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Canadian Journal of Kidney Health and Disease

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https://www.readbyqxmd.com/read/29774167/complete-hypokalemic-quadriparesis-as-a-first-presentation-of-sj%C3%A3-gren-syndrome
#1
Jason An, Branko Braam
Rationale: We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment. Presenting concerns: A 73-year-old female presented to a peripheral hospital with quadriparesis and a critically low serum potassium of 1.6 mmol/L with U waves on the electrocardiogram (ECG). The initial arterial blood gas showed a pH of 7.19, bicarbonate of 13 mEq/L, and a CO2 of 35 mm Hg...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29662679/validation-of-living-donor-nephrectomy-codes
#2
Ngan N Lam, Krista L Lentine, Scott Klarenbach, Manish M Sood, Paul J Kuwornu, Kyla L Naylor, Gregory A Knoll, S Joseph Kim, Ann Young, Amit X Garg
Background: Use of administrative data for outcomes assessment in living kidney donors is increasing given the rarity of complications and challenges with loss to follow-up. Objective: To assess the validity of living donor nephrectomy in health care administrative databases compared with the reference standard of manual chart review. Design: Retrospective cohort study. Setting: 5 major transplant centers in Ontario, Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29636981/perceived-benefits-and-challenges-of-a-risk-based-approach-to-multidisciplinary-chronic-kidney-disease-care-a-qualitative-descriptive-study
#3
Michelle D Smekal, Helen Tam-Tham, Juli Finlay, Maoliosa Donald, Eleanor Benterud, Chandra Thomas, Robert R Quinn, Kin Tam, Braden J Manns, Marcello Tonelli, Aminu Bello, Navdeep Tangri, Brenda R Hemmelgarn
Background: The kidney failure risk equation (KFRE) provides an estimate of risk of progression to kidney failure, and may guide clinical care. Objective: We aimed to describe patient, family, and health care provider's perspectives of the perceived benefits and challenges of using a risk-based approach to guide care delivery for patients with advanced chronic kidney disease (CKD), and refine implementation based on their input. Methods: We used qualitative methodology to explore perceived benefits and challenges of implementing a risk-based approach (using the KFRE) to determine eligibility for multidisciplinary CKD care in Southern Alberta...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29636980/posttransplant-lymphoproliferative-disorder-in-adults-receiving-kidney-transplantation-in-british-columbia-a-retrospective-cohort-analysis
#4
Erin Ready, Kseniya Chernushkin, Nilufar Partovi, Trana Hussaini, Cindy Luo, Olwyn Johnston, R Jean Shapiro
Background: Posttransplant lymphoproliferative disorder (PTLD) is a major complication following kidney transplantation. Objective: We undertook this study to characterize PTLD in kidney transplant patients in British Columbia with regard to incidence, patient and graft survival, histological subtypes, treatment modalities, and management of immunosuppression. Design: Retrospective cohort analysis. Setting: British Columbia...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29593879/the-role-of-desmopressin-in-the-management-of-severe-hypovolemic-hyponatremia-a-single-center-comparative-analysis
#5
Frank L Ward, Sheldon W Tobe, David M J Naimark
Background: The role of desmopressin (DDAVP) to prevent or treat rapid serum sodium concentration ([Na]s) correction during hyponatremia management remains unclear. Objective: To assess DDAVP use during the first 48 hours of severe, hypovolemic hyponatremia management. The primary study hypothesis was that the use of DDAVP would slow the rate of [Na]s correction compared with those not receiving DDAVP. Design: A retrospective, observational, comparison study...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29581885/an-examination-of-the-application-of-the-kidney-donor-risk-index-in-british-columbia
#6
Caren Rose, Yvonne Sun, Ed Ferre, John Gill, David Landsberg, Jagbir Gill
Background: The Kidney Donor Risk Index (KDRI) is a continuous measure of deceased donor kidney transplant failure risk that was derived in US patients based on 10 donor characteristics. In the United States, the KDRI is utilized to guide organ allocation and to inform clinical decisions regarding organ acceptance. Objective: To examine the application of the US-derived KDRI in a large Canadian province. Patients: All deceased donor kidney-only transplant recipients in British Columbia (BC) between 2005 and 2014...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29581884/the-bc-glomerulonephritis-network-improving-access-and-reducing-the-cost-of-immunosuppressive-treatments-for-glomerular-diseases
#7
Sean Barbour, Clifford Lo, Gabriela Espino-Hernandez, Jagbir Gill, Adeera Levin
Glomerulonephritis (GN) is a common cause of end-stage renal disease in Canada and worldwide, and results in significant health care resource utilization and patient morbidity. However, GN has not been a traditional priority of provincial renal health care organizations, despite the known benefits to health services delivery and patient outcomes from integrated provincial care in other types of chronic kidney disease. To address this deficiency, the British Columbia (BC) Provincial Renal Agency created the BC GN Network in 2013 to coordinate provincial GN health services delivery informed by robust population-level data capture on all GN patients in the province via the BC GN Registry...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29568537/a-province-wide-cross-sectional-study-of-demographics-and-medication-use-of-patients-in-hemodialysis-units-across-ontario
#8
Marisa Battistella, Racquel Jandoc, Jeremy Y Ng, Eric McArthur, Amit X Garg
Background: Hemodialysis patients are at an increased risk of polypharmacy as they have the highest pill burden of all chronically ill patient populations, with an estimated average of 12 medications per day. Objectives: The aim of this study was to evaluate prescribing patterns of outpatient medications in patients receiving in-center hemodialysis. This was done to identify potential candidate medications for future quality improvement initiations to optimize prescribing...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29552348/what-we-do-and-do-not-know-about-women-and-kidney-diseases-questions-unanswered-and-answers-unquestioned-reflection-on-world-kidney-day-and-international-woman-s-day
#9
EDITORIAL
Giorgina B Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin
Background: Chronic kidney disease affects approximately 10% of the world's adult population: It is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus giving an occasion to reflect on open questions on the importance of kidney health in women for the present and the future generations. Objectives: In this review, we summarize some aspects that are unique to women's kidney health, offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29511569/vascular-access-practice-patterns-in-canada-a-national-survey
#10
Chance Dumaine, Mercedeh Kiaii, Lisa Miller, Louise Moist, Matthew J Oliver, Charmaine E Lok, Swapnil Hiremath, Jennifer M MacRae
Background: One of the mandates of the Canadian Society of Nephrology's (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29487746/impact-of-exercise-counseling-on-physical-function-in-chronic-kidney-disease-an-observational-study
#11
Clara J Bohm, Leroy J Storsley, Brett M Hiebert, Serena Nelko, Navdeep Tangri, Lawrence J Cheskin, Mara A McAdams-DeMarco, Claudio Rigatto
Background: Individuals with chronic kidney disease (CKD) have low levels of physical activity and physical function. Although guidelines endorse exercise counseling for individuals with CKD, it is not yet part of routine care. Objective: We investigated the effect of attending a real-life exercise counseling clinic (ECC) on physical function in individuals with CKD. Design: Retrospective analysis of prospectively collected observational data with quasi-experimental design...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29479453/practice-patterns-in-the-treatment-and-monitoring-of-acute-t-cell-mediated-kidney-graft-rejection-in-canada
#12
Julie Leblanc, Peter Subrt, Michèle Paré, David Hartell, Lynne Sénécal, Tom Blydt-Hansen, Héloïse Cardinal
Background: One of the goals of the Canadian National Transplant Research Program (CNTRP) is to develop novel therapies for acute rejection that could positively affect graft outcomes with greater efficacy or less toxicity. To develop innovative management strategies for kidney graft rejection, new modalities need to be compared with current clinical practices. However, there are no standardized practices concerning the management of acute T cell-mediated rejection (TCMR). Objectives: To describe clinicians' practice patterns in the diagnosis, treatment, and monitoring of acute TCMR in Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29449955/prospects-for-precision-medicine-in-glomerulonephritis-treatment
#13
REVIEW
Yulu Cherry Liu, Justin Chun
Background: Glomerulonephritis (GN) consists of a group of kidney diseases that are categorized based on shared histopathological features. The current classifications for GN make it difficult to distinguish the individual variability in presentation, disease progression, and response to treatment. GN is a significant cause of end-stage renal disease (ESRD), and improved therapies are desperately needed because current immunosuppressive therapies sometimes lack efficacy and can lead to significant toxicities...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29399366/nephrology-econsults-for-primary-care-providers-original-investigation
#14
Erin Keely, Jennifer Li, Peter Magner, Amir Afkham, Clare Liddy
Background: The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service allows primary care providers (PCPs) to submit patient-specific clinical questions to specialists via a secure web service. Objective: Our objective was to describe the types of nephrology questions asked through an eConsult service based in eastern Ontario and assess the service's impact on the need for face-to-face consultations. Design: Cross-sectional study using descriptive statistics was conducted using nephrology cases submitted between May 2011 and January 2015...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29399365/urinary-hepcidin-25-is-elevated-in-patients-that-avoid-acute-kidney-injury-following-cardiac-surgery
#15
Nora Choi, Claudio Rigatto, Michael Zappitelli, Ang Gao, Simon Christie, Brett Hiebert, Rakesh C Arora, Julie Ho
Background: Acute kidney injury (AKI) following cardiac surgery leads to increased morbidity and mortality. Characterization and validation of early biomarkers of AKI may ultimately facilitate early therapeutic intervention. We have previously identified that elevated urinary hepcidin-25 is inversely and independently associated with the development of AKI in adult cardiac surgery patients. Hepcidin-25 is an antimicrobial peptide that sequesters iron intracellularly, and its elevation following human ischemia reperfusion injury may represent a renoprotective response to minimize renal injury...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29375884/implementation-and-evaluation-of-a-risk-based-approach-to-guide-chronic-kidney-disease-care-protocol-for-a-multiphase-mixed-methods-study
#16
Brenda R Hemmelgarn, Michelle D Smekal, Robert G Weaver, Chandra Thomas, Eleanor Benterud, Kin Tam, Braden J Manns, Marcello Tonelli, Juli Finlay, Maoliosa Donald, Helen Tam-Tham, Aminu Bello, Navdeep Tangri, Robert R Quinn
Background: Risk prediction tools are used in a variety of clinical settings to guide patient care, although their use in chronic kidney disease (CKD) care is limited. Objectives: To assess the association of a risk-based model of CKD care on patient care, satisfaction, outcomes, and cost. Design: Mixed-methods with a pre-post design. Setting: We will use mixed-methods and a pre-post design to evaluate use of the Kidney Failure Risk Equation (KFRE) to guide CKD care...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29372065/as-in-real-estate-location-is-what-matters-a-case-report-of-transplant-ureteral-obstruction-due-to-an-inguinal-hernia
#17
Ann Bugeja, Edward G Clark, Manish M Sood, Sohrab N Ali
Background: Kidney allograft dysfunction is common and often reversible but can lead to allograft loss if not promptly evaluated. Transplant ureteral obstruction in an inguinal hernia is a rare cause of allograft dysfunction, but early recognition may prevent allograft loss. Case Presentation: We present a case of a man with acute kidney allograft dysfunction who received a deceased donor kidney transplant 6 years earlier for end-stage kidney disease secondary to polycystic kidney disease...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29372064/canadians-seeking-solutions-and-innovations-to-overcome-chronic-kidney-disease-can-solve-ckd-form-and-function
#18
Adeera Levin, Evan Adams, Brendan J Barrett, Heather Beanlands, Kevin D Burns, Helen Hoi-Lun Chiu, Kate Chong, Allison Dart, Jack Ferera, Nicolas Fernandez, Elisabeth Fowler, Amit X Garg, Richard Gilbert, Heather Harris, Rebecca Harvey, Brenda Hemmelgarn, Matthew James, Jeffrey Johnson, Joanne Kappel, Paul Komenda, Michael McCormick, Christopher McIntyre, Farid Mahmud, York Pei, Graham Pollock, Heather Reich, Norman D Rosenblum, James Scholey, Etienne Sochett, Mila Tang, Navdeep Tangri, Marcello Tonelli, Catherine Turner, Michael Walsh, Cathy Woods, Braden Manns
Purpose of review: This article serves to describe the Can-SOLVE CKD network, a program of research projects and infrastructure that has excited patients and given them hope that we can truly transform the care they receive. Issue: Chronic kidney disease (CKD) is a complex disorder that affects more than 4 million Canadians and costs the Canadian health care system more than $40 billion per year. The evidence base for guiding care in CKD is small, and even in areas where evidence exists, uptake of evidence into clinical practice has been slow...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29348925/volume-estimates-in-chronic-hemodialysis-patients-by-the-watson-equation-and-bioimpedance-spectroscopy-and-the-impact-on-the-kt-v-urea-calculation
#19
Nazanin Noori, Ron Wald, Arti Sharma Parpia, Marc B Goldstein
Background: Accurate assessment of total body water (TBW) is essential for the evaluation of dialysis adequacy (Kt/Vurea ). The Watson formula, which is recommended for the calculation of TBW, was derived in healthy volunteers thereby leading to potentially inaccurate TBW estimates in maintenance hemodialysis recipients. Bioimpedance spectroscopy (BIS) may be a robust alternative for the measurement of TBW in hemodialysis recipients. Objectives: The primary objective of this study was to evaluate the accuracy of Watson formula-derived TBW estimates as compared with TBW measured with BIS...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29348924/mortality-and-hospitalizations-in-intensive-dialysis-a-systematic-review-and-meta-analysis
#20
Anna Mathew, Jody-Ann McLeggon, Nirav Mehta, Samuel Leung, Valerie Barta, Thomas McGinn, Gihad Nesrallah
Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence...
2018: Canadian Journal of Kidney Health and Disease
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