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Diabetic nephrology

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https://www.readbyqxmd.com/read/28087255/unknown-face-of-known-drugs-what-else-can-we-expect-from-angiotensin-converting-enzyme-inhibitors
#1
REVIEW
Anna Wzgarda, Robert Kleszcz, Monika Prokop, Katarzyna Regulska, Milosz Regulski, Jaroslaw Paluszczak, Beata J Stanisz
The renin-angiotensin system (RAS) is one of important systems among homeostatic mechanisms that controls the function of cardiovascular, renal and adrenal systems. As RAS has a very complex nature, it has been also found as related to the control of cell migration and apoptosis. Angiotensin-converting enzyme inhibitors (ACEI) are drugs most commonly used in the modulation of RAS activity. ACEI have been extensively described as effective in the treatment of hypertension among adults, but also as drugs delaying progression in diabetic nephropathy and reducing mortality in left ventricular dysfunction and congestive heart failure...
January 10, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28077371/markers-of-endothelial-damage-in-patients-with-chronic-kidney-disease-on-hemodialysis
#2
Andrés Carmona, Maria Luisa Agüera, Carlos Luna Ruiz, Paula Buendia, Laura Calleros, Andrea Garcia-Jerez, Manuel Rodríguez-Puyol, Manuel Arias, Marta Arias-Guillen, Gabriel de Arriba, Jose Ballarin, Carmen Bernis, Elvira Fernandez, Sagrario Garcia-Rebollo, Javier Mancha, Gloria Del Peso, Estefania Perez, Esteban Poch, Jose M Portoles, Diego Rodriguez-Puyol, Rafael Sánchez-Villanueva, Felipe Sarro, Armando Torres, Alejandro Martin-Malo, Pedro Aljama, Rafael Ramirez, Julia Carracedo
Patients with stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (REDinREN, Madrid): 80 patients with diabetes mellitus (DM) and 80 patients without DM who were matched for clinical and demographic criteria...
January 11, 2017: American Journal of Physiology. Renal Physiology
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
#3
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/28028051/predicting-5-year-risk-of-rrt-in-stage-3-or-4-ckd-development-and-external-validation
#4
Emily B Schroeder, Xiuhai Yang, Micah L Thorp, Brent M Arnold, David C Tabano, Amanda F Petrik, David H Smith, Robert W Platt, Eric S Johnson
BACKGROUND AND OBJECTIVES: Only a minority of patients with CKD progress to renal failure. Despite the potential benefits of risk stratification in the CKD population, risk prediction models are not routinely used. Our objective was to develop and externally validate a clinically useful and pragmatic prediction model for the 5-year risk of progression to RRT in stage 3 or 4 CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used a retrospective cohort design...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27957414/current-characteristics-of-dialysis-therapy-in-korea-2015-registry-data-focusing-on-elderly-patients
#5
REVIEW
Dong-Chan Jin, Sung-Ro Yun, Seoung Woo Lee, Sang-Woong Han, Won Kim, Jongha Park
Because of increases in the elderly population and diabetic patients, the proportion of elderly among dialysis patients has rapidly increased during the last decades. The mortality and morbidity of these elderly dialysis patients are obviously much higher than those of young patients, but large analytic studies about elderly dialysis patients' characteristics have rarely been published. The registry committee of the Korean Society of Nephrology has collected data about dialysis therapy in Korea through an Internet online registry program and analyzed the characteristics...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27957413/diagnosis-and-treatment-of-patients-with-iga-nephropathy-in-japan
#6
REVIEW
Yasuhiko Tomino
Chronic kidney disease (CKD) is a worldwide public health problem that affects millions of people from all racial and ethnic groups. Although CKD is not one specific disease, it is a comprehensive syndrome that includes IgA nephropathy. As reported by the Japanese Society of Nephrology, 13.0 million people have CKD. In Japan, major causes of end-stage kidney disease are type 2 diabetic nephropathy, chronic glomerulonephritis, especially IgA nephropathy, hypertensive nephrosclerosis, and polycystic kidney disease...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27900966/infective-endocarditis-in-chronic-hemodialysis-a-transition-from-left-heart-to-right-heart
#7
Y Bentata, I Haddiya, N Ismailli, N El Ouafi, A Benzirar, O El Mahi, A Azzouzi
Infective endocarditis (IE) of the left heart is the most frequent type of IE in chronic hemodialysis (CHD) (in 90% of cases) whereas involvement of the right heart is rare. The aim of this study was to determine the clinical, biological, and echocardiographic characteristics, as well as the prognosis of IE in CHD. This is a retrospective study conducted at the Center of Nephrology and Hemodialysis in Oujda, Morocco. Over a period of 56 months, we compiled data on a series of 11 CHD patients with IE. Their mean age was 40...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27853039/pharmacoeconomic-evaluation-of-diabetic-nephropathic-patients-attending-nephrology-department-in-a-tertiary-care-hospital
#8
J V Jose, M Jose, P Devi, R Satish
AIMS: To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital. MATERIALS AND METHODS: A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February-July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost...
November 16, 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27795790/-profile-of-diabetic-nephropathy-at-the-national-reference-general-hospital-of-n-djamena-chad
#9
Ibrahim Hamat, Guillaume Mahamat Abderraman, Mouhamadou Moustapha Cisse, Mahamat Youssouf, Matar Saboune Djafar, Dionadji Mbainguinam, Tara Fotclossou
INTRODUCTION: Diabetes mellitus is a real health problem and its complications affect many organs including the kidneys. Early diagnosis of diabetic nephropathy allows to treat patients more effectively and with a multidisciplinary approach, to slow its progression in chronic renal failure. Few studies have been conducted in Africa in this field of study. In Chad, we have no statistics on renal disease related to diabetes. That is why we propose to study diabetic nephropathy with the aim of analyzing the profile of diabetic nephropathy in patients at the National Reference General Hospital of N'Djamena (CHAD)...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27781388/the-dialysis-outcomes-and-practice-patterns-study-dopps-in-turkey
#10
Tevfik Ecder, Cengiz Utas, Kenan Ates, Brian Bieber, Bruce M Robinson, Ronald L Pisoni, Gültekin Süleymanlar
Introduction Turkey has one of the largest treated end-stage renal disease (ESRD) patient populations in Europe (N = 66,711). In 2013, the international Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective study of hemodialysis (HD) practices and outcomes, initiated data collection in Turkey. Here we provide comparisons of HD patients in DOPPS-Turkey with other international regions and with patients in the Registry of Turkish Nephrology, Dialysis and Transplantation. Methods DOPPS-Turkey study sites were randomly selected from all Turkish HD units treating ≥25 in-center chronic HD patients...
October 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27749383/improving-treatment-for-patients-with-chronic-kidney-disease
#11
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/27747728/colchicine-induced-acute-neuromyopathy-in-a-patient-using-concomitant-fluconazole-case-report-and-literature-review
#12
Yi-Chia Su, Chih-Chien Wu
A 54-year-old woman presented at the emergency department after experiencing lower limb weakness and bilateral ankle pain for 2 days. She had a history of type 2 diabetes mellitus, diabetes mellitus nephropathy with chronic kidney disease, and chronic gouty arthritis. She had received 0.6 mg colchicine orally once or twice daily for 8 months. Four days prior to her emergency department visit, she was discharged from our nephrology ward, where she had been admitted because of a urinary tract infection. During hospitalization, she was treated with intravenous cefazolin for 7 days...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27742277/kidney-transplantation-at-a-southern-brazilian-university-hospital-a-35-year-practice-review
#13
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O d'Avila, C E Poli-de-Figueiredo
BACKGROUND: The Nephrology Unit at São Lucas Hospital, a University Hospital in Southern Brazil, has recently reached 35 years since its first kidney transplant. Few centers in the area have made a longitudinal analysis of processes, problems, grafts, and patient survival changes along this time. METHODS: A single-center, retrospective study was performed. Data were separated into different eras, based on the nature of immunosuppression used: pre-cyclosporine (1978-1986), cyclosporine (1987-1997), mycophenolate introduction (1998-2002), new immunosuppressant drugs (2003-2007), and the current period (2008-2013)...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27738231/prevalence-and-recognition-of-chronic-kidney-disease-in-stockholm-healthcare
#14
Alessandro Gasparini, Marie Evans, Josef Coresh, Morgan E Grams, Olof Norin, Abdul R Qureshi, Björn Runesson, Peter Barany, Johan Ärnlöv, Tomas Jernberg, Björn Wettermark, Carl G Elinder, Juan-Jesüs Carrero
BACKGROUND: Chronic kidney disease (CKD) is common, but the frequency of albuminuria testing and referral to nephrology care has been difficult to measure. We here characterize CKD prevalence and recognition in a complete healthcare utilization cohort of the Stockholm region, in Sweden. METHODS: We included all adult individuals (n = 1 128 058) with at least one outpatient measurement of IDMS-calibrated serum creatinine during 2006-11. Estimated glomerular filtration rate (eGFR) was calculated via the CKD-EPI equation and CKD was solely defined as eGFR <60 mL/min/1...
December 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27692817/an-overview-of-renal-metabolomics
#15
REVIEW
Sahir Kalim, Eugene P Rhee
The high-throughput, high-resolution phenotyping enabled by metabolomics has been applied increasingly to a variety of questions in nephrology research. This article provides an overview of current metabolomics methodologies and nomenclature, citing specific considerations in sample preparation, metabolite measurement, and data analysis that investigators should understand when examining the literature or designing a study. Furthermore, we review several notable findings that have emerged in the literature that both highlight some of the limitations of current profiling approaches, as well as outline specific strengths unique to metabolomics...
January 2017: Kidney International
https://www.readbyqxmd.com/read/27673681/acute-kidney-injury-treated-with-dialysis-outside-the-intensive-care-unit-a-retrospective-observational-single-center-study
#16
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27643796/should-we-still-believe-in-randomized-controlled-trials-in-nephrology
#17
Monica Cortinovis, Norberto Perico, Giuseppe Remuzzi
The randomized controlled trial (RCT) is the cornerstone upon which clinical decision-making is based. Pivotal RCTs in the nephrology area efficiently demonstrated the renoprotective effects of treatment with renin-angiotensin system inhibitors in patients with diabetic and non-diabetic proteinuric nephropathies. However, there is concern about the increasing cost, complexity and duration of clinical studies. Moreover, recent large RCTs addressing key issues for patients with renal disease failed to achieve definitive conclusions mainly due to critical flaws in the investigational strategies, including the adoption of excessive/fixed doses of the study medications, inappropriate use of the placebo-controlled design, enrollment of low-risk individuals, poor reporting of adverse events or unreliable evaluation of renal function...
September 20, 2016: Nephron
https://www.readbyqxmd.com/read/27642455/-renal-dimensions-in-the-nephrology-department-of-befelatanana-hospital-antananarivo
#18
Benja Ramilitiana, Mihary Dodo, Henintsoa Nirina Rakotoarimanga, Rado Lalao Randriamboavonjy, Willy Franck Randriamarotia
The knowledge of normale renal sizes specific for each individual and for any ethnicity, allows diagnostic and therapeutic medical decision. For a low-income country such as Madagascar, ultrasound is an ideal tool for this purpose. This study aims to collect data on renal dimensions and to seek the correlation between these data and the demographic and anthropometric parameters in Malagasies. This is a retrospective study of 200 non-diabetic patients without chronic kidney disease, spanning 3 years, conducted in the Nephrology Department of Befelatanana Hospital, Antananarivo...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27628103/significance-of-frailty-for-predicting-adverse-clinical-outcomes-in-different-patient-groups-with-specific-medical-conditions
#19
Martin Ritt, Karl-Günter Gaßmann, Cornel Christian Sieber
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27598963/-prof-giuseppe-moscati-1880-1927-a-special-issue-on-his-scientific-production
#20
Marco Cascella
Professor Giuseppe Moscati (1880-1927) was canonized by the Catholic Church in 1987. This act recognized the extraordinary qualities of a doctor who, considering his work as a "sublime mission", dedicated his life to helping the sick. The fame of the "Holy doctor" or "doctor of the poor", as people called him, was soon widespread and, immediately after his death, made him the subject of several biographies. These treatises, mainly written by religious hagiographers, have little analyzed Moscati as a doctor and scientist, or, in rare cases, privileged the description of his medical career, touching only marginally salient aspects of his work as a scientist and researcher...
August 2016: Acta Medico-historica Adriatica: AMHA
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