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Interventional nephrology

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https://www.readbyqxmd.com/read/28923834/is-chronic-dialysis-the-right-hard-renal-end-point-to-evaluate-renoprotective-drug-effects
#1
Misghina Weldegiorgis, Dick de Zeeuw, Jamie P Dwyer, Peter Mol, Hiddo J L Heerspink
BACKGROUND AND OBJECTIVES: RRT and doubling of serum creatinine are considered the objective hard end points in nephrology intervention trials. Because both are assumed to reflect changes in the filtration capacity of the kidney, drug effects, if present, are attributed to kidney protection. However, decisions to start RRT are not only on the basis of filtration capacity of the kidney, but also on other factors. We therefore compared the time to RRT with the time to a fixed eGFR threshold and assessed the effect of the renoprotective drug irbesartan on both components...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28915657/the-prevalence-subtypes-and-associated-factors-of-hyperuricemia-in-lupus-nephritis-patients-at-chronic-kidney-disease-stages-1-3
#2
Simeng Liu, Yijun Gong, Hong Ren, Wen Zhang, Xiaonong Chen, Tong Zhou, Xiao Li, Nan Chen
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28875593/implementing-an-evidence-based-clinical-decision-support-tool-to-improve-the-detection-evaluation-and-referral-patterns-of-adult-chronic-kidney-disease-patients-in-primary-care
#3
Mary E Regan
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) is undertreated and under-recognized in primary care. The majority of primary care providers (PCPs) are not aware or knowledgeable of current CKD guidelines. The purpose of this project was to develop a quality improvement intervention for PCPs through the delivery of evidence-based guidelines at the point of care. METHODS: An evidence-based clinical algorithm was developed in the electronic medical record for providers to access within one organization comprising 11 primary care offices with 80 PCPs...
September 6, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28862724/abstracts-from-the-american-society-of-diagnostic-and-interventional-nephrology-13th-annual-scientific-meeting
#4
(no author information available yet)
Abstracts from the American Society of Diagnostic and Interventional Nephrology 13th Annual Scientific Meeting, 10-12 February 2017, New Orleans, USA.
August 31, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28834903/the-cost-saving-effect-and-prevention-of-medication-errors-by-clinical-pharmacist-intervention-in-a-nephrology-unit
#5
Chia-Chi Chen, Fei-Yuan Hsiao, Li-Jiuan Shen, Chien-Chih Wu
Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833793/impact-of-simulation-based-learning-on-immediate-outcomes-of-temporary-haemodialysis-catheter-placements-by-nephrology-fellows
#6
Ru Yu Tan, Kian Guan Lee, Sheryl Wen Shien Gan, Huihua Li, Wenxiang Yeon, Suh Chien Pang, Swee Ping Teh, Htay Htay, Su Hooi Teo, Jia Liang Kwek, Pei Loo Tok, Cheng Boon Poh, Chee Yong Ng, Peiyun Liu, Hui Boon Tay, Riece Koniman, Marjorie Wai Yin Foo, Lina Hui Lin Choong, Chieh Suai Tan
AIM: Traditional apprenticeship model (AM) of teaching in invasive procedures such as temporary haemodialysis catheter (THDC) insertion can result in propagation of errors and complications. Simulation-based learning (SBL) offers standardization of skills and allows trainees to repeatedly practice invasive procedures prior to performing them on actual patient. METHODS: Retrospective cohort study of first-, second- and third-year Nephrology Fellows from a tertiary teaching hospital from September 2008 to September 2015...
August 18, 2017: Nephrology
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#7
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28770395/interventional-nephrology-current-status-and-clinical-impact-in-japan
#8
Masato Ikeda, Hiroyuki Terawaki, Eiichiro Kanda, Maiko Furuya, Yudo Tanno, Masatsugu Nakao, Yukio Maruyama, Masutaka Maeda, Chieko Higuchi, Tsutomu Sakurada, Tomohiro Kaneko, Hiroaki Io, Koji Hashimoto, Atsushi Ueda, Keita Hirano, Naoki Washida, Hiraku Yoshida, Kazuhiro Yoshikawa, Yoshihiro Taniyama, Kenji Harada, Nanae Matsuo, Ichiro Okido, Takashi Yokoo
BACKGROUND: Current status and clinical significance of interventional nephrology has not been reported from Japan. METHODS: Questionnaires were mailed twice to the directors of all 534 Japanese certificated nephrology training institutions in 2014. The main questions were current performance, categorized annual procedure volume and managers of peritoneal dialysis (PD) access, vascular access (VA) surgery, endovascular intervention, and kidney biopsy. Frequencies of nephrologist involvement between high volume center and low volume center and association between the level of nephrologists' involvement to each procedure and annual procedure volume were examined...
August 2, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28765167/standardized-outcomes-in-nephrology-peritoneal-dialysis-song-pd-study-protocol-for-establishing-a-core-outcome-set-in-pd
#9
Karine E Manera, Allison Tong, Jonathan C Craig, Edwina A Brown, Gillian Brunier, Jie Dong, Tony Dunning, Rajnish Mehrotra, Sarala Naicker, Roberto Pecoits-Filho, Jeffrey Perl, Angela Y Wang, Martin Wilkie, Martin Howell, Benedicte Sautenet, Nicole Evangelidis, Jenny I Shen, David W Johnson
BACKGROUND: Worldwide, approximately 11% of patients on dialysis receive peritoneal dialysis (PD). Whilst PD may offer more autonomy to patients compared with hemodialysis, patient and caregiver burnout, technique failure, and peritonitis remain major challenges to the success of PD. Improvements in care and outcomes are likely to be mediated by randomized trials of innovative therapies, but will be limited if the outcomes measured and reported are not important for patients and clinicians...
August 1, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28760487/complications-of-therapeutic-apheresis-in-pediatric-kidney-transplantation
#10
REVIEW
Mattia Parolin, Enrico Vidal
In the setting of kidney transplantation, therapeutic apheresis (TA) is employed both for pre-intervention procedures and during the post-transplant period. In pediatric nephrology units, TA is usually performed as a therapeutic plasma exchange (TPE) with dialysis equipment, and using non-plasma replacement fluids. In children undergoing kidney transplantation, complications of TPE are mainly related to its depletive properties combined with the iatrogenic immunodeficiency status of the patient. Moreover, the use of small central venous catheters and the equipment standardized for adults can increase the risk of adverse events...
July 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28737661/toward-establishing-core-outcome-domains-for-trials-in-kidney-transplantation-report-of-the-standardized-outcomes-in-nephrology-kidney-transplantation-consensus-workshops
#11
MULTICENTER STUDY
Allison Tong, John Gill, Klemens Budde, Lorna Marson, Peter P Reese, David Rosenbloom, Lionel Rostaing, Germaine Wong, Michelle A Josephson, Timothy L Pruett, Anthony N Warrens, Jonathan C Craig, Benedicte Sautenet, Nicole Evangelidis, Angelique F Ralph, Camilla S Hanson, Jenny I Shen, Kirsten Howard, Klemens Meyer, Ronald D Perrone, Daniel E Weiner, Samuel Fung, Maggie K M Ma, Caren Rose, Jessica Ryan, Ling-Xin Chen, Martin Howell, Nicholas Larkins, Siah Kim, Sobhana Thangaraju, Angela Ju, Jeremy R Chapman
BACKGROUND: Treatment decisions in kidney transplantation requires patients and clinicians to weigh the benefits and harms of a broad range of medical and surgical interventions, but the heterogeneity and lack of patient-relevant outcomes across trials in transplantation makes these trade-offs uncertain, thus, the need for a core outcome set that reflects stakeholder priorities. METHODS: We convened 2 international Standardized Outcomes in Nephrology-Kidney Transplantation stakeholder consensus workshops in Boston (17 patients/caregivers; 52 health professionals) and Hong Kong (10 patients/caregivers; 45 health professionals)...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28729383/definitions-and-end-points-for-interventional-studies-for-arteriovenous-dialysis-access
#12
Gerald A Beathard, Charmaine E Lok, Marc H Glickman, Ahmed A Al-Jaishi, Donna Bednarski, David L Cull, Jeffery H Lawson, Timmy C Lee, Vandana D Niyyar, Donna Syracuse, Scott O Trerotola, Prabir Roy-Chaudhury, Surendra Shenoy, Margo Underwood, Haimanot Wasse, Karen Woo, Theodore H Yuo, Thomas S Huber
This paper is part of the Clinical Trial Endpoints for Dialysis Vascular Access Project of the American Society of Nephrology Kidney Health Initiative. The purpose of this project is to promote research in vascular access by clarifying trial end points which would be best suited to inform decisions in those situations in which supportive clinical data are required. The focus of a portion of the project is directed toward arteriovenous access. There is a potential for interventional studies to be directed toward any of the events that may be associated with an arteriovenous access' evolution throughout its life cycle, which has been divided into five distinct phases...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28711905/the-prevalence-subtypes-and-associated-factors-of-hyperuricemia-in-lupus-nephritis-patients-at-chronic-kidney-disease-stages-1-3
#13
Simeng Liu, Yijun Gong, Hong Ren, Wen Zhang, Xiaonong Chen, Tong Zhou, Xiao Li, Nan Chen
There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there's a dearth of research on HUA's prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28709600/challenges-in-conducting-clinical-trials-in-nephrology-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#14
Colin Baigent, William G Herrington, Josef Coresh, Martin J Landray, Adeera Levin, Vlado Perkovic, Marc A Pfeffer, Peter Rossing, Michael Walsh, Christoph Wanner, David C Wheeler, Wolfgang C Winkelmayer, John J V McMurray
Despite the high costs of treatment of people with kidney disease and associated comorbid conditions, the amount of reliable information available to guide the care of such patients is very limited. Some treatments have been assessed in randomized trials, but most such trials have been too small to detect treatment effects of a magnitude that would be realistic to achieve with a single intervention. Therefore, KDIGO convened an international, multidisciplinary controversies conference titled "Challenges in the Conduct of Clinical Trials in Nephrology" to identify the key barriers to conducting trials in patients with kidney disease...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#15
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28689231/barriers-to-exercise-for-patients-with-renal-disease-an-integrative-review
#16
REVIEW
Mary Hannan, Ulf G Bronas
Renal disease is a common health condition that leads to loss of physical function, frailty, and premature loss of independence in addition to other severe comorbidities and increased mortality. Increased levels of physical activity and initiation of exercise training is recommended in the current guidelines for all patients with renal disease, but participation and adherence rates are low. The barriers to exercise and physical activity in patients with renal disease are not well defined and currently based on patient provider perception and opinion...
July 8, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28685173/health-related-quality-of-life-of-children-with-pre-dialysis-chronic-kidney-disease
#17
Hee Sun Baek, Hee Gyung Kang, Hyun Jin Choi, Hae Il Cheong, Il Soo Ha, Kyung Hee Han, Seong Heon Kim, Hee Yeon Cho, Jae Il Shin, Young Seo Park, Joo Hoon Lee, Joongyub Lee, Curie Ahn, Min Hyun Cho
BACKGROUND: The goal of this study was to evaluate the quality of life (QOL) of Asian children with pre-dialysis chronic kidney disease (CKD) and to reveal the factors influencing the QOL of children with CKD. METHODS: We performed a cross-sectional study of the PedsQL 4.0 Generic Core Scale Module in the KNOW-PedCKD (KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease) cohort, and compared the child self-reported and parent proxy-reported QOL of the pediatric cohort...
July 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28680825/the-feasibility-of-surgical-salvage-of-thrombosed-arteriovenous-fistula-by-an-interventional-nephrologist
#18
Seong Cho
BACKGROUND: Salvage of a thrombosed arteriovenous fistula (AVF) by secondary fistula conversion may be more effective than a conventional endovascular procedure for forearm fistula thrombosis. Surgical access procedures are an undeveloped area in interventional nephrology compared to endovascular procedures. Herein, the author report the results of surgical salvage of thrombosed AVFs by interventional nephrologists. METHODS: The author retrospectively analyzed 52 surgical salvage procedures for AVF thrombosis (radiocephalic fistula = 44 cases, brachiocephalic fistula = 8 cases) that were performed by interventional nephrologist between March 2007 and January 2016...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28676642/label-free-detection-of-sensitive-mid-infrared-biomarkers-of-glomerulonephritis-in-urine-using-fourier-transform-infrared-spectroscopy
#19
Mei-Ching Yu, Peter Rich, Liberty Foreman, Jennifer Smith, Mei-Shiuan Yu, Anisha Tanna, Vinod Dibbur, Robert Unwin, Frederick W K Tam
More reliable biomarkers using near-patient technologies are needed to improve early diagnosis and intervention for patients with renal disease. Infrared (IR) vibrational spectroscopy/microspectroscopy is an established analytical method that was first used in biomedical research over 20 years ago. With the advances in instrumentation, computational and mathematical techniques, this technology has now been applied to a variety of diseases; however, applications in nephrology are just beginning to emerge. In the present study, we used attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy to analyze urine samples collected from rodent models of inflammatory glomerulonephritis (GN) as well as from patients with crescentic GN, with the aim of identifying potential renal biomarkers; several characteristic mid-IR spectral markers were identified in urine samples...
July 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28643107/-microscopic-hematuria-reasonable-and-risk-adapted-diagnostic-evaluation
#20
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
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