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Sadayoshi Ito
The presence of chronic kidney disease (CKD) is a strong risk factor not only for end stage kidney disease (ESKD) but also cerebro-cardiovascular disease (CVD). CKD is defined as GFR < 60ml/min/1.73m and/or the evidence of renal damages for more than 3 months. Epidemiological studies have shown that albuminuria even as little as 10mg/gCr is a strong risk factor for CVD, especially stroke. The significance of albuminuria can be recognized when we think of the fact that the amount of albumin in 24 hour-GFR is as large as 6 kg (4...
September 2016: Journal of Hypertension
Francesca Taylor, Jennifer Hare, Gill Combes
BACKGROUND: Many patients with end-stage kidney disease (ESKD) have significant psychosocial needs as a consequence of their illness and treatment. Unmet needs can impact negatively on their health and well-being. Patients want improved psychosocial support particularly in relation to coping and adjustment. Little is known about the relevance and applicability to patients of intervention approaches to support their psychosocial needs. OBJECTIVES: To explore patients' attitudes to different intervention approaches that could be developed to help them cope with the psychosocial stressors of ESKD, and to assess the potential acceptability of these approaches...
October 18, 2016: Journal of Renal Care
Adeniyi A Borire, Ria Arnold, Bruce A Pussell, Natalie C Kwai, Leo H Visser, Luca Padua, Neil G Simon, Matthew C Kiernan, Arun V Krishnan
OBJECTIVE: We explored the nerve ultrasound (US) characteristics of 15 patients with end-stage kidney disease (ESKD) and correlated these findings with clinical severity and electrophysiological parameters of neuropathy. METHODS: 15 ESKD patients on thrice-weekly high-flux haemodialysis and 15 healthy controls were enrolled. Sonographic and electrophysiologic studies were conducted before and after a single session of haemodialysis. Serial measurements of median nerve cross-sectional area (CSA) and hypoechoic fraction (HF) were performed at the same non-entrapment site in the mid-forearm...
October 1, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Michelle C Mann, Derek V Exner, Brenda R Hemmelgarn, David A Hanley, Tanvir C Turin, Jennifer M MacRae, David C Wheeler, Darlene Y Sola, Sharanya Ramesh, Sofia B Ahmed
: End-stage kidney disease (ESKD) patients are at increased cardiovascular risk. Vitamin D deficiency is associated with depressed heart rate variability (HRV), a risk factor depicting poor cardiac autonomic tone and risk of cardiovascular death. Vitamin D deficiency and depressed HRV are highly prevalent in the ESKD population. We aimed to determine the effects of oral vitamin D supplementation on HRV ((low frequency (LF) to high frequency (HF) spectral ratio (LF:HF)) in ESKD patients on hemodialysis...
2016: Nutrients
Monika Buraczynska, Anna Stec, Aleksandra Filipczak, Andrzej Ksiazek
BACKGROUND: The proteasome system is involved in several disorders. The 5' untranslated region of PSMA6 gene contains a single nucleotide polymorphism (SNP) -8 C/G, associated with diabetes, myocardial infarction and coronary artery disease. METHODS: We examined 584 patients with end-stage kidney disease (ESKD) and 430 controls. All were genotyped for -8 C/G SNP by polymerase chain reaction and restriction analysis. RESULTS: We observed lower frequency of CG + GG genotypes in patients than in controls (20 vs...
September 26, 2016: International Urology and Nephrology
Adam Shardlow, Natasha J McIntyre, Richard J Fluck, Christopher W McIntyre, Maarten W Taal
BACKGROUND: Chronic kidney disease (CKD) is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD) and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance. METHODS AND FINDINGS: In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom...
September 2016: PLoS Medicine
Sadayoshi Ito
The presence of chronic kidney disease (CKD) is a strong risk factor not only for end stage kidney disease (ESKD) but also cerebro-cardiovascular disease (CVD). CKD is defined as GFR < 60ml/min/1.73m and/or the evidence of renal damages for more than 3 months. Epidemiological studies have shown that albuminuria even as little as 10mg/gCr is a strong risk factor for CVD, especially stroke. The significance of albuminuria can be recognized when we think of the fact that the amount of albumin in 24 hour-GFR is as large as 6 kg (4...
September 2016: Journal of Hypertension
Diana Jalal, Molly McFadden, Jamie P Dwyer, Kausik Umanath, Erwin Aguilar, Yoram Yagil, Barbara Greco, Mohammed Sika, Julia B Lewis, Tom Greene, Simin Goral
Introduction Oral phosphate binders are the main stay of treatment of hyperphosphatemia. Adherence rates to ferric citrate, a recently approved phosphate binder, are unknown. Methods We conducted a post-hoc analysis to evaluate whether adherence rates were different for ferric citrate vs. active control in 412 subjects with end stage kidney disease (ESKD) who were randomized to ferric citrate vs. active control (sevelamer carbonate and/or calcium acetate). Adherence was defined as percent of actual number of pills taken to total number of pills prescribed...
September 12, 2016: Hemodialysis International
Simon R Knowles, Chantal F Ski, Robyn Langham, Emmet O'Flaherty, David R Thompson, Susan L Rossell, Gaye Moore, Ya-Seng Arthur Hsueh, David J Castle
BACKGROUND: Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis...
2016: Trials
Michael D Hughson, Wendy E Hoy, Susan A Mott, Victor G Puelles, John F Bertram, Cheryl L Winkler, Jeffrey B Kopp
The increased risk of end-stage kidney disease (ESKD) among hypertensive African Americans is partly related to APOL1 allele variants. Hypertension-associated arterionephrosclerosis consists of arteriosclerosis, glomerulosclerosis, and cortical fibrosis. The initial glomerulosclerosis, attributed to preglomerular arteriosclerosis and ischemia, consists of focal global glomerulosclerosis (FGGS), but in biopsy studies, focal segmental glomerulosclerosis (FSGS) is found with progression to ESKD, particularly in African Americans...
May 2016: KI Rep
Wendy M Parker, Kristine Ferreira, Lauren Vernon, Katie E Cardone
OBJECTIVES: Patients with end-stage kidney disease (ESKD) typically have high medication burdens with numerous medications and specialized instructions. Limited data exist regarding ESKD patient perspectives on medication management. Why can some patients self-manage? Which organizational techniques are used? This project sought to determine experiences and attitudes regarding medication management among hemodialysis patients. METHODS: Group interviews were conducted with adult patients from 3 dialysis facilities...
August 3, 2016: Research in Social & Administrative Pharmacy: RSAP
Shozo Yano
In patients with end-stage kidney disease(ESKD), bone disorders are characterized by cortical porosity and by abnormal turnover of bone metabolism:adynamic(low turnover)bone disease and high turnover bone due to various degrees of secondary hyperparathyroidism. Abnormalities of bone metabolism are generally assessed by interview, X-ray, bone mineral density(BMD), serum phosphorus, calcium, and parathyroid hormone levels, and bone metabolic markers. Recent clinical studies have demonstrated that high turnover bone representing elevated bone metabolic markers and low BMD are independent risks of bone fractures as well as mortality among this population...
September 2016: Clinical Calcium
Yasuyuki Nagasawa, Ryohei Yamamoto, Tatsuya Shoji, Maki Shinzawa, Yukiko Hasuike, Katsuyuki Nagatoya, Atsushi Yamauchi, Terumasa Hayashi, Takayuki Kuragano, Toshiki Moriyama, Yoshitaka Isaka, Takeshi Nakanishi
BACKGROUND: Immunoglobulin A nephropathy (IgAN) is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN. STUDY DESIGN: Multicenter retrospective cohort study. SETTING & PARTICIPANTS: 935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital...
2016: PloS One
Claudia Torino, Francesco Mattace-Raso, Jan L C M van Saase, Maurizio Postorino, Giovanni Luigi Tripepi, Francesca Mallamaci, Carmine Zoccali, Progredire Study Group
Alkaline phosphatase (Alk-Phos) is a powerful predictor of death in patients with end-stage kidney disease (ESKD) and oxidative stress is a strong inducer of Alk-Phos in various tissues. We tested the hypothesis that oxidative stress, as estimated by a robust marker of systemic oxidative stress like γ-Glutamyl-Transpeptidase (GGT) levels, may interact with Alk-Phos in the high risk of death in a cohort of 993 ESKD patients maintained on chronic dialysis. In fully adjusted analyses the HR for mortality associated with Alk-Phos (50 IU/L increase) was progressively higher across GGT quintiles, being minimal in patients in the first quintile (HR: 0...
2016: Oxidative Medicine and Cellular Longevity
Philip Masson, Sradha Kotwal, Patrick J Kelly, Jonathan C Craig, Richard I Lindley, Martin Gallagher, Alan Cass, Angela C Webster
BACKGROUND: It is unclear how traditional cardiovascular risk factors and different treatment modalities for end-stage kidney disease (ESKD) affect stroke risk in people with ESKD. We aimed to identify the risk factors for stroke (ischemic and hemorrhagic) in people with ESKD. METHODS: We conducted a retrospective cohort study using data linkage between the Australian and New Zealand Dialysis and Transplant Registry, clinical and administrative datasets. Using Cox proportional hazards models, we estimated the magnitudes of risk of hospitalization with different subtypes of strokes associated with traditional cardiovascular risk factors and ESKD treatment modalities (hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation)...
August 10, 2016: Cerebrovascular Diseases
J Ziaja, A Kolonko, D Kamińska, J Chudek, A J Owczarek, A Kujawa-Szewieczek, M Kuriata-Kordek, K Krzyżowska, J Badura, J Czerwiński, E Jęrdusik, R Król, M Klinger, A Więcek, L Cierpka
BACKGROUND: Kidney transplantation (KTx) markedly reduces mortality in patients with end-stage kidney disease (ESKD) caused by type 1 diabetes mellitus (T1DM). The outstanding issue is whether transplantation should be limited only to KTx, with further insulinotherapy, or combined with pancreas transplantation in patients with ESKD/T1DM. The goal of this study was to compare the results of simultaneous pancreas-kidney transplantation (SPKTx) and deceased donor KTx and to identify factors affecting patient and kidney graft survival in patients with ESKD/T1DM...
June 2016: Transplantation Proceedings
Rebecca Ritte, Joanne Luke, Craig Nelson, Alex Brown, Kerin O'Dea, Alicia Jenkins, James D Best, Robyn McDermott, Mark Daniel, Kevin Rowley
BACKGROUND: Chronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia. METHODS: Cox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants' baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia...
2016: BMC Nephrology
Tony Amin, P Toby Coates, Jeffrey Barbara, Paul Hakendorf, Nazmul Karim
Introduction. Postrenal transplant bone disease is a significant problem. Factors influencing postrenal transplant bone status include high dose acute and low dose long-term steroid use, persistent hypercalcaemia, and graft failure. In this study, we aimed to determine the prevalence of hypercalcaemia and to evaluate the risk factors for postrenal transplant hypercalcaemia in long-term renal transplant patients at our centre. Methods. This is a biochemical audit in which we studied renal transplant recipients from the Central Northern Adelaide Renal Transplant Services, South Australia...
2016: International Journal of Nephrology
Namrata Khanal, Philip Clayton, Stephen McDonald, Matthew Jose
INTRODUCTION: Indigenous Australians (Aboriginal and Torres Strait Islanders, ATSI) make up 3% of the total Australian population [1] and comprised ~ 10% of new patients beginning renal replacement for end-stage kidney disease (ESKD) in Australia during 2013 [2]. In this study, we examined the differences in characteristics, incidence, and prevalence of different modalities of dialysis and survival between indigenous and nonindigenous Australians. METHODS: We examined outcomes of all adults (aged ≥ 18 years at the start of renal replacement therapy (RRT)) in the ANZDATA registry who started RRT from 1st Jan 2003 to 31st Dec 2013 in Australia...
July 29, 2016: Clinical Nephrology
Luxia Zhang, Li Zuo
INTRODUCTION: Understanding the status and trends of patients with ESKD is important to evaluate and predict its impact on the health care system in China. METHODS: Available publications and/or presentations from national and regional dialysis and transplantation registries were collected. RESULTS AND DISCUSSION: A national report in 1999 revealed that the prevalence and incidence of dialysis in China were 33.2 per million population (pmp) and 15...
July 29, 2016: Clinical Nephrology
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