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CKD

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236 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#1
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
#2
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
#3
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 10, 2018: Der Internist
https://www.readbyqxmd.com/read/29315798/end-stage-renal-disease-treatment-options-education-what-matters-most-to-patients-and-families
#4
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...
January 7, 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/29044764/estimated-glomerular-filtration-rate-and-the-risk-benefit-profile-of-intensive-blood-pressure-control-among-non-diabetic-patients-a-post-hoc-analysis-of-a-randomized-clinical-trial
#12
Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Ayumi Shintani, Csaba P Kovesdy, Takayuki Hamano
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials. gov, NCT01206062) reported reduced cardiovascular events by intensive blood pressure (BP) control among hypertensive patients without diabetes. However, the risk-benefit profile of intensive BP control may differ across estimated glomerular filtration rate (eGFR) levels. METHODS: This is a post-hoc analysis of the SPRINT. Non-diabetic hypertensive adults (n=9,361) with eGFR >20 mL/min/1...
October 16, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29036427/impact-of-achieved-blood-pressure-on-renal-function-decline-and-first-stroke-in-hypertensive-patients-with-chronic-kidney-disease
#13
Youbao Li, Min Liang, Chongfei Jiang, Guobao Wang, Jianping Li, Yan Zhang, Fangfang Fan, Ningling Sun, Yiming Cui, Mingli He, Genfu Tang, Delu Yin, Xiaoshu Cheng, Binyan Wang, Yong Huo, Xin Xu, Fan Fan Hou, Xiping Xu, Xianhui Qin
Background: The effect of achieved blood pressure (BP) on first stroke and renal function decline among hypertensive patients with mild to moderate chronic kidney disease (CKD) is still uncertain. Methods: In total, 3230 hypertensive patients with estimated glomerular filtration rate 30-60 mL/min/1.73 m 2 and/or proteinuria were included in the present analyses. Eligible participants were randomly assigned to a daily treatment of a combined enalapril 10 mg and folic acid 0...
September 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28978205/all-cause-costs-increase-exponentially-with-increased-chronic-kidney-disease-stage
#14
Ladan Golestaneh, Paula J Alvarez, Nancy L Reaven, Susan E Funk, Karen J McGaughey, Alain Romero, Melanie S Brenner, Macaulay Onuigbo
OBJECTIVE: To evaluate the economic impact of chronic kidney disease (CKD) on US health plans. STUDY DESIGN: A retrospective analysis identified patients with a renin-angiotensin-aldosterone system inhibitor (RAASi) prescription from an electronic medical record (EMR) database (Humedica); those with =90 days in =1 CKD stage were selected based on estimated glomerular filtration rate or diagnosis code, and a cohort on RAASi medications without CKD was selected. Costs for specific services obtained from OptumInsight were applied to services in EMR data of patients aged <65 years (commercial) and =65 years (Medicare)...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28985328/blood-pressure-variability-predicts-adverse-events-and-cardiovascular-outcomes-in-chronic-kidney-disease-a-post-hoc-analysis-of-the-sprint-trial
#15
Kenechukwu Mezue, Abhinav Goyal, Gregg S Pressman, Jay C Horrow, Janani Rangaswami
BACKGROUND: Visit-to-visit blood pressure variability has been associated with adverse cardiovascular outcomes. Using the SPRINT trial data set, we explored the relationship between blood pressure variability, cardiovascular outcomes, and hypoperfusion-related adverse events of antihypertensive therapy in patients with chronic kidney disease (CKD) enrolled in the study. METHODS: The analyses included patients with CKD randomized in SPRINT who reached the target systolic blood pressure for their respective groups (intensive <120 mm Hg; standard <140 mm Hg)...
December 8, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28750929/blood-pressure-parameters-are-associated-with-all-cause-and-cause-specific-mortality-in-chronic-kidney-disease
#16
Sankar D Navaneethan, Jesse D Schold, Stacey E Jolly, Susana Arrigain, Matthew F Blum, Wolfgang C Winkelmayer, Joseph V Nally
Previous observational studies reported J or U-shaped associations between blood pressure parameters and mortality in patients with chronic kidney disease (CKD). Here we examined the associations of different blood pressure levels with various causes of death in a CKD population that included patients with eGFR 15-59 ml/min/1.73 m(2) with underlying hypertension receiving at least one antihypertensive agent. We obtained data on date and cause of death from State Department of Health mortality files and classified deaths into three categories: cardiovascular, malignancy-related, and non-cardiovascular/non-malignancy related...
November 2017: Kidney International
https://www.readbyqxmd.com/read/28758978/dietary-approaches-in-the-management-of-diabetic-patients-with-kidney-disease
#17
REVIEW
Gang Jee Ko, Kamyar Kalantar-Zadeh, Jordi Goldstein-Fuchs, Connie M Rhee
Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0...
July 31, 2017: Nutrients
https://www.readbyqxmd.com/read/28790143/structural-and-functional-changes-in-human-kidneys-with-healthy-aging
#18
REVIEW
Musab S Hommos, Richard J Glassock, Andrew D Rule
Aging is associated with significant changes in structure and function of the kidney, even in the absence of age-related comorbidities. On the macrostructural level, kidney cortical volume decreases, surface roughness increases, and the number and size of simple renal cysts increase with age. On the microstructural level, the histologic signs of nephrosclerosis (arteriosclerosis/arteriolosclerosis, global glomerulosclerosis, interstitial fibrosis, and tubular atrophy) all increase with age. The decline of nephron number is accompanied by a comparable reduction in measured whole-kidney GFR...
October 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28764920/patients-experiences-after-ckd-diagnosis-a-meta-ethnographic-study-and-systematic-review
#19
REVIEW
Emma J Teasdale, Geraldine Leydon, Simon Fraser, Paul Roderick, Maarten W Taal, Sarah Tonkin-Crine
BACKGROUND: Chronic kidney disease (CKD) is often asymptomatic at first diagnosis, and awareness of CKD is low in the general population. Thus, individuals who are unexpectedly identified as having CKD may struggle to adjust to living with this diagnosis. This study aims to synthesize qualitative research exploring patients' views and experiences of a CKD diagnosis and how they adjust to it. STUDY DESIGN: Systematic review and meta-ethnography. SETTING & POPULATION: Adult patients with CKD stages 1 to 5...
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28693434/symptom-burden-in-chronic-kidney-disease-a-population-based-cross-sectional-study
#20
Sameera Senanayake, Nalika Gunawardena, Paba Palihawadana, Palitha Bandara, Rashan Haniffa, R Karunarathna, Priyantha Kumara
BACKGROUND: Physical and psychological symptoms are among main manifestations of Chronic Kidney Disease (CKD). This study aimed to assess the symptom burden and self-perceived severity of symptoms among CKD patients living in a district in Sri Lanka. METHOD: A community based cross-sectional study included a sample of randomly selected 1174 CKD patients from all 19 Medical Officer of Health areas in the district of Anuradhapura. Trained para-medical staff visited the households and administered the locally validated questionnaire to assess the presence and severity of symptoms...
July 10, 2017: BMC Nephrology
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