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Interventional nephrology

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https://www.readbyqxmd.com/read/29774464/eculizumab-in-stec-hus-need-for-a-proper-randomized-controlled-trial
#1
Sebastian Loos, Jun Oh, Markus J Kemper
Hemolytic uremic syndrome caused by Shiga toxin-producing E. coli (STEC-HUS) is often associated with a severe morbidity including neurological involvement and a mortality of 1-5%. Although STEC-HUS is often self-limited, improvement of treatment strategies is needed for cases with complications and, among others, plasma exchange/plasmapheresis and use of antibiotics have been advocated. With the availability of the complement blocker eculizumab, now a standard treatment of atypical HUS, several series have addressed its use in STEC-HUS, with variable response; randomized controlled trials are lacking...
May 17, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29738040/nephrologists-between-power-and-vulnerability-in-times-of-technology
#2
José Miguel Viscarra Obregón, Marcio Fabri Dos Anjos
The doctor-patient relationship is often discussed from the perspective of patient vulnerability. Little attention is given to the vulnerability of nephrologists in their professional practice, a reality often affected by profound cultural transformation arising from technological development. Nephrology is based on research and procedure instrumentalization, both permeated with technology. In addition, the relationship between nephrologists and institutions is governed by market rules. Recent data showed a shortage of new nephrologists and the need to improve the technical training of new professionals, foster the establishment of interventional nephrology, and attract more graduating physicians to this medical specialty...
May 3, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29725648/nephcure-accelerating-cures-institute-a-multidisciplinary-consortium-to-improve-care-for-nephrotic-syndrome
#3
Debbie S Gipson, David T Selewski, Susan F Massengill, Mary Margaret Modes, Hailey Desmond, Lauren Lee, Elaine Kamil, Matthew R Elliott, Sharon G Adler, Gia Oh, Richard A Lafayette, Patrick E Gipson, Aditi Sinha, Arvind Bagga, Anne Pesenson, Cheryl Courtlandt, Cathie Spino, Richard Eikstadt, Renée Pitter, Samara Attalla, Anne Waldo, Richard Winneker, Noelle E Carlozzi, Jonathan P Troost, Irving Smokler, Mark Stone
Introduction: NephCure Accelerating Cures Institute (NACI) is a collaborative organization sponsored by NephCure Kidney International and the University of Michigan. The Institute is composed of 7 cores designed to improve treatment options and outcomes for patients with glomerular disease: Clinical Trials Network, Data Warehouse, Patient-Reported Outcomes (PRO) and Endpoints Consortium, Clinical Trials Consulting Team, Quality Initiatives, Education and Engagement, and Data Coordinating Center...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29700696/the-vexed-question-of-whether-or-not-to-measure-levels-of-direct-oral-anticoagulants-before-surgery-or-invasive-procedures
#4
REVIEW
Armando Tripodi, Francesco Marongiu, Marco Moia, Gualtiero Palareti, Vittorio Pengo, Daniela Poli, Domenico Prisco, Sophie Testa, Maria Zanazzi
Direct oral anticoagulants (DOAC) possess high bioavailability, and their anticoagulant effect is more predictable than that of vitamin K antagonists, hence they do not require routine dose adjustment based on laboratory testing. However, there are circumstances when laboratory testing may be useful, including patients who need to undergo surgery or invasive procedures. Most guidelines state that patients on DOAC may safely undergo surgery/invasive procedures by stopping anticoagulation for a few days before intervention without testing if renal function is within normal limits...
April 26, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29657218/rapidly-progressive-glomerulonephritis-a-wild-card-manifestation-of-lupus-nephritis
#5
Opeyemi O Komolafe
A significant proportion of individuals with systemic lupus erythematosus (SLE) will have clinical or laboratory evidence of renal involvement at some point in the course of their disease. Lupus nephritis (LN) is one of the more important systemic manifestations of SLE and although progression to end-stage renal disease (ESRD) is not usually the norm, a significant minority of patients will do so, some in a rather dramatic fashion. It is in such instances that LN constitutes a true nephrologic emergency. Gratifyingly, it is rarely a silent emergency and heightened awareness amongst clinicians about its unpredictable course should lead to earlier recognition and intervention...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29607099/building-a-safety-culture-in-global-health-lessons-from-guatemala
#6
REVIEW
Henry E Rice, Randall Lou-Meda, Anthony T Saxton, Bria E Johnston, Carla C Ramirez, Sindy Mendez, Eli N Rice, Bernardo Aidar, Brad Taicher, Joy Noel Baumgartner, Judy Milne, Allan S Frankel, J Bryan Sexton
Programmes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29606094/can-increased-vigilance-for-chronic-kidney-disease-in-hospitalised-patients-decrease-late-referral-and-improve-dialysis-free-survival
#7
M De Wilde, M Speeckaert, W Van Biesen
BACKGROUND: Insufficient vigilance for renal insufficiency is associated with late referral, increased morbidity and mortality. The present study examines whether increased vigilance for chronic kidney disease (CKD) leads to quicker referral to and better follow-up by a nephrologist, and whether it is associated with an improved outcome. METHODS: Patients with an eGFR < 45 ml/min/1.73 m2 during hospitalisation at the Ghent University Hospital were enrolled during a period of 100 days...
April 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29602399/metabolomics-and-metabolic-reprogramming-in-kidney-cancer
#8
REVIEW
Robert H Weiss
Kidney cancer, or renal cell carcinoma (RCC), is a disease of increasing incidence that commonly is seen in the general practice of nephrology. Despite this state of affairs, this fascinating and highly morbid disease frequently is under-represented, or even absent, from the curriculum of nephrologists in training and generally is underemphasized in national nephrology meetings, both scientific as well as clinical. Although classic concepts in cancer research in general had led to the concept that cancer is a disease resulting from mutations in the control of growth-regulating pathways, reinforced by the discovery of oncogenes, more contemporary research, particularly in kidney cancer, has uncovered changes in metabolic pathways mediated by those same genes that control tumor energetics and biosynthesis...
March 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29582964/-the-nephrology-outpatient-triage-an-organizational-model-for-the-ambulatory-care-of-patients-with-advanced-renal-disease
#9
Giorgio Soragna, Francesca Bermond, Laura Fabbrini, Amelia Rodofili, Aldo Soragna, Maggiorina Bauducco, Aspasia Panunzi, Ada Ramondetti, Cristiana Cerri, Corrado Vitale
The clinical course of outpatients with advanced chronic kidney disease requires a close monitoring by the nephrology team, in order to identify emerging clinical problems promptly and prevent subsequent complications. With the aim of improving the outpatient management in our clinic dedicated to advanced renal failure, we implemented the "Nephrology Clinic Triage" (NCT). This organizational model is coordinated by the nephrologist and supported by nurses. In case the outpatients, or their caregivers, have clinical problems or need advice, they can easily get in touch with a nephrology nurse by a dedicated telephone line...
March 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29572749/eculizumab-treatment-in-severe-pediatric-stec-hus-a-multicenter-retrospective-study
#10
Lucas Percheron, Raluca Gramada, Stéphanie Tellier, Remi Salomon, Jérôme Harambat, Brigitte Llanas, Marc Fila, Emma Allain-Launay, Anne-Laure Lapeyraque, Valerie Leroy, Anne-Laure Adra, Etienne Bérard, Guylhène Bourdat-Michel, Hassid Chehade, Philippe Eckart, Elodie Merieau, Christine Piètrement, Anne-Laure Sellier-Leclerc, Véronique Frémeaux-Bacchi, Chloe Dimeglio, Arnaud Garnier
BACKGROUND: Hemolytic uremic syndrome related to Shiga-toxin-secreting Escherichia coli infection (STEC-HUS) remains a common cause of acute kidney injury in young children. No specific treatment has been validated for this severe disease. Recently, experimental studies highlight the potential role of complement in STEC-HUS pathophysiology. Eculizumab (EC), a monoclonal antibody against terminal complement complex, has been used in severe STEC-HUS patients, mostly during the 2011 German outbreak, with conflicting results...
March 23, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29572627/functional-impairment-and-risk-of-mortality-in-patients-on-chronic-hemodialysis-results-of-the-lazio-dialysis-registry
#11
Maurizio Bossola, Claudia Marino, Anteo Di Napoli, Nera Agabiti, Luigi Tazza, Marina Davoli
BACKGROUND: Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of this study was to evaluate if functional impairment represents a risk factor for reduced survival in patients on chronic hemodialysis. METHODS: All incident chronic hemodialysis patients of Lazio, a large region of central Italy, registered in the Dialysis and Transplant Lazio Region Registry (DTLRR) in the period 2008-2013 were considered eligible...
March 23, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29544403/dialysis-arteriovenous-access-monitoring-and-surveillance-according-to-the-2017-spanish-guidelines
#12
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29523567/perspectives-of-healthcare-providers-on-the-nutritional-management-of-patients-on-haemodialysis-in-australia-an-interview-study
#13
Jessica Stevenson, Allison Tong, Katrina L Campbell, Jonathan C Craig, Vincent W Lee
OBJECTIVE: To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. DESIGN: Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. SETTING: 21 haemodialysis centres across Australia. PARTICIPANTS: 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences...
March 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29511569/vascular-access-practice-patterns-in-canada-a-national-survey
#14
Chance Dumaine, Mercedeh Kiaii, Lisa Miller, Louise Moist, Matthew J Oliver, Charmaine E Lok, Swapnil Hiremath, Jennifer M MacRae
Background: One of the mandates of the Canadian Society of Nephrology's (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29503236/society-of-interventional-radiology-reporting-standards-for-thoracic-central-vein-obstruction-endorsed-by-the-american-society-of-diagnostic-and-interventional-nephrology-asdin-british-society-of-interventional-radiology-bsir-canadian-interventional-radiology
#15
Bart L Dolmatch, John C Gurley, Kevin M Baskin, Boris Nikolic, Jeffrey H Lawson, Surendra Shenoy, Theodore F Saad, Ingemar Davidson, Mark O Baerlocher, Emil I Cohen, Sean R Dariushnia, Salomão Faintuch, Bertrand Janne d'Othee, Thomas B Kinney, Mehran Midia, James Clifton
No abstract text is available yet for this article.
April 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29503041/effectiveness-of-an-educational-intervention-and-physical-exercise-on-the-functional-capacity-of-patients-on-haemodialysis
#16
Esmeralda Molina-Robles, Marta Colomer-Codinachs, Marta Roquet-Bohils, Emilia Chirveches-Pérez, Pep Ortiz-Jurado, Mireia Subirana-Casacuberta
OBJECTIVE: To describe the impact of a standard hospital educational intervention including active physical exercises on personal well-being, functional capacity and knowledge of the benefits of prescribed physical activity for patients undergoing haemodialysis. METHOD: An uncontrolled, quasi-experimental, before-and-after study with repeated measures of response variables at 4, 8 and 12 weeks after participating in an educational and physical exercise hospital intervention...
March 2, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29485220/factors-that-influenced-undergoing-renal-replacement-therapy-and-survival-in-children-with-acute-kidney-injury
#17
Fatma Zehra Oztek-Celebi, Sare Gulfem Ozlu, Ozlem Aydog
BACKGROUND: Acute kidney injury (AKI) is an important clinical condition which is associated with increased mortality and morbidity. This study was performed to identify the factors that influence AKI stage, undergoing renal replacement therapy (RRT) and mortality. METHODS: This study was retrospectively conducted on 219 children with AKI who had been referred to paediatric nephrology division of Dr. Sami Ulus Teaching Hospital during their inpatient treatment from 2008 to 2012...
February 27, 2018: Nephrology
https://www.readbyqxmd.com/read/29478866/report-of-the-standardized-outcomes-in-nephrology-hemodialysis-song-hd-consensus-workshop-on-establishing-a-core-outcome-measure-for-hemodialysis-vascular-access
#18
Andrea K Viecelli, Allison Tong, Emma O'Lone, Angela Ju, Camilla S Hanson, Benedicte Sautenet, Jonathan C Craig, Braden Manns, Martin Howell, Eric Chemla, Lai-Seong Hooi, David W Johnson, Timmy Lee, Charmaine E Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Carmel M Hawley
Vascular access outcomes in hemodialysis are critically important for patients and clinicians, but frequently are neither patient relevant nor measured consistently in randomized trials. A Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop was convened to discuss the development of a core outcome measure for vascular access. 13 patients/caregivers and 46 professionals (clinicians, policy makers, industry representatives, and researchers) attended. Participants advocated for vascular access function to be a core outcome based on the broad applicability of function regardless of access type, involvement of a multidisciplinary team in achieving a functioning access, and the impact of access function on quality of life, survival, and other access-related outcomes...
May 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29473380/longitudinal-prospective-observational-type-study-about-determinants-of-renal-resistive-index-variations-in-chronic-renal-failure-patients-treated-with-conventional-medical-and-dietetic-therapy
#19
Simone Brardi, Gabriele Cevenini, Vanni Giovannelli, Giuseppe Romano
OBJECTIVE: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. MATERIAL AND METHODS: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/29439674/establishing-a-clinical-phenotype-for-cachexia-in-end-stage-kidney-disease-study-protocol
#20
Joanne Reid, Helen R Noble, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalantar-Zadeh, John Mallett, C McKeaveney, S Porter, David S Seres, Joanne Shields, Adrian Slee, Miles D Witham, Alexander P Maxwell
BACKGROUND: Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD...
February 13, 2018: BMC Nephrology
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