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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/29333579/factors-associated-with-the-number-and-size-of-renal-angiomyolipomas-in-sporadic-angiomyolipoma-saml-a-study-of-adult-patients-with-saml-managed-in-a-dutch-tertiary-referral-center
#1
J L H Ruud Bosch, Francis Vekeman, Mei Sheng Duh, Maureen Neary, Matthew Magestro, Jonathan Fortier, Paul Karner, Raluca Ionescu-Ittu, Bernard A Zonnenberg
PURPOSE: To describe the patient characteristics, treatments, disease monitoring, and kidney function of patients with sporadic angiomyolipoma (sAML), stratified by the number and size of renal angiomyolipomas (AMLs). METHODS: Single-center retrospective analysis of patients with sAML treated from 1990 to 2015 in a dedicated clinic for inheritable tumor syndromes in a tertiary referral center from the Netherlands. Patients' first AML assessment at the clinic was defined as the index date...
January 15, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29319254/cavitating-lung-lesions-with-encephalopathy-in-a-patient-with-long-standing-sjogren-s-syndrome-an-elusive-cause
#2
Siddharth Jain, Animesh Ray, Manish Soneja, S Leve Joseph Devarajan, Shyam Madabhushi, Anitha Swamy, T Naveen, S K Sharma
A known case of primary Sjogren's syndrome with chronic kidney disease presented with respiratory symptoms and subsequent altered sensorium. Chest imaging suggested cavitating lung lesions in both the lungs. Serum c-ANCA was positive without any upper respiratory tract involvement or active urinary sediments. Treatment with appropriate anti-microbials produced no improvement in the respiratory or neurological parameters. MRI brain revealed tell-tale signs of CNS vascultis. A diagnosis of GPA was made as per European Medical Agency algorithm and the patient was started on immune-suppressants to which there was dramatic response...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29316681/non-transfusion-dependent-thalassemia-an-update-on-complications-and-management
#3
REVIEW
Joseph Sleiman, Ali Tarhini, Rayan Bou-Fakhredin, Antoine N Saliba, Maria Domenica Cappellini, Ali T Taher
Patients with non-transfusion-dependent thalassemia (NTDT) experience many clinical complications despite their independence from frequent transfusions. Morbidities in NTDT stem from the interaction of multiple pathophysiological factors: ineffective erythropoiesis, iron overload (IOL), and hypercoagulability. Ineffective erythropoiesis and hemolysis are associated with chronic hypoxia and a hypercoagulable state. The latter are linked to a high prevalence of thromboembolic and cerebrovascular events, as well as leg ulcers and pulmonary hypertension...
January 8, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29313905/renal-complications-of-anaesthesia
#4
REVIEW
J McKinlay, E Tyson, L G Forni
Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29309655/european-adpkd-forum-multidisciplinary-position-statement-on-autosomal-dominant-polycystic-kidney-disease-care-european-adpkd-forum-and-multispecialist-roundtable-participants
#5
Tess Harris, Richard Sandford, Brenda de Coninck, Olivier Devuyst, Joost P H Drenth, Tevfik Ecder, Alastair Kent, Ron T Gansevoort, José Luis Górriz, Albert C M Ong, Yves Pirson, Vicente E Torres, Klemens Budde, Denis Clément, Lorenzo E Derchi, Marianna Eleftheroudi, Elena Levtchenko, Dorien Peters, Hendrik Van Poppel, Raymond Vanholder
Autosomal dominant polycystic kidney disease (ADPKD) is a chronic, progressive condition characterized by the development and growth of cysts in the kidneys and other organs and by additional systemic manifestations. Individuals with ADPKD should have access to lifelong, multidisciplinary, specialist and patient-centred care involving: (i) a holistic and comprehensive assessment of the manifestations, complications, prognosis and impact of the disease (in physical, psychological and social terms) on the patient and their family; (ii) access to treatment to relieve symptoms, manage complications, preserve kidney function, lower the risk of cardiovascular disease and maintain quality of life; and (iii) information and support to help patients and their families act as fully informed and active partners in care, i...
December 22, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29298736/multiple-frequency-bioimpedance-devices-for-fluid-management-in-people-with-chronic-kidney-disease-receiving-dialysis-a-systematic-review-and-economic-evaluation
#6
Graham Scotland, Moira Cruickshank, Elisabet Jacobsen, David Cooper, Cynthia Fraser, Michal Shimonovich, Angharad Marks, Miriam Brazzelli
BACKGROUND: Chronic kidney disease (CKD) is a long-term condition requiring treatment such as conservative management, kidney transplantation or dialysis. To optimise the volume of fluid removed during dialysis (to avoid underhydration or overhydration), people are assigned a 'target weight', which is commonly assessed using clinical methods, such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. However, these methods are not precise, and measurement devices based on bioimpedance technology are increasingly used in dialysis centres...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29291208/hepatitis-c-infection-in-renal-transplantation-pathogenesis-current-impact-and-emerging-trends
#7
REVIEW
Sailaja Kesiraju, Praneeth Srikanti, S Sahariah
Prevalence of hepatitis C infection, which is associated with mortality and morbidity, is higher in chronic kidney disease patients on hemodialysis and transplant recipients when compared to non HCV infected patients. In addition to the conventional risk factors, HCV infection maybe an additional risk factor in the development of chronic kidney disease. HCV causes adverse effects leading to the poor long term outcome in renal transplant recipients; hepatitis C infection can cause both hepatic as well as extra hepatic complications...
September 2017: Virusdisease
https://www.readbyqxmd.com/read/29289418/long-term-adverse-genitourinary-outcomes-among-endometrial-cancer-survivors-in-a-large-population-based-cohort-study
#8
Sean Soisson, Patricia A Ganz, David Gaffney, Kerry Rowe, John Snyder, Yuan Wan, Vikrant Deshmukh, Mike Newman, Alison Fraser, Ken Smith, Kimberly Herget, Heidi A Hanson, Yelena P Wu, Joseph Stanford, Theresa L Werner, Veronica Wendy Setiawan, Mia Hashibe
OBJECTIVE: With the increasing incidence of endometrial cancer, the high survival rate, and the large number of endometrial cancer survivors, investigations of long-term genitourinary outcomes are important for the management of these outcomes among endometrial cancer survivors. METHODS: Cohorts of 2648 endometrial cancer survivors diagnosed in the state of Utah between 1997 and 2012 and 10,503 general population women were identified. All ICD-9 diagnosis codes were collected from the state's two largest healthcare systems and statewide databases...
December 27, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29285707/an-emerging-treatment-alternative-for-anemia-in-chronic-kidney-disease-patients-a-review-of-daprodustat
#9
REVIEW
Kimberly A Becker, John J Jones
This article reviews an emerging therapeutic agent, which is currently in phase III development for the treatment of anemia secondary to chronic kidney disease, covering promising phase II results, drug characteristics, and the current phase III trials, which, if approved, may significantly impact the management of anemia in this patient population.
December 28, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29280249/-it-s-when-you-re-not-doing-too-much-you-feel-tired-a-qualitative-exploration-of-fatigue-in-end-stage-kidney-disease
#10
Federica Picariello, Rona Moss-Morris, Iain C Macdougall, Joseph Chilcot
BACKGROUND: Fatigue is commonly experienced in end-stage kidney disease (ESKD) patients. In order to develop patient-centred psychosocial interventions to help patients manage fatigue symptoms, a more in-depth understanding regarding the experience of fatigue is needed. OBJECTIVE: The objective of this study was to explore renal patients' experiences of fatigue, across renal replacement therapy (RRT) modalities. METHODS: Twenty-five in-depth semi-structured interviews were conducted...
December 27, 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/29248146/renal-recovery
#11
REVIEW
Ivan Göcze, Christina Wiesner, Hans J Schlitt, Tobias Bergler
Recovery patterns after acute kidney injury (AKI) have increasingly become the focus of research, because currently available preventive measures and specific therapeutic intervention are limited. Moreover, changes in renal functional reserve are recognized as a "hidden" indicator of kidney susceptibility to either acute kidney injury or chronic kidney disease. Understanding these phenomena and their association with outcome may enable the initiation of strategies that facilitate fast and sustained recovery during the time course of AKI and limit AKI progression towards chronic kidney disease...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29240374/case-study-case-studies-in-cystinuria
#12
David S Goldfarb, Michael Grasso
The diagnosis and treatment of patients with rare inherited metabolic disorders associated with recurrent and often obstructive kidney stones are important to the prevention of chronic kidney disease or end stage renal disease. Two case studies in this article describe the diagnosis and management of cystinuria, the most common rare kidney stone disorder.
March 2017: Urologic Nursing
https://www.readbyqxmd.com/read/29239764/treatment-choices-for-the-glycaemic-management-of-patients-with-type-2-diabetes-and-chronic-kidney-disease-analysis-of-the-sail-patient-linked-dataset
#13
Thinzar Min, Gareth I Davies, Sam Rice, James Chess, Jeffrey W Stephens
AIMS: Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD. METHODS: The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60mL/min/1.73m2; moderate CKD eGFR <60mL/min/1...
November 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29238578/bone-eating-kidney-disease
#14
Abhilash Koratala, Muhannad Leghrouz, Amir Kazory
In the current era of early detection of chronic kidney disease and efficient therapeutic options for management of its complications, skeletal manifestations of renal hyperparathyroidism are increasingly rare. A 31-year-old female patient presented for evaluation of severe pain in the left forearm, right hand, right knee, right hip, and lower back following a fall sustained 3 days prior to presentation. She had a history of end-stage renal disease and received maintenance hemodialysis. Review of the medical records revealed that she had poor compliance with her diet, medications, and dialysis treatments...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29229167/glomerular-diseases-in-children
#15
REVIEW
Scott E Wenderfer, Joseph P Gaut
Unique challenges exist in the diagnosis and treatment of glomerular diseases with their onset during childhood. Mounting evidence supports the notion that earlier onset cases occur due to larger numbers of genetic risk alleles. Nearly all causes of adult-onset glomerulonephritis, nephrotic syndrome, and thrombotic microangiopathy have also been described in children, although the prevalence of specific causes differs. Postinfectious glomerulonephritis, Henoch-Schönlein purpura nephritis, and minimal change disease remain the most common causes of glomerular disease in younger children in the United States and can be diagnosed clinically without need for biopsy...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29228345/mechanisms-and-mediators-of-hypertension-induced-by-erythropoietin-and-related-molecules
#16
Rajiv Agarwal
Hypertension is a common but frequently overlooked adverse effect of erythropoietin (EPO) therapy. Underreporting of hypertension with EPO is likely due to either more aggressively managing hypertension through the prescription of antihypertensive drugs or closer attention to dry weight. The purpose and focus of this review is to critically evaluate the mechanisms of EPO-induced hypertension. Preclinical data are considered first, followed by clinical data where available. Mediated by a variety of molecules, there is an imbalance in the vascular tone favoring net vasoconstriction that mediates EPO-induced hypertension...
December 8, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29217892/bowel-migration-of-dormant-chronic-ambulatory-peritoneal-dialysis-catheter-a-vexed-problem-not-avoided-by-flushing
#17
P Vincent, J Gopinathan, R Narayanan
Delayed bowel erosion by peritoneal dialysis catheter is rare with fewer than thirty cases having been reported in the literature. This complication is usually encountered when the catheter is kept dormant. Two cases have also been reported with catheters in active use. The risk factors for bowel erosion include immunosuppression, diverticulosis, and amyloidosis. An 80-year-old male with chronic kidney disease Stage 5 due to hypertensive nephrosclerosis underwent chronic ambulatory peritoneal dialysis catheter insertion...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29216336/managing-diabetic-kidney-disease
#18
Sagen Zac-Varghese, Peter Winocour
Introduction: Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). This review covers the pillars of care essential for the management of diabetic kidney disease (DKD) including (1) early diagnosis, (2) improved glycaemic control, (3) treatment of hypertension, (4) identification and treatment of associated metabolic bone disease and (5) identification and effective management of dyslipidaemia and additional cardiovascular risk factors. Sources of data: We searched PubMed for articles using search terms: diabetic nephropathy, diabetic kidney disease, diabetes and chronic kidney disease...
December 5, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29214511/managing-gout-flares-in-the-elderly-practical-considerations
#19
Abhishek Abhishek
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29208494/bleeding-in-advanced-ckd-patients-on-antithrombotic-medication-a-critical-appraisal
#20
Alexandru Burlacu, Simonetta Genovesi, David Goldsmith, Patrick Rossignol, Alberto Ortiz, Philip A Kalra, Jolanta Małyszko, Maciej Banach, Mehmet Kanbay, Adrian Covic
Patients with advanced chronic kidney disease (CKD) are at an increased risk of bleeding, especially in the context of the complex therapeutic schemes of coronary artery disease (CAD) (from stable angina to acute coronary syndromes), atrial fibrillation or venous thromboembolism. The bleeding issue increases morbidity and mortality, a serious problem in daily medical practice. However, these patients are largely excluded from major randomized clinical trials, which results in the lack of medical evidence-based foundation for specific recommendations regarding antithrombotic treatment in a high bleeding risk setting...
December 2, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
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