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European renal best practice

James Tattersall, Ken Farrington, Giorgio Gentile, Jeroen Kooman, Juan F Macias Núñez, Ionut Nistor, Wim Van Biesen, Adrian Covic
Current guidelines for dialysis specify a minimum Kt/V. For haemodialysis (HD) patients, minimum treatment time and frequency is also specified. The guidelines allow for modification to take account of renal function. The guidelines are not specifically aimed at the elderly and may not be appropriate for all patients in this group. Increasing age is accompanied by physiological and pathological changes that may modify the patient's response to uraemia and dialysis. Frailty and multi-morbidity are likely, but to a variable extent...
May 1, 2018: Nephrology, Dialysis, Transplantation
Xinmiao Shi, Wenke Han, Jie Ding
BACKGROUND: Human leukocyte antigen (HLA) was important biological barrier to a successful transplantation. Quantitative evaluations of the effect of HLA mismatching on heart, liver, umbilical cord blood, and hematopoietic stem cell transplantation, have previously been reported. In new era of immunosuppression, the reported magnitude effect of HLA mismatching on survival outcomes of kidney transplantation was controversial. In addition, the current kidney allocation guideline recommendations in different countries were inconsistent in term of HLA mismatching...
December 2017: Medicine (Baltimore)
Allison Tong, Jonathan C Craig, Evi V Nagler, Wim Van Biesen
No abstract text is available yet for this article.
December 1, 2017: Nephrology, Dialysis, Transplantation
Anju Ranga, Yatish Agarwal, Kanika J Garg
Despite being decked as the most prized compounds in the nugget box of contrast agents for clinical radiologists, and carrying an indisputable tag of safety of the US Food and Drug Administration for close to three decades, all may not be seemingly well with the family of gadolinium compounds. If the first signs of violations of primum non nocere in relation to gadolinium-based contrast agents (GBCAs) appeared in the millennium year with the first published report of skin fibrosis in patients with compromised renal function, the causal relationship between the development of nephrogenic systemic fibrosis (NSF) and GBCAs, first proposed by two European groups in 2006, further precluded their use in renocompromised patients...
April 2017: Indian Journal of Radiology & Imaging
Goce Spasovski, Raymond Vanholder, Bruno Allolio, Djillali Annane, Steve Ball, Daniel Bichet, Guy Decaux, Wiebke Fenske, Ewout J Hoorn, Carole Ichai, Michael Joannidis, Alain Soupart, Robert Zietse, Maria Haller, Sabine van der Veer, Wim van Biesen, Evi Nagler, Liliana Gonzalez-Espinoza, Alberto Ortiz
Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. The prevalence of hyponatremia in a wide variety of conditions and the fact that hyponatremia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and specialty-based approaches to diagnosis and treatment...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
Ken Farrington, Adrian Covic, Ionut Nistor, Filippo Aucella, Naomi Clyne, Leen De Vos, Andrew Findlay, Denis Fouque, Tomasz Grodzicki, Osasuyi Iyasere, Kitty J Jager, Hanneke Joosten, Juan Florencio Macias, Andrew Mooney, Evi Nagler, Dorothea Nitsch, Maarten Taal, James Tattersall, Marijke Stryckers, Dieneke van Asselt, Nele Van den Noortgate, Sabine van der Veer, Wim van Biesen
The population of patients with moderate and severe CKD is growing. Frail and older patients comprise an increasing proportion. Many studies still exclude this group, so the evidence base is limited. In 2013 the advisory board of ERBP initiated, in collaboration with European Union of Geriatric Medicine Societies (EUGMS), the development of a guideline on the management of older patients with CKD stage 3b or higher (eGFR >45 mL/min/1.73 m2). The full guideline has recently been published and is freely available online and on the website of ERBP (www...
January 1, 2017: Nephrology, Dialysis, Transplantation
Kultigin Turkmen, Aydın Guclu, Garip Sahin, Ismail Kocyigit, Levent Demirtas, Fatih Mehmet Erdur, Erkan Sengül, Oktay Ozkan, Habib Emre, Faruk Turgut, Hilmi Unal, Murat Karaman, Cengiz Acıkel, Hasan Esen, Ebru Balli, Gulfidan Bıtırgen, Halil Zeki Tonbul, Mahmut Ilker Yılmaz, Alberto Ortiz
BACKGROUND/AIMS: Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. METHODS: This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy...
2016: Kidney & Blood Pressure Research
Steeve Doizi, Guido Kamphuis, Guido Giusti, Kim Hovgaard Andreassen, Thomas Knoll, Palle Jörn Osther, Cesare Scoffone, Daniel Pérez-Fentes, Silvia Proietti, Oliver Wiseman, Jean de la Rosette, Olivier Traxer
INTRODUCTION: We evaluated a new digital single-use flexible ureteroscope, LithoVue™ with respect to deflection, image quality and maneuverability. METHODS: A prospective cohort study was conducted in eight tertiary reference centers in Europe in December 2015 and January 2016. All consecutive patients included underwent flexible ureteroscopy and were 18 years or older. Deflection and image quality pre- and post-use and maneuverability were rated with a Likert scale...
May 2017: World Journal of Urology
Liviu Segall, Ionuţ Nistor, Julio Pascual, Istvan Mucsi, Lluis Guirado, Robert Higgins, Steven Van Laecke, Rainer Oberbauer, Wim Van Biesen, Daniel Abramowicz, Cristina Gavrilovici, Ken Farrington, Adrian Covic
During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival...
October 2016: Transplantation
Peter Pont'uch
Epidemiological studies show increasing prevalence of diabetic nephropathy. Diabetic patients with chronic kidney disease are the biggest group from among patients on renal replacement therapy. Renal Pathology Society developed pathological classification of diabetic nephropathy. The cardinal biochemical diagnostic parameters are albuminuria and estimated glomerular filtration rate. European Renal Best Practice work group developed Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher...
December 2015: Vnitr̆ní Lékar̆ství
Ron T Gansevoort, Mustafa Arici, Thomas Benzing, Henrik Birn, Giovambattista Capasso, Adrian Covic, Olivier Devuyst, Christiane Drechsler, Kai-Uwe Eckardt, Francesco Emma, Bertrand Knebelmann, Yannick Le Meur, Ziad A Massy, Albert C M Ong, Alberto Ortiz, Franz Schaefer, Roser Torra, Raymond Vanholder, Andrzej Więcek, Carmine Zoccali, Wim Van Biesen
Recently, the European Medicines Agency approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease. In this paper, on behalf of the ERA-EDTA Working Groups of Inherited Kidney Disorders and European Renal Best Practice, we aim to provide guidance for making the decision as to which ADPKD patients to treat with tolvaptan...
March 2016: Nephrology, Dialysis, Transplantation
Terry King-Wing Ma, Philip Kam-Tao Li
Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD). The reported prevalence of depression in dialysis population varied from 22.8% (interview-based diagnosis) to 39.3% (self- or clinician-administered rating scales). Such differences were attributed to the overlapping symptoms of uraemia and depression. Systemic review and meta-analysis of observational studies showed that depression was a significant predictor of mortality in dialysis population. The optimal screening tool for depression in dialysis patients remains uncertain...
August 2016: Nephrology
E Vrdoljak, L Torday, C Szczylik, G Kharkevich, S Bavbek, A Sella
INTRODUCTION: The incidence and mortality rates of kidney cancer in the Central and Eastern European (CEE) region are among the highest in the world. Access to second and subsequent lines of metastatic renal cell carcinoma (mRCC) therapies is highly varied in the region. Despite the increasing body of evidence supporting the clinical benefit of multiple lines of treatment, access to treatment beyond first line is restricted in many of these countries. AREAS COVERED: The adoption of targeted therapies for the first-line treatment of mRCC in the region was slow and faced many obstacles...
2016: Expert Opinion on Pharmacotherapy
Wim van Biesen, Moniek W M van de Luijtgaarden, Edwina A Brown, Jean-Pierre Michel, Barbara C van Munster, Kitty J Jager, Sabine N van der Veer
BACKGROUND: There is a variation in dialysis withdrawal rates, but reasons for this variation across European countries are largely unknown. We therefore surveyed nephrologists' perceptions of factors concerning dialysis withdrawal and palliative care and explored relationships between these perceptions and reports of whether withdrawal actually occurred in practice. METHODS: We developed a 33-item electronic survey, disseminated via an email blast to all European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) members...
December 2015: Nephrology, Dialysis, Transplantation
Jens Bollerslev, Lars Rejnmark, Claudio Marcocci, Dolores M Shoback, Antonio Sitges-Serra, Wim van Biesen, Olaf M Dekkers
Hypoparathyroidism (HypoPT) is a rare (orphan) endocrine disease with low calcium and inappropriately low (insufficient) circulating parathyroid hormone levels, most often in adults secondary to thyroid surgery. Standard treatment is activated vitamin D analogues and calcium supplementation and not replacement of the lacking hormone, as in other hormonal deficiency states. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of chronic HypoPT in adults who do not have end-stage renal disease...
August 2015: European Journal of Endocrinology
Sabine N van der Veer, Maria C Haller, Carina A C M Pittens, Jacqueline Broerse, Clare Castledine, Maurizio Gallieni, Nicholas Inston, Anna Marti Monros, Niels Peek, Wim van Biesen
BACKGROUND: Many decisions around vascular access for haemodialysis warrant a collaborative treatment decision-making process, involving both clinician and patient. Yet, patients' experiences in this regard have been suboptimal. Although clinical practice guidelines could facilitate collaborative decision making, they often focus on the clinicians' side of the process, while failing to address the patients' perspective. The objective of this study was to explore and compare kidney patients' and clinicians' views on what vascular access-related decisions deserved priority for developing guidelines that will contribute to optimizing collaborative decision making...
2015: PloS One
Giuseppe Regolisti, Laura Bozzoli, Enrico Fiaccadori
The publication, within a short time interval, of a consensus statement on the pathophysiology, diagnosis and treatment of hyponatremia by a panel of experts mainly from the US and of the European Guidelines on the same topic has marked an important step towards reducing the differences in the treatment of this frequent, and potentially fatal, electrolyte disorder. Within this framework, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE), and the European Dialysis and Transplantation Association-European Renal Association, represented by the European Renal Best Practice (ERBP), have developed these Guidelines for clinical practice, that are focused mainly on the diagnosis and the treatment of hyponatremia...
May 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
J Hensen
The diuretic tolvaptan has been approved for more than 5 years for the indications of euvolemic hyponatremia due to syndrome of inappropriate antidiuretic hormone (SIADH) secretion. In recent years many patients have been treated with tolvaptan and many physicians could gather practical experience. Other countries, such as the USA had already gained greater experience, also in the indications for hypervolemic hyponatremia. After approval was granted more than 5000 patients worldwide were included in the so-called hyponatremia register and 22 active centers in Germany with 317 patients participated...
July 2015: Der Internist
David Goldsmith, Adrian Covic, Marc Vervloet, Mario Cozzolino, Ionut Nistor
This paper reflects the position of the CKD-MBD workgroup, an official working group of ERA-EDTA and of the ERBP advisory board, the official guideline-producing body of ERA-EDTA, on the topic of the use of calcimimetics in patients with CKD stage 5D, as based on two recent meta-analysis.
May 2015: Nephrology, Dialysis, Transplantation
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