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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/28931420/presence-of-periaortic-gas-in-clostridium-septicum-infected-aortic-aneurysm-aids-in-early-diagnosis-a-case-report-and-systematic-review-of-the-literature
#1
Fumihito Ito, Ryota Inokuchi, Akinori Matsumoto, Yoshibumi Kumada, Hideyuki Yokoyama, Tokiya Ishida, Katsuhiko Hashimoto, Masashi Narita, Kazuaki Shinohara
BACKGROUND: Clostridium septicum-infected aortic aneurysm is a fatal and rare disease. We present a fatal case of C. septicum-infected aortic aneurysm and a pertinent literature review with treatment suggestions for reducing mortality rates. CASE PRESENTATION: A 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. Upon recognition of signs of an abdominal aortic aneurysm and paraplegia, we suspected an occluded Adamkiewicz artery and performed a contrast-enhanced computed tomography scan, which revealed an aortic aneurysm with periaortic gas extending from his chest to his abdomen and both kidneys...
September 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28929298/chronic-kidney-disease-and-anticoagulation-from-vitamin-k-antagonists-and-heparins-to-direct-oral-anticoagulant-agents
#2
REVIEW
Savino Sciascia, Massimo Radin, Karen Schreiber, Roberta Fenoglio, Simone Baldovino, Dario Roccatello
Anticoagulation in patients with impaired kidney function can be challenging since drugs' pharmacokinetics and bioavailability are altered in this setting. Patients with chronic kidney disease (CKD) treated with conventional anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight heparin (LMWH) or unfractionated heparin (UFH)] are at high risk of bleeding events (both non-major and major clinically relevant bleeding). While anticoagulation reduces the risk of thromboembolic events, the co-existing bleeding risk and the fact that the most commonly used anticoagulation agents are eliminated via the kidneys pose additional challenges...
September 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28920174/features-and-effects-of-information-technology-based-interventions-to-improve-self-management-in-chronic-kidney-disease-patients-a-systematic-review-of-the-literature
#3
Fateme Rangraz Jeddi, Ehsan Nabovati, Shahrzad Amirazodi
Slowing down the progression of chronic kidney disease (CKD) and its adverse health outcomes requires the patient's self-management and attention to treatment recommendations. Information technology (IT)-based interventions are increasingly being used to support self-management in patients with chronic diseases such as CKD. We conducted a systematic review of randomized controlled trials (RCTs) to assess the features and effects of IT-based interventions on self-management outcomes of CKD patients. A comprehensive search was conducted in Medline, Scopus, and the Cochrane Library to identify relevant papers that were published until May 2016...
September 18, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28913849/ethnic-disparities-in-renal-cell-carcinoma-an-analysis-of-hispanic-patients-in-a-single-payer-healthcare-system
#4
Alfredo Suarez-Sarmiento, Xiaopan Yao, Jonathan N Hofmann, Jamil S Syed, Wei K Zhao, Mark P Purdue, Wong-Ho Chow, Douglas Corley, Brian Shuch
OBJECTIVE: To investigate differences between Hispanics and non-Hispanic whites diagnosed with and treated for renal cell carcinoma in an equal access healthcare system. METHODS: We carried out a retrospective cohort study within the Kaiser Permanente healthcare system using records from renal cell carcinoma cases. Ethnicity was identified as Hispanic or non-Hispanic whites. Patient characteristics, comorbidities, tumor characteristics and treatment were compared...
September 15, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28912054/effectiveness-of-pharmacist-interventions-on-cardiovascular-risk-in-patients-with-ckd-a-subgroup-analysis-of-the-randomized-controlled-rxeach-trial
#5
Yazid N Al Hamarneh, Ross T Tsuyuki, Charlotte A Jones, Braden Manns, Marcello Tonelli, Nairne Scott-Douglass, Kailash Jindal, Wendy Tink, Brenda R Hemmelgarn
BACKGROUND: Affecting a substantial proportion of adults, chronic kidney disease (CKD) is considered a major risk factor for cardiovascular (CV) events. It has been reported that patients with CKD are underserved when it comes to CV risk reduction efforts. STUDY DESIGN: Prespecified subgroup analysis of a randomized controlled trial. SETTING & PARTICIPANTS: Adults with CKD and at least 1 uncontrolled CV risk factor were enrolled from 56 pharmacies across Alberta, Canada...
September 11, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28885958/repeat-hospitalizations-predict-mortality-in-patients-with-heart-failure
#6
Andrew H Lin, John C Chin, Nicholas M Sicignano, Amber M Evans
INTRODUCTION: Heart failure (HF) affects more than 5.1 million Americans and is projected to increase. Understanding the relationship between hospitalization and mortality can help to guide clinical management. The aim of the study is to evaluate the impact of repeat HF hospitalizations on all-cause mortality and to determine risk variables related to patient mortality. MATERIALS AND METHODS: Using administrative data from the Military Health System, a cohort of patients with an index admission for HF between 2007 and 2011 was identified...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28876706/-acute-kidney-injury-in-2017-management-in-a-secondary-care-hospital-an-example-of-interdisciplinary-collaboration
#7
Guido Marco Caronni, Hadrien Komaromi, Alexandre Guillermin, Mélissa Schneider, Zina Fumeaux
Acute kidney injury (AKI) is frequent and can lead to serious complications. It is classified according to the degree of renal function impairment and classically divided into three categories: pre-renal, intrinsic and post-renal. Identification of risk factors and wise use of additional tests are crucial to the diagnosis, as there are numerous causes of AKI. Identification and specific treatment of the underlying mechanism are essential, all while protecting the kidney. Resorting to a nephrologist is systematic when there are red flags...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28874131/a-chronic-hemodialysis-patient-with-isolated-pulmonary-valve-infective-endocarditis-caused-by-non-albicans-candida-a-rare-case-and-literature-review
#8
Chih-Hao Chang, Myo-Ming Huang, Dong-Feng Yeih, Kuo-Cheng Lu, Yi-Chou Hou
BACKGROUND: Isolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported. CASE PRESENTATION: A 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days...
September 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28874083/azathioprine-induced-pancytopenia-and-septic-complications-a-probable-cause-of-death
#9
Bijoy K Panda, Siddhi Umarje, Arundhati Diwan
Azathioprine, an immunosuppressant which is widely used in the management of the autoimmune neuromuscular disorder. Myasthenia gravis is known to cause myelotoxicity. A 55-year-old male recently diagnosed with myasthenia gravis and chronic kidney disease was put on azathioprine (100 mg/d) along with pyridostigmine and prednisolone. When the treatment was initiated, the hematological reports revealed normal levels of blood count. However, approximately within 3 weeks of continuing the prescribed drugs, the patient was readmitted for complaints of loose watery stools, weakness, and giddiness...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28872780/impaired-renal-function-affects-clinical-outcomes-and-management-of-patients-with-heart-failure
#10
Rebeka Jenkins, Lilly Mandarano, Saraniga Gugathas, Juan Carlos Kaski, Lisa Anderson, Debasish Banerjee
AIMS: Inpatients with heart failure and renal impairment have poor outcomes and variable quality of care. We investigate treatment practice and outcomes in an unselected real-world cohort using historical creatinine measurements. METHODS AND RESULTS: Admissions between 1/4/2013 and 30/4/2015 diagnosed at discharge with heart failure were retrospectively analysed. Stages of chronic kidney disease (CKD) and acute kidney injury (AKI) were calculated from creatinine at discharge and 3-12 months before admission...
September 5, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28869940/severe-secondary-hyperparathyroidism-in-a-hemodialysis-patient-a-case-report-from-mongolia
#11
Saruultuvshin Adiya, Khurtsbayar Damdinsuren, Chuluuntsetseg Dorj
Secondary hyperparathyroidism (SHPT) occurs in patients with chronic renal failure complicated with renal bone disease and soft tissue/vascular calcification. In dialysis patients with severe SHPT, medical treatment may fail and parathyroidectomy (PTX) is indicated for definitive treatment. Severe hypocalcemia from hungry bone disease or postoperative hypoparathyroidism may occur during the postoperative period. We report here a case of severe SHPT in a hemodialysis patient treated with phosphate binders, calcitriol, and calcimimetics but who still required PTX...
2017: Blood Purification
https://www.readbyqxmd.com/read/28856290/recommendations-for-the-treatment-of-hepatitis-c-in-2017
#12
REVIEW
Waldemar Halota, Robert Flisiak, Jacek Juszczyk, Piotr Małkowski, Małgorzata Pawłowska, Krzysztof Simon, Krzysztof Tomasiewicz
The goals of treatment is to eliminate HCV infection, stop or reverse histological changes, reduce the risk of hepatocellular carcinoma development and transmission of the infection to other individuals. According to the recommendation of the Polish Group of Experts for HCV in 2017 all patients with chronic HCV infection should receive treatment, but it is not recommended in patients at high risk of short overall survival. If access to therapy is restricted, priority should be given to patients whose HCV infection can lead to an unfavourable outcome of the disease within a short time frame, particular to individuals with liver cirrhosis, rapidly progressing liver fibrosis, extrahepatic manifestations of HCV infection, chronic kidney diseases, patients before and after organ transplantation...
June 2017: Clin Exp Hepatol
https://www.readbyqxmd.com/read/28852484/sickle-cell-disease-and-albuminuria-recent-advances-in-our-understanding-of-sickle-cell-nephropathy
#13
Vincent Audard, Pablo Bartolucci, Thomas Stehlé
Albuminuria is considered to be a relevant biomarker for the detection of early glomerular damage in patients with sickle cell disease (SCD). Improvements in our understanding of the pathophysiological processes and molecular mechanisms underlying albuminuria are required, because increasing numbers of patients with SCD are developing chronic kidney disease. The early recognition of sickle cell nephropathy (SCN) and studies of the natural course of this emerging renal disease are therefore crucial, together with identification of the associated clinical and biological risk factors, to make it possible to initiate kidney-protective therapy at early stages of renal impairment...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28844314/acute-kidney-injury-in-acute-on-chronic-liver-failure-where-does-hepatorenal-syndrome-fit
#14
REVIEW
Andrew Davenport, Mohammed Faisal Sheikh, Edmund Lamb, Banwari Agarwal, Rajiv Jalan
Renal dysfunction occurs in 25% to 50% of patients with cirrhosis admitted to the hospital with an acute episode of hepatic decompensation and may be due to underlying chronic kidney disease, an acute deterioration, or both. An acute deterioration in renal function in cirrhotic patients is now collectively referred to as acute kidney injury (AKI), which has been subclassified into different grades of severity that identify prognostic groups. Acute-on-chronic liver failure is characterized by acute hepatic and/or extrahepatic organ failure driven by a dysregulated immune response and systemic inflammatory response...
August 23, 2017: Kidney International
https://www.readbyqxmd.com/read/28843391/-management-of-bone-and-mineral-metabolism-disorders-before-the-dialysis-stage-remains-still-perfectible-data-from-the-french-phosphorus-and-calcium-survey-photo-graphe
#15
Guillaume Jean, Éric Daugas, Hubert Roth, Tilman Drueke, Jean-Louis Bouchet, Thierry Hannedouche, Gérard London, Denis Fouque
Only limited data is available on the management of the chronic kidney disease-associated bone and mineral metabolism disorder (CKD-MBD) in the pre-dialysis stages of CKD in France. A better knowledge of current management habits could lead to an improvement in the implementation of international recommendations (KDIGO). The 3rd version of the French Phosphorus and Calcium Survey Photo-Graphe (Sanofi) included a cohort of CKD stages 4 and 5 patients, whose aim was to examine the prevalence of CKD-MBD and the quality of its management in patients under the care of 62 nephrologists from over 20 geographical regions in France...
August 23, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28840500/hypertension-in-obesity-and-the-impact-of-weight-loss
#16
REVIEW
Jordana B Cohen
PURPOSE OF REVIEW: Several interrelated mechanisms promote the development of hypertension in obesity, often contributing to end organ damage including cardiovascular disease and chronic kidney disease. RECENT FINDINGS: The treatment of hypertension in obesity is complicated by a high prevalence of resistant hypertension, as well as unpredictable hemodynamic effects of many medications. Weight loss stabilizes neurohormonal activity and causes clinically significant reductions in blood pressure...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28835848/a-description-of-advanced-chronic-kidney-disease-patients-in-a-major-urban-center-receiving-conservative-care
#17
Fareed B Kamar, Helen Tam-Tham, Chandra Thomas
BACKGROUND: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting. OBJECTIVE: To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context. DESIGN: Retrospective chart review. SETTING: Urban nephrology center...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28831679/update-on-the-role-of-bone-biopsy-in-the-management-of-patients-with-ckd-mbd
#18
REVIEW
P Evenepoel, G J S Behets, M R Laurent, P C D'Haese
Patients with chronic kidney disease (CKD) are at increased risk of fractures. The fracture risk steadily increases along with the progression of renal disease to become several-fold higher in end-stage renal disease (ESRD) patients as compared to age and sex-matched controls. Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease. Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD, but do have important inherent limitations...
August 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28820797/postoperative-renal-dysfunction-after-noncardiac-surgery
#19
Suvi T Vaara, Rinaldo Bellomo
PURPOSE OF REVIEW: The narrative review aims to discuss recent results and important knowledge gaps regarding acute kidney injury (AKI) in postoperative patients undergone major noncardiac surgery. RECENT FINDINGS: Postoperative AKI affects approximately one-fifth of patients after major surgery, but the incidence varies according to the type of surgery. Preexisting chronic kidney disease is a major risk factor for postoperative AKI. It carries a substantial risk for postoperative adverse outcomes, as well as long-term mortality and morbidity...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820361/the-clinical-relevance-of-repeat-renal-biopsies-in-the-management-of-lupus-nephritis-a-south-african-experience
#20
E K Tannor, W D Bates, M R Moosa
Purpose Clinically, repeat renal biopsies (RRBs) have been performed in lupus nephritis to identify changes in class, plan treatment and assist in prognostication. We set out to compare the histopathological features and outcomes of disease flare and protocol biopsy patients. Methods A retrospective descriptive study was conducted on repeat biopsies performed between January 1984 and December 2015 in lupus nephritis patients. Disease flares and protocol biopsies were compared. Results Of 614 systemic lupus erythematosus (SLE) renal biopsies, 127 (20...
January 1, 2017: Lupus
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