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https://www.readbyqxmd.com/read/28255135/patients-blood-pressure-control-and-doctors-adherence-to-hypertension-clinical-practice-guideline-in-managing-patients-at-health-clinics-in-kuala-muda-district-kedah
#1
S H Teoh, A R Razlina, D Norwati, M Y Siti Suhaila
BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined. METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28240423/nutritional-issues-with-incremental-dialysis-the-role-of-low-protein-diets
#2
Francesco Locatelli, Lucia Del Vecchio, Valeria Aicardi
A gentle start of dialysis is a welcome possibility for both patients and physicians. Incident dialysis patients often maintain residual kidney function (RKF) for a considerable period of time; the start of dialysis is often driven mainly by uremic symptoms. Recently, the combination of a low-protein diet, along with a less-frequent dialysis schedule, has regained interest as an alternative option in selected and motivated patients. In addition, there is renewed interest in a low-protein diet in patients with moderate to advanced chronic kidney disease (CKD)...
February 27, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28191531/urine-biomarkers-in-renal-allograft
#3
Hongting Wang, Zuan-Tao Lin, Yulin Yuan, Tianfu Wu
There is a high risk for the survival of patients with an end-stage renal disease for kidney transplantation. To avoid rejection by strict medication adherence is of utmost importance to avoid the failure of a kidney transplant. It is imperative to develop non-invasive biomarkers to assess immunity risk, and to ultimately provide guidance for therapeutic decision-making following kidney transplantation. Urine biomarkers may represent the promising non-invasive tools that will help in predicting risk or success rates of kidney transplantations...
September 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28174318/integrating-quality-improvement-education-into-the-nephrology-curricular-milestones-framework-and-the-clinical-learning-environment-review
#4
Lisa K Prince, Dustin J Little, Katherine I Schexneider, Christina M Yuan
The Accreditation Council for Graduate Medical Education requires that trainees show progressive milestone attainment in the practice-based learning and systems-based practice competencies. As part of the Clinical Learning Environment Review, sponsoring hospitals must educate trainees in health care quality improvement, provide them with specialty-specific quality data, and ensure trainee participation in quality improvement activities and committees. Subspecialty-specific quality improvement curricula in nephrology training programs have not been reported, although considerable curricular and assessment material exists for specialty residencies, including tools for assessing trainee and faculty competence...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28152653/chronic-kidney-disease-progression-a-retrospective-analysis-of-3-year-adherence-to-a-low-protein-diet
#5
Felipe Rizzetto, Viviane de Oliveira Leal, Leonardo Soares Bastos, Denis Fouque, Denise Mafra
The potential benefits and dangers of dietary protein restriction in chronic kidney disease (CKD) are still controversial. Thus, the aim of this study is to evaluate the effect of low protein diet (LPD) on the renal function in nondialysis CKD patients. A retrospective study was conducted from 321 nondialysis CKD patient's medical files (65.1 ± 12.7 yrs, 58.2% men). These patients received individualized dietary protein prescription (0.6-0.8 g protein/kg/day). Protein intake was evaluated by food diary and 24 h-food recall...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28114891/diet-in-chronic-kidney-disease-in-a-mediterranean-african-country
#6
Khawla Kammoun, Hanen Chaker, Hichem Mahfoudh, Nouha Makhlouf, Faical Jarraya, Jamil Hachicha
BACKGROUND: Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake. DISCUSSION: Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures...
January 23, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28052180/advances-in-psoriasis
#7
Jaclyn Smith, Abigail Cline, Steven R Feldman
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28001183/quality-of-life-in-hemodialysis-patients-and-the-relationship-with-mortality-hospitalizations-and-poor-treatment-adherence
#8
Araiê Prado Berger Oliveira, Debora Berger Schmidt, Thaís Malucelli Amatneeks, Jéssica Caroline Dos Santos, Luiza Helena Raittz Cavallet, Renate Brigitte Michel
INTRODUCTION: Chronic kidney disease (CKD) causes sudden changes in the daily lives of patients, creates limitations to perform activities of daily life and creates a great impact on emotions and quality of life (QOL) of patients. OBJECTIVE: To understand the relationship between QOL of patients on dialysis and mortality rates, hospitalization and absences. METHODS: A prospective descriptive study with 286 patients on hemodialysis, by applying demographic questionnaire, KDQOL SF-36 and electronic medical record analysis Dialsist...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27965605/differences-in-knowledge-stress-sensation-seeking-and-locus-of-control-linked-to-dietary-adherence-in-hemodialysis-patients
#9
E Leigh Gibson, Ines Held, Dina Khawnekar, Peter Rutherford
Patients with chronic kidney disease (CKD) often require regular hemodialysis (HD) to prolong life. However, between HD sessions, patients have to restrict their diets carefully to avoid excess accumulation of potassium, phosphate, sodium, and fluid, which their diseased kidneys can no longer regulate. Failure to adhere to their renal dietary regimes can be fatal; nevertheless, non-adherence is common, and yet little is known about the psychological variables that might predict this dietary behavior. Thus, this study aimed to assess whether dietary adherence might be affected by a variety of psychological factors including stress, personality, and health locus of control, as well as dietary knowledge, in chronic HD patients...
2016: Frontiers in Psychology
https://www.readbyqxmd.com/read/27964726/cognition-in-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#10
Israel Berger, Sunny Wu, Philip Masson, Patrick J Kelly, Fiona A Duthie, William Whiteley, Daniel Parker, David Gillespie, Angela C Webster
BACKGROUND: Cognitive impairment is common in people with chronic kidney disease (CKD) and associated with increased morbidity and mortality. Subtle changes can impact engagement with healthcare, comprehension, decision-making, and medication adherence. We aimed to systematically summarise evidence of cognitive changes in CKD. METHODS: We searched MEDLINE (March 2016) for cross-sectional, cohort or randomised studies that measured cognitive function in people with CKD (PROSPERO, registration number CRD42014015226)...
December 14, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27895136/recognition-and-management-of-resistant-hypertension
#11
REVIEW
Branko Braam, Sandra J Taler, Mahboob Rahman, Jennifer A Fillaus, Barbara A Greco, John P Forman, Efrain Reisin, Debbie L Cohen, Mohammad G Saklayen, S Susan Hedayati
Despite improvements in hypertension awareness and treatment, 30%-60% of hypertensive patients do not achieve BP targets and subsequently remain at risk for target organ damage. This therapeutic gap is particularly important to nephrologists, who frequently encounter treatment-resistant hypertension in patients with CKD. Data are limited on how best to treat patients with CKD and resistant hypertension, because patients with CKD have historically been excluded from hypertension treatment trials. First, we propose a consistent definition of resistant hypertension as BP levels confirmed by both in-office and out-of-office measurements that exceed appropriate targets while the patient is receiving treatment with at least three antihypertensive medications, including a diuretic, at dosages optimized to provide maximum benefit in the absence of intolerable side effects...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27856633/effects-of-vitamin-d-receptor-activation-and-dietary-sodium-restriction-on-residual-albuminuria-in-ckd-the-virtue-ckd-trial
#12
Charlotte A Keyzer, G Fenna van Breda, Marc G Vervloet, Maarten A de Jong, Gozewijn D Laverman, Marc H Hemmelder, Wilbert M T Janssen, Hiddo J Lambers Heerspink, Arjan J Kwakernaak, Stephan J L Bakker, Gerjan Navis, Martin H de Borst
Reduction of residual albuminuria during single-agent renin-angiotensin-aldosterone blockade is accompanied by improved cardiorenal outcomes in CKD. We studied the individual and combined effects of the vitamin D receptor activator paricalcitol (PARI) and dietary sodium restriction on residual albuminuria in CKD. In a multicenter, randomized, placebo (PLAC)-controlled, crossover trial, 45 patients with nondiabetic CKD stages 1-3 and albuminuria >300 mg/24 h despite ramipril at 10 mg/d and BP<140/90 mmHg were treated for four 8-week periods with PARI (2 μg/d) or PLAC, each combined with a low-sodium (LS) or regular sodium (RS) diet...
November 17, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27825313/using-pharmacists-to-improve-risk-stratification-and-management-of-stage-3a-chronic-kidney-disease-a-feasibility-study
#13
Alex R Chang, Michael Evans, Christina Yule, Larissa Bohn, Amanda Young, Meredith Lewis, Elisabeth Graboski, Bethany Gerdy, William Ehmann, Jonathan Brady, Leah Lawrence, Natacha Antunes, Jamie Green, Susan Snyder, H Lester Kirchner, Morgan Grams, Robert Perkins
BACKGROUND: Measurement of albuminuria to stratify risk in chronic kidney disease (CKD) is not done universally in the primary care setting despite recommendation in KDIGO (Kidney Disease Improving Global Outcomes) guidelines. Pharmacist medication therapy management (MTM) may be helpful in improving CKD risk stratification and management. METHODS: We conducted a pragmatic, cluster-randomized trial using seven primary care clinic sites in the Geisinger Health System to evaluate the feasibility of pharmacist MTM in patients with estimated glomerular filtration rate (eGFR) 45-59 ml/min/1...
November 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27810277/-community-pharmacists-interventions-to-prevent-and-screen-chronic-kidney-disease-patients
#14
Stéphanie Belaiche, Edwige Mercier, Damien Cuny, Nicolas Kambia, Patrick Wierre, Élisabeth Bertoux, Daniel Mascaut, Raymond Azar, Pierre Bataille, Franck Bourdon, Évelyne Mac Namara, Nathalie Maisonneuve, Bernard Painchart, Laurence Vrigneau, Christian Noël, Bertrand Décaudin, François Glowacki
Chronic kidney disease (CKD) is a major concern of public health. The pharmacist is known as a health practitioner involved in prevention and therapeutic education. Our study aimed at defining the impact of community pharmacists' interventions for preventing and screening CKD. In our observational prospective study of 5 months conducted in 109 community pharmacy, we included 2 groups of patients: A (therapeutic optimization): CKD patients and B (CKD screening): population at risk. In group A, we included 354 patients, mainly women (51...
October 31, 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#15
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754003/js-ish-isn-2-role-of-the-kidney-in-resistant-hypertension-why-so-resistant-to-bp-control-in-ckd-patients
#16
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27721548/prescribing-patterns-of-medicines-in-chronic-kidney-disease-patients-on-maintenance-hemodialysis
#17
Sourav Chakraborty, Saugata Ghosh, Avishek Banerjea, Radha Raman De, Avijit Hazra, Swapan Kumar Mandal
OBJECTIVES: To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis. MATERIALS AND METHODS: This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients' clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item...
September 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/27707612/prevalence-of-treatment-resistant-hypertension-and-important-associated-factors-results-from-the-swedish-primary-care-cardiovascular-database
#18
Lina Holmqvist, Kristina Bengtsson Boström, Thomas Kahan, Linus Schiöler, Jan Hasselström, Per Hjerpe, Björn Wettermark, Karin Manhem
We aimed to describe the prevalence, treatment, and associated comorbidity of treatment-resistant hypertension (TRH). This registry-based cohort study from The Swedish Primary Care Cardiovascular Database assessed 53,090 hypertensive patients attending primary care. Patients adherent to antihypertensive treatment measured by pharmacy fills and with proportion of days covered ≥80% were included. The prevalence of TRH was 17% when considering all current TRH definitions. Adherence to mineralocorticoid receptor antagonists differed between TRH- and non-TRH patients (8 vs...
September 6, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27671037/assessing-outcomes-of-enhanced-chronic-disease-care-through-patient-education-and-a-value-based-formulary-study-access-study-protocol-for-a-2%C3%A3-2-factorial-randomized-trial
#19
David J T Campbell, Marcello Tonelli, Brenda Hemmelgarn, Chad Mitchell, Ross Tsuyuki, Noah Ivers, Tavis Campbell, Raj Pannu, Eric Verkerke, Scott Klarenbach, Kathryn King-Shier, Peter Faris, Derek Exner, Vikas Chaubey, Braden Manns
BACKGROUND: Chronic diseases result in significant morbidity and costs. Although medications and lifestyle changes are effective for improving outcomes in chronic diseases, many patients do not receive these treatments, in part because of financial barriers, patient and provider-level knowledge gaps, and low patient motivation. The Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS) will determine the impact of two interventions: (1) a value-based formulary which eliminates copayment for high-value preventive medications; and (2) a comprehensive self-management support program aimed at promoting health behavior change and medication adherence, combined with relay of information on medication use to healthcare providers, on cardiovascular events and/or mortality in low-income seniors with elevated cardiovascular risk...
September 26, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27648739/medication-taking-behaviours-in-chronic-kidney-disease-with-multiple-chronic-conditions-a-meta-ethnographic-synthesis-of-qualitative-studies
#20
REVIEW
Rebecca J Bartlett Ellis, Janet L Welch
AIMS AND OBJECTIVES: To identify behaviours associated with taking medications and medication adherence reported in qualitative studies of adults with chronic kidney disease and coexisting multiple chronic conditions. BACKGROUND: To inform medication adherence interventions, information is needed to clarify the nature of the relationships between behaviours that support medication-taking and medication adherence in multiple chronic conditions. DESIGN: Meta-ethnographic review and synthesis...
March 2017: Journal of Clinical Nursing
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