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Chronic kidney disease in elderly

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https://www.readbyqxmd.com/read/28721081/insulin-glargine-300-u-ml-for-basal-insulin-therapy-in-type-1-and-type-2-diabetes-mellitus
#1
REVIEW
Ip Tim Lau, Ka Fai Lee, Wing Yee So, Kathryn Tan, Vincent Tok Fai Yeung
OBJECTIVE: To review published clinical studies on the efficacy and safety of new insulin glargine 300 units/mL (Gla-300), a new long-acting insulin analog, for the treatment of type 1 and type 2 diabetes mellitus (T1DM, T2DM). MATERIALS AND METHODS: Data sources comprised primary research articles on Gla-300, including pharmacodynamic, pharmacokinetic, and clinical studies. RESULTS: In pharmacodynamic and pharmacokinetic studies, Gla-300 showed a flatter time-action profile and longer duration of action than Gla-100...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28707259/rhabdomyolysis-and-aki-with-atorvastatin-and-sitagliptin-use-in-the-setting-of-low-25-hydroxyvitamin-d-levels
#2
Rupinder Singh Buttar, Jasveen Batra, Jacqueline Kreimerman, Melissa Aleta, Michal L Melamed
We report a case of an 86-year-old woman admitted to the hospital with rhabdomyolysis and acute kidney injury 3 weeks after starting sitagliptin while on long-term atorvastatin therapy. She also had low levels of 25-hydroxyvitamin D and mild chronic kidney disease, which may have contributed to the development of rhabdomyolysis. A review of the literature reveals four previous reports of this drug interaction in elderly patients, some with underlying kidney disease.
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28699033/low-white-blood-cell-count-is-independently-associated-with-chronic-kidney-disease-progression-in-the-elderly-the-ckd-route-study
#3
Yohei Arai, Eiichiro Kanda, Soichiro Iimori, Shotaro Naito, Yumi Noda, Sei Sasaki, Eisei Sohara, Tomokazu Okado, Tatemitsu Rai, Shinichi Uchida
BACKGROUND: Elevated white blood cell (WBC) count is a well-known predictor of chronic kidney disease (CKD) progression. However, elderly patients commonly fail to develop a high WBC count in response to several diseased states and may instead present a low WBC count. Therefore, we hypothesized that low WBC count, in addition to high WBC count, is associated with CKD progression in the elderly. METHODS: We conducted a prospective cohort study using 3-year follow-up data from the CKD Research of Outcomes in Treatment and Epidemiology study...
July 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28695552/glycaemic-blood-pressure-and-lipid-goal-attainment-and-chronic-kidney-disease-stage-of-type-2-diabetic-patients-treated-in-primary-care-practices
#4
Antonella Corcillo, Edward Pivin, Fabrice Lalubin, Nelly Pitteloud, Michel Burnier, Anne Zanchi
INTRODUCTION: The prevalence of chronic kidney disease and diabetes is rising in Europe. These patients are at high cardiovascular and renal risk and need a challenging multifactorial therapeutic approach. METHOD: The goal of this cross-sectional study was to examine the treatment and attainments of goals related to cardiovascular risk factors within chronic kidney disease stages in type 2 diabetic patients followed up by primary care physicians in Switzerland. Each participating physician entered into a web database the anonymised data of up to 15 consecutive diabetic patients attending her/his office between December 2013 and June 2014...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28695313/elderly-patients-with-chronic-kidney-disease-have-higher-risk-of-hyperparathyroidism
#5
Rosilene M Elias, Rosa M A Moysés
PURPOSE: As the world's population ages, the incidence of chronic kidney disease (CKD) is growing. There is ongoing debate regarding whether high levels of parathyroid hormone (PTH) would be more common in elderly than young patients, and which factors are driven the risk of secondary hyperparathyroidism (SHPT), independent of renal function. METHODS: Elderly patients (age ≥ 65 years, N = 518) were compared to a 1:1 sex- and estimated glomerular filtration rate (eGFR)-matched sample of young patients (age < 65 years), in a cross-sectional analysis...
July 10, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28675267/-antimicrobials-some-practical-considerations
#6
Nadine Ngatchou, Véronique Masserey-Bonvin, Niels Gobin, Luc Barberini
Antibiotics are frequently prescribed in hospitalized and in outpatients. We review four important aspects for their daily prescription. In elderly patients, the prescription should take into account changes in the volume of distribution and the usual decline in renal function even in the absence of chronic kidney disease. Particular antibiotics can trigger infection with Clostridium difficile. We discuss actual and novel strategies for its prevention. Renal toxicity of antibiotics includes acute tubular necrosis, interstitial nephritis and crystals obstructing renal tubule, depending on the class of antibiotics...
September 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28667925/serum-fibroblast-growth-factor-23-concentrations-in-dogs-with-chronic-kidney-disease
#7
Keren E Dittmer, Kalyani C Perera, Peter A Elder
The aim of this study was to determine if serum fibroblast growth factor (FGF23) concentrations were increased in dogs with chronic kidney disease (CKD). Serum samples submitted to a commercial laboratory were collected over a 15-month period, 14 samples were from dogs with a history of polyuria/polydipsia, azotaemia and low urine specific gravity, 20 samples were from non-azotaemic dogs. Serum FGF23, parathyroid hormone, total calcium and phosphorus, urea and creatinine were measured. Mann-Whitney test was used to determine differences between non-azotaemic and CKD groups; a one-way ANOVA with Tukey pairwise comparisons was used to determine any differences between International Renal Interest Society stages; and regression models were used to determine predictors of International Renal Interest Society stage, serum phosphorus and FGF23 concentrations...
June 23, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28659394/pulse-wave-velocity-is-associated-with-cognitive-impairment-in-haemodialysis-patients
#8
Eve Miller-Hodges, Neeraj Dhaun
Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions...
July 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28656517/treatment-of-hyperkalemia-in-heart-failure
#9
REVIEW
Ersilia M DeFilippis, Akshay S Desai
PURPOSE OF REVIEW: The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies. RECENT FINDINGS: Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination...
June 27, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#10
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28617483/epidemiology-of-chronic-kidney-disease-think-at-least-twice
#11
Pierre Delanaye, Richard J Glassock, Marc E De Broe
The introduction of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines has substantially contributed to the early detection of different stages of chronic kidney disease (CKD). Several recent studies from different parts of the world mention a CKD prevalence of between 8 and 13%. There are several reasons the CKD prevalence found in a study of a particular population is clearly overestimated. The structure of the population pyramid (young or older age) of the study sample may result in high or low CKD prevalence...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28615249/reduction-in-podocyte-sirt1-accelerates-kidney-injury-in-aging-mice
#12
Peter Y Chuang, Weijing Cai, Xuezhu Li, Lu Fang, Jin Xu, Rabi Yacoub, John Cijiang He, Kyung Lee
Both the incidence and prevalence of chronic kidney disease are increasing in the elderly population. Although aging is known to induce kidney injury, the underlying molecular mechanisms remain unclear. Sirtuin 1 (Sirt1), a longevity gene, is known to protect kidney cell injury from various cellular stresses. In previous studies, we showed that the podocyte-specific loss of Sirt1 aggravates diabetic kidney injury. However, the role of Sirt1 in aging-induced podocyte injury is not known. Therefore, in this study we sought to determine the effects of podocyte-specific reduction of Sirt1 in age-induced kidney injury...
June 14, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28606408/-common-therapeutic-approaches-of-sarcopenia-in-the-elderly-and-uremic-myopathy
#13
Philippe Chauveau, Karine Moreau, Catherine Lasseur, Christian Combe, Michel Aparicio
The gradual loss of weight and function of muscle in patients with chronic kidney disease as in the elderly impacts the quality of life. Early management should help slow the functional limitation. Physical activity is the first therapy to propose that ensures stability of muscle mass and improved function. Resistance training programs have proven effective but are not yet widely available in nephrology units. The nutritional management should not be forgotten because there is a resistance to anabolism and protein intake should be involved in physical activity program...
June 9, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28585333/prospective-cohort-study-cinacalcet-mediated-lowering-of-pth-level-and-cardiovascular-disease-mortality-in-younger-korean-patients-with-stage-5-ckd-at-a-korean-secondary-hospital
#14
H Y Sin
WHAT IS KNOWN AND OBJECTIVES: Cinacalcet may reduce cardiovascular disease (CVD) mortality in elderly patients with chronic kidney disease (CKD). However, previous studies of the clinical responses to cinacalcet have exhibited discrepancies due to highly variable baseline levels of parathyroid hormone (PTH), kidney function and age. Little is known about the true effect of cinacalcet on stage 5 CKD. The objective of the current observational study was to evaluate whether cinacalcet-mediated lowering of PTH levels improves all-cause mortality and cardiovascular disease mortality in younger stage 5 CKD patients (mean age <55 years)...
June 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28572892/relationship-between-chronic-kidney-disease-and-depression-in-elderly-koreans-using-the-2013-korea-national-health-and-nutrition-examination-survey-data
#15
Ji Woon Kim, Sung Jin Moon, Hyun Ja Kim, Dae Geun Lee
BACKGROUND: Depression is prevalent in patients with chronic kidney disease (CKD) and continues to increase in elderly adults. Therefore, the aim of our study was to examine the relationship between CKD and depression in older patients. METHODS: We conducted a cross-sectional study based on 2013 Korea National Health and Nutrition Examination Survey data. In total, data of 973 subjects aged ≥65 years were analyzed, and the estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation...
May 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/28566584/investigation-into-differences-in-level-of-knowledge-about-hypertension-between-high-school-students-and-elderly-people
#16
Akimasa Sanagawa, Misa Ogasawara, Yuri Kusahara, Miki Yasumoto, Soichiro Iwaki, Satoshi Fujii
 As a major chronic non-communicable disease, hypertension is the most important risk factor for cardiovascular disease, chronic kidney disease, stroke and, if not treated appropriately, premature death. A population-based approach aimed at decreasing high blood pressure among the general population is an important component of any comprehensive plan to prevent hypertension. However, few studies have investigated generational differences in knowledge about, and consciousness of, hypertension. Thus, we conducted a questionnaire survey about hypertension, with the aim of clarifying differences of understanding about hypertension between high school students and elderly people...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28559651/the-2017-focused-update-of-the-guidelines-of-the-taiwan-society-of-cardiology-tsoc-and-the-taiwan-hypertension-society-ths-for-the-management-of-hypertension
#17
REVIEW
Chern-En Chiang, Tzung-Dau Wang, Tsung-Hsien Lin, Hung-I Yeh, Ping-Yen Liu, Hao-Min Cheng, Ting-Hsing Chao, Chen-Huan Chen, Kou-Gi Shyu, Kwo-Chang Ueng, Chung-Yin Chen, Pao-Hsien Chu, Shih-Hsien Sung, Kang-Ling Wang, Yi-Heng Li, Kuo-Yang Wang, Fu-Tien Chiang, Wen-Ter Lai, Jyh-Hong Chen, Wen-Jone Chen, San-Jou Yeh, Ming-Fong Chen, Shing-Jong Lin, Jiunn-Lee Lin
Hypertension (HT) is the most important risk factor for cardiovascular diseases. Over the past 25 years, the number of individuals with hypertension and the estimated associated deaths has increased substantially. There have been great debates in the past few years on the blood pressure (BP) targets. The 2013 European Society of Hypertension and European Society of Cardiology HT guidelines suggested a unified systolic BP target of 140 mmHg for both high-risk and low-risk patients. The 2014 Joint National Committee report further raised the systolic BP targets to 150 mmHg for those aged ≥ 60 years, including patients with stroke or coronary heart disease, and raised the systolic BP target to 140 mmHg for diabetes...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28558717/timing-of-commencement-of-maintenance-dialysis-and-mortality-in-young-and-older-adults-in-singapore
#18
Liang Feng, Ai Zhen Jin, John Carson Allen, Khuan Yew Chow, Tazeen Hasan Jafar
BACKGROUND: The benefit of early dialysis initiation remains controversial with a paucity of data in Asians. Therefore, we undertook this study to investigate the association between timing of initiation of dialysis and mortality in Singapore. METHODS: The study used data from the Singapore Renal Registry database on 3286 patients with incident end-stage renal disease (ESRD) who commenced maintenance dialysis between January 2008 and December 2011. The data was further linked with the National Death Registry to acquire survival information until December 2013...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28549536/non-gfr-determinants-of-low-molecular-weight-serum-protein-filtration-markers-in-the-elderly-ages-kidney-and-mesa-kidney
#19
Meredith C Foster, Andrew S Levey, Lesley A Inker, Tariq Shafi, Li Fan, Vilmundur Gudnason, Ronit Katz, Gary F Mitchell, Aghogho Okparavero, Runolfur Palsson, Wendy S Post, Michael G Shlipak
BACKGROUND: Studies in chronic kidney disease populations suggest that the non-glomerular filtration rate (GFR) determinants of serum levels of the low-molecular-weight protein filtration markers cystatin C, β2-microglobulin (B2M), and beta-trace protein (BTP) are less affected by age, sex, and ethnicity than those of creatinine. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: Predominantly elderly participants selected from the Age, Gene/Environment Susceptibility Kidney Study (AGES-Kidney; N=683; mean [SD] age, 79 [4] years; GFR, 62 [17]mL/min/1...
May 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#20
Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Takamasa Sato, Satoshi Suzuki, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
AIM: To investigate the clinical features of heart failure in extremely elderly patients. METHODS: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075). RESULTS: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group...
May 21, 2017: Geriatrics & Gerontology International
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