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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/28212180/advances-in-the-management-of-hyperkalemia-in-chronic-kidney-disease
#1
Andrea C J Cowan, Elie G Gharib, Matthew A Weir
PURPOSE OF REVIEW: Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia that increases both short-term and long-term mortality. Historically, managing hyperkalemia has relied upon dietary modifications, augmentation of urinary potassium excretion and enhanced enteral potassium elimination. This review discusses current treatments and their limitations and summarizes the evidence supporting novel agents for potassium lowering in patients with CKD. RECENT FINDINGS: The introduction of two novel ion exchange resins represents the first new pharmacologic therapies for hyperkalemia in the last 50 years...
February 15, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28208907/current-practice-of-hypertension-in-india-focus-on-blood-pressure-goals
#2
Jagdish S Hiremath, Vijay M Katekhaye, Vijay S Chamle, Rishi M Jain, Amit I Bhargava
INTRODUCTION: Recommended Blood Pressure (BP) goals in elderly and those with co-morbid conditions like Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) vary in different Hypertension (HTN) management guidelines. AIM: To understand currently followed BP goals and practices among the physicians involved in management of HTN in India. MATERIALS AND METHODS: A cross-sectional, observational survey was conducted at 66(th) annual conference of Cardiological Society of India (CSICON-2014, Hyderabad)...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205311/management-of-cardiovascular-risk-factors-in-patients-with-anca-associated-vasculitis
#3
Carsten Paul Bramlage, Juliane Kröplin, Manuel Wallbach, Joan Minguet, Katherine Helen Smith, Stephan Lüders, Joachim Schrader, Susan Patschan, Oliver Gross, Cornelia Deutsch, Peter Bramlage, Gerhard Anton Müller, Michael Koziolek
OBJECTIVES: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is accompanied by increased cardiovascular (CV) risk. Treatment of AAV patients includes the management of conventional CV risk factors, primarily hypertension and hypercholesterolemia, while lipoprotein(a) (LP(a)) is an emerging potential target. METHODS: We performed a multicenter, retrospective study in Germany. Patients were considered if they were between 18 and 90 years old and presented with AAV...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28204946/clinical-outcomes-in-children-with-henoch-sch%C3%A3-nlein-purpura-nephritis-without-crescents
#4
Jean Daniel Delbet, Julien Hogan, Bilal Aoun, Iulia Stoica, Rémi Salomon, Stéphane Decramer, Isabelle Brocheriou, Georges Deschênes, Tim Ulinski
BACKGROUND: Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. METHODS: All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files...
February 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28194884/long-term-safety-and-efficacy-of-bixalomer-in-hyperphosphatemic-patients-with-chronic-kidney-disease-not-on-dialysis
#5
Tadao Akizawa, Junko Tsukada, Chisato Kameoka, Kentarou Kuroishi, Yusuke Yamaguchi
Bixalomer, a metal-free, nonabsorbable phosphate binder, is approved in Japan to treat hyperphosphatemia in dialysis patients. Bixalomer is effective and has a favorable safety profile in predialysis patients with hyperphosphatemia. This study examined the long-term effectiveness and safety of bixalomer in predialysis patients with hyperphosphatemia. This was a 48-week, multicenter, open-label, phase 3 study in Japanese predialysis patients with hyperphosphatemia. Patients received bixalomer at an initial dose of 1500 mg/day, which was titrated to a maximum of 7500 mg/day depending on patients' serum phosphorus responses to bixalomer...
February 14, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28187016/improving-outcomes-for-patients-with-chronic-kidney-disease-part-2
#6
Jenna M Norton, Eileen P Newman, Gayle Romancito, Stephanie Mahooty, Theresa Kuracina, Andrew S Narva
: Addressing disease complications and treatment for kidney failure: a clinical review. ABSTRACT: Coping with chronic kidney disease (CKD) is challenging for many people, since symptoms often don't appear until the disease is advanced and the patient is close to requiring dialysis. This two-part article aims to provide nurses with the basic information necessary to assess and manage patients with CKD. Part 1, which appeared last month, offered an overview of the disease, described identification and etiology, and discussed ways to slow disease progression...
February 9, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28181057/lipoprotein-a-in-nephrological-patients
#7
Bernd Hohenstein
In contrast to existing EAS/ESC guidelines on the management of lipid disorders, current recommendations from nephrological societies are very conservative and restrictive with respect to any escalation of lipid lowering/statin therapy. Furthermore, lipoprotein(a) (Lp(a)) - an established cardiovascular risk factor - has not even been mentioned. While a number of retrospective and prospective studies suggested that Lp(a) has relevant predictive value and might have - at least in stage-3 chronic kidney disease (CKD) - the same negative effects if draged along in non-CKD patients, there is no guidance on diagnostic or therapeutic procedures...
February 8, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28177103/-quality-of-life-anxiety-and-distress-in-patients-suffering-from-chronic-kidney-disease-pre-dialysis-and-start-of-dialytic-treatment
#8
Maria Monica Ratti, Giulia Bruna Delli Zotti, Eleonora Sangiovanni, Benedetta Vai, Aurelio Limido, Silvio Bertoli, Lucio Sarno, Donatella Spotti
The psychological impact of the Chronic Kidney Disease is well known and several factors contribute to a reduction of quality of life, increase of anxiety levels and psychological distress for affected patients. Psychological intervention is becoming ever more consolidating within the Departments of Nephrology. Nevertheless, literature is lacking about the psychological intervention specificity, especially concerning the dialysis and pre-dialysis phase. The purpose of the study is to identify the mainly critical periods for the dialysed patients in terms of anxiety and distress and to examine the impact of medical management in pre-dialysis period on life quality...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28177092/-newer-anti-diabetic-therapies-and-chronic-kidney-disease
#9
Luca Di Lullo, Claudio Ronco, Vincenzo Barbera, Mario Cozzolino, Francesca Santoboni, Annalisa Villani, Antonio De Pascalis, Antonio Bellasi
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. Intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes 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 25) and without dose adjustment...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28176969/chronic-kidney-disease-associated-pruritus-impact-on-quality-of-life-and-current-management-challenges
#10
REVIEW
Shayan Shirazian, Olufemi Aina, Youngjun Park, Nawsheen Chowdhury, Kathleen Leger, Linle Hou, Nobuyuki Miyawaki, Vandana S Mathur
Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28176463/severe-chronic-norovirus-diarrheal-disease-in-transplant-recipients-clinical-features-of-an-under-recognized-syndrome
#11
Robin K Avery, Bonnie E Lonze, Edward S Kraus, Kieren A Marr, Robert A Montgomery
BACKGROUND: Norovirus (NV) infection has been reported as a cause of severe chronic diarrhea in transplant recipients, but this entity remains under-recognized in clinical practice, leading to diagnostic delays. Transplant clinicians should become familiar with this syndrome in order to facilitate early detection and management. METHODS: Demographic, clinical, and outcomes variables were summarized from a series of transplant recipients with positive stool NV reverse transcription polymerase chain reaction (RT-PCR) assays at Johns Hopkins in 2013-2014...
February 7, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28164170/ambulatory-blood-pressure-in-chronic-kidney-disease-ready-for-prime-time
#12
Manuel T Velasquez, Srinivasan Beddhu, Ehsan Nobakht, Mahboob Rahman, Dominic S Raj
Hypertension is common in patients with chronic kidney disease (CKD) and is the most important modifiable risk factor for CKD progression and adverse cardiovascular events in these patients. Diagnosis and successful management of hypertension are critically dependent on accurate blood pressure (BP) measurement. This is most relevant to CKD patients, in whom BP control is difficult to achieve and in whom early antihypertensive treatment is imperative to prevent kidney and cardiovascular complications. Accumulated data indicate that ambulatory blood pressure monitoring (ABPM) is better in detecting hypertension than office BP measurement...
July 2016: KI Reports
https://www.readbyqxmd.com/read/28161697/in-the-wake-of-systolic-blood-pressure-intervention-trial-new-targets-for-improving-hypertension-management-in-chronic-kidney-disease
#13
Crystal C Tyson, Thomas M Coffman
Systolic Blood Pressure Intervention Trial (SPRINT) was a multicenter randomized controlled trial showing the significant benefit of intensive reduction of blood pressure to a target of 120 mm Hg in individuals with hypertension and elevated cardiovascular risk. Because SPRINT includes the largest cohort of adults with chronic kidney disease (CKD) to be prospectively studied in a hypertension intervention trial, it has particular relevance to the field of nephrology. Here, we review the findings of SPRINT and assess their potential impact on guidelines for treatment of hypertension in patients with CKD...
February 4, 2017: Nephron
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#14
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28120507/effect-of-systemic-insulin-treatment-on-diabetic-wound-healing
#15
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Gregory L Moneta, Amir F Azarbal
This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation...
January 24, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28118622/targeting-hypoxia-inducible-factors-for-the-treatment-of-anemia-in-chronic-kidney-disease-patients
#16
Francesco Locatelli, Steven Fishbane, Geoffrey A Block, Iain C Macdougall
BACKGROUND: Anemia, a common complication of chronic kidney disease (CKD), has previously been attributed primarily to decreased production of erythropoietin. More recently, it has become apparent that the etiology of anemia involves several other factors, most notably dysfunctional iron metabolism, mediated via increased hepcidin activity and reduced clearance. Current management of anemia in patients with advanced CKD is based on erythropoiesis-stimulating agents and iron supplementation, along with red blood cell transfusions when necessary; however, safety considerations associated with these therapies highlight the need to pursue alternative treatment options targeting other mechanisms such as hypoxia-inducible factors (HIFs) that act as central regulators of erythropoiesis by coordinating a series of graded hypoxic responses...
January 25, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28115864/continuous-ambulatory-peritoneal-dialysis-perspectives-on-patient-selection-in-low-to-middle-income-countries
#17
REVIEW
Nicola Wearne, Kajiru Kilonzo, Emmanuel Effa, Bianca Davidson, Peter Nourse, Udeme Ekrikpo, Ikechi G Okpechi
Chronic kidney disease is a major public health problem that continues to show an unrelenting global increase in prevalence. The prevalence of chronic kidney disease has been predicted to grow the fastest in low- to middle-income countries (LMICs). There is evidence that people living in LMICs have the highest need for renal replacement therapy (RRT) despite the lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, much infrastructure, or need for dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28114143/electrolyte-and-acid-base-disorders-in-chronic-kidney-disease-and-end-stage-kidney-failure
#18
Tsering Dhondup, Qi Qian
The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field...
January 24, 2017: Blood Purification
https://www.readbyqxmd.com/read/28113962/a-handheld-and-textile-enabled-bioimpedance-system-for-ubiquitous-body-composition-analysis-an-initial-functional-validation
#19
Javier Ferreira Gonzalez, Ivan Pau de la Cruz, Kaj Lindecrantz, Fernando Seoane
In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease...
November 15, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28110585/anemia-in-the-elderly-a-consequence-of-aging
#20
Racha Halawi, Hassan Moukhadder, Ali Taher
Anemia in the elderly is a common finding that is associated with a poorer quality of life, worse outcomes, and increased mortality. While this entity is frequently overlooked, there is often an underlying cause that is correctable. Areas covered: In this review, we shed light on the prevalence of anemia in the elderly population, review the most common causes, particularly iron deficiency anemia and anemia of chronic disease, and describe the available treatment modalities. When a clear etiology for the anemia is ruled-out, the term unexplained anemia may be utilized; while still an under-explored field, one of the underlying pathophysiological mechanisms appears to be associated with an age-related inflammatory process...
January 21, 2017: Expert Review of Hematology
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