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Nephrology review

Pankti A Gheewala, Gregory M Peterson, Syed Tabish R Zaidi, Matthew D Jose, Ronald L Castelino
BACKGROUND: Screening programs may help to address the burden of chronic kidney disease (CKD) in Australia. Public awareness is an important determinant of the uptake of screening programs. However, data on the public knowledge of CKD in Australia is lacking. The aim of this study was to develop a validated questionnaire and assess the Australian public knowledge of CKD. METHODS: A CKD knowledge questionnaire was developed after reviewing the literature and discussions with nephrology experts...
March 20, 2018: BMC Public Health
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
Pierre Antoine Brown, Swapnil Hiremath, Edward G Clark, Edmund S H Kwok, Christopher McCudden, Ayub Akbari
BACKGROUND: Morbidity and Mortality Conferences (M&MCs) have for generations been part of the education of physicians, yet their effectiveness remains questionable. The Ottawa M&M Model (OM3) was developed to provide a structured approach to M&MCs in order to maximize the quality improvement impact of such rounds. STUDY DESIGN: We conducted a retrospective assessment of the impact of implementing nephrology-specific M&MCs using the OM3. SETTING AND PARTICIPANTS: All physicians, residents and fellows from the division of nephrology at a large academic medical center were invited to participate...
March 12, 2018: International Urology and Nephrology
Chance Dumaine, Mercedeh Kiaii, Lisa Miller, Louise Moist, Matthew J Oliver, Charmaine E Lok, Swapnil Hiremath, Jennifer M MacRae
Background: One of the mandates of the Canadian Society of Nephrology's (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada...
2018: Canadian Journal of Kidney Health and Disease
Boon Wee Teo, Luxia Zhang, Jinn-Yuh Guh, Sydney C W Tang, Vivekanand Jha, Duk-Hee Kang, Roberto Tanchanco, Lai Seong Hooi, Kearkiat Praditpornsilpa, Xianglei Kong, Li Zuo, Gek Cher Chan, Evan J C Lee
The National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines recommended the Modification of Diet in Renal Disease study equation for estimating glomerular filtration rate (GFR) for the classification of CKD, but its accuracy was limited to North American patients with estimated GFR <60 mL/min per 1.73 m2 body surface area of European (White) or African (Black) descent. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed another equation for estimating GFR, derived from a population that included both participants without kidney disease and with CKD...
January 2018: Advances in Chronic Kidney Disease
Varun Agrawal, Kenar D Jhaveri, Hitesh H Shah
Interest in nephrology careers continues to remain low in the USA. Educational innovations that enhance interest in nephrology among medical trainees are being actively studied. While internal medicine (IM) residency programs commonly offer the inpatient nephrology elective to the resident, outpatient nephrology experience is lacking. Understanding the provision of care in outpatient and home dialysis and management of patients with glomerular diseases, chronic kidney disease and kidney transplantation are vital components of an outpatient nephrology rotation...
August 2017: Clinical Kidney Journal
Dalia E Yousif, Alice R Topping, Maha F Osman, Jochen G Raimann, Elfadil M Osman, Peter Kotanko, Omar I Abboud
BACKGROUND: The burden of acute kidney injury (AKI) is high in Africa. While there are no reliable statistics about AKI in Africa, the Global Snapshot Study of the 0by25 initiative of the International Society of Nephrology has determined dehydration, infections, animal envenomation, and complications during pregnancy as the main causes. METHODS: This study was conducted at the Soba University Hospital (SUH), Khartoum, Sudan, a tertiary referral center. We included all hemodialysis patients treated for AKI at SUH between -January 1, 2013 and December 31, 2014 in the study...
January 26, 2018: Blood Purification
Loredana Colla, Davide Diena, Maura Rossetti, Ana Maria Manzione, Luca Marozio, Chiara Benedetto, Luigi Biancone
Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects...
February 23, 2018: Journal of Nephrology
Björn Tampe, Michael Zeisberg
Progression of chronic kidney disease is a principal challenge in Nephrology, as effective therapies to halt or even reverse established lesion are not available yet. While numerous growth factors and environmental stimuli that drive progression of chronic kidney disease are present within the fibrotic microenvironment, the effector cells' genetic information needs to be accessible in order to enable the pro-fibrotic response. As more than 2 m of DNA encoding the genetic information is crammed as protein-DNA complex called chromatin within the nucleus of each cell, an accessible chromatin state is a prerequisite in the hierarchical order of events to enable production of fibrotic proteins and fibrotic cellular responses...
February 20, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
Bedra Sharif, Moumita Barua
PURPOSE OF REVIEW: The widespread adoption of next-generation sequencing by research and clinical laboratories has begun to uncover the previously unknown genetic basis of many diseases. In nephrology, one of the best examples of this is seen in focal and segmental glomerulosclerosis (FSGS) and nephrotic syndrome. We review advances made in 2017 as a result of human and molecular genetic studies as it relates to FSGS and nephrotic syndrome. RECENT FINDINGS: There are more than 50 monogenic genes described in steroid-resistant nephrotic syndrome and FSGS, with seven reported in 2017...
February 19, 2018: Current Opinion in Nephrology and Hypertension
Guangjian Liu, Jinhai Chen
This study investigated the risk factors of peritonitis during early peritoneal dialysis for renal failure in patients with antineutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis (AASV). This study enrolled hospitalized AASV patients with renal failure who underwent peritoneal dialysis at the Department of Nephrology of our hospital between 2008 and 2015. The primary aim of this study was to perform a retrospective analysis to characterize peritonitis during the early period (≤ 8 weeks) of dialysis, and to compare the differences in initial clinical manifestations, vasculitis activity, immunosuppressive therapies prior to the renal replacement therapy, and prognosis between patients with or without peritonitis...
February 21, 2018: Clinical Nephrology
Haresh Selvaskandan, Izabella Pawluczyk, Jonathan Barratt
IgA nephropathy (IgAN) is the most common cause of primary glomerulonephritis worldwide. Up to 30% of cases develop the progressive form of the disease, eventually requiring renal replacement therapy. Diagnosis and risk stratification relies on an invasive kidney biopsy and management options are limited, with recurrence following renal transplantation being common. Thus the quest to understand the pathophysiology of IgAN has been one of great importance. MicroRNAs (miRs) are short nucleotides that suppress gene expression by hybridizing to the 3' untranslated region of messenger RNA (mRNAs), promoting mRNA degradation or disrupting translation...
February 2018: Clinical Kidney Journal
Jochen G Raimann, Miguel C Riella, Nathan W Levin
In developing countries with limited medical infrastructure, preservation and recovery of renal function following acute kidney injury (AKI) is difficult. In conjunction with clinical presentation, rapid measurement of renal function is essential for early diagnosis and management. Especially in low- and middle-income countries, simple interventions such as hydration and avoidance of toxins have the highest probability of recovery. In such contexts, measurement of urine volume and osmolality and serum creatinine with point-of-care devices and saliva urea nitrogen dipsticks can be valuable...
February 2018: Clinical Kidney Journal
Felix Poppelaars, Bernardo Faria, Mariana Gaya da Costa, Casper F M Franssen, Willem J van Son, Stefan P Berger, Mohamed R Daha, Marc A Seelen
Significant advances have lead to a greater understanding of the role of the complement system within nephrology. The success of the first clinically approved complement inhibitor has created renewed appreciation of complement-targeting therapeutics. Several clinical trials are currently underway to evaluate the therapeutic potential of complement inhibition in renal diseases and kidney transplantation. Although, complement has been known to be activated during dialysis for over four decades, this area of research has been neglected in recent years...
2018: Frontiers in Immunology
Eleanor Murray, Mahmoud Eid, Jamie P Traynor, Karen S Stevenson, Ram Kasthuri, David B Kingsmore, Peter C Thomson
Background: The modality by which haemodialysis (HD) is delivered [arteriovenous fistula (AVF), arteriovenous graft (AVG) or central venous catheter (CVC)] varies widely and is influenced by clinical evidence, patient factors and the prevailing service configuration. The aim of this study was to determine the outcome and impact of access strategy on patient outcome by mapping out the HD journey in a cohort of incident patients. Methods: A 2-year cohort of consecutive incident HD patients from the point of referral for first dialysis access to completion of the first 365 days of HD was prospectively reviewed...
February 1, 2018: Nephrology, Dialysis, Transplantation
José Alberto Navarro-García, María Fernández-Velasco, Carmen Delgado, Juan F Delgado, Makoto Kuro-O, Luis Miguel Ruilope, Gema Ruiz-Hurtado
Profound disturbances in mineral metabolism are closely linked to the progression of chronic kidney disease. However, increasing clinical and experimental evidence indicate that alterations in phosphate homeostasis could have an even stronger impact on the heart. The aim of this review is to provide the reader with an update of how alterations in mineral metabolism are related to direct and indirect cardiotoxic effects beyond the nephrology setting. Evidence exists that alterations in mineral metabolism that are related to changes in parathyroid hormone (PTH), vitamin D, and the FGF-23-Klotho axis have direct pathological consequences for the heart...
February 2, 2018: European Journal of Clinical Investigation
Zhen Wang, Li-Min Guo, Hong-Kang Zhou, Hong-Ke Qu, Shu-Chao Wang, Feng-Xia Liu, Dan Chen, Ju-Fang Huang, Kun Xiong
Evolutionary medicine has proven helpful to understand the origin of human disease, e.g. in identifying causal roles of recent environmental changes impacting on human physiology (environment-phenotype mismatch). In contrast, diseases affecting only a limited number of members of a species often originate from evolutionary trade-offs for usually physiologic adaptations assuring reproductive success in the context of extrinsic threats. For example, the G1 and G2 variants of the APOL1 gene supporting control of Trypanosoma infection come with the trade-off that they promote the progression of kidney disease...
February 1, 2018: Histology and Histopathology
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
The recognition of a standardized, consensus definition for acute kidney injury (AKI) has been an important milestone in critical care nephrology, which has facilitated innovation in prevention, quality of care, and outcomes research among the growing population of hospitalized patients susceptible to AKI. Concomitantly, there have been substantial advances in "big data" technologies in medicine, including electronic health records (EHR), data registries and repositories, and data management and analytic methodologies...
2018: Contributions to Nephrology
Gloria E Ashuntantang, Vesna D Garovic, Ita P Heilberg, Liz Lightstone
The theme of World Kidney Day 2018 is 'kidneys and women's health: include, value, empower'. To mark this event, Nature Reviews Nephrology asked four leading researchers to discuss key considerations related to women's kidney health, including specific risk factors, as well as the main challenges and barriers to care for women with kidney disease and how these might be overcome. They also discuss policies and systems that could be implemented to improve the kidney health of women and their offspring and the areas of research that are needed to improve the outcomes of kidney disease in women...
January 30, 2018: Nature Reviews. Nephrology
Alexander A Boucher, Amanda Pfeiffer, Ashley Bedel, Jennifer Young, Patrick T McGann
BACKGROUND: Iron deficiency is a common and clinically diverse hematologic disorder in childhood for which oral iron is often an infeasible or ineffective treatment option. Intravenous (IV) iron can be an efficient and highly successful means of iron replacement but its use has not been well-characterized on a large scale in pediatrics. PROCEDURE: All IV iron doses administered to patients for iron replacement therapy at a tertiary pediatric hospital from January 2010 through October 2016 were evaluated...
January 25, 2018: Pediatric Blood & Cancer
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