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Chronic kidney disease management

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https://www.readbyqxmd.com/read/27926541/major-unanswered-questions-in-the-clinical-gout-field
#1
Lisa K Stamp
PURPOSE OF REVIEW: Although gout is one of the most common forms of inflammatory arthritis, it has been relatively neglected until recently. Despite progress in many areas of pathophysiology and genetics of gout and the development of new urate lowering therapies, there remain a number of unanswered clinical questions. With the resurgence of interest in gout it is important to recognize key aspects of gout management that remain challenging and require further research. RECENT FINDINGS: The unanswered clinical issues outlined in this review are basic aspects of gout management that clinicians treating people with gout face on a daily basis and include when urate lowering therapy should be commenced, the most appropriate target serum urate, use of prophylaxis when starting urate lowering therapy and the most appropriate urate lowering therapy, particularly for those with chronic kidney disease...
December 6, 2016: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27921039/clinical-manifestation-and-management-of-adpkd-in-western-countries
#2
REVIEW
Claudia Sommerer, Martin Zeier
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease in Western countries. The prevalence is between 2.4/10,000 and 3.9/10,000. ADPKD represents a systemic disease resulting in deterioration in renal function. Until now, mutations in two genes (PKD1 and PKD2) have been identified. Recently, the European Medicines Agency (EMA) approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency connected with ADPKD in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921038/the-clinical-manifestation-and-management-of-autosomal-dominant-polycystic-kidney-disease-in-china
#3
REVIEW
Cheng Xue, Chen-Chen Zhou, Ming Wu, Chang-Lin Mei
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic hereditary kidney disease characterized by progressive enlargement of renal cysts. The incidence is 1-2‰ worldwide. Mutations in two genes (PKD1 and PKD2) cause ADPKD. Currently, there is no pharmaceutical treatment available for ADPKD patients in China. Summary: This review focused on advances in clinical manifestation, gene diagnosis, risk factors, and management of ADPKD in China. There is an age-dependent increase in total kidney volume (TKV) and decrease in renal function in Chinese ADPKD patients...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921037/acute-kidney-injury-in-western-countries
#4
REVIEW
Josée Bouchard, Ravindra L Mehta
BACKGROUND: Acute kidney injury (AKI) is frequent and is associated with poor outcomes, including increased mortality, higher risk of chronic kidney disease, and prolonged hospital lengths of stay. The epidemiology of AKI mainly derives from studies performed in Western high-income countries. More limited data are available from Western low-income and middle-income countries (LMICs) located in Central and South America. SUMMARY: In this review, we summarize the most recent data on the epidemiology of AKI in Western countries, aiming to contrast results from industrialized high-income countries with LMICs...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27918931/effectiveness-of-an-educational-intervention-the-encourage-autonomous-self-enrichment-program-in-patients-with-chronic-kidney-disease-a-randomized-controlled-trial
#5
Hiroko Joboshi, Michiyo Oka
BACKGROUND: Self-management is an important step toward preventing and impeding the progression of chronic kidney disease. However, patients with chronic kidney disease may have few or no subjective symptoms and therefore might consider self-management to be unnecessary. Effective support and encouragement of self-management in patients with chronic kidney disease is therefore required. OBJECTIVES: This study tested the effectiveness of the Encourage Autonomous Self-Enrichment patient education program, which supports patient autonomy and intrinsic motivations with the aim of improving self-efficacy and sustaining self-management, on perceived self-efficacy, self-management behaviors, and physiological endpoints (blood pressure and renal function parameters) in patients with chronic kidney disease...
November 22, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27917582/agreement-between-chronic-kidney-disease-epidemiological-collaboration-and-berlin-initiative-study-equations-for-estimating-glomerular-filtration-rate-in-older-people-the-invecchiare-in-chianti-aging-in-chianti-region-study
#6
Andrea Corsonello, Claudio Pedone, Stefania Bandinelli, Luigi Ferrucci, Raffaele Antonelli Incalzi
AIM: The aim was to investigate to what extent chronic kidney disease (CKD) can be staged interchangeably by Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and by Berlin Initiative Study (BIS) equations, and to verify whether cystatin C can improve concordance between formulas. METHODS: Our series consisted of 828 community-dwelling individuals aged 65 years or older enrolled in the Invecchiare in Chianti Study ("Aging in the Chianti Region"). Estimated glomerular filtration rate was calculated using the creatinine-based CKD-EPI, creatinine/cystatin C-based CKD-EPI, creatinine-based BIS and creatinine/cystatin C-based BIS equations...
December 5, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27917261/anti-hepatitis-c-virus-drugs-and-kidney
#7
REVIEW
Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Denis Sautereau, Annick Rousseau, Pierre Marquet, Jérémie Jacques, Véronique Loustaud-Ratti
Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#8
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27914803/effectiveness-of-direct-acting-antivirals-in-hepatitis-c-virus-infection-in-haemodialysis-patients
#9
Soraya Abad, Almudena Vega, Diego Rincón, Eduardo Hernández, Evangelina Mérida, Nicolás Macías, Raquel Muñoz, Mónica Milla, Jose Luño, Juan Manuel López-Gómez
Hepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting antivirals (DAAs). The aim of this study is to retrospectively analyse the current prevalence of HCV infection and efficacy and safety results with different DAA regimens in the haemodialysis population of 2hospital areas...
November 30, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27914731/self-management-in-patients-with-diabetes-and-chronic-kidney-disease-is-associated-with-incremental-benefit-in-hrqol
#10
Edward Zimbudzi, Clement Lo, Sanjeeva Ranasinha, Peter G Kerr, Timothy Usherwood, Alan Cass, Gregory R Fulcher, Sophia Zoungas
AIMS: There is insufficient and inconsistent data regarding the association between diabetes self-management, the process of facilitating the knowledge, skill, and ability necessary for diabetes self-care, and health-related quality of life (HRQOL) in people with diabetes and moderate to severe chronic kidney disease (CKD). METHODS: In a cross sectional study, participation in diabetes self-management assessed by the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire and HRQOL was examined in 308 patients with diabetes and CKD (stages 3 to 5) recruited from outpatient diabetes and renal clinics of 4 public tertiary hospitals...
October 29, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27901544/quantitative-urinalysis-using-aggregation-induced-emission-bioprobes-for-monitoring-chronic-kidney-disease
#11
Tong Chen, Ni Xie, Lucia Viglianti, Yabin Zhou, Hui Tan, Ben Zhong Tang, Youhong Tang
Early detection and appropriate management of chronic kidney disease can reduce the progression of kidney failure and cardiovascular disease. The urine albumin to creatinine ratio (UACR) test is a standard urine test for identifying individuals at high risk of developing progressive kidney disease. In this study, IDATPE, a novel fluorescent probe with aggregation-induced emission (AIE) features, is successfully developed for creatinine detection and quantitation. An excellent correlation between fluorescent light intensity and creatinine concentration is achieved...
November 30, 2016: Faraday Discussions
https://www.readbyqxmd.com/read/27900978/penile-calcific-uremic-arteriolopathy-occurring-postparathyroidectomy-in-a-hemodialysis-patient
#12
Salah Omar Bashir, Mahmoud A Aamer, Hayder A Omer, Mohamed D Morsy
Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare condition most frequently seen in patients with advanced chronic kidney disease. The clinical picture is characterized by painful skin lesions and ulcerations. The underlying pathology is medial calcification and intimal proliferation with microthrombi of small arteries. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. This article reports an atypical case where CUA developed after parathyroidectomy and in the course of treatment of hungry bone syndrome...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900963/initiation-of-darbepoetin-for-management-of-anemia-in-non-dialysis-dependent-patients-with-chronic-kidney-disease
#13
Fatma Al Raisi, Issa Al Salmi, Pramod Kamble, Muna Al Shehri, Faissal A M Shaheen
The anemia of chronic kidney disease (CKD) is a common comorbidity seen in kidney diseases. It is also associated with increased cardiovascular morbidity and mortality and diminished quality of life. Often, patients with CKD of different stages require erythropoiesis-stimulating agents (ESAs) to maintain their hemoglobin (Hb) within the target range. Darbepoetin alfa is a newer ESA with a longer half-life than recombinant human erythropoietin (EPO). The objective of this study is to assess the efficacy and safety profile of twice-monthly (Q2W) and once a month (1QM) darbepoetin alfa in CKD patients, not on dialysis...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900314/renal-and-cardiovascular-morbidities-associated-with-apol1-status-among-african-american-and-non-african-american-children-with-focal-segmental-glomerulosclerosis
#14
Robert P Woroniecki, Derek K Ng, Sophie Limou, Cheryl A Winkler, Kimberly J Reidy, Mark Mitsnefes, Matthew G Sampson, Craig S Wong, Bradley A Warady, Susan L Furth, Jeffrey B Kopp, Frederick J Kaskel
BACKGROUND AND OBJECTIVES: African-American (AA) children with focal segmental glomerulosclerosis (FSGS) have later onset disease that progresses more rapidly than in non-AA children. It is unclear how APOL1 genotypes contribute to kidney disease risk, progression, and cardiovascular morbidity in children. DESIGN SETTING PARTICIPANTS AND MEASUREMENTS: We examined the prevalence of APOL1 genotypes and associated cardiovascular phenotypes among children with FSGS in the Chronic Kidney Disease in Children (CKiD) study; an ongoing multicenter prospective cohort study of children aged 1-16 years with mild to moderate kidney disease...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27896974/learning-attributes-of-disease-progression-from-trajectories-of-sparse-lab-values
#15
Vibhu Agarwal, Nigam H Shah
There is heterogeneity in the manifestation of diseases, therefore it is essential to understand the patterns of progression of a disease in a given population for disease management as well as for clinical research. Disease status is often summarized by repeated recordings of one or more physiological measures. As a result, historical values of these physiological measures for a population sample can be used to characterize disease progression patterns. We use a method for clustering sparse functional data for identifying sub-groups within a cohort of patients with chronic kidney disease (CKD), based on the trajectories of their Creatinine measurements...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896453/management-of-phosphorus-load-in-ckd-patients
#16
REVIEW
Yutaka Taketani, Fumihiko Koiwa, Keitaro Yokoyama
Disturbances in mineral and bone metabolism play a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). The term "renal osteodystrophy" has recently been replaced with "CKD-mineral and bone disorder (CKD-MBD)", which includes vascular calcification as well as bone abnormalities. In Japan, proportions of the aged and long-term dialysis patients are increasing which makes management of vascular calcification and parathyroid function increasingly more important...
November 28, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27890892/a-survey-of-actual-clinical-practice-concerning-blood-pressure-control-among-patients-with-hypertension-in-kanagawa-2014
#17
Nobuo Hatori, Hiroyuki Sakai, Kazuyoshi Sato, Masayuki Miyajima, Shouhei Yuasa, Shingo Kuboshima, Keiichi Kajiwara, Yoshikuni Hara, Kousuke Minamizawa, Masaaki Miyakawa
We performed a cross-sectional survey to investigate actual clinical practice concerning blood-pressure control among patients with hypertension in Kanagawa. The guidelines of the Japanese Society of Hypertension (JSH) for the management of patients with hypertension were revised in 2014. From October 1 to November 30, 2014, questionnaires on the care of patients with hypertension were sent via post to members of the Kanagawa Physicians Association in Kanagawa Prefecture, Japan. -Data on 1,105 patients (mean age: 68...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27884312/management-of-patients-with-diabetes-and-ckd-%C3%A2-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#18
Vlado Perkovic, Rajiv Agarwal, Paola Fioretto, Brenda R Hemmelgarn, Adeera Levin, Merlin C Thomas, Christoph Wanner, Bertram L Kasiske, David C Wheeler, Per-Henrik Groop
The prevalence of diabetes around the world has reached epidemic proportions and is projected to increase to 642 million people by 2040. Diabetes is already the leading cause of end-stage kidney disease (ESKD) in most developed countries, and the growth in the number of people with ESKD around the world parallels the increase in diabetes. The presence of kidney disease is associated with a markedly elevated risk of cardiovascular disease and death in people with diabetes. Several new therapies and novel investigational agents targeting chronic kidney disease patients with diabetes are now under development...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27883326/renal-replacement-therapy-in-patients-with-heart-and-kidney-failure
#19
Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#20
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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