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Canadian Journal of Kidney Health and Disease

Meghan J Elliott, Zahra Goodarzi, Joanna E M Sale, Linda A Wilhelm, Andreas Laupacis, Brenda R Hemmelgarn, Sharon E Straus
Background: Patients and other stakeholders are increasingly engaging as partners in research, although how they perceive such experiences, particularly over the long term, is not well understood. Objective: To characterize how participants from a nondialysis chronic kidney disease (CKD) research priority-setting project conducted 2 years previously perceived the significance of their involvement. Design: Qualitative descriptive study with semi-structured, individual interviews...
2018: Canadian Journal of Kidney Health and Disease
Eric McArthur, Sarah E Bota, Manish M Sood, Gihad E Nesrallah, S Joseph Kim, Amit X Garg, Stephanie N Dixon
Background: Several different indices summarize patient comorbidity using health care data. An accurate index can be used to describe the risk profile of patients, and as an adjustment factor in analyses. How well these indices perform in persons with chronic kidney disease (CKD) is not well known. Objective: Assess the performance of 5 comorbidity indices at predicting mortality in 3 different patient groups with CKD: incident kidney transplant recipients, maintenance dialysis patients, and individuals with low estimated glomerular filtration rate (eGFR)...
2018: Canadian Journal of Kidney Health and Disease
Michael H Chiu, Robert J H Miller, Rebecca Barry, Bing Li, Bryan J Har, Stephen B Wilton, Merril Knudtson, Jonathan G Howlett, Matthew T James
Background: Angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACE-I/ARB) improve outcomes in patients with heart failure and reduced left-ventricular (LV) systolic function. However, these medications can cause a rise in serum creatinine and their benefits in patients with HF accompanied by kidney disease are less certain. Objective: To characterize associations between estimated glomerular filtration rate (eGFR), patterns of ACE-Is and ARBs use, and 1-year survival following hospitalization for heart failure (HF)...
2018: Canadian Journal of Kidney Health and Disease
Steven Soroka, Ahsan Alam, Micheli Bevilacqua, Louis-Philippe Girard, Paul Komenda, Rolf Loertscher, Philip McFarlane, Sanjaya Pandeya, Paul Tam, Daniel G Bichet
Purpose: The purpose of this article is to update the previously published consensus recommendations from March 2017 discussing the optimal management of adult patients with autosomal dominant polycystic kidney disease (ADPKD). This document focuses on recent developments in genetic testing, renal imaging, assessment of risk regarding disease progression, and pharmacological treatment options for ADPKD. Sources of information: Published literature was searched in PubMed, the Cochrane Library, and Google Scholar to identify the latest evidence related to the treatment and management of ADPKD...
2018: Canadian Journal of Kidney Health and Disease
Brendan P Cassidy, Lori Harwood, Leah E Getchell, Michael Smith, Shannon L Sibbald, Louise M Moist
Background: Patients with chronic kidney disease (CKD) are asked to choose a renal replacement therapy or conservative management. Education and knowledge transfer play key roles in this decision-making process, yet they remain a partially met need. Objective: We sought to understand the dialysis modality decision-making process through exploration of the predialysis patient experience to better inform the educational process. Design: Qualitative descriptive study...
2018: Canadian Journal of Kidney Health and Disease
Marie-Michèle Gaudreault-Tremblay, Catherine Litalien, Natalie Patey, Aicha Merouani
Rationale: Acute tubulointerstitial nephritis (ATIN) in children is most commonly due to allergic drug reactions. In neonates, diagnosis of ATIN is clinically suspected and a kidney biopsy is not routinely performed. Presenting concern: A 17-day-old newborn presented with vomiting and dehydration, along with anuric acute kidney injury, severe electrolyte disturbances, hypocomplementemia, and thrombocytopenia. Abdominal ultrasound revealed bilateral nephromegaly and hepatosplenomegaly...
2018: Canadian Journal of Kidney Health and Disease
William Beaubien-Souligny, Marie-Noëlle Pépin, Louis Legault, Jean-François Cailhier, Jean Éthier, Louis Bouchard, Bernard Willems, André Y Denault
Rationale: Acute kidney injury (AKI) is a frequent complication after liver transplantation. In some patients, prompt intervention targeted at a specific etiology is of paramount importance. Presenting concerns of the patients: A 25 years old man with advanced liver cirrhosis caused by sclerosing cholangitis and autoimmune hepatitis underwent orthotopic liver transplantation. One month after surgery, severe AKI developed in conjunction with recurrent ascites and lower extremity edema...
2018: Canadian Journal of Kidney Health and Disease
Vivian S Tan, Amit X Garg, Eric McArthur, Rachel E Patzer, Jennifer Gander, Pavel Roshanov, S Joseph Kim, Greg A Knoll, Seychelle Yohanna, Megan K McCallum, Kyla L Naylor
Background: Many patients with end-stage kidney disease (ESKD) do not appreciate how their survival may differ if treated with a kidney transplant compared with dialysis. A risk calculator (iChoose Kidney) developed and validated in the United States provides individualized mortality estimates for different treatment options (dialysis vs living or deceased donor kidney transplantation). The calculator can be used with patients and families to help patients make more educated treatment decisions...
2018: Canadian Journal of Kidney Health and Disease
Johnny W Huang, Owen J Clarkin, Christopher McCudden, Ayub Akbari, Benjamin J W Chow, Wael Shabana, Salmaan Kanji, Alexandra Davis, Swapnil Hiremath
Background: N-acetylcysteine (NAC) is an antioxidant which can regenerate glutathione and is primarily used for acetaminophen overdose. It is also a potential therapy to prevent iatrogenic acute kidney injury or slow the progression of chronic kidney disease. It has been considered in this context by many studies with mixed results. Notably, a biological-mechanism rationale for a protective effect of NAC has never been adequately reported. Among conflicting reports, there appears to be evidence that NAC may artificially lower measured serum creatinine without improving kidney function, potentially by assay interference...
2018: Canadian Journal of Kidney Health and Disease
Amanda Cunningham, Hallgrimur Benediktsson, Daniel A Muruve, Ainslie M Hildebrand, Pietro Ravani
Background: Kidney biopsy is considered the gold standard for diagnosis of renal disease. It is increasingly performed in cases of diagnostic uncertainty, including in patients with coexistent diabetes and hypertension, for which a presumptive clinical diagnosis can be made. Little is known about the incidence and distribution of biopsy-proven kidney diseases. Changes in the distribution of biopsy diagnoses over time may have significant implications for resource allocation and future research...
2018: Canadian Journal of Kidney Health and Disease
Dorothy A Thomas, Anne Huang, Michelle C E McCarron, Joanne E Kappel, Rachel M Holden, Karen E Yeates, Bonnie R Richardson
Background: Chronic kidney disease is more prevalent among First Nations people than in non-First Nations people. Emerging research suggests that First Nations people are subject to greater disease burden than non-First Nations people. Objective: We aimed to identify the severity of chronic kidney disease and quantify the geographical challenges of obtaining kidney care by Saskatchewan's First Nations people. Design: This study is a retrospective analysis of the provincial electronic medical record clinical database from January 2012 to December 2013...
2018: Canadian Journal of Kidney Health and Disease
Juthaporn Cowan, Alexandria Bennett, Nicholas Fergusson, Cheynne McLean, Ranjeeta Mallick, D William Cameron, Greg Knoll
Background: Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary. Objective: Our objectives were to assess the incidence and types of post-operative infections in kidney transplant recipients at a large tertiary-care facility and determine sample sizes needed for future intervention trials...
2018: Canadian Journal of Kidney Health and Disease
James Kiberd, Usman Khan, Cynthia Stockman, Arun Radhakrishnan, Matthew Phillips, Bryce A Kiberd, Kenneth A West, Steven Soroka, Christopher Chan, Karthik K Tennankore
Background: Improving a patient's experience with their care through an online interface for communication (an eHealth patient portal) has been shown to be beneficial in some studies of chronic disease populations. However, little is known about the effectiveness of an eHealth portal for delivery of care to home dialysis patients. Objectives: Primary: To determine whether an eHealth portal is effective at improving a patient's experience with their home dialysis care...
2018: Canadian Journal of Kidney Health and Disease
Sonali de Chickera, Ayub Akbari, Adeera Levin, Mila Tang, Pierre Brown, Ognjenka Djurdev, Mohan Biyani, Edward G Clark, Manish M Sood
Background: Polycystic kidney disease (PKD) leads to progressive chronic kidney disease (CKD) with a subsequent risk of adverse events such as cardiac disease, infections, end-stage kidney disease (ESKD), and mortality. Objectives: To determine the risks of CKD-related adverse outcomes in patients with PKD compared with patients without PKD. Setting: Canadian study of prediction of death, dialysis and interim cardiovascular events (CanPREDDICT) was a prospective pan-Canadian cohort study from 2008-2013 involving 28 facilities with adjudicated outcomes...
2018: Canadian Journal of Kidney Health and Disease
Judith Klassen, Gail Wilson
Rationale: With marijuana legalization, clinicians need to be aware of Cannabinoid Hyperemesis Syndrome (CHS), which may masquerade as other disease states such as uremia. Presenting concerns of the patient: A 37-year-old man with bipolar affective disease treated with lithium had progressive renal insufficiency presumably on the basis of interstitial fibrosis. He developed persistent and severe nausea and vomiting which was assumed to be on the basis of uremia...
2018: Canadian Journal of Kidney Health and Disease
Sidharth Kumar Sethi, Vinod Krishnappa, Nisha Nangethu, Paul Nemer, Lawrence A Frazee, Rupesh Raina
Purpose of review: Sustained low-efficiency dialysis (SLED) is increasingly used as a renal replacement modality in critically ill patients with acute kidney injury (AKI) and hemodynamic instability. There is, therefore, a greater need for the understanding of the antibiotic dosage and pharmacokinetics in these patients, to provide them with optimal therapy. Sources of information: PubMed/Medline, Embase, and Google Scholar. Methods: PubMed/Medline, Embase, and Google Scholar databases were searched using a combination of key words: dialysis, end stage renal disease, renal failure, sustained low efficiency dialysis, extended daily dialysis, prolonged intermittent renal replacement therapy (PIRRT), and antibiotic dosing...
2018: Canadian Journal of Kidney Health and Disease
Hind H Lazrak, Emilie René, Naoual Elftouh, Jean-Philippe Lafrance
Background: Low-molecular-weight heparins (LMWH) replaced unfractionated heparin (UFH) in multiple indications. Although LMWH efficacy in hemodialysis was demonstrated through multiple studies, their safety remains controversial. The potential bioaccumulation in patients undergoing chronic hemodialysis raised the question of bleeding risk among this population. Objective: The aim of this study was to evaluate bleeding risk among patients with chronic hemodialysis receiving LMWH or UFH for the extracorporeal circuit anticoagulation...
2018: Canadian Journal of Kidney Health and Disease
Raymond K Hsu, Jonathon D Truwit, Michael A Matthay, Joseph E Levitt, Boyd Taylor Thompson, Kathleen D Liu
Background: Acute kidney injury (AKI) commonly occurs in patients with sepsis and acute respiratory distress syndrome (ARDS). Objective: To investigate whether statin treatment is protective against AKI in sepsis-associated ARDS. Design: Secondary analysis of data from Statins for Acutely Injured Lungs in Sepsis (SAILS), a randomized controlled trial that tested the impact of rosuvastatin therapy on mortality in patients with sepsis-associated ARDS...
2018: Canadian Journal of Kidney Health and Disease
Meherzad Kutky, Sarah Aloudat
Rationale: Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup of SLE, and although there is no strict age cut-off, 50 years is commonly used as the minimum age for disease onset. In this report, we present a case of a 74-year-old male with late-onset SLE and biopsy-proven lupus nephritis (LN). Presenting concerns of the patient: A 74-year-old male was referred to the nephrology clinic with a rapidly rising creatinine from a baseline of 60 µmol/L to 176 µmol/L...
2018: Canadian Journal of Kidney Health and Disease
Hamid Mohamadlou, Anna Lynn-Palevsky, Christopher Barton, Uli Chettipally, Lisa Shieh, Jacob Calvert, Nicholas R Saber, Ritankar Das
Background: A major problem in treating acute kidney injury (AKI) is that clinical criteria for recognition are markers of established kidney damage or impaired function; treatment before such damage manifests is desirable. Clinicians could intervene during what may be a crucial stage for preventing permanent kidney injury if patients with incipient AKI and those at high risk of developing AKI could be identified. Objective: In this study, we evaluate a machine learning algorithm for early detection and prediction of AKI...
2018: Canadian Journal of Kidney Health and Disease
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