelour, Nicole J / Weissner, Wendy / Windsor, Regina C / Wortley, Jayme / Yoon, Heeja / Zeolla, Mario M

    Journal of dietary supplements. 2014 June 1, v. 11, no. 2

    2014  

    Abstract: An evidence-based systematic review of chlorophyll by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes ... ...

    Abstract An evidence-based systematic review of chlorophyll by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
    Keywords chlorophyll ; cooperative research ; expert opinion ; pharmacology ; statistical analysis ; systematic review ; toxicology
    Language English
    Dates of publication 2014-0601
    Size p. 198-239.
    Publishing place Taylor & Francis
    Document type Article
    Note NAL-AP-2-clean
    ZDB-ID 2460305-3
    ISSN 1939-022X ; 1939-0211
    ISSN (online) 1939-022X
    ISSN 1939-0211
    DOI 10.3109/19390211.2013.859853
    Database NAL-Catalogue (AGRICOLA)

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    Z 6537: Show issues

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