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Seminars in Nephrology

journal
https://www.readbyqxmd.com/read/28532558/chronic-kidney-disease-gender-and-access-to-care-a-global-perspective
#1
REVIEW
Juan-Jesus Carrero, Manfred Hecking, Ifeoma Ulasi, Laura Sola, Bernadette Thomas
Little is known regarding the ways in which chronic kidney disease (CKD) prevalence and progression differ between the sexes. Still less is known regarding how social disparities between men and women may affect access to care for CKD. In this review, we briefly describe biological sex differences, noting how these differences currently do not influence CKD management recommendations. We then describe what is known within the published literature regarding differences in CKD epidemiology between sexes; namely prevalence, progression, and access to treatment throughout the major world regions...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532557/pd-first-policy-thailand-s-response-to-the-challenge-of-meeting-the-needs-of-patients-with-end-stage-renal-disease
#2
REVIEW
Piyatida Chuengsaman, Vijj Kasemsup
Providing dialysis for end-stage kidney disease (ESKD) patients nationwide in a developing country such as Thailand is challenging. Even after roll-out of the Thai Universal Coverage Scheme in 2002, treatment for ESKD was not covered and patients struggled to afford dialysis. There was an urgent need to improve financial risk protection for patients with ESKD. Advocacy by nephrologists, health economists, and civil society seeking equity in access to dialysis, and responsiveness from policy makers, led to the methodical development of the Peritoneal Dialysis (PD) First policy and marked a turning point in ESKD care in Thailand...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532556/ethical-challenges-in-the-provision-of-dialysis-in-resource-constrained-environments
#3
REVIEW
Valerie A Luyckx, Ingrid Miljeteig, Addisu M Ejigu, M Rafique Moosa
The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532555/integration-of-care-in-management-of-ckd-in-resource-limited-settings
#4
REVIEW
Ikechi G Okpechi, Aminu K Bello, Oluwatoyin I Ameh, Charles R Swanepoel
The prevalence of noncommunicable diseases, including chronic kidney disease (CKD), continues to increase worldwide, and mortality from noncommunicable diseases is projected to surpass communicable disease-related mortality in developing countries. Although the treatment of CKD is expensive, unaffordable, and unavailable in many developing countries, the current structure of the health care system in such countries is not set up to deliver comprehensive care for patients with chronic conditions, including CKD...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532554/traditional-medicines-and-kidney-disease-in-low-and-middle-income-countries-opportunities-and-challenges
#5
REVIEW
John W Stanifer, Kajiru Kilonzo, Daphne Wang, Guobin Su, Wei Mao, Lei Zhang, La Zhang, Shobhana Nayak-Rao, J Jaime Miranda
Traditional medicines are a principal form of health care for many populations, particularly in low- and middle-income countries, and they have gained attention as an important means of health care coverage globally. In the context of kidney diseases, the challenges and opportunities presented by traditional medicine practices are among the most important considerations for developing effective and sustainable public health strategies. However, little is known about the practices of traditional medicines in relation to kidney diseases, especially concerning benefits and harms...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532553/the-potential-impact-of-public-health-interventions-in-preventing-kidney-disease
#6
REVIEW
Rohina Joshi, Oommen John, Vivekanand Jha
The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532552/nephrology-education-and-continuing-education-in-resource-limited-settings
#7
REVIEW
Tushar J Vachharajani, Aminu K Bello, Rhys Evans, Gavin Dreyer, Quentin Eichbaum
Nephrology training programs in high-income countries have transitioned from an apprenticeship model to a well-structured, resource-driven model that supports continual professional development. In contrast, in low- and middle-income countries, medical training and in particular nephrology training has lagged behind owing to resource limitations. Some of the challenges to adequately provide training to health care professionals in low- and middle-income countries include shortage of teaching faculty, difficulty in developing curricula to meet regional needs, and a lack of resources to provide competency-based medical education...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532551/strengthening-renal-registries-and-esrd-research-in-africa
#8
REVIEW
M Razeen Davids, Fergus J Caskey, Taryn Young, Gillian K Balbir Singh
In Africa, the combination of noncommunicable diseases, infectious diseases, exposure to environmental toxins, and acute kidney injury related to trauma and childbirth are driving an epidemic of chronic kidney disease and end-stage renal disease (ESRD). Good registry data can inform the planning of renal services and can be used to argue for better resource allocation, audit the delivery and quality of care, and monitor the impact of interventions. Few African countries have established renal registries and most have failed owing to resource constraints...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532550/introduction-global-health-issues-in-nephrology
#9
EDITORIAL
Valerie A Luyckx
No abstract text is available yet for this article.
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410653/ensuring-patient-safety-during-the-transition-to-esrd
#10
REVIEW
Lee-Ann Wagner, Jeffrey C Fink
Patients with chronic kidney disease (CKD) are at risk for complications both inherent to the disease and as a consequence of its treatment. The dangers that CKD patients face change across the spectrum of the disease. Providers who are well-versed in these safety threats are best poised to safeguard patients as their CKD progresses.
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410652/timing-of-dialysis-initiation-what-has-changed-since-ideal
#11
REVIEW
Matthew B Rivara, Rajnish Mehrotra
The optimal timing of initiation of maintenance dialysis in patients with end-stage renal disease currently is unknown. This transition period is one of exceptionally high vulnerability for patients; annual mortality rates in stage 5 chronic kidney disease through the first year of maintenance dialysis exceed 20%. The results of the Initiating Dialysis Early and Late (IDEAL) study, a randomized trial that tested the impact of dialysis initiation at two different levels of kidney function on outcomes, showed no significant difference in survival or other patient-centered outcomes between treatment groups...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410651/advance-care-planning-for-patients-approaching-end-stage-kidney-disease
#12
REVIEW
Rebecca J Schmidt
Patients with chronic kidney disease typically suffer a cascade of comorbid conditions, the magnitude of which have formidable impact on advance care planning (ACP). Complex health care decisions are complicated further by contextual issues that may change over time. A dynamic and evolving process, ACP ideally begins early in the continuum of chronic kidney disease, long before end-stage kidney disease is reached. Planning ahead for care is preparatory to making decisions about kidney replacement therapy and can make for a smooth transition in addition to preventing the start of dialysis by default...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410650/prehabilitation-for-the-frail-patient-approaching-esrd
#13
REVIEW
Anoop Sheshadri, Kirsten L Johansen
Frailty is a distinct phenotype that is highly prevalent in chronic kidney disease (CKD) and appears to be more prevalent with decreasing glomerular filtration rate. Exercise training or intervention to increase physical activity may ameliorate poor physical functioning and frailty, and even may improve survival in patients with CKD. Although exercise interventions improve outcomes across the spectrum of CKD, including patients treated with dialysis, patients treated with dialysis face barriers to exercise that patients with predialysis CKD do not...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410649/incident-dialysis-access-in-patients-with-end-stage-kidney-disease-what-needs-to-be-improved
#14
REVIEW
Louise M Moist, Charmaine E Lok
The initiation of dialysis is a challenging time of transition for patients, families, and their supporters. Patients with exposure to a comprehensive chronic kidney disease clinic may have had education and subsequent decision making regarding dialysis modality and access; however, many patients with or without prior education will require an urgent start to dialysis, requiring quick decisions regarding dialysis modality and access. In many countries, hemodialysis (HD) using a central venous catheter (CVC) is the most common initial renal replacement modality and dialysis access...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410648/risk-prediction-models-in-ckd
#15
REVIEW
Blake Lerner, Sean Desrochers, Navdeep Tangri
Chronic kidney disease (CKD) currently affects 20 million Americans and is associated with increased morbidity and mortality. Resource-efficient and appropriate treatment of CKD benefits the patient and provides improved resource allocation for the health care system. Prediction models can be useful in efficiently allocating resources, and currently are being used at the bedside for several important clinical decisions. There is a paucity of prediction models in use in nephrology, but one such model, the Kidney Failure Risk Equation, uses routinely collected laboratory values and can inform clinical decisions related to the following: (1) triage of nephrology referrals, (2) evaluating the need for more intensive interdisciplinary clinic care, (3) determining the timing of modality education, and (4) dialysis access planning...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410647/disease-trajectories-before-esrd-implications-for-clinical-management
#16
REVIEW
Keiichi Sumida, Csaba P Kovesdy
One of the biggest challenges nephrologists face is to predict complex clinical pathways of kidney disease progression that do not follow a steady linear decline. This unpredictability often becomes a barrier to timely shared decision making between patients and physicians and could lead to adverse patient outcomes. By using numerous analytic approaches to characterize the longitudinal changes in kidney function, emerging evidence has disclosed the heterogeneous trajectories of kidney disease progression, particularly in late-stage chronic kidney disease (CKD) nearing end-stage renal disease (ESRD), and showed their independent associations with various clinical outcomes...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410646/evolution-of-cardiovascular-disease-during-the-transition-to-end-stage-renal-disease
#17
REVIEW
Nisha Bansal
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The rate of death in incident dialysis patients remains high. This has led to interest in the study of the evolution of CVD during the critical transition period from CKD to ESRD. Understanding the natural history and risk factors of clinical and subclinical CVD during this transition may help guide the timing of appropriate CVD therapies to improve outcomes in patients with kidney disease...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410645/epidemiology-and-risk-factors-for-early-mortality-after-dialysis-initiation
#18
REVIEW
Robert N Foley
Confronted with the decision to initiate dialysis, patients and caregivers often seek information about how expected survival chances evolve, both initially and afterward, providing the patient survives beyond arbitrary periods of time. Large registry data, used to examine these issues, may be subject to early ascertainment bias, such as those accruing from nonregistration of with end-stage kidney disease who die shortly after dialysis initiation and inclusion of patients with acute kidney injury with slower than typical recovery rates...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410644/optimizing-the-transition-to-end-stage-renal-disease
#19
EDITORIAL
Manjula Kurella Tamura
No abstract text is available yet for this article.
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153198/encapsulating-peritoneal-sclerosis
#20
REVIEW
Helen Alston, Stanley Fan, Masaaki Nakayama
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis. In this review, we describe the clinical picture and histologic changes to the peritoneal membrane that are associated with EPS and provide an update on current diagnosis and management. We also discuss the recent studies that have suggested that the use of more biocompatible solutions containing lower concentrations of glucose degradation product that often are pH neutral in combination with a change in clinical practice (reducing glucose exposure and monitoring peritoneal membrane function) might ameliorate peritoneal degeneration, reduce the incidence of EPS, and minimize the severity of the disease...
January 2017: Seminars in Nephrology
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