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Urology and elderly care

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78 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28456346/management-of-gout-and-hyperuricemia-in-ckd
#1
Ana Beatriz Vargas-Santos, Tuhina Neogi
Hyperuricemia and gout, the clinical manifestation of monosodium urate crystal deposition, are common in patients with chronic kidney disease (CKD). Although the presence of CKD poses additional challenges in gout management, effective urate lowering is possible for most patients with CKD. Initial doses of urate-lowering therapy are lower than in the non-CKD population, whereas incremental dose escalation is guided by regular monitoring of serum urate levels to reach the target level of <6mg/dL (or <5mg/dL for patients with tophi)...
April 26, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28355403/when-kidneys-get-old-an-essay-on-nephro-geriatrics
#2
Richard Glassock, Aleksandar Denic, Andrew D Rule
Aging is a nearly universal phenomenon in biology only partially controlled by genetic endowment. Individuals and their organs age at varying rates. The kidneys manifest the aging process by steady loss of nephrons and a corresponding decrease in glomerular filtration rate (GFR) beginning about age 30 years. The mechanisms responsible for this observation is are elusive. However, defining chronic kidney disease based on arbitrary, fixed thresholds of GFR in the later phases of life can be problematical as it may over-diagnosis CKD in the elderly...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27860090/guideline-of-guidelines-priapism
#3
REVIEW
Asif Muneer, David Ralph
No abstract text is available yet for this article.
November 14, 2016: BJU International
https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#4
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#5
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#6
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/25711488/diagnosis-and-treatment-of-chronic-bacterial-prostatitis-and-chronic-prostatitis-chronic-pelvic-pain-syndrome-a-consensus-guideline
#7
Jon Rees, Mark Abrahams, Andrew Doble, Alison Cooper
OBJECTIVES: To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non-specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non-specialist and specialist settings. To promote efficient referral of care between non-specialists and specialists and the involvement of the multidisciplinary team (MDT). PATIENTS AND METHODS: The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months)...
October 2015: BJU International
https://www.readbyqxmd.com/read/27810661/frailty-and-chronic-kidney-disease-a-systematic-review
#8
REVIEW
Rakin Chowdhury, Nancye M Peel, Mitchell Krosch, Ruth E Hubbard
OBJECTIVE: Frailty is associated with increased vulnerability to poor health. There is growing interest in understanding the association between frailty and chronic kidney disease (CKD). This systematic review explored how frailty is measured in patients with CKD and the association between frailty and adverse outcomes across different stages of renal impairment. STUDY DESIGN: Systematic analysis of peer reviewed articles. DATA SOURCES: Pubmed, Medline, Web of Science and Cochrane were used to identify the articles...
January 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27958390/prevalence-and-treatment-of-luts-in-patients-with-parkinson-disease-or-multiple-system-atrophy
#9
REVIEW
Teruyuki Ogawa, Ryuji Sakakibara, Sadako Kuno, Osamu Ishizuka, Takeya Kitta, Naoki Yoshimura
The lower urinary tract is controlled by complex neural mechanisms not only in the periphery, but also in the central nervous systems (CNS). Thus, patients with a wide variety of neurological diseases often also have lower urinary tract symptoms (LUTS), including those with Parkinson disease (PD) or multiple system atrophy (MSA). LUTS are common comorbidities associated with both of these neurodegenerative diseases and are likely to impair patients' quality of life. The motor symptoms of PD and MSA often seem similar; however, the pathophysiology, and thus the treatment of LUTS differs considerably...
February 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28029154/changes-in-the-worldwide-epidemiology-of-peritoneal-dialysis
#10
REVIEW
Philip Kam-Tao Li, Kai Ming Chow, Moniek W M Van de Luijtgaarden, David W Johnson, Kitty J Jager, Rajnish Mehrotra, Sarala Naicker, Roberto Pecoits-Filho, Xue Qing Yu, Norbert Lameire
As the global burden of chronic kidney disease continues to increase, so does the need for a cost-effective renal replacement therapy. In many countries, patient outcomes with peritoneal dialysis are comparable to or better than those with haemodialysis, and peritoneal dialysis is also more cost-effective. These benefits have not, however, always led to increased utilization of peritoneal dialysis. Use of this therapy is increasing in some countries, including China, the USA and Thailand, but has proportionally decreased in parts of Europe and in Japan...
February 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27822135/chronic-kidney-disease-identification-and-management-in-primary-care
#11
REVIEW
Simon Ds Fraser, Tom Blakeman
Chronic kidney disease (CKD) is an important and common noncommunicable condition globally. In national and international guidelines, CKD is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages, and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end-stage kidney disease for most people with CKD...
2016: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/27887750/chronic-kidney-disease
#12
REVIEW
Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence...
March 25, 2017: Lancet
https://www.readbyqxmd.com/read/25214448/-impact-on-cognitive-function-of-anticholinergic-drugs-used-for-the-treatment-of-overactive-bladder-in-the-elderly
#13
REVIEW
J Kerdraon, G Robain, C Jeandel, P Mongiat Artus, X Gamé, B Fatton, M C Scheiber-Nogueira, J-M Vetel, P Mares, A-C Petit, G Amarenco
OBJECTIVES: Describe the central nervous system (CNS) adverse effects of anticholinergic drugs used for the treatment of overactive bladder (OAB) in the elderly. PATIENTS AND METHODS: Relevant data from the literature were identified primarily through a Medline search of articles published through December 2013. The search terms included overactive bladder, central nervous system, elderly, anticholinergic, and antimuscarinic. Articles were chosen for inclusion based on their pertinence to the focus on treatment of OAB in the elderly...
September 2014: Progrès en Urologie
https://www.readbyqxmd.com/read/27616037/effect-of-tamsulosin-on-stone-passage-for-ureteral-stones-a-systematic-review-and-meta-analysis
#14
REVIEW
Ralph C Wang, Rebecca Smith-Bindman, Evans Whitaker, Jersey Neilson, Isabel Elaine Allen, Marshall L Stoller, Jahan Fahimi
STUDY OBJECTIVE: Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. METHODS: MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design...
March 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27573728/heart-failure-and-kidney-dysfunction-epidemiology-mechanisms-and-management
#15
REVIEW
Joerg C Schefold, Gerasimos Filippatos, Gerd Hasenfuss, Stefan D Anker, Stephan von Haehling
Heart failure (HF) is a major health-care problem and the prognosis of affected patients is poor. HF often coexists with a number of comorbidities of which declining renal function is of particular importance. A loss of glomerular filtration rate, as in acute kidney injury (AKI) or chronic kidney disease (CKD), independently predicts mortality and accelerates the overall progression of cardiovascular disease and HF. Importantly, cardiac and renal diseases interact in a complex bidirectional and interdependent manner in both acute and chronic settings...
October 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/27226131/controversies-and-problems-of-volume-control-and-hypertension-in-haemodialysis
#16
REVIEW
Ercan Ok, Gulay Asci, Charles Chazot, Mehmet Ozkahya, Evert J Dorhout Mees
Extracellular volume overload and hypertension are important contributors to the high risk of cardiovascular mortality in patients undergoing haemodialysis. Hypertension is present in more than 90% of patients at the initiation of haemodialysis and persists in more than two-thirds, despite use of several antihypertensive medications. High blood pressure is a risk factor for the development of left ventricular hypertrophy, heart failure, and mortality, although there are controversies with some study findings showing poor survival with low-but not high-blood pressure...
July 16, 2016: Lancet
https://www.readbyqxmd.com/read/27554370/pharmacological-treatment-of-post-prostatectomy-incontinence-what-is-the-evidence
#17
REVIEW
Anja Løvvik, Stig Müller, Hitendra R H Patel
Urinary incontinence is a common and debilitating problem, and post-prostatectomy incontinence (PPI) is becoming an increasing problem, with a higher risk among elderly men. Current treatment options for PPI include pelvic floor muscle exercises and surgery. Conservative treatment has disputable effects, and surgical treatment is expensive, is not always effective, and may have complications. This article describes the prevalence and causes of PPI and the current treatment methods. We conducted a search of the PUBMED database and reviewed the current literature on novel medical treatments of PPI, with special focus on the aging man...
August 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27492013/common-medications-and-prostate-cancer-mortality-a-review
#18
Konrad H Stopsack, Alexandra J Greenberg, Lorelei A Mucci
PURPOSE: Most prostate cancer patients also have comorbidities that are treated with both prescription and nonprescription medications; furthermore, many use dietary supplements. We assess their association with prognosis after prostate cancer diagnosis, and we discuss methodological challenges and clinical implications. METHODS: We reviewed high-quality observational studies investigating the association of commonly used medications and supplements with prostate cancer-specific mortality...
June 2017: World Journal of Urology
https://www.readbyqxmd.com/read/27336470/should-we-stop-angiotensin-converting-enzyme-inhibitors-angiotensin-receptor-blockers-in-advanced-kidney-disease
#19
REVIEW
Aimun Ahmed, Tom Jorna, Sunil Bhandari
Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD) and impaired quality of life. Previous research for preventing loss of glomerular filtration rate (GFR) has focused on reducing blood pressure (BP) and proteinuria. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor antagonists (ARB) are commonly used in patients with early CKD, but their value in advanced CKD (estimated GFR (eGFR) ≤30 ml/min/1.73 m2) is unknown...
2016: Nephron
https://www.readbyqxmd.com/read/27430294/protocol-of-a-randomized-controlled-trial-of-an-erythropoietin-stimulating-agent-decision-aid-for-anemia-treatment-in-kidney-disease
#20
Lauren B Beach, Marcus Wild, Gowri Ramachandran, H Omer Ikizler, Kerri L Cavanaugh
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are commonly used for the treatment of anemia due to chronic kidney disease (CKD) and end stage renal disease (ESRD). Patients often lack an understanding of the potential risks and benefits of ESAs, despite government mandated education on this topic. Decision aids are tools commonly used to discuss important information in health care settings. To address this knowledge gap, we designed this study to evaluate the effectiveness of a novel ESA decision aid at promoting informed shared decision making (ISDM) between patients and providers related to ESA use for CKD- and ESRD-related anemia...
July 18, 2016: BMC Nephrology
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