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https://www.readbyqxmd.com/read/29675052/jianpi-bushen-a-traditional-chinese-medicine-therapy-combined-with-chemotherapy-for-gastric-cancer-treatment-a-meta-analysis-of-randomized-controlled-trials
#1
Yunbo Chen, Guijuan Zhang, Xiaoping Chen, Xuefeng Jiang, Fengjie Bie, Naijun Yuan, Yurong Wang, Xiaoqian Hao, Min Ma
Objective. To investigate the effects of Jianpi Bushen (JPBS), a traditional Chinese medicine that is used to invigorate the spleen and tonify the kidney, combined with chemotherapy for the treatment of gastric cancer. Methods. Literature retrieval was performed in PubMed, EMBASE, Cochrane Library, MEDLINE, CNKI, Wanfang Data Information Site, and VIP from inception to October 2017. Randomized controlled trials to evaluate the effects of JPBS combined with chemotherapy were identified. The primary reported outcomes were KPS (Karnofsky Performance Status), clinical curative efficiency, immune function, blood system, and nonhematologic system...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29673370/early-versus-standard-initiation-of-renal-replacement-therapy-in-furosemide-stress-test-non-responsive-acute-kidney-injury-patients-the-fst-trial
#2
Nuttha Lumlertgul, Sadudee Peerapornratana, Thananda Trakarnvanich, Wanjak Pongsittisak, Kajbundit Surasit, Anan Chuasuwan, Pleumjit Tankee, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, John A Kellum, Nattachai Srisawat
BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29673103/allopurinol-and-endothelial-function-a-systematic-review-with-meta-analysis-of-randomized-controlled-trials
#3
Manal M Alem
AIM: Oxidative stress and endothelial dysfunction are two inter-related conditions commonly seen in patients with cardiovascular risk factors. The enzyme, xanthine oxidase, is an important contributor to these phenomena but to a variable degree in different patient populations. This meta-analysis will summarize the effect of allopurinol, an established xanthine oxidase inhibitor, on endothelial function among patients with different co-morbidities. METHODS: Medline Complete, PubMed, ProQuest, ClinicalKey, Wiley Online Library and Cochrane Central Register of Controlled Trials were searched till 29th July, 2017...
April 19, 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29672718/mineralocorticoid-receptor-antagonists-in-kidney-transplantation-time-to-consider
#4
Sophie Girerd, Frédéric Jaisser
Although patient survival is significantly improved by kidney transplantation (KT) in comparison with dialysis, it remains significantly lower than that observed in the general population. Graft function is one of the major determinants of patient survival after KT. Mineralocorticoid receptor antagonists (MRAs) could be of particular interest in this population to improve graft function and treat or prevent cardiovascular (CV) complications. In KT, ischaemia/reperfusion injury is a major factor involved in delayed graft function, which is often associated with inferior long-term graft survival...
April 17, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29672418/perioperative-use-of-levosimendan-improves-clinical-outcomes-in-patients-post-cardiac-surgery-a-systematic-review-and-meta-analysis
#5
Hua Qiang, Xiu Luo, Jian-Hua Huo, Zhi-Quan Wang
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery (OR 0...
April 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29668577/the-use-of-a-novel-non-steroidal-mineralocorticoid-receptor-antagonist-finerenone-for-the-treatment-of-chronic-heart-failure-a-systematic-review-and-meta-analysis
#6
Hui Pei, Wei Wang, Di Zhao, Lei Wang, Guo-Hai Su, Zhuo Zhao
BACKGROUND: The non-steroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) has been used to treat chronic heart failure (CHF) with reduced ejection fraction (HFrEF). However, conflicting results were reported for its efficacy and safety. The study aimed to compare the efficacy and safety of finerenone versus spironolactone or eplerenone in patients with chronic heart failure. METHODS: Electronic databases including MEDLINE, EMBASE, and CENTRAL were searched from inception to December 2017 for randomized controlled trials assessing finerenone treatment in patients with chronic heart failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668213/physician-and-patient-tools-to-improve-chronic-kidney-disease-care
#7
Thomas D Sequist, Alison M Holliday, E John Orav, David W Bates, Bradley M Denker
OBJECTIVES: To determine if electronic health record (EHR) tools and patient engagement can improve the quality of chronic kidney disease (CKD) care. STUDY DESIGN: Randomized controlled trial. METHODS: We enrolled 153 primary care physicians caring for 3947 high-risk and 3744 low-risk patients with stage III CKD across 13 ambulatory health centers in eastern Massachusetts. Intervention physicians received a set of electronic alerts during office visits recommending risk-appropriate CKD care...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29667173/efficacy-of-corticosteroids-in-prevention-of-acute-kidney-injury-in-neonates-undergoing-cardiac-surgery-a-randomized-controlled-trial
#8
T Jahnukainen, J Keski-Nisula, J Tainio, H Valkonen, T Pätilä, H Jalanko, P Suominen
BACKGROUND: Heart surgery requiring cardiopulmonary bypass (CPB) causes an inflammatory response which may further induce acute kidney injury (AKI). In the present randomized controlled study we evaluated whether corticosteroids can prevent CPB related AKI in neonates undergoing heart surgery. METHODS: Forty neonates were randomized to receive 2 mg/kg methylprednisolone followed by hydrocortisone infusion 0.2 mg/kg/h perioperatively with tapering doses for 5 days, or placebo administered in a similar fashion...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29665840/effects-of-cyclosporine-a-pretreatment-of-deceased-organ-donors-on-kidney-graft-function-cis-a-rein-study-protocol-for-a-randomized-controlled-trial
#9
Jean-Christophe Orban, Eric Fontaine, Elisabeth Cassuto, Karine Baumstarck, Marc Leone, Jean-Michel Constantin, Carole Ichai
BACKGROUND: Renal transplantation represents the treatment of choice of end-stage kidney disease. Delayed graft function (DGF) remains the most frequent complication after this procedure, reaching more than 30%. Its prevention is essential as it impedes early- and long-term prognosis of transplantation. Numerous pharmacological interventions aiming to prevent ischemia-reperfusion injuries failed to reduce the rate of DGF. We hypothesize that cyclosporine as an early preconditioning procedure in donors would be associated with decreased DGF...
April 17, 2018: Trials
https://www.readbyqxmd.com/read/29660004/renal-transplant-outcomes-and-de-novo-donor-specific-anti-human-leukocyte-antigen-antibodies-a-systematic-review
#10
Ankit Sharma, Joshua R Lewis, Wai H Lim, Suetonia Palmer, Giovanni Strippoli, Jeremy R Chapman, Stephen I Alexander, Jonathan C Craig, Germaine Wong
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain. Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29655505/midterm-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-controlled-trials
#11
Yanwei Wang, Yijiang Zhou, Li Zhang, Jianhua Zhu
BACKGROUND: Current guidelines recommend transcatheter aortic valve replacement (TAVR) in patients with severe symptomatic aortic stenosis (AS) who are not suitable for conventional surgical aortic valve replacement (SAVR). In light of the recent trend in performing TAVR in patients with lower risk profile, we assessed the midterm outcome comparing TAVR and SAVR for the treatment of patients with severe AS at low to intermediate risk. METHODS: PubMed, EBSCO, and Cochrane CENTRAL were systematically searched for randomized controlled trials that reported the clinical outcomes of TAVR versus SAVR in patients at low to intermediate surgical risk with at least 2 years of follow-up...
June 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29649631/simultaneous-risk-factor-control-using-telehealth-to-slow-progression-of-diabetic-kidney-disease-stop-dkd-study-protocol-and-baseline-characteristics-of-a-randomized-controlled-trial
#12
Clarissa J Diamantidis, Hayden B Bosworth, Megan M Oakes, Clemontina A Davenport, Jane F Pendergast, Sejal Patel, Jivan Moaddeb, Huiman X Barnhart, Peter D Merrill, Khaula Baloch, Matthew J Crowley, Uptal D Patel
Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD) in the United States. Multiple risk factors contribute to DKD development, yet few interventions target more than a single DKD risk factor at a time. This manuscript describes the study protocol, recruitment, and baseline participant characteristics for the Simultaneous Risk Factor Control Using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study. The STOP-DKD study is a randomized controlled trial designed to evaluate the effectiveness of a multifactorial behavioral and medication management intervention to mitigate kidney function decline at 3 years compared to usual care...
April 9, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29623845/is-treat-to-target-in-lupus-nephritis-realistic-in-clinical-practice
#13
Chi Chiu Mok
The treat-to-target (T2T) principle has been advocated in a number of inflammatory and non-inflammatory medical illnesses. Tight control of disease activity has been shown to improve the outcome of rheumatoid arthritis and psoriatic arthritis as compared to the conventional approach. However, whether T2T can be applied to patients with lupus nephritis is still under hot discussion. Treatment of lupus nephritis should target at inducing and maintaining remission of the kidney inflammation so as to preserve renal function and improve survival in the long-term...
April 5, 2018: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/29619870/effects-of-uric-acid-lowering-therapy-on-the-progression-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#14
Xuemei Liu, Tingting Zhai, Ruixia Ma, Congjuan Luo, Huifang Wang, Liqiu Liu
OBJECTIVES: Whether uric acid levels were associated with the progression of chronic kidney disease (CKD) remained controversial. This meta-analysis was aimed to assess the effect of lowering serum uric acid therapy on the progression of CKD to clarify the role of uric acid in the progression of CKD indirectly. METHODS: Pubmed, Embase, the Cochrane library, CBM were searched for randomized controlled trials (RCTs) that assessed the efficiency of lowering serum uric acid therapy on the progression of CKD without language restriction...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29615792/exercise-in-patients-with-hypertension-and-chronic-kidney-disease-a-randomized-controlled-trial
#15
Franklin C Barcellos, Fabricio Boscolo Del Vecchio, Annelise Reges, Gregore Mielke, Iná S Santos, Daniel Umpierre, Maristela Bohlke, Pedro C Hallal
Hypertension and chronic kidney disease (CKD) are global public health problems, both associated with higher risk of cardiovascular (CV) and renal events. This trial randomized non-diabetic adult patients with hypertension and CKD stages 2-4 to 16 weeks of aerobic and resistance training or usual care. The primary outcome was the change in estimated glomerular filtration rate (eGFR). Secondary outcomes included changes in systolic and diastolic blood pressure (BP), body weight, fasting blood glucose, lipid profile, high-sensitivity C-reactive protein (hs-CRP), and functional capacity...
April 4, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29615724/dual-mtor-pi3k-inhibition-limits-pi3k-dependent-pathways-activated-upon-mtor-inhibition-in-autosomal-dominant-polycystic-kidney-disease
#16
Yang Liu, Martin Pejchinovski, Xueqi Wang, Xuebin Fu, Deborah Castelletti, Terry J Watnick, Alexandre Arcaro, Justyna Siwy, William Mullen, Harald Mischak, Andreas L Serra
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the development of kidney cysts leading to kidney failure in adulthood. Inhibition of mammalian target of rapamycin (mTOR) slows polycystic kidney disease (PKD) progression in animal models, but randomized controlled trials failed to prove efficacy of mTOR inhibitor treatment. Here, we demonstrate that treatment with mTOR inhibitors result in the removal of negative feedback loops and up-regulates pro-proliferative phosphatidylinositol 3-kinase (PI3K)-Akt and PI3K-extracellular signal-regulated kinase (ERK) signaling in rat and mouse PKD models...
April 3, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29594166/robot-assisted-transplant-surgery-vision-or-reality-a-comprehensive-review
#17
REVIEW
Philipp Stiegler, Peter Schemmer
Minimally invasive surgery is standard procedure for many operations. Further refinements include the introduction of robotic surgery which is still an emerging field especially in laparoscopic surgery. Since the successful introduction of the da Vinci Robotic Surgical System, the robotic approach in organ transplantation has become of great interest in both the live donor organ retrieval and the recipient operation. Robotic surgery for kidney, liver, and pancreas transplantation is feasible. Over 700 donor nephrectomies and 100 kidney transplantations have been performed already, and robotic surgery is standard in a small number of pioneer centers; however, larger series and most importantly randomized controlled trials for the highest evidence are needed...
February 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29587863/chinese-herbal-medicine-shenzhuo-formula-treatment-in-patients-with-macroalbuminuria-secondary-to-diabetic-kidney-disease-study-protocol-for-a-randomized-controlled-trial
#18
Xue-Min Zhao, Ying Zhang, Xin-Hui He, Hong-Dong Chen, Zhu-Feng Wang, Jing Guo, Xin-Miao Wang, Ze-Zheng Gao, Ji-Ping Wang, Wei Liu, Lin-Hua Zhao, Xiao-Lin Tong
BACKGROUND: Diabetic kidney disease (DKD) is a serious complication associated with diabetes mellitus and can cause end-stage renal disease (ESRD). Traditional Chinese medicine (TCM) is widely used in China to treat DKD, and in particular microalbuminuria and macroalbuminuria. This study will address the efficacy and safety of Shenzhuo Formula (SZF), a frequently prescribed TCM, in DKD patients with macroalbuminuria. METHODS/DESIGN: This study is a 24-week, randomized, multi-center, double-blinded, double-dummy, controlled, clinical trial that will include 120 DKD patients aged 18 to 80 years old with a 24-h urinary protein (24-h UP) level of between 0...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29582474/dual-kidney-transplantation-as-a-strategy-to-use-expanded-criteria-donors-a-systematic-review
#19
Nuria Montero, Dolores Redondo-Pachón, María José Pérez-Sáez, Marta Crespo, Josep M Cruzado, Julio Pascual
The objective of this review is to assess if dual kidney transplantation(DKT) is better than single KT(SKT) for optimizing the use of expanded criteria donor kidneys. We did a systematic literature search and meta-analyses when possible, pooling data for calculating relative risks(RR) of major outcomes. Twenty-five studies met the inclusion criteria. One-year serum creatinine was better after DKT vs SKT (mean difference -0.27[-0.37,-0.17], p<0.001), with less incidence of acute rejection (RR 0.66 [0.52, 0...
March 27, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29581107/transplant-center-patient-navigator-and-access-to-transplantation-among-high-risk-population-a-randomized-controlled-trial
#20
Mohua Basu, Lisa Petgrave-Nelson, Kayla D Smith, Jennie P Perryman, Kevin Clark, Stephen O Pastan, Thomas C Pearson, Christian P Larsen, Sudeshna Paul, Rachel E Patzer
BACKGROUND AND OBJECTIVES: Barriers exist in access to kidney transplantation, where minority and patients with low socioeconomic status are less likely to complete transplant evaluation. The purpose of this study was to examine the effectiveness of a transplant center-based patient navigator in helping patients at high risk of dropping out of the transplant evaluation process access the kidney transplant waiting list. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: We conducted a randomized, controlled trial of 401 patients ( n =196 intervention and n =205 control) referred for kidney transplant evaluation (January 2013 to August 2014; followed through May 2016) at a single center...
March 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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