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Solène M Laville, Marie Metzger, Bénédicte Stengel, Christian Jacquelinet, Christian Combe, Denis Fouque, Maurice Laville, Luc Frimat, Carole Ayav, Elodie Speyer, Bruce M Robinson, Ziad A Massy, Sophie Liabeuf
AIMS: Drug prescription is difficult to manage in patients with chronic kidney disease (CKD). We assessed the prevalence and determinants of inappropriate drug prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD under nephrology care. We also assessed the impact of the equation used to estimate GFR on the prevalence estimates. METHODS: The CKD-REIN cohort includes 3033 outpatients with CKD (eGFR between 15-60 ml/min per 1...
August 15, 2018: British Journal of Clinical Pharmacology
Shingo Fukuma, Miho Kimachi, Kenji Omae, Yuki Kataoka, Hajime Yamazaki, Manabu Muto, Tadao Akizawa, Motoko Yanagita, Shunichi Fukuhara
BACKGROUND: Although cancer management in dialysis patients has become a commonly encountered issue, known as "onco-nephrology", few evidence-based clinical recommendations have been proposed. Here, we examined the variation in referral behaviors adopted by dialysis physicians on encountering dialysis patients with signs/symptoms suggestive of cancer. METHODS: We conducted a vignette-based study in August 2015. We sent a 14-page questionnaire to 191 dialysis physicians, including the representative dialysis facilities participating in a Japanese dialysis cohort (the Japan Dialysis Outcomes and Practice Patterns Study)...
2018: PloS One
Sabeeta Khatri, Irshad Ali Bajeer, Vina Tresa, Seema Hashmi, Muhammed Mubarak, Ali Asghar Lanewala
OBJECTIVE: To study the frequency, clinicopathological features and short-term outcome of mesangiocapillary glomerulonephritis (MCGN) in children at a tertiary care kidney center in Pakistan. METHODS: A descriptive, observational study was conducted at the Paediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2011 till December 2015. A review of all paediatric (<18 years) renal biopsies during the study period was performed and cases of MCGN were enrolled...
August 2018: JPMA. the Journal of the Pakistan Medical Association
Sevcan A Bakkaloğlu, Yaşar Kandur, Erkin Serdaroğlu, Aytül Noyan, Aysun Karabay Bayazıt, Mehmet Taşdemir, Sare Gülfem Özlü, Gül Özçelik, İsmail Dursun, Caner Alparslan, Meltem Akcaboy, Yeşim Özdemir Atikel, Gönül Parmaksız, Bahriye Atmış, Lale Sever
BACKGROUND: During erythropoietin-stimulating agent (ESA) treatment, hemoglobin (Hb) levels usually fluctuate; this phenomenon is known as "Hb cycling (HC)." In this study, we aimed to evaluate the predictors of HC and its impact on left ventricular hypertrophy (LVH) as a patient-important outcome parameter in pediatric dialysis patients. METHODS: Records of patients followed up in nine pediatric nephrology centers between 2008 and 2013 were reviewed. More than 1 g/dL decrease or increase in Hb level was considered as HC...
August 13, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Nisreen Abu-Shahin, Ali Al-Khader, Duaa' Qattan, Kamal Akl
Abu-Shahin N, Al-Khader A, Qattan D, Akl K. C1q nephropathy among children with nephrotic syndrome: Ten-year experience from a pediatric nephrology unit. Turk J Pediatr 2018; 60: 14-21. C1q nephropathy (C1qN) is a rare glomerulopathy mostly seen in children, and presents with nephrotic syndrome (NS). Diagnosis depends on immunoflourescence or immunohistochemical C1q mesangial deposition, excluding other immune-mediated diseases. We retrospectively investigated C1qN incidence, clinicopathological features, and outcome among pediatric NS in our institution...
2018: Turkish Journal of Pediatrics
Bart L Dolmatch, John C Gurley, Kevin M Baskin, Boris Nikolic, Jeffrey H Lawson, Surendra Shenoy, Theodore F Saad, Ingemar Davidson, Mark O Baerlocher, Emil I Cohen, Sean R Dariushnia, Salomão Faintuch, Bertrand Janne d'Othee, Thomas B Kinney, Mehran Midia, James Clifton
No abstract text is available yet for this article.
August 13, 2018: Journal of Vascular Access
Sun-Ji Park, Yeawon Kim, Ying Maggie Chen
The advent of next-generation sequencing (NGS) in recent years has led to a rapid discovery of novel or rare genetic variants in human kidney cell genes, which is transforming the risk assessment, diagnosis, and treatment of kidney disease. Mutations may lead to protein misfolding, disruption of protein trafficking, and endoplasmic reticulum (ER) retention. An imbalance between the load of misfolded proteins and the folding capacity of the ER causes ER stress and unfolded protein response. Mutations in nephrin (NPHS1), podocin (NPHS2), laminin β2 (LAMB2), and α-actinin-4 (ACTN4) have been shown to induce ER stress in HEK293 cells and podocytes in hereditary nephrotic syndromes; various founder mutations in collagen IV α chains (COL4A) have been demonstrated to activate podocyte ER stress in collagen IV nephropathies; and mutations in uromodulin (UMOD) have been reported to trigger tubular ER stress in autosomal dominant tubulointerstitial kidney disease...
August 11, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Maarten W Taal
No abstract text is available yet for this article.
August 7, 2018: Current Opinion in Nephrology and Hypertension
Meherzad Kutky, Sarah Aloudat
Rationale: Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup of SLE, and although there is no strict age cut-off, 50 years is commonly used as the minimum age for disease onset. In this report, we present a case of a 74-year-old male with late-onset SLE and biopsy-proven lupus nephritis (LN). Presenting concerns of the patient: A 74-year-old male was referred to the nephrology clinic with a rapidly rising creatinine from a baseline of 60 µmol/L to 176 µmol/L...
2018: Canadian Journal of Kidney Health and Disease
J Nossent, W Raymond, A Kang, D Wong, M Ognjenovic, A Chakera
Objectives To investigate the current demographic, clinical and histological characteristics of patients with lupus nephritis (LN) in Western Australia (WA) with regards to their predictive value for patient and renal outcome. Methods Retrospective study of adult systemic lupus erythematosus (SLE) patients with a first renal biopsy demonstrating LN between 1997 and 2017 at a metropolitan tertiary hospital in WA. Clinical data were collected at baseline and last follow-up with renal biopsy findings classified by International Society of Nephrology (ISN) criteria...
August 9, 2018: Lupus
Agnes Katalin Urban, Celine Foote, Frank P Brennan, Mark Brown, Brendon Lee
AIM: To explore the quality of deaths in the acute hospital under a Nephrology service at two teaching hospitals in Sydney with Renal Supportive Care services over time. METHODS: Retrospective chart review of all deaths in the years 2004, 2009 and 2014 at St George Hospital (SGH) and in 2014 at Concord Repatriation General Hospital (CRGH). Domains assessed were recognition of dying, invasive interventions, symptom assessment, anticipatory prescribing, documentation of spiritual needs and bereavement information for families...
August 9, 2018: Nephrology
Faheemuddin Azher Ahmed
The population in the United States is aging and presents many challenges in the healthcare world. According to the report released by United States Census Bureau in June 2017, there are around 50 million residents aged 65 years and over as of 2016. Among the multiple healthcare challenges, kidney disease is a significant one because of its high burden, high cost and low awareness. Medicare spending on chronic kidney disease for 65 plus aged patients exceeded $ 50 billion in 2013. Different studies based on different calculations have estimated that at least one-third of chronic kidney disease patients are aged above 65 years...
August 2018: Aging and Disease
Carmine Zoccali, Mustafa Arici, Peter J Blankestijn, Annette Bruchfeld, Giovambattista Capasso, Danilo Fliser, Denis Fouque, Dimitrios Goumenos, Markus Ketteler, Jolanta Malyszko, Ziad Massy, Ivan Rychlík, Goce Spasovski
Scientific societies are increasingly seen as central to the advancement of information sharing and collaboration among scientists and clinical investigators for the progress of medical research and the promotion of education, professional competence, integrity and quality studies. To more effectively serve the practicing nephrologists and investigators dedicated to renal science, the Council of the European Renal Association and European Dialysis and Transplantation Association (ERA-EDTA) reorganized and integrated the various activities of the society into two branches, the Clinical Nephrology Governance branch and the Renal Science branch...
August 2018: Clinical Kidney Journal
Zachary WareJoncas, Jarryd M Campbell, Gabriel Martínez-Gálvez, William A C Gendron, Michael A Barry, Peter C Harris, Caroline R Sussman, Stephen C Ekker
The expanding field of precision gene editing is empowering researchers to directly modify DNA. Gene editing is made possible using synonymous technologies: a DNA-binding platform to molecularly locate user-selected genomic sequences and an associated biochemical activity that serves as a functional editor. The advent of accessible DNA-targeting molecular systems, such as zinc-finger nucleases, transcription activator-like effectors (TALEs) and CRISPR-Cas9 gene editing systems, has unlocked the ability to target nearly any DNA sequence with nucleotide-level precision...
August 8, 2018: Nature Reviews. Nephrology
Amir Kazory, Peter A McCullough, Janani Rangaswami, Claudio Ronco
The field of cardiorenal medicine is vast, rapidly expanding, and complex. Conventional nephrology training programs provide the fellows with the necessary core knowledge to provide general care for patients with renal and cardiovascular diseases. However, there is a need for focused training of interested physicians to master the specialized aspects of these exceedingly common clinical scenarios and optimize the care of such patients. A cardionephrology-focused training can add value to the nephrology subspecialty and potentially increase its attractiveness for a significant subset of trainees...
August 8, 2018: Cardiorenal Medicine
B Dakshayani, Manjula Lakshmanna, R Premalatha
Aim: To determine the predictors of frequent relapses and steroid dependency in children with steroid-sensitive nephrotic syndrome. Material and Methods: All children aged six months to 18 years with steroid-sensitive nephrotic syndrome registered in the nephrology clinic between 2003 and 2015 at a tertiary center who were followed up for at least 1year after onset were included in the study. Results: Two hundred seventy-seven patients with steroid-sensitive nephrotic syndrome who were followed up for at least 1 year from onset of disease were included...
March 2018: Türk Pediatri Arşivi
Jay B Wish
The Food and Drug Administration (FDA) defines a "biosimilar" agent as a biologic that is highly similar to the reference or originator biologic product notwithstanding minor differences in clinically inactive components with no clinically meaningful differences in terms of the safety, purity, and potency. The advantage of biosimilars is that they are usually about 15%-30% less expensive than the reference product, which results in system-wide cost savings and increased patient access. Because biologic drugs are produced by living organisms, they are by nature heterogeneous and identical copies cannot be made, unlike generic versions of small-molecule drugs...
August 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Connie M Rhee, Yoshitsugu Obi, Anna T Mathew, Kamyar Kalantar-Zadeh
Launched in 2016, the overarching goal of the Precision Medicine Initiative is to promote a personalized approach to disease management that takes into account an individual's unique underlying biology and genetics, lifestyle, and environment, in lieu of a one-size-fits-all model. The concept of precision medicine is pervasive across many areas of nephrology and has been particularly relevant to the care of advanced chronic kidney disease patients transitioning to end-stage kidney disease (ESKD). Given many uncertainties surrounding the optimal transition of incident ESKD patients to dialysis and transplantation, as well as the high mortality rates observed during this delicate transition period, there is a pressing urgency for implementing precision medicine in the management of this population...
July 2018: Seminars in Nephrology
Giorgina Barbara Piccoli, Conrad Breuer, Gianfranca Cabiddu, Angelo Testa, Christelle Jadeau, Giuliano Brunori
Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties...
August 3, 2018: Journal of Clinical Medicine
Mark A Perazella, Mitchell H Rosner
Acute kidney injury (AKI) is a common complication in cancer patients and occurs in up to 30% of patients during their disease course. Multiple myeloma, leukemia/lymphoma, renal cell carcinoma, and hematopoietic stem cell transplantation are commonly associated with the development of AKI. Drugs used to treat various malignancies are also a common and notable cause of AKI in this population. Nephrology consultation is important to ensure proper and rapid diagnosis, as well as appropriate therapy and follow-up...
July 15, 2018: Oncology (Williston Park, NY)
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