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Seminars in Nephrology

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https://www.readbyqxmd.com/read/28711081/illustrative-cases-of-kidney-disease-unique-to-women
#1
Iru Chen, Liz Lightsone, Michelle A Hladunewich, Belinda Jim
No abstract text is available yet for this article.
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711080/menopause-and-chronic-kidney-disease
#2
Sofia B Ahmed
Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore menses and fertility, highlighting the challenges of diagnosing and managing the menopausal transition in the female population with kidney disease. Postmenopausal sex hormone levels affect renovascular physiology, but the clinical impact of menopause on kidney function is unclear...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711079/new-evidence-in-the-management-of-chronic-hypertension-in-pregnancy
#3
Tiina Podymow, Phyllis August
Chronic hypertension complicates 1% to 5% of all pregnancies, but debate continues regarding the benefits of lowering blood pressure in pregnancy as well as the optimal blood pressure targets. Women with chronic hypertension are at significant risk for maternal and fetal morbidity and mortality, yet it remains unclear whether antihypertensive treatment during pregnancy lowers these risks. Severe hypertension (systolic ≥ 160 mm Hg) should be treated, but there is considerable variability in the approach to mild-to-moderate hypertension (140-159/90-109 mm Hg)...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711078/preeclampsia-pathogenesis-prevention-and-long-term-complications
#4
Belinda Jim, S Ananth Karumanchi
Preeclampsia continues to afflict 5% to 8% of all pregnancies throughout the world and is associated with significant morbidity and mortality to the mother and the fetus. Although the pathogenesis of the disorder has not yet been fully elucidated, current evidence suggests that imbalance in angiogenic factors is responsible for the clinical manifestations of the disorder, and may explain why certain populations are risk. In this review, we begin by demonstrating the roles that angiogenic factors play in pathogenesis of preeclampsia and its complications in the mother and the fetus...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711077/acute-kidney-injury-in-pregnancy
#5
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711076/pregnancy-in-renal-transplant-recipients-and-donors
#6
Kate Bramham
Women with renal transplants have restoration of fertility with improved kidney function; however, pregnancy rates in renal transplant recipients appear to be lower than the general population, which might be influenced by patient choice. Women with renal transplants need to evaluate potential neonatal outcomes, graft outcomes, and risks to their own health to make informed decisions about conception. Pregnancy should be carefully planned in renal transplant recipients to reduce risk for graft loss, optimize pregnancy outcomes, and ensure immunosuppression regimes are nonteratogenic...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711075/diabetic-nephropathy-and-pregnancy
#7
Kate Bramham
Women with diabetic nephropathy have challenging pregnancies, with pregnancy outcomes far worse than expected for the stage of chronic kidney disease. The underlying mechanisms that cause the adverse events remain poorly understood, but it is a widely held belief that substantial endothelial injury in these women likely contributes. Maternal hypertension, preeclampsia, and cesarean section rates are high, and offspring are often preterm and of low birth weight, with additional neonatal complications associated with glycemic control...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711074/hereditary-renal-diseases
#8
Lakshmi Mehta, Belinda Jim
Hereditary kidney disease comprises approximately 10% of adults and nearly all children who require renal replacement therapy. Technologic advances have improved our ability to perform genetic diagnosis and enhanced our understanding of renal and syndromic diseases. In this article, we review the genetics of renal diseases, including common monogenic diseases such as polycystic kidney disease, Alport syndrome, and Fabry disease, as well as complex disorders such as congenital anomalies of the kidney and urinary tract...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#9
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#10
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711071/fertility-contraception-and-novel-reproductive-technologies-in-chronic-kidney-disease
#11
Sofia B Ahmed, Wendy S Vitek, Jean L Holley
Chronic kidney disease (CKD) affects hypothalamic-pituitary-gonadal axis function, leading to menstrual abnormalities, sexual dysfunction, functional menopause, and loss of fertility. Pregnancy in a patient with CKD is associated with a higher risk of complications to both the mother and the fetus, highlighting the importance of contraceptive counseling at all stages of CKD. There has been limited research on the safety and efficacy of different contraceptive methods in the CKD population, and it is important to tailor the choice of contraception to the patient's lifestyle and comorbidity status...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711070/female-adolescents-with-chronic-or-end-stage-kidney-disease-and-strategies-for-their-care
#12
Maria E Diaz-Gonzalez De Ferris, Ana Catalina Alvarez-Elías, Michael Ted Ferris, Mara Medeiros
The prevalence of chronic or end-stage kidney disease in pediatric girls is lower than in boys, however, girls have unique morbidities that can have great effect on their quality of life. For female adolescents, creatinine excretion peaks at approximately 14 years of age and is significantly less than males, owing to lower muscle mass. Females have higher nitric oxide activity, and estrogens may contribute to lower blood pressure. Females excrete less growth hormone during the prepubertal and pubertal years...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711069/preterm-birth-and-its-impact-on-renal-health
#13
Valerie A Luyckx
Preterm birth occurs in approximately 10% of all births worldwide. Preterm infants have reduced nephron numbers at birth in proportion to gestational age, and are at increased risk of neonatal acute kidney injury as well as higher blood pressure, proteinuria, and chronic kidney disease later in life. Rapid catch-up growth in preterm infants, especially if resulting in obesity, is a risk factor for end-stage kidney disease among children with proteinuric renal disease. Preterm birth, however, is a risk factor not only for the infant because mothers who deliver preterm have an increased risk of having subsequent preterm deliveries as well as hypertension, cardiovascular disease, and renal disease later in life...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28711068/introduction-women-s-renal-health-across-the-decades
#14
EDITORIAL
Michelle A Hladunewich, Belinda Jim
No abstract text is available yet for this article.
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532558/chronic-kidney-disease-gender-and-access-to-care-a-global-perspective
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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