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Interventional nephrology

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https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#1
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
https://www.readbyqxmd.com/read/28319949/the-impact-of-kidney-development-on-the-life-course-a-consensus-document-for-action
#2
(no author information available yet)
Hypertension and chronic kidney disease (CKD) have a significant impact on global morbidity and mortality. The Low Birth Weight and Nephron Number Working Group has prepared a consensus document aimed to address the relatively neglected issue for the developmental programming of hypertension and CKD. It emerged from a workshop held on April 2, 2016, including eminent internationally recognized experts in the field of obstetrics, neonatology, and nephrology. Through multidisciplinary engagement, the goal of the workshop was to highlight the association between fetal and childhood development and an increased risk of adult diseases, focusing on hypertension and CKD, and to suggest possible practical solutions for the future...
March 21, 2017: Nephron
https://www.readbyqxmd.com/read/28300757/analysis-of-outcomes-of-the-nrs-2002-in-patients-hospitalized-in-nephrology-wards
#3
Paulina Borek, Michał Chmielewski, Sylwia Małgorzewicz, Alicja Dębska Ślizień
INTRODUCTION: Malnutrition is a common problem among hospitalized patients. In chronic kidney disease, it affects up to 50% of the population. Undernourishment has an adverse effect on prognosis and prolongs convalescence. The aim of the study was to test the effectiveness of NRS (Nutrition Risk Screening) -2002 in the assessment of risk of malnutrition for patients hospitalized in nephrology wards. The aim was to develop clinical characteristics of malnourished patients and to assess the relationship between nutritional status and patient outcome...
March 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28260445/renal-impairment-and-complication-after-kidney-transplant-at-queen-rania-abdulla-children-s-hospital
#4
Reham Issa Almardini, Ghazi Mohamad Salita, Mahdi Qasem Farah, Issa Ahmad Katatbeh, Katibh Al-Rabadi
OBJECTIVES: Kidney transplant is the treatment of choice for end-stage renal disease, but it is not without complications. We review the medical cause of significant renal impairment and complications that developed after kidney transplant in pediatric patients who required hospital admission and intervention and/or who were followed between 2007 and 2016. MATERIALS AND METHODS: A retrospective noninterventional chart review study was conducted in pediatric patients who received a kidney transplant and/or followed at the nephrology clinic at Queen Rania Abdulla Children's Hospital between 2007 and 2016...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28249030/low-versus-high-dose-erythropoiesis-stimulating-agents-in-hemodialysis-patients-with-anemia-a-randomized-clinical-trial
#5
Valeria Saglimbene, Suetonia C Palmer, Jonathan C Craig, Marinella Ruospo, Antonio Nicolucci, Marcello Tonelli, David Johnson, Giuseppe Lucisano, Gabrielle Williams, Miriam Valentini, Daniela D'Alonzo, Fabio Pellegrini, Paolo Strippoli, Mario Salomone, Antonio Santoro, Stefano Maffei, Jörgen Hegbrant, Gianni Tognoni, Giovanni F M Strippoli
The increased risks of death and adverse events with erythropoiesis-stimulating agent (ESA) therapy targeting a higher hemoglobin level are established. It is uncertain whether the adverse effects of ESA therapy are related to dose and are mitigated when a fixed low ESA dose is used. We conducted a multicenter, prospective randomized open-label, blinded-endpoint (PROBE) trial to evaluate fixed low versus high dose ESA therapy on patient outcomes. We intended to recruit 2104 hemodialysis patients >18 years with anemia or receiving ESA treated at dialysis clinics in Italy...
2017: PloS One
https://www.readbyqxmd.com/read/28219579/glomerular-diseases-and-renal-transplantation-pathogenic-pathways-and-evolution-of-therapeutic-interventions
#6
S Marinaki, C Skalioti, J Boletis
Glomerular diseases and renal transplantation are the main fields of nephrology in which the immune system plays a prevalent role. Glomerular diseases have traditionally been attributed to auto-immune conditions, whereas allograft rejection has been considered an allo-immune response. However, common immunopathologic mechanisms that include Toll-like receptors, complement and B-cell activation, as well as genetic and infectious factors appear to be involved in the pathogenesis of both entities. Novel therapeutic regimens directed against specific targets of the immune system show promising results in glomerulopathies as well as in renal transplantation...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28182261/improving-the-electronic-capture-of-advance-care-directives-in-a-healthcare-delivery-system
#7
Norifumi Kamo, Barbara L Williams, Donna L Smith, C Craig Blackmore
OBJECTIVES: To determine the effectiveness of a multifaceted quality improvement intervention in outpatient clinics at an integrated healthcare delivery system on capture rate of advance directives (ADs) in the electronic medical record (EMR). DESIGN: Interrupted time series analysis with control groups between January 2010 and June 2015. SETTING: Oncology, nephrology, and primary care outpatient clinics in an integrated healthcare delivery system...
February 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28177103/-quality-of-life-anxiety-and-distress-in-patients-suffering-from-chronic-kidney-disease-pre-dialysis-and-start-of-dialytic-treatment
#8
Maria Monica Ratti, Giulia Bruna Delli Zotti, Eleonora Sangiovanni, Benedetta Vai, Aurelio Limido, Silvio Bertoli, Lucio Sarno, Donatella Spotti
The psychological impact of the Chronic Kidney Disease is well known and several factors contribute to a reduction of quality of life, increase of anxiety levels and psychological distress for affected patients. Psychological intervention is becoming ever more consolidating within the Departments of Nephrology. Nevertheless, literature is lacking about the psychological intervention specificity, especially concerning the dialysis and pre-dialysis phase. The purpose of the study is to identify the mainly critical periods for the dialysed patients in terms of anxiety and distress and to examine the impact of medical management in pre-dialysis period on life quality...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28161697/in-the-wake-of-systolic-blood-pressure-intervention-trial-new-targets-for-improving-hypertension-management-in-chronic-kidney-disease
#9
Crystal C Tyson, Thomas M Coffman
Systolic Blood Pressure Intervention Trial (SPRINT) was a multicenter randomized controlled trial showing the significant benefit of intensive reduction of blood pressure to a target of 120 mm Hg in individuals with hypertension and elevated cardiovascular risk. Because SPRINT includes the largest cohort of adults with chronic kidney disease (CKD) to be prospectively studied in a hypertension intervention trial, it has particular relevance to the field of nephrology. Here, we review the findings of SPRINT and assess their potential impact on guidelines for treatment of hypertension in patients with CKD...
February 4, 2017: Nephron
https://www.readbyqxmd.com/read/28152018/acute-kidney-injury-burden-in-different-clinical-units-data-from-nationwide-survey-in-china
#10
Xiaojing Tang, Dongping Chen, Shengqiang Yu, Li Yang, Changlin Mei
BACKGROUND: The inpatient morbidity and mortality of acute kidney injury (AKI) vary considerably in different clinical units, yet studies to compare the difference remain limited. METHODS: We compared the clinical characteristics of AKI in Intensive Care Unit (ICU), medical and surgical departments by using the data derived from the 2013 nationwide cross-sectional survey of AKI in China to capture variations among different clinical departments in recognition, management, and outcomes of AKI...
2017: PloS One
https://www.readbyqxmd.com/read/28151965/prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-cardiovascular-procedures-a-systematic-review-and-network-meta-analysis
#11
Eliano P Navarese, Paul A Gurbel, Felicita Andreotti, Michalina Marta Kołodziejczak, Suetonia C Palmer, Sofia Dias, Antonino Buffon, Jacek Kubica, Mariusz Kowalewski, Tomasz Jadczyk, Michał Laskiewicz, Marek Jędrzejek, Maximillian Brockmeyer, Flavio Airoldi, Marinella Ruospo, Stefano De Servi, Wojciech Wojakowski, Christopher O' Connor, Giovanni F M Strippoli
BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast...
2017: PloS One
https://www.readbyqxmd.com/read/28122510/a-prospective-2-site-parallel-intervention-trial-of-a-research-based-film-to-increase-exercise-amongst-older-hemodialysis-patients
#12
Pia Kontos, Shabbir M H Alibhai, Karen-Lee Miller, Dina Brooks, Romeo Colobong, Trisha Parsons, Sarbjit Vanita Jassal, Alison Thomas, Malcolm Binns, Gary Naglie
BACKGROUND: Evidence suggests that exercise training for hemodialysis patients positively improves morbidity and mortality outcomes, yet exercise programs remain rare and are not systematically incorporated into care. We developed a research-based film, Fit for Dialysis, designed to introduce, motivate, and sustain exercise for wellness amongst older hemodialysis patients, and exercise counseling and support by nephrologists, nurses, and family caregivers. The objective of this clinical trial is to determine whether and in what ways Fit for Dialysis improves outcomes and influences knowledge/attitudes regarding the importance of exercise for wellness in the context of end-stage renal disease...
January 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28115076/cognitive-bias-and-the-creation-and-translation-of-evidence-into-clinical-practice
#13
REVIEW
Donald A Molony
The optimal translation of evidence into the clinical practice of nephrology follows validated evidence-based medicine (EBM) principles. Most importantly, the evidence-based medicine practitioner requires that the evidence, as much as possible, addresses in an unbiased manner clinical questions of importance to patients and reflects the truth. In this chapter, we evaluate how cognitive biases that affect medical decision making might systematically bias the overall management of patients with kidney disease and, thus, distort the observations about disease causation, prognosis, diagnosis, and management that are derived from analysis of administrative databases or electronic medical records of health care systems...
November 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28104336/indicators-of-cognitive-impairment-from-a-medical-record-review-correlations-with-early-30-d-readmissions-among-hospitalized-patients-in-a-nephrology-unit
#14
Matthew J Jasinski, Mark A Lumley, Sandeep Soman, Jerry Yee, Mark W Ketterer
BACKGROUND: Patients with end-stage renal disease have the highest 30-day hospital readmission rates of any medical condition. Previous research suggests that cognitive impairment contributes to readmission. It is important to identify patients at risk for early readmission, and this might be accomplished efficiently using medical record data. METHOD: We reviewed the medical records of 100 patients with kidney disease (57 women, mean age = 61.2) who were hospitalized in the nephrology unit at an urban U...
October 19, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#15
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28076578/confirmed-clinical-case-of-chronic-kidney-disease-of-nontraditional-causes-in-agricultural-communities-in-central-america-a-case-definition-for-surveillance
#16
Alejandro Ferreiro, Guillermo Álvarez-Estévez, Manuel Cerdas-Calderón, Zulma Cruz-Trujillo, Elio Mena, Marina Reyes, Mabel Sandoval-Diaz, Vicente Sánchez-Polo, Régulo Valdés, Pedro Ordúnez
Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT) might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28075321/effects-of-exercise-and-lifestyle-intervention-on-oxidative-stress-in-chronic-kidney-disease
#17
David M Small, Kassia S Beetham, Erin J Howden, David R Briskey, David W Johnson, Nicole M Isbel, Glenda C Gobe, Jeff S Coombes
OBJECTIVES: Determine the effects of a 12-month exercise and lifestyle intervention program on changes in plasma biomarkers of oxidative stress in pre-dialysis chronic kidney disease (CKD) patients. METHODS: A total of 136 stage 3-4 CKD patients were randomized to receive standard nephrological care with (N = 72) or without (N = 64) a lifestyle and exercise intervention for 12 months. Plasma total F2-isoprostanes (IsoP), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC), anthropometric and biochemical data were collected at baseline and at 12 months...
January 11, 2017: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/28069285/dialysis-modality-and-readmission-following-hospital-discharge-a-population-based-cohort-study
#18
Jeffrey Perl, Eric McArthur, Chaim Bell, Amit X Garg, Joanne M Bargman, Christopher T Chan, Shai Harel, Lihua Li, Arsh K Jain, Danielle M Nash, Ziv Harel
BACKGROUND: Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. STUDY DESIGN: Population-based retrospective-cohort observational study. SETTINGS & PARTICIPANTS: Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada...
January 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28042071/the-edmonton-symptom-assessment-system-25%C3%A2-years-later-past-present-and-future-developments
#19
REVIEW
David Hui, Eduardo Bruera
CONTEXT: Routine symptom assessment represents the cornerstone of symptom management. Edmonton Symptom Assessment System (ESAS) is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time. OBJECTIVES: To discuss the historical development of ESAS, its current uses in different settings, and future developments. METHODS: Narrative review...
March 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042060/the-relationship-between-fatigue-and-depression-in-adults-with-end-stage-renal-disease-on-chronic-in-hospital-hemodialysis-a-scoping-review
#20
REVIEW
Janine F Farragher, Helene J Polatajko, Sarbjit V Jassal
CONTEXT: Fatigue and depression are two prominent concerns in patients on in-hospital hemodialysis (IHHD) that have recently been identified as research priorities in the nephrology community. Although they are often reported to co-exist, no synthesis of the literature examining their relationship is available. OBJECTIVE: The aim of this study was to characterize the literature on the relationship between fatigue and depression in IHHD patients. METHODS: A scoping review as described by Arksey and O'Malley was conducted...
December 29, 2016: Journal of Pain and Symptom Management
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