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Nature nephrology

L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O d'Avila, C E Poli-de-Figueiredo
BACKGROUND: The Nephrology Unit at São Lucas Hospital, a University Hospital in Southern Brazil, has recently reached 35 years since its first kidney transplant. Few centers in the area have made a longitudinal analysis of processes, problems, grafts, and patient survival changes along this time. METHODS: A single-center, retrospective study was performed. Data were separated into different eras, based on the nature of immunosuppression used: pre-cyclosporine (1978-1986), cyclosporine (1987-1997), mycophenolate introduction (1998-2002), new immunosuppressant drugs (2003-2007), and the current period (2008-2013)...
September 2016: Transplantation Proceedings
Marva M Moxey-Mims, Michael F Flessner, Lawrence Holzman, Frederick Kaskel, John R Sedor, William E Smoyer, Aliza M Thompson, Lynne Yao
Nephrology has conducted few high-quality clinical trials, and the trials that have been conducted have not resulted in the approval of new treatments for primary or inflammatory glomerular diseases. There are overarching process issues that affect the conduct of all clinical trials, but there are also some specialty-specific issues. Within nephrology, primary glomerular diseases are rare, making adequate recruitment for meaningful trials difficult. Nephrologists need better ways, beyond histopathology, to phenotype patients with glomerular diseases and stratify the risk for progression to ESRD...
September 26, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Marco Cascella
Professor Giuseppe Moscati (1880-1927) was canonized by the Catholic Church in 1987. This act recognized the extraordinary qualities of a doctor who, considering his work as a "sublime mission", dedicated his life to helping the sick. The fame of the "Holy doctor" or "doctor of the poor", as people called him, was soon widespread and, immediately after his death, made him the subject of several biographies. These treatises, mainly written by religious hagiographers, have little analyzed Moscati as a doctor and scientist, or, in rare cases, privileged the description of his medical career, touching only marginally salient aspects of his work as a scientist and researcher...
August 2016: Acta Medico-historica Adriatica: AMHA
Jolanta Malyszko, Jacek S Malyszko
INTRODUCTION: Anemia has been remained one of the most characteristic and visible manifestations of chronic renal failure. Correction of anemia requires two main treatment strategies: increased stimulation of erythropoiesis, and maintenance of an adequate iron supply to the bone marrow. AREAS COVERED: Erythropoiesis activating agents became a mainstay in the treatment of renal anemia for more than 25 years. Recently, there have been several attempts to introduce new drugs to stimulate erythropoiesis or affect the hepcidin-ferroportin pathway...
September 2016: Expert Opinion on Emerging Drugs
Julius Okel, Ike G Okpechi, Bilal Qarni, Timothy Olanrewaju, Mark J Courtney, Valerie Luyckx, Sarala Naicker, Aminu K Bello
An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care...
July 29, 2016: Clinical Nephrology
Giovanni Montini, Alberto Edefonti, Yajaira Silva Galán, Mabel Sandoval Díaz, Marta Medina Manzanarez, Giuseppina Marra, Fabio Robusto, Gianni Tognoni, Fabio Sereni
BACKGROUND: The widely recognized clinical and epidemiological relevance of the socioeconomic determinants of health-disease conditions is expected to be specifically critical in terms of chronic diseases in fragile populations in low-income countries. However, in the literature, there is a substantial gap between the attention directed towards the medical components of these problems and the actual adoption of strategies aimed at providing solutions for the associated socioeconomic determinants, especially in pediatric populations...
2016: PloS One
R El Habbani, A Chaqroune, T Sqalli Houssaini, M Arrayhani, J El Ammari, F Dami, B A Chouhani, A Lahrichi
OBJECTIVE: In Morocco, few works on morpho-constitutional analysis of urinary calculi have been published, especially for patients in the region of Fez. This work aims to make a retrospective epidemiological study on the nature of urinary calculi with patients from the region of Fez and control the urine of the same patients after a period of three months to report on the risk of recurrence. METHOD AND PATIENTS: Urinary stones were collected mostly in the nephrology service and urology service at the Hassan II Hospital in Fez...
April 2016: Progrès en Urologie
John F Bertram, Stuart L Goldstein, Lars Pape, Franz Schaefer, Rukshana C Shroff, Bradley A Warady
To mark World Kidney Day 2016, Nature Reviews Nephrology invited six leading researchers to highlight the key advances and challenges within their specialist field of paediatric nephrology. Here, advances and remaining challenges in the fields of prenatal patterning, acute kidney injury, renal transplantation, genetics, cardiovascular health, and growth and nutrition, are all discussed within the context of paediatric and neonatal patients with kidney disease. Our global panel of researchers describe areas in which further studies and clinical advances are needed, and suggest ways in which research in these areas should progress to optimize renal care and long-term outcomes for affected patients...
March 2016: Nature Reviews. Nephrology
Krithika Hariharan, Andreas Kurtz, Kai M Schmidt-Ott
The field of regenerative medicine has witnessed significant advances that can pave the way to creating de novo organs. Organoids of brain, heart, intestine, liver, lung and also kidney have been developed by directed differentiation of pluripotent stem cells. While the success in producing tissue-specific units and organoids has been remarkable, the maintenance of an aggregation of such units in vitro is still a major challenge. While cell cultures are maintained by diffusion of oxygen and nutrients, three- dimensional in vitro organoids are generally limited in lifespan, size, and maturation due to the lack of a vascular system...
2015: Frontiers in Cell and Developmental Biology
Simona Granata, Alessandra Dalla Gassa, Paola Tomei, Antonio Lupo, Gianluigi Zaza
Cellular metabolic changes during chronic kidney disease (CKD) may induce higher production of oxygen radicals that play a significant role in the progression of renal damage and in the onset of important comorbidities. This condition seems to be in part related to dysfunctional mitochondria that cause an increased electron "leakage" from the respiratory chain during oxidative phosphorylation with a consequent generation of reactive oxygen species (ROS). ROS are highly active molecules that may oxidize proteins, lipids and nucleic acids with a consequent damage of cells and tissues...
2015: Nutrition & Metabolism
Li Yang, Guolan Xing, Li Wang, Yonggui Wu, Suhua Li, Gang Xu, Qiang He, Jianghua Chen, Menghua Chen, Xiaohua Liu, Zaizhi Zhu, Lin Yang, Xiyan Lian, Feng Ding, Yun Li, Huamin Wang, Jianqin Wang, Rong Wang, Changlin Mei, Jixian Xu, Rongshan Li, Juan Cao, Liang Zhang, Yan Wang, Jinhua Xu, Beiyan Bao, Bicheng Liu, Hongyu Chen, Shaomei Li, Yan Zha, Qiong Luo, Dongcheng Chen, Yulan Shen, Yunhua Liao, Zhengrong Zhang, Xianqiu Wang, Kun Zhang, Luojin Liu, Peiju Mao, Chunxiang Guo, Jiangang Li, Zhenfu Wang, Shoujun Bai, Shuangjie Shi, Yafang Wang, Jinwei Wang, Zhangsuo Liu, Fang Wang, Dandan Huang, Shun Wang, Shuwang Ge, Quanquan Shen, Ping Zhang, Lihua Wu, Miao Pan, Xiting Zou, Ping Zhu, Jintao Zhao, Minjie Zhou, Lin Yang, Wenping Hu, Jing Wang, Bing Liu, Tong Zhang, Jianxin Han, Tao Wen, Minghui Zhao, Haiyan Wang
BACKGROUND: Acute kidney injury (AKI) has become a worldwide public health problem, but little information is available about the disease burden in China. We aimed to evaluate the burden of AKI and assess the availability of diagnosis and treatment in China. METHODS: We launched a nationwide, cross-sectional survey of adult patients who were admitted to hospital in 2013 in academic or local hospitals from 22 provinces in mainland China. Patients with suspected AKI were screened out on the basis of changes in serum creatinine by the Laboratory Information System, and we reviewed medical records for 2 months (January and July) to confirm diagnoses...
October 10, 2015: Lancet
Jürgen Floege, Robert H Mak, Bruce A Molitoris, Giuseppe Remuzzi, Pierre Ronco
Important advances have been made in basic and clinical nephrology research over the past decade, with improved pathological insights into various disease processes and the introduction of new treatments for diseases such as atypical haemolytic uraemic syndrome. However, many challenges remain. In this Viewpoint, we asked five Nature Reviews Nephrology Advisory Board members, who have been associated with the journal since its launch in November 2005, to reflect on the progress and roadblocks of the past 10 years...
November 2015: Nature Reviews. Nephrology
Barbara Wilson, Lori Harwood, Abe Oudshoorn
AIMS AND OBJECTIVES: To determine whether the perpetual novice phenomenon exists beyond nephrology nursing where it was first described. BACKGROUND: The perpetual novice is a state in which nurses are unable to progress from a novice to an expert in one or more essential clinical skills which are used in their practice area. Maintaining clinical competence is essential to quality patient care outcomes. DESIGN: An exploratory, sequential, mixed methods design was used, comprised of a quantitative component followed by in-depth interviews...
December 2015: Journal of Clinical Nursing
S G Firu, C T Streba, D Firu, D E Tache, I Rogoveanu
RATIONALE: Renal dysfunction has a serious impact on the natural evolution of liver cirrhosis. Treatment and prognosis may be improved if an early diagnosis could be established, and specific therapeutic interventions would be applied. Although RIFLE and AKIN classifications have been successfully implemented in the clinical practice of Nephrology and Intensive Care Units, these did not provide major improvements in patients with liver cirrhosis. In the last decade, various biomarkers of kidney injury have been assessed, and Neutrophil Gelatinase-Associated Lipocalin (NGAL) is one of the most promising and most studied novel biomarker...
2015: Journal of Medicine and Life
Anis Belarbia, Safa Nouira, Wissal Sahtout, Yosra Guedri, Abdellatif Achour
To determine the prevalence of metabolic syndrome (MS) in chronic kidney disease (CKD) patients as well as its effects on the progression of CKD, we conducted a prospective, longitudinal study including 180 patients with chronic renal failure followed at the outpatient service of Nephrology at the Saloul's University Hospital of Sousse (Tunisia) over six months. Our study population consisted of 101 men and 79 women. Chronic glomerulonephritis (36.6%) was the most frequent nephropathy. The mean serum creatinine was 249 ± 200 mmol/L and the mean estimated glomerular filtration rate (eGFR) was 55...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
Peter Trnka, Megan M White, William D Renton, Steven J McTaggart, John R Burke, Anthony C Smith
BACKGROUND: Telemedicine has emerged as an alternative mode of health care delivery over the last decade. To date, there is very limited published information in the field of telehealth and paediatric nephrology. The aim of this study was to review our experience with paediatric telenephrology in Queensland, Australia. METHODS: A retrospective audit of paediatric nephrology telehealth consultations to determine the nature of the telehealth activity, reasons for referral to telehealth, and to compare costs and potential savings of the telehealth service...
2015: BMC Nephrology
Domenico Prezioso, Pasquale Strazzullo, Tullio Lotti, Giampaolo Bianchi, Loris Borghi, Paolo Caione, Marco Carini, Renata Caudarella, Manuel Ferraro, Giovanni Gambaro, Marco Gelosa, Andrea Guttilla, Ester Illiano, Marangella Martino, Tiziana Meschi, Piergiorgio Messa, Roberto Miano, Giorgio Napodano, Antonio Nouvenne, Domenico Rendina, Francesco Rocco, Marco Rosa, Roberto Sanseverino, Annamaria Salerno, Sebastiano Spatafora, Andrea Tasca, Andrea Ticinesi, Fabrizio Travaglini, Alberto Trinchieri, Giuseppe Vespasiani, Filiberto Zattoni
OBJECTIVE: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease. MATERIALS AND METHODS: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori...
June 2015: Archivio Italiano di Urologia, Andrologia
Noha A Osman, Safaa M Hassanein, Marwa M Leil, Mohamed M NasrAllah
OBJECTIVE: To explore and compare complementary and alternative medicine (CAM) practice among subsets of patients with chronic kidney disease (CKD) and renal allograft recipients. DESIGN: Cross-sectional survey questionnaire. SETTING: Three outpatient nephrology clinics and dialysis centers in Egypt. SUBJECTS: A total of 1005 subjects were included in the study (560 predialyis patients with CKD 3-4, 245 patients on hemodialysis, and 200 transplant recipients)...
November 2015: Journal of Renal Nutrition
Mehmet Sukru Sever, Norbert Lameire, Wim Van Biesen, Raymond Vanholder
Natural and man-made mass disasters directly or indirectly affect huge populations, who need basic infrastructural help and support to survive. However, despite the potentially negative impact on survival chances, these health care issues are often neglected by the authorities. Treatment of both acute and chronic kidney diseases (CKDs) is especially problematic after disasters, because they almost always require complex technology and equipment, whereas specific drugs may be difficult to acquire for the treatment of the chronic kidney patients...
June 2015: Clinical Kidney Journal
Chandani Upadhyay, Karen Cameron, Laura Murphy, Marisa Battistella
BACKGROUND: Patients undergoing hemodialysis frequently report pain with multifactorial causes, not limited to that experienced directly from hemodialysis treatment. Their pain may be nociceptive, neuropathic, somatic or visceral in nature. Despite this, pain in this population remains under-recognized and under-treated. Although several tools have been used to measure pain in patients undergoing hemodialysis as reported in the literature, none of them have been validated specifically in this population...
August 2014: Clinical Kidney Journal
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