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https://www.readbyqxmd.com/read/28813636/using-systems-science-to-inform-population-health-strategies-in-local-health-departments-a-case-study-in-san-antonio-texas
#1
Yan Li, Norma A Padrón, Anil T Mangla, Pamela G Russo, Thomas Schlenker, José A Pagán
OBJECTIVES: Because of state and federal health care reform, local health departments play an increasingly prominent role leading and coordinating disease prevention programs in the United States. This case study shows how a local health department working in chronic disease prevention and management can use systems science and evidence-based decision making to inform program selection, implementation, and assessment; enhance engagement with local health systems and organizations; and possibly optimize health care delivery and population health...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28811917/drug-information-update-lithium-and-chronic-kidney-disease-debates-and-dilemmas
#2
Sumeet Gupta, Udayan Khastgir
Lithium is an established treatment for bipolar disorder and an augmenting agent for treatment-resistant depression. Despite awareness of renal adverse effects, including chronic kidney disease, for the past five decades, there has been a lack of research evidence. This has led to debates around the existence and magnitude of the risk. This article discusses the current evidence base regarding the link between lithium and chronic kidney disease, monitoring of renal functions and its clinical implications.
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28811651/inkt-cells-prevent-obesity-induced-hepatic-steatosis-in-mice-in-a-c-c-chemokine-receptor-7-dependent-manner
#3
H M Kim, R Lee, E S Lee, M H Kwon, J H Huh, B-E Kwon, E-K Park, S-Y Chang, M-N Kweon, P-H Kim, H-J Ko, C H Chung
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are characterized by an increase in hepatic triglyceride content with infiltration of immune cells, which can cause steatohepatitis and hepatic insulin resistance. C-C chemokine receptor 7 (CCR7) is primarily expressed in immune cells, and CCR7 deficiency leads to the development of multi-organ autoimmunity, chronic renal disease, and autoimmune diabetes. Here, we investigated the effect of CCR7 on hepatic steatosis in a mouse model and its underlying mechanism...
August 16, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28811049/marijuana-and-cannabinoids-in-esrd-and-earlier-stages-of-ckd
#4
Joshua L Rein, Christina M Wyatt
Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#5
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/28810595/sudoscan-an-effective-tool-for-screening-chronic-kidney-disease-in-patients-with-type-2-diabetes
#6
Fei Mao, Siying Liu, Xiaona Qiao, Hangping Zheng, Qian Xiong, Jie Wen, Shuo Zhang, Zhaoyun Zhang, Hongying Ye, Hongli Shi, Bin Lu, Yiming Li
SUDOSCAN is a non-invasive method of measuring peripheral small fiber and autonomic nerve activity by detection of abnormal sweat gland function through electrochemical skin conductance. It has been reported to be an effective screening tool in early detection of microvascular type 2 diabetes mellitus (T2DM) complications including diabetic neuropathy and nephropathy in recent studies. However, previous studies used estimated glomerular filtration rate (eGFR) as the golden standard, which has a 90% chance of being within 30% of the measured GFR at best...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810244/increasing-haemodialytic-clearances-as-residual-renal-function-declines-an-incremental-approach
#7
Kamonwan Tangvoraphonkchai, Andrew Davenport
Many patients with chronic kidney disease start undergoing thrice-weekly haemodialysis (HD), aiming for an HD sessional dialyzer urea clearance target, irrespective of whether they have residual renal function (RRF). While increasing sessional dialyzer urea clearance above a target of 1.2 has not been shown to improve patient survival, it has been shown that the preservation of RRF improves patient self-reported outcomes and survival. Observational studies have suggested that initiating twice-weekly HD schedules leads to greater preservation of RRF...
August 16, 2017: Blood Purification
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#8
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28808355/new-markers-of-inflammation-and-tubular-damage-in-children-with-chronic-kidney-disease
#9
Kinga Musiał, Agnieszka Bargenda, Dorota Drożdż, Danuta Zwolińska
INTRODUCTION AND AIMS: Monocyte chemoattractant protein- (MCP-) 1, macrophage colony-stimulating factor (MCSF), and neopterin are connected with monocyte migration and transition into macrophages, leading to fibrosis and tubular damage in the course of CKD. The aim of the study was to analyze the applicability of urinary fractional excretion (FE) of MCP1, MCSF, and neopterin, as markers of inflammation and tubular damage, in children with CKD. METHODS: The study group consisted of 61 children with CKD stages 1-5 and 23 age-matched controls...
2017: Disease Markers
https://www.readbyqxmd.com/read/28807932/reducing-inflammatory-cytokine-production-from-renal-collecting-duct-cells-by-inhibiting-gata2-ameliorates-acute-kidney-injury
#10
Lei Yu, Takashi Moriguchi, Hiroshi Kaneko, Makiko Hayashi, Atsushi Hasegawa, Masahiro Nezu, Hideyuki Saya, Masayuki Yamamoto, Ritsuko Shimizu
Acute kidney injury (AKI) is a leading cause of chronic kidney disease. Proximal tubules are considered to be the primary origin of pathogenic inflammatory cytokines in AKI. However, it remains unclear whether other cell types, including collecting duct (CD) cells, participate in inflammatory processes. The transcription factor GATA2 is specifically expressed in CD cells and maintains their cellular identity. To explore the pathophysiological function of GATA2 in AKI, we generated renal tubular cell-specific Gata2 deletion (G2CKO) mice and examined their susceptibility to ischemia-reperfusion injury (IRI)...
August 14, 2017: Molecular and Cellular Biology
https://www.readbyqxmd.com/read/28807595/sphingosine-kinase-2-deficiency-ameliorates-kidney-fibrosis-by-up-regulating-smad7-in-a-mouse-model-of-unilateral-ureteral-obstruction
#11
Stephanie Schwalm, Sandra Beyer, Helena Frey, Riad Haceni, Georgios Grammatikos, Dominique Thomas, Gerd Geisslinger, Liliana Schaefer, Andrea Huwiler, Josef Pfeilschifter
Kidney fibrosis is a hallmark of chronic kidney disease and leads to extracellular matrix accumulation, organ scarring, and loss of kidney function. In this study, we investigated the role of sphingosine kinase-2 (SPHK2) on the progression of tubular fibrosis by utilizing a mouse unilateral ureteral obstruction (UUO) model. We found that SPHK2 protein and activity are up-regulated in fibrotic renal tissue. Functionally, Sphk2 deficient (Sphk2(-/-)) mice showed an attenuated fibrotic response to UUO compared to wild-type mice as demonstrated by reduced collagen abundance and decreased expression of fibronectin-1, collagen I, α-smooth muscle actin, connective tissue growth factor (CTGF), and plasminogen activator inhibitor (PAI-1)...
August 11, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28807385/external-validation-of-a-5-year-survival-prediction-model-after-elective-abdominal-aortic-aneurysm-repair
#12
Randall R DeMartino, Ying Huang, Jay Mandrekar, Philip P Goodney, Gustavo S Oderich, Manju Kalra, Thomas C Bower, Jack L Cronenwett, Peter Gloviczki
OBJECTIVE: The benefit of prophylactic repair of abdominal aortic aneurysms (AAAs) is based on the risk of rupture exceeding the risk of death from other comorbidities. The purpose of this study was to validate a 5-year survival prediction model for patients undergoing elective repair of asymptomatic AAA <6.5 cm to assist in optimal selection of patients. METHODS: All patients undergoing elective repair for asymptomatic AAA <6.5 cm (open or endovascular) from 2002 to 2011 were identified from a single institutional database (validation group)...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28806350/blood-pressure-variability-is-increasing-from-the-first-to-the-second-day-of-the-interdialytic-interval-in-hemodialysis-patients
#13
Antonios Karpetas, Charalampos Loutradis, Athanasios Bikos, Georgios Tzanis, Georgios Koutroumpas, Antonios A Lazaridis, Konstantinos Mavromatidis, Vassilios Liakopoulos, Aikaterini Papagianni, Pantelis Zebekakis, Luis M Ruilope, Gianfranco Parati, Pantelis A Sarafidis
OBJECTIVES: Patients with end-stage renal-disease under hemodialysis have increased cardiovascular risk and experience severe blood pressure (BP) fluctuations during the dialysis session and the subsequent interdialytic period. BP variability (BPV) may be an additional risk factor for cardiovascular events and preliminary data suggest increased BPV with advancing stages of chronic kidney disease. This is the first study to examine BPV during the whole intradialytic and interdialytic period in hemodialysis patients with ambulatory BP monitoring...
August 12, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28806192/micrornas-as-biomarkers-in-chronic-kidney-disease
#14
Alexa Wonnacott, Timothy Bowen, Donald J Fraser
PURPOSE OF REVIEW: This review summarizes recent data supporting the concept that urinary microRNAs are a useful new class of biomarker. They may improve capacity to stratify patients with chronic kidney disease according to risk of progression, and may also inform about response to therapy. RECENT FINDINGS: MicroRNAs are present, stable and readily quantifiable in tissues and body fluids, including urine, and have widespread importance as regulators in the kidney...
August 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28806191/a-patient-centred-approach-to-measuring-quality-in-kidney-care-patient-reported-outcome-measures-and-patient-reported-experience-measures
#15
Olalekan L Aiyegbusi, Derek Kyte, Paul Cockwell, Nicola Anderson, Melanie Calvert
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is associated with symptoms that can significantly reduce the health-related quality of life (HRQOL) of patients. Patient-reported outcome and experience measures (PROMs and PREMs) may assist with the evaluation of HRQOL and quality of care from the patient perspective. This review focuses on evidence from recent studies exploring the role of PROMs and PREMs in the measurement of quality in CKD care. RECENT FINDINGS: PROMs are increasingly used in CKD research as measures of clinical effectiveness, whereas the current use of PROMs in routine clinical settings and PREMs in all settings is more limited...
August 12, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28805977/prevention-against-renal-damage-in-rats-with-subtotal-nephrectomy-by-sacubitril-valsartan-lcz696-a-dual-acting-angiotensin-receptor-neprilysin-inhibitor
#16
Kentaro Ushijima, Hitoshi Ando, Yusuke Arakawa, Kenichi Aizawa, Chisato Suzuki, Ken Shimada, Shu-Ichi Tsuruoka, Akio Fujimura
Although patients with chronic kidney disease (CKD) are at increased risk for end-stage renal disease and cardiovascular events, adequate drug therapies for preventing the deterioration of these conditions are still not established. This study was undertaken to evaluate a preventive effect of an angiotensin receptor-neprilysin inhibitor sacubitril/valsartan (LCZ696), which is converted to sacubitril and valsartan in the body, against the progression of renal disease in rats with subtotal nephrectomy, an animal model of human CKD...
August 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28805677/endocytosis-of-albumin-induces-matrix-metalloproteinase-9-by-activating-the-erk-signaling-pathway-in-renal-tubule-epithelial-cells
#17
Xiaoming Chen, Alyssa Cobbs, Jasmine George, Ashmeer Chima, Fidele Tuyishime, Xueying Zhao
Matrix metalloproteinase-9 (MMP-9) is dysregulated in chronic kidney diseases including diabetic nephropathy. This study was performed to examine the expression of MMP-9 in renal tubule epithelial cells (TECs) under diabetic conditions and its regulatory mechanisms. We characterized MMP-9 protein in diabetic animals and primary cultured rat TECs exposed to exogenous albumin and high glucose. We also used specific inhibitors to determine if internalization of albumin and/or extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation were required for MMP-9 secretion...
August 12, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28805481/a-comparison-of-quality-of-sleep-between-patients-with-chronic-kidney-disease-not-on-hemodialysis-and-end-stage-renal-disease-on-hemodialysis-in-a-developing-country
#18
Salman T Shafi, Tahir Shafi
Few studies have compared quality of sleep between pre-dialysis chronic kidney disease (pre-dialysis CKD) patients and end-stage renal disease patients on dialysis (ESRD) and have found inconsistent results. Objective of this study is to compare quality of sleep between patients with pre-dialysis CKD and ESRD in a developing country. This study was conducted in an out-patient department and hemodialysis unit of a tertiary care facility. Patients included had either pre-dialysis CKD or ESRD. Assessment of quality of sleep was done using Pittsburgh sleep quality index (PSQI)...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28805480/current-evidence-on-the-use-of-anti-raas-agents-in-congenital-or-acquired-solitary-kidney
#19
Mariadelina Simeoni, Annarita Armeni, Chiara Summaria, Annamaria Cerantonio, Giorgio Fuiano
RATIONAL: The inhibition of renin-angiotensin-aldosterone system (RAAS) is a major strategy for slowing the progression of chronic kidney disease (CKD). The utility of anti-RAAS agents in patients with congenital or acquired solitary kidney is still controversial. OBJECTIVE: A systematic literature review was conducted. MAIN FINDINGS: The conclusions of the few available studies on the topic are homogeneously in agreement with a long-term reno-protective activity of anti-RAAS drugs in patients with solitary kidney, especially if patients are hypertensive or proteinuric...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28803082/addressing-patient-emotional-and-existential-needs-during-serious-illness-results-of-the-outlook-randomized-controlled-trial
#20
Karen E Steinhauser, Stewart Alexander, Maren K Olsen, Karen M Stechuchak, Jennifer Zervakis, Natalie Ammarell, Ira Byock, James A Tulsky
CONTEXT: Few interventions exist to address patients' existential needs. OBJECTIVE: Determine whether an intervention to address seriously-ill patients' existential concerns improves preparation, completion (elements of quality-of-life at end-of-life) and reduces anxiety and depression. METHODS: A randomized control trial comparing: 1)Outlook intervention, 2)Relaxation meditation (RM); and 3)Usual care (UC). Measures included: primary - quality-of-life (QUAL-E) and secondary - FACT-G, anxiety (POMS), depression (CES-D), and spiritual well-being (FACIT-sp)...
August 9, 2017: Journal of Pain and Symptom Management
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