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Nephrology dialysis and kidney transplant

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https://www.readbyqxmd.com/read/28435157/the-systemic-nature-of-ckd
#1
REVIEW
Carmine Zoccali, Raymond Vanholder, Ziad A Massy, Alberto Ortiz, Pantelis Sarafidis, Friedo W Dekker, Danilo Fliser, Denis Fouque, Gunnar H Heine, Kitty J Jager, Mehmet Kanbay, Francesca Mallamaci, Gianfranco Parati, Patrick Rossignol, Andrzej Wiecek, Gerard London
The accurate definition and staging of chronic kidney disease (CKD) is one of the major achievements of modern nephrology. Intensive research is now being undertaken to unravel the risk factors and pathophysiologic underpinnings of this disease. In particular, the relationships between the kidney and other organs have been comprehensively investigated in experimental and clinical studies in the last two decades. Owing to technological and analytical limitations, these links have been studied with a reductionist approach focusing on two organs at a time, such as the heart and the kidney or the bone and the kidney...
April 24, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28430830/assessment-of-global-kidney-health-care-status
#2
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28381266/cost-effectiveness-of-home-telemonitoring-in-chronic-kidney-disease-patients-at-different-stages-by-a-pragmatic-randomized-controlled-trial-enephro-rationale-and-study-design
#3
Nathalie Thilly, Jacques Chanliau, Luc Frimat, Christian Combe, Pierre Merville, Philippe Chauveau, Pierre Bataille, Raymond Azar, David Laplaud, Christian Noël, Michèle Kessler
BACKGROUND: Home telemonitoring has developed considerably over recent years in chronic diseases in order to improve communication between healthcare professionals and patients and to promote early detection of deteriorating health status. In the nephrology setting, home telemonitoring has been evaluated in home dialysis patients but data are scarce concerning chronic kidney disease (CKD) patients before and after renal replacement therapy. The eNephro study is designed to assess the cost effectiveness, clinical/biological impact, and patient perception of a home telemonitoring for CKD patients...
April 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28340227/transplant-as-a-competing-risk-in-the-analysis-of-dialysis-patients
#4
Nan van Geloven, Saskia le Cessie, Friedo W Dekker, Hein Putter
Time-to-event analyses are frequently used in nephrology research, for instance, when recording time to death or time to peritonitis in dialysis patients. Many papers have pointed out the important issue of competing events (or competing risks) in such analyses. For example, when studying one particular cause of death it can be noted that patients also die from other causes. Such competing events preclude the event of interest from occurring and thereby complicate the statistical analysis. The Kaplan-Meier approach to calculating the cumulative probability of the event of interest yields invalid results in the presence of competing risks, thus the alternative cumulative incidence competing risk (CICR) approach has become the standard...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28336719/colon-cancer-screening-among-patients-receiving-dialysis-in-the-united-states-are-we-choosing-wisely
#5
Christopher A Carlos, Charles E McCulloch, Chi-Yuan Hsu, Barbara Grimes, Meda E Pavkov, Nilka R Burrows, Vahakn B Shahinian, Rajiv Saran, Neil R Powe, Kirsten L Johansen
The American Society of Nephrology recommends against routine cancer screening among asymptomatic patients receiving maintenance dialysis on the basis of limited survival benefit. To determine the frequency of colorectal cancer screening among patients on dialysis and the extent to which screening tests were targeted toward patients at lower risk of death and higher likelihood of receiving a kidney transplant, we performed a cohort study of 469,574 Medicare beneficiaries ages ≥50 years old who received dialysis between January 1, 2007 and September 30, 2012...
March 23, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28260444/pediatric-kidney-transplant-experience-at-an-algerian-nephrology-department
#6
Ali Benziane, Saliha Boutennoune
OBJECTIVES: To evaluate the outcomes, complications, causes of graft loss, and patient and graft survival in pediatric renal transplant. MATERIALS AND METHODS: We conducted a retrospective study using the records of 32 children who had a renal transplant between February 2007 and October 2014. RESULTS: All donations were intrafamily, and all patients had a living donor: the patient's mother in 56.3%, the father in 40.6%, and a brother in 3...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#7
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#8
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27900718/survival-and-time-to-transplantation-of-peritoneal-dialysis-versus-hemodialysis-for-end-stage-renal-disease-patients-competing-risks-regression-model-in-a-single-italian-center-experience
#9
Marta Rigoni, Emanuele Torri, Giandomenico Nollo, Diana Zarantonello, Alessandro Laudon, Laura Sottini, Giovanni Maria Guarrera, Giuliano Brunori
AIMS: Despite several studies reporting similar outcomes for peritoneal dialysis (PD) and hemodialysis (HD), the former is underused worldwide, with a PD prevalence of 15% in Italy. In 2008, the Unit of Nephrology and Dialysis of the Healthcare Trust of the Autonomous Province of Trento implemented a successful PD program which has increased the proportion of PD incident patients from 7 to 47%. We aimed to assess the effect of this extensive use of PD by comparing HD and PD in terms of survival and time-to-transplantation...
November 29, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27832329/burden-of-multimorbidity-and-outcome-in-ambulatory-geriatric-hemodialysis-patients-report-from-the-qin-registry-in-germany
#10
Gabriele Röhrig, Maria Cristina Polidori, Katherine Rascher, Mathias Schaller, Thomas Benzing, Gero von Gersdorff
BACKGROUND: Patients with end-stage renal disease (ESRD) requiring hemodialysis are typically characterized by multimorbidity and increasingly by advanced age; however, there are few data on their geriatric needs. OBJECTIVE: The aim of the study was to evaluate the clinical characteristics of a large cohort of incident patients in ambulatory hemodialysis units with a particular focus on those aged over 80 years in Germany. METHODS: The electronic patient registry of the Board of Trustees (Kuratorium) for Dialysis and Kidney Transplantation (KfH) was searched for all patients who began hemodialysis in 1 of the 191 units between 2007 and 2013 and were 65 years and older...
November 10, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27822135/chronic-kidney-disease-identification-and-management-in-primary-care
#11
REVIEW
Simon Ds Fraser, Tom Blakeman
Chronic kidney disease (CKD) is an important and common noncommunicable condition globally. In national and international guidelines, CKD is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages, and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end-stage kidney disease for most people with CKD...
2016: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/27795953/longitudinal-assessment-of-serum-creatinine-levels-on-graft-survival-after-renal-transplantation-joint-modeling-approach
#12
Elham Maraghi, Abbas Rahimi Foroushani, Shima Younespour, Zohreh Rostami, Behzad Einollahi, Mohammad Reza Eshraghian, Mohammad Reza Akhoond, Kazem Mohammad
BACKGROUND: Chronic kidney disease (CKD) is a major public health problem. The eventual outcome of CKD is end-stage renal disease (ESRD). Early diagnosis and proper management play an important role in preventing CKD progression to ESRD. Dialysis and kidney transplantation are the only treatment options available for patients suffering from ESRD. OBJECTIVES: This study was designed to investigate the etiological role of recipient and donor characteristics on serum creatinine changes within the follow-up period, graft failure risk, and the impact of longitudinal serum creatinine levels on graft survival after renal transplantation...
July 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27760524/a-question-prompt-sheet-for-adult-patients-with-chronic-kidney-disease
#13
Swati Lederer, Michael J Fischer, Howard S Gordon, Anuradha Wadhwa, Subhash Popli, Elisa J Gordon
BACKGROUND: Patients with chronic kidney disease (CKD) commonly have unmet information needs. Greater patient participation in healthcare discussions can address these needs and improve health outcomes. We developed a patient-centered question prompt sheet (QPS) to engage CKD patients in healthcare conversations. METHODS: We conducted a two phase, mixed-methods, cross-sectional study involving semi-structured telephone interviews. Patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1...
October 19, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27693260/a-dynamic-predictive-model-for-progression-of-ckd
#14
Navdeep Tangri, Lesley A Inker, Brett Hiebert, Jenna Wong, David Naimark, David Kent, Andrew S Levey
BACKGROUND: Predicting the progression of chronic kidney disease (CKD) is vital for clinical decision making and patient-provider communication. We previously developed an accurate static prediction model that used single-timepoint measurements of demographic and laboratory variables. STUDY DESIGN: Development of a dynamic predictive model using demographic, clinical, and time-dependent laboratory data from a cohort of patients with CKD stages 3 to 5. SETTING & PARTICIPANTS: We studied 3,004 patients seen April 1, 2001, to December 31, 2009, in the outpatient CKD clinic of Sunnybrook Hospital in Toronto, Canada...
April 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27640125/intestinal-microbiota-in-pediatric-patients-with-end-stage-renal-disease-a-midwest-pediatric-nephrology-consortium-study
#15
Janice Crespo-Salgado, V Matti Vehaskari, Tyrus Stewart, Michael Ferris, Qiang Zhang, Guangdi Wang, Eugene E Blanchard, Christopher M Taylor, Mahmoud Kallash, Larry A Greenbaum, Diego H Aviles
BACKGROUND: End-stage renal disease (ESRD) is associated with uremia and increased systemic inflammation. Alteration of the intestinal microbiota may facilitate translocation of endotoxins into the systemic circulation leading to inflammation. We hypothesized that children with ESRD have an altered intestinal microbiota and increased serum levels of bacterially derived uremic toxins. METHODS: Four groups of subjects were recruited: peritoneal dialysis (PD), hemodialysis (HD), post-kidney transplant and healthy controls...
September 17, 2016: Microbiome
https://www.readbyqxmd.com/read/27604074/pregnancy-outcomes-after-kidney-graft-in-italy-are-the-changes-over-time-the-result-of-different-therapies-or-of-different-policies-a-nationwide-survey-1978-2013
#16
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Rossella Attini, Martina Gerbino, Paola Todeschini, Maria Luisa Perrino, Ana Maria Manzione, Gian Benedetto Piredda, Elisa Gnappi, Flavia Caputo, Giuseppe Montagnino, Vincenzo Bellizzi, Pierluigi Di Loreto, Francesca Martino, Domenico Montanaro, Michele Rossini, Santina Castellino, Marilisa Biolcati, Federica Fassio, Valentina Loi, Silvia Parisi, Elisabetta Versino, Antonello Pani, Tullia Todros
BACKGROUND: Kidney transplantation is the treatment of choice to restore fertility to women on renal replacement therapy. Over time, immunosuppressive, support therapies and approaches towards high-risk pregnancies have changed. The aim of this study was to analyse maternal-foetal outcomes in two cohorts of transplanted women who delivered a live-born baby in Italy in 1978-2013, dichotomized into delivery before and after January 2000. METHODS: A survey involving all the Italian transplant centres was carried out, gathering data on all pregnancies recorded since the start of activity at each centre; the estimated nationwide coverage was 75%...
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27555106/kidney-versus-combined-kidney-and-liver-transplantation-in-young-people-with-autosomal-recessive-polycystic-kidney-disease-data-from-the-european-society-for-pediatric-nephrology-european-renal-association-european-dialysis-and-transplant-espn-era-edta-registry
#17
Djalila Mekahli, Karlijn J van Stralen, Marjolein Bonthuis, Kitty J Jager, Ayşe Balat, Elisa Benetti, Nathalie Godefroid, Vidar O Edvardsson, James G Heaf, Augustina Jankauskiene, Larissa Kerecuk, Svetlana Marinova, Flora Puteo, Tomas Seeman, Aleksandra Zurowska, Jacques Pirenne, Franz Schaefer, Jaap W Groothoff
BACKGROUND: The choice for either kidney or combined liver-kidney transplantation in young people with kidney failure and liver fibrosis due to autosomal recessive polycystic kidney disease (ARPKD) can be challenging. We aimed to analyze the characteristics and outcomes of transplantation type in these children, adolescents, and young adults. STUDY DESIGN: Cohort study. SETTING & PARTICIPANTS: We derived data for children, adolescents, and young adults with ARPKD with either kidney or combined liver-kidney transplants for 1995 to 2012 from the ESPN/ERA-EDTA Registry, a European pediatric renal registry collecting data from 36 European countries...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27538313/-cardiorenal-syndrome-diagnostic-and-therapeutic-approaches
#18
Florence Sens, Éric Pouliquen, Sandrine Lemoine, Éric Bonnefoy-Cudraz, Laurent Juillard
Kidney dysfunction during congestive heart failure, although frequent, is often neglected. Yet, it represents a life-threatening condition, oven when the kidney dysfunction is moderate. The initial approach involvus strict application of recommendations, cardiologic and nephrologic joined management and close follow-up involving patient's general practitioner. Cases of true diuretics resistance are infrequent and late. Yet, it represents a significant turning point. Mortality is high, with a major individual unpredictability...
June 2016: La Revue du Praticien
https://www.readbyqxmd.com/read/27519274/standardised-outcomes-in-nephrology-children-and-adolescents-song-kids-a-protocol-for-establishing-a-core-outcome-set-for-children-with-chronic-kidney-disease
#19
Allison Tong, Susan Samuel, Michael Zappitelli, Allison Dart, Susan Furth, Allison Eddy, Jaap Groothoff, Nicholas J A Webb, Hui-Kim Yap, Detlef Bockenhauer, Aditi Sinha, Stephen I Alexander, Stuart L Goldstein, Debbie S Gipson, Camilla S Hanson, Nicole Evangelidis, Sally Crowe, Tess Harris, Brenda R Hemmelgarn, Braden Manns, John Gill, Peter Tugwell, Wim Van Biesen, David C Wheeler, Wolfgang C Winkelmayer, Jonathan C Craig
BACKGROUND: Children with chronic kidney disease (CKD), requiring dialysis or kidney transplantation, have a mortality rate of up to 30-fold higher than the general aged-matched population, and severely impaired quality of life. Symptoms such as fatigue and pain are prevalent and debilitating. Children with CKD are at risk of cognitive impairment, and poorer educational, vocational, and psychosocial outcomes compared with their well peers, which have consequences through to adulthood...
2016: Trials
https://www.readbyqxmd.com/read/27510453/supportive-care-comprehensive-conservative-care-in-end-stage-kidney-disease
#20
Fliss E M Murtagh, Aine Burns, Olivier Moranne, Rachael L Morton, Saraladevi Naicker
Comprehensive conservative (nondialytic) kidney care is widely recognized and delivered but until recently, has not been clearly defined. We provide a clear definition of comprehensive conservative care. This includes interventions to delay progression of kidney disease and minimize complications as well as detailed communication, shared decision making, advance care planning, and psychologic and family support. It does not include dialysis. Limited epidemiologic evidence from Australia and Canada indicates that, for every new person diagnosed with ESRD who receives dialysis or transplant, there is one new person who is managed conservatively (either actively or not)...
October 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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