Chronic renal insufficiency

Multisystem disease (e.g., chronic renal insufficiency, especially due to diabetes)... 

Chronic kidney disease (CKD), also known as chronic renal insufficiency, progressive kidney disease, or nephropathy, is defined as the presence of kidney damage or decreased... 

NSAIDs can cause renal insufficiency when administered to patients whose renal function depends on prostaglandins. Patients with chronic renal insufficiency or left ventricular dysfunction, the elderly, and those receiving diuretics or drugs that interfere with the renin-angiotensin system are particularly susceptible. Decreased glomerular filtration also may cause hyperkalemia. NSAIDs rarely cause tubulointerstitial nephropathy and renal papillary necrosis. 

Chronic renal insufficiency (baseline serum creatinine 1.6 mg/dL [141.44 pmol/L])... 

CRI Chronic renal insufficiency catheter-related infection EPS Extrapyramidal symptoms... 

Chronic hypercalcemia (i.e., hyperparathyroidism) is associated with metastatic calcification, nephrolithiasis, and chronic renal insufficiency. 

Furosemide is a highly effective and quick-acting diuretic whose action, hke all of the examined loop diuretics, is associated with blocking reabsorption of ions in the ascending bend of Henle s loop. It is used for edema syndrome of various origins, edema of the lungs and brain, chronic renal insufficiency, some forms of hypertonic crises, and poisoning by barbiturates and other compounds excreted mainly with urine. 

Renal function impairment- In patients with severe chronic renal insufficiency, a continuous infusion of bumetanide (12 mg over 12 hours) may be more effective and less toxic than intermittent bolus therapy. 

Renal function /mpa/rmenf Anuria, acute or chronic renal insufficiency and evidence of diabetic nephropathy are contraindications because potassium retention is accentuated and may result in the rapid development of hyperkalemia. Do not give to patients with evidence of renal impairment (BUN greater than 30 mg/dL or serum creatinine greater than 1.5 mg/dL) or diabetes mellitus without continuous monitoring of serum electrolytes, creatinine, and BUN levels. 

Magnesium salicylate Magnesium salicylate in advanced chronic renal insufficiency because of Mg retention. 

Renal effects Use with caution in chronic renal insufficiency aspirin may cause a transient decrease in renal function, and may aggravate chronic kidney diseases (rare). 

Renal impairment - Some degree of renal impairment may be present in patients with gout. A daily dosage of 1 g may be adequate. However, if necessary, the daily dosage may be increased by 0.5 g increments every 4 weeks within tolerance (usually not more than 2 g/day) if symptoms of gouty arthritis are not controlled or the 24 hour urate excretion is not more than 700 mg. Probenecid may not be effective in chronic renal insufficiency, particularly when the glomerular filtration rate is 30 mL/minute or less. 

Contraindications Acute or chronic renal insufficiency, anuria, diabetic nephropathy, patients on other potassium-sparing diuretics, serum potassium greater than 5.5 mEq/L... 

Valentis M (1999) Use of Enterosgel preparation in combined therapy of patients with chronic renal insufficiency. In Proceedings of the Conference Enterosgel and Enterosorption Technology in Medicine , Novosibirsk - Moscow (In Russian), p 18... 

With increased availability of GH, other chnical uses could be explored, such as growth failure due to Turner syndrome [9], chronic renal insufficiency [10], Prader-... 

Treatment of children with short stature should be carried out by specialists experienced in the use of GH. Treatment is begun with 0.025 mg/kg daily and may be increased to a maximum of 0.045 mg/kg daily. Children must be observed closely for slowing of growth velocity, which could indicate a need to increase the dosage or the possibility of epiphyseal fusion or intercurrent problems such as hypothyroidism or malnutrition. Children with Turner syndrome or chronic renal insufficiency require somewhat higher doses. 

Secondary hyperuricemia may be caused by other diseases, for example, cancer, chronic renal insufficiency, etc. 

Budesonide for collagenous colitis caused Cushing s syndrome in a patient with chronic renal insufficiency taking amiodarone for paroxysmal atrial fibrillation (477). 

Three adolescent boys with chronic renal insufficiency, treated with somatropin during the pubertal growth spurt, developed severe hyperparathyroidism (35). It is unclear whether this was coincidental or whether growth hormone and sex steroid hormones had a synergistic effect. 

However, in a North American register of patients with chronic renal insufficiency and end-stage renal disease there was no excess of cases of slipped capital femoral epiphysis or avascular necrosis in those receiving growth hormone (75). 

Low-dose bezafibrate was associated with myositis in a patient with mild chronic renal insufficiency (serum creatinine 210 pmol/l) (59). She was a 58-year-old obese diabetic with isolated hypertriglyceridemia. 

Biesenbach G, Janko O, Stuby U, Zazgornik J. Terminales myoglobinurisches Nierenversagen unter Lovastatintherapie bei praexistenter chronischer Nierenfunktionsstorung. [Terminal myoglobinuric renal failure in lovastatin therapy with pre-existing chronic renal insufficiency.] Wien Klin Wochenschr 1996 108(ll) 334-7. 

An elderly lady with chronic renal insufficiency developed rhabdomyolysis during simvastatin therapy (50). Her symptoms of muscle pain, fatigue, myoglobuli-nuria, oliguria, and pulmonary edema occurred 48 hours after the first dose of simvastatin. Simvastatin was immediately withdrawn, and she was dialysed for 1 week. 

Rhabdomyolysis requiring short-term dialysis occurred in a 57-year-old man with chronic renal insufficiency treated with lovastatin 40 mg/day, gemfibrozil 600 mg bd, and clarithromycin 500 mg tds (18). 

In a meta-analysis of megatrials with simvastatin, the overall incidence of myopathy was 0.025% (32). The authors suggested that potent inhibitors of CYP3A4 greatly increase the risk, but that weak inhibitors do not. Episodes of gout occurred in three of nine patients with chronic renal insufficiency who took simvastatin (33). 

Naesdal et al. [144] studied the pharmacokinetics of 14C-omeprazole and its metabolites after single intravenous and oral doses of 20 0 mg, respectively, to 12 patients with chronic renal insufficiency. Blood samples for determination of total radioactivity, omeprazole, hydroxyomeprazole, sulfone, and sulfide were taken for 24 h. Urine was collected over 96 h for determination of total radioactivity and during the first 24 h for additional assay of omeprazole and metabolites. The mean systemic availability was 70% and the mean plasma t1/z of omeprazole was 0.6 h. 

Benzodiazepines reduced reduced reduced in chronic renal insufficiency... 

Lin J-L, Leu M-L. 1996. Aluminum-containing agents may be toxic in predialysis chronic renal insufficiency patients. J Int Med 240 243-248. 

Lin J-L, Kou —T, Leu M-L. 1996. Effect of long-term low-dose aluminum-containing agents on hemoglobin synthesis in patients with chronic renal insufficiency. Nephron 74 33-38. 

Long-lasting hyperlipidemia probably contributes also to the progression of chronic renal insufficiency (W5), possibly due to lipid (lipoprotein) deposits in... 

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