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Preventive nephrology

Yoshio N Hall
There is ongoing recognition that a wide array of social, economic, and environmental factors influence individuals' opportunities to engage in health care and healthy behaviors. Despite spending $34 billion annually on the care of patients with end-stage renal disease, the American public and nephrology community remain remarkably complacent about addressing "upstream" factors that influence the prevention, progression, and treatment of chronic kidney diseases. Recently, a growing number of health plans and dialysis providers have begun to embrace population health management; accept greater accountability for health, health care, and health costs; and envision kidney health beyond their traditional roles in care delivery...
March 13, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Pierre Antoine Brown, Swapnil Hiremath, Edward G Clark, Edmund S H Kwok, Christopher McCudden, Ayub Akbari
BACKGROUND: Morbidity and Mortality Conferences (M&MCs) have for generations been part of the education of physicians, yet their effectiveness remains questionable. The Ottawa M&M Model (OM3) was developed to provide a structured approach to M&MCs in order to maximize the quality improvement impact of such rounds. STUDY DESIGN: We conducted a retrospective assessment of the impact of implementing nephrology-specific M&MCs using the OM3. SETTING AND PARTICIPANTS: All physicians, residents and fellows from the division of nephrology at a large academic medical center were invited to participate...
March 12, 2018: International Urology and Nephrology
Chadi Y Saad, Joshua Fogel, Sofia Rubinstein
OBJECTIVES: Errors in drug dosing lead to poor patient outcomes and are common in patients with chronic kidney disease (CKD). Because the majority of patients with CKD are being treated by physicians specializing in internal medicine, we studied the awareness and knowledge that internal medicine resident trainees (IMRTs) have regarding the correct dosage of commonly used analgesic and neuropsychotropic medications for patients with CKD. METHODS: We surveyed 353 IMRTs about their awareness of whether a medication needs dose adjustment in patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate...
March 2018: Southern Medical Journal
Fatma Zehra Oztek-Celebi, Sare Gulfem Ozlu, Ozlem Aydog
BACKGROUND: Acute kidney injury (AKI) is an important clinical condition which is associated with increased mortality and morbidity. This study was performed to identify the factors that influence AKI stage, undergoing renal replacement therapy (RRT) and mortality. METHODS: This study was retrospectively conducted on 219 children with AKI who had been referred to paediatric nephrology division of Dr. Sami Ulus Teaching Hospital during their inpatient treatment from 2008 to 2012...
February 27, 2018: Nephrology
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
January 26, 2018: Blood Purification
Xi Chen, Tianlun Huang, Xuan Cao, Gaosi Xu
In the print publication, the affiliations were incorrectly published. The author affiliations which previously read Xi Chen1 · Tianlun Huang2 · Xuan Cao1 · Gaosi Xu2 1 Grade 2013, The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, People's Republic of China2 Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, 330006 Nanchang, Jiangxi, People's Republic of China.
February 23, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Loredana Colla, Davide Diena, Maura Rossetti, Ana Maria Manzione, Luca Marozio, Chiara Benedetto, Luigi Biancone
Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects...
February 23, 2018: Journal of Nephrology
Simone Brardi, Gabriele Cevenini, Vanni Giovannelli, Giuseppe Romano
OBJECTIVE: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. MATERIAL AND METHODS: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
David Y Gaitonde, David L Cook, Ian M Rivera
Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple guidelines recommend at least annual screening with serum creatinine, urine albumin/creatinine ratio, and urinalysis for patients with risk factors, particularly diabetes mellitus, hypertension, and a history of cardiovascular disease...
December 15, 2017: American Family Physician
Jochen G Raimann, Miguel C Riella, Nathan W Levin
In developing countries with limited medical infrastructure, preservation and recovery of renal function following acute kidney injury (AKI) is difficult. In conjunction with clinical presentation, rapid measurement of renal function is essential for early diagnosis and management. Especially in low- and middle-income countries, simple interventions such as hydration and avoidance of toxins have the highest probability of recovery. In such contexts, measurement of urine volume and osmolality and serum creatinine with point-of-care devices and saliva urea nitrogen dipsticks can be valuable...
February 2018: Clinical Kidney Journal
Babak Hadian, Azita Zafar-Mohtashami, Fershteh Ghorbani
INTRODUCTION: Nephrolithiasis is one of the most common urinary tract diseases. After the first episode of urinary calculus, the risk of recurrence is nearly 40% to 50% at 5 years. Nephrolithiasis is a systemic disease that is associated with some metabolic disorders. This study aimed to provide a picture of the frequency of metabolic abnormalities in patients with nephrolithiasis from west part of Iran. MATERIALS AND METHODS: Patients with recurrent urinary tract calculi referred to the Nephrology-Urology Clinics in Khorramabad city were recruited...
January 2018: Iranian Journal of Kidney Diseases
Charles R Swanepoel, Mohamed G Atta, Vivette D D'Agati, Michelle M Estrella, Agnes B Fogo, Saraladevi Naicker, Frank A Post, Nicola Wearne, Cheryl A Winkler, Michael Cheung, David C Wheeler, Wolfgang C Winkelmayer, Christina M Wyatt
HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population...
February 2, 2018: Kidney International
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
The recognition of a standardized, consensus definition for acute kidney injury (AKI) has been an important milestone in critical care nephrology, which has facilitated innovation in prevention, quality of care, and outcomes research among the growing population of hospitalized patients susceptible to AKI. Concomitantly, there have been substantial advances in "big data" technologies in medicine, including electronic health records (EHR), data registries and repositories, and data management and analytic methodologies...
2018: Contributions to Nephrology
Wuhua Jiang, Jiarui Xu, Bo Shen, Yimei Wang, Jie Teng, Xiaoqiang Ding
Acute kidney injury (AKI) is a common global health challenge, affecting patient morbidity adversely and resulting in an estimated 1.4 million deaths per year. Since the International Society of Nephrology proposed a goal of eliminating preventable deaths from AKI by 2025, implementation of this program remains far from optimistic not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI, especially in developing countries, the relative insufficient health care resources to diagnose and treat AKI, and the delayed awareness of the impact of AKI on patient outcomes...
2018: Contributions to Nephrology
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
Rui Alves
No abstract text is available yet for this article.
January 10, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Ran-Hui Cha, Hajeong Lee, Jung Pyo Lee, Young Rim Song, Sung Gyun Kim, Yon Su Kim
Background: Blood pressure (BP) control is the most-established method for the prevention of chronic kidney disease (CKD) progression. However, the ideal BP target for CKD patients is still under debate. Methods: We performed a survey of regular registered members of the Korean Society of Nephrology to determine physician perceptions of BP control in patients with CKD. In addition, we evaluated the target BP achievement rate using data from the APrODiTe-2 study...
December 2017: Kidney Research and Clinical Practice
Sevcan A Bakkaloğlu, Yesim Özdemir Atikel, Fabio Paglialonga, Constantinos J Stefanidis, Varvara Askiti, Enrico Vidal, Gema Ariceta, Engin Melek, Enrico Verrina, Nikoleta Printza, Karel Vondrak, Aleksandra Zurowska, Ilona Zagozdzon, Mesiha Ekim, Elif Nursel Özmert, Stephanie Dufek, Augustina Jankauskiene, Claus Peter Schmitt, Eszter Lévai, Johan Vande Walle, Nur Canpolat, Tuula Holtta, Michel Fischbach, Guenter Klaus, Christoph Aufricht, Rukshana Shroff, Alberto Edefonti
BACKGROUND: Data on the immunization practices in pediatric chronic kidney disease (CKD) patients are scarce. The purpose of this study was to evaluate current vaccination practices for children on dialysis across European pediatric nephrology centers. METHODS: A total of 18 tertiary pediatric nephrology centers from 12 European countries were included in the study. The data on universal national immunization programs and immunization practices for children with chronic disease or risk were recorded from European Center for Disease Prevention and Control and the World Health Organization...
2018: Nephron
Steve Siu-Man Wong, Hau C Kwaan, Todd S Ing
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures...
December 2017: Clinical Kidney Journal
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