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Interventional nephrology

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https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#1
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
#2
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
#3
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
#4
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-years-later-past-present-and-future-developments
#5
REVIEW
David Hui, Eduardo Bruera
CONTEXT: Routine symptom assessment represents the cornerstone of symptom management. 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. OBJECTIVE: To discuss the historical development of ESAS, its current uses in different settings, and future developments. METHODS: Narrative review RESULTS: Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages...
December 29, 2016: 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
#6
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: 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
https://www.readbyqxmd.com/read/28007671/magnesium-based-interventions-for-normal-kidney-function-and-chronic-kidney-disease
#7
Ziad A Massy, Ionut Nistor, Mugurel Apetrii, Vincent M Brandenburg, Jordi Bover, Pieter Evenepoel, David Goldsmith, Sandro Mazzaferro, Pablo Urena-Torres, Marc G Vervloet, Mario Cozzolino, Adrian Covic, On Behalf Of Ckd-Mbd Working Group Of Era-Edta
Magnesium (Mg) is one of the most important cations in the body, playing an essential role in biological systems as co-factor for more than 300 essential enzymatic reactions. In the general population, low levels of Mg are associated with a high risk of cardio-vascular disease (CVD). Despite the accumulating literature data, the effect of Mg administration on mortality in chronic kidney disease (CKD) patients has never been investigated as a primary end-point. We conducted a systematic search of studies assessing the benefits and harms of Mg in CKD (stages 1 to 5 and 5D), and considered all randomized controlled trials (RCTs) and quasi-RCTs evaluating Mg-based interventions in CKD...
December 22, 2016: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/28005240/complicated-pregnancies-in-inherited-distal-renal-tubular-acidosis-importance-of-acid-base-balance
#8
Harald Seeger, Peter Salfeld, Rüdiger Eisel, Carsten A Wagner, Nilufar Mohebbi
Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer from chronic kidney disease (CKD) with an increased risk for adverse pregnancy-related outcomes. Typical complications of dRTA include severe hypokalemia leading to cardiac arrhythmias and paralysis, nephrolithiasis and nephrocalcinosis...
December 22, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27942956/building-on-evidence-to-improve-patient-care
#9
REVIEW
Evelien Snauwaert, Johan VandeWalle, Evi V Nagler, Wim Van Biesen
Evidence-based medicine (EBM) is gaining importance in the current paediatric healthcare landscape. Improvement of paediatric health status is its major aim. However, for EBM to be successful, all stakeholders involved should understand what EBM really is, why and how EBM should or should not be practiced, and have the necessary skills to distinguish methodologically sound papers from biased opinion papers, and understand how and why guidelines are different from systematic reviews. Improving patient outcome requires attention to high-quality evidence and understanding of the processes of medical decision-making...
December 9, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27942955/management-dilemmas-in-pediatric-nephrology-time-limited-trials-of-dialysis-therapy
#10
Aaron Wightman
BACKGROUND: Time-limited trials of dialysis have been proposed as a third option in addition to initiation of treatment and comfort-care only in the setting of high uncertainty or discordance between the treating team and child/family or among the treating team. CASE-DIAGNOSIS/TREATMENT: The index case was noted antenatally to have severe kidney disease and pulmonary hypoplasia. In light of the guarded, but uncertain prognosis and a lack of consensus among the treating team, as well as between the treating team and the family, a time-limited trial of dialysis was initiated...
December 9, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#11
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#12
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27899416/peritoneal-dialysis-access-revision-in-children-causes-interventions-and-outcomes
#13
Dagmara Borzych-Duzalka, T Fazil Aki, Marta Azocar, Colin White, Elizabeth Harvey, Sevgi Mir, Marta Adragna, Erkin Serdaroglu, Rajiv Sinha, Charlotte Samaille, Juan Jose Vanegas, Jameela Kari, Lorena Barbosa, Arvind Bagga, Monica Galanti, Onder Yavascan, Giovanna Leozappa, Maria Szczepanska, Karel Vondrak, Kei-Chiu Tse, Franz Schaefer, Bradley A Warady
BACKGROUND AND OBJECTIVES: Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27871159/-acute-kidney-injury-in-cirrhotic-patients-with-portal-hypertension
#14
REVIEW
So Mi Kim, Il Han Song
Acute kidney injury (AKI) is one of the most common manifestations encountered in clinical practice. It is associated with high morbidity and mortality in cirrhotic pre- and post-transplantation patients. Hepatorenal syndrome (HRS), a special form of AKI in cirrhotic patients, was recognized as a consequence of renal vasoconstriction from systemic/renal hemodynamic alterations developed in advanced cirrhosis with portal hypertension. Recently, multiple factors-such as infection/inflammation, underlying glomerulonephritis, bile cast, or increased abdominal pressure-have been considered to contribute to renal dysfunction in cirrhotic patients, which were presumed to induce HRS...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27751612/nephrology-as-it-was-then-but-is-not-now
#15
Garabed Eknoyan
Diseases of the kidney are old, but the discipline dedicated to their study, nephrology, is barely more than 50 years old. As recounted in this recollection of those events, the rudiments of what would become nephrology emerged in the time between the 2 World Wars from basic studies of normal kidney function and flourished after the integration of their methodologies into clinical medicine thereafter. Although shaped by studies of kidney function in the 1960s, it was the subsequent advent of dialysis that fueled the growth of nephrology well into the 21st century...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27749383/improving-treatment-for-patients-with-chronic-kidney-disease
#16
Kendra Thomsen, Kim Zuber, Jane Davis, Greg Thomas
OBJECTIVE: Kidneys in a Box (KIB) was developed to identify the effect of a performance improvement CME (PI-CME) project on the management of patients with diabetes who are at risk for chronic kidney disease (CKD). The program provided nonnephrology practitioners with research-based interventions known to slow CKD progression. METHODS: PAs were given the KIB tool kit, which described the scope of CKD identified high-risk diagnoses such as diabetes, and listed six modifiable risk factors that have been shown to slow progression of diabetic kidney disease when implemented...
November 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27738765/orphan-drug-policies-and-use-in-pediatric-nephrology
#17
EDITORIAL
Diana Karpman, Peter Höglund
Orphan drugs designed to treat rare diseases are often overpriced per patient. Novel treatments are sometimes even more expensive for patients with ultra-rare diseases, in part due to the limited number of patients. Pharmaceutical companies that develop a patented life-saving drug are in a position to charge a very high price, which, at best, may enable these companies to further develop drugs for use in rare disease. However, is there a limit to how much a life-saving drug should cost annually per patient? Government interventions and regulations may opt to withhold a life-saving drug solely due to its high price and cost-effectiveness...
January 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#18
COMMENT
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
2016: Blood Purification
https://www.readbyqxmd.com/read/27641051/second-vascular-access-after-failure-of-the-first-fistula-in-the-elderly%C3%A2
#19
Tammy Hod, Alexander S Goldfarb-Rumyantzev, Bhanu K Patibandla, Akshita Narra, Robert S Brown
BACKGROUND: In patients with failure of an initial arteriovenous fistula (AVF), a subsequent vascular access is needed before hemodialysis (HD) initiation. METHODS: To assess the optimal access strategy after a failed AVF, we linked data from the US Renal Data System with Medicare claims data identifying 21,436 patients ≥ 67 years old who started HD between January 1, 2005, and December 31, 2008, with an AVF placed as their first predialysis access. Of the 10,568 subjects whose AVF failed, 1,796 patients had an AVF placed as a second access predialysis (AVF2 group) and 399 patients had an arteriovenous graft placed as a second access predialysis (AVG2 group)...
November 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27617144/actualizing-the-benefits-of-genomic-discovery-in-pediatric-nephrology
#20
REVIEW
Matthew G Sampson
The discovery of genetic variation associated with pediatric kidney disease has shed light on the biology underlying these conditions and, in some cases, has improved our clinical management of patients. We are challenged to continue the momentum of the genomic era in pediatric nephrology by identifying novel disease-associated genetic variation and translating these discoveries into clinical applications. This article reviews the diverse forms of genetic architecture that have been found to be associated with kidney diseases and traits...
March 2016: Journal of Pediatric Genetics
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