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https://www.readbyqxmd.com/read/29615306/structural-equation-modeling-to-explore-patient-to-staff-ratios-as-an-explanatory-factor-for-variation-in-dialysis-facility-outcomes
#1
Rosa K Hand, Jeffrey M Albert, Ashwini R Sehgal
OBJECTIVE: Patient to staff ratios vary based on facility characteristics, and therefore have been proposed as an explanatory factor for the variation in dialysis facility outcomes. This analysis tested that hypothesis. DESIGN AND METHODS: Observational study using Dialysis Facility Report data. Reported staff numbers from the Annual Facility Survey were converted to full time equivalents (FTE). Subsequently, ratios were created for patients per FTE registered dietitian (RD), social worker, nurse, and patient care technician...
March 31, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29495132/acid-base-assessment-of-patients-receiving-hemodialysis-what-are-our-management-goals
#2
F John Gennari
Acid-base assessment of patients receiving conventional hemodialysis (HD) has been based solely on predialysis serum [total CO2 ], and treatment is currently driven by the KDOQI guideline from 2000. This guideline was directed solely at minimizing metabolic acidosis and thereby improving bone and muscle metabolism. In 2000, no data were available to assess the effects of acid-base status on morbidity and mortality. Since then, new data have emerged from several large cohort studies about the association between variations in predialysis serum [total CO2 ], as well as blood pH, and morbidity and mortality risk...
March 1, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29411718/glucose-pump-test-can-be-used-to-measure-blood-flow-rate-of-native-arteriovenous-fistula-in-chronic-hemodialysis
#3
Y C Yavuz, N Y Selcuk, L Altıntepe, I Güney, S Yavuz
PURPOSE: In chronic hemodialysis patients, the low flow of vascular access may leads to inadequate dialysis, increased rate of hospitalization, morbidity, and mortality. It was found that surveillance should be performed for native arteriovenous (AV) should not be performed for AV graft in various studies. However, surveillance was done in graft AV fistulas in most studies. Doppler ultrasonography (US) was suggested for surveillance of AV fistulas by the last vascular access guideline of National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI)...
January 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29396252/glycated-albumin-and-the-risk-of-chronic-kidney-disease-in-subjects-with-type-2-diabetes-a-study-in-north-indian-population
#4
Alok Raghav, Jamal Ahmad, Saba Noor, Khursheed Alam, Brijesh Kumar Mishra
AIM: Glycated albumin (GA) suggested being alternative glycemic marker than haemoglobin A1C (HbA1c) in patients with chronic kidney diseases (CKD). We investigated the association between GA and the progression of diabetic nephropathy (DN) in T2DM subjects. METHODS: We recruited T2DM subjects with different stages of CKD who had regularly measured serum creatinine and estimated glomerular filtration rates (eGFR) according to Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, HbA1c consecutively every 3 months along with GA levels and other anthropometric and demographic measurements...
January 30, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29357391/iron-deficiency-across-chronic-kidney-disease-stages-is-there-a-reverse-gender-pattern
#5
Mabel Aoun, Rita Karam, Ghassan Sleilaty, Leony Antoun, Walid Ammar
In non-dialysis chronic kidney disease patients, looking for iron deficiency is highly variable in practice and there is a great variability regarding the cutoffs used to treat iron deficiency. The aim of this study is to investigate the degree of iron deficiency in non-dialysis chronic kidney disease patients on erythropoiesis-stimulating agents. We included all non-dialysis chronic kidney disease patients that applied to the Lebanese Ministry of Public Health for erythropoiesis-stimulating agents' coverage during a 5-month period...
2018: PloS One
https://www.readbyqxmd.com/read/29148006/autogenous-forearm-loop-arteriovenous-fistula-creation
#6
Weng Jun Tang, Arman Zaharil Mat Saad
INTRODUCTION: Arteriovenous fistula is a lifeline for end-stage kidney disease patients on dialysis. The quality of the vein and artery to be used plays a crucial role in attaining a functioning, reliable and long-lasting arteriovenous fistula. The aim of the study is to present an alternative for haemodialysis access to preserve the upper arm vasculature for future use - the forearm loop arteriovenous fistula. METHODS: From October 2015 to September 2016, 202 patients with chronic kidney disease (CKD), stages 4 and 5, underwent arteriovenous fistula creation at the Universiti Sains Malaysia Hospital, Malaysia...
November 13, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29027182/preoperative-management-of-arteriovenous-fistula-avf-for-hemodialysis
#7
Gaetano Alfano, Francesco Fontana, Mario Iannaccone, Patrizia Noussan, Gianni Cappelli
Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients receiving HD...
November 17, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28956807/long-term-therapy-outcomes-when-treating-chronic-kidney-disease-patients-with-paricalcitol-in-german-and-austrian-clinical-practice-top-study
#8
Nicholas Obermüller, Alexander R Rosenkranz, Hans-Walter Müller, Dennis Hidde, András Veres, Sabine Decker-Burgard, Isolde Weisz, Helmut Geiger
Paricalcitol is approved for prevention and therapy of secondary hyperparathyroidism (sHPT) in patients with chronic kidney disease (CKD), with only short-term data in clinical routine settings. A 12-month observational study was conducted in Germany and Austria (90 centers, 761 patients) from 2008 to 2013. Laboratory values, demographical, and clinical data were documented in 629 dialysis patients and 119 predialysis patients. In predialysis patients, median intact parathormone (iPTH) was 180.0 pg/mL (n = 105) at the start of the study, 115...
September 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28941764/kdoqi-us-commentary-on-the-2017-kdigo-clinical-practice-guideline-update-for-the-diagnosis-evaluation-prevention-and-treatment-of-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd
#9
Tamara Isakova, Thomas L Nickolas, Michelle Denburg, Sri Yarlagadda, Daniel E Weiner, Orlando M Gutiérrez, Vinod Bansal, Sylvia E Rosas, Sagar Nigwekar, Jerry Yee, Holly Kramer
Chronic kidney disease-mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular calcification and has deleterious effects on clinical outcomes. KDOQI (Kidney Disease Outcomes Quality Initiative), an initiative of the National Kidney Foundation, addressed this issue with the publication of a clinical practice guideline for bone metabolism and disease in CKD in 2003, and 2 years later, a new definition and classification scheme for CKD-MBD was developed following a KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference...
December 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28941763/oral-anticoagulants-to-prevent-stroke-in-nonvalvular-atrial-fibrillation-in-patients-with-ckd-stage-5d-an-nkf-kdoqi-controversies-report
#10
Vinod K Bansal, Charles A Herzog, Mark J Sarnak, Michael J Choi, Ravindra Mehta, Bernard G Jaar, Michael V Rocco, Holly Kramer
Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as an important intervention for stroke prevention with nonvalvular AF in the general population. However, use of oral anticoagulants for stroke prevention in patients with CKD-5D and nonvalvular AF continues to be debated by the nephrology community...
December 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28920466/annals-express-evaluation-of-common-paediatric-creatinine-based-glomerular-filtration-rate-gfr-estimating-equations-in-black-african-children-in-kwazulu-natal-south-africa
#11
Yashna Rampursat, Rajendra Bhimma, Elaene Naicker, Fozy Peer, Verena Gounden
Background The use of serum creatinine (S-Cr) equations for estimating glomerular filtration rate (GFR) is well known in adults and children. We evaluated the revised Schwartz creatinine based estimated GFR (eGFR) prediction equation in Black African children in KwaZulu-Natal, South Africa. Methods Review of medical records of all Black African patients aged 2-18 years old who have had GFR determined by intravenous Technetium-99m-diethylene-triamine-pentaacetate((9)(9)(m)Tc DTPA), for the period 1 January 2010 to 31 December 2014 at the Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa was performed...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28711962/the-relation-between-hemoglobin-variability-and-carotid-intima-media-thickness-in-chronic-hemodialysis-patients
#12
Safa Ersen Ganidagli, Orcun Altunoren, Ertuğrul Erken, Ismet Onder Isık, Berivan Ganidagli, Necmi Eren, Yasemin Coskun Yavuz, Ozkan Gungor
PURPOSE: Hemoglobin variability is a common problem among hemodialysis patients. We have previously demonstrated an association between Hb variability and left ventricular mass index. In this study, we investigated a possible relation between Hb variability and carotid intima-media thickness (CIMT). METHODS: Twelve-month hemoglobin (Hb) values of 135 patients on maintenance hemodialysis were examined retrospectively. The range of 11-12 gr/dl was accepted as normal according to the KDOQI guidelines...
October 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28495396/cardiovascular-risk-prediction-in-chronic-kidney-disease-patients
#13
Santiago Cedeño Mora, Marian Goicoechea, Esther Torres, Úrsula Verdalles, Ana Pérez de José, Eduardo Verde, Soledad García de Vinuesa, José Luño
INTRODUCTION: Scores underestimate the prediction of cardiovascular risk (CVR) as they are not validated in patients with chronic kidney disease (CKD). Two of the most commonly used scores are the Framingham Risk Score (FRS-CVD) and the ASCVD (AHA/ACC 2013). The aim of this study is to evaluate the predictive ability of experiencing a cardiovascular event (CVE) via these 2scores in the CKD population. MATERIAL AND METHODS: Prospective, observational study of 400 prevalent patients with CKD (stages 4 and 5 according the KDOQI; not on dialysis)...
May 8, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28493902/circulating-levels-of-sclerostin-but-not-dkk1-associate-with-laboratory-parameters-of-ckd-mbd
#14
Geert J Behets, Liesbeth Viaene, Björn Meijers, Frank Blocki, Vincent M Brandenburg, Anja Verhulst, Patrick C D'Haese, Pieter Evenepoel
INTRODUCTION: Mounting evidence indicates that a disturbed Wnt-β-catenin signaling may be involved in the pathogenesis of chronic kidney disease-mineral and bone and mineral disorder (CKD-MBD). Data on the impact of CKD on circulating levels of the Wnt antagonists sclerostin and Dickkopf related protein 1 (DKK1) and the relationship with laboratory parameters of CKD-MBD are incomplete. METHODS: We analyzed serum sclerostin and DKK1 in 308 patients across the stages of chronic kidney disease (kDOQI stage 1-2 n = 41; CKD stage 3 n = 54; CKD stage 4-5 n = 54; hemodialysis n = 100; peritoneal dialysis n = 59) as well as in 49 healthy controls...
2017: PloS One
https://www.readbyqxmd.com/read/28396744/diabetic-nephropathy-as-the-cause-of-end-stage-kidney-disease-reported-on-the-medical-evidence-form-cms2728-at-a-single-center
#15
Christina M Yuan, Robert Nee, Kevin A Ceckowski, Kendral R Knight, Kevin C Abbott
Background: End-stage renal disease (ESRD) incidence due to Type 2 diabetic nephropathy (DN) is 35-50%, according to the United States Renal Data System. Methods: A single-center, retrospective cohort study to determine incidence and diagnostic accuracy for Type 2 DN as the primary cause of ESRD (Code 250.40) on the Center for Medicare & Medicaid (CMS) Medical Evidence Report form (CMS2728) submitted at renal replacement therapy initiation. All patients  ≥18 years of age with a CMS2728 submitted between 1 March 2006 and 31 March 2015 at a single academic military medical center (ESRD Network 5) were included...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28396743/the-large-spectrum-of-renal-disease-in-diabetic-patients
#16
Sheila Bermejo, Julio Pascual, Maria José Soler
The prevalence of diabetic nephropathy (DN) among diabetic patients seems to be overestimated. Recent studies with renal biopsies show that the incidence of non-diabetic nephropathy (NDN) among diabetic patients is higher than expected. Renal impairment of diabetic patients is frequently attributed to DN without meeting the KDOQI criteria or performing renal biopsy to exclude NDN. In this editorial, we update the spectrum of renal disease in diabetic patients and the impact on diagnosis, prognosis and therapy...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28384340/parathyroid-hormone-and-vitamin-d-are-associated-with-the-risk-of-metabolic-obesity-in-a-middle-aged-and-older-korean-population-with-preserved-renal-function-a-cross-sectional-study
#17
Jeonghoon Ha, Kwanhoon Jo, Dong-Jun Lim, Jung-Min Lee, Sang-Ah Chang, Moo I L Kang, Bong Yun Cha, Min-Hee Kim
BACKGROUND: In general, obesity is a major contributor to metabolic syndrome (MetS) and is associated with insulin resistance (IR). Metabolically obese but normal weight (MONW) individuals present metabolic abnormalities and features of MetS despite having a normal range of body mass index (BMI). In recent years, different subtypes of obesity have been introduced, including metabolically healthy obese (MHO) and metabolically obese obese (MOO). Also, it has been reported that vitamin D and parathyroid hormone (PTH) are possibly linked with MetS...
2017: PloS One
https://www.readbyqxmd.com/read/28346348/vitamin-d-in-chronic-kidney-disease-and-dialysis-patients
#18
REVIEW
Guillaume Jean, Jean Claude Souberbielle, Charles Chazot
Vitamin D deficiency (<20 ng/mL) and insufficiency (20-29 ng/mL) are common among patients with chronic kidney disease (CKD) or undergoing dialysis. In addition to nutritional and sunlight exposure deficits, factors that affect vitamin D deficiency include race, sex, age, obesity and impaired vitamin D synthesis and metabolism. Serum 1,25(OH)₂D levels also decrease progressively because of 25(OH)D deficiency, together with impaired availability of 25(OH)D by renal proximal tubular cells, high fibroblast growth factor (FGF)-23 and decreased functional renal tissue...
March 25, 2017: Nutrients
https://www.readbyqxmd.com/read/28279411/dialysis-catheter-placement-in-patients-with-exhausted-access
#19
REVIEW
Syed Rahman, Joshua D Kuban
Patients with end-stage renal disease undergo renal transplant, peritoneal dialysis, or intermittent hemodialysis for renal replacement therapy. For hemodialysis, native fistulas or grafts are preferred but hemodialysis catheters are often necessary. Per KDOQI, the right jugular vein is the preferred vessel of access for these catheters. However, in patients with long-standing end-stage renal disease vein thrombosis, stenosis and occlusion occurs. In these patients with end-stage vascular access, unconventional routes of placement of dialysis catheters are needed...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28279405/vascular-access-guidelines-summary-rationale-and-controversies
#20
REVIEW
Adrian Sequeira, Mihran Naljayan, Tushar J Vachharajani
Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population...
March 2017: Techniques in Vascular and Interventional Radiology
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