HTA and Chronic kidney failure

OBJECTIVE: This study assessed characteristics and outcomes of non-dialysis dependent patients receiving simultaneous heart kidney (SHK) transplantation versus heart transplantation alone (HTA) to identify optimal eGFR threshold where combined transplant strategy may be superior. METHODS: This study retrospectively analyzed 7896 adult patients with estimated glomerular filtration rate (eGFR) < 60 mL/min from the United Network for Organ Sharing (UNOS) database who received HTA or SHK between 2005 and 2021, excluding those who received pre-transplant dialysis...

BACKGROUND: Hypertension is responsible for 8.5 million deaths from stroke, ischemic heart disease and other vascular and kidney diseases. In Algeria, hypertension (HTN) is the most common chronic disease with an estimated prevalence of 23,6%. METHODS: The PACT II study is a national, observational, descriptive, cross-sectional, multicenter and non-interventional study of therapeutic strategy, conducted in Algeria on hypertensive patients treated for at least 3 months, followed by 100 specialists or general practitioners...

BACKGROUND: Cardiovascular diseases (CVDs) and diabetes mellitus (DM) are among the leading cause of morbidity and mortality in low-and-middle-income countries (LMICs) but evidence in these contexts regarding the effectiveness of primary prevention interventions taking into account patient adherence is scarce. We aimed to evaluate the effectiveness of a cardiovascular risk management program (De Todo Corazón - DTC program) in the incidence of the first cardiovascular outcome (CVO) in a low-income population from the Caribbean region of Colombia using adherence as the main variable of exposure...

INTRODUCTION: Chronic kidney disease is fast becoming a worldwide public health problem due to the increase of hypertension and diabetes mellitus, its main risk factors. In countries like DRC where majority of population are in the low income bracket, very few studies about this disease, usually diagnosed at a very advanced stage have been conducted. As a result of such, cases are not always properly taken care of and managed. METHODS: We opted for a descriptive cross-sectional study and it was conducted during the period from July 2014 to July 2015 at CMDC dialysis service...

BACKGROUND: Hypertension (HT) is the second leading cause of kidney failure. In hypertensive patients with chronic kidney disease (CKD), blood pressure (BP) control is the most important intervention to minimise progression. For CKD diagnosis, standardised creatinine and estimated glomerular filtration rate (eGFR) testing by CKD-EPI is recommended. OBJECTIVES: To describe the prevalence and factors associated with a moderate decrease in eGFR (by CKD-EPI) and BP control in subjects with HT...

PURPOSE: In systemic sclerosis, hypertension is feared because it is often heralding severe renal impairment. The objective of our study was to identify the frequency of arterial hypertension and clarify its etiologies in this condition. PATIENTS/METHODS: Our study was prospective. From January 2008 to May 2012, we have included all patients over the age of 16 years which featured a systemic scleroderma meeting the criteria for classification of Leroy and Medsger modified...

BACKGROUND: Current systems in place in healthcare are designed to detect harm after it has happened (e.g critical incident reports) and make recommendations based on an assessment of that event. Safer Clinical Systems, a Health Foundation funded project, is designed to proactively search for risk within systems, rather than being reactive to harm. OBJECTIVES: The aim of the Safer Clinical Systems project in Renal Care was to reduce the risks associated with shared care for patients who are undergoing surgery but are looked after peri-operatively by nephrology teams on nephrology wards...

A low-protein diet is well known to slow the progression of chronic renal failure, delay initiation of dialysis, while achieving significant economic benefits. In the context of a Health Technology Assessment (HTA), a budget impact analysis model was implemented to evaluate the economic advantage of offering of low-protein diet to nephropathic patients in Campania (Italy). The implemented model takes into account only the direct costs to the national healthcare system. In particular, costs related to supplying low-protein foods are compared to dialysis costs avoided, in a scenario that evaluates different indices of Numbers Needed to Treat and compliance to treatment...

OBJECTIVES: Little is known on predictors of hospitalisation in ambulatory patients with chronic heart failure, and known predictors may not apply to Mediterranean countries. Our aim was to document longitudinal trends in hospitalisations and identify patient-related predictors of hospital admission, re-admission and length of stay in the targeted population. METHODS: Population-based retrospective cohort study in Catalonia (North-East Spain), including 7196 ambulatory patients (58...

Chronic renal failure (CRF) represents the major cause of mortality in the nephrology unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hospital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population...

Data recorded from external visit in hospitals, reflects high number of nephrectomized patients. Most of these patients were remitted after any surgery or deteriorizated renal function or any other associated pathology. Several studies of nephrectomized patients are reported in literature concerning both healthy patients and comorbidity factors, and renal function and its evolution are evaluated. However, obtained results present a wide variability, which needs to be assessed. In this study we present a retrospective observational study of 92 one-kidney surgical patients, visited in Nephrology surgery of University Clinic Hospital...

BACKGROUND: End-stage renal disease is a troublesome health problem worldwide. The most usual renal replacement therapy is conventional haemodialysis (CHD), performed three times a week, 3.5-4 h per session. It has been proposed that this schedule is unphysiologic and that daily haemodialysis would be a more appropriate schedule. One of the variants of daily haemodialysis is the so-called short daily haemodialysis (SDHD), performed five to seven times per week, 1.5-3 h per session. The objective of this paper is to compare, through a systematic review, the clinical effectiveness and safety of SDHD versus CHD...

BACKGROUND: There is a suggestion of an identifiable impact of hypertension on all cause mortality in rural Africa. There is however paucity of hard data on the impact of morbidity or modality from this disease. OBJECTIVE: To determine the contribution of hypertension (HT) to adult morbidity and mortality at the University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria. DESIGN: Retrospective study. SETTING: University of Benin Teaching Hospital...

There are currently many hemodialysis modalities that are believed to be superior to conventional hemodialysis. In order to compare the effectiveness and security of the different hemodialysis techniques a systematic review was carried out. Faced with the fact that the scales available mainly focus on study design and tend to ignore external validity, a quality scale was specifically developed to assess the quality of the studies included in the review. The objective of this article is to introduce the quality assessment scale developed and present the results of its usability and applicability...

BACKGROUND AND OBJECTIVES: Epidemiological data on the incidence and prevalence of cardiovascular disease in chronic renal failure are scant The objective of the present study is to assess the relationship between renal function, measured by the estimated glomerular filtration rate, and the presence of early or established cardiovascular disease, in a population of hypertensives from primary care. PATIENTS AND METHODS: Cross-sectional, multicentre study carried out in primary care centres all over Spain...

BACKGROUND: Chronic kidney disease is a major public health problem in developed countries. The incidence of patients on dialysis is increasing progressively in the last years. The ageing population and increasing incidence of diabetes and hypertension are the main causes. Moreover, the level of kidney function is now recognised as a major risk factor for cardiovascular disease, even in mild cases. There is a great unaware about the prevalence of mild to moderate chronic kidney disease in the general population...

BACKGROUND: Patients with end-stage renal disease on dialysis have among the highest cardiovascular event rates documented. Abnormal nitric oxide (NO)-dependent endothelial reactivity and increased arterial stiffness are commonly described in hemodialysis (HD) patients. Measures of aortic stiffness--aortic pulse wave velocity (PWV) and augmentation index (AGI)--have been shown to be powerful predictors of survival on hemodialysis. It is not known how these parameters interfere with successful renal transplantation...

BACKGROUND: HD has been reported to determine an increase in QTc interval and QTc dispersion (QT(max)-QT(min))-risk factors that predispose to severe ventricular arrhythmias and sudden death. However, most studies have included end-stage renal disease (ESRD) patients with significant heart pathology. We therefore aimed to study the impact of a single HD session in subjects without manifest cardiac disease. METHODS: Sixty-eight stable, non-diabetic HD patients (47...

Secondary hypertension in CRF is characterized by particular features; hemodynamics--abnormal high vascular peripheral resistance relative to the cardiac output level; circadian variability--absence of nocturnal physiological BP decline. Hypertension is the main risk factor for renal disease progression, irrespective of the underlying etiology, and is one of the major determinants of the impressive cardiovascular morbidity and mortality seen in uraemic patients (> 50% cases). The atherosclerotic risk and severe retinopathy are more important in CRF hypertension compared to other causes (including essential HTA) at similar BP levels...

We described a patient with a POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal grammapathy and Skin changes) who was found to have renal involvement with peculiar renal pathological findings. Hitherto, 17 other cases, most of them from Japan, of POEMS syndrome with renal involvement, have been published. Clinical features are variable: acute renal failure with anasarca or moderate chronic renal insufficiency with mild proteinuria. This latter presentation often passes unnoticed. There is no severe HTA, no microangiopathic hemolytic anemia...