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Family physicians chronic kidney disease

Karen Tu, Lindsay Bevan, Katie Hunter, Jess Rogers, Jacqueline Young, Gihad Nesrallah
BACKGROUND: The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. METHODS: We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist)...
January 2017: CMAJ Open
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
Bradley Chen, Victoria Y Fan, Yiing-Jenq Chou, Chin-Chi Kuo
BACKGROUND: Despite the urgent need for evidence to guide the end-of-life (EOL) care for patients with chronic kidney disease (CKD), we have limited knowledge of the costs and intensity of EOL care in this population. The present study examined patterns and predictors for EOL care intensity among elderly patients with CKD. METHODS: We conducted a retrospective nationwide cohort study utilizing the Taiwan National Health Insurance (NHI) Research Database. A total of 65,124 CKD patients aged ≥ 60 years, who died in hospitals or shortly after discharge between 2002 and 2012 were analyzed...
January 26, 2017: BMC Nephrology
Elaine Amaral de Paula, Mônica Barros Costa, Fernando Antonio Basile Colugnati, Rita Maria Rodrigues Bastos, Chislene Pereira Vanelli, Christiane Chaves Augusto Leite, Márcio Santos Caminhas, Rogério Baumgratz de Paula
OBJECTIVE: to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. METHOD: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes...
September 9, 2016: Revista Latino-americana de Enfermagem
Carla Bizzarri, Nicole Olivini, Stefania Pedicelli, Romana Marini, Germana Giannone, Paola Cambiaso, Marco Cappa
BACKGROUND: Salt-wasting represents a relatively common cause of emergency admission in infants and may result in life-threatening complications. Neonatal kidneys show low glomerular filtration rate and immaturity of the distal nephron leading to reduced ability to concentrate urine. METHODS: A retrospective chart review was conducted for infants hospitalized in a single Institution from 1(st) January 2006 to 31(st) December 2015. The selection criterion was represented by the referral to the Endocrinology Unit for hyponatremia (serum sodium <130 mEq/L) of suspected endocrine origin at admission...
August 2, 2016: Italian Journal of Pediatrics
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
Sharmeela Saha, Mahboob Rahman
Chronic kidney disease (CKD) affects more than 1 in 10 individuals in the United States. The care of these patients must be managed by family physicians and nephrology subspecialists. The kidneys often are affected by systemic processes such as diabetes and hypertension, and optimal management of these conditions is critical to slow decline in renal function in CKD patients. These patients are at high risk of cardiovascular disease, and statin therapy is recommended for adults with CKD who are at least age 50 years and not receiving dialysis...
May 2016: FP Essentials
Tim Luckett, Lucy Spencer, Rachael L Morton, Carol A Pollock, Lawrence Lam, William Silvester, Marcus Sellars, Karen M Detering, Phyllis N Butow, Allison Tong, Josephine M Clayton
AIM: Advance care planning (ACP) in nephrology is widely advocated but not always implemented. The aims of this study were to describe current ACP practice and identify barriers/facilitators and perceived need for health professional education and chronic kidney disease (CKD)-specific approaches. METHODS: An anonymous cross-sectional survey was administered online. Nephrology health professionals in Australia and New Zealand were recruited via professional societies, email lists and nephrology conferences...
February 2017: Nephrology
Sana R Akbar, Hafiz I Iqbal, Umair Ahmed
BACKGROUND: Chronic kidney disease is an increasingly prevalent health problem with the potential for poor outcome of end-stage renal disease. Hospitalized critically ill patients are prone to acute renal injury from numerous factors such as poor renal perfusion secondary to ischemia and hypotension, nephrotoxin exposure, and intravenous contrast exposure. AIMS: We set to explore resident awareness and knowledge about chronic kidney disease management, timely nephrology referrals, preventing inadvertent acute kidney injury (AKI), and the understanding of basic electrolyte physiology...
November 2015: North American Journal of Medical Sciences
Helen Tam-Tham, Brenda R Hemmelgarn, David J T Campbell, Chandra M Thomas, Karen Fruetel, Robert R Quinn, Kathryn M King-Shier
BACKGROUND: Although primary care physicians (PCPs) are often responsible for the routine care of older adults with chronic kidney disease (CKD), there is a paucity of evidence regarding their perspectives and practice of conservative (non-dialysis) care. We undertook a qualitative study to describe barriers, facilitators and strategies to enhance conservative, non-dialysis, CKD care by PCPs in the community. METHODS: Semi-structured telephone and face-to-face interviews were conducted with PCPs from Alberta, Canada...
November 2016: Nephrology, Dialysis, Transplantation
Domenico Santoro, Maria Teresa Ingegnieri, Giuseppe Vita, Silvia Lucisano, Carmelo Zuppardo, Valeria Canale, Vincenzo Savica, Michele Buemi
BACKGROUND: Hyperphosphoremia is one of the most important risk factors for morbidity and mortality for chronic kidney disease (CKD) patients, and also, for the general population. Excessive dietary intake of phosphate (P) is one of the key factors. In particular, P in its inorganic form, which is contained in food additives, is more readily absorbed. Unfortunately, these food additives are mostly present in convenience so called "fast foods" (pre-cooked), soft drinks, which represent the typical food consumed by our hemodialysis (HD) population, composed by elderly people, mostly low-socio economic class, who often live alone...
July 2015: Nephro-urology Monthly
Patricia Quintana-Bárcena, Anne Lord, Annie Lizotte, Djamal Berbiche, Ghaya Jouini, Lyne Lalonde
PURPOSE: The development and validation of criteria for classifying severity of drug-related problems (DRPs) in chronic kidney disease (CKD) in the community pharmacy setting are described. METHODS: The Severity Categorization for Pharmaceutical Evaluation (SCOPE) criteria were adapted from an existing tool based on the interventions required to manage DRPs in community pharmacy. Ten community pharmacists reviewed the criteria. An expert panel involving community pharmacists, hospital pharmacists, family physicians, and nephrologists scored the relevance of each criterion...
November 1, 2015: American Journal of Health-system Pharmacy: AJHP
Elena Pischik, Raili Kauppinen
Acute intermittent porphyria (AIP) is due to a deficiency of the third enzyme, the hydroxymethylbilane synthase, in heme biosynthesis. It manifests with occasional neuropsychiatric crises associated with overproduction of porphyrin precursors, aminolevulinic acid and porphobilinogen. The clinical criteria of an acute attack include the paroxysmal nature and various combinations of symptoms, such as abdominal pain, autonomic dysfunction, hyponatremia, muscle weakness, or mental symptoms, in the absence of other obvious causes...
2015: Application of Clinical Genetics
E D Kurt-Sukur, Z B Özçakar, S Fitöz, S Yilmaz, B Hoppe, F Yalçinkaya
Primary hyperoxaluria type 1 is a rare autosomal-recessive disease caused by the deficient activity of the liver specific enzyme alanine-glyoxylate aminotransferase. Increased endogenous oxalate production induces severe hyperoxaluria, recurrent urolithiasis, progressive nephrocalcinosis and renal failure. Here we report a 6 month old boy who presented with vomiting and decreased urine volume. He was diagnosed with chronic kidney failure at 4 months of age and peritoneal dialysis was introduced at a local hospital...
September 2015: Klinische Pädiatrie
Nicola Luigi Bragazzi
Ramadan fasting represents one of the five pillars of the Islam creed. Even though patients are exempted from this religious duty, they may be eager to share this particular moment of the year with their family and peers, taking part in the intense spiritual ceremonies and events that characterize this month. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with chronic kidney disease fasting in Ramadan and correctly advising them...
2015: International Journal of Nephrology and Renovascular Disease
Hamid Barahimi, Farid Abolhassani, Farahnaz Rajaee, Ali Akbari Sari
Chronic kidney disease (CKD) is a general health problem with high rates of mortality and morbidity. The increasing prevalence of CKD has led to the recognition of the fact that it needs special care. One approach to CKD management is to present a model of care for the disease. A model of care for CKD was developed by drawing on the literature, including guidelines for CKD care, and by using previous experiences in providing care for patients with diabetes mellitus and CKD. The model focuses on training, identification of patients, care, follow-up, and evaluation of patients...
May 2015: Iranian Journal of Kidney Diseases
Robert Langan, Kristen Jones
Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several lifestyle modifications are associated with improvements in blood pressure, including the Dietary Approaches to Stop Hypertension diet, sodium restriction, regular exercise, and moderate weight loss. There is strong evidence that reducing diastolic blood pressure to less than 90 mm Hg is beneficial in adults older than 30 years...
February 1, 2015: American Family Physician
Davorka Vrdoljak, Renata Pavlov
Diabetes is a major public health problem in the world and one of the leading causes of morbidity and mortality from cardiovascular and chronic kidney disease. Aging of the population is expected to further increase the prevalence of type 2 diabetes, particularly in the age group over 65. According to the 2011 census, in Croatia, 17.7% of thepopulation were elderly, and the estimated prevalence of diabetes in this age group is 15-20%. Taking care of elderly diabetics has its own characteristics compared to other age groups, and a particular challenge for the family physician due to comorbidity and polymedication, as well as more frequent complications of the disease and more common side effects of treatment...
December 2014: Collegium Antropologicum
Ayse Balat
Hypertension (HT) is one of the major problems in chronic kidney disease (CKD), not only for adults, but also for children. It is one of the main factors in the progression of CKD, increased rate of cardiovascular disease, and impairment in quality of life. The most important devastating effect of HT is on the cardiovascular system. It may leave significant footprints in developing children that can be carried over to adulthood. Existing data clearly show that in CKD children with proteinuria the blood pressure goal should be 50th centile, while it is 75th centile in those without proteinuria...
2014: Current Hypertension Reviews
Allison Tong, Shilpa Jesudason, Jonathan C Craig, Wolfgang C Winkelmayer
BACKGROUND: Achieving parenthood in women with chronic kidney disease (CKD) is challenging due to reduced fertility and the risk of adverse outcomes. We aimed to describe women's perspectives of pregnancy in CKD. METHODS: Electronic databases were searched to April 2014. Studies were synthesized thematically. RESULTS: From 15 studies (n = 257) we identified seven themes. 'Pursuing motherhood' was fulfilling an innate or social desire to have a child...
April 2015: Nephrology, Dialysis, Transplantation
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