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Nephrology review

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https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#1
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29324582/quality-measures-in-acute-kidney-injury
#2
Amjad Mehboob, Robert Zimmerman, Stuart Abramson, Mark G Parker
PURPOSE OF REVIEW: Quality measure assessment and reporting is evolving in end-stage renal disease care and is inchoate in ambulatory nephrology clinic care. Acute kidney injury (AKI) quality measures have not received sufficient attention, yet deserve consideration in view of the substantial proportion of effort nephrology providers devote to AKI care. RECENT FINDINGS: Accumulating literature permits consideration of timing of nephrology consultation, follow-up after AKI hospitalization, early detection, medication dosing, hospital readmissions and length of stay, cost, and mortality as putative AKI quality measures...
January 10, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29320993/distribution-of-glomerular-diseases-in-taiwan-preliminary-report-of-national-renal-biopsy-registry-publication-on-behalf-of-taiwan-society-of-nephrology
#3
Hsien-Fu Chiu, Hung-Chun Chen, Kuo-Cheng Lu, Kuo-Hsiung Shu
BACKGROUND: Despite the development of biomarkers and noninvasive imaging tools, biopsy remains the only method for correctly diagnosing patients with unexplained hematuria, proteinuria and renal failure. Renal biopsy has been performed for several decades in Taiwan; however, a national data registry is still lacking until 2013. METHODS: The Renal Biopsy Registry Committee was established within the Taiwan Society of Nephrology in January 2013. A biopsy registry format, including basic demographic data, baseline clinical features, laboratory data, and clinical and pathological diagnosis was developed...
January 10, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29319763/current-distribution-pattern-of-biopsy-proven-glomerular-disease-in-salvador-brazil-40-years-after-an-initial-assessment
#4
Washington Luis Conrado Dos-Santos, Glória Maria Maranhão Sweet, Labene Gondim Azevêdo, Maria Brandão Tavares, Maria Fernanda Sanches Soares, Caroline Vilas Boas de Melo, Márcia Fernanda Melo Carneiro, Rilma Ferreira de Souza Santos, Márcia Cristina Conrado, Daniela Teixeira Leal Braga, Marcia Carvalho Bessa, Nathanael de Freitas Pinheiro Junior, Marília Bahiense-Oliveira
INTRODUCTION: A report on the prevalence of glomerular disease diagnosed via renal biopsy in Salvador, BA, Brazil was published in 1973 and showed a predominance of membranoproliferative glomerulonephritis, which was frequently associated with hepatosplenic schistosomiasis. OBJECTIVE: In this study, we investigate the potential changes in the distribution of glomerular diseases after a period of important epidemiological transition in Brazil. METHODS: Pathology reports of all patients subjected to kidney biopsy from 2003 to 2015 in a referral nephrology service were reviewed...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29314304/role-of-telehealth-in-renal-replacement-therapy-education
#5
Anna Malkina, Delphine S Tuot
The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#6
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29314256/point-of-care-ultrasound-education-to-improve-care-of-dialysis-patients
#7
Surekha Mullangi, Stephen M Sozio, Paul Segal, Steven Menez, Carol Martire, Tariq Shafi
Point-of-care ultrasound (POCUS) is rapidly emerging as a bedside diagnostic tool that can enhance physical diagnosis and facilitate clinical decision making. Although ultrasound is widely used by nephrologists for vascular access and kidney imaging, diagnostic POCUS skills in other anatomic areas are not part of routine nephrology training. In this narrative review, we will provide an overview of selected POCUS techniques, highlight potential uses of POCUS in routine nephrology practice, and describe a new curriculum implemented at Johns Hopkins University School of Medicine to teach diagnostic POCUS skills to nephrology fellows...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29285981/keeping-care-connected-e-consultation-program-improves-access-to-nephrology-care
#8
Priscille Schettini, Kevin P Shah, Colin P O'Leary, Malhar P Patel, John B Anderson, Alex H Cho, Andrea L Long, Hayden B Bosworth, C Blake Cameron
Introduction Health systems are seeking innovative solutions to improve specialty care access. Electronic consultations (eConsults) allow specialists to provide formal clinical recommendations to primary care providers (PCPs) based on patient chart review, without a face-to-face visit. Methods We implemented a nephrology eConsult pilot program within a large, academic primary care practice to facilitate timely communication between nephrologists and PCPs. We used primary care referral data to compare wait times and completion rates between traditional referrals and eConsults...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29285109/acute-kidney-injury-in-cancer-patients-and-impedance-cardiography-assisted-renal-replacement-therapy-experience-from-the-onconephrology-unit-of-a-chinese-tertiary-hospital
#9
Tao Wang, Yan Zhang, Qingxia Li, Shumin Jia, Changjin Shi, Kai Niu, Bing Liu
Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29281774/concept-clarification-uncertainty-in-individuals-with-chronic-kidney-disease
#10
Sarah Llewellyn
Uncertainty is often presented in the literature as a barrier to chronic kidney disease (CKD) management and end stage renal disease (ESRD) planning by individuals, but the definition of uncertainty has not been clarified for individuals with CKD. After reviewing the literature, a conceptual definition for uncertainty in individuals with CKD was developed. To further clarify this concept, exemplars of individuals with CKD who do and do not exhibit uncertainty are offered. This concept clarification may offer nephrology nurses additional insight into assessing and caring for individuals with CKD...
November 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29248052/spanish-clinical-guidelines-on-vascular-access-for-haemodialysis
#11
José Ibeas, Ramon Roca-Tey, Joaquín Vallespín, Teresa Moreno, Guillermo Moñux, Anna Martí-Monrós, José Luis Del Pozo, Enrique Gruss, Manel Ramírez de Arellano, Néstor Fontseré, María Dolores Arenas, José Luis Merino, José García-Revillo, Pilar Caro, Cristina López-Espada, Antonio Giménez-Gaibar, Milagros Fernández-Lucas, Pablo Valdés, Fidel Fernández-Quesada, Natalia de la Fuente, David Hernán, Patricia Arribas, María Dolores Sánchez de la Nieta, María Teresa Martínez, Ángel Barba
Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29247107/low-dose-glucocorticoids-plus-rituximab-versus-high-dose-glucocorticoids-plus-rituximab-for-remission-induction-in-anca-associated-vasculitis-lovas-protocol-for-a-multicentre-open-label-randomised-controlled-trial
#12
Shunsuke Furuta, Takao Sugiyama, Takeshi Umibe, Yuko Kaneko, Koichi Amano, Kazuhiro Kurasawa, Daiki Nakaomi, Masaki Hiraguri, Hideki Hanaoka, Yasunori Sato, Kei Ikeda, Hiroshi Nakajima
INTRODUCTION: Antineutrophil cytoplasm antibody-associated vasculitis (AAV) is a form of systemic vasculitis. The current standard induction therapy with the combination of high-dose glucocorticoids and cyclophosphamide or rituximab has high remission rates of 80%-90%. However, it is also associated with various side effects, including death due to infection or cardiovascular disease. There is an unmet medical need of a new therapy to reduce side effects. METHODS AND ANALYSIS: This is a phase IV multicentre, open-label, randomised controlled trial that aims to evaluate the efficacy and safety of a new remission induction regimen with the combination of low-dose glucocorticoids and rituximab...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29242368/lessons-from-ckd-related-genetic-association-studies-moving-forward
#13
Sophie Limou, Nicolas Vince, Afshin Parsa
Over the past decade, genetic association studies have uncovered numerous determinants of kidney function in the general, diabetic, hypertensive, CKD, ESRD, and GN-based study populations (e.g., IgA nephropathy, membranous nephropathy, FSGS). These studies have led to numerous novel and unanticipated findings, which are helping improve our understanding of factors and pathways affecting both normal and pathologic kidney function. In this review, we report on major discoveries and advances resulting from this rapidly progressing research domain...
December 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29241197/renoprotective-effects-of-metformin
#14
Marc E De Broe, Farshad Kajbaf, Jean-Daniel Lalau
BACKGROUND/AIMS: It has become clear that metformin exerts pleiotropic actions beyond its glucose-lowering agent effect. In this review, we summarise the state of the art concerning the potential renoprotective effects of metformin in vitro, animal models and clinical nephrology. METHODS: A literature search was performed in PUBMED, ScienceDirect, between January 1957 and March 2017 using the following keywords: "metformin," "nephroprotection," "renoprotection," "survival," "renal failure," "chronic kidney diseases," "fibrosis," "polycystic kidney disease" and "microalbuminuria...
December 14, 2017: Nephron
https://www.readbyqxmd.com/read/29225809/venous-air-embolism-related-to-the-use-of-central-catheters-revisited-with-emphasis-on-dialysis-catheters
#15
REVIEW
Steve Siu-Man Wong, Hau C Kwaan, Todd S Ing
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29221624/international-medical-graduates-in-nephrology-roles-rules-and-future-risks
#16
Jeffrey S Berns, Muriel Ghosn, Rodolfo R Altamirano
International medical graduates (IMGs) have become an increasingly essential part of many residency and fellowship programs in the United States. IMGs, who may be of either US or non-US citizenship, contribute significantly to the physician workforce across this country, particularly in underserved areas, as well as in their home countries on their return after training. Approximately 65% of nephrology fellows are IMGs, with most of these being non-US citizens. Non-US IMG applications for nephrology fellowship have been declining, exacerbating an ongoing shortage of nephrology trainees...
December 5, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29220099/supportive-palliative-care-should-be-integrated-into-routine-care-for-paediatric-patients-with-life-limiting-kidney-disease
#17
REVIEW
Julia Thumfart, Tobias Reindl, Cornelia Rheinlaender, Dominik Müller
Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29214330/oxidative-stress-in-kidney-diseases-the-cause-or-the-consequence
#18
REVIEW
Natalia Krata, Radosław Zagożdżon, Bartosz Foroncewicz, Krzysztof Mucha
Exaggerated oxidative stress (OS) is usually considered as a disturbance in regular function of an organism. The excessive levels of OS mediators may lead to major damage within the organism's cells and tissues. Therefore, the OS-associated biomarkers may be considered as new diagnostic tools of various diseases. In nephrology, researchers are looking for alternative methods replacing the renal biopsy in patients with suspicion of chronic kidney disease (CKD). Currently, CKD is a frequent health problem in world population, which can lead to progressive loss of kidney function and eventually to end-stage renal disease...
December 6, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/29212494/epidemiology-and-outcomes-of-children-with-renal-failure-in-the-pediatric-ward-of-a-tertiary-hospital-in-cameroon
#19
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29201804/aneurysm-of-portosystemic-fistula-a-case-report-and-review-of-literature
#20
Sila Ulus, Gulhan Ertan Akan, Cengiz Erol
Aim: A case of asymptomatic aneurysm of spontaneous portosystemic venous fistula (SPVF) with the radiologic findings is described. Background: Although advances and more widespread use of ultrasound (US) and computed tomog -raphy angiography (CTA) have enabled more detection of SPVF in the liver, it is a rare entity. Case report: A 49-year-old male was referred to our hospital's nephrology outpatient clinic due to hypertension. Abdominal sonography examination detected a well-defined cystic lesion adjacent to the middle hepatic vein in the liver...
July 2017: Euroasian Journal of Hepato-Gastroenterology
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