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Chronic Kidney Disease

Viviane Bernardes de Oliveira Chaiben, Thabata Baechtold da Silveira, Murilo Henrique Guedes, João Pedro de Almeida Fernandes, João Henrique Fregadolli Ferreira, Julianna Beltrão, Giovanna Foltran Leal, Lucas Henrique Olandoski Erbano, Natasha Ludmila Bosch, Roberto Pecoits Filho, Thyago Proença de Moraes, Cristina Pellegrino Baena
INTRODUCTION: The prevalence of chronic kidney disease (CKD) is increasing, with a potential impact in the risk of acceleration of dementia. The potential association between glomerular filtration rate (eGFR) and cognitive performance was scarcely studied. The aim of this study was to evaluate cognitive performance levels across different degrees of kidney function. METHODS: We analyzed 240 outpatients in a nephrology service, classified according to eGFR: Advanced (≤ 30ml/min/1...
September 13, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Lisa Frigati, Sana Mahtab, Peter Nourse, Patricio Ray, Sofia Perrazzo, Takwanisa Machemedze, Nana-Akua Asafu Agyei, Mark Cotton, Landon Myer, Heather Zar
BACKGROUND: Little is known about renal pathology among perinatally HIV-infected children and adolescents in Africa. We assessed the prevalence of risk factors for chronic kidney disease in South African children and adolescents with perinatally acquired HIV-1 (HIV+) on antiretroviral therapy (ART) and HIV-negative children and adolescents. METHODS: HIV+ youth aged 9-14 years, on ART for > 6 months and age-matched HIV-negative children and adolescents were eligible for assessment of proteinuria and microalbuminuria using urine dipstick and Vantage analyser method...
September 15, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ryan L Crass, Keith A Rodvold, Bruce A Mueller, Manjunath P Pai
Antibiotic renal dose adjustments are determined in subjects with stable chronic kidney disease and may not translate to patients in late phase trials and practice. Ceftolozane/tazobactam, ceftazidime/avibactam, and telavancin all carry precautionary statements for reduced clinical response in patients with baseline creatinine clearance 30 - 50 mL/min, potentially due to unnecessary dose reduction in the setting of acute kidney injury (AKI). In this review, we discuss the regulatory landscape for antibiotics eliminated by the kidney and highlight the importance of the first 48 hours of therapy...
September 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Makiko Urabe, Tsutomu Nishida, Hiromi Shimakoshi, Akiyoshi Shimoda, Takahiro Amano, Aya Sugimoto, Kei Takahashi, Kaori Mukai, Tokuhiro Matsubara, Masashi Yamamoto, Shiro Hayashi, Sachiko Nakajima, Koji Fukui, Tsukasa Tanida, Takamichi Komori, Shunji Morita, Masami Inada
BACKGROUND/AIMS: It is unclear why colonic diverticular bleeding and diverticulitis rarely coexist. This study compared the characteristics of these conditions. METHODS: This single-center retrospective study examined 310 consecutive patients hospitalized with an episode of diverticular disease (cases) and outpatients without a diverticular episode (controls) from January 2012 to December 2015. We investigated distinct clinical factors in hospitalized patients with diverticular bleeding and diverticulitis...
September 14, 2018: Digestion
Julia Freitas Rodrigues Fernandes, Maria Inês Barreto Silva, Claudio Pinheiro Loivos, Ana Paula Medeiros Menna Barreto, Vagner da Silva Meira, Sergio Emanuel Kaiser, Rachel Bregman, Márcia Regina Simas Torres Klein
OBJECTIVES: Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease (CVD), the main cause of mortality in chronic kidney disease (CKD). Although the prevalence of OSA in patients with CKD has not been established, a few studies suggest that it is higher than in the general population, potentially increasing the risk for CVD. Obesity increases the risk, whereas sarcopenia has been suggested as a consequence of OSA in the general population. To our knowledge, these associations have not been adequately evaluated in patients with CKD...
May 25, 2018: Nutrition
Víctor Lorenzo Sellarés
The decision to initiate renal replacement therapy (RRT) implies a wide margin of uncertainty. Glomerular filtration rate (GFR) tells us the magnitude of renal damage. Proteinuria indicates the speed of progression. However, nowadays more than 50% of patients are still initiating RRT hastily, and it is life threatening. HYPOTHESIS: By analysing Emergency Department (ED) frequentation and causes of a hurried initiation, we can better schedule the timing of the start of RRT. METHOD: Retrospective and observational study of all CKD patients in our outpatient clinic...
September 12, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Jamie A Green, Patti L Ephraim, Felicia F Hill-Briggs, Teri Browne, Tara S Strigo, Chelsie L Hauer, Rebecca A Stametz, Jonathan D Darer, Uptal D Patel, Katina Lang-Lindsey, Brian L Bankes, Shakur A Bolden, Patricia Danielson, Suzanne Ruff, Lana Schmidt, Amy Swoboda, Peter Woods, Brandy Vinson, Diane Littlewood, George Jackson, Jane F Pendergast, Jennifer St Clair Russell, Kelli Collins, Evan Norfolk, Ion D Bucaloiu, Shravan Kethireddy, Charlotte Collins, Daniel Davis, Jeremy dePrisco, Dave Malloy, Clarissa J Diamantidis, Sherri Fulmer, Jennifer Martin, Dori Schatell, Navdeep Tangri, Amanda Sees, Cory Siegrist, Jeffrey Breed, Angela Medley, Elisabeth Graboski, Jonathan Billet, Matthew Hackenberg, Dale Singer, Stephanie Stewart, Aviel Alkon, Nrupen A Bhavsar, LaPricia Lewis-Boyer, Caitlin Martz, Christina Yule, Raquel C Greer, Milda Saunders, Blake Cameron, L Ebony Boulware
Care for patients transitioning from chronic kidney disease to kidney failure often falls short of meeting patients' needs. The PREPARE NOW study is a cluster randomized controlled trial studying the effectiveness of a pragmatic health system intervention, 'Patient Centered Kidney Transition Care,' a multi-component health system intervention designed to improve patients' preparation for kidney failure treatment. Patient-Centered Kidney Transition Care provides a suite of new electronic health information tools (including a disease registry and risk prediction tools) to help providers recognize patients in need of Kidney Transitions Care and focus their attention on patients' values and treatment preferences...
September 12, 2018: Contemporary Clinical Trials
Tomáš Šálek, Alena Adamíková
The aim of this study was to provide evidence for the hypothesis that estimated glomerular filtration rate from serum Cystatin C (eGFRcys) is better to be determined for all elderly type 2 diabetes mellitus (T2DM) patients based on eGFRcys upward and downward reclassification rate for hypothetical metformin dose reduction by eGFRcys at the GFR decision point of 45 mL/min/1.73 m2 . A total of 265 consecutive T2DM elderly patients (age range 65-91 years) from outpatient diabetic clinic were included in the study...
September 15, 2018: Basic & Clinical Pharmacology & Toxicology
Peter Tajti, Aris Karatasakis, Barbara A Danek, Khaldoon Alaswad, Dimitri Karmpaliotis, Farouc A Jaffer, James W Choi, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, M Nicholas Burke, Oleg Krestyaninov, Dmitrii Khelimskii, Catalin Toma, Anthony H Doing, Barry Uretsky, Michalis Koutouzis, Ioannis Tsiafoutis, R Michael Wyman, Santiago Garcia, Elizabeth Holper, Iosif Xenogiannis, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². RESULTS: Compared with patients without CKD (n = 1444; 73%), patients with CKD (n = 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity...
September 15, 2018: Journal of Invasive Cardiology
Giulio Geraci, Marta Maria Zammuto, Alessandro Mattina, Luca Zanoli, Calogero Geraci, Antonio Granata, Emilio Nardi, Pasquale Mario Fatuzzo, Santina Cottone, Giuseppe Mulè
Obesity is a well-known risk factor for the development and progression of chronic kidney disease. Recently, para-perirenal ultrasonographic fat thickness (PUFT) has shown to correlate with both total and visceral fat better than body mass index (BMI), waist circumference (WC), and other indices of obesity. Moreover, a local paracrine and mechanical action of the PUFT on kidney has been described in recent studies. Aim of our study was to assess the relationship between glomerular filtration rate (GFR) and PUFT in comparison with other anthropometric and ultrasonographic indices of adiposity...
September 14, 2018: Journal of Clinical Hypertension
Toshijiro Aoki, Hideki Ishii, Akihito Tanaka, Susumu Suzuki, Satoshi Ichimiya, Masaaki Kanashiro, Toyoaki Murohara
BACKGROUND: The combined influence of CKD and worsening renal function (WRF) on clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been fully understood. METHODS: We analyzed 443 patients diagnosed with AMI who underwent primary PCI. Based on their estimated glomerular filtration rate (eGFR), they were classified into two groups: a high eGFR group (eGFR ≥ 45 mL/min/1.73 m2 , n = 381) and a low eGFR group (eGFR < 45 mL/min/1...
September 14, 2018: Clinical and Experimental Nephrology
Racquel Wells, Mahboob Rahman
PURPOSE OF REVIEW: To review the impact of the Systolic Blood Pressure Interventional Trial (SPRINT) on renal function and chronic kidney disease. RECENT FINDINGS: Hypertension is a risk factor for cardiovascular and kidney outcomes in patients with chronic kidney disease (CKD). The benefits of intensive blood pressure lowering in the CKD population in previous studies are unclear. The SPRINT compared standard (< 140 mmHg) and intensive (< 120 mmHg) blood pressure management in nondiabetic patients with high risk of cardiovascular disease...
September 14, 2018: Current Hypertension Reports
Kelly R McMahon, Maya Harel-Sterling, Michael Pizzi, Louis Huynh, Erin Hessey, Michael Zappitelli
BACKGROUND: Childhood cancer survivors treated with cisplatin, ifosfamide, or carboplatin are at risk for late kidney and blood pressure (BP) abnormalities. Few studies have comprehensively evaluated kidney outcomes and 24-h ambulatory BP monitoring (ABPM) in this population. We aimed to describe chemotherapy-associated acute kidney injury (AKI) and late kidney outcomes using standardized definitions. METHODS: This was a single-center longitudinal pilot study of 23 children who participated in a previous study during cisplatin, carboplatin, or ifosfamide treatment...
September 14, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Tak Kyu Oh, Sunghee Han, Ah-Young Oh, Saeyeon Kim, Jung-Hee Ryu
BACKGROUND: The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery. METHODS: We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016...
September 14, 2018: Journal of Anesthesia
I Elalamy, O Hanon, G Deray, V Launay-Vacher
In the case of venous thromboembolic disease (VTE), physicians are facing more and more difficulties in managing VTE and their treatment in frail patients. These patients could present several risk situations such as: chronic kidney disease (CKD), underweight or malnourished, falls, cognitive impairment, multi-medicated patients, cancer and pregnancy. Guidelines typically recommend anticoagulation. There are multiple challenges in the safe use of anticoagulation in frail patients, including bleeding risk, monitoring and adherence, and polypharmacy...
September 2018: Journal de médecine vasculaire
Yanlin Ren, Dingkun Wang, Fuer Lu, Xin Zou, Lijun Xu, Kaifu Wang, Wenya Huang, Hao Su, Chu Zhang, Yang Gao, Hui Dong
BACKGROUND: Obese subjects have been considered to be in a state of chronic, low-grade systemic inflammation. Excess fat accumulation and persistent inflammation may promote renal dysfunction, to cause chronic kidney disease (CKD) and even end-stage kidney failure. Coptidis Rhizoma is a classical traditional Chinese herb well known for its hypoglycemic and hypolipidemic properties. The mechanism is partially associated with its anti-inflammatory effect. However, this effect is rarely investigated in obesity and obesity-related glomerulopathy (ORG)...
October 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Jason Ge Zelt, Bruno A Svajger, Kieran Quinn, Mandy E Turner, Kimberly J Laverty, Bonnie Shum, Rachel M Holden, Michael A Adams
Pathogenic accumulation of calcium (Ca) and phosphate (PO4 ) in vasculature is a sentinel of advancing cardiovascular disease in chronic kidney disease (CKD). This study sought to characterize acute distribution patterns of radiolabeled 33 PO4 and 45 Ca in cardiovascular tissues of rats with CKD (0.25% dietary adenine). The disposition of 33 PO4 and 45 Ca was assessed in blood and 36 tissues after a 10-minute intravenous infusion of one of the following: (i) PO4  pulse + tracer 33 PO4 ; (ii) PO4  pulse + tracer 45 Ca; or (iii) saline + tracer 45 Ca in CKD and non-CKD animals...
September 14, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
D J X Liu, E Meyer, B J G Broeckx, S Daminet, J R Delanghe, E Stock, E Bogaerts, M Hesta, K Vanderperren
BACKGROUND: Markers of kidney dysfunction and damage have potential to detect chronic kidney disease (CKD) in early stages. However, data on long-term variation of these markers in healthy dogs is lacking and is crucial for the interpretation of results. HYPOTHESIS/OBJECTIVES: To determine temporal variations of serum cystatin C (sCysC) and urinary retinol-binding protein (uRBP), neutrophil gelatinase-associated lipocalin (uNGAL), immunoglobulin G (uIgG), and C-reactive protein (uCRP) in healthy dogs...
September 14, 2018: Journal of Veterinary Internal Medicine
Richard Masoetsa, Ala AʼGroof, Madan Kapoor, Grace Messenger, Imtiaz Hussain
BACKGROUND: Calciphylaxis is a potentially life-threatening condition involving painful necrotic skin ulcerations, especially of the lower extremities. It is generally associated with chronic kidney failure but may be seen in nonuremic cases. CASE REPORT: We report a case of calciphylaxis in a 60-year-old man with diabetes on dialysis for end-stage renal disease and known to have other typical combination of risk factors associated with calciphylaxis syndrome. On examination, he presented with multiple intensely painful calciphylaxis wounds on his legs and ankles...
September 13, 2018: Journal of Wound, Ostomy, and Continence Nursing
Miguel Bigotte Vieira, Rita Magriço, Catarina Viegas Dias, Lia Leitão, João Sérgio Neves
Background: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains uncertain. Methods: We analysed 4863 non-institutionalized USA adults with CKD [defined by an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m2 and/or a urinary albumin:creatinine ratio >30 mg/g] in a nationwide study using the National Health and Nutrition Examination Survey (NHANES) 1999-2010...
September 12, 2018: Nephrology, Dialysis, Transplantation
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