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https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#1
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#2
S Mas-Font, J Ros-Martinez, C Pérez-Calvo, P Villa-Díaz, S Aldunate-Calvo, E Moreno-Clari
Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition...
February 9, 2017: Medicina Intensiva
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
#3
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/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#4
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28138915/evaluation-of-internet-based-patient-education-materials-from-internal-medicine-subspecialty-organizations-will-patients-understand-them
#5
David R Hansberry, Nitin Agarwal, Elizabeth S John, Ann M John, Prateek Agarwal, James C Reynolds, Stephen R Baker
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine...
January 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28100907/critical-care-nephrology-in-2016-managing-organ-dysfunction-in-critical-care
#6
Ravindra L Mehta
No abstract text is available yet for this article.
January 19, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28034287/the-ignored-role-of-intraoperative-hypotension-in-producing-postoperative-acute-kidney-injury-an-obligatory-appeal-for-more-preventative-nephrology
#7
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Intraoperative hypotension (IOH) invariably follows the induction of general anesthesia. There is this general consensus that IOH is beneficial - less bleeding, less blood transfusions, shorter surgery times - and absent adverse consequences on renal, hepatic and neurological functions. Nevertheless, a critical review of the literature revealed that past research studied younger patients with normal kidney function, short surgery times while excluding patients with advanced CKD and uncontrolled hypertension...
December 29, 2016: Current Hypertension Reviews
https://www.readbyqxmd.com/read/27987543/personalized-comments-on-challenges-and-opportunities-in-kidney-disease-therapeutics-the-glom-next-symposium
#8
EDITORIAL
Anna Greka, Deb Gibson, Peter Mundel, George Demetri, Friedhelm Hildebrandt, Martin Pollak, Jose Florez
In the face of ever-increasing incidence and prevalence of kidney disease worldwide, the unmet need for new treatments is unprecedented. Precision medicine is defined as the use of modern technologies to identify mechanisms of diseases in individual patients, and thus deploy treatment using tailored, targeted approaches, in the hopes of avoiding unnecessary toxicities and complications. Is there a place for kidney disease therapeutics in this space? If so, what is required to make significant progress toward precision nephrology? To answer these critical questions, we present a series of personalized comments corresponding to the responses offered to these very questions during the Inaugural Glom-NExT Symposium held at Harvard Medical School on October 23, 2014, a national meeting focused exclusively on kidney disease therapeutics...
November 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27959707/epidemiology-of-acute-kidney-injury-in-critically-ill-children-and-young-adults
#9
MULTICENTER STUDY
Ahmad Kaddourah, Rajit K Basu, Sean M Bagshaw, Stuart L Goldstein
Background The epidemiologic characteristics of children and young adults with acute kidney injury have been described in single-center and retrospective studies. We conducted a multinational, prospective study involving patients admitted to pediatric intensive care units to define the incremental risk of death and complications associated with severe acute kidney injury. Methods We used the Kidney Disease: Improving Global Outcomes criteria to define acute kidney injury. Severe acute kidney injury was defined as stage 2 or 3 acute kidney injury (plasma creatinine level ≥2 times the baseline level or urine output <0...
5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#10
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27938570/-advances-in-diagnosis-and-treatment-of-acute-kidney-injury-in-patients-with-liver-cirrhosis
#11
J Chen, S H Gao
Since the 21st century, nephrology and emergency and critical care medicine have proposed the concept of acute kidney injury (AKI), and its core lies in early diagnosis and early treatment to improve prognosis. The concept of AKI has also been used in the diagnosis and treatment of kidney injury in patients with liver cirrhosis. AKI is one of the common complications in patients with decompensated liver cirrhosis, and AKI has unique features in patients with liver cirrhosis. AKI greatly affects the prognosis of patients with liver cirrhosis and increases hospitalization rate and medical burden...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27927892/a-concept-wide-association-study-of-clinical-notes-to-discover-new-predictors-of-kidney-failure
#12
Karandeep Singh, Rebecca A Betensky, Adam Wright, Gary C Curhan, David W Bates, Sushrut S Waikar
BACKGROUND AND OBJECTIVES: Identifying predictors of kidney disease progression is critical toward the development of strategies to prevent kidney failure. Clinical notes provide a unique opportunity for big data approaches to identify novel risk factors for disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used natural language processing tools to extract concepts from the preceding year's clinical notes among patients newly referred to a tertiary care center's outpatient nephrology clinics and retrospectively evaluated these concepts as predictors for the subsequent development of ESRD using proportional subdistribution hazards (competing risk) regression...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#13
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
December 7, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#14
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#15
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
#16
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/27900717/intravenous-fluids-balancing-solutions
#17
REVIEW
Ewout J Hoorn
The topic of intravenous (IV) fluids may be regarded as "reverse nephrology", because nephrologists usually treat to remove fluids rather than to infuse them. However, because nephrology is deeply rooted in fluid, electrolyte, and acid-base balance, IV fluids belong in the realm of our specialty. The field of IV fluid therapy is in motion due to the increasing use of balanced crystalloids, partly fueled by the advent of new solutions. This review aims to capture these recent developments by critically evaluating the current evidence base...
November 29, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27900491/treatable-renal-disease-in-children-with-silent-lupus-nephritis-detected-by-baseline-biopsy-association-with-serum-c3-levels
#18
Hiroyuki Wakiguchi, Syuji Takei, Tomohiro Kubota, Akinori Miyazono, Yoshifumi Kawano
Lupus nephritis is identified in up to 75% of patients with juvenile systemic lupus erythematosus and may present with abnormal urinary findings (overt lupus nephritis) or be apparent only upon renal biopsy (silent lupus nephritis). We investigated whether serum complement levels correlate with renal pathology in pediatric patients with silent lupus nephritis. We performed baseline renal biopsy in 45 children diagnosed with juvenile systemic lupus erythematosus who were admitted to Kagoshima University Hospital between January 2000 and June 2015...
February 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/27852607/ion-transport-in-the-zebrafish-kidney-from-a-human-disease-angle-possibilities-considerations-and-future-perspectives
#19
Simone Kersten, Francisco J Arjona
Unique experimental advantages, such as its embryonic/larval transparency, high-throughput nature and ease of genetic modification, underpin the rapid emergence of the zebrafish (Danio rerio) as a preeminent model in biomedical research. Particularly in the field of nephrology, the zebrafish provides a promising model for studying the physiological implications of human solute transport processes along consecutive nephron segments. However, while the zebrafish might be considered a valuable model for numerous renal ion transport diseases and functional studies of many channels and transporters, not all human renal electrolyte transport mechanisms and human diseases can be modeled in the zebrafish...
November 16, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27697956/team-based-learning-in-large-enrollment-classes
#20
REVIEW
Jonathan D Kibble, Christine Bellew, Abdo Asmar, Lisa Barkley
The goal of this review is to highlight the key elements needed to successfully deploy team-based learning (TBL) in any class, but especially in large enrolment classes, where smooth logistics are essential. The text is based on a lecture and workshop given at the American Physiological Society's Institute on Teaching and Learning in Madison, WI, in June 2016. After a short overview of the TBL method, its underpinning in learning theory, and a summary of current evidence for its effectiveness, we present two case studies from our own teaching practices in a new medical school...
December 2016: Advances in Physiology Education
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