Kidney disease, chronic evaluation

Comparative studies In a 17-week open-label trial, the effect of L-arginine supplementation on arterial stiffness and oxidative stress in chronic kidney disease was evaluated in 30 patients, of whom 25 completed the study. Diarrhoea was reported as the only adverse effect observed. The authors concluded that L-arginine was safe and well tolerated [93 ]. 

Levey AS, Coresh J, Balk E, et al. National Kidney Foundation practice guidelines for chronic kidney disease Evaluation, classification, and stratification. Ann Intern Med 2003 139(2) 137-147. 

Kluwe, W. M., Abdo, K. M., and Huff, 1. 1984. Chronic kidney disease and organic chemical exposures Evaluations of causal relationships in humans and experimental animals. Fundamental Applications in Toxicology A 889-901. 

CSA use in patients with healthy native kidneys is clearly associated with the potential of renal injury, which ultimately may lead to severe chronic kidney disease (CKD), dialysis or renal transplantation [271, 280, 424, 553, 554]. In fact, recent data indicate an 11-fold increase in the referral for renal transplant evaluation among non-solid organ transplant recipients [555]. 

The terminology associated with kidney diseases has been amended and is clarified here. Previously, renal failure was divided into either acute renal failure (ARF) or chronic renal failure (CRF). These terms indicate the rate at which damage occurs rather than the mechanism by which it occurs. Landmark guidelines developed in the USA by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) attempt to evaluate, classify, and stratify CKD (see Table 45-6). The term renal has largely been replaced by Iddney when referring to chronic disease since it is better understood by patients and nonspecialists. However, acute renal failure (ARF) remains standard nomenclature along with ESRD. 

Modified from National Kidney Foundation Document. CHnical practice guidelines for chronic kidney disease evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 2002 39 81-246. 

Ahn HJ and Hyun C. Evaluation of serum neutrophil gelatinase-associated lipocalin (NGAL) activity in dogs with chronic kidney disease. Vet Rec. 173(18) 452, Nov 9, 2013. 

Lead exposures in diverse human populations produce both acute and chronic nephrotoxic effects. The chronic kidney disease association with occupational Pb exposures in the clinical literature, dating to the nineteenth century, was typically characterized as a glomerulonephritic disease histo-pathologically. This traced to the absence of evaluation of the temporal course of Pb-induced nephropathy, particularly the acute effects. 

---