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https://www.readbyqxmd.com/read/28937069/oral-health-in-diabetic-and-nondiabetic-patients-with-chronic-kidney-disease
#1
Lingam Amara Swapna, Pradeep Koppolu, Jyothi Prince
The objective of our study is to assess the subjective and objective oral manifestations and salivary pH in diabetic and nondiabetic uremic patients at a nephrology clinic. A total of 194 diabetic and nondiabetic patients with chronic kidney disease (CKD), who were divided into four groups, Group A, B, C, D, and who were attending a nephrology clinic were included in the study. Predialytic unstimulated whole salivary pH was recorded using pH- measuring strips. Subjective and objective findings were evaluated and recorded in the specially designed pro forma...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28925068/when-and-how-can-nephrologists-treat-hepatitis-c-virus-infection-in-dialysis-patients
#2
REVIEW
Maya I Davis, Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus (HCV) infection, a major cause of end-stage liver disease, is a common comorbidity in patients on dialysis and causes increased morbidity and mortality. Historically HCV has been extremely difficult to cure with interferon and ribavirin-based therapies, which are also associated with significant side effects, and few dialysis patients ever received HCV treatment. However, in the last 4 years, interferon-free direct-acting antiviral therapies have been approved, and several combinations have been studied in dialysis patients...
September 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28923834/is-chronic-dialysis-the-right-hard-renal-end-point-to-evaluate-renoprotective-drug-effects
#3
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/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#4
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28918595/successful-pregnancy-in-a-ckd-patient-on-a-low-protein-supplemented-diet-an-opportunity-to-reflect-on-ckd-and-pregnancy-in-mexico-an-emerging-country
#5
Julia Nava, Silvia Moran, Veronica Figueroa, Adriana Salinas, Margy Lopez, Rocio Urbina, Abril Gutierrez, Jose Luis Lujan, Alejandra Orozco, Rafael Montufar, Giorgina B Piccoli
Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy...
September 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28898574/integrating-kidney-transplantation-into-value-based-care-for-people-with-renal-failure
#6
Benjamin E Hippen, Franklin W Maddux
Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28893419/telenephrology-current-perspectives-and-future%C3%A2-directions
#7
Rajeev Rohatgi, Michael J Ross, Sandawana W Majoni
There is increasing interest in telemedicine among physicians and patients; however, the evidence regarding the quality of care delivered by telemedicine, and telenephrology in particular, compared with in-person care is limited. In this review, different electronic modalities used to deliver nephrology care are reviewed and critiqued, with a focused analysis from the Australian and United States perspectives. Both countries are geographically expansive with significant rural populations where access to nephrology care is limited...
September 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28885039/primary-health-care-decision-making-in-pre-dialysis-chronic-kidney-disease
#8
Sandra Joan Campbell-Crofts, Janet Roden
Objectives This qualitative descriptive study explored the primary health care decisions of a group of 12 Australians in Stages 3B to 5 with chronic kidney disease in the preservation of kidney health. Methods Questioning within the qualitative interviews focused on gaining an understanding of the participants' perceptions of their kidney health and the decisions made as a consequence of their interaction within the Australian primary health care system. Results Participants were dependent on their General Practitioner to recognise their symptoms, make the correct diagnosis and authorise the correct referral for specialist nephrology care...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28873971/clinical-practice-recommendations-for-treatment-with-active-vitamin-d-analogues-in-children-with-chronic-kidney-disease-stages-2-5-and-on-dialysis
#9
Rukshana Shroff, Mandy Wan, Evi V Nagler, Sevcan Bakkaloglu, Mario Cozzolino, Justine Bacchetta, Alberto Edefonti, Constantinos J Stefanidis, Johan Vande Walle, Gema Ariceta, Günter Klaus, Dieter Haffner, Claus Peter Schmitt
In patients with chronic kidney disease (CKD), renal synthesis of active vitamin D [1,25-dihydroxyvitamin D (1,25(OH)2D)] declines and is associated with hypocalcaemia, secondary hyperparathyroidism and the spectrum of CKD-mineral and bone disorder (MBD). In advanced CKD, active vitamin D analogues, including alfacalcidol, calcitriol and paricalcitol, are routinely administered. There are few studies on the use of vitamin D analogues in children with CKD and on dialysis. It is difficult to define bone-specific outcomes that can guide treatment with active vitamin D analogues in children with CKD-MBD...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28873969/clinical-practice-recommendations-for-native-vitamin-d-therapy-in-children-with-chronic-kidney-disease-stages-2-5-and-on-dialysis
#10
Rukshana Shroff, Mandy Wan, Evi V Nagler, Sevcan Bakkaloglu, Dagmar-C Fischer, Nicholas Bishop, Mario Cozzolino, Justine Bacchetta, Alberto Edefonti, Constantinos J Stefanidis, Johan Vande Walle, Dieter Haffner, Günter Klaus, Claus Peter Schmitt
Vitamin D deficiency is widely prevalent and often severe in children and adults with chronic kidney disease (CKD). Although native vitamin D {25-hydroxyvitamin D [25(OH)D]} is thought to have pleiotropic effects on many organ systems, its skeletal effects have been most widely studied. The 25(OH)D deficiency is causally linked with rickets and fractures in healthy children and those with CKD, contributing to the CKD-mineral and bone disorder (MBD) complex. There are few studies to provide evidence for vitamin D therapy or guidelines for its use in CKD...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28852478/an-end-of-life-practice-survey-among-clinical-nephrologists-associated-with-a-single-nephrology-fellowship-training-program
#11
Kevin A Ceckowski, Dustin J Little, Joseph R Merighi, Teri Browne, Christina M Yuan
BACKGROUND: Our nephrology fellowship requires specific training in recognition and referral of end-stage renal disease patients likely to benefit from palliative and hospice care. METHODS: To identify end-of-life (EOL) referral barriers that require greater training emphasis, we performed a cross-sectional, 17-item anonymous online survey (August-October 2015) of 93 nephrologists associated with the program since 1987. RESULTS: There was a 61% response rate (57/93 surveys)...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28835851/a-survey-of-canadian-nephrologists-assessing-prognostication-in-end-stage-renal-disease
#12
Brian Forzley, Helen H L Chiu, Ognjenka Djurdjev, Rachel C Carson, Gaylene Hargrove, Dan Martinusen, Mohamud Karim
BACKGROUND: Patients with end-stage renal disease (ESRD) frequently have a relatively poor prognosis with complex care needs that depend on prognosis. While many means of assessing prognosis are available, little is known about how Canadian nephrologists predict prognosis, whether they routinely share prognostic information with their patients, and how this information guides management. OBJECTIVE: To guide improvements in the management of patients with ESRD, we aimed to better understand how Canadian nephrologists consider prognosis during routine care...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28835848/a-description-of-advanced-chronic-kidney-disease-patients-in-a-major-urban-center-receiving-conservative-care
#13
Fareed B Kamar, Helen Tam-Tham, Chandra Thomas
BACKGROUND: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting. OBJECTIVE: To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context. DESIGN: Retrospective chart review. SETTING: Urban nephrology center...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28831705/predictors-of-first-ischemic-lower-limb-ulcer-in-dialysis-patients-an-observational-cohort-study
#14
Simeone Andrulli, Chiara Chiavenna, Maria Carla Bigi, Monica Crepaldi, Cesare Dell'Oro, Flavia Tentori, Celestina Manzoni, Giuseppe Bacchini, Mauro Maria Corti, Giuseppe Pontoriero
BACKGROUND: Lower limb ischemia affects the quality of life, physical activity and life expectancy of dialysis patients. The aim of this study was to investigate the risk factors associated with ischemic foot ulcers considering clinical, laboratory and therapeutic domains. METHODS: This observational cohort study was based on data from the Nephrology and Dialysis Department database of Alessandro Manzoni Hospital, Lecco (Italy). All of the incident patients who started dialysis between 1 January 1999 and 29 February 2012 were enrolled, excluding temporary guests, patients with acute renal failure and patients with previous limb ischemia or amputation...
August 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28818166/assessment-of-quality-of-sleep-and-its-relationship-with-psychiatric-morbidity-and-socio-demographic-factors-in-the-patients-of-chronic-renal-disease-undergoing-hemodialysis
#15
Usama Bin Zubair, Batool Butt
OBJECTIVE: To assess the subjective sleep quality and its relationship with the presence of psychiatric morbidity in the patients suffering from chronic kidney disease (CKD) and undergoing the procedure of hemodialysis (HD); and analyze the associated socio-demographic factors. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Nephrology Department, Military Hospital, Rawalpindi, from July to December 2016. METHODOLOGY: Patients of CKD undergoing the HD were included in the final analysis...
July 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#16
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28810622/oral-n-acetylcysteine-for-prophylaxis-of-contrast-induced-nephropathy-in-patients-following-coronary-angioplasty-a-meta-analysis
#17
Jing-Xiu Li, En-Ze Jin, Long-Hao Yu, Yang Li, Nan-Nan Liu, Yu-Mei Dong, Xin Li, Xue-Qi Li
It is acknowledged that contrast-induced nephropathy (CIN) is a common cause of acute renal insufficiency after cardiac catheterization and affects mortality and morbidity. To date, it is unknown whether oral N-acetylcysteine (NAC) is able to prevent contrast-induced nephropathy (CIN) in patients undergoing coronary angioplasty. A meta-analysis of randomized controlled trials was performed to assess the effects of NAC in the prevention of CIN in patients following coronary angioplasty. A total of 19 studies published prior to January 2015 that investigated the efficacy of oral NAC for the prevention of CIN were collected from Medline, Cochrane and Embase databases and conference proceedings from cardiology and nephrology meetings...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28805539/protective-effect-of-regular-physical-activity-on-major-depressive-episodes-in-patients-with-early-stages-of-chronic-kidney-disease
#18
Fu-Xiang Zhu, Xiang-Yang Zhang, Xiao-Kai Ding, Bin Han
Previous studies have demonstrated an association between physical activity (PA) and depression in diverse population. The purpose of our study is to examine if PA within the recommended level over time is associated with major depressive episode (MDE) in patients with early stages of chronic kidney disease (CKD) in Mainland China. Patients with stages 2-5 CKD not receiving dialysis were enrolled from a nephrology outpatient clinic between May 2014 and February 2016. Based on the patterns of PA over time, all patients were divided into four groups: persistently active, from inactive to active, from active to inactive, and persistently inactive...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28792165/acute-stylet-peritoneal-dialysis-in-acute-kidney-injury-the-soul-never-dies
#19
Amith Vijay Leon D'Souza, Nishad Raveendran, Rajendra Singh Tanwar, Piyush Kimmatkar, Pankaj Beniwal, Dhananjai Agarwal, Vinay Vinay
BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28770395/interventional-nephrology-current-status-and-clinical-impact-in-japan
#20
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
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