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1.
Nephrol Dial Transplant ; 35(10): 1652-1662, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33022712

RESUMO

As of 15 August 2020, Coronavirus disease 2019 (COVID-19) has been reported in >21 million people world-wide and is responsible for more than 750,000 deaths. The occurrence of acute kidney injury (AKI) in patients hospitalized with COVID-19 has been reported to be as high as 43%. This is comparable to AKI in other forms of pneumonia requiring hospitalization, as well as in non-infectious conditions like cardiac surgery. The impact of AKI on COVID-19 outcomes is difficult to assess at present but, similar to other forms of sepsis, AKI is strongly associated with hospital mortality. Indeed, mortality is reported to be very low in COVID-19 patients without AKI. Given that AKI contributes to fluid and acid-base imbalances, compromises immune response and may impair resolution of inflammation, it seems likely that AKI contributes to mortality in these patients. The pathophysiologic mechanisms of AKI in COVID-19 are thought to be multifactorial including systemic immune and inflammatory responses induced by viral infection, systemic tissue hypoxia, reduced renal perfusion, endothelial damage and direct epithelial infection with Severe Acute Respiratory Syndrome Coronavirus 2. Mitochondria play a central role in the metabolic deregulation in the adaptive response to the systemic inflammation and are also found to be vital in response to both direct viral damage and tissue reperfusion. These stress conditions are associated with increased glycolysis and reduced fatty acid oxidation. Thus, there is a strong rationale to target AKI for therapy in COVID-19. Furthermore, many approaches that have been developed for other etiologies of AKI such as sepsis, inflammation and ischemia-reperfusion, have relevance in the treatment of COVID-19 AKI and could be rapidly pivoted to this new disease.


Assuntos
Lesão Renal Aguda/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Taxa de Filtração Glomerular/fisiologia , Rim/fisiopatologia , Pandemias , Pneumonia Viral/complicações , Lesão Renal Aguda/fisiopatologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
2.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026202

RESUMO

We report the case of a 68-year-old patient who arrived at the hospital with a fever and a cough for 7 days, a history of high blood pressure and chronic kidney failure stage 2 according to CKD-EPI (GFR: 62 ml/minute with creatinine: 1.2 mg/dl). Home therapy included lercanidipine and clonidine. A chest radiograph performed in the emergency department immediately showed images suggestive of pneumonia from COVID-19, confirmed in the following days by a positive swab for coronavirus. Kidney function parameters progressively deteriorated towards a severe acute kidney failure on the 15th day, with creatinine values of 6.6 mg/dl and urea of 210 mg/dl. The situation was managed first in the intensive care unit with CRRT cycles (continuous renal replacement therapy) and then in a "yellow area" devoted to COVID patients, where the patient was dialyzed by us nephrologists through short cycles of CRRT. In our short experience we have used continuous techniques (CRRT) in positive patients hemodynamically unstable and intermittent dialysis (IRRT) in our stable chronic patients with asymptomatic COVID -19. We found CRRT to be superior in hemodynamically unstable patients hospitalized in resuscitation and in the "yellow area". Dialysis continued with high cut-off filters until the normalization of kidney function; the supportive medical therapy has also improved the course of the pathology and contributed to the favorable outcome for our patient. During the COVID-19 pandemic, our Nephrology Group at Savona's San Paul Hospital has reorganized the department to better manage both chronic dialyzed patients and acute patients affected by the new coronavirus.


Assuntos
Lesão Renal Aguda/terapia , Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Lesão Renal Aguda/diagnóstico por imagem , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Idoso , Anti-Hipertensivos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus/fisiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Creatinina/sangue , Cuidados Críticos/métodos , Gerenciamento Clínico , Hemodinâmica , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Comunicação Interdisciplinar , Falência Renal Crônica/complicações , Masculino , Equipe de Assistência ao Paciente , Isolamento de Pacientes , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Diálise Renal/métodos , Respiração Artificial , Ureia/sangue
3.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 112-117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965368

RESUMO

OBJECTIVE: We aimed to present a review of renal changes in patients with COVID-19. METHODS: We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION: Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION: Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.


Assuntos
Lesão Renal Aguda/etiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Lesão Renal Aguda/fisiopatologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/urina , Creatinina/sangue , Hematúria/etiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/metabolismo , Pneumonia Viral/urina , Proteinúria/etiologia , Urina/química
4.
Dtsch Med Wochenschr ; 145(15): 1068-1073, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32731281

RESUMO

Increasing insight into the clinical phenotype and mechanisms of SARS-CoV-2 infections and COVID-19 has identified damage of the kidneys as a key player in the course of the disease. This manuscript summarizes the current knowledge on direct viral infection of kidney tissue, proteinuria and acute kidney injury in COVID-19, and management of patients on chronic dialysis as well as after kidney transplantation. Direct infection of podocytes and proximal tubular cells by SARS-CoV-2 has been confirmed and results in proteinuria and hematuria at an early stage of COVID-19. In this context, any kidney affection is a predictor of worse outcomes among COVID-19 patients irrespective of the initial presentation and increases the risk of acute kidney injury. Specific therapies for kidney damage and acute kidney injury within COVID-19 that could be generally recommended are currently lacking. Patients on chronic hemodialysis in particular are at risk for contracting SARS-CoV-2 infections as indicated by outbreaks and super-spreading events in hemodialysis facilities. Immunosuppressive therapy after kidney transplantation needs to be adapted upon diagnosis of COVID-19 depending on the severity of the initial presentation.


Assuntos
Lesão Renal Aguda , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/virologia , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Hematúria , Humanos , Rim/fisiopatologia , Rim/virologia , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Proteinúria , Diálise Renal , Insuficiência Renal Crônica/terapia , Fatores de Risco
5.
Int J Nanomedicine ; 15: 4311-4324, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32606679

RESUMO

Purpose: By providing a stem cell microenvironment with particular bioactive constituents in vivo, synthetic biomaterials have been progressively successful in stem cell-based tissue regeneration by enhancing the engraftment and survival of transplanted cells. Designs with bioactive motifs to influence cell behavior and with D-form amino acids to modulate scaffold stability may be critical for the development and optimization of self-assembling biomimetic hydrogel scaffolds for stem cell therapy. Materials and Methods: In this study, we linked naphthalene (Nap) covalently to a short D-form peptide (Nap-DFDFG) and the C domain of insulin-like growth factor-1 (IGF-1C) as a functional hydrogel-based scaffolds, and we hypothesized that this hydrogel could enhance the therapeutic efficiency of human placenta-derived mesenchymal stem cells (hP-MSCs) in a murine acute kidney injury (AKI) model. Results: The self-assembling peptide was constrained into a classical ß-sheet structure and showed hydrogel properties. Our results revealed that this hydrogel exhibited increased affinity for IGF-1 receptor. Furthermore, cotransplantation of the ß-IGF-1C hydrogel and hP-MSCs contributed to endogenous regeneration post-injury and boosted angiogenesis in a murine AKI model, leading to recovery of renal function. Conclusion: This hydrogel could provide a favorable niche for hP-MSCs and thereby rescue renal function in an AKI model by promoting cell survival and angiogenesis. In conclusion, by covalently linking the desired functional groups to D-form peptides to create functional hydrogels, self-assembling ß-sheet peptide hydrogels may serve as a promising platform for tissue-engineering and stem cell therapy.


Assuntos
Lesão Renal Aguda/tratamento farmacológico , Hidrogéis/química , Fator de Crescimento Insulin-Like I/química , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Peptídeos/química , Lesão Renal Aguda/fisiopatologia , Animais , Materiais Biocompatíveis/química , Sobrevivência Celular , Feminino , Fibrose , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Hidrogéis/síntese química , Rim/patologia , Rim/fisiopatologia , Camundongos Transgênicos , Neovascularização Fisiológica , Placenta/citologia , Gravidez , Conformação Proteica em Folha beta , Domínios Proteicos
6.
Rev Bras Enferm ; 73 Suppl 2: e20200354, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32667578

RESUMO

OBJECTIVE: to assess scientific evidence on SARS-CoV-2 Acute Kidney Injury in patients with COVID-19. METHODS: an integrative review, with adoption of PICO strategy and classification of the level of evidence, carried out on April 10, 2020 in the PubMed database, of articles available between December 2019 and April 2020. RESULTS: the sample consisted of six original, five observational and one experimental articles. Observational studies addressed the clinical findings of patients with COVID-19 and association between kidney damage, infection, and morbidity-mortality. CONCLUSION: the studies addressed the mechanism of intracellular infection of SARS-CoV-2, its cytopathic effects on kidney cells and incidence of acute kidney injury in patients infected with SARS-CoV-2. Acute kidney injury is associated with increased mortality and morbidity in these patients. This review realizes the need for new research that can mention kidney care to patients with COVID-19.


Assuntos
Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Lesão Renal Aguda/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Incidência , Pandemias , Pneumonia Viral/epidemiologia , Fatores de Risco
8.
J Coll Physicians Surg Pak ; 30(6): 19-25, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32723443

RESUMO

Acute kidney injury (AKI) is relatively common in critically ill coronavirus disease 2019 (COVID-19) patients and it increases mortality and prolongs hospital stay. This article aimed to investigate the history, virology, epidemiology, clinical manifestations, pathophysiology and management of COVID-19 disease, in general, and the pathogenetic mechanisms of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2)-induced kidney damage, in particular. Keywords like SARS-CoV2, COVID-19, renal impairment, sepsis, viremia, etc. were used to find relevant publications from PubMed, Scopus, Google Scholar, and clinical trials registry websites. According to different studies, kidney involvement in COVID-19 typically occurs in patients who develop acute respiratory distress syndrome (ARDS) or multiorgan failure. The kidney damage in COVID-19 has been shown to be multifactorial, involving direct viral infection, indirect injury by sepsis, hemodynamic alterations, cytokine storm, disseminated intravascular coagulation and other unknown mechanisms. The presence in kidney of angiotensin-converting enzyme 2 (ACE2), a receptor for the virus, has been proven, but few cases of direct viral presence in kidney tissue have been published. Therefore, further studies are needed to investigate the exact mechanisms underlying kidney impairment. Since the development of AKI is one of the important risk factors for mortality in COVID-19 patients, optimal management of AKI may improve the outcomes. Key Words: Acute kidney injury, Angiotensin-converting enzyme, Sepsis, Cytokine storm, Kidney replacement therapy, Coronavirus disease 2019.


Assuntos
Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/terapia , Infecções por Coronavirus/complicações , Coronavirus/isolamento & purificação , Pneumonia Viral/complicações , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/virologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estado Terminal , Humanos , Pandemias , Pneumonia Viral/epidemiologia
9.
Am J Physiol Renal Physiol ; 319(2): F149-F154, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32567347

RESUMO

Ischemia-reperfusion injury of the kidney is caused by the sudden and temporary obstruction of blood flow to the organ. Renal ischemia-reperfusion injury is associated with high morbidity and mortality, but effective therapies are lacking. Sexual dimorphism in renal injury has been acknowledged since the 1940s, and the possible role of sex hormones has been intensively investigated in the past decades. Clinical and experimental data demonstrate sexual differences in renal anatomy, physiology, and susceptibility to renal diseases including but not limited to ischemia-reperfusion injury. Some data suggest the protective role of female sex hormones, whereas others highlight the detrimental effect of male hormones in renal ischemia-reperfusion injury. Although the important role of sex hormones is evident, the exact underlying mechanisms remain to be elucidated. This review focuses on collecting the current knowledge about sexual dimorphism of renal ischemia-reperfusion injury, with emphasis on molecular mechanisms and potential novel therapeutic strategies.


Assuntos
Lesão Renal Aguda/fisiopatologia , Rim/irrigação sanguínea , Rim/fisiopatologia , Traumatismo por Reperfusão/fisiopatologia , Caracteres Sexuais , Animais , Hormônios Esteroides Gonadais/metabolismo , Humanos
10.
Intensive Care Med ; 46(7): 1339-1348, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32533197

RESUMO

Acute kidney injury (AKI) has been reported in up to 25% of critically-ill patients with SARS-CoV-2 infection, especially in those with underlying comorbidities. AKI is associated with high mortality rates in this setting, especially when renal replacement therapy is required. Several studies have highlighted changes in urinary sediment, including proteinuria and hematuria, and evidence of urinary SARS-CoV-2 excretion, suggesting the presence of a renal reservoir for the virus. The pathophysiology of COVID-19 associated AKI could be related to unspecific mechanisms but also to COVID-specific mechanisms such as direct cellular injury resulting from viral entry through the receptor (ACE2) which is highly expressed in the kidney, an imbalanced renin-angotensin-aldosteron system, pro-inflammatory cytokines elicited by the viral infection and thrombotic events. Non-specific mechanisms include haemodynamic alterations, right heart failure, high levels of PEEP in patients requiring mechanical ventilation, hypovolemia, administration of nephrotoxic drugs and nosocomial sepsis. To date, there is no specific treatment for COVID-19 induced AKI. A number of investigational agents are being explored for antiviral/immunomodulatory treatment of COVID-19 and their impact on AKI is still unknown. Indications, timing and modalities of renal replacement therapy currently rely on non-specific data focusing on patients with sepsis. Further studies focusing on AKI in COVID-19 patients are urgently warranted in order to predict the risk of AKI, to identify the exact mechanisms of renal injury and to suggest targeted interventions.


Assuntos
Lesão Renal Aguda/virologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Sistema Renina-Angiotensina/fisiologia , Lesão Renal Aguda/tratamento farmacológico , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/terapia , Betacoronavirus/fisiologia , Transtornos da Coagulação Sanguínea/virologia , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/urina , Creatinina/sangue , Estado Terminal , Hematúria/etiologia , Humanos , Rim/fisiopatologia , Rim/virologia , Pandemias , Pneumonia Viral/metabolismo , Pneumonia Viral/urina , Proteinúria/etiologia , Urinálise , Urina/química , Urina/virologia
11.
Life Sci ; 256: 117860, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32534037

RESUMO

Optimal tissue oxygenation is essential for its normal function. Suboptimal oxygenation or ischemia contributes to increased mortalities during various pathological conditions such as stroke, acute kidney injury (AKI), cardiac failure. Despite the rapid progression of renal tissue injury, the mechanism underlying renal ischemia/reperfusion injury (IRI) remains highly unclear. Experimental in vitro and in vivo models epitomizing the fundamental process is critical to the research of the pathogenesis of IRI and the development of plausible therapeutics. In this review, we describe the in vitro and in vivo models of IRI, ranges from proximal tubular cell lines to surgery-based animal models like clamping of both renal pedicles (bilateral IRI), clamping of one renal pedicle (unilateral IRI), clamping of one/or both renal arteries/or vein, or unilateral IRI with contralateral nephrectomy (uIRIx). Also, advanced technologies like three-dimensional kidney organoids, kidney-on-a-chip are explained. This review provides thoughtful information for establishing reliable and pertinent models for studying IRI-associated acute renal pathologies.


Assuntos
Nefropatias/fisiopatologia , Rim/fisiopatologia , Traumatismo por Reperfusão/fisiopatologia , Lesão Renal Aguda/fisiopatologia , Animais , Modelos Animais de Doenças , Progressão da Doença , Humanos , Rim/irrigação sanguínea , Oxigênio/metabolismo , Artéria Renal/metabolismo , Reprodutibilidade dos Testes
12.
Int J Mol Sci ; 21(9)2020 May 05.
Artigo em Inglês | MEDLINE | ID: covidwho-175942

RESUMO

Coronaviruses (CoVs), including Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and the novel coronavirus disease-2 (SARS-CoV-2) are a group of enveloped RNA viruses that cause a severe respiratory infection which is associated with a high mortality [...].


Assuntos
Lesão Renal Aguda/mortalidade , Lesão Renal Aguda/virologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/virologia , Túbulos Renais Proximais/metabolismo , Túbulos Renais Proximais/virologia , Pneumonia Viral/virologia , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/prevenção & controle , Angiotensina II/farmacologia , Catepsinas/metabolismo , Morte Celular/efeitos dos fármacos , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/fisiopatologia , Creatinina/sangue , Estado Terminal/mortalidade , Endossomos/efeitos dos fármacos , Endossomos/enzimologia , Endossomos/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Incidência , Túbulos Renais Proximais/fisiopatologia , Lisossomos/efeitos dos fármacos , Lisossomos/enzimologia , Lisossomos/metabolismo , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Pneumonia Viral/fisiopatologia , Receptores Virais/metabolismo , Síndrome Respiratória Aguda Grave/sangue , Síndrome Respiratória Aguda Grave/mortalidade , Síndrome Respiratória Aguda Grave/fisiopatologia , Internalização do Vírus , Replicação Viral
13.
Int J Mol Sci ; 21(9)2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32380787

RESUMO

Coronaviruses (CoVs), including Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and the novel coronavirus disease-2 (SARS-CoV-2) are a group of enveloped RNA viruses that cause a severe respiratory infection which is associated with a high mortality [...].


Assuntos
Lesão Renal Aguda/mortalidade , Lesão Renal Aguda/virologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/virologia , Túbulos Renais Proximais/metabolismo , Túbulos Renais Proximais/virologia , Pneumonia Viral/virologia , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/prevenção & controle , Angiotensina II/farmacologia , Catepsinas/metabolismo , Morte Celular/efeitos dos fármacos , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/fisiopatologia , Creatinina/sangue , Estado Terminal/mortalidade , Endossomos/efeitos dos fármacos , Endossomos/enzimologia , Endossomos/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Incidência , Túbulos Renais Proximais/fisiopatologia , Lisossomos/efeitos dos fármacos , Lisossomos/enzimologia , Lisossomos/metabolismo , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Pneumonia Viral/fisiopatologia , Receptores Virais/metabolismo , Síndrome Respiratória Aguda Grave/sangue , Síndrome Respiratória Aguda Grave/mortalidade , Síndrome Respiratória Aguda Grave/fisiopatologia , Internalização do Vírus , Replicação Viral
18.
Medicina (B Aires) ; 80(2): 150-156, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32282321

RESUMO

In the last few years the general results in the treatment of acute kidney injury has improved constantly, without a complete comprehension of its pathophysiology. With this paradigm in mind, in these last few years we have seen an evolving comprehension of the possible answers that may be based on recognizing the more proactive role of fluid management in the resuscitation of critical patients, not limited only to the delivery of fluids, but also to their active removal, having as the principal objective the improvement of tissue perfusion. The key role of vascular integrity in fluid overload is discussed, emphasizing the role of the endothelial glycocalyx. Active desresuscitation maneuvers with diuretics or with renal support therapies could be increasingly recognized instruments in the management of fluid overload, particularly in those patients with acute kidney injury.


Assuntos
Lesão Renal Aguda/etiologia , Hidratação , Ressuscitação , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/terapia , Hidratação/efeitos adversos , Hemodinâmica , Humanos
20.
Artigo em Inglês | MEDLINE | ID: mdl-32280422

RESUMO

This column is supplied by Amol Patel, DO, and Peter Nguyen, MD. Dr. Patel is an internal medicine resident at Houston Methodist Hospital, where he is in his final year as chief resident. He received his bachelor's degree in biomedical engineering at Texas A&M University and his medical degree at UNT Health Science center in Forth Worth, Texas. Dr. Nguyen is a nephrologist with Houston Kidney Consultants and practices at Houston Methodist Hospital, where he is currently the secretary of the medical staff. He obtained his medical degree from Texas Tech School of Medicine and completed his residency and nephrology fellowship at Baylor College of Medicine in Houston, Texas.


Assuntos
Lesão Renal Aguda/terapia , Taxa de Filtração Glomerular , Balão Intra-Aórtico , Rim/fisiopatologia , Terapia de Substituição Renal , Choque Cardiogênico/terapia , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Progressão da Doença , Humanos , Balão Intra-Aórtico/efeitos adversos , Balão Intra-Aórtico/instrumentação , Balão Intra-Aórtico/mortalidade , Recuperação de Função Fisiológica , Terapia de Substituição Renal/efeitos adversos , Terapia de Substituição Renal/mortalidade , Fatores de Risco , Choque Cardiogênico/complicações , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/fisiopatologia , Resultado do Tratamento
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