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https://www.readbyqxmd.com/read/28636754/linagliptin-and-its-effects-on-hyperglycaemia-and-albuminuria-in-patients-with-type-2-diabetes-and-renal-dysfunction-the-randomized-marlina-t2d%C3%A2-trial
#1
P-H Groop, M E Cooper, V Perkovic, B Hocher, K Kanasaki, M Haneda, G Schernthaner, K Sharma, R C Stanton, R Toto, J Cescutti, M Gordat, T Meinicke, A Koitka-Weber, S Thiemann, M von Eynatten
AIMS: The MARLINA-T2D™ study (ClinicalTrials.gov, NCT01792518) was designed to investigate the glycaemic and renal effects of linagliptin added to standard-of-care in individuals with type 2 diabetes and albuminuria. METHODS: 360 individuals with type 2 diabetes, HbA1c 6.5 - 10.0% (48 - 86 mmol/mol), estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m(2) , and urinary albumin-to-creatinine ratio (UACR) 30-3000 mg/g despite single agent renin-angiotensin-system blockade were randomized to double-blind linagliptin (n = 182) or placebo (n = 178) for 24 weeks...
June 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28620578/surgical-management-of-advanced-and-metastatic-renal-cell-carcinoma-a-multidisciplinary-approach
#2
REVIEW
Brian M Shinder, Kevin Rhee, Douglas Farrell, Nicholas J Farber, Mark N Stein, Thomas L Jang, Eric A Singer
The past decade has seen a rapid proliferation in the number and types of systemic therapies available for renal cell carcinoma. However, surgery remains an integral component of the therapeutic armamentarium for advanced and metastatic kidney cancer. Cytoreductive surgery followed by adjuvant cytokine-based immunotherapy (predominantly high-dose interleukin 2) has largely given way to systemic-targeted therapies. Metastasectomy also has a role in carefully selected patients. Additionally, neoadjuvant systemic therapy may increase the feasibility of resecting the primary tumor, which may be beneficial for patients with locally advanced or metastatic disease...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28619533/-dyslipidemia-management-in-patients-with-high-cardiovascular-risk-in-spain-alma-study
#3
Xavier Pintó, Ferran Trias Vilagut, Joan Rius Taruella, Esther Mairal Sallán
OBJECTIVE: To assess the attitude of primary care (PCPs) and specialized care (SCPs) physicians towards the general set of patients with dyslipidemia, particularly those with cardiovascular risk factors. DESIGN: Observational, descriptive, multi-center study based on a survey. LOCATION: Different healthcare regions in Spain. PARTICIPANTS: 1,402 PCPs, and 596 SCPs. MAIN MEASUREMENTS: Physician's profile, routine practices in the management of patients with dyslipidemia...
June 12, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28616249/quality-of-care-for-patients-with-chronic-kidney-disease-in-the-primary-care-setting-a-retrospective-cohort-study-from-ontario-canada
#4
Danielle M Nash, Scott Brimble, Maureen Markle-Reid, Eric McArthur, Karen Tu, Gihad E Nesrallah, Allan Grill, Amit X Garg
BACKGROUND: Patients with chronic kidney disease may not be receiving recommended primary renal care. OBJECTIVE: To use recently established primary care quality indicators for chronic kidney disease to determine the proportion of patients receiving recommended renal care. DESIGN: Retrospective cohort study using administrative data with linked laboratory information. SETTING: The study was conducted in Ontario, Canada, from 2006 to 2012...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28616213/postoperative-goal-directed-therapy-and-development-of-acute-kidney-injury-following-major-elective-noncardiac-surgery-post-hoc-analysis-of-pom-o-randomized-controlled-trial
#5
Amour Patel, John R Prowle, Gareth L Ackland
Background: The role of goal-directed therapy (GDT) in preventing creatinine rise following noncardiac surgery is unclear. We performed a post-hoc analysis of a randomized controlled trial to assess the relationship between postoperative optimization of oxygen delivery and development of acute kidney injury (AKI)/creatinine rise following noncardiac surgery. Methods: Patients were randomly assigned immediately postoperatively to receive either fluid and/or dobutamine therapy to maintain/restore their preoperative oxygen delivery, or protocolized standard care (oxygen delivery only recorded)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28607686/improving-care-for-patients-with-or-at-risk-for-chronic-kidney-disease-using-electronic-medical-record-interventions-a-pragmatic-cluster-randomized-trial-protocol
#6
Danielle M Nash, Noah M Ivers, Jacqueline Young, R Liisa Jaakkimainen, Amit X Garg, Karen Tu
BACKGROUND: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. OBJECTIVE: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. DESIGN: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28605053/prevalence-of-cyp3a5-genomic-variances-and-their-impact-on-tacrolimus-dosing-requirements-among-kidney-transplant-recipients-in-eastern-north-carolina
#7
Angela Q Maldonado, Tomefa Asempa, Suzanne Hudson, Lorita M Rebellato
STUDY OBJECTIVE: To assess the prevalence of CYP3A5 genomic variances and their impact on tacrolimus dosing requirements among kidney transplant recipients in eastern North Carolina. DESIGN: Single-center, retrospective cohort study. SETTING: Large tertiary care medical center. PATIENTS: A total of 162 adults who received a kidney transplant between March 1, 2013, and February 28, 2015, and received oral tacrolimus as part of their maintenance immunosuppression; of these patients, 85 patients expressed a genotype with a CYP3A5*1 variant (CYP3A5*1 group), and 77 patients expressed genotypes with other CYP3A5 variants (nonexpressor group)...
June 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28599963/prevalence-of-type-2-diabetes-mellitus-complications-among-palestinians-with-t2dm
#8
Ahmad Abu Al-Halaweh, Nadav Davidovitch, Thomas Peter Almdal, Anna Cowan, Samah Khatib, Lana Nasser-Eddin, Ziad Baradia
AIMS: To assess the prevalence of microvascular and macrovascular complications of type 2 diabetes (T2DM) among Palestinians. METHODS: 1308 diagnosed T2DM attending four main Primary Health Care Clinics on the Southern West Bank of Palestine examined by a Mobile Diabetes Clinic team. All diabetes patients visiting the clinics during a one-month period for each clinic were included. Interviews, anthropometric measurements, physical examination, and laboratory tests: HbA1c, lipid profile, and kidney function tests analyzed in a central laboratory were obtained RESULTS: 1308 diabetes patients, including 839 females (64%), with a mean age of 57 years (SD=8...
June 3, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28598051/prevention-and-management-of-acute-kidney-injury-what-a-physician-should-know
#9
Danish Kathuria, N P Singh
The incidence of acute kidney injury (AKI) has been increasing worldwide. The increase is attributable not only to ageing population with multiple comorbidities, polypharmacy, increasing use of contrast for diagnostic and therapeutic procedures but also to the fact that now it is being recognized more often. The 'Zero by 25' initiative by International Society of Nephrology aims at preventing all avoidable deaths from AKI worldwide by the year 2025. It calls for greater awareness about management of AKI among primary care physicians...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28595193/the-economic-consequences-of-acute-kidney-injury
#10
Samuel A Silver, Glenn M Chertow
Acute kidney injury (AKI) is an increasingly common condition associated with poor health outcomes. Combined with its rising incidence, AKI has emerged as a major public health concern with high human and financial costs. In England, the estimated inpatient costs related to AKI consume 1% of the National Health Service budget. In the United States, AKI is associated with an increase in hospitalization costs that range from $5.4 to $24.0 billion. The most expensive patients are those with AKI of sufficient severity to require dialysis, where cost increases relative to patients without AKI range from $11,016 to $42,077 per hospitalization...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28592388/characterization-of-clinical-cases-of-advanced-papillary-renal-cell-carcinoma-via-comprehensive-genomic-profiling
#11
Sumanta K Pal, Siraj M Ali, Evgeny Yakirevich, Daniel M Geynisman, Jose A Karam, Julia A Elvin, Garrett M Frampton, Xuan Huang, Douglas I Lin, Mark Rosenzweig, Doron Lipson, Philip J Stephens, Jeffrey S Ross, Vincent A Miller, Neeraj Agarwal, Brian Shuch, Toni K Choueiri, Jon H Chung
BACKGROUND: Papillary renal cell carcinoma (PRCC) is a rare subset of RCC. The Cancer Genome Atlas (TCGA) data largely reflect localized disease, and there are limited data for advanced PRCC. OBJECTIVE: To characterize the frequency of genomic alterations (GAs) in patients with advanced PRCC for whom comprehensive genomic profiling (CGP) was performed in the context of routine clinical care. DESIGN, SETTING, AND PARTICIPANTS: Formalin-fixed, paraffin-embedded tissue was obtained for 169 consecutive patients with confirmed PRCC...
May 30, 2017: European Urology
https://www.readbyqxmd.com/read/28588112/the-hoorn-diabetes-care-system-dcs-cohort-a-prospective-cohort-of-persons-with-type-2-diabetes-treated-in-primary-care-in-the-netherlands
#12
Amber Awa van der Heijden, Simone P Rauh, Jacqueline M Dekker, Joline W Beulens, Petra Elders, Leen M 't Hart, Femke Rutters, Nienke van Leeuwen, Giel Nijpels
PURPOSE: People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort. PARTICIPANTS: The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28588070/risk-factors-for-fractures-in-children-hospitalized-in-intensive-and-intermediate-care-units
#13
Ian S Zenlea, Patrice Melvin, Susanna Y Huh, Nilesh Mehta, Suzanne J Reidy, Erinn T Rhodes, Nina S Ma
BACKGROUND AND OBJECTIVES: Fragility fractures are increasingly recognized in hospitalized children. Our study aim was to identify risk factors for fracture in children hospitalized in intensive and intermediate care units. METHODS: We conducted a retrospective, case-control study comparing the clinical characteristics of children with fractures (cases) to children without fractures (controls) matched for age, sex, hospital unit, admission quarter and year, ICU length of stay, severity of illness, and resource utilization...
June 6, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28584428/a-pilot-randomized-controlled-trial-of-comparison-between-extended-daily-hemodialysis-and-continuous-veno-venous-hemodialysis-in-patients-of-acute-kidney-injury-with-septic-shock
#14
Shakti Bedanta Mishra, Afzal Azim, Narayan Prasad, Ratendra Kumar Singh, Banani Poddar, Mohan Gurjar, Arvind Kumar Baronia
AIM OF STUDY: Acute kidney injury (AKI) is common in patients of septic shock. There is sparse data comparing sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in patients with septic shock. MATERIALS AND METHODS: This is a prospective randomized study in a 12-bedded medical intensive care unit. After clearance from institute's ethics committee and obtaining informed consent from the relatives, sixty adult patients with septic shock who were to undergo dialysis for AKI were included in the study...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28569129/early-versus-late-initiation-of-renal-replacement-therapy-in-critically-ill-patients-systematic-review-and-meta-analysis
#15
Bruno Adler Maccagnan Pinheiro Besen, Thiago Gomes Romano, Pedro Vitale Mendes, Cesar Albuquerque Gallo, Fernando Godinho Zampieri, Antonio Paulo Nassar, Marcelo Park
OBJECTIVE: Early initiation of renal replacement therapy (RRT) effect on survival and renal recovery of critically ill patients is still uncertain. We aimed to systematically review current evidence comparing outcomes of early versus late initiation of RRT in critically ill patients. METHODS: We searched the Medline (via Pubmed), LILACS, Science Direct, and CENTRAL databases from inception until November 2016 for randomized clinical trials (RCTs) or observational studies comparing early versus late initiation of RRT in critically ill patients...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28558814/approach-to-growth-hormone-therapy-in-children-with-chronic-kidney-disease-varies-across-north-america-the-midwest-pediatric-nephrology-consortium-report
#16
Oleh M Akchurin, Amy J Kogon, Juhi Kumar, Christine B Sethna, Hoda T Hammad, Paul J Christos, John D Mahan, Larry A Greenbaum, Robert Woroniecki
BACKGROUND: Growth impairment remains common in children with chronic kidney disease (CKD). Available literature indicates low level of recombinant human growth hormone (rhGH) utilization in short children with CKD. Despite efforts at consensus guidelines, lack of high-level evidence continues to complicate rhGH therapy decision-making and the level of practice variability in rhGH treatment by pediatric nephrologists is unknown. METHODS: Cross-sectional online survey electronically distributed to pediatric nephrologists through the Midwest Pediatric Nephrology Consortium and American Society of Pediatric Nephrology...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28555652/reducing-the-costs-of-chronic-kidney-disease-while-delivering-quality-health-care-a-call-to-action
#17
REVIEW
Raymond Vanholder, Lieven Annemans, Edwina Brown, Ron Gansevoort, Judith J Gout-Zwart, Norbert Lameire, Rachael L Morton, Rainer Oberbauer, Maarten J Postma, Marcello Tonelli, Wim Van Biesen, Carmine Zoccali
The treatment of chronic kidney disease (CKD) and of end-stage renal disease (ESRD) imposes substantial societal costs. Expenditure is highest for renal replacement therapy (RRT), especially in-hospital haemodialysis. Redirection towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure. However, costs for CKD are not limited to RRT, but also include nonrenal health-care costs, costs not related to health care, and costs for patients with CKD who are not yet receiving RRT...
July 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28554882/diagnosis-prevalence-awareness-treatment-prevention-and-control-of-hypertension-in-cameroon-protocol-for-a-systematic-review-and-meta-analysis-of-clinic-based-and-community-based-studies
#18
Barthelemy Kuate Defo, Jean Claude Mbanya, Jean-Claude Tardif, Olugbemiga Ekundayo, Sylvie Perreault, Louise Potvin, Robert Cote, Andre Pascal Kengne, Simeon Pierre Choukem, Felix Assah, Samuel Kingue, Lucie Richard, Roland Pongou, Katherine Frohlich, Jude Saji, Pierre Fournier, Eugene Sobngwi, Valery Ridde, Marie-Pierre Dubé, Simon De Denus, Wilfred Mbacham, Jean-Philippe Lafrance, Dickson Shey Nsagha, Warner Mampuya, Anastase Dzudie, Lyne Cloutier, Christina Zarowsky, Agatha Tanya, Paul Ndom, Marie Hatem, Evelyne Rey, Louise Roy, Roxane Borgès Da Silva, Christian Dagenais, David Todem, Robert Weladji, Dora Mbanya, Elham Emami, Zakariaou Njoumemi, Laurence Monnais, Carl-Ardy Dubois
BACKGROUND: Hypertension holds a unique place in population health and health care because it is the leading cause of cardiovascular disease and the most common noncommunicable condition seen in primary care worldwide. Without effective prevention and control, raised blood pressure significantly increases the risk of stroke, myocardial infarction, chronic kidney disease, heart failure, dementia, renal failure, and blindness. There is an urgent need for stakeholders-including individuals and families-across the health system, researchers, and decision makers to work collaboratively for improving prevention, screening and detection, diagnosis and evaluation, awareness, treatment and medication adherence, management, and control for people with or at high risk for hypertension...
May 29, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28553315/improving-ckd-diagnosis-and-blood-pressure-control-in-primary-care-a-tailored-multifaceted-quality-improvement-programme
#19
John Humphreys, Gill Harvey, Janet Hegarty
BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health issue. From 2009 to 2014, the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Greater Manchester (NIHR CLAHRC GM) in England ran 4 phased, 12-month quality improvement (QI) projects with 49 primary care practices in GM. Two measureable aims were set - halve undiagnosed CKD in participating practices using modelled estimates of prevalence; and optimise blood pressure (BP) control (<140/90 mm Hg in CKD patients without proteinuria; <130/80 mm Hg in CKD patients with proteinuria) for 75% of recorded cases of CKD...
January 2017: Nephron Extra
https://www.readbyqxmd.com/read/28546367/intensive-versus-minimal-standard-dosage-for-peritoneal-dialysis-in-acute-kidney-injury-a-randomized-pilot-study
#20
Watanyu Parapiboon, Treechada Chamradpan
♦Background: Dosage for peritoneal dialysis (PD) in acute kidney injury (AKI) is controversial. This study aims to find benefits and risks of intensive versus minimal standard dosage of PD in AKI. ♦ Methods: In a tertiary-hospital, 93 AKI patients who required PD between May 2015 and January 2016 were enrolled in a randomized, open-label controlled study. Patients were randomized to intensive group (> 30 L) and minimal standard group (< 20 L) of PD volume per day for the first 2 consecutive days. The primary outcome was in-hospital mortality...
May 25, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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