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Preventive nephrology

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https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#1
S Mas-Font, J Ros-Martinez, C Pérez-Calvo, P Villa-Díaz, S Aldunate-Calvo, E Moreno-Clari
Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition...
February 9, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28151965/prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-cardiovascular-procedures-a-systematic-review-and-network-meta-analysis
#2
Eliano P Navarese, Paul A Gurbel, Felicita Andreotti, Michalina Marta Kołodziejczak, Suetonia C Palmer, Sofia Dias, Antonino Buffon, Jacek Kubica, Mariusz Kowalewski, Tomasz Jadczyk, Michał Laskiewicz, Marek Jędrzejek, Maximillian Brockmeyer, Flavio Airoldi, Marinella Ruospo, Stefano De Servi, Wojciech Wojakowski, Christopher O' Connor, Giovanni F M Strippoli
BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast...
2017: PloS One
https://www.readbyqxmd.com/read/28139394/serious-fall-injuries-before-and-after-initiation-of-hemodialysis-among-older-esrd-patients-in-the-united-states-a-retrospective-cohort-study
#3
Laura C Plantinga, Rachel E Patzer, Harold A Franch, C Barrett Bowling
BACKGROUND: Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and after dialysis therapy initiation. STUDY DESIGN: Retrospective cohort study of claims data from the 2 years spanning dialysis therapy initiation among patients initiating dialysis therapy in 2010 to 2012. SETTING & PARTICIPANTS: Claims from 81,653 Medicare end-stage renal disease beneficiaries aged 67 to 100 years...
January 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28112049/kidney-disease-in-hepatitis-b-surface-antigen-positive-children-experience-from-a-centre-in-south-west-nigeria-and-a-review-of-the-nigerian-literature
#4
Adanze O Asinobi, Adebowale D Ademola, Clement A Okolo, Adedayo A Adepoju, Susan M Samuel, Wendy E Hoy
BACKGROUND: Kidney disease is an important extra-hepatic manifestation of hepatitis B virus (HBV) infection. However, there is paucity of recent literature on kidney disease in children and adolescents with HBV infection from several parts of sub-Saharan Africa including Nigeria. OBJECTIVE: To review the pattern of kidney disease in hepatitis B surface antigen (HBsAg)-positive children and adolescents seen at a tertiary hospital in south-west Nigeria. METHODS: A retrospective study was undertaken of HBsAg-seropositive children with kidney disease managed at University College Hospital, Ibadan, from January 2004 to December 2015...
January 23, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#5
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28095816/awareness-and-knowledge-among-internal-medicine-house-staff-for-dose-adjustment-of-commonly-used-medications-in-patients-with-ckd
#6
Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein
BACKGROUND: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. METHODS: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#7
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077371/markers-of-endothelial-damage-in-patients-with-chronic-kidney-disease-on-hemodialysis
#8
Andrés Carmona, Maria Luisa Agüera, Carlos Luna Ruiz, Paula Buendia, Laura Calleros, Andrea Garcia-Jerez, Manuel Rodríguez-Puyol, Manuel Arias, Marta Arias-Guillen, Gabriel de Arriba, Jose Ballarin, Carmen Bernis, Elvira Fernandez, Sagrario Garcia-Rebollo, Javier Mancha, Gloria Del Peso, Estefania Perez, Esteban Poch, Jose M Portoles, Diego Rodriguez-Puyol, Rafael Sánchez-Villanueva, Felipe Sarro, Armando Torres, Alejandro Martin-Malo, Pedro Aljama, Rafael Ramirez, Julia Carracedo
Patients with stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (REDinREN, Madrid): 80 patients with diabetes mellitus (DM) and 80 patients without DM who were matched for clinical and demographic criteria...
January 11, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28076578/confirmed-clinical-case-of-chronic-kidney-disease-of-nontraditional-causes-in-agricultural-communities-in-central-america-a-case-definition-for-surveillance
#9
Alejandro Ferreiro, Guillermo Álvarez-Estévez, Manuel Cerdas-Calderón, Zulma Cruz-Trujillo, Elio Mena, Marina Reyes, Mabel Sandoval-Diaz, Vicente Sánchez-Polo, Régulo Valdés, Pedro Ordúnez
Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT) might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28076576/-optimization-of-registry-of-deaths-from-chronic-kidney-disease-in-agricultural-communities-in-central-america
#10
José Antonio Escamilla-Cejudo, Jorge Lara Báez, Rodolfo Peña, Patricia Lorena Ruiz Luna, Pedro Ordunez
Several Central American countries are seeing continued growth in the number of deaths from chronic kidney disease of nontraditional causes (CKDnT) among farm workers and there is underreporting. This report presents the results of a consensus process coordinated by the Pan American Health Organization/World Health Organization (PAHO/WHO), the United States Centers for Disease Control and Prevention (CDC), and the Latin American Society of Nephrology and Hypertension (SLANH). This consensus seeks to increase the probability of detecting and recording deaths from these causes...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28034287/the-ignored-role-of-intraoperative-hypotension-in-producing-postoperative-acute-kidney-injury-an-obligatory-appeal-for-more-preventative-nephrology
#11
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Intraoperative hypotension (IOH) invariably follows the induction of general anesthesia. There is this general consensus that IOH is beneficial - less bleeding, less blood transfusions, shorter surgery times - and absent adverse consequences on renal, hepatic and neurological functions. Nevertheless, a critical review of the literature revealed that past research studied younger patients with normal kidney function, short surgery times while excluding patients with advanced CKD and uncontrolled hypertension...
December 29, 2016: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#12
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27927892/a-concept-wide-association-study-of-clinical-notes-to-discover-new-predictors-of-kidney-failure
#13
Karandeep Singh, Rebecca A Betensky, Adam Wright, Gary C Curhan, David W Bates, Sushrut S Waikar
BACKGROUND AND OBJECTIVES: Identifying predictors of kidney disease progression is critical toward the development of strategies to prevent kidney failure. Clinical notes provide a unique opportunity for big data approaches to identify novel risk factors for disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used natural language processing tools to extract concepts from the preceding year's clinical notes among patients newly referred to a tertiary care center's outpatient nephrology clinics and retrospectively evaluated these concepts as predictors for the subsequent development of ESRD using proportional subdistribution hazards (competing risk) regression...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27921037/acute-kidney-injury-in-western-countries
#14
REVIEW
Josée Bouchard, Ravindra L Mehta
BACKGROUND: Acute kidney injury (AKI) is frequent and is associated with poor outcomes, including increased mortality, higher risk of chronic kidney disease, and prolonged hospital lengths of stay. The epidemiology of AKI mainly derives from studies performed in Western high-income countries. More limited data are available from Western low-income and middle-income countries (LMICs) located in Central and South America. SUMMARY: In this review, we summarize the most recent data on the epidemiology of AKI in Western countries, aiming to contrast results from industrialized high-income countries with LMICs...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921036/acute-kidney-injury-in-asia
#15
REVIEW
Li Yang
BACKGROUND: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. SUMMARY: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27915348/delayed-nephrology-consultation-and-high-mortality-on-acute-kidney-injury-a-meta-analysis
#16
Débora M Soares, José F Pessanha, Aashish Sharma, Alessandra Brocca, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) is a complex syndrome associated with substantial morbidity, mortality and costs. Despite advancements in diagnosis and care practice, AKI remains a disorder usually under/late-recognized with high mortality. One of the hidden reasons for poor outcome might be delayed nephrology consultation, with the involvement of the specialist only in severe stages of AKI when renal replacement therapy (RRT) is required. METHODS: We searched PubMed, EMBASE and Cochrane central register for related work on the subject...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#17
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27900959/effect-of-vitamin-c-supplementation-on-lipid-profile-serum-uric-acid-and-ascorbic-acid-in-children-on-hemodialysis
#18
Ghada Mohamed El Mashad, Hanan M ElSayed, Nahla A Nosair
Children with end-stage renal disease (ESRD) suffer from dyslipidemia and hyperuricemia that might play a causal role in the progression of cardiovascular disease (CVD). The aim of the study is to assess the effects of Vitamin C supplementation on uric acid, ascorbic acid, and serum lipid levels among children on hemodialysis (HD). This prospective study was conducted in the pediatric nephrology unit at Menoufia University Hospital. The study included a total of 60 children with ESRD on maintenance HD therapy...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27890486/towards-a-multidisciplinary-approach-to-understand-and-manage-obesity-and-related-diseases
#19
REVIEW
Stephan C Bischoff, Yves Boirie, Tommy Cederholm, Michael Chourdakis, Cristina Cuerda, Nathalie M Delzenne, Nicolaas E Deutz, Denis Fouque, Laurence Genton, Carmen Gil, Berthold Koletzko, Miguel Leon-Sanz, Raanan Shamir, Joelle Singer, Pierre Singer, Nanette Stroebele-Benschop, Anders Thorell, Arved Weimann, Rocco Barazzoni
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens...
November 16, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27885903/opinions-of-nephrologists-on-the-efficacy-and-tolerance-of-statins-in-hemodialysis-patients
#20
Ewa Budzisz, Michał Nowicki
Large randomized controlled trials have not confirmed the effects of statin therapy on reduction of cardiovascular morbidity and mortality in end-stage kidney disease, despite that statins are still widely prescribed by nephrologists to chronic dialysis patients. The aim of the study was to analyze the attitudes of nephrologists towards statin use in hemodialysis patients. Self-designed questionnaire, containing 18 questions, was distributed among 115 nephrologists. The survey contained description of the results of 3 largest statin trials in nephrology...
November 25, 2016: Renal Failure
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