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https://www.readbyqxmd.com/read/28092350/long-term-renal-survival-in-patients-undergoing-t-cell-depleted-versus-conventional-hematopoietic-stem-cell-transplants
#1
I G Glezerman, S Devlin, M Maloy, M Bui, E A Jaimes, S A Giralt, A A Jakubowski
Calcineurin inhibitor (CNI)-sparing T-cell depleted (TCD) hematopoietic stem cell transplants (HSCTs) are presumed to be less nephrotoxic than conventional HSCTs. We evaluated incidence and risk factors for kidney failure and chronic kidney disease (CKD) in 231 TCD and 212 conventional HSCT recipients. Kidney failure required a median glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) for ⩾100 days anytime after 180-days post-HSCT. Two-year cumulative incidence (CI) of kidney failure was 42% in the conventional versus 31% in the TCD group (P=0...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28092113/hemodialysis-treatment-time-as-important-as-it-seems
#2
John T Daugirdas
Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function...
January 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28091752/management-of-secondary-hyperparathyroidism-practice-patterns-and-outcomes-of-cinacalcet-treatment-with-or-without-active-vitamin%C3%A2-d-in-austria-and-switzerland-the-observational-transit-study
#3
Wolfgang Pronai, Alexander R Rosenkranz, Andreas Bock, Renate Klauser-Braun, Christine Jäger, Gunther Pendl, Margit Hemetsberger, Karl Lhotta
Secondary hyperparathyroidism is a complex disorder requiring an individualized multicomponent treatment approach. This study was conducted to identify treatment combinations used in clinical practice in Austria and Switzerland and the potential to control this disorder. A total of 333 adult hemodialysis and peritoneal dialysis patients were analyzed. All patients received conventional care prior to initiation of a cinacalcet-based regimen. During the study, treatment components, e.g. cinacalcet, active vitamin D analogues and phosphate binders, were adapted to individual patient requirements and treatment dynamics were documented...
January 13, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28091436/acute-kidney-injury-in-lagos-pattern-outcomes-and-predictors-of-in-hospital-mortality
#4
B T Bello, A A Busari, C O Amira, Y R Raji, R W Braimoh
CONTEXT: The pattern of acute kidney injury (AKI) differs significantly between developed and developing countries. AIMS: The aim of th study was to determine the pattern and clinical outcomes of AKI in Lagos, Southwest Nigeria. SETTINGS AND DESIGN: A retrospective review of hospital records of all patients with a diagnosis of AKI over a 20-month period. SUBJECTS AND METHODS: Records of 54 patients were reviewed. Information retrieved included, bio-data, etiology of AKI, results of laboratory investigations, and patient outcomes...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090764/incremental-and-infrequent-hemodialysis-a-new-paradigm-for-both-dialysis-initiation-and-conservative-management
#5
Connie M Rhee, Mehrdad Ghahremani-Ghajar, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Registry or national dialysis data show that a sizeable proportion of contemporary dialysis patients have substantial levels of residual kidney function especially upon transitioning to dialysis therapy. However, among incident hemodialysis patients, the prevailing paradigm has been to initiate "full-dose" thrice-weekly treatment schedules irrespective of native kidney function in most developed countries. Recognizing the benefits of residual kidney function upon the health and survival of dialysis patients, there has been growing interest in incremental hemodialysis, in which dialysis frequency and dose are tailored according to the degree of patients' residual kidney function...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#6
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28089754/stem-cell-therapy-an-emerging-modality-in-glomerular-diseases
#7
REVIEW
Umang G Thakkar, Aruna V Vanikar, Hargovind L Trivedi
The kidney has been considered a highly terminally differentiated organ with low proliferative potential and thus unlikely to undergo regeneration. Glomerular disease progresses to end-stage renal disease (ESRD), which requires dialysis or renal transplantation for better quality of life for patients with ESRD. Because of the shortage of implantable kidneys and complications such as immune rejection, septicemia and toxicity of immunosuppression, kidney transplantation remains a challenge. Therapeutic options available for glomerular disease include symptomatic treatment and strategies to delay progression...
January 12, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28089477/bioimpedance-and-fluid-status-in-children-and-adolescents-treated-with-dialysis
#8
Gregorio P Milani, Jaap W Groothoff, Federica A Vianello, Emilio F Fossali, Fabio Paglialonga, Alberto Edefonti, Carlo Agostoni, Dario Consonni, Dewi van Harskamp, Johannes B van Goudoever, Henk Schierbeek, Michiel J S Oosterveld
BACKGROUND: Assessment of hydration status in patients with chronic kidney failure treated by dialysis is crucial for clinical management decisions. Dilution techniques are considered the gold standard for measurement of body fluid volumes, but they are unfit for day-to-day care. Multifrequency bioimpedance has been shown to be of help in clinical practice in adults and its use in children and adolescents has been advocated. We investigated whether application of multifrequency bioimpedance is appropriate for total-body water (TBW) and extracellular water (ECW) measurement in children and adolescents on dialysis therapy...
January 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28089476/serum-asymmetric-and-symmetric-dimethylarginine-and-morbidity-and-mortality-in-hemodialysis-patients
#9
Tariq Shafi, Thomas H Hostetter, Timothy W Meyer, Seungyoung Hwang, Xin Hai, Michal L Melamed, Tanushree Banerjee, Josef Coresh, Neil R Powe
BACKGROUND: Asymmetric (ADMA) and symmetric dimethylarginine (SDMA) are putative uremic toxins that may exert toxicity by a number of mechanisms, including impaired nitric oxide synthesis and generation of reactive oxygen species. The study goal was to determine the association between these metabolites and cardiovascular outcomes in hemodialysis patients. STUDY DESIGN: Post hoc analysis of the Hemodialysis (HEMO) Study. SETTING & PARTICIPANTS: 1,276 prevalent hemodialysis patients with available samples 3 to 6 months after randomization...
January 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28088776/prognostic-utility-of-estimated-albumin-excretion-rate-in-chronic-kidney-disease-results-from-the-study-of-heart-and-renal-protection
#10
Marion M Mafham, Natalie Staplin, Jonathan Emberson, Richard Haynes, William Herrington, Christina Reith, Christoph Wanner, Robert Walker, Alan Cass, Adeera Levin, Bengt Fellström, Lixin Jiang, Hallvard Holdaas, Bertram Kasiske, David C Wheeler, Martin J Landray, Colin Baigent
BACKGROUND: Estimated albumin excretion rate (eAER) provides a better estimate of 24-h albuminuria than albumin:creatinine ratio (ACR). However, whether eAER is superior to ACR in predicting end-stage renal disease (ESRD), vascular events (VEs) or death is uncertain. METHODS: The prognostic utility of ACR and eAER (estimated from ACR, sex, age and race) to predict mortality, ESRD and VEs was compared using Cox proportional hazards regression among 5552 participants with chronic kidney disease in the Study of Heart and Renal Protection, who were not on dialysis at baseline...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28087911/-aortic-stiffness-and-its-influencing-factors-in-patients-with-chronic-kidney-disease
#11
Binxian Ye, Li Zhao, Wei Shen, Yan Ren, Bo Lin, Maosheng Chen, Junda Tang, Xinxin Jiang, Yiwen Li, Qiang He
Objective: To investigate the changes of aortic stiffness and its influencing factors in patients with chronic kidney diseases (CKD). Methods: Eightyfour patients with CKD from Department of Nephrology, Zhejiang Provincial People's Hospital were divided into the dialysis group (CKD stage 5, n=48) and non-dialysis group (CKD stage 3-5, n=36). Clinical data, biochemical parameters and echocardiography findings were collected. SphygmoCor pulse wave analysis system was used to obtain pulse wave analysis (PWA) parameters including central aortic systolic blood pressure (CSP), central pulse pressure (CPP), augmented pressure (AP), augmentation index (AIX), and heart rate 75-adjusted augmentation index (HR75AIX)...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28081061/vital-signs-decrease-in-incidence-of-diabetes-related-end-stage-renal-disease-among-american-indians-alaska-natives-united-states-1996-2013
#12
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28078749/total-phosphate-elimination-is-negatively-associated-with-increased-serum-fibroblast-growth-factor-23-levels-in-patients-who-undergo-peritoneal-dialysis
#13
Shunsuke Yamada, Kazuhiko Tsuruya, Masanori Tokumoto, Hisako Yoshida, Narihito Tatsumoto, Hiroaki Ooboshi, Takanari Kitazono
As fibroblast growth factor 23 (FGF23) has been shown to induce cardiovascular disease directly in patients with chronic kidney disease, identification of factors and treatments that can modulate serum FGF23 (sFGF23) level is clinically important. This retrospective longitudinal study investigated factors that modulate sFGF23 in 49 patients who underwent peritoneal dialysis (PD). sFGF23 ratio (sFGF23 at 18 months/baseline sFGF23) was used as an indicator of changes in sFGF23 level. Total phosphate elimination was the sum of both renal phosphate excretion and dialysate phosphate elimination...
January 12, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28078211/a-case-series-of-the-safety-and-efficacy-of-testosterone-replacement-therapy-in-renal-failure-and-kidney-transplant-patients
#14
Ahmad Majzoub, Daniel A Shoskes
BACKGROUND: Hypogonadism is common in patients with renal dysfunction and does not always correct following transplantation. Recent studies show increased mortality for dialysis and transplant patients with low testosterone (T). These patients are often not treated due to concerns over efficacy and complications (both real and imagined). There is surprisingly scant literature supporting the use of T therapy in these patients. We wished to examine the results of T therapy in our patients with renal failure or following transplant...
December 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28077806/low-protein-diet-for-the-prevention-of-renal-failure
#15
Shaw Watanabe
The prevalence of chronic kidney disease (CKD) is estimated to be 8-16% worldwide, and it is increasing. CKD is a risk factor for heart attack and stroke, and it can progress to kidney failure requiring dialysis or transplantation. Recently, diabetic nephropathy has become the most common cause of CKD. In Japan, the cumulative probability of requiring hemodialysis by the age 80 years is 1/50 in males and 1/100 in females. The number of patients under hemodialysis in Japan exceeded 320,000 in 2014, among which 38,000 were newcomers and 27,000 died...
2017: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#16
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077142/steroid-withdrawal-after-renal-transplantation-a-retrospective-cohort-study
#17
Maria C Haller, Michael Kammer, Alexander Kainz, Heather J Baer, Georg Heinze, Rainer Oberbauer
BACKGROUND: Immunosuppressive regimens in renal transplantation frequently contain corticosteroids, but many centers withdraw steroids as a consequence of unwanted side effects of steroids. The optimal timing to withdraw steroids after transplantation, however, remains unclear. The aim of this study was to determine an optimal time point following kidney transplantation that is associated with reduced mortality without jeopardizing the allograft to allow safe discontinuation of steroids...
January 12, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#18
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28075321/effects-of-exercise-and-lifestyle-intervention-on-oxidative-stress-in-chronic-kidney-disease
#19
David M Small, Kassia S Beetham, Erin J Howden, David R Briskey, David W Johnson, Nicole M Isbel, Glenda C Gobe, Jeff S Coombes
OBJECTIVES: Determine the effects of a 12-month exercise and lifestyle intervention program on changes in plasma biomarkers of oxidative stress in pre-dialysis chronic kidney disease (CKD) patients. METHODS: A total of 136 stage 3-4 CKD patients were randomized to receive standard nephrological care with (N = 72) or without (N = 64) a lifestyle and exercise intervention for 12 months. Plasma total F2-isoprostanes (IsoP), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC), anthropometric and biochemical data were collected at baseline and at 12 months...
January 11, 2017: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/28074773/low-dose-dialysis-combined-with-low-protein-intake-can-maintain-nitrogen-balance-in-peritoneal-dialysis-patients-in-poor-economies%C3%A2
#20
Chun-Yan Su, Tao Wang, Xin-Hong Lu, Sha Ma, Wen Tang, Pei-Yu Wang
OBJECTIVE: Due to limited economic conditions, we tried to provide "fitted" dialysis doses instead of the doses recommended by the international guidelines to the individual patients. In the present cross-sectional study, we studied the dialysis adequacy and nutritional status of 5 peritoneal dialysis patients who had a low dialysis dose (2 bags, 4,000 mL/day). METHODS: The 3-day dietary records were reviewed to calculate patients' energy, protein, and nitrogen intake (NI)...
February 2017: Clinical Nephrology
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