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https://www.readbyqxmd.com/read/28340010/non-proteinuric-rather-than-proteinuric-renal-diseases-are-the-leading-cause-of-end-stage-kidney-disease
#1
Davide Bolignano, Carmine Zoccali
Proteinuria is a distinguishing feature in primary and secondary forms of chronic glomerulonephritis, which contribute to no more than the 20% of the end-stage kidney disease (ESKD) population. The contribution of non-proteinuric nephropathies to the global ESKD burden is still poorly focused and scarce research efforts are dedicated to the elucidation of risk factors and mechanistic pathways triggering ESKD in these diseases. We abstracted information on proteinuria in the main renal diseases other than glomerulonephritides that may evolve into ESKD...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#2
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28334754/rate-of-renal-function-decline-race-and-referral-to-nephrology-in-a-large-cohort-of-primary-care-patients
#3
Farrukh M Koraishy, Denise Hooks-Anderson, Joanne Salas, Jeffrey F Scherrer
Introduction.: Late nephrology referral is associated with adverse outcomes especially among minorities. Research on the association of the rate of chronic kidney disease (CKD) progression with nephrology referral in white versus black patients is lacking. Objectives.: Compute the odds of nephrology referral in primary care and their associations with race and the rate of CKD progression. Methods.: Electronic health record data were obtained from 2170 patients in primary care clinics in the Saint Louis metropolitan area with at least two estimated glomerular filtration rate (eGFR) values over a 7-year observation period...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28329340/baseline-characteristics-of-participants-in-the-aspree-aspirin-in-reducing-events-in-the-elderly-study
#4
John J McNeil, Robyn L Woods, Mark R Nelson, Anne M Murray, Christopher M Reid, Brenda Kirpach, Elsdon Storey, Raj C Shah, Rory S Wolfe, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Jessica E Lockery, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Ruth E Trevaks, Suzanne G Orchard, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Richard H Grimm
Background: There are no primary prevention trials of aspirin with relevant geriatric outcomes in elderly people. ASPirin in Reducing Events in the Elderly (ASPREE) is a placebo-controlled trial of low-dose aspirin that will determine whether 5 years of daily 100-mg enteric-coated aspirin extends disability-free and dementia-free life in a healthy elderly population and whether these benefits outweigh the risks. Methods: Set in primary care, this randomized double-blind placebo-controlled trial has a composite primary endpoint of death, incident dementia or persistent physical disability...
January 20, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329026/the-effect-of-early-versus-late-initiation-of-renal-replacement-therapy-in-patients-with-acute-kidney-injury-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#5
Yan-Mei Feng, Yuan Yang, Xiao-Li Han, Fan Zhang, Dong Wan, Rui Guo
BACKGROUND: The optimal timing for initiating renal replacement therapy (RRT) in patients with acute kidney injury (AKI) remains controversial. METHODS: We conducted a meta-analysis with trial sequential analysis (TSA) of randomized controlled trials (RCTs) using PUBMED, Cochrane Library databases, and Web of Science (from January 1, 1985, to August 21, 2016). Adult patients with AKI who received RRT with different timing were included. The primary outcome was mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28324597/the-burden-of-chronic-heart-failure-in-primary-care-in-italy
#6
Carlo Piccinni, Ippazio Cosimo Antonazzo, Monica Simonetti, Marco Giovanni Mennuni, Damiano Parretti, Claudio Cricelli, Delia Colombo, Mihaela Nica, Iacopo Cricelli, Francesco Lapi
INTRODUCTION: Chronic heart failure (CHF) is a major public health concern. From a public health perspective, the epidemiology of CHF needs to be distinguished from that of its related acute form. Data stemming from primary care are crucial to better know and update the prevalence and incidence rates of CHF. AIM: To update the epidemiology of CHF in an Italian primary care setting and to describe socio-demographic, lifestyle, and clinical characteristics of these patients...
March 21, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28320238/early-renal-replacement-therapy-versus-standard-care-in-the-icu
#7
Dipayan Chaudhuri, Brent Herritt, Daren Heyland, Louis-Philippe Gagnon, Kednapa Thavorn, Daniel Kobewka, Kwadwo Kyeremanteng
OBJECTIVE: Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28318861/medical-comorbidities-impact-the-episode-of-care-reimbursements-of-total-hip-arthroplasty
#8
Samuel Rosas, Karim G Sabeh, Leonard T Buller, Tsun Yee Law, Martin W Roche, Victor H Hernandez
BACKGROUND: Total hip arthroplasty (THA) costs are a source of great interest in the currently evolving health care market. The initiation of a bundled payment system has led to further research into costs drivers of this commonly performed procedure. One aspect that has not been well studied is the effect of comorbidities on the reimbursements of THA. The purpose of this study was to determine if common medical comorbidities affect these reimbursements. METHODS: A retrospective, level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary THA between 2007 and 2015...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28316856/giant-splenorenal-shunt-in-a-young-patient-with-autoimmune-hepatitis-primary-biliary-cholangitis-overlap-syndrome-and-portal-vein-thrombosis
#9
F Chegai, A U Cavallo, M Forcina, V Giuricin, F Castellani, L Greco, M Manuelli, T M Manzia, G Sergiacomi
We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28316316/colonic-diverticulosis-and-diverticulitis-in-renal-transplant-recipients-management-and-long-term-outcomes
#10
Ahmet Rencuzogullari, Gokhan Ozuner, Sinan Binboga, Erman Aytac, Venkatesh Krishnamurthi, Emre Gorgun
Data regarding management of colonic diverticulitis in renal transplant recipients (RTRs) are limited. This study aims to identify prevalence, risk factors, and outcomes in RTRs with colonic diverticulosis and diverticulitis. Between January 2004 and December 2013, all patients who underwent kidney transplantation were analyzed. Among all RTSs, patients who had a pretransplant colonoscopic diagnosis of diverticulosis and patients with a proven attack of diverticulitis were included in our analysis. There were 1578 RTRs with a mean age of 50 ± 14 years at the time of transplantation...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28315574/consensus-statement-on-insulin-therapy-in-chronic-kidney-disease
#11
REVIEW
Rajesh Rajput, Binayak Sinha, Sujoy Majumdar, M Shunmugavelu, Sarita Bajaj
INTRODUCTION: Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD) which eventually leads to insulin resistance and decreased insulin degradation. In patients with diabetic kidney disease (DKD), the overall insulin requirement declines which necessitates the reassessment for individualization, adjustment and titration of insulin doses depending on the severity of kidney disease. OBJECTIVE: To provide simple and easily implementable guidelines to primary care physicians on appropriate insulin dosing and titration of various insulin regimens in patients with DKD...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#12
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28300046/final-year-nursing-students-in-nigeria-how-knowledgeable-and-prepared-are-they-to-offer-medical-care-to-patients-with-chronic-kidney-disease
#13
Chimezie Godswill Okwuonu, Hannah Sylvanus Kanu, Ojeh-Oziegbe Odigie
BACKGROUND: Nurses play an important role in the management of chronic kidney disease (CKD) patients at primary, secondary, and tertiary levels of care. In other to perform their functions, it is pertinent that they have a good understanding of kidney functions and CKD. We do not know if the current educational curriculum prepares them adequately for this role. AIM: To assess the knowledge level of kidney functions and diseases among final year nursing students in Abia State Nigeria...
January 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28291091/impact-of-acute-kidney-injury-in-patients-hospitalized-with-pneumonia
#14
Lakhmir S Chawla, Richard L Amdur, Charles Faselis, Ping Li, Paul L Kimmel, Carlos E Palant
OBJECTIVES: Pneumonia is a common cause of hospitalization and can be complicated by the development of acute kidney injury. Acute kidney injury is associated with major adverse kidney events (death, dialysis, and durable loss of renal function [chronic kidney disease]). Because pneumonia and acute kidney injury are in part mediated by inflammation, we hypothesized that when acute kidney injury complicates pneumonia, major adverse kidney events outcomes would be exacerbated. We sought to assess the frequency of major adverse kidney events after a hospitalization for either pneumonia, acute kidney injury, or the combination of both...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28290162/tavr-in-intermediate-risk-patients-a-review-of-the-partner-2-trial-and-its-future-implications
#15
Sameer Arora, Cassandra J Ramm, Jacob A Misenheimer, John P Vavalle
BACKGROUND: Following publication of the results of the PARTNER trial, the American College of Cardiology/American Heart Association recognized the success of transcatheter aortic valve replacement (TAVR) by incorporating it as a feasible option in high-surgical risk patients, and recommending it as the standard of care for patients at prohibitive risk of surgery. Although this was recognized as a major success in the field of percutaneous valve replacement, surgical aortic valve replacement (SAVR) continued to be realized as the procedure of choice for low and intermediate surgical risk patients...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28288543/renal-function-weaning-and-survival-in-patients-with-ventilator-dependent-respiratory-failure
#16
Debapriya Datta, Raymond J Foley, Rong Wu, James Grady, Paul Scalise
BACKGROUND: Acute kidney injury in acute critical illness has been associated with poor weaning and survival outcomes. The relation between renal dysfunction as defined by creatinine clearance (CrCl) and weaning from prolonged mechanical ventilation (PMV) is not known. The objective of this study was to determine the relation of measured CrCl to weaning and survival in patients on PMV. METHODS: We retrospectively studied 167 patients on PMV admitted to a long-term acute care facility for weaning over a 3-year period...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#17
Christina H Shin, Dustin R Long, Duncan McLean, Stephanie D Grabitz, Karim Ladha, Fanny P Timm, Tharusan Thevathasan, Alberto Pieretti, Cristina Ferrone, Andreas Hoeft, Thomas W L Scheeren, Boyd Taylor Thompson, Tobias Kurth, Matthias Eikermann
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols driven by such measures are limited in their ability to define the optimal fluid state during surgery. METHODS: This analysis of data on file included 92,094 adult patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014 at an academic tertiary care hospital and two affiliated community hospitals...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28279964/serum-creatinine-elevation-after-renin-angiotensin-system-blockade-and-long-term-cardiorenal-risks-cohort-study
#18
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
Objective To examine long term cardiorenal outcomes associated with increased concentrations of creatinine after the start of angiotensin converting enzyme inhibitor/angiotensin receptor blocker treatment.Design Population based cohort study using electronic health records from the Clinical Practice Research Datalink and Hospital Episode Statistics.Setting UK primary care, 1997-2014.Participants Patients starting treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers (n=122 363)...
March 9, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28274964/predicting-aki-in-emergency-admissions-an-external-validation-study-of-the-acute-kidney-injury-prediction-score-aps
#19
L E Hodgson, B D Dimitrov, P J Roderick, R Venn, L G Forni
OBJECTIVES: Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). DESIGN, SETTING AND PARTICIPANTS: External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr)...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28273171/body-mass-index-and-risk-of-advanced-chronic-kidney-disease-prospective-analyses-from-a-primary-care-cohort-of-1-4-million-adults-in-england
#20
William G Herrington, Margaret Smith, Clare Bankhead, Kunihiro Matsushita, Sarah Stevens, Tim Holt, F D Richard Hobbs, Josef Coresh, Mark Woodward
BACKGROUND: It is uncertain whether being overweight, but not obese, is associated with advanced chronic kidney disease (CKD) and how the size and shape of associations between body-mass index (BMI) and advanced CKD differs among different types of people. METHODS: We used Clinical Practice Research Datalink records (2000-2014) with linkage to English secondary care and mortality data to identify a prospective cohort with at least one BMI measure. Cox models adjusted for age, sex, smoking and social deprivation and subgroup analyses by diabetes, hypertension and prior cardiovascular disease assessed relationships between BMI and CKD stages 4-5 and end-stage renal disease (ESRD)...
2017: PloS One
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