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Interventional nephrology

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https://www.readbyqxmd.com/read/28643107/-microscopic-hematuria-reasonable-and-risk-adapted-diagnostic-evaluation
#1
REVIEW
N Löbig, F Wezel, T Martini, B Schröppel, C Bolenz
BACKGROUND: Microscopic hematuria that is not explained by an obvious underlying condition is a frequent and often an incidental finding that commonly triggers urological or nephrological evaluation. Potential underlying conditions range from benign to severe malignant diseases of the kidneys and urinary tract. MATERIALS AND METHODS: A nonsystematic literature search was performed, focusing on potential urological and nephrological causes of hematuria. National and international guidelines were considered and diagnostic as well as follow-up strategies are discussed...
June 22, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28638600/quantification-of-bleeding-volume-using-computed-tomography-and-clinical-complications-after-percutaneous-renal-biopsy
#2
Yoichiro Chikamatsu, Ken Matsuda, Yoichi Takeuchi, Saeko Kagaya, Yoshie Ojima, Hirotaka Fukami, Hiroyuki Sato, Ayako Saito, Yoshitsugu Iwakura, Tasuku Nagasawa
Background: The aim of this study was to investigate specific bleeding volume after percutaneous renal biopsy (PRB) and the correlation between bleeding volume and clinical parameters. Methods: A retrospective study of 252 consecutive patients (153 male patients and 99 female patients) who underwent PRB at the Department of Nephrology, Japanese Red Cross Ishinomaki Hospital, between July 2013 and January 2016 was conducted. PRB was performed under ultrasound guidance using an automated spring-loaded biopsy device and a 16-cm, 16-gauge needle...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28638567/nephrology-key-information-for-internists
#3
Sohail Abdul Salim, Juan A Medaura, Bharat Malhotra, Vishnu Garla, Shradha Ahuja, Nicki Lawson, Amaleswari Pamarthy, Hardik Sonani, Karthik Kovvuru, Venkataraman Palabindala
Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Other causes of immediate consultation are cresenteric glomerulonephritis / rapidly progressive glomerulonephritis in which renal prognosis of the patient depends on timely intervention...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28579421/an-interactive-ambulatory-nephrology-curriculum-for-internal%C3%A2-medicine-interns-design-implementation-and-participant%C3%A2-feedback
#4
Alexis C Gomez, Karen M Warburton, Rachel K Miller, Dan Negoianu, Jordana B Cohen
While diminishing nephrology fellow recruitment is a known issue, more work is needed to evaluate possible interventions to reverse this trend. We designed and implemented a curriculum to increase exposure to ambulatory nephrology among internal medicine interns. The curriculum focused on key aspects of outpatient nephrology practice, including supervised clinic visits, formal themed didactic content, and an online interactive forum with assigned evidence-based readings and small-group responses to relevant cases...
June 2, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28540855/interest-of-the-combined-measurement-of-selected-urinary-proteins-in-the-diagnosis-approach-in-nephrology
#5
Jean-Philippe Bastard, Soraya Fellahi, François-Xavier Lescure, Jacqueline Capeau, Pierre Ronco, Emmanuelle Plaisier
Determination of the protein composition of urine is a non-invasive method helping to diagnose renal lesions and evaluate therapeutic interventions. We present here five observations that highlight the performance and relevance of urine protein analysis combining selected glomerular and tubular protein measurements. Total urine protein level and measurements of urinary IgG, albumin, transferrin alpha-1 microglobulin and retinol binding protein were performed on a urine sample by immunonephelometry. The results were normalized for urine creatinine concentration and integrated in the MDI interpretation software that provides a "urine protein profile" (UPP)...
June 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28537418/short-term-changes-in-algometry-inclinometry-stabilometry-and-urinary-ph-analysis-after-a-thoracolumbar-junction-manipulation-in-patients-with-kidney-stones
#6
Ángel Oliva Pascual-Vaca, Ramón Punzano-Rodríguez, Pablo Escribá-Astaburuaga, Juan Carlos Fernández-Domínguez, François Ricard, Maria Angeles Franco-Sierra, Cleofás Rodríguez-Blanco
OBJECTIVES: To determine the efficacy of a high-velocity low-amplitude manipulation of the thoracolumbar junction in different urologic and musculoskeletal parameters in subjects suffering from renal lithiasis. DESIGN: Randomized, controlled blinded clinical study. SETTINGS/LOCATION: The Nephrology departments of two hospitals and one private consultancy of physiotherapy in Valencia (Spain). SUBJECTS: Forty-six patients suffering from renal lithiasis...
May 24, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28497090/association-between-prostate-specific-antigen-levels-and-coronary-artery-angioplasty
#7
Arezoo Khosravi, Eghlim Nemati, Mahdi Soleimanian, Neda Raesi, Shahin Abbaszadeh
Introduction: Prostate-specific antigen (PSA) is a protein, whose serum levels changes during various physiologic and pathologic situations. Recently, the relationship between PSA and cardiologic disorders has been assessed. Objectives: The purpose of this study was to assess the association of percutaneous coronary intervention (PCI) complications with PSA serum levels. Patients and Methods: In this study, 100 eligible patients undergoing PCI were included. The total PSA serum values were analyzed pre- and post-procedure...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28476482/report-on-the-society-for-fetal-urology-panel-discussion-on-the-selection-criteria-and-intervention-for-fetal-bladder-outlet-obstruction
#8
M K Farrugia, M C Braun, C A Peters, R Ruano, C D Herndon
INTRODUCTION: The Society for Fetal Urology panel section at the 2016 Fall Congress featured a multidisciplinary discussion on appropriate patient selection, the conservative versus surgical management, and postnatal renal outcome of fetuses with lower urinary tract obstruction (LUTO). SELECTION CRITERIA FOR INTERVENTION: Rodrigo Ruano shared his experience of prenatal intervention, presenting the outcome of 111 fetuses with severe LUTO treated with vesicoamniotic shunting (VAS) (n = 16), cystoscopy (n = 34) or no intervention (n = 61) in a non-randomized series...
March 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28463635/research-priorities-for-palliative-care-for-older-adults-with-advanced-chronic-kidney-disease
#9
Ann M O'Hare, Mi-Kyung Song, Manjula Kurella Tamura, Alvin H Moss
Older adults with advanced chronic kidney disease (CKD) often have multiple comorbid conditions, a high symptom burden, and limited life expectancy. There is mounting concern that the intensive patterns of care that many of these patients receive at the end of life are discordant with their values and preferences. The nephrology community has recognized that there are significant unmet palliative care needs in this population. In this article, we identify three broad areas of knowledge deficit where more evidence is needed to support the "best care possible" for this population: (1) what matters most to older adults with advanced CKD and their caregivers near the end of life; (2) how the nephrology community can best support older adults with advanced CKD to navigate complex treatment decisions throughout their illness; and (3) how the healthcare system should be reconfigured to promote patient- and family-centered care for older adults with advanced CKD...
May 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28445893/early-mortality-associated-with-inpatient-versus-outpatient-hemodialysis-initiation-in-a-large-cohort-of-us-veterans-with-incident-end-stage-renal-disease
#10
Faisal M Arif, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Jun Ling Lu, Fatima Hassan, Fridtjof Thomas, Omer A Siddiqui, Geeta G Gyamlani, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Mortality in the immediate post-hemodialysis transition period is extremely high. Many end-stage renal disease (ESRD) patients in the US start dialysis in an inpatient setting, but the characteristics of patients starting dialysis as inpatients, and the association of inpatient hemodialysis transition with mortality remain unclear. METHODS: We examined 48,261 US veterans who transitioned to hemodialysis between October 2007 and September 2011. Associations of inpatient hemodialysis starting with all-cause mortality were examined in Cox proportional hazard models, with adjustments for demographics, comorbidities, vascular access type, pre-dialysis nephrology care and medication use, and last pre-ESRD estimated glomerular filtration rate and hemoglobin...
April 27, 2017: Nephron
https://www.readbyqxmd.com/read/28434761/improvement-in-nutritional-status-in-patients-with-chronic-kidney-disease-4-by-a-nutrition-education-program-with-no-impact-on-renal-function-and-determined-by-male-sex
#11
Almudena Pérez-Torres, Elena González Garcia, Helena Garcia-Llana, Gloria Del Peso, Ana María López-Sobaler, Rafael Selgas
OBJECTIVE: Protein-energy wasting (PEW) is associated with increased morbidity and mortality and a rapid deterioration of kidney function in patients with chronic kidney disease (CKD). However, there is little information regarding the effect of nutrition intervention. The aims of this study were to evaluate the efficacy and safety of a nutrition education program (NEP) in patients with nondialysis dependent CKD (NDD-CKD), based on the diagnostic criteria for PEW proposed by the International Society of Renal Nutrition and Metabolism...
April 20, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28434650/global-kidney-health-2017-and-beyond-a-roadmap-for-closing-gaps-in-care-research-and-policy
#12
REVIEW
Adeera Levin, Marcello Tonelli, Joseph Bonventre, Josef Coresh, Jo-Ann Donner, Agnes B Fogo, Caroline S Fox, Ron T Gansevoort, Hiddo J L Heerspink, Meg Jardine, Bertram Kasiske, Anna Köttgen, Matthias Kretzler, Andrew S Levey, Valerie A Luyckx, Ravindra Mehta, Orson Moe, Gregorio Obrador, Neesh Pannu, Chirag R Parikh, Vlado Perkovic, Carol Pollock, Peter Stenvinkel, Katherine R Tuttle, David C Wheeler, Kai-Uwe Eckardt
The global nephrology community recognises the need for a cohesive plan to address the problem of chronic kidney disease (CKD). In July, 2016, the International Society of Nephrology hosted a CKD summit of more than 85 people with diverse expertise and professional backgrounds from around the globe. The purpose was to identify and prioritise key activities for the next 5-10 years in the domains of clinical care, research, and advocacy and to create an action plan and performance framework based on ten themes: strengthen CKD surveillance; tackle major risk factors for CKD; reduce acute kidney injury-a special risk factor for CKD; enhance understanding of the genetic causes of CKD; establish better diagnostic methods in CKD; improve understanding of the natural course of CKD; assess and implement established treatment options in patients with CKD; improve management of symptoms and complications of CKD; develop novel therapeutic interventions to slow CKD progression and reduce CKD complications; and increase the quantity and quality of clinical trials in CKD...
April 20, 2017: Lancet
https://www.readbyqxmd.com/read/28434090/a-best-practice-position-statement-on-the-role-of-the-nephrologist-in-the-prevention-and-follow-up-of-preeclampsia-the-italian-study-group-on-kidney-and-pregnancy
#13
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Donatella Spotti, Franca Giacchino, Rossella Attini, Monica Limardo, Stefania Maxia, Antioco Fois, Linda Gammaro, Tullia Todros
Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide...
June 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#14
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28428332/education-in-nephrology-fellowship-a-survey-based-needs-assessment
#15
Robert W Rope, Kurtis A Pivert, Mark G Parker, Stephen M Sozio, Sylvia Bereknyei Merell
Educational needs assessments for nephrology fellowship training are limited. This study assessed fellows' perceptions of current educational needs and interest in novel modalities that may improve their educational experience and quantified educational resources used by programs and fellows. We distributed a seven-question electronic survey to all United States-based fellows receiving complimentary American Society of Nephrology (ASN) membership at the end of the 2015-2016 academic year in conjunction with the ASN Nephrology Fellows Survey...
April 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28399810/a-programme-to-spread-egfr-graph-surveillance-for-the-early-identification-support-and-treatment-of-people-with-progressive-chronic-kidney-disease-assist-ckd-protocol-for-the-stepped-wedge-implementation-and-evaluation-of-an-intervention-to-reduce-late-presentation
#16
Hugh Gallagher, Shona Methven, Anna Casula, Nicola Thomas, Charles R V Tomson, Fergus J Caskey, Tracey Rose, Stephen J Walters, David Kennedy, Anne Dawnay, Martin Cassidy, Richard Fluck, Hugh C Rayner, Michael Nation
BACKGROUND: Patients who start renal replacement therapy (RRT) for End-Stage Kidney Disease (ESKD) without having had timely access to specialist renal services have poor outcomes. At one NHS Trust in England, a community-wide CKD management system has led to a decline in the incident rate of RRT and the lowest percentage of patients presenting within 90 days of starting RRT in the UK. We describe the protocol for a quality improvement project to scale up and evaluate this innovation...
April 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28399022/palliative-and-end-of-life-care-in-nephrology-moving-from-observations-to-interventions
#17
Nwamaka D Eneanya, Michael K Paasche-Orlow, Angelo Volandes
PURPOSE OF REVIEW: In comparison with patients who have other serious illnesses, patients with advanced kidney disease have a higher rate of intensive care utilization at the end of life and receive palliative care less frequently. Consensus and clinical practice guidelines have therefore recommended the incorporation of palliative care earlier in the disease trajectory. This review summarizes recent literature on this aspect of care and will highlight future directions for patient-centered care within palliative nephrology...
July 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28391345/new-approaches-to-trials-in-glomerulonephritis
#18
Jonathan C Craig, Allison Tong, Giovanni F M Strippoli
Randomized controlled trials are required to reliably identify interventions to improve the outcomes for people with glomerulonephritis (GN). Unfortunately, although easier, observational studies are inherently unreliable even though the findings of both study designs agree most of the time. Currently there are ∼790 trials in GN, but suboptimal design and reporting, together with small sample sizes, mean that they may not be reliable for decision making. If the history is somewhat bleak, the future looks bright, with recent initiatives to improve the quality, size and relevance of clinical trials in nephrology, including greater patient engagement, trial networks, core outcome sets, registry-based trials and adaptive designs...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28363480/targeted-release-budesonide-versus-placebo-in-patients-with-iga-nephropathy-nefigan-a-double-blind-randomised-placebo-controlled-phase-2b-trial
#19
Bengt C Fellström, Jonathan Barratt, Heather Cook, Rosanna Coppo, John Feehally, Johan W de Fijter, Jürgen Floege, Gerd Hetzel, Alan G Jardine, Francesco Locatelli, Bart D Maes, Alex Mercer, Fernanda Ortiz, Manuel Praga, Søren S Sørensen, Vladimir Tesar, Lucia Del Vecchio
BACKGROUND: IgA nephropathy is thought to be associated with mucosal immune system dysfunction, which manifests as renal IgA deposition that leads to impairment and end-stage renal disease in 20-40% of patients within 10-20 years. In this trial (NEFIGAN) we aimed to assess safety and efficacy of a novel targeted-release formulation of budesonide (TRF-budesonide), designed to deliver the drug to the distal ileum in patients with IgA nephropathy. METHODS: We did a randomised, double-blind, placebo-controlled phase 2b trial, comprised of 6-month run-in, 9-month treatment, and 3-month follow-up phases at 62 nephrology clinics across ten European countries...
March 28, 2017: Lancet
https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#20
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
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