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https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#1
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#2
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28538499/expectations-and-experiences-of-follow-up-and-self-care-after-living-kidney-donation-a-focus-group-study
#3
Karine E Manera, Camilla S Hanson, Jeremy R Chapman, John Kanellis, John Gill, Jonathan C Craig, Steve J Chadban, Germaine Wong, Angelique F Ralph, Allison Tong
BACKGROUND: Ensuring donor wellbeing warrants ongoing monitoring following living kidney donation. However, there is considerable variability in donor follow up processes, including information provided to donors regarding self-care. Loss to follow up is common, suggesting that the aims and benefits of monitoring and follow up may not be apparent. We aimed to describe the experiences and expectations of living kidney donors regarding follow up and self-care after donation. METHODS: Participants from 3 transplant centers in Australia and Canada participated in 14 focus groups (n=123)...
May 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28538426/managing-kidney-transplant-recipients-in-primary-care
#4
Shira Roth
Patients who have undergone kidney transplant are at increased risk for heart disease, new-onset diabetes, metabolic syndrome, and certain malignancies, in addition to opportunistic infections associated with immunosuppression. This article describes guidelines for routine management of kidney transplant recipients in primary care, as well as how to recognize risk factors and complications.
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28532553/the-potential-impact-of-public-health-interventions-in-preventing-kidney-disease
#5
REVIEW
Rohina Joshi, Oommen John, Vivekanand Jha
The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532551/strengthening-renal-registries-and-esrd-research-in-africa
#6
REVIEW
M Razeen Davids, Fergus J Caskey, Taryn Young, Gillian K Balbir Singh
In Africa, the combination of noncommunicable diseases, infectious diseases, exposure to environmental toxins, and acute kidney injury related to trauma and childbirth are driving an epidemic of chronic kidney disease and end-stage renal disease (ESRD). Good registry data can inform the planning of renal services and can be used to argue for better resource allocation, audit the delivery and quality of care, and monitor the impact of interventions. Few African countries have established renal registries and most have failed owing to resource constraints...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28531232/changes-in-primary-healthcare-providers-attitudes-and-counseling-behaviors-related-to-dietary-sodium-reduction-docstyles-2010-and-2015
#7
Zerleen S Quader, Mary E Cogswell, Jing Fang, Sallyann M Coleman King, Robert K Merritt
High blood pressure is a major risk factor for cardiovascular disease. The 2013 ACC/AHA Lifestyle Management Guideline recommends counseling pre-hypertensive and hypertensive patients to reduce sodium intake. Population sodium reduction efforts have been introduced in recent years, and dietary guidelines continued to emphasize sodium reduction in 2010 and 2015. The objective of this analysis was to determine changes in primary health care providers' sodium-reduction attitudes and counseling between 2010 and 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28520833/evaluation-of-diabetic-retinal-screening-and-factors-for-ophthalmology-referral-in-a-telemedicine-network
#8
Pooja D Jani, Lauren Forbes, Arkopal Choudhury, John S Preisser, Anthony J Viera, Seema Garg
Importance: Retinal telescreening for evaluation of diabetic retinopathy (DR) in the primary care setting may be useful in reaching rural and underserved patients. Objectives: To evaluate telemedicine retinal screenings for patients with type 1 or 2 diabetes and identify factors for ophthalmology referral in the North Carolina Diabetic Retinopathy Telemedicine Network. Design, Setting, and Participants: A preimplementation and postimplementation evaluation was conducted from January 6, 2014, to November 1, 2015, at 5 primary care clinics serving rural and underserved populations in North Carolina among 1787 adult patients with type 1 or 2 diabetes who received primary care at the clinics and obtained retinal telescreening to determine the presence and severity of DR...
May 18, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28514268/primary-care-perspectives-in-autosomal-dominant-polycystic-kidney-disease
#9
Anna Lucena S Yrad, Candi Humphreys
No abstract text is available yet for this article.
June 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28509578/the-burden-of-hepatorenal-syndrome-among-commercially-insured-and-medicare-patients-in-the-united-states
#10
J Bradford Rice, Alan G White, Philip Galebach, Kevin M Korenblat, Aneesha Wagh, Belinda Lovelace, George J Wan, Khurram Jamil
BACKGROUND: This study evaluated the characteristics healthcare resource utilization (HCRU), and costs, from the payer perspective, of hepatorenal syndrome (HRS) patients covered by commercial and Medicare insurance. Mortality was assessed as a secondary outcome. METHODS: Patients were identified from claims databases of commercially-insured (OptumHealth Care Solutions, Inc.) in 1998-2014 and Medicare beneficiaries in 2009-2013 (5% Standard Analytic Files). At the time of their first inpatient admission ("index date") with an HRS diagnosis (ICD-9 code 572...
May 16, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28504837/immunotherapy-for-metastatic-renal-cell-carcinoma
#11
REVIEW
Susanne Unverzagt, Ines Moldenhauer, Monika Nothacker, Dorothea Roßmeißl, Andreas V Hadjinicolaou, Frank Peinemann, Francesco Greco, Barbara Seliger
BACKGROUND: Since the mid-2000s, the field of metastatic renal cell carcinoma (mRCC) has experienced a paradigm shift from non-specific therapy with broad-acting cytokines to specific regimens, which directly target the cancer, the tumour microenvironment, or both.Current guidelines recommend targeted therapies with agents such as sunitinib, pazopanib or temsirolimus (for people with poor prognosis) as the standard of care for first-line treatment of people with mRCC and mention non-specific cytokines as an alternative option for selected patients...
May 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28502744/effect-of-high-dose-sodium-selenite-in-cardiac-surgery-patients-a%C3%A2-randomized-controlled-bi-center-trial
#12
Tanja Schmidt, Hans Pargger, Esther Seeberger, Friedemann Eckhart, Stefanie von Felten, Christoph Haberthür
BACKGROUND & AIMS: Cardiac surgery is accompanied by oxidative stress and systemic inflammatory response, which may be associated with organ dysfunction and increased mortality. Selenium and selenoenzymes are important constituents of anti-oxidative defense. We hypothesized that high-dose sodium selenite supplementation can attenuate the postoperative inflammation and might, therefore, improve clinical outcome. METHODS: Randomized, placebo-controlled, double-blinded, bi-center study on 411 adult patients undergoing elective cardiac surgery...
May 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28495639/safety-and-tolerability-of-the-first-in-class-agent-cpi-613-in-combination-with-modified-folfirinox-in-patients-with-metastatic-pancreatic-cancer-a-single-centre-open-label-dose-escalation-phase-1-trial
#13
Angela Alistar, Bonny B Morris, Rodwige Desnoyer, Heidi D Klepin, Keyanoosh Hosseinzadeh, Clancy Clark, Amy Cameron, John Leyendecker, Ralph D'Agostino, Umit Topaloglu, Lakmal W Boteju, Asela R Boteju, Rob Shorr, Zuzana Zachar, Paul M Bingham, Tamjeed Ahmed, Sandrine Crane, Riddhishkumar Shah, John J Migliano, Timothy S Pardee, Lance Miller, Gregory Hawkins, Guangxu Jin, Wei Zhang, Boris Pasche
BACKGROUND: Pancreatic cancer statistics are dismal, with a 5-year survival of less than 10%, and more than 50% of patients presenting with metastatic disease. Metabolic reprogramming is an emerging hallmark of pancreatic adenocarcinoma. CPI-613 is a novel anticancer agent that selectively targets the altered form of mitochondrial energy metabolism in tumour cells, causing changes in mitochondrial enzyme activities and redox status that lead to apoptosis, necrosis, and autophagy of tumour cells...
May 8, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28493145/influence-of-the-recipient-body-mass-index-on-the-outcomes-after-kidney-transplantation
#14
Juliane Liese, Nils Bottner, Stefan Büttner, Alexander Reinisch, Guido Woeste, Markus Wortmann, Ingeborg A Hauser, Wolf Otto Bechstein, Frank Ulrich
PURPOSE: The relationship between the body mass index (BMI) of kidney transplant recipients and outcomes after kidney transplantation (KT) is not fully understood and remains controversial. We studied the influence of BMI on clinically relevant outcomes in kidney transplant recipients. METHODS: In this retrospective single-centre study, all patients who underwent kidney transplantation at our institution between January 2007 and December 2012 were included. Demographic data and BMI were correlated with the clinical course of the disease, rejection rates, delayed graft function rates, and graft and patient survival...
May 10, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28493038/perioperative-implications-of-thoracic-decortications-a-retrospective-cohort-study
#15
Jay Gorman, Duane Funk, Sadeesh Srinathan, John Embil, Linda Girling, Stephen Kowalski
PURPOSE: An increasing number of thoracic decortications have been performed in Manitoba, from five in 2007 to 45 in 2014. The primary objective of this study was to define the epidemiology of decortications in Manitoba. The secondary objective was to compare patients who underwent decortication due to primary infectious vs non-infectious etiology with respect to their perioperative outcomes. METHODS: Data for this cohort study were extracted from consecutive charts of all adult patients who underwent a decortication in Manitoba from 2007-2014 inclusive...
May 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28480719/stereotactic-body-radiation-therapy-for-metastases-to-the-kidney-in-patients-with-non-small-cell-lung-cancer-a-new-treatment-paradigm-for-durable-palliation
#16
Vivek Verma, Charles B Simone
BACKGROUND: Cancer metastasis to the kidney is a rare event; treatment must take into account the associated and unique anatomic and physiological challenges of treating the kidney. Stereotactic body radiation therapy (SBRT) is a widely emerging modality of radiotherapy touted for its ability to minimize irradiation to surrounding tissues and to provide a vastly shortened treatment course that is highly biologically potent. However, the use of SBRT to treat kidney neoplasms has been described in only a few case reports generally for primary renal malignancies...
April 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28475670/randomized-trial-of-red-cell-washing-for-the-prevention-of-transfusion-associated-organ-injury-in-cardiac-surgery
#17
M J Wozniak, N Sullo, S Qureshi, W Dott, R Cardigan, M Wiltshire, T Morris, M Nath, N Bittar, S K Bhudia, T Kumar, A H Goodall, G J Murphy
Background: Experimental studies suggest that mechanical cell washing to remove pro-inflammatory components that accumulate in the supernatant of stored donor red blood cells (RBCs) might reduce inflammation and organ injury in transfused patients. Methods: Cardiac surgery patients at increased risk of large-volume RBC transfusion were eligible. Participants were randomized to receive either mechanically washed allogenic RBCs or standard care RBCs. The primary outcome was serum interleukin-8 measured at baseline and at four postsurgery time points...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28475248/effectiveness-of-an-evidence-based-induction-therapy-protocol-revision-in-adult-kidney-transplant-recipients
#18
Jillian P Casale, Dave J Taber, Carmelina Staino, Kimberly Boyle, Kelly Covert, Nicole A Pilch, Caitlin Mardis, Holly B Meadows, Kenneth D Chavin, John W McGillicuddy, Prabhakar K Baliga, James N Fleming
STUDY OBJECTIVE: Induction immunosuppression significantly improves graft outcomes following kidney transplantation, but protocols vary among transplant centers due to the lack of data identifying an optimal induction agent. The objective of this study was to assess the effectiveness of an evidence-based protocol change in induction therapy in adult kidney transplant recipients. DESIGN: Retrospective cohort study. SETTING: Large tertiary care academic medical center...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28474361/iconnect-ckd-virtual-medical-consulting-a-web-based-chronic-kidney-disease-hypertension-and-diabetes-integrated-care-program
#19
Ivor J Katz, Saiyini Pirabhahar, Paula Williamson, Vishwas Raghunath, Frank Brennan, Anthony O'Sullivan, George Youssef, Cathie Lane, Gary Jacobson, Peter Feldman, John Kelly
AIMS: Chronic kidney disease (CKD) patients overwhelm specialist services and can potentially be managed in the primary care (PC). Opportunistic screening of high risk (HR) patients and follow-up in PC is the most sustainable model of care. A 'virtual consultation' (VC) model instead of traditional face to face (F2F) consultations was used, aiming to assess efficacy and safety of the model. METHODS: Seventy patients were recruited from PC sites and hospital clinics, and followed for one year...
May 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28463961/herpes-zoster-risk-after-21-specific-cancers-population-based-case-control-study
#20
Erik Hansson, Harriet J Forbes, Sinéad M Langan, Liam Smeeth, Krishnan Bhaskaran
BACKGROUND: Some malignancies are known to be associated with increased risk of herpes zoster, but little is known about how associations between cancer and subsequent zoster risk vary by cancer site, by time since cancer diagnosis, and by age. METHODS: An age-, sex-, calendar time-, and practice-matched case-control study, nested in the broadly UK representative Clinical Practice Research Datalink (CPRD) primary care database, was analysed using conditional logistic regression to estimate the association between 21 of the most common specific malignancies and subsequent zoster risk...
May 2, 2017: British Journal of Cancer
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