Renal Insufficiency (Renal Failure)

Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.

Also Known As:

Networked: 23239 relevant articles (1118 outcomes, 1667 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Heart Failure
3.	Proteinuria
4.	Hemorrhage
5.	Stroke (Strokes)

Experts

1.	Ritz, Eberhard: 25 articles (01/2013 - 01/2002)
2.	Levey, Andrew S: 21 articles (12/2014 - 07/2003)
3.	Deray, Gilbert: 19 articles (09/2014 - 08/2002)
4.	Sarnak, Mark J: 16 articles (09/2014 - 07/2003)
5.	Launay-Vacher, Vincent: 16 articles (09/2014 - 08/2002)
6.	Remuzzi, Giuseppe: 15 articles (01/2015 - 01/2002)
7.	Tonelli, Marcello: 15 articles (01/2015 - 08/2002)
8.	Vanholder, Raymond: 15 articles (12/2014 - 01/2002)
9.	D'Agati, Vivette D: 15 articles (03/2013 - 03/2002)
10.	Nasr, Samih H: 14 articles (11/2015 - 08/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Renal Insufficiency:

1.	CreatinineIBA 01/01/2007 - "The main outcome was the frequency of prescription of LMWHs for curative treatment in patients with severe renal insufficiency, defined as having a creatinine clearance of <or=30 mL/min, estimated using the Cockroft formula. " 06/01/1998 - "Renal failure responded favorably over weeks to corticosteroid therapy (serum creatinine level, 2.8 mg/dL) with a marked reduction in bilateral renal enlargement by CT scan." 07/01/2015 - "In this pilot study of patients with moderate renal insufficiency undergoing cardiac catheterization, with-holding ACEI/ARB resulted in a non-significant reduction in contrast-induced AKI and a significant reduction in post-procedural rise of creatinine. " 05/01/2014 - "No significant differences between MMF and AZA were found in sustained remission, relapse, renal failure, creatinine increase or death. " 01/01/2010 - "Furthermore, due to reduced muscle mass, older subjects frequently have depressed glomerular filtration rate despite normal serum creatinine, and such a concealed renal insufficiency may impact significantly the clearance of hydrosoluble drugs. "
2.	Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors)IBA 08/01/1999 - "ACE inhibitors may be beneficial in patients with nondiabetic renal insufficiency as well. " 11/01/2000 - "It is noted that several studies indicate that angiotensin-converting enzyme inhibitors may be more effective in preventing or retarding renal failure than other conventional drugs. " 05/01/1995 - "Further comparative trials are needed to fully determine its efficacy with respect to other ACE inhibitors, and a better understanding of its effects on renal function will clarify its role in hypertensive patients with renal failure." 01/01/1990 - "Angiotensin-converting enzyme inhibitors: therapeutic implications in the management of chronic renal failure." 08/01/2002 - "Current recommendations for the management of chronic renal insufficiency (CRI) include the use of angiotensin-converting enzyme inhibitors (ACEI) and achieving target blood pressure control. "
3.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 05/01/2007 - "However, the cumulative incidence of persistent complete remission (>2 years without medication) increased over time (35% at 2 years, 52% at 6 years, and 71% at 15 years after the start of cyclophosphamide therapy), and no patient developed kidney failure. " 01/01/1994 - "At 21 months after such therapeutic regimen in 10 out of 12 patients a complete clinical remission was found, in one patient a partial response with persistent moderate renal failure occurred, while one patient was refractory even to the additional administration of cyclophosphamide. " 07/01/2007 - "There were no differences in the outcomes of death, renal failure, reversal or relapse of active renal disease, or toxicity in those using or not using cyclophosphamide. " 01/01/2006 - "Although limited data are available about cyclophosphamide disposition in patients with renal insufficiency, nothing has been reported in anephric patients. " 05/01/2004 - "Renal survival is good if patients with iMN and renal insufficiency are treated with oral cyclophosphamide. "
4.	CalciumIBA 12/01/2004 - "In the 27-week study, high calcium intake decreased blood pressure, retarded progression of renal failure, reduced glomerulosclerosis, interstitial damage, and aortic calcifications, and improved survival from 50% to 92% in NTX rats. " 05/01/2015 - "However, new studies comparing previous donors with equally healthy controls indicate increased risk of metabolic derangements (particularly involving calcium homeostasis), renal failure, and possibly, mortality. " 07/01/1991 - "Clinical trials also suggest that the calcium antagonists retard the progression of renal insufficiency in hypertensive patients by mechanism(s) that do not depend on blood pressure lowering per se. " 11/01/1980 - "[A study on calcium metabolism in renal failure--clinical aspects and treatment (author's transl)]." 02/01/1978 - "[Experimental study of calcium metabolism in renal failure. "
5.	Urea (Carbamide)FDA LinkGeneric 07/01/1997 - "4. In clinical urea kinetic studies in a healthy subject and in a renal failure patient without residual renal function, reproducible values of the distribution volume, production rate and clearance of urea were determined using minimal amounts of [13C]urea (25-50 mg). " 07/01/1997 - "We devised a urea dilution for measurement of the distribution volume, production rate and clearance of urea in healthy subjects and renal failure patients using the inexpensive single labelled [13C]urea isotope with subsequent analysis by headspace chromatography-isotope ratio MS (GC-IRMS) of the [13C]urea enrichment. " 11/01/1991 - "To document the efficacy of continuous arteriovenous hemofiltration with dialysis following renal failure, without protein restriction, and to explore the magnitude and clinical applications of total daily urea clearance. " 07/01/1997 - "5. Because only low [13C]urea enrichments are needed in this urea dilution method using GC-IRMS analysis, the costs of urea kinetic studies are reduced considerably, especially in patients with renal failure." 05/01/2010 - "Abnormal platelet function in patients with renal failure is not caused by high concentrations of urea."
6.	Insulin (Novolin)FDA Link 02/01/2013 - "Renal failure causes a decrease in the clearance of insulin, especially exogenous injected insulin. " 09/01/2007 - "The metabolic mayhem of severe acute illness has many parallels with those induced by kidney failure itself, and patients with kidney failure are at increased risk from many of the complications potentially improved by insulin therapy. " 09/01/2007 - "We reviewed the potential benefits of intensive insulin therapy and examined the published trials for data directly applicable to patients with kidney failure. " 04/25/2007 - "According to the results of this study, common risk factors for hypoglycaemia in the elderly (advanced age, insulin therapy, renal insufficiency, polymedication, fragility) have no significant predictive value. " 01/01/1985 - "Although most patients in both studies were insulin-treated type-1 diabetics, death due to renal failure was observed only in 7%. "
7.	SteroidsIBA 05/01/2006 - "The diagnosis was confirmed by skin biopsy, and treatment with statins and steroids proved effective, as renal failure progressively improved. " 06/01/1995 - "However, four of 10 patients whose renal failure initially improved, failed to respond to definitive therapy, and died 3 to 4 weeks after cessation of the steroids. " 02/01/2000 - "In a study on the use of steroids for patients with progressive moderate renal dysfunction caused by Chinese herbs, Vanherweghem et al. reported that the progression of renal failure was appreciably slowed in patients given steroids when compared with the control group. " 12/13/1984 - "A power analysis showed that a study of 100 high-risk patients (development of renal insufficiency in 50 per cent) would be needed to prove that an immunosuppressive agent is 50 per cent superior to steroids alone in preventing renal deterioration. " 10/01/2015 - "Concurrent use of NMBAs with aminoglycoside and steroids should be avoided, especially in the setting of renal failure. "
8.	Sirolimus (Rapamycin)FDA Link 03/01/2010 - "The replacement of CNI by sirolimus for imunosuppressive therapy for patients with renal failure after OHT was associated with a significant improvement in renal function after 6 months." 03/15/2009 - "Conversion toward a CNI-free immunosuppression (Mycophenolate, sirolimus) is superior to CNI-reduced immunosuppression in improving renal failure in late HTx-recipients. " 10/01/2010 - "Conversion to sirolimus from CNIs is associated with a nonsignificant improvement in renal function in LT recipients with renal insufficiency, although the results are limited by heterogeneity, a risk of bias, and a lack of standardized reporting." 04/01/2005 - "Sirolimus, a macrolide immunosuppressant with a distinct mechanism of action, may prevent renal failure but was found to have a high infectious and toxicity rate in the only relevant study conducted so far. " 01/01/2012 - "Reason for conversion to sirolimus was renal insufficiency (34%), vasculopathy (29%), recurrent rejection (19%), and other (18%). "
9.	Anti-Bacterial Agents (Antibiotics)IBA 05/01/1998 - "The improved survival of SLE patients since the 1950s is the result of not only better treatment, but also supportive treatment of renal failure and the wealth of antibiotics now available. " 04/01/2009 - "The potential neurotoxicity of betalactam antibiotics are well-known and is frequently associated with drug accumulation in patients with renal failure since these antibiotics are eliminated mostly by kidneys. " 03/01/2009 - "The patient's renal insufficiency subsequently improved following eradication of the microbe with antibiotics alone. " 01/01/1993 - "During vascular clamping without venovenous bypass, clearance of both antibiotics decreased in relation to renal insufficiency. " 03/01/1992 - "Many antibiotics are eliminated renally and dosage adjustments are commonly made in patients with renal insufficiency. "
10.	SodiumIBA 07/01/2012 - "Laboratory tests showed normal sodium levels, and the renal insufficiency had improved. " 01/01/2015 - "Data collected in two contemporaneous CKD cohort studies, the Renal Research Institute (RRI)-CKD study (n = 834) and the Study of Treatment of Renal Insufficiency: Data and Evaluation (STRIDE) (n = 1,348) were combined and analyzed to study the association between serum sodium (Na(+)) and clinical outcomes. " 09/01/2014 - "Here we evaluated the association of mean baseline 24-h urinary sodium excretion with kidney failure and a composite outcome of kidney failure or all-cause mortality using Cox regression in 840 participants enrolled in the Modification of Diet in Renal Disease Study. " 11/01/2015 - "Post-AKI diuresis in the face of inability to maximally concentrate the urine because of renal failure often leads to mainly mild elevations in serum sodium concentration. " 09/01/2014 - "Thus, we noted no association of urine sodium with kidney failure. "

Therapies and Procedures

1.	Renal Dialysis (Hemodialysis) 06/01/1995 - "Seventeen (53%) patients attained a complete remission and 22 (69%) survived (five in advanced renal failure and long-term hemodialysis). " 07/01/2012 - "Patients with renal failure exhibited pronounced cognitive impairment and these functions significantly improved after the introduction of hemodialysis." 06/01/2009 - "In renal failure animal models, acid-base parameters improved significantly after hemodialysis with ionized alkaline water compared with the conventional water treated with reverse osmosis (RO). " 08/01/1992 - "The accumulation of this E-21 IA in renal failure is evidence that the kidney has a major role in the clearance of this fragment, which is not accomplished by the membranes used in hemodialysis." 04/01/2003 - "Depolymerized holothurian glycosaminoglycan (DHG), a novel alternative anticoagulant for hemodialysis, is safe and effective in a dog renal failure model."
2.	Kidney Transplantation 01/01/2014 - "Renal transplantation is the best treatment for kidney failure, in terms of length and quality of life and cost-effectiveness. " 03/01/2012 - "Kidney transplantation is the best treatment option for kidney failure, but the supply of donor kidneys remains small. " 04/01/2009 - "Renal transplantation is the best treatment for kidney failure. " 08/01/2007 - "Kidney transplantation is the best option for all patients with terminal renal failure. " 01/09/2006 - "Preemptive kidney transplantation (PreKT) before initiation of chronic dialysis has been examined recently with favorable results as the most effective treatment for kidney failure. "
3.	Transplants (Transplant) 09/01/2010 - "Kidney transplant is the best treatment option for renal failure. " 06/01/2006 - "As most mito-mice without a transplant died due to renal failure, we examined whether transplanted bone marrow cells transdifferentiated into renal tissues carrying improved renal function. " 01/01/2014 - "Graft and patient outcome compare very favorably with other causes of kidney failure and several recent studies have indicated that these outcomes have improved further in recent years. " 01/01/2001 - "The survival of the graft, although able to be improved, is excellent and gives a great deal of hope to patients with renal insufficiency. " 01/01/2005 - "The dual transplant has cured his diabetes and renal failure and has had a beneficial effect on his neuropathy, retinopathy and quality of life. "
4.	Transplantation (Transplant Recipients) 12/24/2014 - "Transplantation in children is the best option to treat renal failure. " 01/01/1997 - "For patients with FHF undergoing transplantation, pretransplant renal failure strongly predicts poor outcome with significantly greater consumption of resources." 07/01/2007 - "In summary, we could demonstrate that in heart transplant recipients with renal insufficiency the introduction of 1.5 mg/d EVL in combination with a reduced TAC dose is effective in preventing cardiac rejections and has less adverse effects on lipid metabolism than the usually prescribed SRL dose, whereas both therapy regimens are not associated with major haematological side-effects." 01/01/2012 - "The first patient relapsed 86 months after transplantation, benefited from surgical treatment, then died of renal failure. " 12/01/2011 - "Pre-emptive living donor transplantation should always be promoted as the first-line treatment for kidney failure. "
5.	Peritoneal Dialysis 10/15/2014 - "Peritoneal dialysis confers therapeutic advantages in patients with renal insufficiency and has proven beneficial in other indications, such as removal of excess metabolites or overdosed drugs. " 12/01/2009 - "An innovative predicting model was developed, which employed the improved genetic algorithm embedded in neural network for predicting the important PFAR index in the peritoneal dialysis treatment process of renal failure. " 06/01/1986 - "In the patients without renal failure, low-flow peritoneal dialysis (one exchange per day) seemed to be of some value in maintaining remission but was ineffective in treating more active disease. " 01/01/1990 - "Peritoneal dialysis is effective in the newborn period in the management of metabolic disturbances as well as renal failure. " 06/01/1992 - "To evaluate the efficacy of peritoneal dialysis (PD) in the management of post-traumatic renal failure, the authors reviewed the courses of five critically injured patients treated with PD over an 18-month period. "