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Ckd guidelines

Julio Rosenstock, Vlado Perkovic, John H Alexander, Mark E Cooper, Nikolaus Marx, Michael J Pencina, Robert D Toto, Christoph Wanner, Bernard Zinman, David Baanstra, Egon Pfarr, Michaela Mattheus, Uli C Broedl, Hans-Juergen Woerle, Jyothis T George, Maximilian von Eynatten, Darren K McGuire
BACKGROUND: Cardiovascular (CV) outcome trials in type 2 diabetes (T2D) have underrepresented patients with chronic kidney disease (CKD), leading to uncertainty regarding their kidney efficacy and safety. The CARMELINA® trial aims to evaluate the effects of linagliptin, a DPP-4 inhibitor, on both CV and kidney outcomes in a study population enriched for cardio-renal risk. METHODS: CARMELINA® is a randomized, double-blind, placebo-controlled clinical trial conducted in 27 countries in T2D patients at high risk of CV and/or kidney events...
March 14, 2018: Cardiovascular Diabetology
Subir Bhatia, Shilpkumar Arora, Sravya M Bhatia, Mohammed Al-Hijji, Yogesh N V Reddy, Parshva Patel, Charanjit S Rihal, Bernard J Gersh, Abhishek Deshmukh
BACKGROUND: Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS: Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD...
March 10, 2018: Journal of the American Heart Association
Alma L Saucedo-Yanez, Marlene M Perales-Quintana, David Paniagua-Vega, Concepcion Sanchez-Martinez, Paula Cordero-Perez, Noemi Waskman Minsky
Chronic kidney disease (CKD) is a progressive condition characterized by a permanent and irreversible loss of renal function. In accordance to international guidelines, CKD clinical diagnosis methods are based on creatinine and albumin levels and glomerular filtration rate. Unfortunately, these parameters are scarcely affected in early stages, and its inherent intrinsic variability only allows for the identification of intermediate and advanced stages, when life expectancy has become shorter and treatment poses a significant financial investment...
March 6, 2018: Current Medicinal Chemistry
Antonio Bellasi, Luigi Morrone, Maria Cristina Mereu, Carlo Massimetti, Elena Pelizzaro, Giuseppe Cianciolo, Marzia Pasquali, Vincenzo Panuccio
We herein report on a nationwide survey conducted in Italy to investigate the use of parathyroidectomy (PTX). In spite of the availability of newer and more effective drugs to control chronic kidney disease mineral bone disorder (CKD-MBD) biochemical abnormalities, PTX still remains a resource for nephrologists to use. However, observational analyses suggest that in recent years there has been a constant decline in the number of patients undergoing PTX. The reasons are not clear, though the increasing age and number of comorbidities of dialysis patients may partly explain this trend...
March 7, 2018: Journal of Nephrology
Y R Raji, M O Mabayoje, B T Bello, C O Amira
Screening of individuals at increased risk of developing chronic kidney disease (CKD) has been advocated by several guidelines. Among individuals at increased risk are first-degree relatives (FDRs) of patients with CKD. There is a paucity of data on the prevalence and risk of CKD in FDRs of patients with CKD in sub-Saharan African population. This study aimed to screen FDRs of patients with CKD for albuminuria and reduced estimated glomerular filtration rate (eGFR). A cross-sectional survey of 230 FDRs of patients with CKD and 230 individuals without family history of CKD was conducted...
January 2018: Indian Journal of Nephrology
Hitesh H Shah, Steven Fishbane
Anemia is a common complication of advanced chronic kidney disease (CKD). Treatment with erythropoiesis-stimulating agents (ESAs) remains a common approach in managing anemia of CKD. The 2012 Kidney Disease Improving Global Outcomes Clinical Practice Guideline for Anemia in CKD suggests avoiding ESA therapy use to maintain Hb level above 11.5 g/dL. However, optimal Hb target range in adult patients undergoing chronic dialysis remains unknown. Clinical studies suggest risks associated with normalization of Hb levels in adult patients with CKD...
March 6, 2018: Seminars in Dialysis
Ying Zheng, Li Tang, Xiangmei Chen, Guangyan Cai, Wenge Li, Zhaohui Ni, Wei Shi, Xiaoqiang Ding, Hongli Lin
BACKGROUND: Hypertension is prevalent in chronic kidney disease (CKD), but the control of hypertension is suboptimal. We reported the prevalence and characteristics of resistant and undertreated hypertension based on a nationwide survey aiming to improve blood pressure (BP) control. METHODS: Resistant hypertension (RH) was defined as BP above the target (<140/90 mm Hg) despite the use of 3 antihypertensive drugs or achieving the target BP by using ≥4 antihypertensive drugs...
March 6, 2018: Clinical and Experimental Hypertension: CHE
W Greg Miller, Graham R D Jones
In 2002, the Kidney Disease Outcomes Quality Initiative guidelines for identifying and treating CKD recommended that clinical laboratories report estimated glomerular filtration rate (eGFR) with every creatinine result to assist clinical practitioners to identify people with early-stage CKD. At that time, the original Modification of Diet in Renal Disease (MDRD) Study equation based on serum creatinine measurements was recommended for calculating eGFR. Because the MDRD Study equation was developed using a nonstandardized creatinine method, a Laboratory Working Group of the National Kidney Disease Education program was formed and implemented standardized calibration traceability for all creatinine methods from global manufacturers by approximately 2010...
January 2018: Advances in Chronic Kidney Disease
Lesley A Inker, Andrew S Levey, Josef Coresh
The recent Kidney Disease Improving Global Outcomes 2012 CKD guidelines recommend estimating GFR from serum creatinine (eGFRcr ) as a first-line test to assess kidney function and using cystatin C or measured glomerular filtration rate (GFR) as confirmatory tests. eGFRcr may be inaccurate in people with variation in muscle mass or diet, and eGFRcys is not more accurate than eGFRcr. eGFRcrcys is more accurate than either, but it is not independent of eGFRcr . Measured GFR is not practical and is susceptible to error due to variation in clearance methods and in the behavior of exogenous filtration markers...
January 2018: Advances in Chronic Kidney Disease
Boon Wee Teo, Luxia Zhang, Jinn-Yuh Guh, Sydney C W Tang, Vivekanand Jha, Duk-Hee Kang, Roberto Tanchanco, Lai Seong Hooi, Kearkiat Praditpornsilpa, Xianglei Kong, Li Zuo, Gek Cher Chan, Evan J C Lee
The National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines recommended the Modification of Diet in Renal Disease study equation for estimating glomerular filtration rate (GFR) for the classification of CKD, but its accuracy was limited to North American patients with estimated GFR <60 mL/min per 1.73 m2 body surface area of European (White) or African (Black) descent. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed another equation for estimating GFR, derived from a population that included both participants without kidney disease and with CKD...
January 2018: Advances in Chronic Kidney Disease
Kenneth Mangion, Kirsty McDowell, Patrick B Mark, Elaine Rutherford
Purpose of Review: The aim of the review was to identify and describe recent advances (over the last 3 years) in cardiac magnetic resonance (CMR) imaging in patients with chronic kidney disease (CKD). We conducted a literature review in line with current guidelines. Recent Findings: The authors identified 22 studies. Patients with CKD had left ventricular global and regional dysfunction and adverse remodeling. Stress testing with CMR revealed a reduced stress-response in CKD patients...
2018: Current Cardiovascular Imaging Reports
Clara J Bohm, Leroy J Storsley, Brett M Hiebert, Serena Nelko, Navdeep Tangri, Lawrence J Cheskin, Mara A McAdams-DeMarco, Claudio Rigatto
Background: Individuals with chronic kidney disease (CKD) have low levels of physical activity and physical function. Although guidelines endorse exercise counseling for individuals with CKD, it is not yet part of routine care. Objective: We investigated the effect of attending a real-life exercise counseling clinic (ECC) on physical function in individuals with CKD. Design: Retrospective analysis of prospectively collected observational data with quasi-experimental design...
2018: Canadian Journal of Kidney Health and Disease
M C Politi, N George, T Li, K M Korenblat, K J Fowler, C Ho, A Liapakis, D Roth, J Yee
Background: Recent advances in treatment have given patients with chronic kidney disease (CKD) access to safer and more effective medications to treat comorbid hepatitis C virus (HCV) infection. Given the variety and complexity of treatment options that depend on patients' clinical characteristics and personal preferences, education and decision support are needed to prepare patients better to discuss treatment options with their clinicians. Methods: Drawing on International Patient Decision Aids Standards guidelines, literature reviews, and guidance from a diverse expert advisory group of nephrologists, hepatologists, and patients, we will develop and test a HCV and CKD decision support tool...
2018: Pilot and Feasibility Studies
George Thomas, Paul E Drawz
Patients with CKD typically have hypertension. Manual BP measurement in the office setting was used to define hypertension, establish eligibility, and assess BP targets in the epidemiologic studies and early randomized, controlled trials that inform current management of hypertension. Use of automated oscillometric devices has largely replaced manual BP measurement in the office and clinical trials. These newer devices may reduce the white coat effect and facilitate guideline-adherent measurement protocols...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
L Parker Gregg, S Susan Hedayati
Patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) are 10 times more likely to die of cardiovascular (CV) diseases than the general population, and dialysis-dependent patients are at even higher risk. Although traditional CV risk factors are highly prevalent in individuals with CKD, these patients were often excluded from studies targeting modification of these risks. Although treatment of hypertension is beneficial in CKD, the best target blood pressure has not been established. Trial data showed that renin-angiotensin-aldosterone blockade may prevent CV events in patients with CKD...
February 23, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Fabiana B Nerbass, Viviane Calice-Silva, Roberto Pecoits-Filho
BACKGROUND: Hypertension affects almost all chronic kidney disease patients and is related to poor outcomes. Sodium intake is closely related to blood pressure (BP) levels in this population and decreasing its intake consistently improves the BP control particularly in short-term controlled trials. However, most patients struggle in following a controlled diet on sodium according to the guidelines recommendation due to several factors and barriers discussed in this article. SUMMARY: This review article summarizes the current knowledge related to the associations between sodium consumption, BP, and the risk of cardiovascular disease and chronic kidney disease (CKD); it also provides recommendations of how to achieve sodium intake lowering...
January 26, 2018: Blood Purification
Shuang Liang, Wen-Ling Wang, Fang-Lei Zhu, Shu-Wei Duan, Xue-Feng Sun, Xiang-Mei Chen, Guang-Yan Cai
INTRODUCTION: The proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk...
February 24, 2018: BMJ Open
Markus Ketteler, Geoffrey A Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A Herzog, Linda McCann, Sharon M Moe, Rukshana Shroff, Marcello A Tonelli, Nigel D Toussaint, Marc G Vervloet, Mary B Leonard
Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods: Development of the guideline update followed an explicit process of evidence review and appraisal...
February 20, 2018: Annals of Internal Medicine
Panagiotis I Georgianos, Eleni Champidou, Vassilios Liakopoulos, Elias V Balaskas, Pantelis E Zebekakis
In the era of newly introduced hypertension guidelines recommending lower blood pressure (BP) targets for drug-treated hypertensives, the necessity for optimized management of hypertension becomes even more urgent. The concept of home BP-guided antihypertensive therapy is for long suggested as a simple and feasible approach to improve BP control rates and optimize the management of hypertension. Home BP-guided antihypertensive therapy is particularly applicable to hypertensives with chronic kidney disease (CKD) for several reasons including the following: (1) difficult-to-control BP and high BP variability in the CKD setting; (2) poor accuracy of office BP in determining hypertension control status and detecting "white-coat" and "masked" hypertension; (3) poor value of routine office BP recordings in predicting the longitudinal progression of target-organ damage; and (4) superiority of home BP over office BP recordings in prognosticating the risk of incident end-stage renal disease or death...
February 10, 2018: Journal of the American Society of Hypertension: JASH
Xiaoxi Zeng, Jing Liu, Sibei Tao, Hyokyoung G Hong, Yi Li, Ping Fu
BACKGROUND: Socioeconomic status (SES) has long been conjectured to be associated with the incidence and progression of chronic kidney disease (CKD), but few studies have examined this quantitatively. This meta-analysis aims to fill this gap. METHODS: A systematic literature review was performed using Medline and EMBASE to identify observational studies on associations between SES and incidence and progression of CKD, published between 1974 and March 2017. Individual results were meta-analysed using a random effects model, in line with Meta-analysis of Observational Studies in Epidemiology guidelines...
February 2, 2018: Journal of Epidemiology and Community Health
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