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Conservative treatment of CKD

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https://www.readbyqxmd.com/read/29220099/supportive-palliative-care-should-be-integrated-into-routine-care-for-paediatric-patients-with-life-limiting-kidney-disease
#1
REVIEW
Julia Thumfart, Tobias Reindl, Cornelia Rheinlaender, Dominik Müller
AIM: Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). METHOD: We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29159529/plasma-p-cresol-lowering-effect-of-sevelamer-in-non-dialysis-ckd-patients-evidence-from-a-randomized-controlled-trial
#2
Eleonora Riccio, Massimo Sabbatini, Dario Bruzzese, Lucia Grumetto, Cristina Marchetiello, Maria Amicone, Michele Andreucci, Bruna Guida, Davide Passaretti, Giacomo Russo, Antonio Pisani
BACKGROUND: The accumulation of p-cresol, a metabolic product of aromatic amino acids generated by intestinal microbiome, increases the cardiovascular risk in chronic kidney disease (CKD) patients. Therefore, therapeutic strategies to reduce plasma p-cresol levels are highly demanded. It has been reported that the phosphate binder sevelamer (SEV) sequesters p-cresol in vitro, while in vivo studies on dialysis patients showed controversial results. Aim of our study was to evaluate the effect of SEV on p-cresol levels in non-dialysis CKD patients...
November 20, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29150712/unacylated-ghrelin-and-obestatin-promising-biomarkers-of-protein-energy-wasting-in-children-with-chronic-kidney-disease
#3
Alice Monzani, Michela Perrone, Flavia Prodam, Stefania Moia, Giulia Genoni, Sara Testa, Fabio Paglialonga, Anna Rapa, Gianni Bona, Giovanni Montini, Alberto Edefonti
BACKGROUND: Impairment in orexigenic/anorexigenic hormone balance may be key in the pathogenesis of protein energy wasting in children with chronic kidney disease (CKD). Measurement of ghrelin and obestatin concentrations in children with CKD would help assess the potential contribution of these hormones to uremic protein energy wasting. METHODS: This was a cross-sectional case-control study. Acylated and unacylated ghrelin and obestatin were measured in 42 children on conservative treatment (CT), 20 children on hemodialysis, 48 pediatric renal transplant (RTx) recipients and 43 controls (CTR) (mean age 11...
November 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29067991/does-combination-of-paricalcitol-with-cinacalcet-in-secondary-hyperparathyroidism-in-hemodialysis-treatment-make-sense
#4
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Tomasz Prystacki, Wojciech Marcinkowski, Teresa Dryl-Rydzyńska
INTRODUCTION    Secondary hyperparathyroidism (SHPT) is a common hormonal disorder associated with  chronic kidney disease (CKD). SHPT treatment should lead to reduction of parathormon concentration by calcimimetics or active vitamin D administration and calcium-phosphate metabolism stabilization. In the event of failure of conservative treatment complete or partial parathyroid resection should be considered.  OBJECTIVES    The aim of the study was assessement of beneficial effects of treatment with paricalcitol and cinacalcet simultaneously versus paricalcitol alone...
October 25, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29044340/renouncement-of-renal-replacement-therapy-withdrawal-and-refusal
#5
José Andrade Moura, Ana Flávia de Souza Moura, José Hermógenes Rocco Suassuna
Renouncement of renal replacement therapy (RRT) is a medical dilemma. This review covers the concept, the magnitude, the prognosis, and discusses strategies and management approaches about this subject in patients with CKD and AKI. Evidence suggests that refusal is more frequent and carries a more guarded prognosis than withdrawal of RRT. When RRT is not expected to be beneficial in terms of survival or quality of life, conservative treatment and palliative care are alternatives. We review the historical evolution of guidelines about renouncement of RRT and palliative care, and highlight the absence of specific recommendations in Brazil...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28953816/association-between-depression-and-hemodialysis-in-patients-with-chronic-kidney-disease
#6
Aleksandra Ćwiek, Marcelina Czok, Bartłomiej Kurczab, Krzysztof Kramarczyk, Karolina Drzyzga, Krzysztof Kucia
Depression is the most common and serious psychiatric disorder that affects patients with chronic kidney disease and end-stage renal disease, and, has a significant impact on their quality of life. The aim of this study was to investigate and compare prevalence rates of depression among hemodialyzed patients, and non-dialyzed patients with a glomerular filtration rate<30 ml/min/1.73m(2) receiving conservative treatment or following kidney transplantation. A total of 50 hemodialyzed and 50 non-dialyzed patients with stage 4/5 of CKD was assessed using the following questionnaires: Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), The Satisfaction with Life Scale (SWLS), The Acceptance of Illness Scale (AIS), and The Life Orientation Test-Revised (LOT-R)...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#7
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...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28835848/a-description-of-advanced-chronic-kidney-disease-patients-in-a-major-urban-center-receiving-conservative-care
#8
Fareed B Kamar, Helen Tam-Tham, Chandra Thomas
BACKGROUND: Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting. OBJECTIVE: To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context. DESIGN: Retrospective chart review. SETTING: Urban nephrology center...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28793118/quality-of-life-of-elderly-people-with-chronic-kidney-disease-in-conservative-treatment
#9
Roberta Maria de Pina Pereira, Marcelo Aparecido Batista, Aline de Sousa Meira, Marília Pilotto de Oliveira, Luciana Kusumota
Objective: To describe the quality of life (QOL) of elderly people with Chronic Kidney Disease (CKD) in conservative treatment, correlating it with sociodemographic and health-related aspects. Method: This is a quantitative, cross-sectional, and descriptive study that used: a previously validated instrument for data collection; the WHOQOL-BREF and WHOQOL-OLD QOL scales; and the Mini-Mental State Examination. Results: Thirty-five elderly people (54...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28742145/survival-analysis-of-conservative-vs-dialysis-treatment-of-elderly-patients-with-ckd-stage-5
#10
Roman Reindl-Schwaighofer, Alexander Kainz, Michael Kammer, Alexandra Dumfarth, Rainer Oberbauer
Elderly patients represent a growing population among people suffering from ESRD. So far only limited data on actual survival benefits of elderly adults initiating dialysis have been published. Besides the high burden of preexisting comorbidities, dialysis treatment itself may be associated with a further deterioration in functional status in this population. We retrospectively analyzed the Austrian Dialysis and Transplant Registry and identified 8,622 patients who started maintenance hemodialysis after the age of 65 years between 2002 and 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#11
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28533146/bioactive-lipids-derived-from-arachidonic-acid-metabolism-in-different-types-of-renal-replacement-therapy
#12
Joanna Stępniewska, Barbara Dołęgowska, Kamila Puchałowicz, Edyta Gołembiewska, Kazimierz Ciechanowski
INTRODUCTION: Metabolism and plasma concentration of lipids and lipid-derived compounds play an important role in kidney physiology and pathological processes. The component of membrane phospholipids - arachidonic acid (AA) and its active derivatives - eicosanoids are involved in the development of hypertension, diabetes, inflammation and may contribute to progression of chronic kidney disease (CKD). The purpose of the study was to determine, whether the type of renal replacement therapy has an effect on eicosanoids metabolism...
August 2017: Chemistry and Physics of Lipids
https://www.readbyqxmd.com/read/28449953/detection-of-colonization-by-carbapenem-resistant-organisms-by-real-time-polymerase-chain-reaction-from-rectal-swabs-in-patients-with-chronic-renal-disease
#13
T F T Rezende, A M Doi, M G Quiles, A C C Pignatari, S Manfrendi, C Grothe, M Taminato, D A Barbosa
BACKGROUND: Carbapenem-resistant organism (CRO) colonization is a serious problem that increases the risk of infection and contributes to dissemination of antimicrobial resistance in healthcare-associated environments. The risk of acquisition and dissemination of CRO is high in chronic renal failure patients and the surveillance culture is recommended as a component of infection control programmes. AIM: To assess colonization by CRO, comparing phenotypic and molecular-based methods of diagnostics, in rectal swabs in a large population of chronic renal failure patients...
March 24, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28424504/prevalence-and-factors-associated-with-erectile-dysfunction-in-patients-with-chronic-kidney-disease-on-conservative-treatment
#14
M R Costa, V C Ponciano, T R Costa, A M de Oliveira, C P Gomes, E C de Oliveira
Population with chronic kidney disease (CKD) has had many problems, and some of these have arisen from sexual disorders. The present study intends to determine the prevalence and the associated factors with erectile dysfunction (ED) among patients with CKD on conservative treatment (CKDCT). This transversal study was conducted from May 2013 to December 2015. The tools used were: medical records and the International Index of Erectile Function. Data were analyzed by univariate and multivariate logistic regression analysis...
November 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/28381549/a-dominant-mutation-in-nuclear-receptor-interacting-protein-1-causes-urinary-tract-malformations-via-dysregulation-of-retinoic-acid-signaling
#15
Asaf Vivante, Nina Mann, Hagith Yonath, Anna-Carina Weiss, Maike Getwan, Michael M Kaminski, Tobias Bohnenpoll, Catherine Teyssier, Jing Chen, Shirlee Shril, Amelie T van der Ven, Hadas Ityel, Johanna Magdalena Schmidt, Eugen Widmeier, Stuart B Bauer, Simone Sanna-Cherchi, Ali G Gharavi, Weining Lu, Daniella Magen, Rachel Shukrun, Richard P Lifton, Velibor Tasic, Horia C Stanescu, Vincent Cavaillès, Robert Kleta, Yair Anikster, Benjamin Dekel, Andreas Kispert, Soeren S Lienkamp, Friedhelm Hildebrandt
Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of CKD in the first three decades of life. However, for most patients with CAKUT, the causative mutation remains unknown. We identified a kindred with an autosomal dominant form of CAKUT. By whole-exome sequencing, we identified a heterozygous truncating mutation (c.279delG, p.Trp93fs*) of the nuclear receptor interacting protein 1 gene (NRIP1) in all seven affected members. NRIP1 encodes a nuclear receptor transcriptional cofactor that directly interacts with the retinoic acid receptors (RARs) to modulate retinoic acid transcriptional activity...
August 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28249270/dialysis-requirement-and-long-term-major-adverse-cardiovascular-events-in-patients-with-chronic-kidney-disease-and-superimposed-acute-kidney-injury
#16
Bolanle A Omotoso, Faruk Turgut, Emaad M Abdel-Rahman, Wenjun Xin, Jennie Z Ma, Kenneth W Scully, Fatiu A Arogundade, Rasheed A Balogun
BACKGROUND: Chronic kidney disease (CKD) patients who experience superimposed acute kidney injury (AKI) have been shown to be at higher risk of long-term sequelae of AKI when compared to those who do not experience AKI. It remains unclear whether the need for temporary dialysis intervention following superimposed AKI in patients with CKD has any effect on the long-term major adverse cardiovascular events (MACE). This study examines the relationship between temporary dialysis therapy following AKI and long-term major cardiovascular events in patients with background CKD...
2017: Nephron
https://www.readbyqxmd.com/read/28181057/lipoprotein-a-in-nephrological-patients
#17
REVIEW
Bernd Hohenstein
In contrast to existing EAS/ESC guidelines on the management of lipid disorders, current recommendations from nephrological societies are very conservative and restrictive with respect to any escalation of lipid lowering/statin therapy. Furthermore, lipoprotein(a) (Lp(a)) - an established cardiovascular risk factor - has not even been mentioned. While a number of retrospective and prospective studies suggested that Lp(a) has relevant predictive value and might have - at least in stage-3 chronic kidney disease (CKD) - the same negative effects if draged along in non-CKD patients, there is no guidance on diagnostic or therapeutic procedures...
March 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28001026/keto-analogues-and-essential-aminoacids-and-other-supplements-in-the-conservative-management-of-chronic-kidney-disease
#18
REVIEW
Adamasco Cupisti, Piergiorgio Bolasco
The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with the aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of chronic kidney disease (CKD) patients...
June 2017: Panminerva Medica
https://www.readbyqxmd.com/read/27752007/chemerin-a-biomarker-for-cardiovascular-disease-in-diabetic-chronic-kidney-disease-patients
#19
Farag E Salama, Qasem A Anass, Abdelnaem A Abdelrahman, Elsayed B Saeed
Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The carotid intima-media thickness (CIMT) and arterial stiffness are useful markers of subclinical atherosclerosis and significantly correlate with various metabolic risk factors. Chemerin is one of the adipokines that may represent a link between obesity and inflammation and may be a potential candidate playing a role in the pathogenesis of atherosclerosis and cardiovascular complications. Therefore, we studied the relationship of chemerin levels with atherosclerosis as measured by CIMT in diabetic CKD patients, either predialysis or on hemodialysis (HD)...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27669324/symptom-management-in-patients-with-stage-5-ckd-opting-for-conservative-management
#20
REVIEW
Sheila Johnston
Chronic kidney disease (CKD) stages 3-5 now affects 8.5% of adults in the United Kingdom; with 4% of patients expected to reach stage 5 CKD. Increasing numbers of older patients are contributing to the growth of demand of kidney services. With the exception of transplantation, dialysis has been the main form of renal replacement therapy (RRT) for advanced CKD. This elderly population is usually too frail and has many other co-existing medical complaints or co morbidities to undergo transplantation. Dialysis is an invasive treatment, and some frail elderly patients can experience many dialysis related symptoms...
September 22, 2016: Healthcare (Basel, Switzerland)
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