Acute kidney injury
Contrast-induced nephropathy (CIN) is associated with a significant risk of acute kidney injury and death in outpatients undergoing contrast-enhanced computed tomography (CECT). Mitchell et al. assessed serum creatinine level and outcome in 633 patients who received CECT. 11% of these patients had CIN, 1% developed severe renal failure and 2% died within 45 days; two-fifths of these deaths were in patients who had CIN.
Sepsis
Corticosteroids can induce adverse hyperglycemia in patients with septic shock. The COIITSS investigators found no difference in mortality in patients with septic shock who were treated with either conventional or intensive insulin therapy as an adjunct to hydrocortisone treatment. Furthermore, the addition of fludrocortisone to the combination therapy had no benefit and did not improve patient mortality.
Transplantation
Ocular complications after renal transplantation are common in adults but little is known about their incidence in children. Krause and colleagues assessed ocular morbidity in pediatric patients who received a renal graft in a retrospective, observational study. 17% of pediatric patients had ocular complications, including disk swelling, hypertensive retinopathy, increased intraocular pressure and cataract. The researchers say that the findings emphasize the need for opthalmological follow-up in pediatric patients with a renal graft.
Mineral metabolism
The role of androgens in the renal handling of calcium is poorly understood. Hsu et al. used mice to determine whether regulation of calcium transport proteins by testosterone affects the active reabsorption of renal calcium. The researchers found that male mice had higher urinary calcium excretion than female mice and that this increase was associated with suppression of the renal calcium transporters TRPV5 and calbindin-D28K by testosterone.
ORIGINAL RESEARCH PAPERS
Mitchell, A. M. et al. Incidence of contrast-induced nephropathy after contrast-enhanced computed tomography in the outpatient setting. Clin. J. Am. Soc. Nephrol. 5, 4–9 (2010)
COIITTS Study Investigators. Corticosteroid treatment and intensive insulin therapy for septic shock in adults. JAMA 303, 341–348 (2010)
Krause, I. et al. Ocular complications in children and adolescents following renal transplantation. Pediatr. Transplant. 14, 77–81 (2010)
Hsu, Y. J. et al. Testosterone increases urinary calcium excretion and inhibits expression of renal calcium transport proteins. Kidney Int. doi: 10.1038/ki.2009.522
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In brief. Nat Rev Nephrol 6, 189 (2010). https://doi.org/10.1038/nrneph.2010.28
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DOI: https://doi.org/10.1038/nrneph.2010.28