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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/28102522/present-and-future-of-interventional-treatment-of-resistant-hypertension
#1
REVIEW
Ayhan Yoruk, Sinan S Tankut, John P Gassler, John D Bisognano
The increasing prevalence of hypertension, a significant cause of disability and premature death throughout the world, is a major public health concern. This is especially true for the subset of patients who suffer from resistant hypertension, which is associated with a fourfold greater risk of cardiovascular events as compared to those hypertensive patients able to achieve target blood pressure. Though quite daunting in number and ill effect, hypertension remains the most common and the most important modifiable risk factor for coronary heart disease, congestive heart failure, peripheral vascular disease, stroke, and chronic kidney disease...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28098097/protective-role-of-nigella-sativa-in-diabetic-nephropathy-a-randomized-clinical-trial
#2
Zafar Masood Ansari, Mohammad Nasiruddin, Rahat Ali Khan, Shahzad Faizul Haque
This study aims to evaluate efficacy and safety of Nigella sativa oil supplementation in patients with chronic kidney disease Stage 3 and 4 due to diabetic nephropathy. It was a prospective, comparative, and open-label study. Patients were randomized into two groups. Group 1 (Control) received conservative management of diabetic nephropathy, whereas Group 2 (Test) received N. sativa oil (2.5 mL, once daily and per orally) along with conservative management for 12 weeks. Blood glucose, hemogram, and kidney function test were done at 0, 6, and 12 weeks of treatment...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28095816/awareness-and-knowledge-among-internal-medicine-house-staff-for-dose-adjustment-of-commonly-used-medications-in-patients-with-ckd
#3
Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein
BACKGROUND: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. METHODS: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28095258/the-safety-of-treatment-options-available-for-gout
#4
Naomi Schlesinger
Gout is the most common inflammatory arthritis in humans. Gout treatment includes rapid initiation of anti-inflammatory medications for acute attacks and chronically treating with urate lowering drugs as well as chronic anti-inflammatory prophylaxis. Areas covered: This review aims to provide an overview and discussion of the safety concerns of current treatment options available for gout. Expert opinion: Gout is a curable disease with appropriate treatment. The advent of new therapies provides encouraging opportunities to improve gout management...
January 17, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28095147/management-of-small-renal-masses-american-society-of-clinical-oncology-clinical-practice-guideline
#5
Antonio Finelli, Nofisat Ismaila, Bill Bro, Jeremy Durack, Scott Eggener, Andrew Evans, Inderbir Gill, David Graham, William Huang, Michael A S Jewett, Sheron Latcha, William Lowrance, Mitchell Rosner, Bobby Shayegan, Houston R Thompson, Robert Uzzo, Paul Russo
Purpose To provide recommendations for the management options for patients with small renal masses (SRMs). Methods By using a literature search and prospectively defined study selection, we sought systematic reviews, meta-analyses, randomized clinical trials, prospective comparative observational studies, and retrospective studies published from 2000 through 2015. Outcomes included recurrence-free survival, disease-specific survival, and overall survival. Results Eighty-three studies, including 20 systematic reviews and 63 primary studies, met the eligibility criteria and form the evidentiary basis for the guideline recommendations...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28093874/management-of-coronary-artery-disease-and-acute-coronary-syndrome-in-the-chronic-kidney-disease-population-a-review-of-the-current-literature
#6
REVIEW
Justin M Lingel, Mukta C Srivastava, Anuj Gupta
Coronary Artery Disease (CAD) is a large contributor to morbidity and mortality in the chronic kidney disease (CKD) and end-stage renal disease (ESRD) population. Due to the fact that many large-scale trials evaluating management for acute coronary syndromes (ACS) and CAD have excluded patients with CKD, there is a paucity of data investigating medical management of CAD and revascularization strategies of these patients. Further, while there have been many advances in the treatment for ACS and CAD, both medically and technologically, few studies have focused on the CKD population and many predate these advancements in management...
January 17, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28091429/chronic-kidney-disease-in-chinese-postmenopausal-women-a-cross-sectional-survey
#7
F Pei, Z Zhou, Y Li, Y Ren, X Yang, G Liu, Q Xia, Z Hu, L Zhang, M Zhao, H Wang
INTRODUCTION: Despite advances in the management of chronic kidney disease (CKD), there is ongoing uncertainty regarding the prevalence of CKD in postmenopausal women. This study was designed to investigate both CKD prevalence and related risk factors in a cohort of postmenopausal Chinese women. MATERIALS AND METHODS: A cross-sectional survey was administered to a nationally representative sample of female Chinese participants, including a total of 47,204 subjects, among whom were 8573 self-reported postmenopausal women...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#8
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28069603/treatment-of-b-cell-disorder-improves-renal-outcome-of-patients-with-monoclonal-gammopathy-associated-c3-glomerulopathy
#9
Sophie Chauvet, Véronique Frémeaux-Bacchi, Florent Petitprez, Alexandre Karras, Laurent Daniel, Stéphane Burtey, Gabriel Choukroun, Yahsou Delmas, Dominique Guerrot, Arnaud François, Moglie Le Quintrec, Vincent Javaugue, David Ribes, Laurence Vrigneaud, Bertrand Arnulf, Jean Michel Goujon, Pierre Ronco, Guy Touchard, Frank Bridoux
The high frequency of monoclonal gammopathy in adult patients with C3 glomerulopathy (C3G) emphasizes the role of the monoclonal immunoglobulin (MIg) in the occurrence of renal disease and raises the issue of the therapeutic management. The aim of the study was to evaluate the effect of chemotherapy in a large cohort of patients with MIg-associated C3G. Fifty adult patients with MIg and biopsy-proven C3G were extracted from the French national database of C3G. We retrospectively compared renal outcomes in patients who received or not chemotherapy targeting the underlying B-cell clone...
January 9, 2017: Blood
https://www.readbyqxmd.com/read/28067588/health-benefits-of-fiber-fermentation
#10
Wendy J Dahl, Nicole C Agro, Åsa M Eliasson, Kaley L Mialki, Joseph D Olivera, Carley T Rusch, Carly N Young
Although fiber is well recognized for its effect on laxation, increasing evidence supports the role of fiber in the prevention and treatment of chronic disease. The aim of this review is to provide an overview of the health benefits of fiber and its fermentation, and describe how the products of fermentation may influence disease risk and treatment. Higher fiber intakes are associated with decreased risk of cardiovascular disease, type 2 diabetes, and some forms of cancer. Fiber may also have a role in lowering blood pressure and in preventing obesity by limiting weight gain...
January 9, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28062909/paediatric-anti-neutrophil-cytoplasmic-antibody-anca-associated-vasculitis-an-update-on-renal-management
#11
REVIEW
Lucy A Plumb, Louise Oni, Stephen D Marks, Kjell Tullus
The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of disorders characterized by necrotizing inflammation of the small to medium vessels in association with autoantibodies against the cytoplasmic region of the neutrophil. Included in this definition are granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). AAV are chronic, often relapsing diseases that can be organ or life threatening...
January 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28062617/growth-differentiation-factor-15-as-a-biomarker-in-cardiovascular-disease
#12
REVIEW
Kai C Wollert, Tibor Kempf, Lars Wallentin
BACKGROUND: Growth differentiation factor 15 (GDF-15) is expressed and secreted in response to inflammation, oxidative stress, hypoxia, telomere erosion, and oncogene activation. Cardiovascular (CV) disease is a major driver of GDF-15 production. GDF-15 has favorable preanalytic characteristics and can be measured in serum and plasma by immunoassay. CONTENT: In community-dwelling individuals higher concentrations of GDF-15 are associated with increased risks of developing CV disease, chronic kidney disease, and cancer, independent of traditional CV risk factors, renal function, and other biomarkers (C-reactive protein, B-type natriuretic peptide, cardiac troponin)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28052180/advances-in-psoriasis
#13
Jaclyn Smith, Abigail Cline, Steven R Feldman
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28044233/management-of-secondary-hyperparathyroidism-how-and-why
#14
REVIEW
Hirotaka Komaba, Takatoshi Kakuta, Masafumi Fukagawa
Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease. Currently, various treatment options are available, including vitamin D receptor activators, cinacalcet hydrochloride, and parathyroidectomy. These treatment options have contributed to the successful control of SHPT, and recent clinical studies have provided evidence suggesting that effective treatment of SHPT leads to improved survival. Although bone disease is the most widely recognized consequence of SHPT and remains a major target for treatment of SHPT, there is increasing evidence that parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), both of which are markedly elevated in SHPT, have multiple adverse effects on extraskeletal tissues...
January 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28043082/a-dialysis-patient-s-choice-and-a-nephrologist-s-obligation-the-need-to-understand-and-value-the-patient-s-perspective
#15
EDITORIAL
Juliya Hemmett, Christopher W McIntyre
Patient-centered care is critical to the successful management of chronic diseases, such as chronic kidney disease. While a course of treatment may prolong life it may come with a reduced quality of life (QOL). For many patients, the decision to prolong life at the expense of lower QOL is not an obvious choice. Dialysis patients make treatment decisions daily, some of which can be life-altering. Therefore, the need for optimal decision-making may be more pressing in dialysis patients than in many other chronic disease states...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28042364/predictors-of-acute-kidney-injury-in-neurocritical-care-patients-receiving-continuous-hypertonic-saline
#16
Michael J Erdman, Heidi Riha, Lauren Bode, Jason J Chang, G Morgan Jones
BACKGROUND AND PURPOSE: Continuous intravenous 3% hypertonic saline (HTS) infusions are commonly used for the management of cerebral edema following severe neurologic injuries. Despite widespread use, data regarding the incidence and predictors of nephrotoxicity are lacking. The purpose of this study was to describe the incidence and identify predictors of acute kidney injury (AKI) in neurocritical care patients administered continuous infusion HTS. METHODS: This was an institutional review board-approved, multicenter, retrospective cohort study of patients receiving HTS infusions at 2 academic medical centers...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28031020/assessing-key-cost-drivers-associated-with-caring-for-chronic-kidney-disease-patients
#17
Paul Damien, Holly J Lanham, Murali Parthasarathy, Nikhil L Shah
BACKGROUND: To examine key factors influencing chronic kidney disease (CKD) patients' total expenditure and offer recommendations on how to reduce total cost of CKD care without compromising quality. METHODS: Using the 2002-2011 Medical Expenditure Panel Survey (MEPS) data, our cross-sectional study analyzed 197 patient records-79 patients with one record and 59 with two entries per patient (138 unique patients). We used three patient groups, based on international statistical classification of diseases version 9 code for condition (ICD9CODX) classification, to focus inference from the analysis: (a) non-dialysis dependent CKD, (b) dialysis and (c) transplant...
December 28, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/28001026/keto-analogues-and-essential-amino-acids-and-other-supplements-in-the-conservative-management-of-chronic-kidney-disease
#18
Adamasco Cupisti, Piergiorgio Bolasco
The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with an aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of CKD patients...
December 21, 2016: Panminerva Medica
https://www.readbyqxmd.com/read/28000536/immune-checkpoint-inhibitors-renal-side-effects-and-management
#19
Elie El Rassy, Hampig R Kourie, Jamale Rizkallah, Fadi El Karak, Colette Hanna, Dania N Chelala, Marwan Ghosn
The choice of immunotherapy in the treatment of cancer has improved the prognosis of many patients affected by various malignancies. The high expectations foreseen with immunotherapy have led to fast approvals despite the incomplete understanding of the toxicity profiles in the different organs, including the kidneys. The high prevalence of chronic kidney disease in cancer patients complicates the issue further and requires a better knowledge of the renal safety profile to ensure an optimal safe treatment. This review summarizes the present knowledge of renal adverse events secondary to immune checkpoint inhibitors and discusses their pathophysiology, clinical presentation and adequate management...
December 2016: Immunotherapy
https://www.readbyqxmd.com/read/27995959/a-nationwide-cross-sectional-survey-on-prevalence-management-and-pharmacoepidemiology-patterns-on-hypertension-in-chinese-patients-with-chronic-kidney-disease
#20
Wen Zhang, Wei Shi, Zhangsuo Liu, Yong Gu, Qinkai Chen, Weijie Yuan, Yanlin Zhang, Li Gong, Rong Zhou, Mingxu Li, Hong Cheng, Jian Liu, Jun Cen, Chaoxing Huang, Yeping Ren, Peiju Mao, Changying Xing, Fuyuan Hong, Dongsheng Jiang, Li Wang, Gang Xu, Jianshe Liu, Nan Chen
Limited data are available on epidemiology and drug use in Chinese hypertensive patients with chronic kidney disease (CKD). We determined the prevalence; awareness, treatment, and control rates of hypertension; anti-hypertensive use, expenditure pattern; and factors associated with hypertension prevalence and control in Chinese patients with CKD. This was one of the largest cross-sectional surveys that enrolled 6079 CKD participants (mean age, 51.0 ± 16.37 years) with or without hypertension from 22 centres across China...
December 20, 2016: Scientific Reports
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