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https://www.readbyqxmd.com/read/28845470/the-ascent-allocation-system-changes-for-equity-in-kidney-transplantation-study-a-randomized-effectiveness-implementation-study-to-improve-kidney-transplant-waitlisting-and-reduce-racial-disparity
#1
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
https://www.readbyqxmd.com/read/28750367/challenges-associated-with-managing-end-stage-renal-disease-in-extremely-morbid-obese-patients-case-series-and-literature-review
#2
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
https://www.readbyqxmd.com/read/28620603/advances-in-the-knowledge-about-kidney-decellularization-and-repopulation
#3
REVIEW
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
https://www.readbyqxmd.com/read/28604116/the-cognitive-decline-in-older-patients-with-end-stage-renal-disease-cope-study-rationale-and-design
#4
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
https://www.readbyqxmd.com/read/28457025/decisional-conflict-between-treatment-options-among-end-stage-renal-disease-patients-evaluated-for-kidney-transplantation
#5
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
https://www.readbyqxmd.com/read/28436018/early-clinical-presentations-and-progression-of-calciphylaxis
#6
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
https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#7
REVIEW
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
https://www.readbyqxmd.com/read/28284384/autosomal-dominant-tubulointerstitial-kidney-disease
#8
REVIEW
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
https://www.readbyqxmd.com/read/28276631/antithrombotic-medications-in-dialysis-patients-a-double-edged-sword
#9
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
https://www.readbyqxmd.com/read/28152573/survival-probabilities-of-end-stage-renal-disease-patients-on-renal-replacement-therapy-in-iran
#10
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
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#11
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
https://www.readbyqxmd.com/read/28079821/febuxostat-induced-agranulocytosis-in-an-end-stage-renal-disease-patient-a-case-report
#12
Xue Er Poh, Chien-Te Lee, Sung-Nan Pei
INTRODUCTION: Febuxostat, a nonpurine xanthine oxidase inhibitor, is approved as the first-line urate-lowering therapy in gout patients with normal renal function or mild to moderate renal impairment. The most common adverse effects of febuxostat are liver function test abnormalities, diarrhea, and skin rash. However, there is insufficient data in patients with severe renal impairment and end-stage renal disease (ESRD). We report the first case, to our knowledge, in which agranulocytosis developed after febuxostat treatment in an ESRD patient...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27643979/clinical-application-and-pharmacodynamic-monitoring-of-apixaban-in-a-patient-with-end-stage-renal-disease-requiring-chronic-hemodialysis
#13
Wesley D Kufel, Adam S Zayac, David F Lehmann, Christopher D Miller
Despite prescribing guidance, limited data exist to describe the use of apixaban in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD). Current apixaban dosing recommendations for this patient population are based largely on a single-dose pharmacokinetic study of eight patients. We describe the clinical application and pharmacodynamic monitoring of apixaban in a 62-year-old 156-kg African-American woman with nonvalvular atrial fibrillation and ESRD requiring hemodialysis who developed calciphylaxis while receiving warfarin therapy...
November 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27561174/incremental-hemodialysis-how-i-do-it
#14
Thomas A Golper
Incremental hemodialysis (incrHD) is not widely used nor is it well understood. In addition, and perhaps with more impact, governmental regulations in the United States and their consequential influences on dialysis provider organizations have made the practice of incrHD more difficult than traditional thrice weekly in-center HD. IncrHD is critically dependent on the amount of residual kidney function (RKF) as well as the individualized goals of end-stage renal disease (ESRD) management. RKF has to be assessed frequently and dialysis adjusted accordingly...
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27512289/a-systematic-review-of-sleep-disorders-in-patients-with-chronic-kidney-disease-undergoing-hemodialysis
#15
Nina Teixeira Fonseca, Jessica Julioti Urbano, Sergio Roberto Nacif, Anderson Soares Silva, Roger Andre Oliveira Peixoto, Giovanni Julioti Urbano, Ezequiel Fernandes Oliveira, Israel Reis Santos, Claudia Santos Oliveira, Giuseppe Insalaco, Luis Vicente Franco Oliveira
The purpose of this study was to conduct a systematic review of the available evidence on sleep disorders in patients with end stage renal disease (ESRD) undergoing hemodialysis (HD). [Subjects and Methods] Two independent reviewers performed a computer-assisted search of the MEDLINE, SciELO, LILACS, and BIREME Virtual Health Library medical databases from their inception to November 2015. [Results] One thousand one hundred twenty-six articles were found that met the inclusion criteria. Articles were excluded if they were not in English, the patients did not undergo HD, or the studies were not cross-sectional or clinical trials...
July 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27430294/protocol-of-a-randomized-controlled-trial-of-an-erythropoietin-stimulating-agent-decision-aid-for-anemia-treatment-in-kidney-disease
#16
Lauren B Beach, Marcus Wild, Gowri Ramachandran, H Omer Ikizler, Kerri L Cavanaugh
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are commonly used for the treatment of anemia due to chronic kidney disease (CKD) and end stage renal disease (ESRD). Patients often lack an understanding of the potential risks and benefits of ESAs, despite government mandated education on this topic. Decision aids are tools commonly used to discuss important information in health care settings. To address this knowledge gap, we designed this study to evaluate the effectiveness of a novel ESA decision aid at promoting informed shared decision making (ISDM) between patients and providers related to ESA use for CKD- and ESRD-related anemia...
July 18, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27424696/the-knowledge-awareness-and-acceptability-of-renal-transplantation-among-patients-with-end-stage-renal-disease-in-ibadan-nigeria
#17
A O Takure, Y O Jinadu, S A Adebayo, O B Shittu, B L Salako, S Kadiri
Renal transplantation is well established in the USA, Europe, India, and South Africa. However, it is still in its infancy in Nigeria. The objective of our study is to determine the knowledge, awareness, and acceptability of renal transplant among patients with end-stage renal disease (ESRD) and the factors which are responsible for the low level of transplantation in Ibadan, Nigeria. A 15-item pilot-tested questionnaire was administered to willing patients with ESRD seen at the medical outpatient clinic of the University Teaching Hospital, from January to December 2011...
July 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27401523/spatial-and-temporal-clustering-of-anti-glomerular-basement-membrane-disease
#18
Mark Canney, Paul V O'Hara, Caitriona M McEvoy, Samar Medani, Dervla M Connaughton, Ahad A Abdalla, Ross Doyle, Austin G Stack, Conall M O'Seaghdha, Michael R Clarkson, Matthew D Griffin, John Holian, Anthony M Dorman, Aileen Niland, Mary Keogan, Eleanor M Wallace, Niall P Conlon, Cathal Walsh, Alan Kelly, Mark A Little
BACKGROUND AND OBJECTIVES: An environmental trigger has been proposed as an inciting factor in the development of anti-GBM disease. This multicenter, observational study sought to define the national incidence of anti-GBM disease during an 11-year period (2003-2014) in Ireland, investigate clustering of cases in time and space, and assess the effect of spatial variability in incidence on outcome. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We ascertained cases by screening immunology laboratories for instances of positivity for anti-GBM antibody and the national renal histopathology registry for biopsy-proven cases...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27391406/protocol-of-a-mixed-method-randomized-controlled-study-to-assess-the-efficacy-of-a-psychosocial-intervention-to-reduce-fatigue-in-patients-with-end-stage-renal-disease-esrd
#19
Wieke E van der Borg, Karen Schipper, Tineke A Abma
BACKGROUND: Patients with end-stage renal disease (ESRD) commonly suffer from severe fatigue, which strongly impacts their quality of life (QoL). Although fatigue is often attributed to disease- and treatment characteristics, research also shows that behavioural, psychological and social factors affect perceived fatigue in dialysis patients. Whereas studies on fatigue in other chronic patient groups suggest that psychological or psychosocial interventions are effective in reducing fatigue, such interventions are not yet available for ESRD patients on dialysis treatment...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27377659/protection-against-death-and-renal-failure-by-renin-angiotensin-system-blockers-in-patients-with-diabetes-and-kidney-disease
#20
REVIEW
Jian Shen, Yan-Mei Huang, Xin-Nan Song, Xue-Zhi Hong, Min Wang, Wei Ling, Xiao-Xi Zhang, Hai-Lu Zhao
INTRODUCTION: Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are widely used to block the renin-angiotensin system (RAS). Yet it remains uncertain whether these drugs are equally effective and safe. METHODS: Systematic reviews and meta-analyses of ACEis/ARBs in diabetes and kidney disease published in PubMed, Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases were searched for clinical outcomes including all-cause mortality, end-stage renal disease (ESRD), hyperkalemia and cough...
July 2016: Journal of the Renin-angiotensin-aldosterone System: JRAAS
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