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Oxford, United States

Barbour T.D.,Oxford Kidney Unit
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association | Year: 2011

Glomerulonephritis occurs in 1% of Hodgkin's lymphoma patients. In the even rarer setting of rapidly progressive glomerulonephritis, lymphoma may go unrecognized. We describe a case of necrotizing glomerulonephritis in which treatment with cyclophosphamide and steroids led to resolution of lymphadenopathy. Two years later, recrudescent lymphadenopathy was shown to be Hodgkin's lymphoma, but renal disease did not recur. Source


Winearls C.G.,Oxford Kidney Unit | Glassock R.J.,University of California at Los Angeles
Nephron - Clinical Practice | Year: 2011

The average glomerular filtration rate (GFR) is lower in the elderly than in the young and is usually a consequence of biological ageing, the rate of which varies between individuals. In some subjects, the decline is aggravated by concomitant vascular disease. The prevalence of significant kidney disease in the elderly has been overestimated - largely by rendering a diagnosis of chronic kidney disease by reference to estimates of GFR which are found in the young. A stable low GFR in the elderly, provided it is physiologically sufficient to meet homeostatic demands, is not a disease per se and seldom progresses to true kidney failure. However, it can be a risk factor for acute kidney injury drug misdosing, and possibly cardiovascular disease, so it should be noted. Copyright © 2011 S. Karger AG, Basel. Source


Glassock R.J.,University of California at Los Angeles | Winearls C.,Oxford Kidney Unit
Current Opinion in Nephrology and Hypertension | Year: 2010

Purpose of Review: To review the current state-of-the art in diagnosing chronic kidney disease (CKD) using classification systems based on estimated glomerular filtration rate (eGFR) and kidney damage. Recent Findings: CKD, as defined by current classification systems, has many pitfalls, but the presence and stage of CKD has important value in determining prognosis, particularly when the effects of albuminuria are added to eGFR Summary: The diagnosis of CKD using current classification schema based on eGFR alone needs to be approached with some caution, particularly in the elderly without concomitant signs of kidney damage. The presence and magnitude of albuminuria has important diagnostic and prognostic significance. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Herrington W.G.,Oxford Kidney Unit | Talbot D.C.,University of Oxford | Lahn M.M.,Eli Lilly and Company | Brandt J.T.,Eli Lilly and Company | And 4 more authors.
American Journal of Kidney Diseases | Year: 2011

A 57-year-old man with metastatic melanoma was treated with the survivin inhibitor and antisense oligonucleotide LY2181308 as part of a First-in-Human Dose trial. After 18 months of treatment, he developed kidney injury and the treatment was discontinued. At 9 months and before the development of kidney injury, LY2181308 concentrations were 8- to 10-fold higher relative to median predicted values, but within the targeted exposure considered to be safe. However, at 17 months, 28 days after stopping LY2181308 therapy, LY2181308 concentration exceeded the predicted range by 38-fold. His decreased kidney function was slow to improve after stopping treatment. A kidney biopsy showed signs of acute tubular injury with regeneration. Complete recovery of kidney function occurred 6 months after treatment was stopped. The relationship between high exposures and slow LY2181308 clearance with the gradual improvement in kidney function after stopping the antisense treatment suggests that the oligonucleotide was related to the kidney injury. Based on this case report, kidney function should be monitored frequently in patients receiving long-term treatment with antisense oligonucleotides that specifically target survivin, particularly when they receive concomitant angiotensin-converting enzyme inhibitors or nonsteroidal anti-inflammatory drugs. © 2011 National Kidney Foundation, Inc. Source


Garcia G.G.,University of Guadalajara | Harden P.,Oxford Kidney Unit | Chapman J.,University of Sydney
Kidney and Blood Pressure Research | Year: 2012

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit. Copyright © 2012 S. Karger AG. Source

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