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https://www.readbyqxmd.com/read/28944153/sequential-development-of-non-arteritic-anterior-ischemic-optic-neuropathy-in-a-patient-on-hemodialysis
#1
Mukesh Jain, Renuka Srinivasan, K Ramesh Babu, M Swapnil Parchand
Purpose: Non-arteritic anterior ischemic optic neuropathy (NA-AION) is typically a disorder of patients 50 years and older predisposed to the vascular and structural optic disc risk factors. We present an interesting case of sequential development of NA-AION in a 45-year-old patient with end-stage renal disease undergoing hemodialysis. Methods: Observational case report. Results: A 45-year-old female on hemodialysis for chronic renal failure complained of sequential acute onset sudden painless gross diminution of vision in right eye followed by the left eye...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28938954/blood-pressure-targets-for-hemodialysis-patients
#2
REVIEW
Jeffrey M Turner, Aldo J Peixoto
The association between blood pressure (BP) and mortality is unique in hemodialysis patients compared with that in the general population. This is because of an altered benefit-risk balance associated with BP reduction in these patients. An adequately designed study comparing BP targets in hemodialysis patients remains to be conducted. The current evidence available to guide dialysis providers regarding treatment strategies for managing hypertension in this population is limited to large observational studies and small randomized controlled trials...
October 2017: Kidney International
https://www.readbyqxmd.com/read/28938950/hospital-readmission-for-the-dialysis-patient-who-is-not-responsible
#3
Elani Streja
A new study in dialysis patients demonstrates that more than one-third of rehospitalizations within 30 days of discharge occur within the first week, and these rehospitalizations are associated with worse survival. Imposing a penalty on the dialysis provider for these rehospitalizations, as mandated by the Hospital Readmissions Reduction Program, may be inefficient in reducing health care costs and improving patient outcomes. Systems for improving communication between the hospital and posthospitalization nephrologist about patient care are needed...
October 2017: Kidney International
https://www.readbyqxmd.com/read/28937054/the-importance-of-bone-biopsy-in-chronic-kidney-disease-mineral-bone-disorders
#4
REVIEW
Periklis Dousdampanis, Kostantina Trigka
Renal osteodystrophy (ROD) is not a uniform bone disease; it is a heterogeneous group of metabolic bone diseases due to chronic kidney disease (CKD). The traditional term of ROD does not accurately include the wide spectrum of "CKD-mineral and bone disorder" (CKD-MBD) and has been restricted to define the several specific histologic disturbances of bone disease associated with CKD. Circulating parathyroid hormone (PTH) and total alkaline phosphatase levels do not always reflect bone turnover in CKD-MBD, whereas bone biopsy provides precise information regarding bone pathology...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28931698/let-us-listen-to-patients-underutilization-of-peritoneal-dialysis-from-patients-perspectives
#5
Randah A Dahlan, Abdulkareem O Alsuwaida, Mai S Farrash, Mohammad A Qureshi, Fayez Hejaili, Abdullah A Al Sayyari
Despite the fact that many of the medical outcome data of peritoneal dialysis (PD) have been improving over the past few years, PD remains an underutilized modality in many countries worldwide. Most nephrologists in those countries report a high rate of patients' refusal. We conducted this survey-based study to determine the obstacles behind underutilization of PD in Saudi Arabia from patients' perspectives and to understand the reasons for their refusal. Nine-hundred and twenty hemodialysis (HD) patients, who had never been on PD before, participated in this study...
September 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28927317/worse-renal-outcome-of-subclass-iv-g-lupus-nephritis-patients-over-iv-s
#6
E J Duque de Sá Carneiro Filho, L B Jorge, L Testagrossa, C Bitencourt, L Yu, V Woronik
Background International Society of Nephrology/ Renal Pathology Society (ISN/RPS) consensus on the classification of lupus nephritis (LN) subdivided class IV into diffuse segmental (IV-S) and diffuse global (IV-G). Nephrologists and nephropathologists believe that this subclassification would be clinically relevant based on hypothetical distinct immunopathogenesis of those subclasses guiding therapy as well as judging prognosis. Methods All adult patients with a renal biopsy-confirmed diagnosis of LN class IV undergoing regular follow-up in the Nephrology Division between January 2004 and December 2014 were enrolled excluding those with diabetes, hepatitis B, hepatitis C, HIV as well as those with insufficient clinical and hystopathological data...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28925068/when-and-how-can-nephrologists-treat-hepatitis-c-virus-infection-in-dialysis-patients
#7
REVIEW
Maya I Davis, Donald F Chute, Raymond T Chung, Meghan E Sise
Hepatitis C virus (HCV) infection, a major cause of end-stage liver disease, is a common comorbidity in patients on dialysis and causes increased morbidity and mortality. Historically HCV has been extremely difficult to cure with interferon and ribavirin-based therapies, which are also associated with significant side effects, and few dialysis patients ever received HCV treatment. However, in the last 4 years, interferon-free direct-acting antiviral therapies have been approved, and several combinations have been studied in dialysis patients...
September 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#8
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28919820/prediction-models-for-the-mortality-risk-in-chronic-dialysis-patients-a-systematic-review-and-independent-external-validation-study
#9
Chava L Ramspek, Pauline Wm Voskamp, Frans J van Ittersum, Raymond T Krediet, Friedo W Dekker, Merel van Diepen
OBJECTIVE: In medicine, many more prediction models have been developed than are implemented or used in clinical practice. These models cannot be recommended for clinical use before external validity is established. Though various models to predict mortality in dialysis patients have been published, very few have been validated and none are used in routine clinical practice. The aim of the current study was to identify existing models for predicting mortality in dialysis patients through a review and subsequently to externally validate these models in the same large independent patient cohort, in order to assess and compare their predictive capacities...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28916546/approach-to-membranous-lupus-nephritis-a-survey-of-pediatric-nephrologists-and-pediatric-rheumatologists
#10
Alexis Boneparth, Suhas M Radhakrishna, Larry A Greenbaum, Eric Yen, Daryl M Okamura, Jennifer C Cooper, Sherene Mason, Deborah M Levy, Sangeeta D Sule, Paul T Jensen, Cagri Yildirim-Toruner, Stacy P Ardoin, Scott E Wenderfer
OBJECTIVE: To describe treatment practices for childhood pure membranous lupus nephritis (MLN). METHODS: Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members. RESULTS: There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists). Steroids and nonsteroid immunosuppression (NSI) were routinely used by the majority for MLN...
September 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28910788/uremia-retention-molecules-and-clinical-outcomes
#11
Fellype Carvalho Barreto, Daniela Veit Barreto, Maria Eugênia Fernandes Canziani
Chronic kidney disease is characterized by the accumulation of organic compounds in the bloodstream that may exert a variety of toxic effects in the body. These compounds, collectively known as uremic toxins, may be classified according to their physicochemical properties as free water-soluble low molecular weight molecules, middle molecules or protein-bound uremic toxins. Most of these retention molecules, due to either their size and/or binding to protein, constitute a complex therapeutic challenge to the nephrologist, particularly in end-stage renal disease, because of their limited removal by conventional dialysis therapies...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28902768/economic-and-clinical-outcomes-resulting-from-the-stage-4-chronic-kidney-disease-case-management-quality-improvement-initiative
#12
Beverly Everett, Liana D Castel, Matthew McGinnis, Amy Beresky, Rudolph C Cane, Tasha Cooper, Rajesh K Davda, Donna Farmer, Stella M John, Denise L Sollars, John F Rausch
PURPOSE OF STUDY: Chronic kidney disease (CKD) is a costly and burdensome public health concern. The goal of this study was to evaluate the impact on outcomes and utilization of a pilot program to identify and engage beneficiaries with CKD at risk for progression from Stage 4 to Stage 5. PRIMARY PRACTICE SETTINGS: A quality improvement initiative was conducted to assess the impact of case management on costs and outcomes among 7,720 Cigna commercial medical beneficiaries with Stage 4 CKD enrolled in the United States between January 2012 and October 2012...
September 11, 2017: Professional Case Management
https://www.readbyqxmd.com/read/28899351/association-of-plasma-potassium-with-mortality-and-end-stage-kidney-disease-in-patients-with-chronic-kidney-disease-under-nephrologist-care-the-nephrotest-study
#13
Sandra Wagner, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann, François Vrtovsnik, Eric Thervet, Jean-Jacques Boffa, Ziad A Massy, Bénédicte Stengel, Patrick Rossignol
BACKGROUND: Low and high blood potassium levels are common and were both associated with poor outcomes in patients with chronic kidney disease (CKD). Whether such relationships may be altered in CKD patients receiving optimized nephrologist care is unknown. METHODS: NephroTest is a hospital-based prospective cohort study that enrolled 2078 nondialysis patients (mean age: 59 ± 15 years, 66% men) in CKD stages 1 to 5 who underwent repeated extensive renal tests including plasma potassium (PK) and glomerular filtration rate (GFR) measured (mGFR) by (51)Cr-EDTA renal clearance...
September 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28891237/the-incidence-and-prevalence-of-systemic-lupus-erythematosus-in-san-francisco-county-california-the-california-lupus-surveillance-project
#14
Maria Dall'Era, Miriam G Cisternas, Kurt Snipes, Lisa J Herrinton, Caroline Gordon, Charles G Helmick
OBJECTIVE: Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of this study was to conduct the California Lupus Surveillance Project (CLSP) to determine credible estimates of SLE incidence and prevalence, with a special focus on Hispanics and Asians. METHODS: The CLSP, which is funded by the Centers for Disease Control and Prevention, is a population-based registry of individuals with SLE residing in San Francisco County, CA, from January 1, 2007 through December 31, 2009...
September 10, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#15
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28880437/prevalence-of-earlobe-creases-and-their-association-with-history-of-cardiovascular-disease-in-patients-undergoing-hemodialysis-a-cross-sectional-study
#16
Minako Wakasugi, Junichiro James Kazama, Kazuko Kawamura, Suguru Yamamoto, Masaaki Nagai, Kentaro Omori, Saori Yokota, Hirokazu Fujikawa, Ikuo Aoike, Tsukasa Omori, Ichiei Narita
Earlobe creases are surrogate markers for high risk of cardiovascular disease. There is no data concerning earlobe creases among hemodialysis patients, who have an increased risk of cardiovascular disease. A cross-sectional study was conducted to determine the prevalence of earlobe creases and their association with prevalent cardiovascular disease among hemodialysis patients. Patients undergoing hemodialysis were recruited from five outpatient hemodialysis centers. Both earlobes were photographed during a dialysis session with the patient in a supine position and the photos evaluated independently by two experienced nephrologists blinded to the participants' clinical characteristics...
September 7, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28879535/hypercalcemia-a-consultant-s-approach
#17
Ari Auron, Uri S Alon
Due to their daily involvement in mineral metabolism, nephrologists are often asked to consult on children with hypercalcemia. This might become even more pertinent when the hypercalcemia is associated with acute kidney injury and/or hypercalciuria and renal calcifications. The best way to assess the severity of hypercalcemia is by measurement of plasma ionized calcium, and if not available by adjusting serum total calcium to albumin concentration. The differential diagnosis of the possible etiologies of the disturbance in the mineral homeostasis starts with the assessment of serum parathyroid hormone concentration, followed by that of vitamin D metabolites in search of both genetic and acquired etiologies...
September 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28876706/-acute-kidney-injury-in-2017-management-in-a-secondary-care-hospital-an-example-of-interdisciplinary-collaboration
#18
Guido Marco Caronni, Hadrien Komaromi, Alexandre Guillermin, Mélissa Schneider, Zina Fumeaux
Acute kidney injury (AKI) is frequent and can lead to serious complications. It is classified according to the degree of renal function impairment and classically divided into three categories: pre-renal, intrinsic and post-renal. Identification of risk factors and wise use of additional tests are crucial to the diagnosis, as there are numerous causes of AKI. Identification and specific treatment of the underlying mechanism are essential, all while protecting the kidney. Resorting to a nephrologist is systematic when there are red flags...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28873222/uremic-pericarditis-pericardial-effusion-and-constrictive-pericarditis-in-end-stage-renal-disease-insights-and-pathophysiology
#19
REVIEW
Karim Abdur Rehman, Jorge Betancor, Bo Xu, Arnav Kumar, Carlos Godoy Rivas, Kimi Sato, Leslie P Wong, Craig R Asher, Allan L Klein
A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis...
September 5, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28870047/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-gitelman-syndrome
#20
(no author information available yet)
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. The prevalence of GS is even higher in Asia than other countries. The majority of GS patients present mild and nonspecific symptoms during adolescence or adulthood...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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