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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/28820797/postoperative-renal-dysfunction-after-noncardiac-surgery
#1
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...
August 17, 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
#2
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
https://www.readbyqxmd.com/read/28814591/spleno-renal-artery-transposition-in-a-solitary-functioning-kidney-for-treatment-resistant-hypertension-and-acute-kidney-injury
#3
Subash Somalanka, Fiona E Harris, Eric Chemla, Rebecca Jo Suckling, Pauline A Swift
Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. We present an interesting case of a Caucasian male with peripheral vasculopathy, abdominal aortic aneurysm (AAA), single functioning kidney and ostial RAS caused by stent struts from an endovascular AAA stent graft...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28799704/the-nature-consequences-and-management-of-neurological-disorders-in-chronic-kidney-disease
#4
REVIEW
Bahman Jabbari, Nosratola D Vaziri
Perhaps no other organ in the body is affected as often and in as many ways as the brain is in patients with chronic kidney disease (CKD). Several factors contribute to the neurological disorders in CKD including accumulation of uremic toxins, metabolic and hemodynamic disorders, oxidative stress, inflammation, and impaired blood brain barrier among others. The neurological disorders in CKD involve both peripheral and central nervous system. The peripheral neurological symptoms of CKD are due to somatic and cranial peripheral neuropathies as well as a myopathy...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28794290/e-learning-model-in-chronic-kidney-disease-management-a-controlled-clinical-trial
#5
Hamid Barahimi, Mitra Zolfaghari, Farid Abolhassani, Abass Rahimi Foroushani, Aeen Mohammadi, Farahnaz Rajaee
INTRODUCTION: Chronic kidney disease (CKD) is a challenging health problem. The present study examined impact of self-care education through e-learning on improving kidney function among individuals with CKD. MATERIALS AND METHODS: The studied population consisted of CKD patients receiving care at 10 centers for treating noncommunicable diseases in Tehran. Three centers were randomly selected and 39 patients with a glomerular filtration rate (GFR) less than 60 mL/min/1...
July 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28782147/adolescent-nephrology-an-emerging-frontier-for-kidney-care-in-sub-saharan-africa
#6
REVIEW
Bianca Davidson, Ikechi Okpechi, Mignon McCulloch, Nicola Wearne
Adolescents make up a quarter of the world's population and are important users of health services. In South Africa little is known about the extent of renal disease or outcomes in this group. Adolescents are a vulnerable age group, due to their neurocognitive development, engagement in high-risk social activities, prevalence of mental illness and increasing rates of HIV infection. In Africa access to renal replacement therapy is rationed, therefore the focus of renal disease must be one of prevention rather than dealing with the management of end stage renal disease...
August 6, 2017: Nephrology
https://www.readbyqxmd.com/read/28779902/-erythropoiesis-stimulating-agents-literature-review-of-uses-and-indications-in-advanced-oncological-and-non-oncological-disease-in-the-elderly
#7
Nieves Fernandez Letamendi, Teresa Fernandez Letamendi, M Angeles Montañes Gracia, Valle Recasens Flores
The aim of this article is to review possible indications and controversies about the most frequent uses of ESAs in the treatment of anaemia in elderly patients with oncological and non-oncological diseases. Using PubMed a systematic review was carried out on articles published from 1985 to September 2016, as well as a review of the main Spanish, European, and American consensus guidelines on each of the following diseases in which could pose the treatment of anaemia associated with ESA. A review was also carried out on the main Spanish, European and American consensus guidelines regarding the management of anaemia related to the diseases outlined in this article...
August 2, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28779862/neurological-complications-of-renal-disease
#8
Jorge H Baluarte
Neurological manifestations related to electrolyte disorders, drug toxicity, and uremia are common in chronic kidney disease (CKD). Seizures and coma are frequent complications of acute renal insufficiency (uremia), whereas peripheral neuropathy and encephalopathy, observed in progressive uremia, are terminal events. Failure to excrete metabolic products causes their accumulation and can lead to severe intoxication. Clinically, the signs and symptoms of uremia can vary widely, depending on the biological characteristics of the patient, the specific type of renal disease, and the time of the uremic intoxication...
February 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/28774438/individualized-drug-dosing-using-rbf-galerkin-method-case-of-anemia-management-in-chronic-kidney-disease
#9
Hossein Mirinejad, Adam E Gaweda, Michael E Brier, Jacek M Zurada, Tamer Inanc
BACKGROUND AND OBJECTIVE: Anemia is a common comorbidity in patients with chronic kidney disease (CKD) and is frequently associated with decreased physical component of quality of life, as well as adverse cardiovascular events. Current treatment methods for renal anemia are mostly population-based approaches treating individual patients with a one-size-fits-all model. However, FDA recommendations stipulate individualized anemia treatment with precise control of the hemoglobin concentration and minimal drug utilization...
September 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28764630/optimising-assessment-of-kidney-function-when-managing-localised-renal-masses
#10
REVIEW
Robert J Ellis, Andre Joshi, Keng L Ng, Ross S Francis, Glenda C Gobe, Simon T Wood
Increased early and incidental detection, improved surgical techniques and technological advancement mean that the management of renal mass lesions is constantly evolving. The treatment of choice for renal mass lesions has historically been radical nephrectomy. Partial nephrectomy is now recommended for localised renal masses, owing to favourable renal functional outcomes. Ablative renal surgery confers a significant risk of chronic kidney disease. There are few studies assessing long term outcomes of nephrectomy on renal outcomes, and virtually no studies assessing long term outcomes for less invasive therapies such as ablation...
August 7, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28762691/hiv-associated-complications-a-systems-based-approach
#11
REVIEW
Carolyn Chu, Lealah C Pollock, Peter A Selwyn
Persons with human immunodeficiency virus (HIV) infection often develop complications related directly to the infection, as well as to treatment. Aging, lifestyle factors, and comorbidities increase the risk of developing chronic conditions such as diabetes mellitus and chronic kidney disease. HIV-associated neurologic complications encompass a wide spectrum of pathophysiology and symptomatology. Cardiovascular and pulmonary conditions are common among persons with HIV infection. Although some specific antiretroviral medications have been linked to disease development, traditional risk factors (e...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28755740/vascular-damage-and-kidney-transplant-outcomes-an-unfriendly-and-harmful-link
#12
REVIEW
Domingo Hernández, Javier Triñanes, Ana María Armas, Pedro Ruiz-Esteban, Juana Alonso-Titos, Ana Duarte, Miguel González-Molina, Eulalia Palma, Eduardo Salido, Armando Torres
Kidney transplant (KT) is the treatment of choice for most patients with chronic kidney disease, but this has a high cardiovascular mortality due to traditional and nontraditional risk factors, including vascular calcification. Inflammation could precede the appearance of artery wall lesions, leading to arteriosclerosis and clinical and subclinical atherosclerosis in these patients. Additionally, mineral metabolism disorders and activation of the renin-angiotensin system could contribute to this vascular damage...
July 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28737134/nephrotic-syndrome-in-primary-myelofibrosis-with-renal-extramedullary-hematopoiesis-and-glomerulopathy-in-the-jak-inhibitor-era
#13
Rachele Del Sordo, Rachele Brugnano, Carla Covarelli, Gioia Fiorucci, Franca Falzetti, Giorgio Barbatelli, Emidio Nunzi, Angelo Sidoni
Primary myelofibrosis (PMF) is an uncommon form of myeloproliferative neoplasm (MPN) characterized by a proliferation of predominantly megakaryocytes and granulocytes in the bone marrow that, in fully-developed disease, is associated with reactive deposition of fibrous connective tissue, extramedullary hematopoiesis (EMH), and splenomegaly. Kidney involvement is rare and clinically presents with proteinuria, nephrotic syndrome, and renal insufficiency. Renal damage can be due to EMH and glomerulopathy. Renal EMH presents three patterns: infiltration of the interstitium with possible renal failure caused by functional damage of parenchyma and vessels, infiltration of capsule and pericapsular adipose tissue, and sclerosing mass-like lesions that can cause hydronephrosis and hydroureter with obstructive uropathy and renal failure...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28723471/urinary-tract-infections-in-immunocompromised-patients-with-diabetes-chronic-kidney-disease-and-kidney-transplant
#14
REVIEW
Zafer Tandogdu, Tommaso Cai, Bela Koves, Florian Wagenlehner, Truls Erik Bjerklund-Johansen
CONTEXT: This paper provides a brief overview of urinary tract infections (UTIs) in immunocompromised patients from the perspective of a practicing urologist. OBJECTIVE: The primary objective was to provide an update on UTIs in immunocompromised patients. Diabetes mellitus (DM), chronic kidney disease, and kidney transplant (KT) are the most common clinical cases encountered by urologists. Diagnosis, management, and future research needs are summarised. EVIDENCE ACQUISITION: We conducted a nonsystematic review of the literature...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28714648/-phosphate-binders-what-are-the-recent-evidences
#15
Iméne Achek Bouajila, Pierre-Yves Martin, Sophie De Seigneux
Hyperphosphatemia is a late complication of chronic kidney disease (CKD). It is a major non-traditional cardiovascular risk factor in CKD. The management of hyperphosphatemia is based on restriction of phosphate intake, phosphate binders and dialysis. Phosphate binders are divided into calcium-based and non-calcium-based binders. Recent evidence suggest restricting the dose of calcium-based phosphate binders because of the associated increased mortality in compared to non-calcic ones. New treatments are under development such as inhibitors of kidney or intestinal phosphate absorption...
February 22, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28711080/menopause-and-chronic-kidney-disease
#16
Sofia B Ahmed
Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore menses and fertility, highlighting the challenges of diagnosing and managing the menopausal transition in the female population with kidney disease. Postmenopausal sex hormone levels affect renovascular physiology, but the clinical impact of menopause on kidney function is unclear...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28704129/electromagnetic-information-transfer-through-aqueous-system
#17
Alberto Foletti, Mario Ledda, Maria Grazia Lolli, Settimio Grimaldi, Antonella Lisi
Several beneficial effects of the electromagnetic information transfer through aqueous system (EMITTAS) procedure have previously been reported in vitro. The clinical potential of this procedure has also started to be evaluated. Information flow in biological systems can be investigated through chemical and molecular approaches or by a biophysical approach focused on endogenous electrodynamic activities. Electromagnetic signals are endogenously generated at different levels of the biological organization and, likely, play an active role in synchronizing internal cell function or local/systemic adaptive response...
July 13, 2017: Electromagnetic Biology and Medicine
https://www.readbyqxmd.com/read/28686681/kir-and-their-hla-class-i-ligands-two-more-pieces-towards-completing-the-puzzle-of-chronic-rejection-and-graft-loss-in-kidney-transplantation
#18
Roberto Littera, Gianbenedetto Piredda, Davide Argiolas, Sara Lai, Elena Congeddu, Paola Ragatzu, Maurizio Melis, Elisabetta Carta, Maria Benigna Michittu, Donatella Valentini, Luisella Cappai, Rita Porcella, Francesco Alba, Maria Serra, Valentina Loi, Roberta Maddi, Sandro Orrù, Giorgio La Nasa, Giovanni Caocci, Roberto Cusano, Marcella Arras, Mauro Frongia, Antonello Pani, Carlo Carcassi
BACKGROUND: Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function...
2017: PloS One
https://www.readbyqxmd.com/read/28683787/the-effect-and-safety-of-postmenopausal-hormone-therapy-and-selective-estrogen-receptor-modulators-on-kidney-outcomes-in-women-a-protocol-for-systematic-review-and-meta-analysis
#19
Sandra M Dumanski, Sharanya Ramesh, Matthew T James, Amy Metcalfe, Kara Nerenberg, Ellen W Seely, Helen Lee Robertson, Sofia B Ahmed
BACKGROUND: The prevalence of menopause in women with or at risk of chronic kidney disease is increasing globally. Although international guidelines on menopause recommend the use of postmenopausal hormone therapy with or without selective estrogen receptor modulators for control of vasomotor symptoms, the effects of these treatments on kidney function and albuminuria are unclear. Furthermore, women with chronic kidney disease are at significantly increased risk of venous thromboembolism and malignancy, well-documented adverse effects of postmenopausal hormone therapy...
July 7, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#20
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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