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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/28318510/comparative-efficacy-of-coronary-revascularization-procedures-for-multivessel-coronary-artery-disease-in-patients-with-chronic-kidney-disease
#1
John K Roberts, Sunil V Rao, Linda K Shaw, Dianne S Gallup, Oscar C Marroquin, Uptal D Patel
Patients with chronic kidney disease (CKD) are at increased risk of cardiovascular disease and death, yet little data exist regarding the comparative efficacy of coronary revascularization procedures in CKD patients with multivessel disease. We created a cohort of 4,687 adults who underwent cardiac catheterization, had a serum creatinine value measured within 30 days, and had more than one vessel with ≥50% stenosis. We used Cox proportional hazard regression modeling weighted by the inverse probability of treatment to examine the association between 4 treatment strategies (medical management, percutaneous coronary intervention [PCI] with bare metal stent, PCI with drug-eluting stent, and coronary artery bypass grafting [CABG]) and mortality among patients across categories of estimated glomerular filtration rate; secondary outcome was a composite of mortality, myocardial infarction, or revascularization...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28314735/non-alcoholic-fatty-liver-disease-and-its-relationship-with-cardiovascular-disease-and-other-extrahepatic-diseases
#2
REVIEW
Leon A Adams, Quentin M Anstee, Herbert Tilg, Giovanni Targher
Key physiological functions of the liver, including glucose and lipid metabolism, become disturbed in the setting of non-alcoholic fatty liver disease (NAFLD) and may be associated with a systemic inflammatory 'milieu' initiated in part by liver-secreted cytokines and molecules. Consequently, the pathophysiological effects of NAFLD extend beyond the liver with a large body of clinical evidence demonstrating NAFLD to be independently associated with both prevalent and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM)...
March 17, 2017: Gut
https://www.readbyqxmd.com/read/28292575/the-treatment-of-type-2-diabetes-mellitus-in-patients-with-chronic-kidney-disease-what-to-expect-from-new-oral-hypoglycemic-agents
#3
REVIEW
Luca Di Lullo, Michela Mangano, Claudio Ronco, Vincenzo Barbera, Antonio De Pascalis, Antonio Bellasi, Domenico Russo, Biagio Di Iorio, Mario Cozzolino
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD and intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes mellitus include metformin, sulfonylureas, meglitinides, thiazolidinediones, and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 2-5) and without dose adjustment...
March 6, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28289413/mica-and-nkg2d-is-there-an-impact-on-kidney-transplant-outcome
#4
REVIEW
Matilde Risti, Maria da Graça Bicalho
This paper aims to present an overview of MICA and natural killer group 2 member D (NKG2D) genetic and functional interactions and their impact on kidney transplant outcome. Organ transplantation has gone from what can accurately be called a "clinical experiment" to a routine and reliable practice, which has proven to be clinically relevant, life-saving and cost-effective when compared with non-transplantation management strategies of both chronic and acute end-stage organ failures. The kidney is the most frequently transplanted organ in the world (transplant-observatory)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28284381/mechanisms-of-drug-induced-interstitial-nephritis
#5
REVIEW
Rajeev Raghavan, Saed Shawar
Drug-induced acute interstitial nephritis (DI-AIN) is a drug hypersensitivity reaction (DHR) that manifests 7 to 10 days after exposure to the culprit drug. DHRs account for fewer than 15% of reported adverse drug reactions. The kidneys are susceptible to DHR because: (1) the high renal blood flow whereby antigens are filtered, secreted, or concentrated, and (2) it is a major site of excretion for drugs and drug metabolites. More than 250 different drugs from various classes have been incriminated as causative agents of DI-AIN, the third most common cause of acute kidney injury in the hospital...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28284380/clinical-approach-to-diagnosing-acute-and-chronic-tubulointerstitial-disease
#6
REVIEW
Mark A Perazella
Tubulointerstitial diseases are a relatively common cause of acute and/or chronic kidney disease. Acute tubulointerstitial nephritis (ATIN) most commonly develops in patients exposed to various medications; however, it can occur from infections, autoimmune and systemic diseases, environmental exposures, and some idiopathic causes. Chronic tubulointerstitial nephritis may develop in patients with previous ATIN or may be the initial manifestation of an autoimmune, systemic, environmental, or metabolic process...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28276289/natural-antioxidants-in-the-treatment-and-prevention-of-diabetic-nephropathy-a-potential-approach-that-warrants-clinical-trials
#7
Noori Al-Waili, Hamza Al-Waili, Thia Al-Waili, Khelod Salom
Diabetic nephropathy is the major cause of end-stage renal disease and effective and new therapeutic approaches are needed in diabetic nephropathy and chronic kidney diseases. Oxidative stress and inflammatory process are important factors contributing to kidney damage by increasing production of oxidants. KEAP1/Nrf2/ARE pathway regulates the transcription of many antioxidant genes and modulation of the pathway up regulates antioxidants. NFB controls the expression of genes involved in the inflammatory response...
March 9, 2017: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/28255135/patients-blood-pressure-control-and-doctors-adherence-to-hypertension-clinical-practice-guideline-in-managing-patients-at-health-clinics-in-kuala-muda-district-kedah
#8
S H Teoh, A R Razlina, D Norwati, M Y Siti Suhaila
BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined. METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28249270/dialysis-requirement-and-long-term-major-adverse-cardiovascular-events-in-patients-with-chronic-kidney-disease-and-superimposed-acute-kidney-injury
#9
Bolanle A Omotoso, Faruk Turgut, Emaad M Abdel-Rahman, Wenjun Xin, Jennie Z Ma, Kenneth W Scully, Fatiu A Arogundade, Rasheed A Balogun
BACKGROUND: Chronic kidney disease (CKD) patients who experience superimposed acute kidney injury (AKI) have been shown to be at higher risk of long-term sequelae of AKI when compared to those who do not experience AKI. It remains unclear whether the need for temporary dialysis intervention following superimposed AKI in patients with CKD has any effect on the long-term major adverse cardiovascular events (MACE). This study examines the relationship between temporary dialysis therapy following AKI and long-term major cardiovascular events in patients with background CKD...
March 2, 2017: Nephron
https://www.readbyqxmd.com/read/28245741/isfm-consensus-guidelines-on-the-diagnosis-and-management-of-hypertension-in-cats
#10
Samantha S Taylor, Andrew H Sparkes, Katherine Briscoe, Jenny Carter, Salva Cervantes Sala, Rosanne E Jepson, Brice S Reynolds, Brian A Scansen
Practical relevance: Feline hypertension is a common disease in older cats that is frequently diagnosed in association with other diseases such as chronic kidney disease and hyperthyroidism (so-called secondary hypertension), although some cases of apparent primary hypertension are also reported. The clinical consequences of hypertension can be severe, related to 'target organ damage' (eye, heart and vasculature, brain and kidneys), and early diagnosis followed by appropriate therapeutic management should help reduce the morbidity associated with this condition...
March 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28243928/pathophysiology-and-potential-non-pharmacologic-treatments-of-obesity-or-kidney-disease-associated-refractory-hypertension
#11
REVIEW
Thierry H Le Jemtel, William Richardson, Rohan Samson, Abhishek Jaiswal, Suzanne Oparil
PURPOSE OF REVIEW: The review assesses the role of non-pharmacologic therapy for obesity and chronic kidney disease (CKD) associated refractory hypertension (rf HTN). RECENT FINDINGS: Hypertensive patients with markedly heightened sympathetic nervous system (SNS) activity are prone to develop refractory hypertension (rfHTN). Patients with obesity and chronic kidney disease (CKD)-associated HTN have particularly heightened SNS activity and are at high risk of rfHTN...
February 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28242135/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitors-a%C3%A2-potential-new-treatment-for-anemia-in-patients-with-ckd
#12
REVIEW
Nupur Gupta, Jay B Wish
Erythropoiesis-stimulating agents (ESAs) increase hemoglobin levels, reduce transfusion requirements, and have been the standard of treatment for anemia in patients with chronic kidney disease (CKD) since 1989. Many safety concerns have emerged regarding the use of ESAs, including an increased occurrence of cardiovascular events and vascular access thrombosis. Hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzyme inhibitors are a new class of agents for the treatment of anemia in CKD. These agents work by stabilizing the HIF complex and stimulating endogenous erythropoietin production even in patients with end-stage kidney disease...
February 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28237283/ablative-therapies-for-renal-tumors-patient-selection-treatment-planning-and-follow-up
#13
Jean-Michel Correas, Christophe Delavaud, Jules Gregory, Thomas Le Guilchet, Lionel Lamhaut, Marc-Olivier Timsit, Arnaud Méjean, Olivier Hélénon
The increased use of abdominal imaging has led to a major increase in small renal tumors incidence particularly in the elderly population. Their management is evolving with the development of percutaneous ablation, particularly radiofrequency ablation, cryoablation, and microwave ablation. The typical indications that must be validated by a multidisciplinary committee include solid tumors less than 3cm in patients with multiple comorbidity factors (including age), contraindications to surgery, hereditary renal cancer, bilateral renal tumors, solitary kidney, pre-existing chronic kidney disease, or at high risk of predialysis renal function after partial nephrectomy...
February 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#14
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#15
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28225432/use-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-type-2-diabetes-and-chronic-kidney-disease
#16
Polly A Bittle
There is a need for treatment options in patients with type 2 diabetes mellitus and kidney disease to achieve glucose targets without risk of hypoglycemia. This article describes management options for these patients using glucose-lowering therapies, in particular dipeptidyl peptidase-4 inhibitors.
February 20, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28223836/dyslipidemia-in-patients-with-chronic-kidney-disease-etiology-and-management
#17
REVIEW
Ivana Mikolasevic, Marta Žutelija, Vojko Mavrinac, Lidija Orlic
Patients with chronic kidney disease (CKD), including those with end-stage renal disease, treated with dialysis, or renal transplant recipients have an increased risk for cardiovascular disease (CVD) morbidity and mortality. Dyslipidemia, often present in this patient population, is an important risk factor for CVD development. Specific quantitative and qualitative changes are seen at different stages of renal impairment and are associated with the degree of glomerular filtration rate declining. Patients with non-dialysis-dependent CKD have low high-density lipoproteins (HDL), normal or low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol, increased triglycerides as well as increased apolipoprotein B (apoB), lipoprotein(a) (Lp (a)), intermediate- and very-low-density lipoprotein (IDL, VLDL; "remnant particles"), and small dense LDL particles...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28223818/an-evidence-based-review-on-urate-lowering-treatments-implications-for-optimal-treatment-of-chronic-hyperuricemia
#18
REVIEW
Marilisa Bove, Arrigo Francesco Giuseppe Cicero, Maddalena Veronesi, Claudio Borghi
Several studies suggest that chronic hyperuricemia, the main precursor of gout, is involved in the pathogenesis of different systemic disorders that affect cardiovascular and renal systems, such as hypertension, obesity, hypercholesterolemia, atherosclerosis, metabolic syndrome, chronic heart failure, and chronic kidney disease. Recent epidemiological evidence has shown an increasing trend in the prevalence of hyperuricemia and gout in the Western world: a number of population-based studies estimate a prevalence of up to 21% for hyperuricemia and 1%-4% for gout...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28217256/interferon-free-regimens-in-patients-with-hepatitis-c-infection-and-renal-dysfunction-or-kidney-transplantation
#19
REVIEW
Evangelos Cholongitas, Chrysoula Pipili, George V Papatheodoridis
Treatment of patients with chronic kidney disease (CKD) and chronic hepatitis C (CHC) differs from that used in the general CHC population mostly when glomerular filtration rate (GFR) is below 30 mL/min, as sofosbuvir, the backbone of several current regimens, is officially contraindicated. Given that ribavirin free regimens are preferable in CKD, elbasvir/grazoprevir is offered in CHC patients with genotype 1 or 4 and ombitasvir/paritaprevir and dasabuvir in genotype 1b for 12 wk. Although regimens containing peginterferon with or without ribavirin are officially recommended for patients with CKD and genotype 2, 3, 5, 6, such regimens are rarely used because of their low efficacy and the poor safety and tolerance profile...
February 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28216281/clinicians-perspectives-on-advance-care-planning-for-patients-with-ckd-in-australia-an-interview-study
#20
Marcus Sellars, Allison Tong, Tim Luckett, Rachael L Morton, Carol A Pollock, Lucy Spencer, William Silvester, Josephine M Clayton
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia...
February 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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