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'randomed control trial' and kidney

Edward Zimbudzi, Clement Lo, Marie L Misso, Sanjeeva Ranasinha, Peter G Kerr, Helena J Teede, Sophia Zoungas
BACKGROUND: Self-management support interventions may potentially delay kidney function decline and associated complications in patients with comorbid diabetes and chronic kidney disease. However, the effectiveness of these interventions remains unclear. We investigated the effectiveness of current self-management support interventions and their specific components and elements in improving patient outcomes. METHODS: Electronic databases were systematically searched from January 1, 1994, to December 19, 2017...
June 13, 2018: Systematic Reviews
E Pestine, A Stokes, L Trinquart
Background: Obesity is a risk factor for numerous cancer types, and may influence cancer treatment outcomes. Underrepresentation of obese patients in obesity-related cancer randomized controlled trials (RCTs) may affect generalizability of results. We aimed to assess the reporting of information about eligibility and enrollment of obese participants in obesity-related cancer RCTs. Methods: We conducted a systematic review of RCTs of 10 obesity-related cancer types (esophagus, colon/rectum, liver, gallbladder, pancreas, postmenopausal breast, endometrium, ovary, kidney, and thyroid cancer)...
April 20, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Lin Zhang, JinKui Yang, LanTing Li, DongDong Liu, XiaoPing Xie, Peng Dong, Yong Lin
AIM: Reducing the fluctuation of blood pressure has recently been recognized as a potential target for improving management of hypertension to prevent cardiovascular events, particularly for strokes. Some randomized controlled trials demonstrated that amlodipine can effectively reduce blood pressure as a well-established, long-acting calcium channel blocker (CCB). However, few data are available for amlodipine on blood pressure variability (BPV) in China in a real-world setting. This study aimed to assess the effect of amlodipine versus other CCB antihypertensive agents on BPV...
June 11, 2018: Journal of Comparative Effectiveness Research
Carlo Garofalo, Silvio Borrelli, Michele Provenzano, Toni De Stefano, Carlo Vita, Paolo Chiodini, Roberto Minutolo, Luca De Nicola, Giuseppe Conte
BACKGROUND: A clear evidence on the benefits of reducing salt in people with chronic kidney disease (CKD) is still lacking. Salt restriction in CKD may allow better control of blood pressure (BP) as shown in a previous systematic review while the effect on proteinuria reduction remains poorly investigated. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the effects of low versus high salt intake in adult patients with non-dialysis CKD on change in BP, proteinuria and albuminuria...
June 6, 2018: Nutrients
Fernanda Stringuetta Belik, Viviana Rugolo Oliveira E Silva, Gabriel Pereira Braga, Rodrigo Bazan, Barbara Perez Vogt, Jacqueline Costa Teixeira Caramori, Pasqual Barretti, Renato de Souza Gonçalves, Paulo José Fortes Villas Bôas, João Carlos Hueb, Luis Cuadrado Martin, Roberto Jorge da Silva Franco
BACKGROUND AND OBJECTIVES: Changes in cerebral blood flow may play an important role in cognitive impairment among hemodialysis (HD) patients. Physical activity has a promising role in delaying cognitive impairment in general population, but there are only a few studies in HD to confirm this finding. We aimed to evaluate the effects of intradialytic aerobic training on cerebral blood flow and cognitive impairment in HD. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: This is a pilot, controlled, randomized trial...
June 7, 2018: Nephron
Pierre I Karakiewicz, Emanuele Zaffuto, Anil Kapoor, Naveen S Basappa, Georg A Bjarnason, Normand Blais, Rodney H Breau, Christina Canil, Darrel Drachenberg, Sebastien J Hotte, Claudio Jeldres, Michael A S Jewett, Wassim Kassouf, Christian Kollmannsberger, Luke T Lavallée, Ranjena Maloni, Francois Patenaude, Frédéric Pouliot, M Neil Reaume, Robert Sabbagh, Bobby Shayegan, Alan So, Denis Soulières, Simon Tanguay, Lori Wood, Marco Bandini
INTRODUCTION: The Kidney Cancer Research Network of Canada (KCRNC) collaborated to prepare this consensus statement about the use of target agents as adjuvant therapy in patients with non-metastatic renal cell carcinoma (nmRCC) after nephrectomy. We reviewed the published data and performed a meta-analysis of studies that focused on vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). METHODS: A systematic literature search identified seven trials on adjuvant target therapy in nmRCC...
June 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Yujia Lin, Junya Jia, Yipeng Guo, Dandan He, Yaru Zhang, Fuzhen Wang, Tiekun Yan, Youxia Liu, Shan Lin
BACKGROUND: IgA nephropathy (IgAN) is a common chronic glomerular disease that, in most patients, slowly progresses to end-stage kidney disease. The therapy with corticosteroid in IgAN is still a worldwide problem that is confusing the clinicians. METHODS: MEDLINE, EMBASE, the Cochrane Library, and article reference lists were searched for randomized controlled trials (RCTs) that compared corticosteroids with placebo and any other non-immunosuppressive agents in treating IgAN...
June 6, 2018: American Journal of Nephrology
Susanne Stads, Louise Schilder, S Azam Nurmohamed, Frank H Bosch, Ilse M Purmer, Sylvia S den Boer, Cynthia G Kleppe, Marc G Vervloet, Albertus Beishuizen, Armand R J Girbes, Pieter M Ter Wee, Diederik Gommers, A B Johan Groeneveld, Heleen M Oudemans-van Straaten
INTRODUCTION: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with high mortality. The creatinine-based stage of AKI is considered when deciding to start or delay RRT. However, creatinine is not only determined by renal function (excretion), but also by dilution (fluid balance) and creatinine generation (muscle mass). The aim of this study was to explore whether fluid balance-adjusted creatinine at initiation of RRT is related to 28-day mortality independent of other markers of AKI, surrogates of muscle mass and severity of disease...
2018: PloS One
Cynthia J Janmaat, Merel van Diepen, Cheyenne Ce van Hagen, Joris I Rotmans, Friedo W Dekker, Olaf M Dekkers
Purpose: Substantial heterogeneity exists in reported kidney function decline in pre-dialysis chronic kidney disease (CKD). By design, kidney function decline can be studied in CKD 3-5 cohorts or dialysis-based studies. In the latter, patients are selected based on the fact that they initiated dialysis, possibly leading to an overestimation of the true underlying kidney function decline in the pre-dialysis period. We performed a systematic review and meta-analysis to compare the kidney function decline during pre-dialysis in CKD stage 3-5 patients, in these two different study types...
2018: Clinical Epidemiology
Qi-Hong Chen, Hua-Ling Wang, Lei Liu, Jun Shao, Jiangqian Yu, Rui-Qiang Zheng
PURPOSE: Restrictive red blood cell transfusion strategies remain controversial in patients undergoing cardiac surgery. We performed a meta-analysis to assess the prognostic benefits of restrictive red blood cell transfusion strategies in patients undergoing cardiac surgery. METHODS: We identified randomized clinical trials through the 9th of December 2017 that investigated a restrictive red blood cell transfusion strategy versus a liberal transfusion strategy in patients undergoing cardiac surgery...
May 31, 2018: Critical Care: the Official Journal of the Critical Care Forum
Michael Bowie, Violet Valencia, Ingrid Perez-Alvarez, Minh-Ha Tran
Anticoagulation in patients with advanced kidney disease, defined as those with an eGFR < 25 mL/min, including patients with end-stage renal disease on hemodialysis, remains an area of controversy and debate. Due to safety concerns regarding the increased risk for bleeding in this population, these patients have been excluded from all large-scale, randomized controlled trials to date. Warfarin and apixaban are both FDA-approved for use in this population and although warfarin remains the anticoagulant of choice, apixaban use is steadily increasing...
May 30, 2018: Journal of Thrombosis and Thrombolysis
Claire Gerber, Xuan Cai, Jungwha Lee, Timothy Craven, Julia Scialla, Nao Souma, Anand Srivastava, Rupal Mehta, Amanda Paluch, Alexander Hodakowski, Rebecca Frazier, Mercedes R Carnethon, Myles Selig Wolf, Tamara Isakova
BACKGROUND AND OBJECTIVES: Type 2 diabetes and associated CKD disproportionately affect blacks. It is uncertain if racial disparities in type 2 diabetes-associated CKD are driven by biologic factors that influence propensity to CKD or by differences in type 2 diabetes care. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a post hoc analysis of 1937 black and 6372 white participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial to examine associations of black race with change in eGFR and risks of developing microalbuminuria, macroalbuminuria, incident CKD (eGFR<60 ml/min per 1...
May 24, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Tatsufumi Oka, Takayuki Hamano, Yusuke Sakaguchi, Satoshi Yamaguchi, Keiichi Kubota, Masamitsu Senda, Sayoko Yonemoto, Karin Shimada, Ayumi Matsumoto, Nobuhiro Hashimoto, Daisuke Mori, Chikako Monden, Atsushi Takahashi, Yoshitsugu Obi, Ryohei Yamamoto, Yoshitsugu Takabatake, Jun-Ya Kaimori, Toshiki Moriyama, Masaru Horio, Isao Matsui, Yoshitaka Isaka
Background: Hypomagnesemia (Hypo-Mg) predicts mortality and chronic kidney disease (CKD) progression. However, in CKD, its prevalence, kidney-intrinsic risk factors, and the effectiveness of oral magnesium (Mg) therapy on serum Mg levels is uncertain. Methods: In a cross-sectional study enrolling pre-dialysis outpatients with CKD, the prevalence of electrolyte abnormalities (Mg, sodium, potassium, calcium and phosphorus) was compared. In an open-label randomized controlled trial (RCT), we randomly assigned CKD patients to either the magnesium oxide (MgO) or control arm...
May 22, 2018: Nephrology, Dialysis, Transplantation
N A Koziolova, E A Polyanskaya, M V Surovtseva, P G Karavaev
In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries...
April 2018: Kardiologiia
Ru Yu Tan, Michelle Manning, Jacqueline Spurway, Thulasi Jegatheesan, Michelle Bertram, Lisa Phipps, Jan Swinnen
AIM: Formation of autogenous arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD) is complicated by a high primary failure rate due to pre-existing vascular damage. We hypothesized that Venous Preservation Scan (VPS) - early (months to years before AVF creation) vascular mapping followed by vasculature preservation is effective in protecting the patient's best "for fistula" vasculature. This study was performed to evaluate the impact of VPS on AVF outcomes...
May 20, 2018: Nephrology
Marjorie E Bateman, Amy L Strong, Jeffrey M Gimble, Bruce A Bunnell
OBJECTIVE: The objective of this review is to describe the safety and efficacy of ASC and SVF in treating common diseases and the next steps in research that must occur prior to clinical use. EVIDENCE REVIEW: Pubmed, Ovid Medline, Embase, Web of Science, and the Cochrane Library were searched for articles about use of SVF or ASC for disease therapy published between 2012 and 2017. One meta-analysis, 2 randomized controlled trials, and 16 case series were included, representing 844 human patients...
May 15, 2018: Stem Cells
Chikara Ueki, Hiroaki Miyata, Noboru Motomura, Ryuzo Sakata, Genichi Sakaguchi, Takehide Akimoto, Shinichi Takamoto
OBJECTIVES: Most randomized controlled trials of off-pump versus on-pump coronary artery bypass grafting (CABG) have included limited numbers of patients with preoperative renal failure. This study was performed to evaluate the association between the clinical benefit of the off-pump technique and chronic kidney disease stage. METHODS: We analyzed 38,051 patients with chronic kidney disease who underwent primary nonemergent isolated CABG from 2013 to 2015 as reported in the Japan Cardiovascular Surgery Database-Adult section...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
Eri Ito, Daijo Inaguma, Shigehisa Koide, Kazuo Takahashi, Hiroki Hayashi, Midori Hasegawa, Yukio Yuzawa
BACKGROUND: Whether vitamin D receptor activator (VDRA) use is beneficial in chronic kidney disease (CKD) is unclear, because it is possible that VDRA increases serum fibroblast growth factor 23 (FGF23) levels. We will conduct a randomized controlled trial in predialysis patients to determine the effect of VDRA alone or in combination with lanthanum carbonate (LC) on serum FGF23 levels. METHODS: This is a single-center, open-label, randomized controlled trial. Enrollment will commence February 1, 2018, using the following inclusion criteria: (1) age ≥ 20 years, (2) CKD with an estimated glomerular filtration rate of 10-45 mL/min/1...
May 10, 2018: Clinical and Experimental Nephrology
Ai-Mei Zhao, Wen-Ran Qiu, Li-Jun Mao, Jun-Guo Ren, Li Xu, Ming-Jiang Yao, Kellie Bilinksi, Dennis Chang, Jian-Xun Liu
BACKGROUND: Post-stroke depression (PSD) is the most common psychiatric complication after a stroke. The most frequently used antidepressants are selective serotonin receptor inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), however, these exhibit a series of side effects. Traditional Chinese medicine has been used to treat PSD with few side effects. The aim of this study is to evaluate the efficacy and safety of Jiedu Tongluo granules for treating PSD with qi deficiency and blood stasis syndrome...
May 10, 2018: Trials
J W Han, J T Liu, P L Ma
To investigate the sources of inconsistent findings between two randomized control trials["initiation strategies for renal-replacement therapy in the intensive care unit"(AKIKI trial) vs"effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury"(ELAIN trial) ], regarding"timing of renal replacement therapy (RRT) on mortality in patients with acute kidney injury (AKI). By reanalysis of the published data, it was found that demographics, severity of primary disease and stage of AKI before initiation of RRT were quite different between AKIKI and ELAIN trials...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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