Isolated microscopic haematuria of glomerular origin: clinical significance and diagnosis in the 21st century.
Abstract
Isolated microscopic, or non-visible, haematuria of glomerular origin was previously regarded a benign finding, but it is now known that, even in the absence of proteinuria, hypertension or renal impairment at presentation, haematuria is associated with increased risk of kidney failure in the long term. The most common causes of isolated microscopic haematuria among children and young adults are IgA nephropathy, Alport syndrome (AS), and thin basement membrane nephropathy (TBMN). AS, which is usually inherited as an X-linked or autosomal recessive trait, and TBMN, which is usually autosomal domina...
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Chan MM, Gale DP Tags: Clin Med Source Type: research
Acute kidney injury.
Abstract
Acute kidney injury (AKI) - an abrupt deterioration in renal function - causes a rise in serum creatinine (SCr) or fall in urine output. It is common, occurring in up to 20% of hospital admissions. Importantly, even small rises in SCr are associated with increased risk of death and longer hospital stays. A 2009 National Confidential Enquiry into Patient Outcome and Death report found that a proportion of AKI in secondary care was avoidable. In addition, management of established AKI was 'good' less than half the time. In practice, AKI represents a heterogeneous group of conditions, encompassing im...
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Connell A, Laing C Tags: Clin Med Source Type: research
The health impacts of dietary sodium and a low-salt diet.
Abstract
High salt intake is now endemic worldwide. It contributes to the generation and maintenance of high blood pressure, which is now the biggest risk factor for global disease. There is now compelling evidence to support salt reduction in hypertensives and a substantial body of evidence to support salt reduction in the general population to reduce risk of death from cardiovascular disease. In specific diseases such as heart failure and chronic kidney disease, guidelines support the World Health Organization target for reduced salt intake at 5 g daily. Achieving a diet that is lower in salt has challe...
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Suckling RJ, Swift PA Tags: Clin Med Source Type: research
CME Renal medicine (100621): self-assessment questionnaire.
PMID: 26621955 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Caplin B, Chowdhury T Tags: Clin Med Source Type: research
Pneumonitis and pulmonary haemorrhage after acute myocardial infarction.
Abstract
A 55-year-old man presented with acute ST-elevation myocardial infarction. He received rescue angioplasty with one drug eluting stent. He developed marked breathlessness and haemoptysis two days later. Investigations led to the diagnosis of pulmonary haemorrhage, possibly from pneumonitis caused by ticagrelor. He was successfully managed with high-dose steroids and ticagrelor was replaced with clopidogrel. On stopping the steroids a month later, mild haemoptysis recurred and this was managed conservatively. Pneumonitis and pulmonary haemorrhage is rarely reported with acute myocardial infarction, ...
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Parasuraman SK, Teo AI, Millar CG, Noman A Tags: Clin Med Source Type: research
Lesson of the month 2: Non-uraemic calciphylaxis - an unexpected differential diagnosis for a necrotic ulcer.
We present an unexpected diagnosis of calciphylaxis in a patient with normal renal and parathyroid function. The patient presented with a month-long history of painful bilateral necrotic leg ulcers, resistant to conventional treatment. She developed severe sepsis requiring admission to the intensive care unit, and despite escalation of antibiotic therapy and meticulous wound care management, eventually died. A biopsy confirmed a diagnosis of calciphylaxis. We suspect that warfarin therapy may have contributed to the development of this condition. Through this case we aim to raise awareness of calciphylaxis as a differentia...
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Bataillard EJ, Clayton J, Riordan J, Galliford T Tags: Clin Med Source Type: research
The Mount Fuji sign.
PMID: 26621958 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Anandpara KM, Aswani Y, Hira P Tags: Clin Med Source Type: research
From Darzi to Keogh: are doctors under 'report fatigue'.
PMID: 26621959 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Chadwick A, Mohabir A Tags: Clin Med Source Type: research
Upper gastrointestinal cancer misses: could we do better?
PMID: 26621960 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Ardakani AH, Mann S Tags: Clin Med Source Type: research
Venous thromboembolism: a role for weight-stratified thromboprophylaxis?
PMID: 26621961 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Balaji A, Mercer R, Mainwaring J Tags: Clin Med Source Type: research
The limited role of cranial computerised tomography in the assessment of a medical patient.
PMID: 26621962 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - December 1, 2015 Category: Journals (General) Authors: Pathmanathan S, Welagedara S, Mutalithas K Tags: Clin Med Source Type: research
Retail therapy.
PMID: 26430175 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 4, 2015 Category: Journals (General) Authors: Hodgson H Tags: Clin Med Source Type: research
'Part of the problem, part of the solution' - adult physicians' role in adolescent and young adult health.
PMID: 26430176 [PubMed - in process] (Source: Clinical Medicine)
Source: Clinical Medicine - October 4, 2015 Category: Journals (General) Authors: Gleeson H Tags: Clin Med Source Type: research
Establishing an infrastructure to support the development and delivery of clinical research in patients with kidney disease.
Abstract
The UK Kidney Research Consortium (UKKRC) was established in 2007 to promote clinical research in adults and children affected by kidney disease. Clinical study groups (CSGs) are the core subgroups of UKKRC. The aim of the CSGs is to generate a portfolio of clinical studies that can and should be undertaken in the UK. Since 2007 the CSGs have helped develop and secure funding for 13 studies to a total value of £13443648. Funders include Kidney Research UK, Medical Research Council, British Heart Foundation and National Institute of Health Research (NIHR). The studies address the full translationa...
Source: Clinical Medicine - October 4, 2015 Category: Journals (General) Authors: UK Kidney Research Consortium Tags: Clin Med Source Type: research
Transcatheter aortic valve implantation - what the general physician needs to know.
Abstract
With an increasingly elderly population, the incidence of aortic stenosis (AS) is rising. While surgical aortic valve replacement remains the gold standard treatment for patients with severe symptomatic AS, transcatheter aortic valve implantation (TAVI) has emerged as the treatment of choice for patients who are inoperable or high surgical risk. TAVI has been shown to be associated with a clear mortality benefit when compared with medical therapy and to be at least as good as surgical aortic valve replacement in this patient group. The last few years have seen rapid development in this revolutiona...
Source: Clinical Medicine - October 4, 2015 Category: Journals (General) Authors: Ruparelia N, Prendergast BD Tags: Clin Med Source Type: research
