Hipocalcemia e hiperparatiroidismo extremos tras denosumab. ¿Es seguro este fármaco en la enfermedad renal crónica? / Extreme hypocalcaemia and hyperparathyroidism following denosumab. Is this drug safe in chronic kidney disease?

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Renal artery occlusion in autosomal dominant polycystic kidney disease.

Several vascular abnormalities have been reported in autosomal dominant polycystic kidney disease (ADPKD). Occlusion of the renal artery is uncommon in ADPKD and can be associated with hypertension. We report a 38-year-old woman with ADPKD and severe hypertension, abdominal magnetic resonance angiogram and arteriography revealed left renal artery total occlusion. A revascularization approach was not considered feasible and she was given conservative treatment. We review the literature and make some comments about renal artery occlusion in ADPKD. This association should be kept in mind in cases of ADPKD with severe or resistant hypertension.

Performance of global-appearance descriptors in map building and localization using omnidirectional vision.

Map building and localization are two crucial abilities that autonomous robots must develop. Vision sensors have become a widespread option to solve these problems. When using this kind of sensors, the robot must extract the necessary information from the scenes to build a representation of the environment where it has to move and to estimate its position and orientation with robustness. The techniques based on the global appearance of the scenes constitute one of the possible approaches to extract this information. They consist in representing each scene using only one descriptor which gathers global information from the scene. These techniques present some advantages comparing to other classical descriptors, based on the extraction of local features. However, it is important a good configuration of the parameters to reach a compromise between computational cost and accuracy. In this paper we make an exhaustive comparison among some global appearance descriptors to solve the mapping and localization problem. With this aim, we make use of several image sets captured in indoor environments under realistic working conditions. The datasets have been collected using an omnidirectional vision sensor mounted on the robot.

Acute renal failure and severe thrombocytopenia associated with metamizole.

Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diagnosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously.

Glomerulonefritis membranosa en paciente con linfoma de Hodgkin en remisión / Membranous glomerulonephritis in a patient with Hodgkin's lymphoma in remission

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Rabdomiólisis y fracaso renal agudo tras trabajo intenso en un paciente en tratamiento con rosuvastatina / Rhabdomyolysis and acute renal failure following hard physical activity in a patient treated with rosuvastatin

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Severe hemorrhage because of delayed iliac vein rupture after dialysis catheter placement: is it preventable?

Mechanical complications of femoral catheterization for hemodialysis include pseudoaneurysm, arteriovenous fistulae, neurological injury, and vessel perforation. With regard to the latter, severe hemorrhage is a rare but devastating and potentially fatal complication. We report the case of a 76-year-old female who underwent femoral catheterization for hemodialysis using ultrasound guidance. The first hemodialysis session was conducted without incident. Unfortunately, inadvertent injury and delayed perforation of the iliac vein resulted in severe hemorrhage and retroperitoneal hematoma. Surgical repair was performed. The patient was asymptomatic after the procedure and was discharged 15 days later. Based on this case and a review of the literature, we present mechanisms and ways to prevent this complication.

Serum tryptase levels and markers of renal dysfunction in a population with chronic kidney disease.

BACKGROUND: Mast cells (MCs) might play a pathogenetic role in renal fibrosis. Tryptase is a marker for activated MCs. Little is known about tryptase levels in the chronic renal disease population. METHODS: We examined serum MC tryptase concentrations in relation to specific laboratory abnormalities in 153 outpatients with chronic kidney disease (CKD) and in 35 hemodialysis (HD) patients. RESULTS: Here we found that tryptase mean values were higher in men than in women (12.4 +/- 7.6 microg/L vs. 10.2 +/- 8.4 microg/L; p<0.05). Tryptase levels were increased in CKD stages 4 and 5 and in HD patients, versus CKD stages 1 and 2: 12.7 +/- 7.3 microg/L, 13.8 +/- 7.8 microg/L, 15 +/- 8.9 microg/L vs. 6.7 +/- 5.1 microg/L (p<0.01). In univariate analysis, in the conservative treatment CKD population, tryptase was positively correlated with urea, creatinine, potassium, uric acid, phosphorus, parathyroid hormone, homocysteine, fibrinogen and proteinuria (p<0.01); tryptase was negatively correlated with calcium, albumin, creatinine clearance, estimated glomerular filtration rate (by abbreviated MDRD equation) and urine creatinine (p<0.01). In HD patients, the only significative correlation found was with systolic blood pressure and diastolic blood pressure (p<0.01). No significant correlations were found between tryptase and other parameters such as albumin, glucose, hemoglobin, leukocytes, immunoglobulins or C-reactive protein. Multiple regression analysis showed estimated glomerular filtration rate and proteinuria to be independent determinants of tryptase. CONCLUSIONS: This is the first study to determine that tryptase levels increase with higher degrees of kidney dysfunction. The association with markers of diminished renal function suggests impaired metabolism or a negative effect of inflammation on glomerular filtration rate. Further studies are required to ascertain the clinical implications of these findings.