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Thrombotic microangiopathy (TMA) is a clinicopathological entity characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury, occurring due to endothelial damage and microthrombi formation in small vessels (
TMA is primary when a genetic or acquired defect is identified (as in atypical hemolytic uremic syndrome [aHUS] and thrombotic thrombocytopenic purpura) or secondary when occurring in the context of another disease process, such as infection, autoimmune disease, malignancy, or drugs (
Belatacept is a soluble recombinant fusion protein composed of the constant fragment of human immunoglobulin G1 and modified extracellular domain of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). It inhibits T-lymphocyte activation by blocking costimulation, the requisite signal that T-lymphocytes must receive through interactions between proteins expressed on antigen-presenting cells and T-lymphocytes in addition to signal from engagement of the antigen receptor (
Belatacept mechanism of action
In 2011, the US Food and Drug Administration (FDA) approved belatacept for prophylaxis against acute rejection in de novo adult kidney transplant recipients based on randomized trials that showed better
Discovery of the genetic association between
The short period of 2020 to 2022 has felt like its own era in the field of kidney transplantation, with significant advances in the field on various fronts. The next two editions of
The kidney allocation policy within the United States was initially established in 1987 to promote the equitable and utilitarian distribution of deceased donor kidneys (
Oxalate or oxalic acid is a dicarboxylic acid formed in the human body from exogenous dietary sources and endogenous metabolism of ascorbic acid and some amino acids. It is essentially a terminal metabolic product that is produced by the liver, absorbed by the intestine from dietary sources, and freely filtered by the kidneys (
Regional disparity in deceased donor kidney transplant rates
During the past few months, I have participated in several meetings that included in-depth discussions about the future of the health care workforce in the United States. Each time, the discussion started with predictions about shortages of every kind of health professional—from physicians to nurses to physician assistants/associates to other clinicians—and then shifted to concerns about the ability to provide high-quality patient care in the future as a result.
Although this editorial will focus on the future of nephrologists in the United States, I recognize that the situation is dire throughout the world, particularly for nurses. Earlier this year, the
Structural racism is a root cause of health inequities. The term structural racism refers to differential access by racial group to opportunities, resources, and societal well-being and is mediated through complex health care systems (
In 1964, the first kidney xenotransplant from a chimpanzee to human was performed successfully (
Over the past 10 to 20 years, there has been a revolution in the care of patients with cancer. In addition to classic chemotherapy agents, anti-cancer agents now include targeted therapies and immunotherapies, which harness the power of the immune system. These new therapies have transformed cancer into a chronic disease for many patients. Importantly, acute and chronic kidney diseases, electrolyte and acid-base disorders, and hypertension have become highly prevalent complications in this group of patients. This is particularly true for those with liver cancer, multiple myeloma, renal cell carcinoma, leukemias and lymphomas, and cancer patients treated with potentially nephrotoxic
