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Dialysis, nephrology

Yanhua Wu, Yuanhan Chen, Shaowen Li, Wei Dong, Huaban Liang, Miaoyi Deng, Yingnan Chen, Shixin Chen, Xinling Liang
PURPOSE: To investigate the application value of "electronic alerts" ("e-alerts") for acute kidney injury (AKI) among high-risk wards of hospitals. METHODS: A prospective, randomized, controlled study was conducted. We developed an e-alert system for AKI and ran the system in intensive care units and divisions focusing on cardiovascular disease. The e-alert system diagnosed AKI automatically based on serum creatinine levels. Patients were assigned randomly to an e-alert group (467 patients) or non-e-alert group (408 patients)...
March 19, 2018: International Urology and Nephrology
Yoshio N Hall
There is ongoing recognition that a wide array of social, economic, and environmental factors influence individuals' opportunities to engage in health care and healthy behaviors. Despite spending $34 billion annually on the care of patients with end-stage renal disease, the American public and nephrology community remain remarkably complacent about addressing "upstream" factors that influence the prevention, progression, and treatment of chronic kidney diseases. Recently, a growing number of health plans and dialysis providers have begun to embrace population health management; accept greater accountability for health, health care, and health costs; and envision kidney health beyond their traditional roles in care delivery...
March 13, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
Kavitha Vellanki, Susan Hou
Most women with dialysis-dependent chronic kidney disease (CKD) stage 5 (CKD stage 5D) are in the postmenopausal age group. Early menopause is reported for all CKD stages (stages 3-5D). The traditional definition of menopause is not applicable in CKD stage 5(D) because menses can resume with hormone replacement therapy or kidney transplantation. Treatment of vasomotor symptoms continues to be the primary indication for hormone replacement therapy, with no dosing studies done specifically for CKD or kidney transplantation populations...
March 9, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Giorgina B Piccoli, Bernard G Jaar, Hayley Henderson
This editorial introduces a series of interviews with the pioneers of Nephrology. It's a story that speaks by itself, given the thousands of people that are now alive thanks to the remarkable advances in renal replacement therapies such as dialysis, and kidney transplantation but also the many scientific advances in our understanding of the pathophysiology and treatment of kidney diseases worldwide.The interviews that we have selected for this series are, however, not dealing with their achievements, and their success; they try to pass on to future generations the idea of how they were, why they were passionate, what they loved, and, not last, where they found poetry in our profession...
March 12, 2018: BMC Nephrology
Antonio Bellasi, Luigi Morrone, Maria Cristina Mereu, Carlo Massimetti, Elena Pelizzaro, Giuseppe Cianciolo, Marzia Pasquali, Vincenzo Panuccio
We herein report on a nationwide survey conducted in Italy to investigate the use of parathyroidectomy (PTX). In spite of the availability of newer and more effective drugs to control chronic kidney disease mineral bone disorder (CKD-MBD) biochemical abnormalities, PTX still remains a resource for nephrologists to use. However, observational analyses suggest that in recent years there has been a constant decline in the number of patients undergoing PTX. The reasons are not clear, though the increasing age and number of comorbidities of dialysis patients may partly explain this trend...
March 7, 2018: Journal of Nephrology
Ping Liu, Robert R Quinn, Matthew J Oliver, Paul E Ronksley, Brenda R Hemmelgarn, Hude Quan, Swapnil Hiremath, Aminu K Bello, Peter G Blake, Amit X Garg, John Johnson, Mauro Verrelli, James M Zacharias, Samar Abd ElHafeez, Marcello Tonelli, Pietro Ravani
BACKGROUND AND OBJECTIVES: Early nephrology referral is recommended for people with CKD on the basis of observational studies showing that longer nephrology care before dialysis start (predialysis care) is associated with lower mortality after dialysis start. This association may be observed because predialysis care truly reduces mortality or because healthier people with an uncomplicated course of disease will have both longer predialysis care and lower risk for death. We examined whether the survival benefit of longer predialysis care exists after accounting for the potential confounding effect of disease course that may also be affected by predialysis care...
March 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Laurel Willig, Erin Paquette, D Micah Hester, Bradley A Warady, John D Lantos
A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function...
February 28, 2018: Pediatrics
Varun Agrawal, Kenar D Jhaveri, Hitesh H Shah
Interest in nephrology careers continues to remain low in the USA. Educational innovations that enhance interest in nephrology among medical trainees are being actively studied. While internal medicine (IM) residency programs commonly offer the inpatient nephrology elective to the resident, outpatient nephrology experience is lacking. Understanding the provision of care in outpatient and home dialysis and management of patients with glomerular diseases, chronic kidney disease and kidney transplantation are vital components of an outpatient nephrology rotation...
August 2017: Clinical Kidney Journal
Andrea K Viecelli, Allison Tong, Emma O'Lone, Angela Ju, Camilla S Hanson, Benedicte Sautenet, Jonathan C Craig, Braden Manns, Martin Howell, Eric Chemla, Lai-Seong Hooi, David W Johnson, Timmy Lee, Charmaine E Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Carmel M Hawley
Vascular access outcomes in hemodialysis are critically important for patients and clinicians, but frequently are neither patient relevant nor measured consistently in randomized trials. A Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop was convened to discuss the development of a core outcome measure for vascular access. 13 patients/caregivers and 46 professionals (clinicians, policy makers, industry representatives, and researchers) attended. Participants advocated for vascular access function to be a core outcome based on the broad applicability of function regardless of access type, involvement of a multidisciplinary team in achieving a functioning access, and the impact of access function on quality of life, survival, and other access-related outcomes...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Dalia E Yousif, Alice R Topping, Maha F Osman, Jochen G Raimann, Elfadil M Osman, Peter Kotanko, Omar I Abboud
BACKGROUND: The burden of acute kidney injury (AKI) is high in Africa. While there are no reliable statistics about AKI in Africa, the Global Snapshot Study of the 0by25 initiative of the International Society of Nephrology has determined dehydration, infections, animal envenomation, and complications during pregnancy as the main causes. METHODS: This study was conducted at the Soba University Hospital (SUH), Khartoum, Sudan, a tertiary referral center. We included all hemodialysis patients treated for AKI at SUH between -January 1, 2013 and December 31, 2014 in the study...
January 26, 2018: Blood Purification
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
January 26, 2018: Blood Purification
Jacqueline Deloumeaux, Gaël Samut, Devi Rochemont, Henri Merault, Roger Dufresne, Valérie Galantine, Yannick Tirolien, Catherine Léonardi, Antoine Adenis, Jessica Peruvien, Mathieu Nacher, Jean-Marc Gabriel
End stage renal disease is a major public health problem in the French Departments of Guadeloupe and Guiana because of the high prevalence of both type 2 diabetes and hypertension. We investigated factors associated with an emergency start of dialysis, 3 months' quality of life for patients starting a first replacement therapy in Guadeloupe and French Guiana using the data of the Réseau épidémiologie et information en néphrologie network, completed with data from the quality of life questionnaires SF-36 and KDQoL...
February 21, 2018: Néphrologie & Thérapeutique
Allison Tong, Benedicte Sautenet, Emilio D Poggio, Krista L Lentine, Rainer Oberbauer, Roslyn Mannon, Barbara Murphy, Benita Padilla, Kai Ming Chow, Lorna Marson, Steve Chadban, Jonathan C Craig, Angela Ju, Karine E Manera, Camilla S Hanson, Michelle A Josephson, Greg Knoll
BACKGROUND: Graft loss, a critically important outcome for transplant recipients, is variably defined and measured, and incompletely reported in trials. We convened a consensus workshop on establishing a core outcome measure for graft loss for all trials in kidney transplantation. METHODS: Twenty-five kidney transplant recipients/caregivers and 33 health professionals from eight countries participated. Transcripts were analyzed thematically. RESULTS: Five themes were identified...
February 22, 2018: Transplantation
Guangjian Liu, Jinhai Chen
This study investigated the risk factors of peritonitis during early peritoneal dialysis for renal failure in patients with antineutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis (AASV). This study enrolled hospitalized AASV patients with renal failure who underwent peritoneal dialysis at the Department of Nephrology of our hospital between 2008 and 2015. The primary aim of this study was to perform a retrospective analysis to characterize peritonitis during the early period (≤ 8 weeks) of dialysis, and to compare the differences in initial clinical manifestations, vasculitis activity, immunosuppressive therapies prior to the renal replacement therapy, and prognosis between patients with or without peritonitis...
February 21, 2018: Clinical Nephrology
Karin Windahl, Gerd Faxén Irving, Tora Almquist, Maarit Korkeila Lidén, Moniek van de Luijtgaarden, Nicholas C Chesnaye, Pauline Voskamp, Peter Stenvinkel, Marian Klinger, Maciej Szymczak, Claudia Torino, Maurizio Postorini, Christiane Drechsler, Fergus J Caskey, Christoph Wanner, Friedo W Dekker, Kitty J Jager, Marie Evans
OBJECTIVES: Prevalence and risk factors for protein-energy wasting (PEW) are poorly studied in the nondialysis, older population with advanced chronic kidney disease (CKD). Our aim was to evaluate the prevalence of PEW in advanced stage CKD patients aged greater than 65 years. Furthermore, we aimed to describe risk factors for PEW in the overall study population and among obese individuals. DESIGN: Prospective observational cohort study. METHODS: The EQUAL study, a European Quality Study on treatment in advanced chronic kidney disease, is a multicenter prospective observational cohort study in six European countries...
February 16, 2018: Journal of Renal Nutrition
Joanne Reid, Helen R Noble, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalantar-Zadeh, John Mallett, C McKeaveney, S Porter, David S Seres, Joanne Shields, Adrian Slee, Miles D Witham, Alexander P Maxwell
BACKGROUND: Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD...
February 13, 2018: BMC Nephrology
Moglie Le Quintrec, Anne-Laure Lapeyraque, Arnaud Lionet, Anne-Laure Sellier-Leclerc, Yahsou Delmas, Véronique Baudouin, Eric Daugas, Stéphane Decramer, Leila Tricot, Mathilde Cailliez, Philippe Dubot, Aude Servais, Catherine Mourey-Epron, Franck Pourcine, Chantal Loirat, Véronique Frémeaux-Bacchi, Fadi Fakhouri
BACKGROUND: Cases reports and small series of patients with C3 glomerulopathy have reported variable efficacy of eculizumab. STUDY DESIGN: Case series of C3 glomerulopathy. SETTING & PARTICIPANTS: Pediatric and adult patients with C3 glomerulopathy treated with eculizumab between 2010 and 2016 were identified through the C3 glomerulopathy French registry database, and a questionnaire was sent to participating French pediatric and adult nephrology centers, as well as one pediatric referral center in Québec, Canada...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
February 8, 2018: International Angiology: a Journal of the International Union of Angiology
Felix Poppelaars, Bernardo Faria, Mariana Gaya da Costa, Casper F M Franssen, Willem J van Son, Stefan P Berger, Mohamed R Daha, Marc A Seelen
Significant advances have lead to a greater understanding of the role of the complement system within nephrology. The success of the first clinically approved complement inhibitor has created renewed appreciation of complement-targeting therapeutics. Several clinical trials are currently underway to evaluate the therapeutic potential of complement inhibition in renal diseases and kidney transplantation. Although, complement has been known to be activated during dialysis for over four decades, this area of research has been neglected in recent years...
2018: Frontiers in Immunology
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