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CKD

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245 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29661769/introduction-to-nephropharmacology-for-the-clinician-a-new-cjasn-series
#1
Thomas D Nolin, Mark A Perazella
No abstract text is available yet for this article.
April 16, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29668213/physician-and-patient-tools-to-improve-chronic-kidney-disease-care
#2
Thomas D Sequist, Alison M Holliday, E John Orav, David W Bates, Bradley M Denker
OBJECTIVES: To determine if electronic health record (EHR) tools and patient engagement can improve the quality of chronic kidney disease (CKD) care. STUDY DESIGN: Randomized controlled trial. METHODS: We enrolled 153 primary care physicians caring for 3947 high-risk and 3744 low-risk patients with stage III CKD across 13 ambulatory health centers in eastern Massachusetts. Intervention physicians received a set of electronic alerts during office visits recommending risk-appropriate CKD care...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29623638/the-cost-of-patients-with-chronic-kidney-failure-before-dialysis-results-from-the-iride-observational-study
#3
Claudio Jommi, Patrizio Armeni, Margherita Battista, Paolo di Procolo, Giuseppe Conte, Claudio Ronco, Mario Cozzolino, Anna Maria Costanzo, Umberto di Luzio Paparatti, Gabriella Concas, Giuseppe Remuzzi
BACKGROUND: Chronic kidney disease (CKD) is an important public health problem. Most of the evidence on its costs relates to patients receiving dialysis or kidney transplants, which shows that, in these phases, CKD poses a high burden to payers. Less evidence is available on the costs of the predialytic phase. OBJECTIVE: The aim of this study was to estimate the annual cost of patients with CKD not receiving dialysis treatment, using the Italian healthcare system perspective and a prospective approach...
December 4, 2017: PharmacoEconomics open
https://www.readbyqxmd.com/read/29609874/-detection-of-chronic-kidney-disease-using-estimated-glomerular-filtration-and-urine-albumin-are-we-complying-with-the-recommendations-of-the-guidelines
#4
Jose Luis Górriz, Maria Jesús Puchades
No abstract text is available yet for this article.
March 2018: Semergen
https://www.readbyqxmd.com/read/28507057/benefit-of-ezetimibe-added-to-simvastatin-in-reduced-kidney-function
#5
RANDOMIZED CONTROLLED TRIAL
John W Stanifer, David M Charytan, Jennifer White, Yuliya Lokhnygina, Christopher P Cannon, Matthew T Roe, Michael A Blazing
Efficacy of statin-based therapies in reducing cardiovascular mortality in individuals with CKD seems to diminish as eGFR declines. The strongest evidence supporting the cardiovascular benefit of statins in individuals with CKD was shown with ezetimibe plus simvastatin versus placebo. However, whether combination therapy or statin alone resulted in cardiovascular benefit is uncertain. Therefore, we estimated GFR in 18,015 individuals from the IMPROVE-IT (ezetimibe plus simvastatin versus simvastatin alone in individuals with cardiovascular disease and creatinine clearance >30 ml/min) and examined post hoc the relationship of eGFR with end points across treatment arms...
October 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29495340/dietary-approach-to-recurrent-or-chronic-hyperkalaemia-in-patients-with-decreased-kidney-function
#6
Adamasco Cupisti, Csaba P Kovesdy, Claudia D'Alessandro, Kamyar Kalantar-Zadeh
Whereas the adequate intake of potassium is relatively high in healthy adults, i.e., 4.7 g per day, a dietary potassium restriction of usually less than 3 g per day is recommended in the management of patients with reduced kidney function, especially those who tend to develop hyperkalaemia including patients who are treated with angiotensin pathway modulators. Most potassium-rich foods are considered heart-healthy nutrients with high fibre, high anti-oxidant vitamins and high alkali content such as fresh fruits and vegetables; hence, the main challenge of dietary potassium management is to maintain high fibre intake and a low net fixed-acid load, because constipation and metabolic acidosis are per se major risk factors for hyperkalaemia...
February 25, 2018: Nutrients
https://www.readbyqxmd.com/read/29483139/bp-measurement-techniques-what-they-mean-for-patients-with-kidney-disease
#7
REVIEW
George Thomas, Paul E Drawz
Patients with CKD typically have hypertension. Manual BP measurement in the office setting was used to define hypertension, establish eligibility, and assess BP targets in the epidemiologic studies and early randomized, controlled trials that inform current management of hypertension. Use of automated oscillometric devices has largely replaced manual BP measurement in the office and clinical trials. These newer devices may reduce the white coat effect and facilitate guideline-adherent measurement protocols...
February 26, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29429319/the-importance-of-adequate-referrals-for-chronic-kidney-disease
#8
Julian Wright, Kristen M Glenister, Rebecca Thwaites, Daniel Terry
Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015...
January 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/28873137/association-between-more-intensive-vs-less-intensive-blood-pressure-lowering-and-risk-of-mortality-in-chronic-kidney-disease-stages-3-to-5-a-systematic-review-and-meta-analysis
#9
REVIEW
Rakesh Malhotra, Hoang Anh Nguyen, Oscar Benavente, Mihriye Mete, Barbara V Howard, Jonathan Mant, Michelle C Odden, Carmen A Peralta, Alfred K Cheung, Girish N Nadkarni, Ruth L Coleman, Rury R Holman, Alberto Zanchetti, Ruth Peters, Nigel Beckett, Jan A Staessen, Joachim H Ix
Importance: Trials in patients with hypertension have demonstrated that intensive blood pressure (BP) lowering reduces the risk of cardiovascular disease and all-cause mortality but may increase the risk of chronic kidney disease (CKD) incidence and progression. Whether intensive BP lowering is associated with a mortality benefit in patients with prevalent CKD remains unknown. Objectives: To conduct a systematic review and meta-analysis of randomized clinical trials (RCTs) to investigate if more intensive compared with less intensive BP control is associated with reduced mortality risk in persons with CKD stages 3 to 5...
October 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#10
Mark McClure, Thomas Jorna, Laura Wilkinson, Joanne Taylor
INTRODUCTION: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006. These two initiatives have had a significant impact on referral patterns to renal services...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29318218/potential-benefit-associated-with-delaying-initiation-of-hemodialysis-in-a-japanese-cohort
#11
Satoshi Higuchi, Izaya Nakaya, Kazuhiro Yoshikawa, Yoichiro Chikamatsu, Ken-Ei Sada, Suguru Yamamoto, Satoko Takahashi, Hiroyo Sasaki, Jun Soma
Introduction: Late referral to a nephrologist, the type of vascular access, nutritional status, and the estimated glomerular filtration rate (eGFR) at the start of hemodialysis (HD) have been reported as independent risk factors of survival for patients who begin HD. The aim of this study was to clarify the influence of the HD-free interval from the time of an eGFR of 10 ml/min per 1.73 m2 (IGFR10-HD ) on patient outcome. Methods: We enrolled 124 patients aged older than 20 years who had HD initiated in a general hospital...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29322215/-assessment-of-kidney-function-creatinine-is-not-the-whole-story
#12
REVIEW
U Huynh-Do, M Fiedler, B Vogt
Chronic renal insufficiency has a high prevalence and leads not only to a severe impairment in the quality of life but also to a higher mortality, mainly due to cardiovascular complications; however, in the early stages where there is still a chance for a therapeutic intervention, it is often underestimated because depending on endogenous factors (e.g. age and muscle mass), serum creatinine could falsely remain in the normal range while kidney function is already impaired. An exact measurement of the glomerular filtration rate (GFR) using radionuclide techniques is cumbersome and usually confined to rare cases, such as in clinical studies...
January 2018: Der Internist
https://www.readbyqxmd.com/read/29315798/end-stage-renal-disease-treatment-options-education-what-matters-most-to-patients-and-families
#13
Jennifer St Clair Russell, L Ebony Boulware
Treatment modality education can offer many important benefits to patients and their families. Evidence suggests such education can increase use of home dialysis, reduce catheter use, decrease 90-day mortality, and increase transplantation. While these benefits are encouraging, not all patients are offered options education and when they are, it may not be presented in a way that is immediately applicable to them and their lives. Furthermore, little is known regarding specific characteristics (e.g. format such as group or individual or in-person or online, duration, teaching methods, location, content) of educational programs that are most successful...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29240784/effects-of-calcium-channel-blockers-comparing-to-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-in-patients-with-hypertension-and-chronic-kidney-disease-stage-3-to-5-and-dialysis-a-systematic-review-and-meta-analysis
#14
REVIEW
Yen-Chung Lin, Jheng-Wei Lin, Mai-Szu Wu, Kuan-Chou Chen, Chiung-Chi Peng, Yi-No Kang
BACKGROUND: Calcium channel blocker (CCB) or two renin angiotensin aldosterone system blockades (RAAS), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are major potent and prevalently used as initial antihypertensive agents for mild to moderate hypertension, but no uniform agreement as to which antihypertensive drugs should be given for initial therapy, especially among chronic kidney disease (CKD) patients. DESIGN: A systematic review and meta-analysis comparing CCBs and the two RAAS blockades for hypertensive patients with CKD stage 3 to 5D...
2017: PloS One
https://www.readbyqxmd.com/read/29216260/angiotensin-receptor-blockers-are-associated-with-lower-mortality-than-ace-inhibitors-in-predialytic-stage-5-chronic-kidney-disease-a-nationwide-study-of-therapy-with-renin-angiotensin-system-blockade
#15
Chih-Ching Lin, Yu-Te Wu, Wu-Chang Yang, Min-Juei Tsai, Jia-Sin Liu, Chi-Yu Yang, Szu-Yuan Li, Shuo-Ming Ou, Der-Cherng Tarng, Chih-Cheng Hsu
Dual renin angiotensin system (RAS) blockade using angiotensin-receptor blockers (ARBs) in combination with angiotensin converting enzyme inhibitors (ACEIs) is reported to improve proteinuria in both diabetic and non-diabetic patients. However, its renoprotective effect and safety remain uncertain in patients with advanced chronic kidney disease (CKD). From January 1, 2000 through June 30, 2009, we enrolled 14,117 pre-dialytic stage 5 CKD patients with serum creatinine >6mg/dL and hematocrit <28% under the treatment with erythropoiesis stimulating agents and RAS blockade...
2017: PloS One
https://www.readbyqxmd.com/read/29070030/patient-s-and-physician-s-awareness-of-kidney-disease-in-coronary-heart-disease-patients-a-cross-sectional-analysis-of-the-german-subset-of-the-euroaspire-iv-survey
#16
Martin Wagner, Christoph Wanner, Martin Schich, Kornelia Kotseva, David Wood, Katrin Hartmann, Georg Fette, Viktoria Rücker, Mehmet Oezkur, Stefan Störk, Peter U Heuschmann
BACKGROUND: Chronic kidney disease (CKD) is a common comorbid condition in coronary heart disease (CHD). CKD predisposes the patient to acute kidney injury (AKI) during hospitalization. Data on awareness of kidney dysfunction among CHD patients and their treating physicians are lacking. In the current cross-sectional analysis of the German EUROASPIRE IV sample we aimed to investigate the physician's awareness of kidney disease of patients hospitalized for CHD and also the patient's awareness of CKD in a study visit following hospital discharge...
October 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29031361/treatment-of-disorders-of-sodium-balance-in-chronic-kidney-disease
#17
REVIEW
David H Ellison
Extracellular fluid volume expansion is nearly universal in patients with CKD. Such volume expansion has features similar to the syndrome of heart failure with preserved ejection fraction, which not only leads to symptoms but can also lead to further organ damage. Unique treatment challenges are present in this patient population, including low glomerular filtration, which limits sodium chloride filtration, intrinsic tubule predisposition to sodium chloride retention, and proteinuria. In addition, pharmacokinetic considerations alter the disposition of diuretics in patients with CKD and nephrotic syndrome...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29058840/-use-of-oral-glucose-lowering-agents-in-patients-with-renal-impairment
#18
A J Scheen, N Paquot
Patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) are increasingly numerous, especially in the elderly population. Surprisingly, this situation is often under-recognized or even neglected in clinical practice. Yet, most oral antidiabetic (OAD) agents have limitations in case of renal impairment, either because they require a dose reduction, or are contra-indicated mainly for safety reasons. This clinical case gives the opportunity to discuss the modalities of prescription and cautions to be taken when using most commonly prescribed OAD, metformin, insulin secretagogues (sulfonylureas, repaglinide), DPP-4 inhibitors (gliptins) and SGLT2 inhibitors, in a patient with T2D and CKD...
October 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29055352/deprescribing-in-ckd-the-proof-is-in-the-process
#19
EDITORIAL
Chanel F Whittaker, Jeffrey C Fink
No abstract text is available yet for this article.
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29045334/blood-pressure-parameters-and-morbid-and-mortal-outcomes-in-nondialysis-dependent-chronic-kidney-disease
#20
Carl P Walther, Aravind Chandra, Sankar D Navaneethan
PURPOSE OF REVIEW: Observational and interventional studies provide conflicting evidence regarding optimal blood pressure (BP) control in persons with chronic kidney disease (CKD). Recent publications provide additional information to inform therapeutic decision-making. RECENT FINDINGS: Targeting SBP to less than 120 mmHg, versus less than 140 mmHg, decreased cardiovascular events and all-cause mortality in persons with nondiabetic CKD. A meta-analysis of trials testing blood pressure management among nondialysis-dependent CKD patients (15 924 total patients) found more intensive therapies generally reduced mortality in all subgroups...
January 2018: Current Opinion in Nephrology and Hypertension
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