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Nephrology dialysis and kidney transplant

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
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...
September 29, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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...
2016: Microbiome
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%...
July 5, 2016: Nephrology, Dialysis, Transplantation
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...
August 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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
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
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)...
August 10, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Ebun Ladipo Bamgboye
Chronic kidney disease (CKD) is a significant cause of morbidity and mortality in sub-Saharan Africa. This, along with other noncommunicable diseases like hypertension, diabetes, and heart diseases, poses a double burden on a region that is still struggling to cope with the scourge of communicable diseases like malaria, tuberculosis, HIV, and more recently Ebola. Causes of CKD in the region are predominantly glomerulonephritis and hypertension, although type 2 diabetes is also becoming a significant cause as is the retroviral disease...
August 10, 2016: Clinical Nephrology
John Feehally
ISN (the International Society of Nephrology) is a global organization with more than 9,000 members in 130 countries. The ISN's mission is to "advance the diagnosis, treatment, and prevention of kidney diseases in the developing and developed world". ISN delivers this mission in low-resource settings through its five education and training programs available exclusively to low- and middle-income countries. These programs are designed to enable sustainable growth in capacity in nephrology and related disciplines to provide the basis for the improvement of care for kidney patients worldwide...
August 10, 2016: Clinical Nephrology
A Dobies, M Renke, W Wołyniec, L Palenicek, J Januszczyk, E Król, S Lizakowski, P Rutkowski, L Tylicki, A Dębska-Ślizień, B Rutkowski
BACKGROUND: The beneficial effect of kidney transplantation in patients requiring continuous renal replacement therapy owing to chronic kidney disease is well known and accepted. Kidney transplantation protects the patient from complications that may develop during chronic dialysis. Unfortunately, there is also evidence that kidney transplant patients are more prone to developing cancer than healthy persons. The aim of this study was to evaluate the prevalence of gastrointestinal pathologies in patients after kidney transplantation...
June 2016: Transplantation Proceedings
Michael J Fischer, Kevin T Stroupe, James S Kaufman, Ann M O'Hare, Margaret M Browning, Min-Woong Sohn, Zhiping Huo, Denise M Hynes
BACKGROUND: Predialysis nephrology care is associated with lower mortality and rates of hospitalization following chronic dialysis initiation. Whether more frequent predialysis nephrology care is associated with other favorable outcomes for older adults is not known. METHODS: Retrospective cohort study of patients ≥66 years who initiated chronic dialysis in 2000-2001 and were eligible for VA and/or Medicare-covered services. Nephrology visits in VA and/or Medicare during the 12-month predialysis period were identified and classified by low intensity (<3 visits), moderate intensity (3-6 visits), and high intensity (>6 visits)...
2016: BMC Nephrology
Jeremy A Saban, Michael Zappitelli, Susan M Samuel, Manish M Sood, R Todd Alexander, Steven Arora, Robin L Erickson, Kristine Kroeker, Braden J Manns, Allison B Dart
BACKGROUND: Significant practice variation exists in Canada with respect to timing of dialysis initiation in children. In the absence of evidence to guide practice, physicians' perceptions may significantly influence decision-making. OBJECTIVE: The objectives of this study are to (1) evaluate Canadian pediatric nephrologists' perceptions regarding dialysis initiation in children with chronic kidney disease (CKD) and (2) determine the factors guiding practice that may contribute to practice variation across Canada...
2016: Canadian Journal of Kidney Health and Disease
Rubina Naqvi
OBJECTIVE: To describe the clinical spectrum and outcome of patients presenting to a tertiary care kidney center, developing acute kidney injury (AKI) after snake-bite. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Nephrology Department, Sindh Institute of Urology and Transplantation (SIUT), Karachi, from January 1990 to December 2014. METHODOLOGY: All patients coming to SIUTidentified as having AKI after snake-bite during the study period were included...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ramón García-Trabanino, Zulma Trujillo, Ana Verónica Colorado, Salvador Magaña Mercado, Carlos Atilio Henríquez
: El Salvador has the highest renal failure mortality rate in the Americas. Five healthcare providers offer renal replacement therapy (RRT) in the country. The national RRT prevalence has never been reported. AIMS: To determine the RRT prevalence in El Salvador and some basic characteristics. METHODS: The association of nephrology coordinated a nationwide cross-sectional survey during the third quarter of 2014. 31 renal centres participated in the survey, covering 99...
June 3, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Aynur Gulcan, Erim Gulcan, Mustafa Keles, Esin Aktas
We aimed to investigate the frequency of oral yeast colonization (OYC) and the risk factors for patients who received continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis (HD) or were renal transplant recipients (RTRs). The patients admitted to the Nephrology Clinic at Ataturk University Medical School from January through April 2013 were included in the study. A questionnaire about risk factors was filled out, and swab cultures were taken from the tongue surface of each participant. OYC was detected in 32...
June 2016: Comparative Immunology, Microbiology and Infectious Diseases
Niraj Desai, Mahboob Rahman
End-stage renal disease (ESRD) is associated with high rates of morbidity and mortality, and increased health care use. Optimal management of patients with ESRD requires close collaboration among primary care physicians, nephrology subspecialists, and other subspecialists. Critical issues for the family physician include helping patients transition from chronic kidney disease to ESRD, recognizing and managing common issues in patients receiving dialysis or after kidney transplantation, and understanding palliative care for patients with ESRD...
May 2016: FP Essentials
M D Del Pino, A Ortiz, R Torra, D Hernandez
BACKGROUND: Renal failure is one of the main causes of death in patients with Fabry disease (FD). Due to the low prevalence of FD, delayed diagnosis and misdiagnosis, often the correct diagnosis is made when organ damage is already present. Early recognition of the disease would allow the prevention of severe complications and the premature death of patients with FD. OBJECTIVE: We present here the PrEFiNE project, which includes a wide spectrum of activities with the aim of improve knowledge and diagnosis of FD...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Mala Sachdeva, Daniel W Ross, Hitesh H Shah
Procedures are a key component to the practice of nephrology. The Accreditation Council for Graduate Medical Education (ACGME) requires nephrology fellows to acquire skills and demonstrate competency in the performance of several procedures during fellowship training, including temporary hemodialysis catheter placement, biopsy of native and transplanted kidneys, and various dialytic therapies. It is also required that fellows acquire competency in the interpretation of renal imaging, including renal ultrasound, during their training...
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Laura Mariani, Bénédicte Stengel, Christian Combe, Ziad A Massy, Helmut Reichel, Danilo Fliser, Roberto Pecoits-Filho, Antonio A Lopes, Kunihiro Yamagata, Takashi Wada, Michelle M Y Wong, Elodie Speyer, Friedrich K Port, Ronald L Pisoni, Bruce M Robinson
BACKGROUND: Minimizing clinical complications in patients with advanced chronic kidney disease (CKD) and improving the transition to dialysis therapy and transplantation represents a challenge, requiring reliable evidence regarding the effects of CKD care on outcomes. STUDY DESIGN: The CKD Outcomes and Practice Patterns Study (CKDopps) is a new international prospective cohort study designed to describe and evaluate variation in nephrologist-led CKD practices. SETTING & PARTICIPANTS: CKDopps is underway in Brazil, France, Germany, Japan, and the United States...
September 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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