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https://www.readbyqxmd.com/read/29348264/employment-among-patients-starting-dialysis-in-the-united-states
#1
Kevin F Erickson, Bo Zhao, Vivian Ho, Wolfgang C Winkelmayer
BACKGROUND AND OBJECTIVES: Patients with ESRD face significant challenges to remaining employed. It is unknown when in the course of kidney disease patients stop working. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined employment trends over time among patients ages 18-54 years old who initiated dialysis in the United States between 1996 and 2013 from a national ESRD registry. We compared unadjusted trends in employment at the start of dialysis and 6 months before ESRD and used linear probability models to estimate changes in employment over time after adjusting for patient characteristics and local unemployment rates in the general population...
January 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29348194/health-care-costs-associated-with-incident-complications-in-patients-with-type-2-diabetes-in-germany
#2
Katharina Kähm, Michael Laxy, Udo Schneider, Wolf H Rogowski, Stefan K Lhachimi, Rolf Holle
OBJECTIVE: The aim of this study is to provide reliable regression-based estimates of costs associated with different type 2 diabetes complications. RESEARCH DESIGN AND METHODS: We used nationwide statutory health insurance (SHI) data from 316,220 patients with type 2 diabetes. Costs for inpatient and outpatient care, pharmaceuticals, rehabilitation, and nonmedical aids and appliances were assessed in the years 2013-2015. Quarterly observations are available for each year...
January 18, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29344881/the-impact-of-exercise-on-physical-function-cardiovascular-outcomes-and-quality-of-life-in-chronic-kidney-disease-patients-a-systematic-review
#3
REVIEW
Baris Afsar, Dimitrie Siriopol, Gamze Aslan, Ozgur C Eren, Tuncay Dagel, Ugur Kilic, Asiye Kanbay, Alexandru Burlacu, Adrian Covic, Mehmet Kanbay
The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is increasing steadily. CKD does not only relate to morbidity and mortality but also has impact on quality of life, depression and malnutrition. Such patients often have significantly decreased physical activity. Recent evidence suggests that low physical activity is associated with morbidity, mortality, muscle atrophy, quality of life impairment, cardiovascular outcomes and depression. Based on this, it is now recommended to regularly improve the physical activity of these patients...
January 17, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29342320/association-of-pre-esrd-serum-calcium-with-post-esrd-mortality-among-incident-esrd-patients-a-cohort-study
#4
Yoshitsugu Obi, Christina Park, Melissa Soohoo, Keiichi Sumida, Takayuki Hamano, Connie M Rhee, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Elani Streja
Albumin-corrected serum calcium (cSCa) decline at late stages of chronic kidney disease and rise after dialysis initiation. While hypercalcemia is associated with higher mortality in end-stage renal disease (ESRD), there are scarce data on the impact of pre-ESRD cSCa on post-ESRD mortality. Therefore, we used a large national cohort of 21,826 US veterans with incident ESRD who transitioned to dialysis in all US Department of Veterans Affairs healthcare facilities over 2009-2014 to examine the associations with all-cause and cause-specific post-ESRD mortality of (1) cSCa concentrations averaged over the last six months and (2) its rate of decline during the last 12 months before dialysis initiation...
January 17, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29340320/association-of-a-low-protein-diet-with-slower-progression-of-ckd
#5
Marie Metzger, Wen Lun Yuan, Jean-Philippe Haymann, Martin Flamant, Pascal Houillier, Eric Thervet, Jean-Jacques Boffa, François Vrtovsnik, Marc Froissart, Lise Bankir, Denis Fouque, Bénédicte Stengel
Introduction: Reducing protein intake is recommended for slowing chronic kidney disease (CKD) progression, but assessment of its true effectiveness is sparse. Methods: Using the Maroni formula, we assessed dietary protein intake (DPI) from 24-hour urinary urea excretion in 1594 patients (67% men and 33% women) with CKD, 784 of whom also had 7-day food records. Cause-specific hazard ratios (HRs) and 95% confidence intervals for the competing risks of DPI-associated end-stage renal disease (ESRD) or death were estimated in 1412 patients with baseline glomerular filtration rate ≥15 ml/min per 1...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29340319/life-expectancy-for-patients-from-the-southeastern-united-states-with-iga-nephropathy
#6
M Colleen Hastings, Zoran Bursac, Bruce A Julian, Emanuel Villa Baca, Jennifer Featherston, Susan Y Woodford, Lisa Bailey, Robert J Wyatt
Introduction: Although end-stage renal disease (ESRD) and surrogate markers for renal dysfunction are frequently used as outcome markers for IgA nephropathy, the clinical course after reaching ESRD is not well documented. This study examined outcomes of progression to ESRD and age at death in a cohort of adults with IgA nephropathy with a long duration of follow-up. Methods: Patient and kidney survival of 251 adult patients with IgA nephropathy from the southeastern United States diagnosed between January 1, 1976 and December 31, 2005 were analyzed...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29340316/npt-iib-inhibition-does-not-improve-hyperphosphatemia-in-ckd
#7
Tobias E Larsson, Chisato Kameoka, Ikumi Nakajo, Yuta Taniuchi, Satoshi Yoshida, Tadao Akizawa, Ronald A Smulders
Introduction: Serum phosphate levels are insufficiently controlled in many patients with end-stage renal disease (ESRD), and novel therapeutic strategies are needed. Blocking intestinal phosphate absorption mediated by sodium-dependent phosphate co-transporter type 2b (NPT-IIb) holds promise; thus, we evaluated the efficacy, safety, tolerability, and pharmacokinetics of the novel and specific small molecule NPT-IIb inhibitor ASP3325 for the first time in humans. Methods: We conducted a randomized, double-blind, placebo-controlled, phase 1a single (n = 88) and multiple (n = 36) ascending dose study in healthy subjects, and a randomized, open-label, uncontrolled, phase 1b study in hyperphosphatemic ESRD patients on hemodialysis (single oral dose, n = 5; multiple oral doses, n = 17)...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29339549/apol1-genotype-and-renal-function-of-black-living-donors
#8
Mona D Doshi, Mariella Ortigosa-Goggins, Amit X Garg, Lihua Li, Emilio D Poggio, Cheryl A Winkler, Jeffrey B Kopp
Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1...
January 16, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29338859/renal-function-and-outcome-after-heart-transplantation
#9
Oscar Kolsrud, Kristjan Karason, Erik Holmberg, Sven-Erik Ricksten, Marie Felldin, Ola Samuelsson, Göran Dellgren
OBJECTIVES: To investigate whether measured glomerular filtration rate (mGFR) is a risk factor for death and/or end-stage renal disease (ESRD) after heart transplantation (HTx). METHODS: All adult patients (n = 416) who underwent HTx between 1988 and 2010 were included. mGFR was performed both preoperatively and postoperatively as annual follow-up. Eight patients received a concomitant kidney transplant (KTx), and 15 underwent late KTx due to chronic renal failure after HTx...
December 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338014/value-of-adding-the-renal-pathological-score-to-the-kidney-failure-risk-equation-in-advanced-diabetic-nephropathy
#10
Masayuki Yamanouchi, Junichi Hoshino, Yoshifumi Ubara, Kenmei Takaichi, Keiichi Kinowaki, Takeshi Fujii, Kenichi Ohashi, Koki Mise, Tadashi Toyama, Akinori Hara, Kiyoki Kitagawa, Miho Shimizu, Kengo Furuichi, Takashi Wada
BACKGROUND: There have been a limited number of biopsy-based studies on diabetic nephropathy, and therefore the clinical importance of renal biopsy in patients with diabetes in late-stage chronic kidney disease (CKD) is still debated. We aimed to clarify the renal prognostic value of pathological information to clinical information in patients with diabetes and advanced CKD. METHODS: We retrospectively assessed 493 type 2 diabetics with biopsy-proven diabetic nephropathy in four centers in Japan...
2018: PloS One
https://www.readbyqxmd.com/read/29336855/update-on-anemia-in-esrd-and-earlier-stages-of-ckd-core-curriculum-2018
#11
Steven Fishbane, Bruce Spinowitz
Anemia is a frequent complication during the later stages of chronic kidney disease. When present, it may cause symptoms such as fatigue and shortness of breath. The pathogenesis of anemia in chronic kidney disease is complex, but a central feature is a relative deficit of erythropoietin. New information has elucidated the critical role of the hypoxia-sensing system in mediating erythropoietin synthesis and release. Iron deficiency is a second important factor in the anemia of chronic kidney disease. New insights into the dynamics of iron metabolism have clarified the role of chronic inflammation and hepcidin as key mediators of impaired iron utilization...
January 11, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29336060/what-the-non-nephrologist-needs-to-know-about-dialysis
#12
Matt Foy, C John Sperati
The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non-nephrologists have a working knowledge of issues germane to dialysis...
January 15, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29335242/effect-of-bariatric-surgery-on-ckd-risk
#13
Allon N Friedman, Abdus S Wahed, Junyao Wang, Anita P Courcoulas, Gregory Dakin, Marcelo W Hinojosa, Paul L Kimmel, James E Mitchell, Alfons Pomp, Walter J Pories, Jonathan Q Purnell, Carel le Roux, Konstantinos Spaniolas, Kristine J Steffen, Richard Thirlby, Bruce Wolfe
Obesity is linked to the development and progression of CKD, but whether bariatric surgery protects against CKD is poorly understood. We, therefore, examined whether bariatric surgery influences CKD risk. The study included 2144 adults who underwent bariatric surgery from March of 2006 to April of 2009 and participated in the Longitudinal Assessment of Bariatric Surgery-2 Study cohort. The primary outcome was CKD risk categories as assessed by the Kidney Disease Improving Global Outcomes (KDIGO) consortium criteria using a combination of eGFR and albuminuria...
January 15, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29334900/process-evaluation-of-the-radiant-community-study-a-dialysis-facility-level-intervention-to-increase-referral-for-kidney-transplantation
#14
Reem E Hamoda, Jennifer C Gander, Laura J McPherson, Kimberly J Arriola, Loren Cobb, Stephen O Pastan, Laura Plantinga, Teri Browne, Erica Hartmann, Laura Mulloy, Carlos Zayas, Jenna Krisher, Rachel E Patzer
BACKGROUND: The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. METHODS: To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January-December 2014)...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29333147/novel-filtration-markers-for-gfr-estimation
#15
Amy B Karger, Lesley A Inker, Josef Coresh, Andrew S Levey, John H Eckfeldt
Creatinine-based glomerular filtration rate estimation (eGFRcr) has been improved and refined since the 1970s through both the Modification of Diet in Renal Disease (MDRD) Study equation in 1999 and the CKD Epidemiology Collaboration (CKD-EPI) equation in 2009, with current clinical practice dependent primarily on eGFR for accurate assessment of GFR. However, researchers and clinicians have recognized limitations of relying on creatinine as the only filtration marker, which can lead to inaccurate GFR estimates in certain populations due to the influence of non-GFR determinants of serum or plasma creatinine...
December 2017: EJIFCC
https://www.readbyqxmd.com/read/29329515/engaging-clinicians-and-patients-to-assess-and-improve-frailty-measurement-in-adults-with-end-stage-renal-disease
#16
Sarah Van Pilsum Rasmussen, Jonathan Konel, Fatima Warsame, Hao Ying, Brian Buta, Christine Haugen, Elizabeth King, Sandra DiBrito, Ravi Varadhan, Leocadio Rodríguez-Mañas, Jeremy D Walston, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: The Fried frailty phenotype, a measure of physiologic reserve defined by 5 components (exhaustion, unintentional weight loss, low physical activity, slow walking speed, and poor grip strength), is associated with poor outcomes among ESRD patients. However, these 5 components may not fully capture physiologic reserve in this population. We aimed to ascertain opinions of ESRD clinicians and patients about the usefulness of the Fried frailty phenotype and interventions to improve frailty in ESRD patients, and to identify novel components to further characterize frailty in ESRD...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329323/stroke-risk-and-outcomes-in-patients-with-chronic-kidney-disease-or-end-stage-renal-disease-two-nationwide-studies
#17
Yih-Giun Cherng, Chao-Shun Lin, Chun-Chuan Shih, Yung-Ho Hsu, Chun-Chieh Yeh, Chaur-Jong Hu, Ta-Liang Chen, Chien-Chang Liao
BACKGROUND AND AIMS: Because the risk and outcomes of stroke in patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) were unclear, we evaluated these risks using a retrospective cohort study and a nested cohort study. METHODS: We used Taiwan's National Health Insurance Research Database to identify 1378 patients aged ≥20 years who had ESRD in 2000-2004. An age- and sex-matched CKD cohort (n = 5512) and a control cohort (n = 11,024) were selected for comparison...
2018: PloS One
https://www.readbyqxmd.com/read/29323708/microrna501-5p-induces-p53-proteasome-degradation-through-the-activation-of-the-mtor-mdm2-pathway-in-adpkd-cells
#18
Lucia de Stephanis, Alessandra Mangolini, Miriam Servello, Peter C Harris, Lucio Dell'Atti, Paolo Pinton, Gianluca Aguiari
Cell proliferation and apoptosis are typical hallmarks of autosomal dominant polycystic kidney disease (ADPKD) and cause the development of kidney cysts that lead to end-stage renal disease (ESRD). Many factors, impaired by polycystin complex loss of function, may promote these biological processes, including cAMP, mTOR and EGFR signalling pathways. In addition, microRNAs (miRs) may also regulate the ADPKD related signalling network and their dysregulation contributes to disease progression. However, the role of miRs in ADPKD pathogenesis has not been fully understood, but also the function of p53 is quite obscure, especially its regulatory contribution on cell proliferation and apoptosis...
January 11, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29320795/direct-oral-anticoagulants-in-end-stage-renal-disease
#19
Adi J Klil-Drori, Vicky Tagalakis
Patients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD...
January 10, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29319781/a-future-for-nephrology
#20
Richard Glassock
It is interesting that some of my predictions came true and some did not, but I think the jury is still out on many of them. I start to remind everyone on the glorious past of Nephrology, from the physiology, translational and methodological discoveries that have contributed to the development of our discipline. I predict that the Academic branch of Nephrology will continue to excel in three domains: Creative Research,Teaching (Training) and Innovative Clinical Care. I forsee dramatic changes in Nephrology practice in the short term (10 years) and I discuss which areas will have a most dramatic impact...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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