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https://www.readbyqxmd.com/read/28212407/epidemiology-of-low-proteinuric-chronic-kidney-disease-in-renal-clinics
#1
Luca De Nicola, Michele Provenzano, Paolo Chiodini, Silvio Borrelli, Luigi Russo, Antonio Bellasi, Domenico Santoro, Giuseppe Conte, Roberto Minutolo
CKD patients with low-grade proteinuria (LP) are common in nephrology clinics. However, prevalence, characteristics, and the competing risks of ESRD and death as the specific determinants, are still unknown. We analyzed epidemiological features of LP status in a prospective cohort of 2,340 patients with CKD stage III-V referred from ≥6 months in 40 nephrology clinics in Italy. LP status was defined as proteinuria <0.5 g/24h according to current KDIGO guidelines. Patients with higher proteinuria constituted the control group (CON)...
2017: PloS One
https://www.readbyqxmd.com/read/28212179/hard-choices-better-outcomes-a-review-of-shared-decision-making-and-patient-decision-aids-around-dialysis-initiation-and-conservative-kidney-management
#2
Janet L Davis, Sara N Davison
PURPOSE OF REVIEW: Patients reaching end-stage kidney disease face difficult decisions, including choosing among renal replacement therapies (RRTs). With an increasingly elderly and frail population, there is growing interest in conservative kidney management (CKM) as a viable alternative to dialysis. Shared decision-making (SDM) is a patient-centered approach to these decisions, in which choices are viewed within the explicitly discussed values and preferences of the patient. Patient decision aids (PDAs) are tools designed to facilitate these discussions...
February 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28209606/long-term-experiences-of-norwegian-live-kidney-donors-qualitative-in-depth-interviews
#3
Käthe B Meyer, Ida Torunn Bjørk, Astrid Klopstad Wahl, Annette Lennerling, Marit Helen Andersen
OBJECTIVE: Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. DESIGN: Qualitative explorative in-depth interviews...
February 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28208985/pattern-of-inpatient-dermatology-consultations-in-a-tertiary-care-centre-from-northern-india
#4
Abhilasha Williams, Anuradha Bhatia, Bimal Kanish, Paulina Rose Chaudhary, Clarence James Samuel
INTRODUCTION: The importance of dermatology inpatient consultation is of significant importance yet is not well documented. AIM: To retrospectively analyse the spectrum of dermatology inpatient consultations from the various departments and to document the most commonly occurring dermatological disorders from each speciality. MATERIALS AND METHODS: This study was done in an 800 bedded premier teaching hospital in Ludhiana, Punjab, North Western India...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207893/career-interest-and-perceptions-of-nephrology-a-repeated-cross-sectional-survey-of-internal-medicine-residents
#5
Michael N Daniels, Sharon Maynard, Ivan Porter, Hope Kincaid, Deepika Jain, Nabeel Aslam
BACKGROUND: Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. METHODS: This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions...
2017: PloS One
https://www.readbyqxmd.com/read/28205136/a-comparative-study-of-the-risk-profile-of-hemodialysis-patients-in-a-for-profit-network-and-in-two-regional-registries-of-the-italian-society-of-nephrology
#6
Maurizio Postorino, Claudia Amato, Elena Mancini, Paola Carioni, Graziella D'Arrigo, Attilio Di Benedetto, Fabrizio Cerino, Carmela Marino, Antonio Vilasi, Giovanni Tripepi, Stefano Stuard, Giovanbattista Capasso, Antonio Santoro, Carmine Zoccali
In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system...
February 16, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28204946/clinical-outcomes-in-children-with-henoch-sch%C3%A3-nlein-purpura-nephritis-without-crescents
#7
Jean Daniel Delbet, Julien Hogan, Bilal Aoun, Iulia Stoica, Rémi Salomon, Stéphane Decramer, Isabelle Brocheriou, Georges Deschênes, Tim Ulinski
BACKGROUND: Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. METHODS: All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files...
February 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28197886/spot-urine-protein-to-creatinine-ratio
#8
EDITORIAL
Guido Filler, Shih-Han Susan Huang
In a recent article in Pediatric Nephrology, EM Yang and colleagues (Pediatr Nephrol 2017: doi: 10.1007/s00467-016-3587-6 ) published a retrospective cross-sectional study involving a cohort of 442 children with an mean estimated glomerular filtration rate of >60 mL/min/1.73 m(2). The authors measured 24-h urine protein excretion (24-h UProt) alongside the morning spot urine protein to creatinine ratio (Prot/Cr) in this group of patients. While the Prot/Cr may be the only feasible way to routinely estimate the daily protein excretion of a young child, inter-individual variability in childrens' urinary creatinine excretion (UCr) may heavily influence the result...
February 14, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28194573/hyponatremia-and-cyst-growth-in-neonatal-polycystic-kidney-disease-a-case-for-aquaretics
#9
EDITORIAL
Detlef Bockenhauer
Hyponatremia is a common complication in neonatal polycystic kidney disease and is thought to be due to water retention. Aquaretics are drugs that promote free water excretion by blocking the arginine vasopressin receptor type 2 (AVPR2) in the collecting duct and thus impair urinary concentration. AVPR2 is also a key stimulant for cyclic AMP production in the collecting duct and in this way promotes cyst proliferation and pathologic kidney growth in autosomal dominant polycystic kidney disease (ADPKD). Consequently, the aquaretic tolvaptan is now used to slow down progression of ADPKD in adult patients...
February 13, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#10
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/28187786/low-renal-replacement-therapy-incidence-among-slowly-progressing-elderly-chronic-kidney-disease-patients-referred-to-nephrology-care-an-observational-study
#11
Ulrika Hahn Lundström, Alessandro Gasparini, Rino Bellocco, Abdul Rashid Qureshi, Juan-Jesus Carrero, Marie Evans
BACKGROUND: Elderly patients with advanced chronic kidney disease (CKD) have a high risk of death before reaching end-stage kidney disease. In order to allocate resources, such as advanced care nephrology where it is most needed, it is essential to know which patients have the highest absolute risk of advancing to renal replacement therapy (RRT). METHODS: We included all nephrology-referred CKD stage 3b-5 patients in Sweden 2005-2011 included in the Swedish renal registry (SRR-CKD) who had at least two serum creatinine measurements one year apart (+/- 6 months)...
February 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28187736/thrombocytopenia-on-the-first-day-of-emergency-department-visit-predicts-higher-risk-of-acute-kidney-injury-among-elderly-patients
#12
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang
BACKGROUND: Few studies have addressed risk factors for acute kidney injury (AKI) in geriatric patients. We investigated whether thrombocytopenia was a risk factor for AKI in geriatric patients with medical illnesses. METHODS: A prospective cohort study was conducted, by recruiting elderly (≥65 years) patients who visited the emergency department (ED) for medical illnesses during 2014. They all received hemogram for platelet count determination, and were stratified according to the presence of thrombocytopenia (platelets, <150 K/μL) during their initial ED evaluation...
February 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28182261/improving-the-electronic-capture-of-advance-care-directives-in-a-healthcare-delivery-system
#13
Norifumi Kamo, Barbara L Williams, Donna L Smith, C Craig Blackmore
OBJECTIVES: To determine the effectiveness of a multifaceted quality improvement intervention in outpatient clinics at an integrated healthcare delivery system on capture rate of advance directives (ADs) in the electronic medical record (EMR). DESIGN: Interrupted time series analysis with control groups between January 2010 and June 2015. SETTING: Oncology, nephrology, and primary care outpatient clinics in an integrated healthcare delivery system...
February 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28182041/assessment-of-health-related-quality-of-life-and-its-determinants-in-patients-with-chronic-kidney-disease
#14
M Manavalan, A Majumdar, K T Harichandra Kumar, P S Priyamvada
Health-related quality of life is an important, yet neglected aspect of chronic kidney disease (CKD) care. We evaluated the quality of life and its determinants across CKD 3 to 5D using a kidney disease specific tool (Kidney Disease Quality of Life-SF™) in an underprivileged, predominantly rural population with high rates of illiteracy and unemployment. The scores of individual domains were summarized to three composite scores - physical composite summary (PCS), mental composite summary (MCS), and kidney disease component summary score (KDCS)(...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181057/lipoprotein-a-in-nephrological-patients
#15
Bernd Hohenstein
In contrast to existing EAS/ESC guidelines on the management of lipid disorders, current recommendations from nephrological societies are very conservative and restrictive with respect to any escalation of lipid lowering/statin therapy. Furthermore, lipoprotein(a) (Lp(a)) - an established cardiovascular risk factor - has not even been mentioned. While a number of retrospective and prospective studies suggested that Lp(a) has relevant predictive value and might have - at least in stage-3 chronic kidney disease (CKD) - the same negative effects if draged along in non-CKD patients, there is no guidance on diagnostic or therapeutic procedures...
February 8, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28177103/-quality-of-life-anxiety-and-distress-in-patients-suffering-from-chronic-kidney-disease-pre-dialysis-and-start-of-dialytic-treatment
#16
Maria Monica Ratti, Giulia Bruna Delli Zotti, Eleonora Sangiovanni, Benedetta Vai, Aurelio Limido, Silvio Bertoli, Lucio Sarno, Donatella Spotti
The psychological impact of the Chronic Kidney Disease is well known and several factors contribute to a reduction of quality of life, increase of anxiety levels and psychological distress for affected patients. Psychological intervention is becoming ever more consolidating within the Departments of Nephrology. Nevertheless, literature is lacking about the psychological intervention specificity, especially concerning the dialysis and pre-dialysis phase. The purpose of the study is to identify the mainly critical periods for the dialysed patients in terms of anxiety and distress and to examine the impact of medical management in pre-dialysis period on life quality...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28174318/integrating-quality-improvement-education-into-the-nephrology-curricular-milestones-framework-and-the-clinical-learning-environment-review
#17
Lisa K Prince, Dustin J Little, Katherine I Schexneider, Christina M Yuan
The Accreditation Council for Graduate Medical Education requires that trainees show progressive milestone attainment in the practice-based learning and systems-based practice competencies. As part of the Clinical Learning Environment Review, sponsoring hospitals must educate trainees in health care quality improvement, provide them with specialty-specific quality data, and ensure trainee participation in quality improvement activities and committees. Subspecialty-specific quality improvement curricula in nephrology training programs have not been reported, although considerable curricular and assessment material exists for specialty residencies, including tools for assessing trainee and faculty competence...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28166740/delineation-of-cystinuria-in-saudi-arabia-a-case-series
#18
Abdulrahman Obaid, Marwan Nashabat, Khalid Al Fakeeh, Abdullah T Al Qahtani, Majid Alfadhel
BACKGROUND: Cystinuria is an inherited metabolic disease that is caused by defects in two genes, SLC3A1 and SLC7A9, which result in a renal reabsorptive defect of cystine and other dibasic amino acids, including ornithine, arginine, and lysine. Patients usually present with recurrent renal calculi and may develop renal impairment. Medical management includes high fluid intake and chelating agents. To the best of our knowledge, this is the first study describing cystinuria in Saudi Arabia...
February 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28161697/in-the-wake-of-systolic-blood-pressure-intervention-trial-new-targets-for-improving-hypertension-management-in-chronic-kidney-disease
#19
Crystal C Tyson, Thomas M Coffman
Systolic Blood Pressure Intervention Trial (SPRINT) was a multicenter randomized controlled trial showing the significant benefit of intensive reduction of blood pressure to a target of 120 mm Hg in individuals with hypertension and elevated cardiovascular risk. Because SPRINT includes the largest cohort of adults with chronic kidney disease (CKD) to be prospectively studied in a hypertension intervention trial, it has particular relevance to the field of nephrology. Here, we review the findings of SPRINT and assess their potential impact on guidelines for treatment of hypertension in patients with CKD...
February 4, 2017: Nephron
https://www.readbyqxmd.com/read/28161265/-reasons-for-first-consultation-in-nephrology-in-the-health-area-5-of-britanny-during-the-year-2014
#20
Jeanne Prévot, Sahar Bayat-Makoei, Cécile Vigneau
BACKGROUND: In France, the coordinated healthcare circuit means that patients should be referred to specialists, for example nephrologists, by another physician. However, there are no recommendations concerning the reasons justifying the referral to a nephrologist. The main purpose of our study is to describe the motif of first consultations in nephrology in the health area 5 of Brittany. METHODS: We retrospectively collected medical reports of first consultations by 17 nephrologists in the 4 centers of the study area, during the year 2014...
February 1, 2017: Néphrologie & Thérapeutique
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