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https://www.readbyqxmd.com/read/28794287/point-of-care-ultrasonography-is-it-time-nephrologists-were-equipped-with-the-21th-century-s-stethoscope
#1
Afagh Hassanzadeh Rad, Hamidreza Badeli
In the past 3 decades, ultrasonography has gifted internal organs visualization to physicians to have a better detection of various diseases. Previously performed solely by radiologists as a method with high feasibility and accuracy, recently ultrasonography is being recommended and used by many other physicians in practice. Ultrasonography not only can be used to diagnose and manage kidney diseases, but also is an essential tool in nephrology for the guidance of invasive procedures. This method of bedside ultrasonography by physicians in real time is called point-of-care ultrasonography (POCUS)...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28779782/future-research-directions-to-improve-fistula-maturation-and-reduce-access-failure
#2
REVIEW
Haidi Hu, Sandeep Patel, Jesse J Hanisch, Jeans M Santana, Takuya Hashimoto, Hualong Bai, Tambudzai Kudze, Trenton R Foster, Jianming Guo, Bogdan Yatsula, Janice Tsui, Alan Dardik
With the increasing prevalence of end-stage renal disease, there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis, but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes in the setting of uremia, systemic inflammation, oxidative stress, and pre-existent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis and development of neointimal hyperplasia that narrows the AVF lumen, typically near the fistula anastomosis...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28770395/interventional-nephrology-current-status-and-clinical-impact-in-japan
#3
Masato Ikeda, Hiroyuki Terawaki, Eiichiro Kanda, Maiko Furuya, Yudo Tanno, Masatsugu Nakao, Yukio Maruyama, Masutaka Maeda, Chieko Higuchi, Tsutomu Sakurada, Tomohiro Kaneko, Hiroaki Io, Koji Hashimoto, Atsushi Ueda, Keita Hirano, Naoki Washida, Hiraku Yoshida, Kazuhiro Yoshikawa, Yoshihiro Taniyama, Kenji Harada, Nanae Matsuo, Ichiro Okido, Takashi Yokoo
BACKGROUND: Current status and clinical significance of interventional nephrology has not been reported from Japan. METHODS: Questionnaires were mailed twice to the directors of all 534 Japanese certificated nephrology training institutions in 2014. The main questions were current performance, categorized annual procedure volume and managers of peritoneal dialysis (PD) access, vascular access (VA) surgery, endovascular intervention, and kidney biopsy. Frequencies of nephrologist involvement between high volume center and low volume center and association between the level of nephrologists' involvement to each procedure and annual procedure volume were examined...
August 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28762685/fabry-disease-in-southern-sardinia-epidemiological-results-from-screening-in-an-extensive-area
#4
Piergiorgio Bolasco, Irene Sitzia, Stefano Murtas
Introduction: Epidemiological data relating to the prevalence and incidence of Fabry disease (FD) and other Lysosomal Storage diseases (LSDs) are largely underestimated and not yet well known. Distribution of the disease varies according to geographical area and to ethnic origin. Heterozygous females are also at risk of contracting severe and multi-symptomatic forms of FD. Aim: To demonstrate the results obtained in outpatient surgeries situated in an area comprising 319,340 inhabitants...
August 1, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28761353/hypertension-and-blood-pressure-variability-management-practices-among-physicians-in-singapore
#5
Sajita Setia, Kannan Subramaniam, Jam Chin Tay, Boon Wee Teo
PURPOSE: There are limited data on blood pressure variability (BPV) in Singapore. The absence of updated local guidelines might contribute to variations in diagnosis, treatment and control of hypertension and BPV between physicians. This study evaluated BPV awareness, hypertension management and associated training needs in physicians from Singapore. MATERIALS AND METHODS: Physicians from Singapore were surveyed between September 8, 2016, and October 5, 2016. Those included were in public or private practice for ≥3 years, cared directly for patients ≥70% of the time and treated ≥30 patients for hypertension each month...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28761230/renal-biopsy-in-paroxysmal-nocturnal-hemoglobinuria-an-insight-into-the-spectrum-of-morphologic-changes
#6
V Puri, A Gandhi, S Sharma
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired, potentially life-threatening disease of blood, characterized by complement-induced intravascular hemolytic anemia and thrombosis. PNH can sometimes present directly with renal manifestations, without showing any hematological manifestation. It, therefore, becomes essential for clinicians and pathologists to be aware of the spectrum of renal changes in PNH. The aim of this study was to document the morphologic changes observed in renal biopsies in patients with PNH...
July 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28754457/impact-of-electronic-acute-kidney-injury-aki-alerts-with-automated-nephrologist-consultation-on-detection-and-severity%C3%A2-of-aki-a-quality-improvement-study
#7
Sehoon Park, Seon Ha Baek, Soyeon Ahn, Kee-Hyuk Lee, Hee Hwang, Jiwon Ryu, Shin Young Ahn, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
BACKGROUND: Several electronic alert systems for acute kidney injury (AKI) have been introduced. However, their clinical benefits require further investigation. STUDY DESIGN: Before-and-after quality improvement study. SETTING & PARTICIPANTS: A tertiary teaching hospital in Korea, which adopted an AKI alert system on June 1, 2014. Before and after launch of the alert system, 1,884 and 1,309 patients with AKI were included in the usual-care and alert groups, respectively...
July 25, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28751970/service-evaluation-of-the-implementation-of-a-digitally-enabled-care-pathway-for-the-recognition-and-management-of-acute-kidney-injury
#8
Alistair Connell, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, Omid Sadeghi-Alavijeh, Charles Merrick, Dominic King, Alan Karthikesalingam, Cian Hughes, Joseph Ledsam, Trevor Back, Geraint Rees, Rosalind Raine, Christopher Laing
Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians...
2017: F1000Research
https://www.readbyqxmd.com/read/28750605/hemodialysis-patients-preferences-for-the-management-of-secondary-hyperparathyroidism
#9
Brett Hauber, John Caloyeras, Joshua Posner, Deborah Brommage, Vasily Belozeroff, Kerry Cooper
BACKGROUND: Patient engagement and patient-centered care are critical in optimally managing patients with end-stage renal disease (ESRD). Understanding patient preferences is a key element of patient-centered care and shared decision making. The objective of this study was to elicit patients' preferences for the treatment of secondary hyperparathyroidism (SHPT) associated with ESRD using a discrete-choice experiment survey. METHODS: Clinical literature, nephrologist input, patient-education resources, and a patient focus group informed development of the survey instrument, which was qualitatively pretested before its administration to a broader sample of patients...
July 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#10
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28748893/complication-rate-and-diagnostic-yield-of-percutaneous-native-kidney-biopsies-a-10-year-experience-at-a-tertiary-care-hospital-in-pakistan
#11
Sonia Yaqub, Nayla Ahmed, Urooj Fatima, Ayesha Maqbool, Waqar Ashif, Syed A Hussain
The use of an automated biopsy device, and real-time ultrasound for percutaneous kidney biopsies (PKBs) has improved the likelihood of obtaining adequate tissue for diagnosis and also has reduced the complications associated with the procedure. We aimed to determine the frequency and type of complications associated with PKB and to determine the diagnostic yield. It was a retrospective file-based review of cases who underwent PKB of native kidney between January 2003 and December 2013 at the Aga Khan University Hospital in Karachi, Pakistan...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748890/prevalence-of-hepatitis-b-core-antibodies-with-negative-hepatitis-b-surface-antigen-in-dialysis-and-chronic-kidney-disease-patients
#12
Nauman Tarif, Muhammad Mohsin Riaz, Omer Sabir, Rizwan Akhter, Kashif Rafique, Nabiha Rizvi
Occult hepatitis B infection (OBI) is a potential cause of infection transmission in patients with chronic kidney disease (CKD) and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb), is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II-V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A total of 188 patients were included in this study, 124 were dialysis dependent and 64 had acute or CKD Stage II-V...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748872/assessment-of-frailty-in-elderly-pre-dialysis-population-using-simple-tools
#13
REVIEW
Hatem Ali, Fatima Abdelaal, Jyoti Baharani
Prevalence of chronic kidney disease (CKD) is increasing worldwide principally among the elderly population many of whom will eventually need renal replacement therapy. The relationship between frailty and CKD in the elderly population has been recognized. However, studies concentrating on frailty in pre-dialysis patients are limited. CKD predisposes to frailty through many potential mechanisms; anemia, bone mineral disease, oxidative stress, and malnutrition which in turn lead to progression of CKD culminating in a vicious cycle...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28741581/regret-about-the-decision-to-start-dialysis-a-cross-sectional-dutch-national-survey
#14
N Berkhout-Byrne, A Gaasbeek, M J K Mallat, T J Rabelink, S P Mooijaart, F W Dekker, M van Buren
BACKGROUND: More older patients with end-stage renal disease (ESRD) are starting dialysis. Elderly patients often prefer treatments that focus on quality of life rather than primarily extending life and a substantial group of elderly dialysis patients might regret their decision to start dialysis. Healthcare provider and patient-related factors may be involved. Our objective was to measure the percentage of patients in the Netherlands who regretted their decision to start dialysis. METHODS: Cross-sectional Dutch national survey of dialysis patients...
July 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28741051/a-nationwide-prospective-cohort-study-of-patients-with-advanced-chronic-kidney-disease-in-japan-the-reach-j-ckd-cohort-study
#15
Junichi Hoshino, Kei Nagai, Hirayasu Kai, Chie Saito, Yukiko Ito, Koichi Asahi, Masahide Kondo, Kunitoshi Iseki, Chiho Iseki, Hirokazu Okada, Naoki Kashihara, Ichiei Narita, Takashi Wada, Christian Combe, Ronald L Pisoni, Bruce M Robinson, Kunihiro Yamagata
BACKGROUND: Epidemiology and outcomes of Japanese patients with advanced chronic kidney disease (CKD)-an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m(2)-has remained largely unexamined. METHODS: We conducted a nationwide survey to determine the distribution of Japanese CKD patients, and are conducting a cohort study of these patients. A questionnaire eliciting details about facilities and their CKD practices was sent to all clinics/hospitals with nephrologists...
July 24, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28738858/erythema-nodosum-masking-nephrogenic-systemic-fibrosis-as-initial-skin-manifestation
#16
Kar Wah Fuah, Christopher Thiam Seong Lim
BACKGROUND: Nephrogenic systemic fibrosis (NSF) is a complication of the gadolinium-based contrast agent used in imaging studies. It is typically characterised by hard, erythematous and indurated skin plaques with surrounding subcutaneous oedema. Distinct papules and subcutaneous nodules can also be seen. Fibrocytes in NSF are immunohistochemically positive for CD34. CASE PRESENTATION: We present a case of NSF occurred after gadolinium exposure in which the initial presentation mimics an erythema nodosum (EN)-like picture...
July 24, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28738354/review-of-extracorporeal-membrane-oxygenation-and-dialysis-based-liver-support-devices-for-the-use-of-nephrologists
#17
Tamim Hamdi, Biff F Palmer
Acute kidney injury in the intensive care unit (ICU) is a manifestation of an underlying severe illness that commonly involves other organ systems. Pulmonary, cardiac, and hepatic failures are the most prevalent. This article provides a simplified review of the technical aspects of extracorporeal cardiopulmonary and liver support devices used in the adult ICU patient, as well as a summary of the most relevant and up-to-date clinical evidence that supports their use.
July 22, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28737880/-pheochromocytoma-presenting-with-secondary-enuresis-in-a-13-year-old-girl
#18
Elia Zoido Garrote, Marta Fernández Fernández, María C Álvarez Cañas, Cristina García Aparicio, María D Revilla Orias, Juan P Martínez Badás
Pheochromocytoma is a rare tumor which is infrequent in children. Although the clinical presentation in children can be atypical, the classic symptoms are headache, sweating and tachycardia. Hypertension is often a constant sign in most patients. There are few cases in literature reporting pheochromocytoma presented with polyuria. We present a 13-year-old girl who came to the Pediatric Nephrologist due to a year of evolution of secondary enuresis. When her blood pressure was taken, she was above the 99th percentile that corresponds to her age and her height that is why she was admitted for treatment and diagnostic study...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28737134/nephrotic-syndrome-in-primary-myelofibrosis-with-renal-extramedullary-hematopoiesis-and-glomerulopathy-in-the-jak-inhibitor-era
#19
Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28736962/diagnosis-and-management-of-white-coat-hypertension-in-children-and-adolescents-a-midwest-pediatric-nephrology-consortium-study
#20
Yosuke Miyashita, Joseph T Flynn, Coral D Hanevold
Although the definition of white-coat hypertension (WCH) in children and adolescents is clearly defined, little is known about how this condition is actually approached clinically. To better understand the contemporary approach to the diagnosis and management of WCH in pediatric patients, the authors surveyed the membership of the Midwest Pediatric Nephrology Consortium. Seventy-four faculty pediatric nephrologists responded to the survey. The survey results demonstrated uniformity in diagnosing WCH, including ambulatory blood pressure monitoring use in 93% of the respondents and a 75% adherence rate according to the 2014 American Heart Association scientific statement on pediatric ambulatory blood pressure monitoring...
July 23, 2017: Journal of Clinical Hypertension
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