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https://www.readbyqxmd.com/read/28434208/dietary-interventions-for-adults-with-chronic-kidney-disease
#1
REVIEW
Suetonia C Palmer, Jasjot K Maggo, Katrina L Campbell, Jonathan C Craig, David W Johnson, Bernadet Sutanto, Marinella Ruospo, Allison Tong, Giovanni Fm Strippoli
BACKGROUND: Dietary changes are routinely recommended in people with chronic kidney disease (CKD) on the basis of randomised evidence in the general population and non-randomised studies in CKD that suggest certain healthy eating patterns may prevent cardiovascular events and lower mortality. People who have kidney disease have prioritised dietary modifications as an important treatment uncertainty. OBJECTIVES: This review evaluated the benefits and harms of dietary interventions among adults with CKD including people with end-stage kidney disease (ESKD) treated with dialysis or kidney transplantation...
April 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28433995/effect-of-prophylactic-dialysis-on-morbidity-and-mortality-in-non-dialysis-dependent-patients-after-coronary-artery-bypass-grafting-a-pilot-study
#2
Roghayeh Borji, Seyyed Hossein Ahmadi, Khosrow Barkhordari, Ali Pasha Meysami, Abbas Ali Karimi, Seyedeh Hamideh Mortazavi, Parinaaz Dadlani, Farah Ayatollah Zadeh Esfahani, Seyyed Mohammad Reza Khatami
BACKGROUND/AIMS: Coronary artery bypass grafting (CABG) is associated with an increased risk of morbidity and mortality in patients with pre-existing renal dysfunction. Numerous measures have been implemented to overcome this problem; however, no improvement in outcomes has been achieved. This study was aimed at investigating the effects of prophylactic dialysis on mortality and morbidity in these patients. METHODS: This randomized-controlled clinical trial enrolled 88 non-dialysis-dependent patients with chronic kidney disease awaiting CABG surgery...
April 22, 2017: Nephron
https://www.readbyqxmd.com/read/28429558/is-there-a-role-or-target-value-for-nutritional-vitamin-d-in-chronic-kidney-disease
#3
Wai H Lim, Emma L Duncan
Vitamin D is important for bone health in the general population but the value of vitamin D supplementation, and the role of 25-hydroxyvitamin D independently of 1,25-dihydroxyvitmain D, in individuals with chronic kidney disease (CKD), particularly in those who require dialysis, remains uncertain. Supplementation may improve some biochemical parameters, such as reducing PTH levels in patients to CKD-stage 4 who have vitamin D deficiency; but it remains to be established whether the role of nutritional vitamin D in maintaining bone health in the general population can be extrapolated to the CKD population...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#4
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28421638/renal-replacement-therapy-and-incremental-hemodialysis-for-veterans-with-advanced-chronic-kidney-disease
#5
Kamyar Kalantar-Zadeh, Susan T Crowley, Srinivasan Beddhu, Joline L T Chen, John T Daugirdas, David S Goldfarb, Anna Jin, Csaba P Kovesdy, David J Leehey, Hamid Moradi, Sankar D Navaneethan, Keith C Norris, Yoshitsugu Obi, Ann O'Hare, Tariq Shafi, Elani Streja, Mark L Unruh, Tushar J Vachharajani, Steven Weisbord, Connie M Rhee
Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources...
April 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28420645/association-between-chronic-kidney-disease-and-rates-of-transfusion-and-progression-to-end-stage-renal-disease-in-patients-undergoing-transradial-versus-transfemoral-cardiac-catheterization-an-analysis-from-the-veterans-affairs-clinical-assessment-reporting
#6
Amit N Vora, Maggie Stanislawski, Gary K Grunwald, Mary E Plomondon, John S Rumsfeld, Thomas M Maddox, Mladen I Vidovich, Walter Woody, Brahmajee K Nallamothu, Hitinder S Gurm, Sunil V Rao
BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk for bleeding, transfusion, and dialysis after cardiac catheterization. Whether rates of these complications are increased in this high-risk population undergoing transradial access compared with transfemoral access is unknown. METHODS AND RESULTS: From the Veterans Affairs (VA) Clinical Assessment Reporting and Tracking program, we identified 229 108 patients undergoing cardiac catheterization between 2007 and 2014, of which 48 155 (21...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28419771/aspects-of-carotid-structure-and-function-in-health-and-different-stages-of-chronic-kidney-disease
#7
Anna M Asp, Carin Wallquist, Anette Rickenlund, Britta Hylander, Stefan H Jacobson, Kenneth Caidahl, Maria J Eriksson
INTRODUCTION: Arterial remodelling and stiffening have been demonstrated in end-stage renal disease (ESRD). The presence of vascular alterations in earlier-stage chronic kidney disease (CKD) is less studied. We evaluated vascular structure and function in mild-to-moderate CKD (stages 2-3) compared with healthy subjects and advanced CKD (stages 4-5). METHODS: Carotid ultrasound was performed in 103 non-dialysis CKD patients and 54 healthy controls. Carotid intima-media thickness (CIMT) and common carotid artery (CCA) diameter were measured...
April 16, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28419150/disparities-in-dialysis-allocation-an-audit-from-the-new-south-africa
#8
Kajiru G Kilonzo, Erika S W Jones, Ikechi G Okpechi, Nicola Wearne, Zunaid Barday, Charles R Swanepoel, Karen Yeates, Brian L Rayner
End Stage Kidney Disease (ESKD) is a public health problem with an enormous economic burden. In resource limited settings management of ESKD is often rationed. Racial and socio-economic inequalities in selecting candidates have been previously documented in South Africa. New guidelines for dialysis developed in the Western Cape have focused on prioritizing treatment. With this in mind we aimed at exploring whether the new guidelines would improve inequalities previously documented. A retrospective study of patients presented to the selection committee was conducted at Groote Schuur Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#9
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in >80% of patients undergoing haemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28412933/beyond-quality-of-life-a-cross-sectional-study-on-the-mental-health-of-patients-with-chronic-kidney-disease-undergoing-dialysis-and-their-caregivers
#10
Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Nayara Pires de Melo, Renata Abrita, Fabiane Rossi Dos Santos Grincenkov, Natália Maria da Silva Fernandes
BACKGROUND: Patients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers. METHOD: This cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015...
April 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28411233/vasculopathy-in-the-setting-of-cardiorenal-syndrome-the-roles-of-protein-bound-uremic-toxins
#11
Jingbin Guo, Lu Lu, Yue Hua, Kevin Huang, Ian Wang, Li Huang, Qiang Fu, Aihua Chen, Paul Chan, Huimin Fan, Zhong-Min Liu, Bing Hui Wang
Chronic kidney disease (CKD) often leads to and accelerates the progression of cardiovascular disease (CVD), whilst CVD also causes kidney dysfunction. This bidirectional interaction leads to the development of a complex syndrome known as cardiorenal syndrome (CRS). CRS not only involves both the heart and the kidney, but also the vascular system through a vast array of contributing factors. In addition to hemodynamic, neuro-hormonal, mechanical and biochemical factors, the non-dialyzable protein-bound uremic toxins (PBUTs) are also key contributing factors that have been demonstrated through in vitro, in vivo and clinical observations...
April 14, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28407130/impact-of-end-stage-renal-disease-on-glucose-metabolism-a-matched-cohort-analysis
#12
Martina Guthoff, Robert Wagner, Dorothea Vosseler, Andreas Peter, Silvio Nadalin, Hans-Ulrich Häring, Andreas Fritsche, Nils Heyne
Background: . Renal function is known to affect glucose metabolism. The aim of this study was to assess glucose metabolism in end-stage renal disease (ESRD) patients and in matched controls with normal renal function and to delineate its underlying pathophysiology. Methods: . ESRD patients without diabetes mellitus on the active kidney transplant waiting list of a large European university hospital were metabolically phenotyped by an oral glucose tolerance test (OGTT) and by calculating insulin sensitivity and secretion indices...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#13
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28404600/qualitative-interviews-exploring-palliative-care-perspectives-of-latinos-on-dialysis
#14
Lilia Cervantes, Jacqueline Jones, Stuart Linas, Stacy Fischer
BACKGROUND AND OBJECTIVES: Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015...
April 12, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28402487/circulating-klotho-associates-with-cardiovascular-morbidity-and-mortality-during-hemodialysis
#15
Christophe Marçais, Delphine Maucort-Boulch, Jocelyne Drai, Emmanuelle Dantony, Marie-Christine Carlier, Emilie Blond, Leslie Genet, François Kuentz, Dominique Lataillade, Eric Legrand, Xavier Moreau-Gaudry, Guillaume Jean, Denis Fouque
Background: Klotho gene was identified as an aging suppressor. In animals klotho over-expression extends lifespan and defective klotho results in rapid aging and early death. The kidney is the main contributor to circulating klotho levels and during chronic kidney disease, renal klotho gene expression is drastically reduced in animals and humans as well. Objective: We aimed to determine the consequences of a serum klotho defect on cardiovascular morbidity and mortality during chronic dialysis...
April 11, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28398983/effectiveness-of-educational-or-behavioral-interventions-on-adherence-to-phosphate-control-in-adults-receiving-hemodialysis-a-systematic-review
#16
Molly Milazi, Ann Bonner, Clint Douglas
BACKGROUND: People with end-stage kidney disease (ESKD) develop impaired excretion of phosphate. Hyperphosphatemia develops in ESKD as a result of the kidney's reduced ability to excrete ingested phosphate load and is characterized by high bone turnover and increased musculoskeletal morbidity including bone pain and muscle weakness. Increased serum phosphate levels are also associated with cardiovascular disease and associated mortality. These effects are significant considering that cardiovascular disease is the leading cause of death in ESKD, making phosphate control a crucial treatment goal...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28396914/-anticoagulation-in-patients-with-chronic-kidney-disease-recommendations-from-the-working-group-heart-kidney-of-the-german-cardiac-society-and-the-german-society-of-nephrology
#17
G Schlieper, V Schwenger, A Remppis, T Keller, R Dechend, S Massberg, S Baldus, T Weinreich, G Hetzel, J Floege, F Mahfoud, D Fliser
Indications for anticoagulation are thromboembolic events, prosthetic heart valves, and atrial fibrillation with a corresponding risk score. Clinical trials have excluded patients with advanced chronic kidney disease and these data cannot be always generalized to patients with chronic kidney disease. Non-vitamin K antagonist oral anticoagulants (NOACs) are mostly not recommended or are contraindicated in advanced stages of chronic kidney disease. Observational studies have shown that dialysis patients with atrial fibrillation do not profit from coumarin anticoagulants; prospective studies are lacking...
April 10, 2017: Der Internist
https://www.readbyqxmd.com/read/28396734/low-lean-tissue-mass-is-an-independent-risk-factor-for-mortality-in-patients-with-stages-4-and-5-non-dialysis-chronic-kidney-disease
#18
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo, Alba Santos, Isabel Galán, Santiago Cedeño, Juan Manuel López-Gómez
Background: Mortality in patients with stages 4 and 5 chronic kidney disease (CKD) is higher than in the general population. Body composition predicts mortality. Our objective was to evaluate the effect of body composition on mortality in patients with stages 4 and 5 non-dialysis CKD. Methods: We performed a prospective study of 356 patients with stages 4 and 5 non-dialysis CKD. At baseline, we recorded general characteristics, history of cardiovascular events, body composition, serum inflammatory markers, nutrition and cardiac biomarkers...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28389813/plasma-neutrophil-gelatinase-associated-lipocalin-is-associated-with-iron-status-in-anemic-patients-with-pre-dialysis-chronic-kidney-disease
#19
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak
BACKGROUND: Iron deficiency anemia is common in patients with chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of acute kidney injury, is known to be associated with iron metabolism. We investigated whether plasma NGAL level is associated with iron status in pre-dialysis CKD patients with anemia. METHODS: This study included 419 patients who had anemia. The subjects were into categorized into a pre-dialysis group (estimated glomerular filtration rate [eGFR] <60 ml/min/1...
April 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28388509/nodular-lesions-in-diabetic-nephropathy-collagen-staining-and-renal-prognosis
#20
Koki Mise, Toshiharu Ueno, Junichi Hoshino, Ryo Hazue, Keiichi Sumida, Masayuki Yamanouchi, Noriko Hayami, Tatsuya Suwabe, Rikako Hiramatsu, Eiko Hasegawa, Naoki Sawa, Takeshi Fujii, Shigeko Hara, Jun Wada, Hirofumi Makino, Kenmei Takaichi, Kenichi Ohashi, Yoshifumi Ubara
AIMS: Nodular lesions are one of the most characteristic pathological changes of advanced diabetic nephropathy (DN). Previous studies have demonstrated that the pattern of both routine and collagen staining of nodular lesions changes during their development. However, the association between such changes of staining and the renal prognosis remains unclear. METHODS: Among 252 patients with biopsy-proven DN, 67 met the selection criteria and were enrolled to investigate this relationship...
March 22, 2017: Diabetes Research and Clinical Practice
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