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Seminars in Nephrology

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https://www.readbyqxmd.com/read/30082062/dialysis-patient-centeredness-and-precision-medicine-focus-on-incremental-home-hemodialysis-and-preserving-residual-kidney-function
#1
REVIEW
Nieltje Gedney, Kamyar Kalantar-Zadeh
An exponential interest in incremental transition to dialysis recently has emerged in lieu of outright three times/wk hemodialysis initiation as the standard of care. Incremental dialysis is consistent with precision medicine, given individualized dialysis dose adjustment based on patient's dynamic needs, leading to reduced patient suffering from longer or more frequent dialysis treatments and improved health-related quality of life. It includes twice-weekly or less frequent hemodialysis treatments with or without a low-protein diet on nondialysis days, or a shorter (<3 h) hemodialysis treatment three times per week or more frequent treatments, a useful approach for home hemodialysis initiation...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082061/using-technology-to-inform-and-deliver-precise-personalized-care-to-patients-with-end-stage-kidney-disease
#2
REVIEW
Len Usvyat, Lorien S Dalrymple, Franklin W Maddux
Consistent with the increase of precision medicine, the care of patients with end-stage kidney disease (ESKD) requiring maintenance dialysis therapy should evolve to become more personalized. Precise and personalized care is nuanced and informed by a number of factors including an individual's needs and preferences, disease progression, and response to and tolerance of treatments. Technology can support the delivery of more precise and personalized care through multiple mechanisms, including more accurate and real-time assessments of key care elements, enhanced treatment monitoring, and remote monitoring of home dialysis therapies...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082060/personalized-anemia-management-and-precision-medicine-in-esa-and-iron-pharmacology-in-end-stage-kidney-disease
#3
REVIEW
Michael E Brier, Adam E Gaweda, George R Aronoff
Substantial progress has been made in the application of computer-driven methods to provide erythropoietic dosing information for patients with anemia resulting from chronic kidney disease. Initial solutions were simply computerized versions of traditional paper-based anemia management protocols. True personalization was achieved through the use of advanced modeling techniques such as artificial neural networks, physiologic models, and feedback control systems. The superiority of any one technique over another has not been determined, but all methods have shown an advantage in at least one area over the traditional paper expert system used by most dialysis facilities...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082059/personalized-management-of-bone-and-mineral-disorders-and-precision-medicine-in-end-stage-kidney-disease
#4
REVIEW
Anna Jovanovich, Jessica Kendrick
Chronic kidney disease mineral bone disorder (CKD-MBD) is common in end-stage renal disease and is associated with an increased risk of cardiovascular morbidity and mortality. Mainstays of treatment include decreasing serum phosphorus level toward the normal range with dietary interventions and phosphate binders and treating increased parathyroid hormone levels with activated vitamin D and/or calcimimetics. There is significant variation in serum levels of mineral metabolism markers, intestinal absorption of phosphorus, and therapeutic response among individual patients and subgroups of patients with end-stage renal disease...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082058/precision-medicine-for-nutritional-management-in-end-stage-kidney-disease-and-transition-to-dialysis
#5
REVIEW
Angela Yee-Moon Wang, Kamyar Kalantar-Zadeh, Denis Fouque, Pieter T Wee, Csaba P Kovesdy, S Russ Price, Joel D Kopple
Chronic kidney disease (CKD) is a global public health burden. Dialysis is not only costly but may not be readily available in developing countries. Even in highly developed nations, many patients may prefer to defer or avoid dialysis. Thus, alternative options to dialysis therapy or to complement dialysis are needed urgently and are important objectives in CKD management that could have huge clinical and economic implications globally. The role of nutritional therapy as a strategy to slow CKD progression and uremia was discussed as early as the late 19th and early 20th century, but was only seriously explored in the 1970s...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082057/precision-medicine-and-personalized-management-of-lipoprotein-and-lipid-disorders-in-chronic-and-end-stage-kidney-disease
#6
REVIEW
Elani Streja, Dan A Streja, Melissa Soohoo, Carola-Ellen Kleine, Jui-Ting Hsiung, Christina Park, Hamid Moradi
Precision medicine is an emerging field that calls for individualization of treatment strategies based on characteristics unique to each patient. In lipid management, current guidelines are driven mainly by clinical trial results that presently indicate that patients with non-dialysis-dependent chronic kidney disease (CKD) should be treated with a β-hydroxy β-methylglutaryl-CoA reductase inhibitor, also known as statin therapy. For patients with end-stage kidney disease (ESKD) being treated with hemodialysis, statin therapy has not been shown to successfully reduce poor outcomes in trials and therefore is not recommended...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082056/patient-centered-approach-for-hypertension-management-in-end-stage-kidney-disease-art-or-science
#7
REVIEW
Elvira O Gosmanova, Csaba P Kovesdy
Hypertension is present in most patients with end-stage kidney disease initiating dialysis and management of hypertension is a routine but challenging task in everyday dialysis care. End-stage kidney disease patients are uniquely heterogeneous individuals with significant variations in demographic characteristics, functional capacity, and presence of concomitant comorbid conditions and their severity. Therefore, these patients require personalized approaches in addressing not only hypertension but related illnesses, while also accounting for overall prognosis and projected longevity...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082055/precision-medicine-and-personalized-approach-to-renal-transplantation
#8
REVIEW
Donald C Dafoe, Ekamol Tantisattamo, Uttam Reddy
Successful renal transplantation is a highly effective endeavor that improves and prolongs the lives of patients with chronic kidney disease. Transplant surgery and immunosuppression carries risk and the demand for donor kidneys outstrips supply by far. These realities mandate thoughtful allocation and utilization of this limited resource to select candidates. As the criteria for candidates and donor grafts continue to expand, the field must adapt and seek new approaches. The complex process-from evaluation of candidates, transplant surgery, immunosuppression, and follow-up care after transplantation-is, of necessity, tightly structured and regulated...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082054/personalized-approach-and-precision-medicine-in-supportive-and-end-of-life-care-for-patients-with-advanced-and-end-stage-kidney-disease
#9
REVIEW
Sara N Davison
Kidney supportive care requires a highly personalized approach to care. Precision medicine holds promise for a deeper understanding of the pathophysiology of symptoms and related syndromes and more precise individualization of prognosis and treatment estimates, therefore providing valuable opportunities for greater personalization of supportive care. However, the major drivers of quality of life are psychosocial, economic, lifestyle, and preference-based, and consideration of these factors and skilled communication are integral to the provision of excellent and personalized kidney supportive care...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082053/precision-medicine-in-the-transition-to-dialysis-and-personalized-renal-replacement-therapy
#10
REVIEW
Connie M Rhee, Yoshitsugu Obi, Anna T Mathew, Kamyar Kalantar-Zadeh
Launched in 2016, the overarching goal of the Precision Medicine Initiative is to promote a personalized approach to disease management that takes into account an individual's unique underlying biology and genetics, lifestyle, and environment, in lieu of a one-size-fits-all model. The concept of precision medicine is pervasive across many areas of nephrology and has been particularly relevant to the care of advanced chronic kidney disease patients transitioning to end-stage kidney disease (ESKD). Given many uncertainties surrounding the optimal transition of incident ESKD patients to dialysis and transplantation, as well as the high mortality rates observed during this delicate transition period, there is a pressing urgency for implementing precision medicine in the management of this population...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082052/genetics-genomics-and-precision-medicine-in-end-stage-kidney-disease
#11
REVIEW
Jeffrey B Kopp, Cheryl A Winkler
Recent advances in genetics of renal disease have deepened our understanding of progressive kidney disease. Here, we review genetic variants that are of particular importance to progressive glomerular disease that result in end-stage kidney disease (ESKD). Some of the most striking findings relate to APOL1 genetic variants, seen exclusively in individuals of sub-Saharan African descent, that create a predisposition to particular renal disorders, including focal segmental glomerulosclerosis and arterionephrosclerosis...
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/30082051/introduction-precision-medicine-in-end-stage-kidney-disease-and-personalized-renal-replacement-therapy-challenges-and-unmet-need
#12
EDITORIAL
Hamid Moradi, Kamyar Kalantar-Zadeh
No abstract text is available yet for this article.
July 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753405/cardiovascular-disease-risk-in-children-with-kidney-disease
#13
REVIEW
Christine B Sethna, Kumail Merchant, Abigail Reyes
Cardiovascular disease is a major cause of death in individuals diagnosed with kidney disease during childhood. Children with kidney disease often incur a significant cardiovascular burden that leads to increased risk for cardiovascular disease. Evidence has shown that children with kidney disease, including chronic kidney disease, dialysis, kidney transplantation, and nephrotic syndrome, develop abnormalities in cardiovascular markers such as hypertension, dyslipidemia, left ventricular hypertrophy, left ventricular dysfunction, atherosclerosis, and aortic stiffness...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753404/cardiovascular-disease-after-kidney-transplant
#14
REVIEW
Nitesh N Rao, P Toby Coates
Renal transplantation is the preferred treatment for patients with end-stage kidney disease. However, despite successful kidney transplantation, cardiovascular disease (CVD) remains one of the major causes of patient death and hence graft loss. The antecedents of this increased risk reside within the development of end-stage kidney disease and dialysis. Risk factors for the development of CVD include diabetes, hypertension, and dyslipidemia. Other transplant-specific factors include the presence of a patent arteriovenous fistula and immunosuppressive therapy...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753403/clinical-studies-of-interventions-to-mitigate-cardiovascular-risk-in-peritoneal-dialysis-patients
#15
REVIEW
Dev Jegatheesan, Yeoungjee Cho, David W Johnson
Cardiovascular disease (CVD) is highly prevalent in the peritoneal dialysis (PD) population, affecting up to 60% of cohorts. CVD is the primary cause of death in up to 40% of PD patients in Australia, New Zealand, and the United States. Cardiovascular mortality rates are reported to be approximately 14 per 100 patient-years, which are 10- to 20-fold greater than those of age- and sex-matched controls. The excess risk of CVD is related to a combination of traditional risk factors (such as hypertension, dyslipidemia, obesity, smoking, sedentary lifestyle, and insulin resistance), nontraditional (kidney disease-related) risk factors (such as anemia, chronic volume overload, inflammation, malnutrition, hyperuricemia, and mineral and bone disorder), and PD-specific risk factors (such as dialysis solutions, glycation end products, hypokalemia, residual kidney function, and ultrafiltration failure)...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753402/hif-activation-against-cvd-in-ckd-novel-treatment-opportunities
#16
REVIEW
Tetsuhiro Tanaka, Kai-Uwe Eckardt
Cardiovascular disease is a common and serious complication in patients with chronic kidney disease (CKD). One of the fundamental functions of the cardiovascular system is oxygen delivery, therefore cardiovascular disease inherently is linked to insufficient tissue oxygenation. Advances in our knowledge of cellular oxygen sensing by a family of prolyl hydroxylases (PHDs) and their role in regulating hypoxia-inducible factors (HIFs) have led to the discovery of PHD inhibitors as HIF stabilizers. Several small-molecule PHD inhibitors are currently in clinical trials for the treatment of anemia in CKD...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753401/vitamin-d-and-calcimimetics-in-cardiovascular-disease
#17
REVIEW
Kenneth Lim, Takayuki Hamano, Ravi Thadhani
Cardiovascular disease has earned its place as one of the leading noncommunicable diseases that has become a modern-day global epidemic. The increasing incidence and prevalence of chronic kidney disease (CKD) has added to this enormous burden, given that CKD is now recognized as an established risk factor for accelerated cardiovascular disease. In fact, cardiovascular disease remains the leading cause of death in the CKD population, with significant prognostic implications. Alterations in vitamin D levels as renal function declines has been linked invariably to the development of cardiovascular disease beyond a mere epiphenomenon, and has become an important focus in recent years in our search for new therapies...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753400/updates-on-the-mechanisms-and-the-care-of-cardiovascular-calcification-in-chronic-kidney-disease
#18
REVIEW
Lucie Hénaut, Jean-Marc Chillon, Saïd Kamel, Ziad A Massy
In chronic kidney disease (CKD), the progressive decrease in renal function leads to disturbances of mineral metabolism that generally cause secondary hyperparathyroidism. The increase in serum parathyroid hormone is associated with reduced serum calcium and calcitriol levels and/or increased serum fibroblast growth factor-23 and phosphate levels. The resulting CKD-associated disorder of mineral and bone metabolism is associated with various other metabolic dysregulations such as acidosis, malnutrition, inflammation, and accumulation of uremic toxins...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753399/cardiovascular-disease-and-diabetic-kidney-disease
#19
REVIEW
Muhammad Maqbool, Mark E Cooper, Karin A M Jandeleit-Dahm
Diabetic kidney disease commonly is associated with an increased risk of cardiovascular disease. There are traditional common risk factors for both conditions including hypertension and poor glycemic control. However, it is likely that there are other pathophysiological mechanisms that explain the clinical phenomenon of increased cardiovascular disease in diabetic patients with chronic kidney and vice versa. Current management of both conditions includes aggressive glucose and blood pressure control. The protective role of treating dyslipidemia has been shown for cardiovascular disease, but the results for renal disease are not as clear...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29753398/cardiovascular-risk-prediction-in-ckd
#20
REVIEW
Shoshana H Ballew, Kunihiro Matsushita
Cardiovascular disease is an important complication for patients with chronic kidney disease (CKD), warranting accurate risk prediction, but clinical guidelines are inconsistent regarding whether or how to use information on measures of CKD for predicting risk. Recent large meta-analyses have shown that key CKD measures (estimated glomerular filtration rate and albuminuria) improve cardiovascular risk prediction beyond traditional risk factors, especially when albuminuria is added to prediction models. In addition, several recent studies have shown that the use of filtration markers other than serum creatinine, cystatin C, and β2 -microglobulin can improve cardiovascular risk prediction...
May 2018: Seminars in Nephrology
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