Renal toxicity of the nonsteroidal anti-inflammatory drugs

Brown et al determined the potential for aluminum toxicity caused by parenteral nutrition in patients (n=36; age ± y, weight ± kg) who have risk factors of both acute kidney injury and parenteral nutrition support. [ 4 ] Aluminum exposure was determined for each patient by multiplying the volume of each parenteral nutrition component by its concentration of aluminum. The initial serum urea nitrogen and serum creatinine levels were 47±23 and ± mg/dL, respectively. Twelve patients received supportive dialysis. The mean aluminum exposure was ±2 μg/kg/day in the 36 patients; the majority of patients, 29 out of 36, had safe calculated aluminum exposure (< 5 μg/kg/d), and 7 had high calculated aluminum exposure (>5 μg/kg/d). Patients with high aluminum exposure received more aluminum from calcium gluconate compared with those who had safe aluminum exposure (357±182 vs 250±56 μg/d).

In 2012 Congress passed the Honoring America's Veterans and Caring for Camp Lejeune Families Act. The law provides health benefits to veterans and family members who have any of 15 health outcomes associated with exposure to TCE, PCE, or solvent mixtures. At the request of the Veteran's Administration, Review of the VA Guidance for the Health Conditions Identified by the Camp Lejeune Legislation reviews the latest scientific literature to ensure that the clinical guidance provided for the 15 covered medical conditions is scientifically sound. This report also describes the medical conditions that result from renal toxicity due to solvent exposures and characterizes neurobehavioral effects as mandated for coverage in the law.

Contrast-enhanced computed tomography (CT) scanning is routinely used to determine the stage of the renal cell carcinoma in the abdominal and pelvic regions. CT scans have the potential to distinguish solid masses from cystic masses and may provide information on the localization, stage or spread of the cancer to other organs of the patient. Key parts of the human body which are examined for metastatic involvement of renal cell carcinoma may include the renal vein , lymph node and the involvement of the inferior vena cava . [45] According to a study conducted by Sauk et al., multidetector CT imaging characteristics have applications in diagnosing patients with clear renal cell carcinoma by depicting the differences of these cells at the cytogenic level. [46]

Edgar V Lerma, MD, FACP, FASN, FAHA, FASH, FNLA, FNKF  Clinical Professor of Medicine, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine; Research Director, Internal Medicine Training Program, Advocate Christ Medical Center; Consulting Staff, Associates in Nephrology, SC

Edgar V Lerma, MD, FACP, FASN, FAHA, FASH, FNLA, FNKF is a member of the following medical societies: American Heart Association , American Medical Association , American Society of Hypertension , American Society of Nephrology , Chicago Medical Society , Illinois State Medical Society , National Kidney Foundation , Society of General Internal Medicine

Disclosure: Author for: UpToDate, ACP Smart Medicine, Elsevier, McGraw-Hill, Wolters Kluwer.

Renal toxicity of the nonsteroidal anti-inflammatory drugs

renal toxicity of the nonsteroidal anti-inflammatory drugs

Edgar V Lerma, MD, FACP, FASN, FAHA, FASH, FNLA, FNKF  Clinical Professor of Medicine, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine; Research Director, Internal Medicine Training Program, Advocate Christ Medical Center; Consulting Staff, Associates in Nephrology, SC

Edgar V Lerma, MD, FACP, FASN, FAHA, FASH, FNLA, FNKF is a member of the following medical societies: American Heart Association , American Medical Association , American Society of Hypertension , American Society of Nephrology , Chicago Medical Society , Illinois State Medical Society , National Kidney Foundation , Society of General Internal Medicine

Disclosure: Author for: UpToDate, ACP Smart Medicine, Elsevier, McGraw-Hill, Wolters Kluwer.

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