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Chronic kidney management

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https://www.readbyqxmd.com/read/28340246/considerations-on-glycaemic-control-in-older-and-or-frail-individuals-with-diabetes-and-advanced-kidney-disease
#1
Nicolae Mircea Panduru, Ionut Nistor, Per-Henrik Groop, Wim Van Biesen, Ken Farrington, Adrian Covic
The increasing prevalence of chronic kidney disease (CKD) and diabetes over the last decade has resulted in increasing numbers of frail older patients with a combination of these conditions. Current treatment guidelines may not necessarily be relevant for such patients, who are mostly excluded from the trials upon which these recommendations are based. There is a paucity of data upon which to base the management of older patients with CKD. Nearly all current guidelines recommend less-tight glycaemic control for the older population, citing the lack of proven medium-term benefits and concerns about the high short-term risk of hypoglycaemia...
March 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339928/opioid-use-in-chronic-pain-patients-with-chronic-kidney-disease-a-systematic-review
#2
Vittal R Nagar, Pravardhan Birthi, Sara Salles, Paul A Sloan
Objectives. : To investigate the prevalence of chronic pain and opioid management among patients with chronic kidney disease (CKD). Design.:  Systematic review. Methods.:  A systematic search was performed, including citations from 1960 to May 2015. The review highlights methodological quality assessment of the selected studies; prevalence of pain; type, dose, and reason for opioid use; effectiveness of pain control and associated adverse effects of opioids in CKD patients...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#3
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28332417/cost-effectiveness-of-angiotensin-converting-enzyme-inhibitors-versus-angiotensin-ii-receptor-blockers-as-first-line-treatment-in-autosomal-dominant-polycystic-kidney-disease
#4
L A Clark, S Whitmire, S Patton, C Clark, C M Blanchette, R Howden
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is a rare kidney disorder impacting approximately 1:2500 individuals among the general US population. Hypertension is a significant predictor of ADPKD progression and risk factor for development of cardiovascular disease (CVD), the most common cause for mortality among ADPKD patients. Angiotensin-converting enzymes inhibitors (ACE-I) are widely used as first-line treatment in ADPKD for the management of hypertension. However, their cost-effectiveness relative to other hypertensive medications, such as angiotensin II receptor blockers (ARB) has never been assessed...
March 23, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28329420/towards-a-symptom-cluster-model-in-chronic-kidney-disease-a-structural-equation-approach
#5
Hayfa Almutary, Clint Douglas, Ann Bonner
AIMS: To test a symptom cluster model in chronic kidney disease patients based on the Theory of Unpleasant Symptoms, accounting for the relationships between influencing factors, symptom experience and consequences for quality of life. BACKGROUND: The evaluation of symptom clusters is a new field of scientific inquiry directed toward more focused symptom management. Yet, little is known about relationships between symptom clusters, predictors and the synergistic effect of multiple symptoms on outcomes...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28328097/markers-of-iron-status-in-chronic-kidney-disease
#6
Adam E Gaweda
Anemia is one of the main comorbidities related to chronic kidney disease (CKD). Until the advent of erythropoiesis stimulating agents (ESA), endogenous erythropoietin deficiency has been thought to be the main culprit of anemia in CKD patients. The use of ESAs has shed new light on the physiology of CKD anemia, where iron homeostasis plays an increasingly important role. Disorders of iron homeostasis occurring in CKD turn the anemia management in those patients into a complex multifactorial therapeutic task, where ESA and Iron dose must be properly balanced to achieve the desired outcome without exposing the patients to the risk of serious adverse events...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28321399/renocardiovascular-biomarkers-from-the-perspective-of-managing-chronic-kidney-disease-and-cardiovascular-disease
#7
REVIEW
Shinichiro Niizuma, Yoshitaka Iwanaga, Takaharu Yahata, Shunichi Miyazaki
Mortality among the patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) remains high because of the very high incidence of cardiovascular disease (CVD) such as coronary artery disease, cardiac hypertrophy, and heart failure. Identifying CVD in patients with CKD/ESRD remains a significant hurdle and the early diagnosis and therapy for CVD is crucial in these patients. Therefore, it is necessary for the better management to identify and utilize cardiovascular (CV) biomarkers in profiling CVD risk and enabling stratification of early mortality...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28321326/first-canadian-case-report-of-kidney-transplantation-from-an-hiv-positive-donor-to-an-hiv-positive-recipient
#8
Georges Ambaraghassi, Héloïse Cardinal, Daniel Corsilli, Claude Fortin, Marie-Chantal Fortin, Valérie Martel-Laferrière, Jacques Malaise, Michel R Pâquet, Danielle Rouleau
RATIONALE: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28321237/management-and-risk-factor-control-of-coronary-artery-disease-in-elderly-versus-nonelderly-a-multicenter-registry
#9
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Smonporn Boonyaratavej, Chaiyasith Wongvipaporn, Woraporn Tiyanon, Pakaphan Dinchuthai, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
BACKGROUND: Coronary artery disease (CAD) is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attainment in elderly compared to nonelderly CAD patients. METHODS: The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28318623/the-complexity-of-chronic-kidney-disease-mineral-and-bone-disorder-across-stages-of-chronic-kidney%C3%A2-disease
#10
Fabiana G Graciolli, Katia R Neves, Fellype Barreto, Daniela V Barreto, Luciene M Dos Reis, Maria E Canziani, Yves Sabbagh, Aluizio B Carvalho, Vanda Jorgetti, Rosilene M Elias, Susan Schiavi, Rosa M A Moysés
Chronic Kidney Disease (CKD)-Mineral and Bone Disorder (CKD-MBD) is a complex disease that is not completely understood. However, some factors secreted by the osteocytes might play an important role in its pathophysiology. Therefore, we evaluated the bone expression of proteins in a group of patients with CKD 2-3, CKD 4, and CKD 5 on dialysis and healthy individuals. We also tested several bone remodeling markers, and correlated these levels with bone biopsy findings. As expected, as serum calcium decreased, serum phosphate, alkaline phosphatase, fibroblast growth factor-23 (FGF-23), parathyroid hormone, and osteoprotegerin increased, as CKD progressed...
March 15, 2017: Kidney International
https://www.readbyqxmd.com/read/28318510/comparative-efficacy-of-coronary-revascularization-procedures-for-multivessel-coronary-artery-disease-in-patients-with-chronic-kidney-disease
#11
John K Roberts, Sunil V Rao, Linda K Shaw, Dianne S Gallup, Oscar C Marroquin, Uptal D Patel
Patients with chronic kidney disease (CKD) are at increased risk of cardiovascular disease and death, yet little data exist regarding the comparative efficacy of coronary revascularization procedures in CKD patients with multivessel disease. We created a cohort of 4,687 adults who underwent cardiac catheterization, had a serum creatinine value measured within 30 days, and had more than one vessel with ≥50% stenosis. We used Cox proportional hazard regression modeling weighted by the inverse probability of treatment to examine the association between 4 treatment strategies (medical management, percutaneous coronary intervention [PCI] with bare metal stent, PCI with drug-eluting stent, and coronary artery bypass grafting [CABG]) and mortality among patients across categories of estimated glomerular filtration rate; secondary outcome was a composite of mortality, myocardial infarction, or revascularization...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28314735/non-alcoholic-fatty-liver-disease-and-its-relationship-with-cardiovascular-disease-and-other-extrahepatic-diseases
#12
REVIEW
Leon A Adams, Quentin M Anstee, Herbert Tilg, Giovanni Targher
Key physiological functions of the liver, including glucose and lipid metabolism, become disturbed in the setting of non-alcoholic fatty liver disease (NAFLD) and may be associated with a systemic inflammatory 'milieu' initiated in part by liver-secreted cytokines and molecules. Consequently, the pathophysiological effects of NAFLD extend beyond the liver with a large body of clinical evidence demonstrating NAFLD to be independently associated with both prevalent and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM)...
March 17, 2017: Gut
https://www.readbyqxmd.com/read/28306566/anemia-management-in-chronic-kidney-disease-and-dialysis-a-narrative-review
#13
David Collister, Claudio Rigatto, Navdeep Tangri
PURPOSE OF REVIEW: This review describes the current state of anemia management with erythropoietin (EPO)-stimulating agents and iron supplementation in both chronic kidney disease and dialysis patients, with a focus on novel therapies. RECENT FINDINGS: We review the benefits and risks of EPO-stimulating agents, focusing on health-related quality of life and the uncertainties regarding optimal iron utilization in patients with kidney disease. We discuss novel therapies for iron supplementation including iron-based phosphate binders and dialysate iron delivery as well as alternatives to EPO-stimulating agents including hypoxia-inducible factor prolyl hydroxylase inhibitors...
March 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28302014/role-of-hepcidin-25-in-chronic-kidney-disease-anemia-and-beyond
#14
Norishi Ueda, Kazuya Takasawa
Iron is an essential element for all living organisms, but produces toxic oxidants. Thus, iron homeostasis is tightly regulated in mammals. Hepcidin-25 (hepcidin) has emerged as a molecule that regulates iron metabolism. Binding of hepcidin to its receptor, ferroportin, inhibits intestinal iron absorption and iron efflux from hepatocytes and macrophages. Decreased hepcidin enhances iron absorption and efflux. Hepcidin could be predictive of iron status and the response to iron supplementation or erythropoietin-stimulating agents...
March 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28300046/final-year-nursing-students-in-nigeria-how-knowledgeable-and-prepared-are-they-to-offer-medical-care-to-patients-with-chronic-kidney-disease
#15
Chimezie Godswill Okwuonu, Hannah Sylvanus Kanu, Ojeh-Oziegbe Odigie
BACKGROUND: Nurses play an important role in the management of chronic kidney disease (CKD) patients at primary, secondary, and tertiary levels of care. In other to perform their functions, it is pertinent that they have a good understanding of kidney functions and CKD. We do not know if the current educational curriculum prepares them adequately for this role. AIM: To assess the knowledge level of kidney functions and diseases among final year nursing students in Abia State Nigeria...
January 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28299459/the-impact-of-evacuation-on-the-incidence-of-chronic-kidney-disease-after-the-great-east-japan-earthquake-the-fukushima-health-management-survey
#16
Yoshimitsu Hayashi, Masato Nagai, Tetsuya Ohira, Hiroaki Satoh, Akira Sakai, Akira Ohtsuru, Mitsuaki Hosoya, Yukihiko Kawasaki, Hitoshi Suzuki, Atsushi Takahashi, Yoshihiro Sugiura, Hiroaki Shishido, Hideto Takahashi, Seiji Yasumura, Junichiro James Kazama, Shigeatsu Hashimoto, Gen Kobashi, Kotaro Ozasa, Masafumi Abe
BACKGROUND: About 146,000 people were forced into long-term evacuation due to the nuclear power plant accident caused by the Great East Japan Earthquake in 2011. Disaster is known to induce hypertension in survivors for a certain period, but it is unclear whether prolonged disaster stress influences chronic kidney disease (CKD). We conducted an observational cohort study to elucidate the effects of evacuation stress on CKD incidence. METHODS: Participants were individuals living in communities near the Fukushima nuclear power plant, aged 40-74 years without CKD as of their 2011 general health checkup (non-evacuees: n = 9780, evacuees: n = 4712)...
March 15, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28296920/prevalence-of-chronic-kidney-disease-and-risk-factors-for-its-progression-a-cross-sectional-comparison-of-indians-living-in-indian-versus-u-s-cities
#17
Shuchi Anand, Dimple Kondal, Maria Montez-Rath, Yuanchao Zheng, Roopa Shivashankar, Kalpana Singh, Priti Gupta, Ruby Gupta, Vamadevan S Ajay, Viswanathan Mohan, Rajendra Pradeepa, Nikhil Tandon, Mohammed K Ali, K M Venkat Narayan, Glenn M Chertow, Namratha Kandula, Dorairaj Prabhakaran, Alka M Kanaya
BACKGROUND: While data from the latter part of the twentieth century consistently showed that immigrants to high-income countries faced higher cardio-metabolic risk than their counterparts in low- and middle-income countries, urbanization and associated lifestyle changes may be changing these patterns, even for conditions considered to be advanced manifestations of cardio-metabolic disease (e.g., chronic kidney disease [CKD]). METHODS AND FINDINGS: Using cross-sectional data from the Center for cArdiometabolic Risk Reduction in South Asia (CARRS, n = 5294) and Mediators of Atherosclerosis in South Asians Living in America (MASALA, n = 748) studies, we investigated whether prevalence of CKD is similar among Indians living in Indian and U...
2017: PloS One
https://www.readbyqxmd.com/read/28296010/overview-of-iron-metabolism-in-health-and-disease
#18
Som Dev, Jodie L Babitt
Iron is an essential element for numerous fundamental biologic processes, but excess iron is toxic. Abnormalities in systemic iron balance are common in patients with chronic kidney disease and iron administration is a mainstay of anemia management in many patients. This review provides an overview of the essential role of iron in biology, the regulation of systemic and cellular iron homeostasis, how imbalances in iron homeostasis contribute to disease, and the implications for chronic kidney disease patients...
March 15, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28293043/treatment-of-post-transplantation-lymphoproliferative-disorders-after-kidney-transplant-with-rituximab-and-conversion-to-m-tor-inhibitor
#19
John Fredy Nieto-Rios, Sandra Milena Gómez de Los Ríos, Lina María Serna-Higuita, Catalina Ocampo-Kohn, Arbey Aristizabal-Alzate, Kenny Mauricio Gálvez-Cárdenas, Gustavo Adolfo Zuluaga-Valencia
BACKGROUND: Post-transplantation lymphoproliferative disorders are serious complications of organ transplantation which treatment is not yet standardized. OBJECTIVE: To describe the clinical response, overall and graft survival of patients in our center with this complication after kidney transplantation, which received rituximab as part of their treatment as well as conversion to m-TOR. METHODS: Retrospective study, which included patients, diagnosed with post-transplant lymphoproliferative disorders after kidney transplantation from January 2011 to July 2014...
December 30, 2016: Colombia Médica: CM
https://www.readbyqxmd.com/read/28292575/the-treatment-of-type-2-diabetes-mellitus-in-patients-with-chronic-kidney-disease-what-to-expect-from-new-oral-hypoglycemic-agents
#20
REVIEW
Luca Di Lullo, Michela Mangano, Claudio Ronco, Vincenzo Barbera, Antonio De Pascalis, Antonio Bellasi, Domenico Russo, Biagio Di Iorio, Mario Cozzolino
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD and intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes mellitus include metformin, sulfonylureas, meglitinides, thiazolidinediones, and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 2-5) and without dose adjustment...
March 6, 2017: Diabetes & Metabolic Syndrome
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