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Canadian Journal of Kidney Health and Disease

Tharshika Thangarasa, Rameez Imtiaz, Swapnil Hiremath, Deborah Zimmerman
BACKGROUND: Patients with chronic diseases are known to benefit from exercise. Despite a lack of compelling evidence, patients with end-stage kidney disease treated with peritoneal dialysis are often discouraged from participating in exercise programs that include resistance training due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for these patients remain unclear. The purpose of this study is to more completely define the risks and benefits of physical activity in the end-stage kidney disease population treated with peritoneal dialysis...
2017: Canadian Journal of Kidney Health and Disease
Georges Ambaraghassi, Héloïse Cardinal, Daniel Corsilli, Claude Fortin, Marie-Chantal Fortin, Valérie Martel-Laferrière, Jacques Malaise, Michel R Pâquet, Danielle Rouleau
RATIONALE: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression...
2017: 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
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disorder worldwide. The disease is characterized by renal cysts and progressive renal failure due to progressive enlargement of cysts and renal fibrosis. An estimated 45% to 70% of patients with ADPKD progress to end-stage renal disease by age 65 years. Although both targeted and nontargeted therapies have been tested in patients with ADPKD, tolvaptan is currently the only pharmacological therapy approved in Canada for the treatment of ADPKD...
2017: Canadian Journal of Kidney Health and Disease
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
Navdeep Tangri, Ingrid Hougen, Ahsan Alam, Ronald Perrone, Phil McFarlane, York Pei
PURPOSE OF REVIEW: Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by the formation of kidney cysts and kidney enlargement, which progresses to kidney failure by the fifth to seventh decade of life in a majority of patients. Disease progression is evaluated primarily through serum creatinine and estimated glomerular filtration rate (eGFR) measurements; however, it is known that serum creatinine and eGFR values typically do not change until the fourth or fifth decade of life...
2017: Canadian Journal of Kidney Health and Disease
Elizabeth Sunmin Lee, Christine P Collier, Christine A White
BACKGROUND: The international initiative to standardize creatinine (Cr) assays by tracing reference materials to Isotope Dilution Mass Spectrometry (IDMS) assigned values was implemented to reduce interlaboratory variability and improve assay accuracy. OBJECTIVE: The aims of this study were to examine whether IDMS standardization has improved Cr assay accuracy (bias), interlaboratory variability (precision), total error (TE), and attainment of recommended analytical performance goals...
2017: Canadian Journal of Kidney Health and Disease
Rashid Alobaidi, Catherine Morgan, Rajit K Basu, Erin Stenson, Robin Featherstone, Sumit R Majumdar, Sean M Bagshaw
BACKGROUND: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. OBJECTIVES: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children...
2017: Canadian Journal of Kidney Health and Disease
Louis-Philippe Laurin, Patrick H Nachman, Bethany J Foster
PURPOSE OF REVIEW: Primary focal segmental glomerulosclerosis (FSGS) is the most common cause of nephrotic syndrome in adults. Glucocorticoids have been evaluated in the treatment of primary FSGS in numerous retrospective studies. Evidence suggesting a role for including calcineurin inhibitors (CNIs) in early therapy remains limited. The aim of this study was to systematically review the literature examining the efficacy of CNIs in the treatment of primary FSGS both as first-line therapy and as an adjunctive agent in steroid-resistant patients, with respect to remission in proteinuria and renal survival...
2017: Canadian Journal of Kidney Health and Disease
Kevin D Burns, Adeera Levin, Elisabeth Fowler, Leah Butcher, Marc Turcotte, Mary-Jo Makarchuk, Benoît Macaluso, Vincent Larivière, Philip M Sherman
BACKGROUND: The Kidney Research Scientist Core Education and National Training (KRESCENT) Program was launched in 2005 to enhance kidney research capacity in Canada and foster knowledge translation across the 4 themes of health research. OBJECTIVE: To evaluate the impact of KRESCENT on its major objectives and on the careers of trainees after its first 10 years. METHODS: An online survey of trainees (n = 53) who had completed or were enrolled in KRESCENT was conducted in 2015...
2017: Canadian Journal of Kidney Health and Disease
Kelly R McMahon, Shahrad Rod Rassekh, Kirk R Schultz, Maury Pinsk, Tom Blydt-Hansen, Cherry Mammen, Ross T Tsuyuki, Prasad Devarajan, Geoff D E Cuvelier, Lesley G Mitchell, Sylvain Baruchel, Ana Palijan, Bruce C Carleton, Colin J D Ross, Michael Zappitelli
BACKGROUND: Childhood cancer survivors experience adverse drug events leading to lifelong health issues. The Applying Biomarkers to Minimize Long-Term Effects of Childhood/Adolescent Cancer Treatment (ABLE) team was established to validate and apply biomarkers of cancer treatment effects, with a goal of identifying children at high risk of developing cancer treatment complications associated with thrombosis, graft-versus-host disease, hearing loss, and kidney damage. Cisplatin is a chemotherapy well known to cause acute and chronic nephrotoxicity...
2017: Canadian Journal of Kidney Health and Disease
Amber O Molnar, Carl van Walraven, Dean Fergusson, Amit X Garg, Greg Knoll
BACKGROUND: Acute kidney injury (AKI) is common in the kidney transplant population. OBJECTIVE: To derive a multivariable survival model that predicts time to graft loss following AKI. DESIGN: Retrospective cohort study using health care administrative and laboratory databases. SETTING: Southwestern Ontario (1999-2013) and Ottawa, Ontario, Canada (1996-2013). PATIENTS: We included first-time kidney only transplant recipients who had a hospitalization with AKI 6 months or greater following transplant...
2017: Canadian Journal of Kidney Health and Disease
Mirela Maier, Tomoko Takano, Ruth Sapir-Pichhadze
PURPOSE OF REVIEW: P4 medicine denotes an evolving field of medicine encompassing predictive, preventive, personalized, and participatory medicine. Using the example of kidney allograft rejection because of donor-recipient incompatibility in human leukocyte antigens, this review outlines P4 medicine's relevance to the various stages of the kidney transplant cycle. SOURCES OF INFORMATION: A search for English articles was conducted in Medline via OvidSP (up to August 18, 2016) using a combination of subject headings (MeSH) and free text in titles, abstracts, and author keywords for the concepts kidney transplantation and P4 medicine...
2017: Canadian Journal of Kidney Health and Disease
Ariel Lefkowitz, Blair Henry, Jennifer Bottoms, Jeffery Myers, David M J Naimark
BACKGROUND: Patient-centered care requires knowledge of patients' goals of care (GoC) on the part of health care providers (HCPs). Whether HCPs caring for in-center hemodialysis patients meet this criterion is uncertain. OBJECTIVE: We designed and conducted a GoC survey among patients and HCPs within a single in-center hemodialysis (ICHD) program to determine whether HCPs have an understanding of their patients' GoC. DESIGN: This was a prospective comparative quantitative survey study...
2016: Canadian Journal of Kidney Health and Disease
Nikhil Shah, Prenilla Naidu, Robert P Pauly
BACKGROUND: Abiotrophia defectiva is a fastidious aerobic gram-positive bacterium which is part of the normal flora of the human oral cavity. It is an unusual cause of peritoneal dialysis-related peritonitis. CASE PRESENTATION: We present a case of a man in his fifties with end-stage renal failure secondary to polycystic kidney disease who presented with a cloudy peritoneal fluid effluent and a cell count of 35 620 × 10(6) cells/L with 90% polymorphonuclear cells...
2016: Canadian Journal of Kidney Health and Disease
Deep Jaiswal, Drea Uzans, Jill Hayden, Bryce A Kiberd, Karthik K Tennankore
BACKGROUND: Patients undergoing hemodialysis or peritoneal dialysis often experience pruritus which is associated with morbidity and mortality. One proposed treatment approach is to target the opioid pathway using either µ-opioid antagonists or κ-opioid agonists. OBJECTIVE: To review the efficacy of targeting the opioid pathway for pruritus among dialysis patients (uremic pruritus). DESIGN: Systematic review and meta-analysis. SETTING/METHODS: The systematic review included randomized controlled and randomized crossover trials identified in the MEDLINE, EMBASE, and Cochrane databases (1990 to June 2014) evaluating the efficacy of µ-opioid antagonists or κ-opioid agonists in the treatment of uremic pruritus...
2016: Canadian Journal of Kidney Health and Disease
Gabriel Chan, Mikael Soucisse
BACKGROUND: Obesity is associated with increased surgical complications and long-term cardiovascular mortality. Studies of access in kidney transplantation have found a bias against obese patients on the wait-listing. OBJECTIVE: To determine the current state of clinical practice for the management of obesity in kidney transplantation. DESIGN: A survey in two versions, PDF and traditional paper, composed of categorical questions. SETTING: A pan-Canadian survey of transplant nephrologists and surgeons...
2016: Canadian Journal of Kidney Health and Disease
Srinivasan Beddhu, Rebecca Filipowicz, Bin Wang, Guo Wei, Xiaorui Chen, Abinash C Roy, Scott L DuVall, Hanadi Farrukh, Arsalan N Habib, Terrence Bjordahl, Debra L Simmons, Mark Munger, Greg Stoddard, Donald E Kohan, Tom Greene, Yufeng Huang
BACKGROUND: In observational studies, higher uric acid levels are associated with metabolic syndrome, diabetes, and kidney disease. OBJECTIVE: The objective of this study is to examine whether reduction of plasma uric acid with febuxostat, a xanthine oxido reductase inhibitor, impacts adipose tissue oxidative stress, adipokines, and markers of systemic inflammation or kidney fibrosis. DESIGN: This was a double-blinded randomized controlled trial...
2016: Canadian Journal of Kidney Health and Disease
Lisa Miller, Jennifer MacRae
No abstract text is available yet for this article.
2016: Canadian Journal of Kidney Health and Disease
Lisa M Miller, Jennifer M MacRae, Mercedeh Kiaii, Edward Clark, Christine Dipchand, Joanne Kappel, Charmaine Lok, Rick Luscombe, Louise Moist, Matthew Oliver, Pamela Pike, Swapnil Hiremath
Noninfectious hemodialysis catheter complications include catheter dysfunction, catheter-related thrombus, and central vein stenosis. The definitions, causes, and treatment strategies for catheter dysfunction are reviewed below. Catheter-related thrombus is a less common but serious complication of catheters, requiring catheter removal and systemic anticoagulation. In addition, the risk factors, clinical manifestation, and treatment options for central vein stenosis are outlined.
2016: Canadian Journal of Kidney Health and Disease
Lisa M Miller, Edward Clark, Christine Dipchand, Swapnil Hiremath, Joanne Kappel, Mercedeh Kiaii, Charmaine Lok, Rick Luscombe, Louise Moist, Matthew Oliver, Jennifer MacRae
Catheter-related bloodstream infections, exit-site infections, and tunnel infections are common complications related to hemodialysis central venous catheter use. The various definitions of catheter-related infections are reviewed, and various preventive strategies are discussed. Treatment options, for both empiric and definitive infections, including antibiotic locks and systemic antibiotics, are reviewed.
2016: Canadian Journal of Kidney Health and Disease
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