Apellis Pharmaceuticals’ Post

Urine output is an early and strong predictor of acute kidney injury and associated mortality: a systematic literature review of 50 clinical studies #Acute kidney injury#Urine output#Serum creatinine #AIC #SRLF #FICS @Manu L. N. G. Malbrain https://zurl.co/UGZs0

Urine output is an early and strong predictor of acute kidney injury and associated mortality: a systematic literature review of 50 clinical studies #Acute kidney injury#Urine output#Serum creatinine #AIC #SRLF #FICS @Manu L. N. G. Malbrain https://zurl.co/UGZs0

Are all these benefits of semaglutide and tirzepatide legitimate or are the clinical studies exaggerating the benefits? https://loom.ly/IIxfWHk #semaglutide #tirzepatide #longevity #regenerative #medicine

Ever considered the impact of medication on electrolyte balance? A recent case report authored by a multidisciplinary team from Osijek, Croatia, featuring the expertise of Luka Švitek, Barbara Grubišić, Ema Schonberger, Mihaela Zlosa, Dario Sabadi, Dubravka Lišnjić, Silvija Canecki-Varžić, Ines Bilić-Ćurčić and Sanja Mandicć, sheds light on ciprofloxacin-induced hyponatremia. In the emergency room, a 67-year-old male presented symptoms aligning with syndrome of inappropriate antidiuretic hormone secretion (SIADH) after a week-long ciprofloxacin regimen for prostatitis. His serum sodium levels dropped to 129 mmol/L, prompting further investigation. Laboratory findings, including serum and urine osmolality, confirmed SIADH. With ciprofloxacin discontinuation and fluid restriction, his sodium levels normalized within days, alleviating symptoms. This case underscores the importance of vigilance regarding medication-induced electrolyte imbalances. Clinicians, take heed and consider adverse drug reactions in your differential diagnoses. Read more about the case here: https://lnkd.in/dg6aArmE #CaseReport #SIADH #DrugSafety #Ciprofloxacin

A- 27 year- old man was reviewed in the nephrology clinic . He had been diagnosed with autosomal dominant polycystic kidney disease at age of 18 following screening. His father,aunt and sister were also affected by the condition. He was asymptomatic and blood pressure was 120/70mmHg. Blood tests showed that his eGFR had fallen from 90mL/ min/ 1.73m2 to 65mL/min/1.73m2 over the past year. A recent ultrasound scan had shown multiple bilateral renal cysts,with both kidneys enlarging from 12cm to 14cm since the previous scan two years ago. What treatment should be offered ? A- Angiotensin receptor blockers ( ARB). B- Tolvaptan. C- Simvastatin. D- Bilateral nephrectomy.

CKD management is an effort that extends across the patient’s care team. So, all health care professionals involved – nephrologists and non-nephrologists – need to stay current on the latest nephrology evidence to help enhance the care of our CKD patients. These article summaries cover a range of crucial nephrology literature from 2023, curated from more than 120 journals. It is a valuable resource for navigating necessary research about CKD management and CKD-related conditions. Together, we can continue to improve outcomes for our CKD patients. Explore the article here.

Very interesting paper published in the Paper of the day section in ESC Heart Failure -Congestive nephropathy: a neglected entity? Proposal for diagnostic criteria and future perspectives https://lnkd.in/dH92EKsR ✅ Some extracted ideas: ✔ Among patients hospitalized for acute HF and deteriorating renal function, outcome is worse in those with residual congestion at discharge than in those without congestion ✔ Renal function improvement was probably owing to decreased venous congestion, increased systemic perfusion, and decreased hormonal activation ✔ What remains unknown is how underlying intrinsic renal insufficiency can be distinguished from the dynamic changes in GFR that commonly occur in the course of HF and during its management with diuretics and HF medications.  ✔ However, determining and maintaining the ideal volume status in patients with right HF is one of the most challenging problems in nephrology. A combination of different tools may be necessary to assess volume status, and monitoring of renal function during therapy would be needed to confirm the initial assessment ✔  Early decongestion can improve renal function and outcome ✔ Intrarenal Doppler ultrasonography studies should include patients requiring renal replacement therapy for diuretic-resistant volume overload and acute kidney injury to evaluate the severity of renal congestion and to identify when, during renal replacement therapy, improvement in residual renal function will permit discontinuation of renal replacement therapy

분당서울대학교병원 (SNUH Bundang Hospital) ® has published findings demonstrating that bioimpedance analysis (#BIA) offers more precise fluid management for patients with acute kidney injury (#AKI) undergoing continuous kidney replacement therapy (#CKRT). https://lnkd.in/gtUxCkxK

... "I would never wish dialysis to my worst enemy" ... Yesterday, 16th of May, I attended one of the best sessions ever at the National Kidney Foundation Spring Meeting 2024 in Long Beach #NKFCSM. The session "Xenotransplantation: The Need, The Progress, The Future" provided insightful updates about kidney xenotransplant directly from Dr. Montgomery. But even more striking for me were data showed by NKF Heather Murphy from the NKF Patient-Focused Meeting with the FDA and the methodological approach used to evaluate, from a patient perspective, the benefits and risks of xenotransplant. Now, if you consider that among 800,000 patients in US needing a kidney, 9% are on list and 3% are finally able to have it, you would understand, citing Dr. Montgomery, how much close to death you need to be, to get a new organ. But also, I think it is valuable reconsidering the terminology we are using in clinical development. Recently, great part of my work together with an amazing group of colleagues was to quantitatively show in our publications the impressive increase in clinical development activities in Chronic Kidney Disease (CKD) and Glomerular Diseases (GDs), thanks to improved understanding of renal pathophysiology. These are exciting times, so many drugs in clinical development, a golden age for nephrology. Back to my earlier point about terminology, we are used to consider efficacy and the aim of new drugs often as reduction of proteinuria, eGFR slope and time to End Stage Kidney Disease (ESKD). Don't get me wrong, dialysis is life-saving, I am just saying I am going to reconsider our purpose from prolonging time to or avoid ESKD and dialysis to prolonging or avoid decreasing good quality of life.

## Managing Anemia in Chronic Kidney Disease (CKD) – Evidence-Based Approach Anemia is a common complication in patients with chronic kidney disease (CKD). Effective management requires a structured approach guided by clinical evidence and established guidelines such as KDIGO (Kidney Disease: Improving Global Outcomes) and KDOQI (Kidney Disease Outcomes Quality Initiative). This flowchart highlights the steps in managing anemia in CKD: 1️⃣ Diagnosis begins with hemoglobin (Hgb) levels: - <12 g/dL in females - <13 g/dL in males 2️⃣ Assess iron status and other indices (e.g., TIBC, ferritin, folate, and vitamin B12). 3️⃣ Treat iron deficiency with oral or parenteral iron. If no improvement in Hgb, ESA (erythropoiesis-stimulating agents)is initiated alongside iron therapy for patients with Hgb <10 g/dL. 4️⃣ Monitor response every 2–4 weeks, adjusting ESA dose accordingly: - Increase ESA dose by 25% if Hgb rise is <1 g/dL in 4 weeks. - Decrease ESA dose by 25% if Hgb rise exceeds 1 g/dL in 2 weeks. 5️⃣ The goal is to maintain Hgb levels <11 g/dL to avoid adverse outcomes associated with overtreatment. This evidence-based framework ensures safe and effective anemia management, improving patient outcomes. 💡 What’s your experience with managing CKD-related anemia? Let’s discuss best practices! #Pharmacy #ClinicalPharmacy #Nephrology #AnemiaManagement #KDIGO #CKD #bps #Alaeltigani clinical pharmacist