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https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#1
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28226325/lung-ultrasound-in-hemodialysis-a-card-to-be-played
#2
Pierpaolo Di Nicolò, Giacomo Magnoni, Antonio Granata
The end-stage renal disease is characterized by a profound impairment in the regulation of body fluid distribution, and volume assessment in hemodialysis is one of the challenging goals for the nephrologist. To determine a state of euvolemia, different validated techniques have been employed and among them lung ultrasonography (LUS) has recently attracted growing attention on account of its capacity to estimate accurately extra vascular lung water and to detect lung edema even in its early asymptomatic stage, that is, hidden lung congestion...
February 23, 2017: Blood Purification
https://www.readbyqxmd.com/read/28224944/managing-ckd-by-telemedicine-the-zuni-telenephrology-clinic
#3
REVIEW
Andrew S Narva, Gayle Romancito, Thomas Faber, Michael E Steele, Kenneth M Kempner
Telemedicine has significant potential to extend nephrology consultation to rural and isolated communities. We describe a telenephrology clinic that has delivered ongoing consultative care from a nephrologist based at the National Institutes of Health in Bethesda, MD, to the Zuni Comprehensive Health Center in western New Mexico. Over the past 9 years, the clinic has conducted 1870 patient visits managing patients using a collaborative approach engaging a nurse case manager, nephrologist, primary clinicians, pharmacists, and community health nurses...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28224937/telehealth-in-the-delivery-of-home-dialysis-care-catching-up-with-technology
#4
REVIEW
Vinay N Krishna, Kamesha Managadi, Michael Smith, Eric Wallace
Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28223290/nephrologists-perspectives-on-defining-and-applying-patient-centered-outcomes-in-hemodialysis
#5
Allison Tong, Wolfgang C Winkelmayer, David C Wheeler, Wim van Biesen, Peter Tugwell, Braden Manns, Brenda Hemmelgarn, Tess Harris, Sally Crowe, Angela Ju, Emma O'Lone, Nicole Evangelidis, Jonathan C Craig
BACKGROUND AND OBJECTIVES: Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists' perspectives on defining and implementing patient-centered outcomes in hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand...
February 21, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28216281/clinicians-perspectives-on-advance-care-planning-for-patients-with-ckd-in-australia-an-interview-study
#6
Marcus Sellars, Allison Tong, Tim Luckett, Rachael L Morton, Carol A Pollock, Lucy Spencer, William Silvester, Josephine M Clayton
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia...
February 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28207893/career-interest-and-perceptions-of-nephrology-a-repeated-cross-sectional-survey-of-internal-medicine-residents
#7
Michael N Daniels, Sharon Maynard, Ivan Porter, Hope Kincaid, Deepika Jain, Nabeel Aslam
BACKGROUND: Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. METHODS: This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions...
2017: PloS One
https://www.readbyqxmd.com/read/28202028/management-of-everolimus-associated-adverse-events-in-patients-with-tuberous-sclerosis-complex-a-practical-guide
#8
REVIEW
Mark Davies, Anurag Saxena, John C Kingswood
Tuberous sclerosis complex (TSC) is a genetic disorder characterised by highly variable comorbid dysfunction and subsequent morbidity. The mTOR inhibitor everolimus is indicated for the treatment of adult TSC patients with renal angiomyolipomas (AMLs) and for subependymal giant astrocytoma (SEGA) in both adults and children, based on data from the EXIST-1 and EXIST-2 trials. However, due to the historical predominance of everolimus in the oncology setting, some physicians who treat TSC patients may be unfamiliar with everolimus-associated adverse events (AEs) and appropriate management strategies...
February 15, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28201528/pharmacoepidemiology-for-nephrologists-do-proton-pump-inhibitors-cause-chronic-kidney-disease
#9
Laurie A Tomlinson, Damian G Fogarty, Ian Douglas, Dorothea Nitsch
No abstract text is available yet for this article.
February 11, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28190377/collaborative-approach-to-the-creation-of-an-arteriovenous-fistula-on-a-us-navy-hospital-ship
#10
Kimberly A Thompson, Amrish Krishnan, Charles Stehman, Steven Hanling, Kevin Casey
Early creation of arteriovenous fistulas (AVFs) decreases morbidity and mortality in patients with end-stage renal disease and is the standard of care in the United States. However, this procedure is frequently not accessible in low- and middle-income countries (LMICs). We present the first reported case of successful AVF creation as part of a humanitarian assistance mission. The patient was a 51-year-old male with diabetes, hypertension, and end-stage renal disease on hemodialysis via a temporary dialysis catheter...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28186959/percutaneous-ultrasound-guided-renal-biopsy-a-comparison-of-axial-vs-sagittal-probe-location
#11
Farnaz Shamshirgar, Seyed Morteza Bagheri
BACKGROUND: Renal biopsy is an important method for diagnosis of renal parenchymal abnormalities. Here, we compare the effectiveness and complications of percutaneous ultrasound-guided renal biopsy using axial vs. sagittal probe locations. METHODS: In a cross-sectional survey, in 2012, patients with a nephrologist order were biopsied by a radiology resident. Renal biopsy was done on 15 patients using axial (A group) and the same number of biopsies done with sagittal probe location (S group)...
February 7, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28177096/-severe-multifactorial-hyponatremia
#12
Massimo Manes, Elisabetta Radin, Valentina Pellù, Donatella Caputo, Danila Gabrielli, Andrea Molino, Giuseppe Paternoster, Emanuele Parodi, Pier Eugenio Nebiolo
Hyponatremia is the most common electrolyte disorder observed in hospitalized patients. The most severe forms are neurological and potentially fatal emergencies; yet increased morbidity, length of hospital stay and costs associated with less severe forms are aspects of major concern. Nephrologists are frequently consulted regarding the therapeutic management and the key pathophysiological issues of hyponatremia, as this latter aspect represents a true challenge in an emergency setting. We report a case of a woman admitted to the emergency room for gait instability caused by a very severe multifactorial hyponatremia with a favourable clinical outcome...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28165579/a-national-appraisal-of-haemodialysis-vascular-access-provision-in-scotland
#13
Scott W Oliver, Jacqueline Campbell, David B Kingsmore, Ram Kasthuri, Wendy Metcalfe, Jamie P Traynor, Denis Fischbacher-Smith, Alan G Jardine, Peter C Thomson
PURPOSE: Published registry data demonstrate longstanding variation in the utilisation of different vascular access (VA) modalities between Scottish renal units; this may reflect different clinical processes between centres. A comprehensive appraisal was undertaken to understand the processes underpinning VA creation and maintenance across Scotland. METHODS: A mixed methods approach was utilised. Fifty-two semi-structured interviews were conducted with patients and clinicians in all ten, adult and paediatric, Scottish renal units...
January 31, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28161265/-reasons-for-first-consultation-in-nephrology-in-the-health-area-5-of-britanny-during-the-year-2014
#14
Jeanne Prévot, Sahar Bayat-Makoei, Cécile Vigneau
BACKGROUND: In France, the coordinated healthcare circuit means that patients should be referred to specialists, for example nephrologists, by another physician. However, there are no recommendations concerning the reasons justifying the referral to a nephrologist. The main purpose of our study is to describe the motif of first consultations in nephrology in the health area 5 of Brittany. METHODS: We retrospectively collected medical reports of first consultations by 17 nephrologists in the 4 centers of the study area, during the year 2014...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28161262/-factors-affecting-the-choice-of-peritoneal-dialysis-perspective-of-patients-and-nephrologists
#15
Aida Habib, Anne-Claire Durand, Philippe Brunet, Ariane Duval-Sabatier, Olivier Moranne, Stanislas Bataille, Laurent Benhaim, Évelyne Bargas, Stéphanie Gentile
PURPOSE: To identify factors related to the choice of peritoneal dialysis as a first dialysis technique: the viewpoint of patients and viewpoint of nephrologists. METHODS: A retrospective multicenter study, type case-control was conducted in patients starting dialysis between 2010 and 2014 in 4 dialysis facilities in the PACA region. Nephrologists take care of patients included in the study were also interviewed. Data were collected using two standardized questionnaires: One for the patient and one for the nephrologists and using the French REIN registry...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28158576/web-based-consultation-between-general-practitioners-and-nephrologists-a-cluster-randomized-controlled-trial
#16
Vincent A van Gelder, Nynke D Scherpbier-de Haan, Saskia van Berkel, Reinier P Akkermans, Inge S de Grauw, Eddy M Adang, Pim J Assendelft, Wim J C de Grauw, Marion C J Biermans, Jack F M Wetzels
No abstract text is available yet for this article.
February 2, 2017: Family Practice
https://www.readbyqxmd.com/read/28156631/survival-benefits-among-patients-with-end-stage-renal-disease-receiving-dialysis-versus-no-dialysis
#17
Maen Abdelrahim, Valda D Page, Shouhao Zhou, Chan Shen, Sriram Yennu, Bo Zhao, Joanna-Grace Mayo Manzano, Marina Ciny George, Joseph L Nates, Alvin Howard Moss, Rima Pai, Ala Abudayyeh
: 55 Background: Retrospective study of the outcomes of Stage IV Cancer Patients with End Stage Renal disease Receiving Dialysis and comparing the survival benefits among the patients who received Hemodialysis versus who didn't at a Comprehensive Cancer Center. METHODS: Retrospectively review all patients admitted to MDACC from 2005-2014 and diagnosed with stage IV solid tumor admitted with Acute kidney injury and a nephrology consult were included (N = 903) 19...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#18
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28148557/symptom-management-of-the-patient-with-ckd-the-role-of-dialysis
#19
Valerie Jorge Cabrera, Joni Hansson, Alan S Kliger, Fredric O Finkelstein
As kidney disease progresses, patients often experience a variety of symptoms. A challenge for the nephrologist is to help determine if these symptoms are related to advancing CKD or the effect of various comorbidities and/or medications prescribed. The clinician also must decide the timing of dialysis initiation. The initiation of dialysis can have a variable effect on quality of life measures and the alleviation of uremic signs and symptoms, such as anorexia, fatigue, cognitive impairment, depressive symptoms, pruritus, and sleep disturbances...
February 1, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28145625/pediatric-renal-transplant-practices-in-india
#20
Sidharth Kumar Sethi, Rajiv Sinha, Smriti Rohatgi, Vijay Kher, Arpana Iyengar, Arvind Bagga
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India...
February 1, 2017: Pediatric Transplantation
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