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Conservative treatment of CKD

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https://www.readbyqxmd.com/read/29606989/conservative-care-as-a-treatment-option-for-patients-aged-75-years-and-older-with-ckd-stage-v-a-national-survey-in-the-netherlands
#1
Christopher Susanto, J Kooman, A M Courtens, C J A M Konings
Background and objectives: Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. Design setting participants and measurement: A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Results: Twenty-one medical managers (35%) completed the survey...
2018: European Geriatric Medicine
https://www.readbyqxmd.com/read/29551009/assessment-of-physical-performance-and-body-composition-in-male-renal-transplant-patients
#2
Andrea Petronio Rossi, Gianluigi Zaza, Marina Zanardo, Francesco Pedelini, Laura Dalla Verde, Chiara Caletti, Alessia D'Introno, Antonio Lupo, Mauro Zamboni
BACKGROUND: Renal transplant (RTX) recipients seem to experience a better quality of life compared to dialysis patients. However, the factors responsible for this positive effect are not completely defined. Conceivably, a change in the physical performance of these patients could play a role. METHODS: To assess this, we measured: (1) waist circumference, fat mass and appendicular fat-free mass (aFFM) by dual-energy X-ray densitometry, (2) physical performance with the Short Physical Performance Battery, and (3) muscle strength with the handgrip test, in 59 male RTX, 11 chronic kidney disease in conservative treatment (CKD) and 10 peritoneal dialysis (PD) patients...
March 17, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29525779/non-st-segment-elevation-myocardial-infarction-among-patients-with-chronic-kidney-disease-a-propensity-score-matched-comparison-of-percutaneous-coronary-intervention-versus-conservative-management
#3
Subir Bhatia, Shilpkumar Arora, Sravya M Bhatia, Mohammed Al-Hijji, Yogesh N V Reddy, Parshva Patel, Charanjit S Rihal, Bernard J Gersh, Abhishek Deshmukh
BACKGROUND: Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS: Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD...
March 10, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29463395/-cardiovascular-protection-of-diabetic-patient-with-chronic-renal-disease-and-particular-case-of-end-stage-renal-disease-in-elderly-patients
#4
P Zaoui, T Hannedouche, C Combe
Type 2 diabetes has an increasing prevalence. Life expectancy is dominated by cardiovascular risk, which is the leading cause of death in these patients. Up to one third of diabetic patients will develop diabetic nephropathy related to micro-angiopathy. Renal impairment further increases cardiovascular risk. Reducing cardiovascular morbidity and mortality is a major public health issue, as well as early preventing and managing chronic kidney disease (CKD). Good glycemic control prevents the micro-vascular complications of the disease (retinopathy, nephropathy, etc...
June 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29429032/comparative-risk-benefit-profile-of-biosimilar-and-originator-erythropoiesis-stimulating-agents-esas-data-from-an-italian-observational-study-in-nephrology
#5
Domenico Motola, Alberto Vaccheri, Andrea Roncadori, Monia Donati, Giulia Bonaldo, Anna Covezzoli, Piera Polidori, Stefano Bianchi
PURPOSE: The aim of this multicenter prospective study was to evaluate efficacy and safety of biosimilar erythropoiesis-stimulating agents (ESAs) vs originator, based on data from clinical practice in patients with chronic kidney disease (CKD). METHODS: We collected data of the patients with diagnosis of CKD on conservative treatment from nine Italian structures. Patients were enrolled applying different exclusion criteria, and various individual parameters were registered at the beginning for descriptive analysis...
February 10, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29396240/discussing-conservative-management-with-older-patients-with-ckd-an-interview-study-of-nephrologists
#6
Keren Ladin, Renuka Pandya, Allison Kannam, Rohini Loke, Tira Oskoui, Ronald D Perrone, Klemens B Meyer, Daniel E Weiner, John B Wong
BACKGROUND: Although dialysis may not provide a large survival benefit for older patients with kidney failure, few are informed about conservative management. Barriers and facilitators to discussions about conservative management and nephrologists' decisions to present the option of conservative management may vary within the nephrology provider community. STUDY DESIGN: Interview study of nephrologists. SETTING & PARTICIPANTS: National sample of US nephrologists sampled based on sex, years in practice, practice type, and region...
January 31, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29298736/multiple-frequency-bioimpedance-devices-for-fluid-management-in-people-with-chronic-kidney-disease-receiving-dialysis-a-systematic-review-and-economic-evaluation
#7
Graham Scotland, Moira Cruickshank, Elisabet Jacobsen, David Cooper, Cynthia Fraser, Michal Shimonovich, Angharad Marks, Miriam Brazzelli
BACKGROUND: Chronic kidney disease (CKD) is a long-term condition requiring treatment such as conservative management, kidney transplantation or dialysis. To optimise the volume of fluid removed during dialysis (to avoid underhydration or overhydration), people are assigned a 'target weight', which is commonly assessed using clinical methods, such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. However, these methods are not precise, and measurement devices based on bioimpedance technology are increasingly used in dialysis centres...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29220099/supportive-palliative-care-should-be-integrated-into-routine-care-for-paediatric-patients-with-life-limiting-kidney-disease
#8
REVIEW
Julia Thumfart, Tobias Reindl, Cornelia Rheinlaender, Dominik Müller
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). 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...
March 2018: 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
#9
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
#10
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/treatment-of-secondary-hyperparathyroidism-with-paricalcitol-with-or-without-cinacalcet-in-hemodialysis-patients
#11
Jacek Zawierucha, Jolanta Małyszko, Jacek S Małyszko, Tomasz Prystacki, Wojciech Marcinkowski, Teresa Dryl-Rydzyńska
INTRODUCTION    Secondary hyperparathyroidism (SHPT) is a common hormonal disorder associated with chronic kidney disease (CKD). The treatment of SHPT should lead to a reduction in parathormone concentrations by calcimimetics or active vitamin D administration and stabilization of calciumand phosphate metabolism. In the event of failure of conservative treatment, complete or partial parathyroid resection should be considered. OBJECTIVES    The aim of the study was to assess the beneficial effects of a combination treatment with paricalcitol and cinacalcet in comparison with paricalcitol alone...
December 22, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29044340/renouncement-of-renal-replacement-therapy-withdrawal-and-refusal
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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