Paraprotein-Mediated Glomerular Diseases.

Paraproteinemias are a group of complex diseases associated with an overproduction of a monoclonal immunoglobulin that can cause a diversity of kidney disorders and end-organ damage. In this review, we focus on paraprotein-mediated glomerular diseases. Kidney biopsy plays a crucial role in diagnosing these disorders, enabling the identification of specific histological patterns. These lesions are categorized into organized (such as amyloidosis, immunotactoid glomerulopathy, fibrillary glomerulonephritis, cryoglobulinemic glomerulonephritis, and monoclonal crystalline glomerulopathies) and nonorganized deposits (such as monoclonal Ig deposition disease and proliferative glomerulonephritis with monoclonal Ig deposits) based on the characteristics of immunofluorescence findings and the ultrastructural appearance of deposits on electron microscopy. This review aims to provide an update, highlight, and discuss clinicopathological aspects such as definition, epidemiology, clinical manifestations, mechanisms of kidney injury, histological features, and diagnostic procedures.

Onconephrology 2022: An Update.

Onconephrology is an upcoming and expanding subspecialty that deals with the intersections between hematology/oncology and nephrology. With the paradigm shift in the understanding of cancer immunobiology and mechanisms of oncotherapeutic drug toxicities, it is important for a nephrologist to have a sound understanding of this field. Over the last 5 years, there have been immense developments in our understanding of kidney-related adverse events from various targeted, immuno- and cellular-based therapies. Pathogenic mechanisms of electrolyte imbalance, hypertension (oncohypertension), and AKI from multiple forms of cancer therapies have been explored. Significant research has also been conducted in the field of transplant onconephrology. In this review, we have tried to assimilate the most recent updates in the last 2 years in this ever-growing and fascinating field.

Anaplastic lymphoma kinase inhibitors and their effect on the kidney.

Lung cancer is the leading cause of cancer-related mortality and approximately 5% of non-small-cell lung cancer (NSCLC) patients are positive for anaplastic lymphoma kinase (ALK) gene rearrangement or fusion with echinoderm microtubule-associated protein-like 4. ALK inhibitors are the mainstay treatment for patients with NSCLC harboring a rearrangement of the ALK gene or the ROS1 oncogenes. With the recent publication of pivotal trials leading to the approval of these compounds in different indications, their toxicity profile warrants an update. Several ALK-1 inhibitors are used in clinical practice, including crizotinib, ceritinib and alectinib. According to the package insert and published literature, treatment with several ALK-1 inhibitors appears to be associated with the development of peripheral edema and rare electrolyte disorders, kidney failure, proteinuria and an increased risk for the development and progression of renal cysts. This review introduces the different types of ALK inhibitors, focusing on their detailed kidney-related side effects in clinical practice.

Hypomagnesemia in Patients With Cancer: The Forgotten Ion.

Magnesium is crucial for various cellular and enzymatic processes, yet it often is overlooked or underappreciated. Hypomagnesemia, a deficiency of magnesium in the blood, is a frequent problem in cancer patients and can lead to severe symptoms and morbidity. In this review, we provide an in-depth analysis of the physiology and regulation of magnesium, and signs and symptoms of hypomagnesemia in cancer patients. We also examine the causes and mechanisms of magnesium imbalances in cancer patients, specifically focusing on cancer-specific therapies that can lead to hypomagnesemia. Finally, we provide updates on the management of hypomagnesemia, including oral and parenteral supplementation, as well as the role of drugs in cases that are resistant to treatment. This review aims to raise awareness among health care providers caring for cancer patients about the significance of monitoring magnesium levels in cancer patients and function as a guide. Future clinical studies should focus on magnesium monitoring, its impact on cancer progression, and its potential for preventing acute kidney injury.

Análisis pre mundial del paso de un marchista de élite en pista electrónica / Análise prémundial do passo de um marchista de elite em pista eletrônica / Pre-world analysis of the step of an elite marchist on an electronic track

Problema: en el mundial, los marchistas participan con el más alto nivel de ejecución técnica y con las mejores condiciones físicas, por lo que el análisis de los pasos de un marchista es clave para la obtención de un resultado óptimo. Objetivo: analizar la técnica del paso de un marchista de elite y el comportamiento de las variables de la marcha atlética, pre competencia al mundial de atletismo. Método: al deportista se le aplicó una prueba en una pista electrónica, evaluando las variables cinemáticas: longitud de paso, frecuencia de pasos, tiempo de vuelo y velocidad. Se utilizó ANOVA para determinar diferencias significativas (p ≤0.05). Resultados: en las tres pruebas realizadas, todas las variables incrementaron significativamente, aunque la diferencia más significativa se encontró entre tiempo de vuelo y frecuencia de pasos p=0.0000001, p<0.05. Conclusión: debido a que el tiempo de vuelo se incrementa rápidamente, se debe cuidar que no influya en la ejecución técnica del marchista para que sea más efectiva y así evitar una amonestación o descalificación.

Problem: In the World Athletics Championships, the racewalkers participate with the highest level of technical execution and with the best physical conditions, so the analysis of the steps of a racewalker is key to obtain an optimal result. Objective: To analyze the technique of an elite racewalker and the behavior of the variables of the athletic racewalking, pre-competition to the World Athletics Championships. Method: A test on an electronic track was given to one athlete, evaluating the kinematic variables: step length, step frequency, flight time, and speed. ANOVA was used to determine significant differences (p ≤0.05). Result: In the three tests carried out, all the variables increased significantly, although the most significant difference was found between flight time and step frequency p = 0.0000001, p <0.05. Conclusion: Since the flight time increases rapidly, it must be careful that this not influence the technical execution of the racewalkers, to be more effective, and thus avoid a warning or disqualification.

Problema: No mundial, os marchistas participam com o maior nível de execução técnica e com as melhores condições físicas, é por isso que a análise dos passos de um marchista é a chave para a obtenção de melhores resultados. Objetivo: analisar a técnica de passo de um marchista de elite e o comportamento das variáveis da marcha atlética, pré-competição rumo ao mundial de atletismo. Método: um teste foi aplicado em uma pista eletrônica de um marchista e se estudaram as seguintes variáveis cinemáticas: o comprimento do passo, a frequência de passos, o tempo de voo e a velocidade. ANOVA foi utilizada para determinar as diferenças significativas (p ≤0.05). Resultados: Em todos os três testes realizados, todas as variáveis aumentaram significativamente, embora a diferença mais significativa foi encontrada entre o tempo de voo e a frequência de passos p = 0.0000001, p <0,05. Conclusão: Porque o tempo de voo aumenta rapidamente, deve ser assegurado que não tenha nenhuma influência sobre a execução técnica do marchista, para que seja mais eficaz e, assim, evitar uma advertência ou desqualificação.