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patient knowledge of ESRD

Panagiotis I Georgianos, Maria I Pikilidou, Vassilios Liakopoulos, Elias V Balaskas, Pantelis E Zebekakis
Arterial stiffness is an important risk factor for cardiovascular morbidity and mortality in patients with end-stage renal disease (ESRD). Arterial stiffness aggravates cardiovascular risk via multiple pathways, such as augmentation of aortic systolic pressure, subendocardial hypoperfusion, and excess pulsatile energy transmission from macro- to microcirculation. Pathogenesis of the arteriosclerotic process in ESRD is complex and not yet fully understood. Several factors unique to ESRD, such as mineral metabolism disturbances, vascular calcifications, formation of advanced glycation end-products, and acute and chronic volume overload, are proposed to play a particular role in the progression of arteriosclerosis in ESRD...
March 12, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Jing Lin, Zhen Cheng, Xiaoqiang Ding, Qi Qian
Acid-base and electrolyte alterations are common in patients with chronic kidney disease (CKD) and end-stage kidney failure (ESRD). The alterations become more complex as CKD advances to ESRD, leading to morbidity and mortality. Three cases are presented illustrating some key prototypic features in CKD and ESRD. Each is accompanied by discussion of pathophysiology, diagnosis, and treatment options. Newer investigational results are integrated into the existing body of knowledge. Although rigorous assessment of various dialysis prescriptions is scanty, in its current state, instituting a well thought-out, multi-pronged management plan to minimize CKD/ESRD and dialysis-related electrolyte and acid-base disruptions is appropriate...
January 26, 2018: Blood Purification
Mohamed Amine Hamzi, Kawtar Hassani, Driss El Kabbaj
Choreoathetotic syndrome is a rare complication of open cardiac surgery that is seen usually in children after surgery for congenital cardiac anomalies. Here, we report two cases of adult patients with end-stage renal disease (ESRD) on regular hemodialysis who developed acute choreoathetotic syndrome few days after cardiac surgeries under cardiopulmonary bypass (CPB). Improvement was seen after an interval with complete resolution in one case. Investigations of the cause have been noncontributory. Long CPB time seems to be the main identified risk factor in these cases...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Abdol-Mohammad Kajbafzadeh, Nastaran Sabetkish, Shabnam Sabetkish
BACKGROUND: Conventional treatments for patients suffering with end-stage renal disease (ESRD) has several disadvantages, highlighting the importance of other reproducible modalities such as colonic dialysis (CD). OBJECTIVES: The aim was to establish a CD model in uremic rats and evaluate the effect of two different peritoneal dialysis (PD) solutions. METHODS: Thirty-two male Wistar rats were randomly divided into four groups. After right nephrectomy and left partial nephrectomy, a Malone antegrade continence enema (MACE) stoma was created...
February 7, 2018: Journal of Pediatric Urology
Kathryn Ducharlet, Dominic Thyagarajan, Francesco Ierino, Lawrence P McMahon, Darren Lee
BACKGROUND: Leigh syndrome (LS) is a rare neurodegenerative mitochondrial disorder which typically presents in childhood but has a varied clinical course. Renal involvement such as proximal tubulopathy in patients with mitochondrial disorders has been described. However, end stage renal disease (ESRD) is uncommon and literature regarding patients undergoing kidney transplantation is limited. Successful deceased donor renal transplant has not been previously described in a patient with Leigh Syndrome...
February 1, 2018: BMC Nephrology
Arthur J Matas, Danielle M Berglund, David M Vock, Hassan N Ibrahim
End stage renal disease (ESRD) is a risk after kidney donation. We sought, in a large cohort of kidney donors to determine the causes of donor ESRD, the interval from donation to ESRD, the role of donor/recipient relationship, and the trajectory of the estimated GFR (eGFR) from donation to ESRD. Between 1/1/1963 thru 12/31/2015, 4030 patients underwent living donor nephrectomy at our center, and have had ascertainment of ESRD status. Of these, 39 have developed ESRD (mean age at ESRD, 62.4 ± 14.1 years; mean interval between donation and ESRD, 27...
January 25, 2018: American Journal of Transplantation
Matt Foy, C John Sperati
The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non-nephrologists have a working knowledge of issues germane to dialysis...
January 15, 2018: Seminars in Dialysis
Cristina Mega, Edite Teixeira-de-Lemos, Rosa Fernandes, Flávio Reis
Diabetic nephropathy (DN) is now the single commonest cause of end-stage renal disease (ESRD) worldwide and one of the main causes of death in diabetic patients. It is also acknowledged as an independent risk factor for cardiovascular disease (CVD). Since sitagliptin was approved, many studies have been carried out revealing its ability to not only improve metabolic control but also ameliorate dysfunction in various diabetes-targeted organs, especially the kidney, due to putative underlying cytoprotective properties, namely, its antiapoptotic, antioxidant, anti-inflammatory, and antifibrotic properties...
2017: Journal of Diabetes Research
Jennifer C Gander, Elisa J Gordon, Rachel E Patzer
PURPOSE OF REVIEW: For the more than 636,000 adults with end-stage renal disease (ESRD) in the U.S., kidney transplantation is the preferred treatment compared to dialysis. Living donor kidney transplantation (LDKT) comprised 31% of kidney transplantations in 2015, an 8% decrease since 2004. We aimed to summarize the current literature on decision aids that could be used to improve LDKT rates. RECENT FINDINGS: Decision aids are evidence-based tools designed to help patients and their families make difficult treatment decisions...
March 2017: Current Transplantation Reports
Rachel E Patzer, Kayla Smith, Mohua Basu, Jennifer Gander, Sumit Mohan, Cam Escoffery, Laura Plantinga, Taylor Melanson, Sean Kalloo, Gary Green, Alex Berlin, Gary Renville, Teri Browne, Nicole Turgeon, Susan Caponi, Rebecca Zhang, Stephen Pastan
INTRODUCTION: The United Network for Organ Sharing (UNOS) implemented a new Kidney Allocation System (KAS) in December 2014 that is expected to substantially reduce racial disparities in kidney transplantation among waitlisted patients. However, not all dialysis facility clinical providers and end stage renal disease (ESRD) patients are aware of how the policy change could improve access to transplant. METHODS: We describe the ASCENT (Allocation System Changes for Equity in KidNey Transplantation) study, a randomized controlled effectiveness-implementation study designed to test the effectiveness of a multicomponent intervention to improve access to the early steps of kidney transplantation among dialysis facilities across the United States...
May 2017: KI Reports
Faruk Turgut, Emaad M Abdel-Rahman
Obesity has grown into an epidemic across the globe. Mirroring this growth in the number of obese individuals in the general population, the prevalence of obesity and extremely morbid obesity (body mass index >50 kg/m2) is similarly rising in patients with end-stage renal disease (ESRD). Obesity, and more so, extremely morbid obesity, creates additional challenges for clinicians aiming at providing the best treatment options to patients with ESRD. Although literature is available regarding renal replacement therapy (RRT) for obese patients, literature about challenges facing clinicians managing ESRD in the extremely obese patients is lacking...
July 28, 2017: Nephron
Afrânio Côgo Destefani, Gabriela Modenesi Sirtoli, Breno Valentim Nogueira
End-stage renal disease (ESRD) is characterized by the progressive deterioration of renal function that may compromise different tissues and organs. The major treatment indicated for patients with ESRD is kidney transplantation. However, the shortage of available organs, as well as the high rate of organ rejection, supports the need for new therapies. Thus, the implementation of tissue bioengineering to organ regeneration has emerged as an alternative to traditional organ transplantation. Decellularization of organs with chemical, physical, and/or biological agents generates natural scaffolds, which can serve as basis for tissue reconstruction...
2017: Frontiers in Bioengineering and Biotechnology
Noeleen Berkhout-Byrne, Marije H Kallenberg, André Gaasbeek, Ton J Rabelink, Sebastiaan Hammer, Mark A van Buchem, Matthias J van Osch, Lucia J M Kroft, Henk Boom, Simon P Mooijaart, Marjolijn van Buren
BACKGROUND: Older patients with end stage renal disease (ESRD) are at increased risk for cognitive decline, but detailed studies of the magnitude of cognitive decline on dialysis or comprehensive conservative management (CCM) are lacking and the underlying pathophysiological mechanisms have poorly been studied. OBJECTIVES: To describe the rationale and design of the COPE study. Study objectives are as follows. Firstly, to examine the severity of cognitive impairment in older patients reaching ESRD before dialysis and the rate of decline after dialysis or CCM initiation...
July 11, 2017: Current Medical Research and Opinion
Laura McPherson, Mohua Basu, Jennifer Gander, Stephen O Pastan, Sumit Mohan, Michael S Wolf, Mariana Chiles, Allison Russell, Kristie Lipford, Rachel E Patzer
Although kidney transplantation provides a significant benefit over dialysis, many patients with end-stage renal disease (ESRD) are conflicted about their decision to undergo kidney transplant. We aimed to identify the prevalence and characteristics associated with decisional conflict between treatment options in ESRD patients presenting for transplant evaluation. Among a cross-sectional sample of patients with ESRD (n=464) surveyed in 2014 and 2015, we assessed decisional conflict through a validated 10-item questionnaire...
April 29, 2017: Clinical Transplantation
Toshi Ghosh, Daniel S Winchester, Mark D P Davis, Rokea El-Azhary, Nneka I Comfere
BACKGROUND: Untreated calciphylaxis is a fatal disease of intra- and extravascular calcification, most commonly presenting in end-stage renal disease (ESRD) patients. While early identification is critical for timely treatment, early-stage clinical and histopathological descriptions have not, to our knowledge, been elucidated. As early clinical recognition is essential to prompt definitive histopathological diagnosis, this study describes a range of clinical and histopathological manifestations of early-stage calciphylaxis...
April 23, 2017: International Journal of Dermatology
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 1, 2017: Nephrology, Dialysis, Transplantation
Anthony J Bleyer, Kendrah Kidd, Martina Živná, Stanislav Kmoch
There are 3 major forms of autosomal dominant tubulointerstitial kidney disease (ADTKD): ADTKD due to UMOD mutations, MUC1 mutations, and mutations in the REN gene encoding renin. Lack of knowledge about these conditions contributes to frequent nondiagnosis, but with even limited knowledge, nephrologists can easily obtain a diagnosis and improve patient care. There are 3 cardinal features of these disorders: (1) the conditions are inherited in an autosomal dominant manner and should be considered whenever both a parent and child suffer from kidney disease; the presence of even more affected family members provides further support...
March 2017: Advances in Chronic Kidney Disease
Georgios Vlachopanos, Farid Girgis Ghalli
In the clinical context of end-stage renal disease (ESRD), thrombosis and bleeding risks are simultaneously increased and may have devastating consequences. While anticoagulant and antiplatelet drugs are indispensable for the prevention of thromboembolic events, the significantly higher bleeding risk makes their handling extremely complicated. In ESRD, they are frequently administered for a wide array of conditions. For example, atrial fibrillation is quite common in ESRD and warrants the use of anticoagulants like warfarin...
February 2017: Journal of Evidence-based Medicine
Alireza Heidary Rouchi, Mohammad Ali Mansournia, Mohammad Aghighi, Mitra Mahdavi-Mazdeh
BACKGROUND: To bridge the gap in the current knowledge, the present study was conducted to obtain evidences relating to clinical outcomes of the ESRD population in Iran over the last two decades. METHODS: The records of 84,652 incident ESRD patients from 1995 up to and including 2014 in the national registry of ESRD patients were analyzed retrospectively. Data were collected from dialysis and transplant centers in Iran from 1995 to 2008 via paper forms and from 2009 to 2014 through web-based records...
February 2, 2017: Nephrology
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
March 2017: Seminars in Dialysis
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