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Mallika L Mendu, Sushrut S Waikar, Sandhya K Rao
Since its passage in 2010, the Affordable Care Act has led to the creation of numerous accountable care organizations that face the challenge of transforming the traditional care delivery model to provide more patient-centered, high-quality, and low-cost care. Complex patients, including those with chronic kidney disease (CKD), present the most challenges and opportunities. CKD is a condition with significant morbidity, mortality, and cost and thought to be partly secondary to known gaps in care delivery. Successful population management for CKD requires consideration of the needs of patients at all phases of the disease...
January 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Michel Jadoul, Paul Martin
BACKGROUND: Hepatitis C virus (HCV) infection is a very common infection found among hemodialysis (HD) and kidney transplant patients. It is associated with substantial morbidity and mortality. Direct-acting antiviral agents (DAAs) have much better efficacy (sustained viral response (SVR)) and tolerance than interferon-based regimens. Very recent studies extend this breakthrough finding to chronic kidney disease (CKD) populations. SUMMARY: CKD patients with an estimated glomerular filtration rate (eGFR) >30 ml/min/1...
2017: Blood Purification
Carlotta Caprara, Gilbert R Kinsey, Valentina Corradi, Wenjun Xin, Jennie Z Ma, Elisa Scalzotto, Francesca K Martino, Mark D Okusa, Federico Nalesso, Fiorenza Ferrari, Mitchell Rosner, Claudio Ronco
AIMS: The study aimed to determine whether the available literature supports a positive or negative influence of dialysis on regulatory T-cells (Tregs). METHODS: We performed a systematic search and a meta-analysis. Mean differences in Tregs number of chronic kidney disease stages G5 on dialysis patients (CKD G5D) and healthy controls (HCs) were compared. Random effects model was applied. The software used was general package for meta-analysis (version 4.3-0, depends R (≥2...
2016: Blood Purification
Paul K Whelton
BACKGROUND/AIMS: National and international agencies recommend a reduction in dietary sodium intake. However, some have questioned the wisdom of these policies. The goal of this report was to assess the findings and quality of studies that have examined the relationship between dietary sodium and both blood pressure and cardiovascular disease. METHODS: Literature review of the available observational studies and randomized controlled trials, including systematic reviews and meta-analyses...
2015: Blood Purification
Emily Docherty, Anastasios Koulaouzidis, Sarah Douglas, John N Plevris
BACKGROUND: There are only few reports on the diagnostic yield (DY) of small bowel capsule endoscopy (SBCE) in patients with chronic kidney disease (CKD). We aim to report our SBCE experience in patients with CKD. METHODS: Retrospective study; case notes of patients with low estimated glomerular filtration rate (eGFR) who underwent SBCE (March 2005-August 2012) for anemia and/or obscure gastrointestinal bleeding (OGIB) were retrieved and abstracted. Severity of CKD was defined according to Renal Association recommendations as: stage 3 (eGFR: 30-59); stage 4 (eGFR: 15-29); and stage 5 (eGFR <15 or on dialysis)...
January 2015: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Sandeep K Mallipattu, Jaime Uribarri
PURPOSE OF REVIEW: The critical role of advanced glycation end products (AGEs) in the progression of chronic diseases and their complications has recently become more apparent. This review summarizes the recent contributions to the field of AGEs in chronic kidney disease (CKD). RECENT FINDINGS: Over the past 3 decades, AGEs have been implicated in the progression of CKD, and specifically diabetic nephropathy. Although numerous in-vitro and in-vivo studies highlight the detrimental role of AGEs accumulation in tissue injury, few prospective human studies or clinical trials show that inhibiting this process ameliorates disease...
November 2014: Current Opinion in Nephrology and Hypertension
Yves Sabbagh, Susan C Schiavi
PURPOSE OF REVIEW: Maintaining phosphate homeostasis is essential and any deviation can lead to several acute and chronic disease states. To maintain normal physiological levels, phosphate needs to be tightly regulated. This is achieved through a complex relationship of organ cross-talk via hormonal regulation of the type II sodium-dependent phosphate co-transporters. This editorial provides evidence of the importance of intestinal NPT2b in health and chronic kidney disease (CKD). RECENT FINDINGS: The advent of the different Npt2b knockout mice has increased our understanding of how the intestinal phosphate co-transporter contributes to the regulation of systemic phosphate...
July 2014: Current Opinion in Nephrology and Hypertension
Veronica M Swallow, Andrew G Hall, Ian Carolan, Sheila Santacroce, Nicholas J A Webb, Trish Smith, Noreen Hanif
BACKGROUND: There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. METHODS: Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. RESULTS: 32 parents, 26 patients and 12 professionals were interviewed...
February 18, 2014: BMC Nephrology
Elisabeth Mathus-Vliegen, Maria Pellisé, Denis Heresbach, Wolfgang Fischbach, Tricia Dixon, Jonathan Belsey, Fabrizio Parente, Ricardo Rio-Tinto, Alistair Brown, Ervin Toth, Cristiano Crosta, Peter Layer, Owen Epstein, Christian Boustiere
BACKGROUND: Adequate bowel preparation prior to colonic diagnostic procedures is essential to ensure adequate visualisation. SCOPE: This consensus aims to provide guidance as to the appropriate use of bowel preparation for a range of defined clinical circumstances. A consensus group from across Europe was convened and met to discuss appropriate bowel preparation. The use of polyethylene glycol (PEG), sodium picosulphate and sodium phosphate (NaP), together with other agents, prokinetics and simethicone, in colonoscopy and small bowel video capsule endoscopy were considered...
August 2013: Current Medical Research and Opinion
Hugh Rayner, Jyoti Baharani, Steve Smith, Vijayan Suresh, Indranil Dasgupta
BACKGROUND: Pruritus (skin irritation or itching) is common in patients with chronic kidney disease (CKD) stages 4 and 5. It is associated with disrupted sleep, reduced quality of life, depression and increased mortality. A video of a patient describing the symptoms is at METHODS: We used gabapentin or pregabalin in 71 consecutive patients, 82% male. 25 had CKD stage 4 or 5, median eGFR = 17, range 9-30; 40 were on haemodialysis; 6 on peritoneal dialysis...
2012: Nephron. Clinical Practice
Elizabeth Bollinger, Daniel Raines, Patrick Saitta
AIM: To define which segments of the gastrointestinal tract are most likely to yield angioectasias for ablative therapy. METHODS: A retrospective chart review was performed for patients treated in the Louisiana State University Health Sciences Center Gastroenterology clinics between the dates of July 1, 2007 and October 1, 2010. The selection of cases for review was initiated by use of our electronic medical record to identify all patients with a diagnosis of angioectasia, angiodysplasia, or arteriovenous malformation...
November 21, 2012: World Journal of Gastroenterology: WJG
Giorgina Barbara Piccoli, Martina Ferraresi, Antonio Murciano, Amina Pereno, Valentina Consiglio, Stefania Scognamiglio, Maria Chiara Deagostini, Olga Randone, Gerardo Digiorgio, Mario Pasquale Calderale
BACKGROUND: The resurgence of home hemodialysis (HHD) underlines the importance of educational programs. Brainstorming is a powerful tool for innovation, widely employed in industry but seldom used in medicine. The aim of this study was to define an e-learning Web platform for HHD patients via a brainstorming approach. METHODS: Four brainstorming sessions were held 2-6 weeks apart. Twelve people were involved: 2 dialysis physicians, 2 nurses, 2 HHD patients, 2 caregivers, a filmmaker, 2 computer experts (1 with a psychology degree) and a senior engineer...
November 2012: Journal of Nephrology
L Ebony Boulware, Felicia Hill-Briggs, Edward S Kraus, J Keith Melancon, Brenda Falcone, Patti L Ephraim, Bernard G Jaar, Luis Gimenez, Michael Choi, Mikiko Senga, Maria Kolotos, LaPricia Lewis-Boyer, Courtney Cook, Laney Light, Nicole DePasquale, Todd Noletto, Neil R Powe
BACKGROUND: Many patients with chronic kidney disease (CKD) have difficulty becoming actively engaged in the pursuit of preemptive living donor kidney transplantation. STUDY DESIGN: The Talking About Live Kidney Donation (TALK) Study was a randomized controlled trial of the effectiveness of educational and social worker interventions designed to encourage early discussions and active pursuit of preemptive living donor kidney transplantation in patients with progressive CKD...
March 2013: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kenji Tsuboshima, Yasumi Matoba, Masanobu Sato, Iwao Kobayashi, Shinichiro Kobayashi, Hiroaki Ohue, Yoshihisa Watanabe, Toru Ohno
A 59-year-old man treated with hemodialysis for liver cirhhosis and chronic kidney disease developed right pleural effusion and ascites. Ascites always decreased after thoracocentesis for pleural effusion. In spite of repeated treatment with chest tube drainage, massive pleural effusion reappeared. Under the diagnosis of pleuroperitoneal communication, surgical repair of the diaphragm by video assisted thoracoscopic surgery (VATS) were performed. Bulla and pin hole were found and they were resected and sutured...
July 2012: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Yu-Feng Wei, Huey-Dong Wu
Obesity is a well-known major risk factor of cardiovascular disease and is associated with various comorbidities. The impact of obesity on pulmonary function remains unclear. Reductions in chest wall compliance and respiratory muscle strength due to a high percent body fat and localized fat distribution contributes to impaired pulmonary function and the occurrence of adverse respiratory symptoms. Dietary modifications and pharmaceutical agents are not effective in the long-term treatment of obesity. Treatment of morbidly obese patients using bariatric surgery has increased each year, especially after the introduction of video laparoscopic techniques...
2012: Journal of Obesity
A Parente, J M Angulo, R M Romero, S Rivas, C Corona, A R Tardáguila
INTRODUCTION: The closure of urinary diversions performed on newly born infants has a notable failure percentage in patients with bladder disease. We present the use of botulinum toxin as a useful and minimally invasive alternative to treat these patients. MATERIAL AND METHODS: We present two patients with a single kidney and with posterior urethral valves (PUV), in whom it was necessary to perform a ureterostomy due to chronic kidney disease. In both patients, the subsequent attempt to close the diversion failed...
July 2011: Actas Urologicas Españolas
Guido Filler, Mireille Gharib, Shelley Casier, Petra Lödige, Jochen H H Ehrich, Sumit Dave
OBJECTIVE: The prevalence of progressive chronic kidney disease (CKD) in children and adults with spina bifida is considerable, rising, and entirely preventable. REMOVING THE CAUSE: PREVENTION OF SPINA BIFIDA: The best prevention of CKD in spina bifida is prevention of spina bifida itself through strategies that include folate supplementation, ideally before pregnancy. THE CAUSE OF CKD: Dysfunctional bladder outlet causes febrile Urinary Tract Infections (UTI), even with clean intermittent catheterization (CIC), and subsequent renal scarring...
June 2012: International Urology and Nephrology
Carlos Abaeté de Los Santos, Ana Elizabeth Prado Lima Figueiredo, Carlos Eduardo Poli-de-Figueiredo
Streptococcus agalactiae causes a rare and often fatal peritonitis in continuous ambulatory peritoneal dialysis (CAPD). A 52-year-old white female with Alport and chronic kidney disease was initiated on CAPD treatment. Nineteen months later she had a S. agalactiae peritonitis identified and received initially gentamicin-cephalothin, which was changed to ceftazidime, tobramycin, and vancomycin. Recovery started after peritoneal catheter removal. After 3 weeks, severe leucopenia occurred. Granulokine and steroids were given...
2010: Renal Failure
Allison F Williams, Elizabeth Manias, Rowan G Walker
BACKGROUND: About 30-60% of individuals are non-adherent to their prescribed medications and this risk increases as the number of prescribed medications increases. This paper outlines the development of a consumer-centred Medicine Self-Management Intervention (MESMI), designed to improve blood pressure control and medication adherence in consumers with diabetes and chronic kidney disease recruited from specialist outpatients' clinics. METHODS: We developed a multifactorial intervention consisting of Self Blood Pressure Monitoring (SBPM), medication review, a twenty-minute interactive Digital Versatile Disc (DVD), and follow-up support telephone calls to help consumers improve their blood pressure control and take their medications as prescribed...
2010: BMC Family Practice
Richard Nissel, Dagmar-Christiane Fischer, Andreas Puhlmann, Birgit Holdt-Lehmann, Andrea Mitzner, Michael Petzsch, Thomas Körber, Michael Tiess, Reinhard Schmidt, Dieter Haffner
Endothelial dysfunction is common in patients with chronic kidney disease (CKD) and contributes significantly to the high long-term cardiovascular morbidity and mortality. The short-term cardiovascular effects of recombinant human growth hormone (rhGH) in CKD patients (stages III-V) and healthy controls (n=15 each) were explored in a single-center, non-randomized pilot study. Subjects were investigated before, after a 7 day treatment with rhGH, and after a 7 day wash-out period. Microcirculation was assessed by nailfold capillaroscopy and leg strain gauge plethysmography...
September 2009: Microvascular Research
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