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Renal older

Xue-Qing Yu, Jiang-Hua Chen, Zhaohui Ni, Nan Chen, Meng-Hua Chen, Jie Dong, Limeng Chen, Yusheng Yu, Xiao Yang, Wei Fang, Qiang Yao, James A Sloand, Mark Marshall
BACKGROUND: We report outcomes on ≥ 4 compared with < 4 exchanges/day in a Chinese cohort on continuous ambulatory peritoneal dialysis (CAPD). METHODS: Data were sourced from the Baxter (China) Investment Co. Ltd Patient Support Program database, comprising an inception cohort commencing CAPD between 1 January 2005 and 13 August 2015. We used cause-specific Cox proportional hazards and Fine-Gray competing risks (kidney transplantation, change to hemodialysis) models to estimate mortality risk on ≥ 4 compared with < 4 exchanges/day...
October 12, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Divya Garg, Christopher Naugler, Vishal Bhella, Fahmida Yeasmin
OBJECTIVE: To determine the positive predictive value (PPV) of a single random abnormal urine albumin-to-creatinine ratio (ACR) compared with repeat test results in patients with type 2 diabetes to diagnose chronic kidney disease (CKD). DESIGN: Retrospective, longitudinal secondary data analysis using Calgary Laboratory Services data. SETTING: Calgary, Alta. PARTICIPANTS: Patients aged 21 and older with a new diagnosis of diabetes in the study period from January 2008 to December 2015 and with a first abnormal urine ACR followed by another ACR test completed within 120 days...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Joshua Loewenstern, Remi A Kessler, John Caridi
PURPOSE: Thoracic vertebral fracture repair after a traumatic injury can be associated with significant risk for postoperative complications. Surgical outcomes are further complicated by patient comorbidity, particularly diabetes mellitus. The present study compared outcomes and complication rates for traumatic thoracic vertebral fracture repair in a matched sample of diabetic patients and non-diabetic controls. METHODS: Patients with a surgical repair of a trauma-induced thoracic vertebral fracture treated from 2010-2015 were identified from the Trauma Quality Improvement Program (TQIP) database yielding 5,557 cases...
October 9, 2018: World Neurosurgery
Andrea Corsonello, Lisanne Tap, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Carmine Zoccali, Tomasz Kostka, Agnieszka Guligowska, Francesco Mattace-Raso, Pedro Gil, Lara Guardado Fuentes, Itshak Meltzer, Ilan Yehoshua, Francesc Formiga-Perez, Rafael Moreno-González, Christian Weingart, Ellen Freiberger, Johan Ärnlöv, Axel C Carlsson, Silvia Bustacchini, Fabrizia Lattanzio
BACKGROUND: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align laboratory and biomarker results with medical and functional data obtained from this cohort...
October 11, 2018: BMC Nephrology
Laura Sandbergen, Selcuk Guven, Maria Pilar Laguna
PURPOSE OF REVIEW: Currently, small renal masses account for the largest proportion of renal tumour and small renal cell carcinomas (RCC). Although partial nephrectomy, whenever possible, is recognized as the gold standard for treatment, thermal ablation has gained increasing attention as optional treatment in a population sector harbouring small renal masses/small RCCs. The purpose of this review is to update comparative outcomes between these two options of treatment. RECENT FINDINGS: Recent observational case-control and population-based cohorts applying propensity score or inverse probability treatment weighted methodology adjusting for baseline patient and tumour characteristics, compare outcomes between partial nephrectomy and thermal ablation (both cryotherapy and radiofrequency), radical nephrectomy and thermal ablation and between thermal ablation and nonsurgical management...
October 10, 2018: Current Opinion in Urology
Victoria M White, David J T Marco, Damien Bolton, Nathan Papa, Rachel E Neale, Michael Coory, Ian D Davis, Simon Wood, Graham G Giles, Susan J Jordan
OBJECTIVES: To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states. MATERIALS AND METHODS: All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages treated by PN were determined for the two age groups...
October 11, 2018: BJU International
Tiffany R Washington, Debra J Hain, Sheryl Zimmerman, Iris Carlton-LaNey
Controlled fluid intake is an important aspect of living with end stage renal disease (ESRD), and is complicated by depression, the most common mental health issue affecting individuals with ESRD. Factors that mitigate the deleterious effects of depression are underexplored. This study sought to identify potential mediators between depression and fluid adherence in 107 individuals with ESRD aged 50 years and older by comparing four logistic regression models. Age was associated with an increase in fluid adherence (adjusted odds ratio [AOR]=1...
May 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Zachary Bouck, Graham C Mecredy, Noah M Ivers, Moumita Barua, Danielle Martin, Peter C Austin, Joshua Tepper, R Sacha Bhatia
Importance: International nephrology societies advise against nonsteroidal anti-inflammatory drug (NSAID) use in patients with hypertension, heart failure, or chronic kidney disease (CKD); however, recent studies have not investigated the frequency or associations of use in these patients. Objectives: To estimate the frequency of and variation in prescription NSAID use among high-risk patients, to identify characteristics associated with prescription NSAID use, and to investigate whether use is associated with short-term, safety-related outcomes...
October 8, 2018: JAMA Internal Medicine
Sonia Jiménez-Mola, César Calvo-Lobo, Javier Idoate-Gil, Jesús Seco-Calvo
BACKGROUND: Hip fractures may be the greatest complication secondary to osteoporotic disorder. The objective of this study was to determine the influence of age distribution in the functionality, comorbidity, complications and surgical features of older adults with hip fractures. METHODS: A prospective cohort study was carried out from 2013 to 2014. A sample of 557 adults over 75 years old with osteoporotic hip fractures was recruited from the Orthogeriatric Unit of the León University Hospital (Spain)...
May 2018: Revista da Associação Médica Brasileira
Jakub Baran, Jakub Podolec, Marek T Tomala, Bartłomiej Nawrotek, Łukasz Niewiara, Andrzej Gackowski, Tadeusz Przewłocki, Krzysztof Żmudka, Anna Kabłak-Ziembicka
Introduction: Currently, Cardiology Centres are overfilled with patients with degenerative aortic valve stenosis (DAS), usually eldery, with severe concommittant comorbidities, who are referred for further decisions and possible intervention. Aim: To evaluate changes in the risk profile of patients with severe DAS admitted to the cardiology department a decade ago compared with patients currently being admitted. Material and methods: We retrospectively evaluated all patients admitted with confirmed severe DAS, hospitalized during 2005-2006 (group I: 140 patients) and in 2016 (group II: 152 patients), admitted for aortic valve intervention...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Akihiro Kosoku, Junji Uchida, Kazuya Kabei, Shunji Nishide, Hisao Shimada, Tomoaki Iwai, Nobuyuki Kuwabara, Toshihide Naganuma, Keiko Maeda, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
BACKGROUND: The growth in the end-stage kidney disease (ESKD) population has been predominantly in the older adult population. In Japan, ABO-incompatible kidney transplantation has become an acceptable treatment option. However, few studies have been conducted on elderly ABO-incompatible kidney transplantation. PATIENTS AND METHODS: Seventeen patients aged 60 years and older who received their grafts from ABO-incompatible living donors at our institution between December 2006 and September 2016 were enrolled in this study, and the outcome of these recipients was evaluated...
October 9, 2018: Urologia Internationalis
L Murthy, P Dreyer, P Suriyaarachchi, F Gomez, C L Curcio, D Boersma, G Duque
BACKGROUND: Frailty is associated with poor outcomes hence identification of risks factors is pivotal. Since the independent role of parathyroid hormone (PTH) in frailty remains unexplored, we aimed to determine this in a population of older individuals with a history of falling. DESIGN: Cross-sectional study. SETTING: Falls and Fracture Clinic, Nepean Hospital (Penrith, Australia). PARTICIPANTS: 692 subjects (mean age=79, 65% women) assessed between 2009-2015...
2018: Journal of Frailty & Aging
X Li, K Liu, X Gu, X J Yuan, Z J Shao
Objective: To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Wei River Basin from 2005 to 2015, and analyze the environmental factors that cause the differences of spatial distribution. Methods: HFRS reported cases in Wei River Basin from 2005 to 2015 were collected form "National Disease Reporting Information System" , and the epidemiological features of HFRS were analyzed. Boosted regression trees (BRT) model was applied to evaluate the environment factors on the geographical distribution of HFRS in Wei River basin at 5 km×5 km gird scale...
September 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Katie E Barber, Alison M Bell, Mary Joyce B Wingler, Jamie L Wagner, Kayla R Stover
Omadacycline is a novel aminomethylcycline seeking approval for treatment of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections. This article reviews existing data pertaining to the biochemistry, mechanism of action, pharmacokinetics/pharmacodynamics, in vitro activity, and current progress with omadacycline in clinical trials. Omadacycline inhibits protein synthesis by binding to the 30S subunit of the bacterial ribosome at the tetracycline binding site with an affinity similar to glycylcyclines...
October 5, 2018: Pharmacotherapy
Ruth A Morgan, John A Keen, Natalie Homer, Mark Nixon, Anna McKinnon-Garvin, Jodie Moses-Williams, Sarah Davis, Patrick W F Hadoke, Brian R Walker
Equine Cushing's Disease (Pituitary pars intermedia dysfunction (PPID)) is a common condition of older horses but its pathophysiology is complex and poorly understood. In contrast to pituitary-dependent hyperadrenocorticism in other species, PPID is characterised by elevated plasma ACTH but not elevated plasma cortisol. In this study, we address this paradox and the hypothesis that PPID is a syndrome of ACTH excess in which there is dysregulation of peripheral glucocorticoid metabolism and binding. In 14 PPID horses compared with 15 healthy controls, we show that: in plasma, cortisol levels and cortisol binding to CBG were not different; in urine, glucocorticoid and androgen metabolites were increased up to four-fold; in liver, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) expression was reduced; in peri-renal adipose tissue 11β-HSD1 and carbonyl reductase 1 expression was increased; and tissue cortisol levels were not measurably different...
October 4, 2018: Endocrinology
Stephen M Korbet, Casey N Gashti, Joni K Evans, William L Whittier
Background: Percutaneous renal biopsy (PRB) of native kidneys (NKs) to better understand and treat acute kidney injury (AKI) is being advocated, but little is known about the risk of complications. Methods: We performed a retrospective study of PRB of NKs in 955 adults from 1991 to 2015 at an academic medical center with real-time ultrasound and automated biopsy needles. Patients undergoing PRB for evaluation of AKI ( n = 160) were compared with 795 patients biopsied for other reasons (not-AKI) for postbiopsy complications [need for transfusion of packed red blood cells (PRBCs), an interventional radiologic or surgical procedure, readmission or death]...
October 2018: Clinical Kidney Journal
Catherine Atkin, Alex Richter, Elizabeth Sapey
Monoclonal gammopathy of undetermined significance (MGUS) is characterised by the presence of a monoclonal paraprotein in the blood, without the characteristic end organ damage seen in multiple myeloma. MGUS is more common in older age groups and has a risk of progression to myeloma of 1% per year. Population screening is not currently recommended, but retrospective studies have suggested improvements in myeloma outcomes in those under MGUS follow-up; in addition, MGUS has associated complications, including fracture, osteoporosis, renal disease and infection, which can be treated...
October 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Pavlos Msaouel, Andrew L Hong, Elizabeth A Mullen, Michael B Atkins, Cheryl Lyn Walker, Chung-Han Lee, Marcus A Carden, Giannicola Genovese, W Marston Linehan, Priya Rao, Maria J Merino, Howard Grodman, Jeffrey S Dome, Conrad V Fernandez, James I Geller, Andrea B Apolo, Najat C Daw, H Courtney Hodges, Marva Moxey-Mims, Darmood Wei, Donald P Bottaro, Michael Staehler, Jose A Karam, W Kimryn Rathmell, Nizar M Tannir
Renal medullary carcinoma (RMC) is one of the most aggressive renal cell carcinomas. It predominantly afflicts young adults and adolescents with sickle cell trait and other sickle hemoglobinopathies, and is refractory to targeted and antiangiogenic therapies used in patients with clear-cell renal cell carcinoma. Platinum-based cytotoxic chemotherapy is the mainstay for RMC treatment. On the basis of recent advances in the diagnosis, management, and clinical trial development for RMC, a panel of experts met in October 2017 and developed updated consensus recommendations to inform clinicians, researchers, and patients...
September 12, 2018: Clinical Genitourinary Cancer
Hanwen Zhang, Wei Du, Danijela Gnjidic, Shanley Chong, Emily Lancsar, Nicholas Glasgow
AIMS: To examine trends in adverse drug reactions (ADR)-related hospitalisations in New South Wales (NSW). METHODS: Data were extracted from the Admitted Patient Data Collection (APDC), a census of hospital separations in NSW. We estimated age-adjusted rates of ADE-related hospitalisation between 1st July 2001 and 30th June 2014, and rates by patient characteristics, main therapeutic medication groups, and clinical condition groups that warranted the hospitalisation...
October 3, 2018: Internal Medicine Journal
Hans C Dreyer, Erin C Owen, Lisa A Strycker, Keith Smolkowski, Jonathan B Muyskens, Tessa K Kirkpatrick, Anita D Christie, Kerry S Kuehl, Brick A Lantz, Steven N Shah, Craig G Mohler, Brian A Jewett
Background: Substantial muscle atrophy occurs after total knee arthroplasty (TKA), resulting in decreased strength and impaired mobility. We sought to determine whether perioperative supplementation with essential amino acids (EAA) would attenuate muscle atrophy following TKA and whether the supplements were safe for ingestion in an older surgical population. Methods: We performed a double-blind, placebo-controlled, randomized trial of 39 adults (age range, 53 to 76 years) undergoing primary unilateral TKA who ingested 20 g of EAA (n = 19) or placebo (n = 20) twice daily for 7 days preoperatively and for 6 weeks postoperatively...
June 28, 2018: JB & JS open access
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