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https://www.readbyqxmd.com/read/29350175/update-on-the-nephrotoxicity-of%C3%A2-novel%C3%A2-anticancer-agents%C3%A2
#1
Eliezer Zachary Nussbaum, Mark A Perazella
Anticancer drug-induced kidney disease is a problem commonly encountered by nephrologists. The number of medications employed by oncologists causing acute and chronic kidney injury as well as electrolyte and acid-base disturbances has increased significantly over the past several decades. While conventional chemotherapeutic drugs induce a number of kidney lesions, emergence of very effective and well-tolerated targeted therapies and novel immunotherapies has increased the occurrence of drug-induced acute and chronic kidney injury in cancer patients...
January 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29344507/definition-management-and-outcomes-of-acute-kidney-injury-an-international-survey-of-nephrologists
#2
Umar Farooq, Aaron Tober, Vernon Chinchilli, W Brian Reeves, Nasrollah Ghahramani
Background: Acute kidney injury (AKI) is a complex disease burdened by uncertainties of definition, management strategies, and prognosis. This study explores the relationship between demographic characteristics of nephrologists and their perceptions about the definition, management, and follow-up of AKI. Methods: We developed a Web-based survey, the International Survey on Acute Kidney Injury (ISAKI), consisting of 29 items in 4 categories: (1) demographic and practice characteristics, (2) definition of AKI, (3) management of renal replacement therapy (RRT) in AKI, and (4) sequelae of AKI...
December 2017: Kidney Diseases
https://www.readbyqxmd.com/read/29336064/home-hemodialysis-education-during-postdoctoral-training-challenges-and-innovations
#3
Joel D Glickman, Rebecca Kurnik Seshasai
Inadequate education in home hemodialysis (HHD) fellowship training might contribute to underutilization of this modality in the United States. Most graduates of nephrology fellowships do not grade themselves as competent in HHD suggesting that fellowship training in HHD is inadequate. An essential component for fellow education is at least one faculty member with expertise in HHD who is passionate about promoting the use of this modality. At a minimum, fellow training should utilize a curriculum that includes both lectures about HHD and outpatient clinical exposure to this modality over a period of at least 6-12 months...
January 15, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29336060/what-the-non-nephrologist-needs-to-know-about-dialysis
#4
Matt Foy, C John Sperati
The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non-nephrologists have a working knowledge of issues germane to dialysis...
January 15, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29335397/pediatric-renal-transplantation-focus-on-current-transition-care-and-proposal-of-the-rise-to-transition-protocol
#5
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29334930/safety-and-adequacy-of-percutaneous-kidney-biopsy-performed-by-nephrology-trainees
#6
Vittoria Esposito, Giulia Mazzon, Paola Baiardi, Massimo Torreggiani, Luca Semeraro, Davide Catucci, Marco Colucci, Alice Mariotto, Fabrizio Grosjean, Giacomo Bovio, Ciro Esposito
BACKGROUND: Recently there has been a progressive loss of specialty related skills for nephrologists. Among the skills we find the kidney biopsy that has a central role in diagnosis of renal parenchymal disease. One of the causes might be the belief that the kidney biopsy should be performed only in larger Centers which can rely on the presence of a renal pathologist and on nephrologists with a large experience. This trend may increase in the short term procedural safety but may limit the chance of in training nephrologists to become confident with the technique...
January 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29333675/sharing-innovations-to-enhance-renal-fellow-education-in-dialysis
#7
Laura J Maursetter, Lisa K Prince, Christina M Yuan, James F Simon
Dialysis care is an integral part of the practice of nephrology. Despite this, education of fellows in providing dialysis often remains rudimentary, relying on a combination of didactics and learning through experience. This runs the risk of training nephrologists who can provide dialysis care without truly being experts on the subject. In this article, a collection of novel or innovative teaching methods is presented that are meant to provide training programs with additional tools with which to improve the training of their fellows in dialysis...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#8
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29332935/novel-treatment-strategies-for-chronic-kidney-disease-insights-from-the-animal-kingdom
#9
REVIEW
Peter Stenvinkel, Johanna Painer, Makoto Kuro-O, Miguel Lanaspa, Walter Arnold, Thomas Ruf, Paul G Shiels, Richard J Johnson
Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress...
January 15, 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29332204/supplementing-living-kidney-transplantees-medical-records-with-donor-and-recipient-narratives
#10
Anne Hambro Alnæs
Norway provides total social welfare coverage for organ transplantations, including free immunosuppressive medication and prepaid life-long follow up for both recipients and donors. Despite these benefits the proportion of living kidney donors (LKD) has in recent years declined from around 40% (2011) of all kidney transplantations to 24% (2016). This study suggests harnessing patient- and donor-narratives as a tool for addressing the current fall in donation rates. The hospital records of 18 recipient/donor dyads were compared with patient and donor accounts elicited in semi-structured interviews...
January 13, 2018: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29329530/design-and-evaluation-of-a-mobile-application-to-assist-the-self-monitoring-of-the-chronic-kidney-disease-in-developing-countries
#11
Alvaro Sobrinho, Leandro Dias da Silva, Angelo Perkusich, Maria Eliete Pinheiro, Paulo Cunha
BACKGROUND: The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. METHODS: A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29326308/addressing-physician-burnout-nephrologists-how-safe-are-we
#12
Amy W Williams
No abstract text is available yet for this article.
January 11, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29319781/a-future-for-nephrology
#13
Richard Glassock
It is interesting that some of my predictions came true and some did not, but I think the jury is still out on many of them. I start to remind everyone on the glorious past of Nephrology, from the physiology, translational and methodological discoveries that have contributed to the development of our discipline. I predict that the Academic branch of Nephrology will continue to excel in three domains: Creative Research,Teaching (Training) and Innovative Clinical Care. I forsee dramatic changes in Nephrology practice in the short term (10 years) and I discuss which areas will have a most dramatic impact...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29318218/potential-benefit-associated-with-delaying-initiation-of-hemodialysis-in-a-japanese-cohort
#14
Satoshi Higuchi, Izaya Nakaya, Kazuhiro Yoshikawa, Yoichiro Chikamatsu, Ken-Ei Sada, Suguru Yamamoto, Satoko Takahashi, Hiroyo Sasaki, Jun Soma
Introduction: Late referral to a nephrologist, the type of vascular access, nutritional status, and the estimated glomerular filtration rate (eGFR) at the start of hemodialysis (HD) have been reported as independent risk factors of survival for patients who begin HD. The aim of this study was to clarify the influence of the HD-free interval from the time of an eGFR of 10 ml/min per 1.73 m2 (IGFR10-HD) on patient outcome. Methods: We enrolled 124 patients aged older than 20 years who had HD initiated in a general hospital...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29314256/point-of-care-ultrasound-education-to-improve-care-of-dialysis-patients
#15
Surekha Mullangi, Stephen M Sozio, Paul Segal, Steven Menez, Carol Martire, Tariq Shafi
Point-of-care ultrasound (POCUS) is rapidly emerging as a bedside diagnostic tool that can enhance physical diagnosis and facilitate clinical decision making. Although ultrasound is widely used by nephrologists for vascular access and kidney imaging, diagnostic POCUS skills in other anatomic areas are not part of routine nephrology training. In this narrative review, we will provide an overview of selected POCUS techniques, highlight potential uses of POCUS in routine nephrology practice, and describe a new curriculum implemented at Johns Hopkins University School of Medicine to teach diagnostic POCUS skills to nephrology fellows...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29314253/peritoneal-dialysis-education-challenges-and-innovation
#16
Rajnish Mehrotra
Peritoneal dialysis is the most common modality for home dialysis and to ensure patients have access to dialysis at home, training programs have to ensure that the fellows attain clinical competency in the care of such patients. The limited data available however are sobering; about 10 years ago, 44% of nephrologists reported that they did not feel competent in the care of patients undergoing peritoneal dialysis. There are recognizable challenges in ensuring clinical competency of trainees that may need creative solutions...
January 4, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29314241/dialysis-access-procedure-training-for-the-nephrologist
#17
Sana Waheed, Laura Maursetter, Alexander Yevzlin
Historically, the placement and maintenance of dialysis access has been an integral part of nephrology training. However, in recent years, a big debate has ensued regarding whether this should be limited to trainees' understanding and counseling the patients regarding indications, alternatives, risks and possible complications of these procedures or should it actually involve more of a hands-on experience for the trainees. Some of the barriers in making these procedures a requirement across the board are the lack of standardization of procedural training across various training programs and the absence of consensus on what achieving competency in these procedures looks like...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29310600/warfarin-anticoagulation-in-hemodialysis-patients-with-atrial-fibrillation-comparison-of-nephrologist-led-and-anticoagulation-clinic-led-management
#18
Hamad Bahbahani, Ahmed AlTurki, Ahmed Dawas, Mark L Lipman
BACKGROUND: There is conflicting evidence of benefit versus harm for warfarin anticoagulation in hemodialysis patients with atrial fibrillation. This equipoise may be explained by suboptimal Time in Therapeutic Range (TTR), which correlates well with thromboembolic and bleeding complications. This study aimed to compare nephrologist-led management of warfarin therapy versus that led by specialized anticoagulation clinic. METHODS: In a retrospective cohort of chronic hemodialysis patients from two institutions (Institution A: Nephrologist-led warfarin management, Institution B: Anticoagulation clinic-led warfarin management), we identified patients with atrial fibrillation who were receiving warfarin for thromboembolic prophylaxis...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29307101/aciclovir-induced-acute-kidney-injury-in-patients-with-suspected-viral-encephalitis-encountered-on-a-liaison-neurology-service
#19
Petya Bogdanova-Mihaylova, David Burke, John P O'Dwyer, David Bradley, Jennifer A Williams, Simon J Cronin, Shane Smyth, Raymond P Murphy, Sinead M Murphy, Catherine Wall, Dominick J H McCabe
BACKGROUND: Patients with 'suspected viral encephalitis' are frequently empirically treated with intravenous aciclovir. Increasing urea and creatinine are 'common', but rapidly progressive renal failure is reported to be 'very rare'. AIMS: To describe the clinical course and outcome of cases of aciclovir-induced acute kidney injury (AKI) encountered by the Liaison Neurology Service at AMNCH and to highlight the importance of surveillance and urgent treatment of this iatrogenic complication...
January 6, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29299004/ambulatory-medication-reconciliation-in-dialysis-patients-benefits-and-community-practitioners-perspectives
#20
Jo-Anne S Wilson, Matthew A Ladda, Jaclyn Tran, Marsha Wood, Penelope Poyah, Steven Soroka, Glenn Rodrigues, Karthik Tennankore
Background: Ambulatory medication reconciliation can reduce the frequency of medication discrepancies and may also reduce adverse drug events. Patients receiving dialysis are at high risk for medication discrepancies because they typically have multiple comorbid conditions, are taking many medications, and are receiving care from many practitioners. Little is known about the potential benefits of ambulatory medication reconciliation for these patients. Objectives: To determine the number, type, and potential level of harm associated with medication discrepancies identified through ambulatory medication reconciliation and to ascertain the views of community pharmacists and family physicians about this service...
November 2017: Canadian Journal of Hospital Pharmacy
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