2010
Experience with outpatient computed tomographic-guided renal biopsy.
Margaryan A, Perazella MA, Mahnensmith RL, Abu-Alfa AK. Experience with outpatient computed tomographic-guided renal biopsy. Clinical Nephrology 2010, 74: 440-5. PMID: 21084047, DOI: 10.5414/cnp74440.Peer-Reviewed Original ResearchConceptsNative kidney biopsiesKidney biopsyRenal biopsyPost-biopsy observation periodInpatient observation periodObservation periodLow complication rateTime of admissionYale-New Haven Medical CenterDuration of procedureInstances of deathHemoglobin concentration changesDetectable bleedingSerum creatinineComplication rateMean ageRenal sizeAdequate tissueMedical CenterOutpatient unitDiagnostic tissueBiopsyLaboratory dataTransfusionPatients
2009
Acute phosphate nephropathy
Markowitz GS, Perazella MA. Acute phosphate nephropathy. Kidney International 2009, 76: 1027-1034. PMID: 19675530, DOI: 10.1038/ki.2009.308.Peer-Reviewed Original ResearchConceptsAcute phosphate nephropathyAcute kidney injuryChronic kidney diseasePhosphate nephropathySubsequent chronic renal failureChronic tubular injuryAngiotensin receptor blockersChronic renal failureHigh-risk patientsRenal biopsy findingsClinical-pathological entityAggressive hydrationKidney injuryReceptor blockersBiopsy findingsRenal failureTubular injuryKidney diseasePathological entityRisk factorsFemale genderDistal tubulesEpidemiologic studiesDistal nephronEnzyme inhibitors
2004
Fellows’ Forum in Dialysis. Depression: A Common but Underrecognized Condition Associated with End‐Stage Renal Disease
Perazella M, Wang P, Watnick S. Fellows’ Forum in Dialysis. Depression: A Common but Underrecognized Condition Associated with End‐Stage Renal Disease. Seminars In Dialysis 2004, 17: 237-241. PMID: 15144552, DOI: 10.1111/j.0894-0959.2004.17313.x.Peer-Reviewed Original ResearchIntravenous Iron and the Risk of Infection in End‐Stage Renal Disease Patients
Perazella M, Brewster U, Perazella M. Intravenous Iron and the Risk of Infection in End‐Stage Renal Disease Patients. Seminars In Dialysis 2004, 17: 57-60. PMID: 14717813, DOI: 10.1111/j.1525-139x.2004.17115.x.BooksConceptsInnate immune responseRisk of infectionIntravenous ironEnd-stage renal disease patientsHost innate immune responseRenal disease patientsIron-deficient patientsAdministration of ironOral ironIron therapyMost patientsHemodialysis patientsActive infectionDisease patientsIron preparationsIron overloadAllergic reactionsClinical studiesImmune responsePatientsBacterial infectionsIron deficiencyInfectionRiskBacterial growth
2003
Nephrogenic Fibrosing Dermopathy: An Unusual Skin Condition Associated with Kidney Disease
Perazella MA, Ishibe S, Perazella MA, Reilly RF. Nephrogenic Fibrosing Dermopathy: An Unusual Skin Condition Associated with Kidney Disease. Seminars In Dialysis 2003, 16: 276-280. PMID: 12753692, DOI: 10.1046/j.1525-139x.2003.16053.x.BooksConceptsCommon patient complaintLong-term hemodialysisNephrogenic fibrosing dermopathyCorticosteroid therapyInflammatory cellsKidney diseasePatient complaintsMucin depositsSkin biopsiesSpindle cellsSkin disordersFibroblast-type cellsReticular dermisCollagen bundlesInternal organsIncreased numberHemodialysisPatientsSclerodermaDisordersCellsDysesthesiaPruritusBiopsyDysfunction
2001
Treatment of Severe Intradialytic Hypotension With the Addition of High Dialysate Calcium Concentration to Midodrine and/or Cool Dialysate
Alappan R, Cruz D, Abu-Alfa A, Mahnensmith R, Perazella M. Treatment of Severe Intradialytic Hypotension With the Addition of High Dialysate Calcium Concentration to Midodrine and/or Cool Dialysate. American Journal Of Kidney Diseases 2001, 37: 294-299. PMID: 11157369, DOI: 10.1053/ajkd.2001.21292.Peer-Reviewed Original ResearchConceptsHigh dialysate calcium concentrationSevere intradialytic hypotensionDialysate calcium concentrationIntradialytic hypotensionBlood pressureEnd-stage renal disease populationCalcium concentrationLow dialysate calciumSeverity of hypotensionMean arterial pressurePeripheral vascular resistanceIntradialytic blood pressureRenal disease populationProspective crossover studyTreatment of patientsMultiple pathogenic factorsType of therapyDialysate calciumHemodynamic instabilityVascular resistanceHemodynamic stabilityArterial pressureCrossover studyCardiac outputCool dialysate
2000
Ace inhibitors do not induce recombinant human erythropoietin resistance in hemodialysis patients
Abu-Alfa A, Cruz D, Perazella M, Mahnensmith R, Simon D, Bia M. Ace inhibitors do not induce recombinant human erythropoietin resistance in hemodialysis patients. American Journal Of Kidney Diseases 2000, 35: 1076-1082. PMID: 10845820, DOI: 10.1016/s0272-6386(00)70043-6.Peer-Reviewed Original ResearchMeSH KeywordsAnemiaAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBlood PressureBlood TransfusionCross-Over StudiesDiabetes ComplicationsDrug ResistanceEpoetin AlfaErythropoietinFemaleFollow-Up StudiesHematinicsHematocritHospitalizationHumansInfectionsKidney Failure, ChronicLisinoprilMaleMiddle AgedProspective StudiesRecombinant ProteinsRenal DialysisTime FactorsConceptsACE inhibitor therapyACE inhibitorsHemodialysis patientsRHuEPO resistanceInhibitor therapyRecombinant human erythropoietin resistanceRecombinant human erythropoietin (rHuEPO) requirementsBlood pressure controlChronic renal failureDuration of infectionRHuEPO doseTransfusion requirementsErythropoietin resistanceRenal failureDialysis patientsHospitalization daysLaboratory parametersRHuEPO dosesAntihypertensive agentsCrossover studyErythropoietin requirementsInclusion criteriaPatientsAverage ageEnzyme inhibitorsAre selective COX-2 inhibitors nephrotoxic?
Perazella M, Eras J. Are selective COX-2 inhibitors nephrotoxic? American Journal Of Kidney Diseases 2000, 35: 937-940. PMID: 10793030, DOI: 10.1016/s0272-6386(00)70266-6.Peer-Reviewed Original ResearchConceptsHigh-risk patientsRenal insufficiencySelective cyclooxygenase-2 enzyme inhibitorsSuch high-risk patientsNonsteroidal anti-inflammatory drugsSelective COX-2 inhibitorsChronic renal impairmentChronic renal insufficiencyAcute renal failureAcute renal insufficiencyAdverse gastrointestinal effectsCyclooxygenase-2 enzyme inhibitorsAnti-inflammatory drugsCourse of therapyCOX-2 inhibitorsPain syndromeRenal impairmentRenal failureGastrointestinal effectsNephrotoxic potentialInflammatory diseasesEnzyme inhibitorsPatientsInsufficiencyInhibitors
1999
Trimethoprim-Sulfamethoxazole Therapy in Outpatients: Is Hyperkalemia a Significant Problem?
Alappan R, Buller G, Perazella M. Trimethoprim-Sulfamethoxazole Therapy in Outpatients: Is Hyperkalemia a Significant Problem? American Journal Of Nephrology 1999, 19: 389-394. PMID: 10393376, DOI: 10.1159/000013483.Peer-Reviewed Original ResearchConceptsSerum potassium concentrationSerum creatinine levelsTrimethoprim-sulfamethoxazole therapyBaseline serum potassium concentrationVariety of infectionsCreatinine levelsDay 5Treatment groupsPotassium concentrationControl groupMean serum potassium concentrationBlood urea nitrogen levelsDevelopment of hyperkalemiaLife-threatening hyperkalemiaMild renal insufficiencyDays of therapyHigher serum potassium concentrationsImmunodeficiency syndrome (AIDS) patientsUrea nitrogen levelsSerum glucose concentrationRelevant hyperkalemiaOral antibioticsRenal insufficiencyMost patientsSevere hyperkalemiaMidodrine and cool dialysate are effective therapies for symptomatic intradialytic hypotension
Cruz D, Mahnensmith R, Brickel H, Perazella M. Midodrine and cool dialysate are effective therapies for symptomatic intradialytic hypotension. American Journal Of Kidney Diseases 1999, 33: 920-926. PMID: 10213650, DOI: 10.1016/s0272-6386(99)70427-0.Peer-Reviewed Original ResearchConceptsSymptomatic intradialytic hypotensionPost-HD blood pressuresIntradialytic blood pressureIntradialytic hypotensionBlood pressureEffective therapyLaboratory valuesCombination therapy phaseConsecutive HD treatmentsProspective crossover studyBlood pressure measurementsKt/VVolume of salineControl phaseAlpha1 agonistHypotensive symptomsMorbid complicationCrossover studyUseful therapyProspective studyNursing interventionsHD treatmentMidodrineTreatment phaseTherapy phaseRinger's lactate: An inexpensive and effective dialysate for continuous renal replacement therapy
Perazella M, Cruz D. Ringer's lactate: An inexpensive and effective dialysate for continuous renal replacement therapy. American Journal Of Kidney Diseases 1999, 33: 614-615. PMID: 10070931, DOI: 10.1016/s0272-6386(99)70206-4.Peer-Reviewed Original Research
1998
Acute Renal Failure and Intravenous Immune Globulin
Perazella M, Cayco A. Acute Renal Failure and Intravenous Immune Globulin. American Journal Of Therapeutics 1998, 5: 399-404. PMID: 10099084, DOI: 10.1097/00045391-199811000-00008.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAdultAgedAged, 80 and overHumansImmunoglobulins, IntravenousMiddle AgedSucroseConceptsAcute renal failureRenal failureRenal insufficiencyIntravenous immune globulin therapyImmune globulin therapyChronic renal insufficiencyIntravenous immune globulinAcute renal insufficiencyRenal replacement therapyVariety of complicationsGlobulin therapyIVIG infusionIVIG therapyMaintenance dialysisRenal impairmentImmune globulinIVIG preparationsReplacement therapyDrug trialsNumber of casesClinical disordersOlder agePrecise causeTherapyAdverse effectsIndinavir nephropathy in an AIDS patient with renal insufficiency and pyuria.
Perazella M, Kashgarian M, Cooney E. Indinavir nephropathy in an AIDS patient with renal insufficiency and pyuria. Clinical Nephrology 1998, 50: 194-6. PMID: 9776425.Peer-Reviewed Original ResearchConceptsRenal biopsy findingsRenal insufficiencyBiopsy findingsMild renal insufficiencyAcute renal failureIndinavir crystalsIndinavir therapyRenal failureAntiretroviral agentsUrinary obstructionAIDS patientsCellular castsPatientsPyuriaInsufficiencyRecent reportsSmall percentDiscontinuationNephropathyMedicationsSecond caseDiuresisNephrolithiasisIndinavirObstructionReduction in arteriovenous graft impairment: Results of a vascular access surveillance protocol
Cayco A, Abu-Alfa A, Mahnensmith R, Perazella M. Reduction in arteriovenous graft impairment: Results of a vascular access surveillance protocol. American Journal Of Kidney Diseases 1998, 32: 302-308. PMID: 9708617, DOI: 10.1053/ajkd.1998.v32.pm9708617.Peer-Reviewed Original ResearchConceptsDynamic venous pressureHistorical control groupVenous pressureArteriovenous graftsSurveillance protocolStudy groupBlood flow rateThrombosis rateControl groupSimilar historical control groupHemodialysis vascular accessSynthetic arteriovenous graftsLower thrombosis rateML/minGraft impairmentVenous stenosisHD sessionVascular accessVascular stenosisPatientsScreening testStenosisStudy periodFrustrating problemConsecutive readingsMidodrine is effective and safe therapy for intradialytic hypotension over 8 months of follow-up.
Cruz D, Mahnensmith R, Brickel H, Perazella M. Midodrine is effective and safe therapy for intradialytic hypotension over 8 months of follow-up. Clinical Nephrology 1998, 50: 101-7. PMID: 9725781.Peer-Reviewed Original ResearchConceptsSymptomatic intradialytic hypotensionIntradialytic hypotensionMidodrine therapyHD sessionSafe therapyEnd-stage renal disease patientsStage renal disease patientsAlpha-1 adrenergic agonistMean ultrafiltration volumeSignificant causative roleRenal disease patientsTreatment-related factorsPatient-specific factorsMost therapeutic interventionsKt/VHypotensive symptomsBlood pressureHemodialysis patientsHD patientsDisease patientsSubjective improvementAdverse reactionsFrustrating complicationMean albuminSafe treatment
1997
Intradialytic hypotension: Is midodrine beneficial in symptomatic hemodialysis patients?
Cruz D, Mahnensmith R, Perazella M. Intradialytic hypotension: Is midodrine beneficial in symptomatic hemodialysis patients? American Journal Of Kidney Diseases 1997, 30: 772-779. PMID: 9398120, DOI: 10.1016/s0272-6386(97)90081-0.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAdrenergic alpha-AgonistsAgedAged, 80 and overBlood PressureDiastoleDizzinessFatigueFemaleFollow-Up StudiesHumansHypotensionKidney Failure, ChronicLongitudinal StudiesMaleMiddle AgedMidodrineMuscle CrampMuscle WeaknessParesthesiaProspective StudiesPulseRenal DialysisRisk FactorsSafetyScalpSystoleConceptsDiastolic blood pressureSystolic blood pressureBlood pressureMidodrine therapyArterial pressureHemodialysis patientsIntradialytic hypotensionPulse rateEnd-stage renal disease patientsIntradialytic systolic blood pressureEfficacy of midodrineSymptomatic hemodialysis patientsNeurogenic orthostatic hypotensionMean arterial pressureRenal disease patientsAdequate patient numbersBlood pressure measurementsAlpha-adrenergic agonist activityConsecutive dialysis sessionsAutonomic dysfunctionDialysis hypotensionOral agentsOrthostatic hypotensionSymptomatic hypotensionProspective trialRenal insufficiency after intravenous immune globulin therapy: a report of two cases and an analysis of the literature.
Cayco A, Perazella M, Hayslett J. Renal insufficiency after intravenous immune globulin therapy: a report of two cases and an analysis of the literature. Journal Of The American Society Of Nephrology 1997, 8: 1788-94. PMID: 9355083, DOI: 10.1681/asn.v8111788.Peer-Reviewed Original ResearchConceptsIntravenous immune globulin therapyAcute renal failureImmune globulin therapyGlobulin therapyRenal replacement therapyNumber of complicationsIVIG treatmentRenal insufficiencyRenal failureRenal injuryIVIG preparationsSuch patientsReplacement therapyClinical disordersTherapyCases recoveryComplicationsPatientsRecurrenceWidespread useInjuryInsufficiencyAgentsCases
1996
Angiotensin-converting enzyme inhibitor therapy in chronic hemodialysis patients: Any evidence of erythropoietin resistance?
Cruz D, Perazella M, Abu-Alfa A, Mahnensmith R. Angiotensin-converting enzyme inhibitor therapy in chronic hemodialysis patients: Any evidence of erythropoietin resistance? American Journal Of Kidney Diseases 1996, 28: 535-540. PMID: 8840943, DOI: 10.1016/s0272-6386(96)90464-3.Peer-Reviewed Original ResearchConceptsChronic hemodialysis patientsEnzyme inhibitor therapyACE inhibitorsHemodialysis patientsInhibitor therapySevere anemiaGroup 2Group 1End-stage renal diseaseExacerbation of anemiaSuppression of angiotensinChronic renal failureCongestive heart failureTherapy of anemiaBone marrow responseSignificant differencesRed blood cell productionRecombinant human EpoRHuEPO responseChronic hemodialysisErythropoietin resistanceRenal transplantationBaseline characteristicsHospital daysRenal failureA Middle-Aged Woman with Back and Flank Pain
Cruz D, Perazella M, Mahnensmith R. A Middle-Aged Woman with Back and Flank Pain. Hospital Practice 1996, 31: 193-209. PMID: 8814129, DOI: 10.1080/21548331.1996.11443354.Peer-Reviewed Original ResearchConceptsMiddle-aged womenFlank painFrank renal failureAbnormal liver enzymesCareful preoperative evaluationUrinary tract infectionExtent of inflammationLipid-laden macrophagesRadiologic imaging techniquesChronic pyelonephritisConstitutional symptomsFlank massRenal failureTract infectionsPreoperative evaluationDraining sinusMild azotemiaXanthogranulomatous pyelonephritisXanthoma cellsSubsequent careLiver enzymesAdequate exposureUncommon variantCT scanSurgical planningHyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole.
Alappan R, Perazella M, Buller G. Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole. Annals Of Internal Medicine 1996, 124: 316-20. PMID: 8554227, DOI: 10.7326/0003-4819-124-3-199602010-00006.Peer-Reviewed Original ResearchConceptsSerum potassium concentrationSerum creatinine levelsMumol/LBlood urea nitrogen levelsPeak potassium concentrationTrimethoprim-sulfamethoxazole therapyCreatinine levelsUrea nitrogen levelsTrimethoprim-sulfamethoxazoleTreatment groupsPotassium concentrationControl groupCommunity-based teaching hospitalDevelopment of hyperkalemiaDays of therapyProspective chart reviewConcurrent renal insufficiencyRenal insufficiencyChart reviewSevere hyperkalemiaHospitalized patientsSerum sodiumTeaching hospitalAnion gapPatients