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https://www.readbyqxmd.com/read/28815461/drug-induced-kidney-injury-in-the-elderly
#1
REVIEW
Sana Khan, Valentina Loi, Mitchell H Rosner
The incidence of acute kidney injury in the elderly has grown over the past decade. One of the primary drivers is drug-induced nephrotoxicity, which is the result of a combination of the unique susceptibilities to kidney injury and the increased use of medications in the elderly population. Specific drug classes are associated with increased rates of kidney injury including agents that block the renin angiotensin system, antimicrobials, and chemotherapeutic agents. Mechanistically, injury may be due to hemodynamic effects, tubular or glomerular toxicity, and interstitial nephritis...
August 16, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28811281/multimorbidity-dementia-and-health-care-in-older-people-a-population-based-cohort-study
#2
Marcello Tonelli, Natasha Wiebe, Sharon Straus, Martin Fortin, Bruce Guthrie, Matthew T James, Scott W Klarenbach, Helen Tam-Tham, Richard Lewanczuk, Braden J Manns, Hude Quan, Paul E Ronksley, Peter Sargious, Brenda Hemmelgarn
BACKGROUND: Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes. METHODS: We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013. We used validated algorithms applied to administrative and laboratory data from the provincial health ministry to assess the presence/absence of dementia and 29 other morbidities, and their associations with mortality (our primary outcome), other clinical outcomes (emergency department visits, all-cause hospital admissions) and a proxy for loss of independent living (discharge to long-term care)...
August 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#3
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#4
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28808078/relationship-of-kidney-injury-biomarkers-with-long-term-cardiovascular-outcomes-after-cardiac-surgery
#5
Chirag R Parikh, Jeremy Puthumana, Michael G Shlipak, Jay L Koyner, Heather Thiessen-Philbrook, Eric McArthur, Kathleen Kerr, Peter Kavsak, Richard P Whitlock, Amit X Garg, Steven G Coca
Clinical AKI, measured by serum creatinine elevation, is associated with long-term risks of adverse cardiovascular (CV) events and mortality in patients after cardiac surgery. To evaluate the relative contributions of urine kidney injury biomarkers and plasma cardiac injury biomarkers in adverse events, we conducted a multicenter prospective cohort study of 968 adults undergoing cardiac surgery. On postoperative days 1-3, we measured five urine biomarkers of kidney injury (IL-18, NGAL, KIM-1, L-FABP, and albumin) and five plasma biomarkers of cardiac injury (NT-proBNP, H-FABP, hs-cTnT, cTnI, and CK-MB)...
August 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#6
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28789948/burden-of-multiple-chronic-conditions-among-urologic-cancer-patients
#7
Tullika Garg, Amanda J Young, Korey A Kost, John F Danella, Sharon Larson, Matthew E Nielsen, H Lester Kirchner
PURPOSE: To describe age, multiple chronic condition (MCC) profiles, and health system contact in urologic cancer patients. MATERIALS & METHODS: Using Geisinger Health System electronic health records, we identified adult primary care patients and a subset with at least one urology encounter between 2001-2015. Agency for Healthcare Research and Quality Chronic Condition Indicator and Clinical Classifications Software tools were applied to International Classification of Diseases, Ninth Revision (ICD-9) codes to identify chronic conditions...
August 5, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28782123/the-effects-of-storage-of-red-blood-cells-on-the-development-of-postoperative-infections-after-noncardiac-surgery
#8
Savino Spadaro, Fabio Silvio Taccone, Alberto Fogagnolo, Vito Fontana, Riccardo Ragazzi, Marco Verri, Giorgia Valpiani, Pantaleo Greco, Margherita Bianconi, Maurizio Govoni, Roberto Reverberi, Carlo Alberto Volta
BACKGROUND: Prolonged storage of red blood cells (RBCs) is a potential risk factor for postoperative infections. The objective of this study was to examine the effect of age of RBCs transfused on development of postoperative infection. STUDY DESIGN AND METHODS: In this prospective, double-blind randomized trial, 199 patients undergoing elective noncardiac surgery and requiring RBC transfusion were assigned to receive nonleukoreduced RBCs stored for not more than 14 days ("fresh blood" group, n = 101) or for more than 14 days ("old blood" group, n = 98)...
August 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28780553/a-national-surveillance-project-on-chronic-kidney-disease-management-in-canadian-primary-care-a-study-protocol
#9
Aminu K Bello, Paul E Ronksley, Navdeep Tangri, Alexander Singer, Allan Grill, Dorothea Nitsch, John A Queenan, Cliff Lindeman, Boglarka Soos, Elizabeth Freiheit, Delphine Tuot, Dee Mangin, Neil Drummond
INTRODUCTION: Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28780148/intra-abdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#10
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal Compartment Syndrome (ACS) is the endpoint of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen (such as ascites or a hematoma) leads to a pathologically increased pressure. This results in so-called Intra-Abdominal Hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28779781/vascular-access-should-be-tailored-to-the-patient
#11
REVIEW
Krzysztof Letachowicz, Przemysław Szyber, Tomasz Gołębiowski, Mariusz Kusztal, Waldemar Letachowicz, Wacław Weyde, Jerzy Garcarek, Marian Klinger
A cornerstone of hemodialysis treatment is the creation of a functional and durable dialysis vascular access. Every patient with chronic kidney disease should have a plan of renal replacement therapy and access site protection. Factors having a crucial impact on vascular access selection include age, comorbidity, vessel quality, prognosis, dialysis urgency, and surgeon's preferences. Our medical group have reviewed these factors in our patients and, based on recently published data, developed a clinical decision tree for dialysis access in the chronic kidney disease patient...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28767410/orellanine-specifically-targets-renal-clear-cell-carcinoma
#12
Lisa Buvall, Heidi Hedman, Alina Khramova, Deman Najar, Lovisa Bergwall, Kerstin Ebefors, Carina Sihlbom, Sven Lundstam, Anders Herrmann, Hanna Wallentin, Emelie Roos, Ulf A Nilsson, Martin Johansson, Jan Törnell, Börje Haraldsson, Jenny Nyström
Renal cell carcinoma (RCC), arising from the proximal tubule in the kidney, accounts for approximately 85% of kidney cancers and causes over 140,000 annual deaths worldwide. In the last decade, several new therapies have been identified for treatment of metastatic RCC. Although these therapies increase survival time compared to standard care, none of them has curative properties. The nephrotoxin orellanine specifically targets proximal tubular epithelial cells, leaving other organs unaffected. We therefore hypothesized that the selective toxicity of orellanine extends to clear cell RCC (ccRCC) cells since they emanate from proximal tubular cells...
July 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28766108/a-pharmacoepidemiology-database-system-for-monitoring-risk-due-to-the-use-of-medicines-by-new-zealand-primary-care-patients
#13
Andrew M Tomlin, David M Reith, David J Woods, Hywel S Lloyd, Alesha Smith, John S Fountain, Murray W Tilyard
INTRODUCTION: The use of large record-linked healthcare databases for drug safety research and surveillance is now accepted practice. New Zealand's standardized national healthcare datasets provide the potential to automate the conduct of pharmacoepidemiological studies to provide rapid validation of medicine safety signals. OBJECTIVES: Our objectives were to describe the methodology undertaken by a semi-automated computer system developed to rapidly assess risk due to drug exposure in New Zealand's population of primary care patients and to compare results from three studies with previously published findings...
August 1, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28764919/effects-of-higher-quality-of-care-on-initiation-of-long-term-dialysis-in-patients-with-ckd-and-diabetes
#14
Hon-Yen Wu, Shingo Fukuma, Sayaka Shimizu, Edward C Norton, Yu-Kang Tu, Kuan-Yu Hung, Mei-Ru Chen, Kuo-Liong Chien, Shunichi Fukuhara
BACKGROUND: The burden of diabetes-related chronic kidney disease (CKD) on individuals and society is increasing, shifting attention toward improving the quality of care for patients with CKD and diabetes. We assessed the quality of CKD care and its association with long-term dialysis, acute kidney injury (AKI), and death. STUDY DESIGN: Retrospective cohort study (2004-2011). SETTING & PARTICIPANTS: Adults in Taiwan with incident CKD enrolled in the Longitudinal Cohort of Diabetes Patients...
July 29, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28760891/influence-of-beta-lactam-infusion-strategy-on-acute-kidney-injury
#15
Sarah E Cotner, W Cliff Rutter, Donna R Burgess, Katie L Wallace, Craig A Martin, David S Burgess
Background Limited literature is available assessing nephrotoxicity with prolonged beta-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged beta-lactam infusion (PI) or an intermittent infusion.Methods. This was a retrospective, matched cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 hours were evaluated. Patients were excluded for pre-existing renal dysfunction or pregnancy...
July 31, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28754457/impact-of-electronic-acute-kidney-injury-aki-alerts-with-automated-nephrologist-consultation-on-detection-and-severity%C3%A2-of-aki-a-quality-improvement-study
#16
Sehoon Park, Seon Ha Baek, Soyeon Ahn, Kee-Hyuk Lee, Hee Hwang, Jiwon Ryu, Shin Young Ahn, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
BACKGROUND: Several electronic alert systems for acute kidney injury (AKI) have been introduced. However, their clinical benefits require further investigation. STUDY DESIGN: Before-and-after quality improvement study. SETTING & PARTICIPANTS: A tertiary teaching hospital in Korea, which adopted an AKI alert system on June 1, 2014. Before and after launch of the alert system, 1,884 and 1,309 patients with AKI were included in the usual-care and alert groups, respectively...
July 25, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28752289/diabetes-mellitus-as-a-cause-or-comorbidity-of-chronic-kidney-disease-and-its-outcomes-the-gonryo-study
#17
Toshiki Iwai, Mariko Miyazaki, Gen Yamada, Masaaki Nakayama, Tae Yamamoto, Michihiro Satoh, Hiroshi Sato, Sadayoshi Ito
BACKGROUND: Diabetes mellitus (DM) is a major cause of end-stage kidney disease (ESKD). However, the difference in renal outcomes between DM patients with non-diabetic renal disease (DM and NDRD) and those with diabetic nephropathy (DN) is controversial. The aim of the present study was to evaluate the differences among patients with DN, DM, and NDRD, and non-DM chronic kidney disease (CKD) in a prospective observational study. METHODS: We extracted the data of 2484 patients from 11 nephrology care centers and categorized into three groups as described above...
July 27, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28750875/chronic-kidney-disease-in-hypertensive-subjects-%C3%A2-60-years-treated-in-primary-care
#18
Betlem Salvador-González, Jordi Mestre-Ferrer, Maria Soler-Vila, Luisa Pascual-Benito, Eva Alonso-Bes, Oriol Cunillera-Puértolas
BACKGROUND: Hypertension (HT) is the second leading cause of kidney failure. In hypertensive patients with chronic kidney disease (CKD), blood pressure (BP) control is the most important intervention to minimise progression. For CKD diagnosis, standardised creatinine and estimated glomerular filtration rate (eGFR) testing by CKD-EPI is recommended. OBJECTIVES: To describe the prevalence and factors associated with a moderate decrease in eGFR (by CKD-EPI) and BP control in subjects with HT...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28750609/hemodialysis-patients-preferences-for-the-management-of-anemia
#19
Brett Hauber, John Caloyeras, Joshua Posner, Deborah Brommage, Spiros Tzivelekis, Allan Pollock
BACKGROUND: Patient engagement in end-stage renal disease (ESRD) is expected to result in a more patient-centered approach to care that aligns with patients' values, preferences, and goals for treatment. Nevertheless, no previous studies of which we are aware have evaluated patients' benefit-risk preferences for the management of anemia associated with ESRD. The primary objective of this study was to quantify the tradeoffs patients are willing to make between cardiovascular risks associated with some anemia medicines and red blood cell (RBC) transfusions...
July 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28746663/hospitalizations-due-to-primary-care-sensitive-conditions-among-children-under-five-years-of-age-cross-sectional-study
#20
Erika Morganna Neves de Araujo, Gabriela Maria Cavalcanti Costa, Dixis Figueroa Pedraza
CONTEXT AND OBJECTIVE: Hospitalizations due to primary care-sensitive conditions constitute an important indicator for monitoring the quality of primary healthcare. This study aimed to describe hospitalizations due to primary care-sensitive conditions found among children under five years of age (according to their age and sex), in two cities in Paraíba, Brazil. DESIGN AND SETTING: Cross-sectional study carried out in the municipalities of Cabedelo and Bayeux, in Paraíba, Brazil...
May 2017: São Paulo Medical Journal, Revista Paulista de Medicina
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