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Canadian Journal of Kidney Health and Disease

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
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
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
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
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
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
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
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
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
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
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/V urea ). 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
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
Amit X Garg, Nadine Shehata, Shay McGuinness, Richard Whitlock, Dean Fergusson, Ron Wald, Chirag Parikh, Sean M Bagshaw, Boris Khanykin, Alex Gregory, Summer Syed, Gregory M T Hare, Meaghan S Cuerden, Kevin E Thorpe, Judith Hall, Subodh Verma, Pavel S Roshanov, Jessica M Sontrop, C David Mazer
Background: When safe to do so, avoiding blood transfusions in cardiac surgery can avoid the risk of transfusion-related infections and other complications while protecting a scarce resource and reducing costs. This protocol describes a kidney substudy of the Transfusion Requirements in Cardiac Surgery III (TRICS-III) trial, a multinational noninferiority randomized controlled trial to determine whether the risk of major clinical outcomes in patients undergoing planned cardiac surgery with cardiopulmonary bypass is no greater with a restrictive versus liberal approach to red blood cell transfusion...
2018: Canadian Journal of Kidney Health and Disease
Anna T Mathew, Joonho Park, Mala Sachdeva, Manish M Sood, Karen Yeates
Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study...
2018: Canadian Journal of Kidney Health and Disease
Jeffery M Patterson, Lauren Bolster, Loree Larratt
Rationale: Atypical hemolytic uremic syndrome, which has a high probability of chronic kidney disease, morbidity, and mortality, needs to be promptly recognized when patients present with microangiopathic hemolysis. Presenting Concerns of the Patient: Three patients present with laboratory parameters consistent with a thrombotic microangiopathy. With a suspected diagnosis of thrombotic thrombocytopenic purpura, steroids with plasmapheresis were initiated. Diagnoses: With ADAMTS13 levels reported normal, the suspected diagnoses were reevaluated...
2018: Canadian Journal of Kidney Health and Disease
Anne Tsampalieros, Gregory A Knoll, Nicholas Fergusson, Alexandria Bennett, Monica Taljaard, Dean Fergusson
Background: Kidney transplantation is the best treatment option for patients with end-stage renal disease. While patient-level factors affecting survival are established, the presence of variation in the management of transplant recipients remains unknown. Objective: The objective of this study was to examine center variation in kidney transplantation and identify center and provider characteristics that may be associated with clinical outcomes. Design: This is a systematic review...
2017: Canadian Journal of Kidney Health and Disease
Amber O Molnar, Moumita Barua, Ana Konvalinka, Kara Schick-Makaroff
Purpose of Review: Patient engagement in research is increasingly recognized as an important component of the research process and may facilitate translation of research findings. To heighten awareness on this important topic, this review presents opportunities and challenges of patient engagement in research, drawing on specific examples from 4 areas of Canadian kidney research conducted by New Investigators in the Kidney Research Scientist Core Education and National Training (KRESCENT) Program...
2017: Canadian Journal of Kidney Health and Disease
Jérôme Pineault, Caroline Lamarche, Robert Bell, Jean-Philippe Lafrance, Georges Ouellet, Martine Leblanc, Vincent Pichette, Sarah Bezzaoucha, Michel Vallée
Background: Neutrophil-to-lymphocyte ratio (NLR) was widely studied as a prognostic marker in various medical and surgical specialties, but its significance in nephrology is not yet established. Objective: We evaluated its accuracy as an inflammation biomarker in a dialysis population. Design setting: Single-center retrospective study. Patients: The records of all 550 patients who were treated with hemodialysis (HD) or peritoneal dialysis (PD) from September 2008 to March 2011 were included...
2017: Canadian Journal of Kidney Health and Disease
Sharanya Ramesh, Matthew T James, Jayna M Holroyd-Leduc, Stephen B Wilton, Ellen W Seely, David C Wheeler, Sofia B Ahmed
Background: Chronic kidney disease (CKD) in reproductive-age women is accompanied by menstrual and fertility disorders and premature menopause. Objective: We sought to determine nephrologists' and allied health care providers' perceptions on management of sex hormone status in women with CKD. Methods: An anonymous, Internet-based survey was sent to nephrology society members from Canada, Australia, New Zealand, and the United Kingdom, and the Canadian Association of Nephrology Nurses and Technologists (February-November 2015)...
2017: Canadian Journal of Kidney Health and Disease
Alvin Ho-Ting Li, Ahmed A Al-Jaishi, Matthew Weir, Ngan N Lam, Janet Maclean, Sonny Dhanani, S Joseph Kim, Greg Knoll, Amit X Garg
Background: Many families choose not to consent to organ donation at the time of their loved one's death. In Ontario, Canada, whether these decisions vary by ethnicity remains unclear. Objective: To compare the proportion of families of immigrants who consented for deceased organ donation with families of long-term residents. Design: Population-based retrospective cohort study. Setting: Potential donors in Ontario, Canada, between November 2008 and March 2013...
2017: Canadian Journal of Kidney Health and Disease
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