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Chronic kidney disease management and treatment

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https://www.readbyqxmd.com/read/29768353/correlation-of-increased-th17-treg-cell-ratio-with-endoplasmic-reticulum-stress-in-chronic-kidney-disease
#1
Xiaojing Zhu, Shuiqin Li, Qiaona Zhang, Dan Zhu, Yang Xu, Pengqian Zhang, Jin Han, Zhaoyang Duan, Jie Gao, Yan Ou
To investigate the relationship between the regulatory immune network and endoplasmic reticulum stress (ERS) in patients with different stages of chronic kidney disease (CKD).A total of 91 patients diagnosed with CKD were divided into different groups according to the stage of disease and treatment with hemodialysis (HD) or peritoneal dialysis (PD). Routine blood and biochemical tests were performed in patients in the different CKD groups and in healthy controls (n = 20). The frequencies of T helper type 17 (Th17) and regulatory T (Treg) cells in the overall T cell population were measured by flow cytometric analysis...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29763911/clinical-correlates-of-ambulatory-blood-pressure-phenotypes-at-a-tertiary-care-hospital-in-turkey
#2
Siyar Erdogmus, Sim Kutlay, Zeynep Kendi Celebi, Tolga Aydın, Damla Ors Sendogan, Gizem Kumru, Kenan Keven, Gokhan Nergizoglu, Sehsuvar Erturk, Sule Sengul
BACKGROUND/AIMS: Hypertension and its complications are major public health issues worldwide due to their association with high cardiovascular morbidity and mortality. Despite significant progress in health, the prevalence of hypertension is increasing. Ambulatory blood pressure monitoring (ABPM) is becoming increasingly important for the management of hypertension. In this study, we aimed to investigate the clinical and laboratory correlates of ambulatory blood pressure (ABP) phenotypes at a tertiary care hospital in Turkey...
May 10, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29753399/cardiovascular-disease-and-diabetic-kidney-disease
#3
REVIEW
Muhammad Maqbool, Mark E Cooper, Karin A M Jandeleit-Dahm
Diabetic kidney disease commonly is associated with an increased risk of cardiovascular disease. There are traditional common risk factors for both conditions including hypertension and poor glycemic control. However, it is likely that there are other pathophysiological mechanisms that explain the clinical phenomenon of increased cardiovascular disease in diabetic patients with chronic kidney and vice versa. Current management of both conditions includes aggressive glucose and blood pressure control. The protective role of treating dyslipidemia has been shown for cardiovascular disease, but the results for renal disease are not as clear...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29750634/effectiveness-of-febuxostat-in-patients-with-allopurinol-refractory-hyperuricemic-chronic-kidney-disease
#4
Chae Hee Kwak, Minji Sohn, Nayoung Han, Yoon-Sook Cho, Yon Su Kim, Jung Mi Oh
OBJECTIVE: As uncontrolled hyperuricemia has been associated with an increased risk of cardiovascular disease and the progression of chronic kidney disease (CKD), management of serum uric acid levels is important. The aim of this study was to evaluate the effectiveness of febuxostat in regulating uncontrolled hyperuricemia in patients with renal dysfunction. MATERIALS AND METHODS: We included patients with CKD and persistent uncontrolled hyperuricemia despite treatment with allopurinol...
May 11, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29741651/serum-phosphate-optimal-timing-and-range-associated-with-patients-survival-in-haemodialysis-the-cosmos-study
#5
José L Fernández-Martín, Adriana Dusso, Pablo Martínez-Camblor, Maria P Dionisi, Jürgen Floege, Markus Ketteler, Gérard London, Francesco Locatelli, José L Górriz, Boleslaw Rutkowski, Willem-Jan Bos, Christian Tielemans, Pierre-Yves Martin, Rudolf P Wüthrich, Drasko Pavlovic, Miha Benedik, Diego Rodríguez-Puyol, Juan J Carrero, Carmine Zoccali, Jorge B Cannata-Andía
Background: Serum phosphate is a key parameter in the management of chronic kidney disease-mineral and bone disorder (CKD-MBD). The timing of phosphate measurement is not standardized in the current guidelines. Since the optimal range of these biomarkers may vary depending on the duration of the interdialytic interval, in this analysis of the Current management of secondary hyperparathyroidism: a multicentre observational study (COSMOS), we assessed the influence of a 2- (midweek) or 3-day (post-weekend) dialysis interval for blood withdrawal on serum levels of CKD-MBD biomarkers and their association with mortality risk...
May 7, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29738034/evaluation-of-prevalence-biochemical-profile-and-drugs-associated-with-chronic-kidney-disease-mineral-and-bone-disorder-in-11-dialysis-centers
#6
Rodrigo Reis Abrita, Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Renata Abrita, Rosalia Maria Nunes Henriques Huaira, Marcus Gomes Bastos, Natália Maria da Silva Fernandes
INTRODUCTION: The diagnosis and treatment of mineral and bone disorder of chronic kidney disease (CKD-MBD) is a challenge for nephrologists and health managers. The aim of this study was to evaluate the prevalence, biochemical profile, and drugs associated with CKD-MBD. METHODS: Cross-sectional study between July and November 2013, with 1134 patients on dialysis. Sociodemographic, clinical, and laboratory data were compared between groups based on levels of intact parathyroid hormone (iPTH) (< 150, 150-300, 301-600, 601-1000, and > 1001 pg/mL)...
May 7, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29736929/determinants-of-regret-in-elderly-dialysis-patients
#7
Edlyn Gui Fang Tan, Irene Teo, Eric A Finkelstein, Choong Meng Chan
BACKGROUND: In Singapore, most elderly end stage renal disease (ESRD) patients choose dialysis over palliative management. However, dialysis may not be the optimal treatment option given only moderate survival benefits and high costs and treatment burden compared to non-dialysis management. Elderly patients may therefore come to regret this decision. This study investigated (1) extent of patients' decision regret after starting dialysis, and (2) potentially modifiable predictors of regret: satisfaction with chronic kidney disease education, decisional conflict, and decision-making involvement...
May 7, 2018: Nephrology
https://www.readbyqxmd.com/read/29734154/treatment-of-posttransplantation-anemia
#8
Kohei Unagami, Masayoshi Okumi, Tomomi Tamura, Hideki Ishida, Kazunari Tanabe, Kosaku Nitta
Kidney transplantation represents a renal replacement therapy for end-stage renal failure, with outcomes improving from year to year. With the improved survival prognosis, treatment of complications of chronic kidney disease after transplantation is becoming increasingly important. In particular, posttransplantation anemia (PTA) is often protracted, which could be related to a variety of factors, including the renal function status, graft rejection episodes, and infectious causes. PTA occurs in about 30-40% of transplant recipients, and is known to affect the function of the transplanted kidney as well as patient survival...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29734149/recent-advances-in-treatment-strategies-for-lupus-nephritis
#9
Kazunori Karasawa, Keiko Uchida, Tomo Takabe, Takahito Moriyama, Kosaku Nitta
Systemic lupus erythematosus (SLE) is an autoimmune chronic inflammatory disease that affects multiple organs and tissues. Lupus nephritis (LN) is a serious complication of SLE, which occurs at a high rate. Conventional treatment strategies of LN have been widely accepted by two concepts such as induction therapy and maintenance therapy. In LN induction therapy until recently, cyclophosphamide in combination with prednisone (PSL) has been the standard method of treatment for proliferative forms of LN. In the latest review, the combination of mycophenolate mofetil (MMF) is also considered a standard treatment option...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29733462/current-and-potential-therapeutic-strategies-for-the-management-of-vascular-calcification-in-patients-with-chronic-kidney-disease-including-those-on-dialysis
#10
REVIEW
Irene Ruderman, Stephen G Holt, Tim D Hewitson, Edward R Smith, Nigel D Toussaint
Patients with CKD have accelerated vascular stiffening contributing significantly to excess cardiovascular morbidity and mortality. Much of the arterial stiffening is thought to involve vascular calcification (VC), but the pathogenesis of this phenomenon is complex, resulting from a disruption of the balance between promoters and inhibitors of calcification in a uremic milieu, along with derangements in calcium and phosphate metabolic pathways. Management of traditional cardiovascular risk factors to reduce VC may be influential but has not been shown to significantly improve mortality...
May 7, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29731610/treatment-adherence-among-adult-hypertensive-patients-a-cross-sectional-retrospective-study-in-primary-care-in-romania
#11
Ioan Tilea, Dorina Petra, Septimiu Voidazan, Elena Ardeleanu, Andreea Varga
Purpose: This study was performed to elucidate the level of adherence to antihypertensive treatment in adult subjects attending a family medicine clinic in a city in central Romania. Patients and methods: A cross-sectional, retrospective study was performed on a cohort of hypertensive adults. A total of 525 participants were selected from 1,714 adults attending a single urban family medicine practice. Assessment of adherence to therapy was performed by a chart review of prescription and clinical records over a 4-year study period...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29726985/expert-consensus-document-on-the-management-of-hyperkalaemia-in-patients-with-cardiovascular-disease-treated-with-raas-inhibitors-coordinated-by-the-working-group-on-cardiovascular-pharmacotherapy-of-the-european-society-of-cardiology
#12
Giuseppe M C Rosano, Juan Tamargo, Keld P Kjeldsen, Mitja Lainscak, Stefan Agewall, Stefan D Anker, Claudio Ceconi, Andrew J S Coats, Heinz Drexel, Gerasimos Filippatos, Juan Carlos Kaski, Lars Lund, Alexander Niessner, Gianluigi Savarese, Thomas A Schmidt, Petar Seferovic, Sven Wassmann, Thomas Walther, Basil S Lewis
Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard end-points. RAASi are also the basis in treatment of arterial hypertension and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit...
May 3, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29725779/expansive-renal-osteitis-fibrosa-a-case-report
#13
Gabriel Silva Andrade, Abrahão Cavalcante Gomes de Souza Carvalho, Tibério Gomes Magalhães, Edson Luiz Cetira Filho, Roberta Barroso Cavalcante, Renato Luiz Maia Nogueira
Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment...
May 4, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29725636/treatment-of-hyperkalemia-with-a-low-dose-insulin-protocol-is-effective-and-results-in-reduced-hypoglycemia
#14
Bairbre A McNicholas, Mai H Pham, Katrina Carli, Chang Huei Chen, Nancy Colobong-Smith, Arthur Eric Anderson, Hien Pham
Introduction: Complications associated with insulin treatment for hyperkalemia are serious and common. We hypothesize that, in chronic kidney disease (CKD) and end-stage renal disease (ESRD), giving 5 units instead of 10 units of i.v. regular insulin may reduce the risk of causing hypoglycemia when treating hyperkalemia. Methods: A retrospective quality improvement study on hyperkalemia management (K+  ≥ 6 mEq/l) from June 2013 through December 2013 was conducted at an urban emergency department center...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29707830/esrd-induced-dyslipidemia-should-management-of-lipid-disorders-differ-in-dialysis-patients
#15
Hamid Moradi, Elani Streja, Nosratola D Vaziri
Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Although numerous modifiable risk factors in the pathogenesis of CVD and its associated mortality have been identified, dyslipidemia remains to be a key focus for therapy. In this regard, significant progress has been made in reducing cardiovascular mortality via the use of lipid-lowering agents such as HMG CoA reductase inhibitors (statins). Yet, despite the disproportionate risk of CVD and mortality in patients with advanced chronic and end stage renal disease (ESRD), treatment of dyslipidemia in this patient population has not been associated with a notable improvement in outcomes...
April 29, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29707319/perioperative-management-and-outcomes-of-minimally-invasive-esophagectomy-case-study-of-a-high-volume-tertiary-center-in-taiwan
#16
Tzu Chang, Po-Ni Hsiao, Man-Yin Tsai, Pei-Ming Huang, Ya-Jung Cheng
Background: Mortality and complication rates for surgical esophagectomy remain high despite progress in surgical techniques and perioperative care. Minimally invasive surgery and intraoperative goal-directed fluid management are gaining popularity in Taiwan; however, perioperative complications and short-term outcomes have been rarely reported. In this retrospective study, we analyzed the surgical procedures performed as well as the perioperative outcomes and treatments after esophagectomy in a high-volume medical center in Taiwan...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29704093/trends-in-the-treatment-of-chronic-kidney-disease-associated-anaemia-in-a-cohort-of-haemodialysis-patients-the-irish-experience
#17
Roisin Gardiner, Davood Roshan, Ann Brennan, Denise Connolly, Susan Murray, Donal Reddan
BACKGROUND: Anaemia among haemodialysis patients is treated with iron and erythropoietin-stimulating agents (ESAs). ESAs reduce requirements for blood transfusions but are also expensive and overzealous use may be associated with adverse outcomes. Recent international trends have been characterised by reduced ESA doses and a greater reliance on intravenous (IV) iron. We determined trends in prescribing patterns of ESAs and IV iron for the treatment of anaemia in two representative Irish dialysis centres and correlated with current guidelines and international trends...
April 27, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29703048/tolvaptan-rescue-contrast-induced-acute-kidney-injury-a-case-report
#18
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
RATIONALE: Contrast-induced acute kidney injury is one of the most serious adverse effects of contrast media and is related to three distinct but interacting mechanisms: medullary ischemia, formation of reactive oxygen species and direct tubular cell toxicity, especially in the patients with chronic kidney disease. The strategies of treatment, including stabilization of hemodynamic parameters and maintenance of normal fluid and electrolyte balance, were similar to the management of other types of acute kidney injury...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701176/consequences-of-delay-in-screening-monitoring-and-treatment-of-angiomyolipoma-and-tuberous-sclerosis-a-case-report
#19
Tanjala T Gipson
BACKGROUND: Tuberous sclerosis complex (TSC) is a multisystem disorder that results in tumor growth in various organs. TSC can affect the kidneys in the form of renal angiomyolipomas and cysts that can lead to chronic kidney disease. CASE PRESENTATION: A 38-year-old woman was referred to Kennedy Krieger Institute for comprehensive TSC management. Before referral, the patient had gone most of her life without a definite diagnosis of TSC despite visually-prominent signs such as forehead plaques, facial angiofibromas, and ungual fibromas...
April 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29699926/-spanish-society-of-hypertension-position-statement-on-the-2017-acc-aha-hypertension-guidelines
#20
T Gijón-Conde, M Gorostidi, M Camafort, M Abad-Cardiel, E Martín-Rioboo, F Morales-Olivas, E Vinyoles, P Armario, J R Banegas, A Coca, A de la Sierra, N Martell-Claros, J Redón, L M Ruilope, J Segura
The American College of Cardiology (ACC) and the American Heart Association (AHA) have recently published their guidelines for the prevention, detection, evaluation, and management of hypertension in adults. The most controversial issue is the classification threshold at 130/80mmHg, which will allow a large number of patients to be diagnosed as hypertensive who were previously considered normotensive. Blood pressure (BP) is considered normal (<120mmHg systolic and <80mmHg diastolic), elevated (120-129 and <80mmHg), stage 1 (130-139 or 80-89mmHg), and stage 2 (≥140 or ≥90mmHg)...
April 23, 2018: Hipertensión y Riesgo Vascular
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