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https://www.readbyqxmd.com/read/28916546/approach-to-membranous-lupus-nephritis-a-survey-of-pediatric-nephrologists-and-pediatric-rheumatologists
#1
Alexis Boneparth, Suhas M Radhakrishna, Larry A Greenbaum, Eric Yen, Daryl M Okamura, Jennifer C Cooper, Sherene Mason, Deborah M Levy, Sangeeta D Sule, Paul T Jensen, Cagri Yildirim-Toruner, Stacy P Ardoin, Scott E Wenderfer
OBJECTIVE: To describe treatment practices for childhood pure membranous lupus nephritis (MLN). METHODS: Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members. RESULTS: There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists). Steroids and nonsteroid immunosuppression (NSI) were routinely used by the majority for MLN...
September 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28910788/uremia-retention-molecules-and-clinical-outcomes
#2
Fellype Carvalho Barreto, Daniela Veit Barreto, Maria Eugênia Fernandes Canziani
Chronic kidney disease is characterized by the accumulation of organic compounds in the bloodstream that may exert a variety of toxic effects in the body. These compounds, collectively known as uremic toxins, may be classified according to their physicochemical properties as free water-soluble low molecular weight molecules, middle molecules or protein-bound uremic toxins. Most of these retention molecules, due to either their size and/or binding to protein, constitute a complex therapeutic challenge to the nephrologist, particularly in end-stage renal disease, because of their limited removal by conventional dialysis therapies...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28902768/economic-and-clinical-outcomes-resulting-from-the-stage-4-chronic-kidney-disease-case-management-quality-improvement-initiative
#3
Beverly Everett, Liana D Castel, Matthew McGinnis, Amy Beresky, Rudolph C Cane, Tasha Cooper, Rajesh K Davda, Donna Farmer, Stella M John, Denise L Sollars, John F Rausch
PURPOSE OF STUDY: Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5. PRIMARY PRACTICE SETTINGS: A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012...
September 11, 2017: Professional Case Management
https://www.readbyqxmd.com/read/28899351/association-of-plasma-potassium-with-mortality-and-end-stage-kidney-disease-in-patients-with-chronic-kidney-disease-under-nephrologist-care-the-nephrotest-study
#4
Sandra Wagner, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann, François Vrtovsnik, Eric Thervet, Jean-Jacques Boffa, Ziad A Massy, Bénédicte Stengel, Patrick Rossignol
BACKGROUND: Low and high blood potassium levels are common and were both associated with poor outcomes in patients with chronic kidney disease (CKD). Whether such relationships may be altered in CKD patients receiving optimized nephrologist care is unknown. METHODS: NephroTest is a hospital-based prospective cohort study that enrolled 2078 nondialysis patients (mean age: 59 ± 15 years, 66% men) in CKD stages 1 to 5 who underwent repeated extensive renal tests including plasma potassium (PK) and glomerular filtration rate (GFR) measured (mGFR) by (51)Cr-EDTA renal clearance...
September 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28891237/the-incidence-and-prevalence-of-systemic-lupus-erythematosus-in-san-francisco-county-california-the-california-lupus-surveillance-project
#5
Maria Dall'Era, Miriam G Cisternas, Kurt Snipes, Lisa J Herrinton, Caroline Gordon, Charles G Helmick
OBJECTIVE: Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of this study was to conduct the California Lupus Surveillance Project (CLSP) to determine credible estimates of SLE incidence and prevalence, with a special focus on Hispanics and Asians. METHODS: The CLSP, which is funded by the Centers for Disease Control and Prevention, is a population-based registry of individuals with SLE residing in San Francisco County, CA, from January 1, 2007 through December 31, 2009...
September 10, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#6
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28880437/prevalence-of-earlobe-creases-and-their-association-with-history-of-cardiovascular-disease-in-patients-undergoing-hemodialysis-a-cross-sectional-study
#7
Minako Wakasugi, Junichiro James Kazama, Kazuko Kawamura, Suguru Yamamoto, Masaaki Nagai, Kentaro Omori, Saori Yokota, Hirokazu Fujikawa, Ikuo Aoike, Tsukasa Omori, Ichiei Narita
Earlobe creases are surrogate markers for high risk of cardiovascular disease. There is no data concerning earlobe creases among hemodialysis patients, who have an increased risk of cardiovascular disease. A cross-sectional study was conducted to determine the prevalence of earlobe creases and their association with prevalent cardiovascular disease among hemodialysis patients. Patients undergoing hemodialysis were recruited from five outpatient hemodialysis centers. Both earlobes were photographed during a dialysis session with the patient in a supine position and the photos evaluated independently by two experienced nephrologists blinded to the participants' clinical characteristics...
September 7, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28879535/hypercalcemia-a-consultant-s-approach
#8
Ari Auron, Uri S Alon
Due to their daily involvement in mineral metabolism, nephrologists are often asked to consult on children with hypercalcemia. This might become even more pertinent when the hypercalcemia is associated with acute kidney injury and/or hypercalciuria and renal calcifications. The best way to assess the severity of hypercalcemia is by measurement of plasma ionized calcium, and if not available by adjusting serum total calcium to albumin concentration. The differential diagnosis of the possible etiologies of the disturbance in the mineral homeostasis starts with the assessment of serum parathyroid hormone concentration, followed by that of vitamin D metabolites in search of both genetic and acquired etiologies...
September 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28876706/-acute-kidney-injury-in-2017-management-in-a-secondary-care-hospital-an-example-of-interdisciplinary-collaboration
#9
Guido Marco Caronni, Hadrien Komaromi, Alexandre Guillermin, Mélissa Schneider, Zina Fumeaux
Acute kidney injury (AKI) is frequent and can lead to serious complications. It is classified according to the degree of renal function impairment and classically divided into three categories: pre-renal, intrinsic and post-renal. Identification of risk factors and wise use of additional tests are crucial to the diagnosis, as there are numerous causes of AKI. Identification and specific treatment of the underlying mechanism are essential, all while protecting the kidney. Resorting to a nephrologist is systematic when there are red flags...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28873222/uremic-pericarditis-pericardial-effusion-and-constrictive-pericarditis-in-end-stage-renal-disease-insights-and-pathophysiology
#10
REVIEW
Karim Abdur Rehman, Jorge Betancor, Bo Xu, Arnav Kumar, Carlos Godoy Rivas, Kimi Sato, Leslie P Wong, Craig R Asher, Allan L Klein
A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis...
September 5, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28870047/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-gitelman-syndrome
#11
(no author information available yet)
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. The prevalence of GS is even higher in Asia than other countries. The majority of GS patients present mild and nonspecific symptoms during adolescence or adulthood...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28856498/the-effectiveness-of-multidisciplinary-care-models-for-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#12
REVIEW
Yu Shi, Jiachuan Xiong, Yan Chen, Junna Deng, Hongmei Peng, Jinghong Zhao, Jing He
AIM: To assess the efficacy of the multidisciplinary care (MDC) model for patients with chronic kidney disease (CKD). BACKGROUND: The MDC model has been used in clinical practice for years, but the effectiveness of the MDC model for patients with CKD remains controversial. METHODS: Embase, PubMed, Medline, the Cochrane Library, and China National Knowledge Infrastructure databases were used to search for relevant articles. Only randomized controlled trials and cohort studies were pooled...
August 30, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28853726/enhancing-clinical-trial-development-for-pediatric-kidney-diseases
#13
REVIEW
H William Schnaper, Joseph T Flynn, Coleman Gross, Anne B Cropp, Bastian Dehmel, Leah B Patel, Larry A Greenbaum, Elisabeth Houtsmuller, Frederick Kaskel, Marva Moxey-Mims, Karen Nowak, Douglas Silverstein, Aliza Thompson, Lynne Yao, Edress Darsey, William E Smoyer
The conduct of clinical trials in small pediatric subspecialties such as pediatric nephrology is hampered by both clinical demands on the pediatric nephrologist and the small number of appropriate patients available for such studies. The American Society of Pediatric Nephrology Therapeutics Development Committee (TDC) was established to (1) identify the various stakeholders with interests and/or expertise related to clinical trials in children with kidney disease and (2) develop more effective partnerships among all parties regarding strategies for successful clinical trial development and execution...
August 30, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28852497/risk-factors-for-bleeding-complications-after-nephrologist-performed-native-renal-biopsy
#14
Jennifer S Lees, Emily P McQuarrie, Natalie Mordi, Colin C Geddes, Jonathan G Fox, Bruce Mackinnon
BACKGROUND: Bleeding is a recognized complication of native percutaneous renal biopsy. This study aimed to describe the incidence of major bleeding after biopsy in a single centre over a 15-year period and examine factors associated with major bleeding. METHODS: We identified consecutive adult patients undergoing ultrasound-guided native renal biopsy in the Glasgow Renal and Transplant Unit from 2000 to 2014. From the electronic patient record, we collected data pertaining to biopsy indication, pre- and post-biopsy laboratory measurements, prescribed medication and diagnosis...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28852486/diabetes-deafness-and-renal-disease
#15
Iolanda Godinho, Joana Gameiro, Sofia Jorge, Fernando Abreu, Marta Neves, José António Lopes, António Gomes da Costa
Deafness, kidney disease and diabetes are not a usual association, neither is a family history of these diseases. We present the case of a 47-year-old woman with non-nephrotic proteinuria, no haematuria, normal renal function, sensorineural hearing loss, recently diagnosed diabetes and maculopathy. There was a maternal family history of deafness, diabetes and renal disease. Renal biopsy revealed focal and segmental glomerulosclerosis (FSGS), leading to the pursuit of an m.3243A > G mitochondrial mutation and diagnosis of maternally inherited diabetes and deafness...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28852478/an-end-of-life-practice-survey-among-clinical-nephrologists-associated-with-a-single-nephrology-fellowship-training-program
#16
Kevin A Ceckowski, Dustin J Little, Joseph R Merighi, Teri Browne, Christina M Yuan
BACKGROUND: Our nephrology fellowship requires specific training in recognition and referral of end-stage renal disease patients likely to benefit from palliative and hospice care. METHODS: To identify end-of-life (EOL) referral barriers that require greater training emphasis, we performed a cross-sectional, 17-item anonymous online survey (August-October 2015) of 93 nephrologists associated with the program since 1987. RESULTS: There was a 61% response rate (57/93 surveys)...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28851313/minding-the-gap-and-overlap-a-literature-review-of-fragmentation-of-primary-care-for-chronic-dialysis-patients
#17
Virginia Wang, Clarissa J Diamantidis, JaNell Wylie, Raquel C Greer
BACKGROUND: Care coordination is a challenge for patients with kidney disease, who often see multiple providers to manage their associated complex chronic conditions. Much of the focus has been on primary care physician (PCP) and nephrologist collaboration in the early stages of chronic kidney disease, but less is known about the co-management of the patients in the end-stage of renal disease. We conducted a systematic review and synthesis of empirical studies on primary care services for dialysis patients...
August 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28845467/proton-pump-inhibitors-and-kidney-disease-gi-upset-for-the-nephrologist
#18
Stephanie Toth-Manikowski, Morgan E Grams
Widely regarded as safe and effective, proton pump inhibitors (PPIs) are among the most commonly used medications in the world today. However, a spate of observational studies suggest an association between PPI use and adverse events, including infection, bone fracture, and dementia. This review details evidence linking the use of PPI therapy to the development of kidney disease, including early case reports of acute interstitial nephritis and subsequent large observational studies of acute kidney injury (AKI), chronic kidney disease (CKD), and end-stage renal disease (ESRD)...
May 2017: KI Reports
https://www.readbyqxmd.com/read/28843391/-management-of-bone-and-mineral-metabolism-disorders-before-the-dialysis-stage-remains-still-perfectible-data-from-the-french-phosphorus-and-calcium-survey-photo-graphe
#19
Guillaume Jean, Éric Daugas, Hubert Roth, Tilman Drueke, Jean-Louis Bouchet, Thierry Hannedouche, Gérard London, Denis Fouque
Only limited data is available on the management of the chronic kidney disease-associated bone and mineral metabolism disorder (CKD-MBD) in the pre-dialysis stages of CKD in France. A better knowledge of current management habits could lead to an improvement in the implementation of international recommendations (KDIGO). The 3rd version of the French Phosphorus and Calcium Survey Photo-Graphe (Sanofi) included a cohort of CKD stages 4 and 5 patients, whose aim was to examine the prevalence of CKD-MBD and the quality of its management in patients under the care of 62 nephrologists from over 20 geographical regions in France...
August 23, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28838226/intradialytic-exercise-improves-physical-function-and-reduces-intradialytic-hypotension-and-depression-in-hemodialysis-patients
#20
So Yon Rhee, Jin Kyung Song, Suk Chul Hong, Jae Won Choi, Hee Jung Jeon, Dong Ho Shin, Eun Hee Ji, Eun-Hee Choi, Jiyeon Lee, Aram Kim, Seung Wook Choi, Jieun Oh
Background/Aims: As numbers of maintenance hemodialysis patients are growing, debilitating conditions of muscle wasting and atrophy are becoming some of the greatest concerns in end-stage renal disease patients. Exercise training has various potential benefits in terms of prevention of a sustained decline in functional status. This study aimed to evaluate the physical, psychological, laboratory, and dialysis-related effects of intradialytic exercise. Methods: We enrolled 22 patients from a hemodialysis center for a 6-month non-randomized prospective trial...
August 25, 2017: Korean Journal of Internal Medicine
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