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nature reviews nephrology

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
Julius Okel, Ike G Okpechi, Bilal Qarni, Timothy Olanrewaju, Mark J Courtney, Valerie Luyckx, Sarala Naicker, Aminu K Bello
An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care...
July 29, 2016: Clinical Nephrology
John F Bertram, Stuart L Goldstein, Lars Pape, Franz Schaefer, Rukshana C Shroff, Bradley A Warady
To mark World Kidney Day 2016, Nature Reviews Nephrology invited six leading researchers to highlight the key advances and challenges within their specialist field of paediatric nephrology. Here, advances and remaining challenges in the fields of prenatal patterning, acute kidney injury, renal transplantation, genetics, cardiovascular health, and growth and nutrition, are all discussed within the context of paediatric and neonatal patients with kidney disease. Our global panel of researchers describe areas in which further studies and clinical advances are needed, and suggest ways in which research in these areas should progress to optimize renal care and long-term outcomes for affected patients...
March 2016: Nature Reviews. Nephrology
Krithika Hariharan, Andreas Kurtz, Kai M Schmidt-Ott
The field of regenerative medicine has witnessed significant advances that can pave the way to creating de novo organs. Organoids of brain, heart, intestine, liver, lung and also kidney have been developed by directed differentiation of pluripotent stem cells. While the success in producing tissue-specific units and organoids has been remarkable, the maintenance of an aggregation of such units in vitro is still a major challenge. While cell cultures are maintained by diffusion of oxygen and nutrients, three- dimensional in vitro organoids are generally limited in lifespan, size, and maturation due to the lack of a vascular system...
2015: Frontiers in Cell and Developmental Biology
Simona Granata, Alessandra Dalla Gassa, Paola Tomei, Antonio Lupo, Gianluigi Zaza
Cellular metabolic changes during chronic kidney disease (CKD) may induce higher production of oxygen radicals that play a significant role in the progression of renal damage and in the onset of important comorbidities. This condition seems to be in part related to dysfunctional mitochondria that cause an increased electron "leakage" from the respiratory chain during oxidative phosphorylation with a consequent generation of reactive oxygen species (ROS). ROS are highly active molecules that may oxidize proteins, lipids and nucleic acids with a consequent damage of cells and tissues...
2015: Nutrition & Metabolism
Li Yang, Guolan Xing, Li Wang, Yonggui Wu, Suhua Li, Gang Xu, Qiang He, Jianghua Chen, Menghua Chen, Xiaohua Liu, Zaizhi Zhu, Lin Yang, Xiyan Lian, Feng Ding, Yun Li, Huamin Wang, Jianqin Wang, Rong Wang, Changlin Mei, Jixian Xu, Rongshan Li, Juan Cao, Liang Zhang, Yan Wang, Jinhua Xu, Beiyan Bao, Bicheng Liu, Hongyu Chen, Shaomei Li, Yan Zha, Qiong Luo, Dongcheng Chen, Yulan Shen, Yunhua Liao, Zhengrong Zhang, Xianqiu Wang, Kun Zhang, Luojin Liu, Peiju Mao, Chunxiang Guo, Jiangang Li, Zhenfu Wang, Shoujun Bai, Shuangjie Shi, Yafang Wang, Jinwei Wang, Zhangsuo Liu, Fang Wang, Dandan Huang, Shun Wang, Shuwang Ge, Quanquan Shen, Ping Zhang, Lihua Wu, Miao Pan, Xiting Zou, Ping Zhu, Jintao Zhao, Minjie Zhou, Lin Yang, Wenping Hu, Jing Wang, Bing Liu, Tong Zhang, Jianxin Han, Tao Wen, Minghui Zhao, Haiyan Wang
BACKGROUND: Acute kidney injury (AKI) has become a worldwide public health problem, but little information is available about the disease burden in China. We aimed to evaluate the burden of AKI and assess the availability of diagnosis and treatment in China. METHODS: We launched a nationwide, cross-sectional survey of adult patients who were admitted to hospital in 2013 in academic or local hospitals from 22 provinces in mainland China. Patients with suspected AKI were screened out on the basis of changes in serum creatinine by the Laboratory Information System, and we reviewed medical records for 2 months (January and July) to confirm diagnoses...
October 10, 2015: Lancet
Jürgen Floege, Robert H Mak, Bruce A Molitoris, Giuseppe Remuzzi, Pierre Ronco
Important advances have been made in basic and clinical nephrology research over the past decade, with improved pathological insights into various disease processes and the introduction of new treatments for diseases such as atypical haemolytic uraemic syndrome. However, many challenges remain. In this Viewpoint, we asked five Nature Reviews Nephrology Advisory Board members, who have been associated with the journal since its launch in November 2005, to reflect on the progress and roadblocks of the past 10 years...
November 2015: Nature Reviews. Nephrology
Peter Trnka, Megan M White, William D Renton, Steven J McTaggart, John R Burke, Anthony C Smith
BACKGROUND: Telemedicine has emerged as an alternative mode of health care delivery over the last decade. To date, there is very limited published information in the field of telehealth and paediatric nephrology. The aim of this study was to review our experience with paediatric telenephrology in Queensland, Australia. METHODS: A retrospective audit of paediatric nephrology telehealth consultations to determine the nature of the telehealth activity, reasons for referral to telehealth, and to compare costs and potential savings of the telehealth service...
2015: BMC Nephrology
Chandani Upadhyay, Karen Cameron, Laura Murphy, Marisa Battistella
BACKGROUND: Patients undergoing hemodialysis frequently report pain with multifactorial causes, not limited to that experienced directly from hemodialysis treatment. Their pain may be nociceptive, neuropathic, somatic or visceral in nature. Despite this, pain in this population remains under-recognized and under-treated. Although several tools have been used to measure pain in patients undergoing hemodialysis as reported in the literature, none of them have been validated specifically in this population...
August 2014: Clinical Kidney Journal
Ikechi G Okpechi, Charles R Swanepoel, Francois Venter
Access to essential medications is limited in many low-to-middle income countries (LMICs) and those that are available may be prohibitively expensive to the general population. Clinical trials have been suggested as an approach to improve drug access in LMICs but the number of trials conducted in these countries is small because of regulatory issues and a lack of infrastructure. In this article, Nature Reviews Nephrology asks three experts their opinions on how to improve drug access and increase the numbers of clinical trials conducted in LMICs...
March 2015: Nature Reviews. Nephrology
John W M Agar
The US Environmental Protection Agency Resource Conservation website begins: "Natural resource and energy conservation is achieved by managing materials more efficiently--reduce, reuse, recycle," yet healthcare agencies have been slow to heed and practice this simple message. In dialysis practice, notable for a recurrent, per capita resource consumption and waste generation profile second to none in healthcare, efforts to: (1) minimize water use and wastage; (2) consider strategies to reduce power consumption and/or use alternative power options; (3) develop optimal waste management and reusable material recycling programs; (4) design smart buildings that work with and for their environment; (5) establish research programs that explore environmental practice; all have been largely ignored by mainstream nephrology...
March 2015: Seminars in Dialysis
Jeonghwan Lee, Jung Pyo Lee, Ji In Park, Jin Ho Hwang, Hye Min Jang, Ji-Young Choi, Yong-Lim Kim, Chul Woo Yang, Shin-Wook Kang, Nam-Ho Kim, Yon Su Kim, Chun Soo Lim
BACKGROUND: The nature of cost-saving effects of early referral to a nephrologist in patients with chronic kidney disease (CKD) is not fully evaluated. We evaluated the health care costs before and after dialysis according to the referral time. METHODS: A total of 879 patients who were newly diagnosed as having end-stage renal disease from August 2008 to June 2011 were prospectively enrolled. The early referral (ER) group was defined as patients who were referred to a nephrologist more than a year before dialysis and had visited a nephrology clinic 2 or more times...
2014: PloS One
G I McGil Ugwu, G Nwajei, U Chinemelu
INTRODUCTION: Childhood renal diseases are increasing in Nigeria. It is necessary to monitor the nature of these diseases in each locality for effective health care planning. Our aim was to document the nature of renal diseases in the Niger Delta Region of Nigeria and compare it with other regions in the country. METHODS: We reviewed the documents of all children presenting with renal diseases between January 2010 and December 2012 to the Delta State University Teaching Hospital in Oghara and GN Children's Clinic in Warri, the two major pediatric nephrology service providers in the Niger Delta region of Nigeria...
January 2014: Arab Journal of Nephrology and Transplantation
Malte Böhm, Martin Schostak, Oliver W Hakenberg
Urine cytology is considered a valid diagnostic method of urological and nephrological diagnosis and follow-up, whereas immunohistochemistry is an indispensable adjunct to histopathology. The combination of both--urinary immunocytology--has, so far, only attained a marginal role. This review gives a state-of-the-art update of urinary markers and relevant epitopes, elucidates some methodological pitfalls, and gives an outlook on the promise of urinary immunocytology today. It suggests that morphological urine cytology should be amended by immunology in a mutual quest of urologists and pathologists to improve the diagnostic power of urine cytology...
May 2014: Urologic Oncology
Mohamed Hassan, Denis Selimovic, Abdelouahid El-Khattouti, Hanan Ghozlan, Youssef Haikel, Ola Abdelkader
Hepatitis C virus (HCV) is a significant health problem facing the world. This virus infects more than 170 million people worldwide and is considered the major cause of both acute and chronic hepatitis. Persons become infected mainly through parenteral exposure to infected material by blood transfusions or injections with nonsterile needles. Although the sexual behavior is considered as a high risk factor for HCV infection, the transmission of HCV infection through sexual means, is less frequently. Currently, the available treatment for patients with chronic HCV infection is interferon based therapies alone or in combination with ribavirin and protease inhibitors...
April 20, 2012: World Journal of Experimental Medicine
F J O' Brien, M Danapal, S Jairam, A K Lalani, J Cunningham, M Morrin, S McNally, M G Donovan, D Little, A Tuthill, P J Conlon
INTRODUCTION: Von Hippel Lindau (VHL) disease is a syndrome that is defined by variety of tumours such as cerebellar haemangioblastomas, renal cell carcinomas, phaeochromocytomas, pancreatic adenomas and ear, nose and throat (ENT) adenomas. This disease is often genetic and inherited in an autosomal dominant fashion, and can present in childhood, adolescence or adult life. This study describes the presentation, natural history and manifestations of patients attending our institutions with this condition...
April 2014: QJM: Monthly Journal of the Association of Physicians
Margaret Colleen Hastings, Zina Moldoveanu, Hitoshi Suzuki, Francois Berthoux, Bruce A Julian, John T Sanders, Matthew B Renfrow, Jan Novak, Robert J Wyatt
INTRODUCTION: IgA nephropathy, the most prevalent glomerular disease in the world, requires a renal biopsy for diagnosis. Reliable biomarkers are needed for the non-invasive diagnosis of this disease and to more fully delineate its natural history and risk for progression. AREAS COVERED: In this review, the authors examine serum levels of galactose-deficient IgA1 (Gd-IgA1) and glycan-specific IgG and IgA autoantibodies that are integral to pathogenesis of IgA nephropathy...
November 2013: Expert Opinion on Medical Diagnostics
Piergiorgio Messa, Manuela Curreri, Anna Regalia, Carlo Maria Alfieri
Since the discovery that the enzyme catalyzing the synthesis of the most active natural vitamin D metabolite(calcitriol) and the vitamin D-specific receptor (VDR)were expressed in a wide range of tissues and organs, not only involved in the mineral metabolism (MM), there has been increasing interest on the putative ‘non classical’ roles of vitamin D metabolites, particularly on their possible effects on the cardiovascular (CV) system. These hypothetical CV effects of vitamin D gained particular interesting the nephrology field, given the high prevalence of CV disease in patients affected by either acute or chronic kidney diseases...
February 2014: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
R T Noel Gibney, Mehmet S Sever, Raymond C Vanholder
Disasters result in a substantial number of renal challenges, either by the creation of crush injury in victims trapped in collapsed buildings or by the destruction of existing dialysis facilities, leaving chronic dialysis patients without access to their dialysis units, medications, or medical care. Over the past two decades, lessons have been learned from the response to a number of major natural disasters that have impacted significantly on crush-related acute kidney injury and chronic dialysis patients...
May 2014: Kidney International
Manuel Heras, Pedro García-Cosmes, María J Fernández-Reyes, Rosa Sánchez
In the last few years a debate has emerged on the range of normal renal function and the rate at which renal disease progresses in the elderly. In this review we analysed, on the basis of the results of the study Ancianos con enfermedad renal crónica del Hospital General de Segovia (Elderly people with chronic kidney disease of the Hospital General de Segovia), the poor prognosis factors associated with this disease: proteinuria, episodes of acute renal failure and heart failure, and the role of uric acid...
2013: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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