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CKD Progression

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165 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28410648/risk-prediction-models-in-ckd
#1
REVIEW
Blake Lerner, Sean Desrochers, Navdeep Tangri
Chronic kidney disease (CKD) currently affects 20 million Americans and is associated with increased morbidity and mortality. Resource-efficient and appropriate treatment of CKD benefits the patient and provides improved resource allocation for the health care system. Prediction models can be useful in efficiently allocating resources, and currently are being used at the bedside for several important clinical decisions. There is a paucity of prediction models in use in nephrology, but one such model, the Kidney Failure Risk Equation, uses routinely collected laboratory values and can inform clinical decisions related to the following: (1) triage of nephrology referrals, (2) evaluating the need for more intensive interdisciplinary clinic care, (3) determining the timing of modality education, and (4) dialysis access planning...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410647/disease-trajectories-before-esrd-implications-for-clinical-management
#2
REVIEW
Keiichi Sumida, Csaba P Kovesdy
One of the biggest challenges nephrologists face is to predict complex clinical pathways of kidney disease progression that do not follow a steady linear decline. This unpredictability often becomes a barrier to timely shared decision making between patients and physicians and could lead to adverse patient outcomes. By using numerous analytic approaches to characterize the longitudinal changes in kidney function, emerging evidence has disclosed the heterogeneous trajectories of kidney disease progression, particularly in late-stage chronic kidney disease (CKD) nearing end-stage renal disease (ESRD), and showed their independent associations with various clinical outcomes...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410652/timing-of-dialysis-initiation-what-has-changed-since-ideal
#3
REVIEW
Matthew B Rivara, Rajnish Mehrotra
The optimal timing of initiation of maintenance dialysis in patients with end-stage renal disease currently is unknown. This transition period is one of exceptionally high vulnerability for patients; annual mortality rates in stage 5 chronic kidney disease through the first year of maintenance dialysis exceed 20%. The results of the Initiating Dialysis Early and Late (IDEAL) study, a randomized trial that tested the impact of dialysis initiation at two different levels of kidney function on outcomes, showed no significant difference in survival or other patient-centered outcomes between treatment groups...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410653/ensuring-patient-safety-during-the-transition-to-esrd
#4
REVIEW
Lee-Ann Wagner, Jeffrey C Fink
Patients with chronic kidney disease (CKD) are at risk for complications both inherent to the disease and as a consequence of its treatment. The dangers that CKD patients face change across the spectrum of the disease. Providers who are well-versed in these safety threats are best poised to safeguard patients as their CKD progresses.
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28399810/a-programme-to-spread-egfr-graph-surveillance-for-the-early-identification-support-and-treatment-of-people-with-progressive-chronic-kidney-disease-assist-ckd-protocol-for-the-stepped-wedge-implementation-and-evaluation-of-an-intervention-to-reduce-late-presentation
#5
Hugh Gallagher, Shona Methven, Anna Casula, Nicola Thomas, Charles R V Tomson, Fergus J Caskey, Tracey Rose, Stephen J Walters, David Kennedy, Anne Dawnay, Martin Cassidy, Richard Fluck, Hugh C Rayner, Michael Nation
BACKGROUND: Patients who start renal replacement therapy (RRT) for End-Stage Kidney Disease (ESKD) without having had timely access to specialist renal services have poor outcomes. At one NHS Trust in England, a community-wide CKD management system has led to a decline in the incident rate of RRT and the lowest percentage of patients presenting within 90 days of starting RRT in the UK. We describe the protocol for a quality improvement project to scale up and evaluate this innovation...
April 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28401396/applying-the-temporal-abstraction-technique-to-the-prediction-of-chronic-kidney-disease-progression
#6
Li-Chen Cheng, Ya-Han Hu, Shr-Han Chiou
Chronic kidney disease (CKD) has attracted considerable attention in the public health domain in recent years. Researchers have exerted considerable effort in attempting to identify critical factors that may affect the deterioration of CKD. In clinical practice, the physical conditions of CKD patients are regularly recorded. The data of CKD patients are recorded as a high-dimensional time-series. Therefore, how to analyze these time-series data for identifying the factors affecting CKD deterioration becomes an interesting topic...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28392998/resistive-index-as-a-predictor-of-renal-progression-in-patients-with-moderate-renal-dysfunction-regardless-of-angiotensin-converting-enzyme-inhibitor-or-angiotensin-receptor-antagonist-medication
#7
Jae Hoon Kim, Su Mi Lee, Young Ki Son, Seong Eun Kim, Won Suk An
BACKGROUND: Previous studies have shown that a higher resistive index (RI) on renal duplex ultrasonography was related with renal progression and acute kidney injury, especially in patients with chronic kidney disease (CKD) using an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB). We evaluated whether a RI value is a predictive factor for renal progression regardless of ACEI or ARB medication in patients with moderate renal dysfunction. METHODS: We retrospectively analyzed 119 patients with moderate renal dysfunction that had been evaluated with renal duplex ultrasonography from February 2011 to April 2015...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28380035/longitudinal-change-in-estimated-gfr-among-ckd-patients-a-10-year-follow-up-study-of-an-integrated-kidney-disease-care-program-in-taiwan
#8
Ching-Wei Tsai, I-Wen Ting, Hung-Chieh Yeh, Chin-Chi Kuo
BACKGROUND: This study examined the progression of chronic kidney disease (CKD) by using average annual decline in estimated GFR (eGFR) and its risk factors in a 10-year follow-up CKD cohort. METHODS: A prospective, observational cohort study, 4600 individuals fulfilled the definition of CKD, with or without proteinuria, were followed for 10 years. The eGFR was estimated by the MDRD equation. Linear regression was used to estimate participants' annual decline rate in eGFR...
2017: PloS One
https://www.readbyqxmd.com/read/28366227/fast-renal-decline-to-end-stage-renal-disease-an-unrecognized-feature-of-nephropathy-in-diabetes
#9
REVIEW
Andrzej S Krolewski, Jan Skupien, Peter Rossing, James H Warram
A new model of diabetic nephropathy in type 1 diabetes emerged from our studies of Joslin Clinic patients. The dominant feature is progressive renal decline, not albuminuria. This decline is a unidirectional process commencing while patients have normal renal function and, in the majority, progressing steadily (linearly) to end-stage renal disease (ESRD). While an individual's rate of renal decline is constant, the estimated glomerular filtration rate (eGFR) slope varies widely among individuals from -72 to -3...
March 30, 2017: Kidney International
https://www.readbyqxmd.com/read/28348030/association-between-monocyte-count-and-risk-of-incident-ckd-and-progression-to-esrd
#10
Benjamin Bowe, Yan Xie, Hong Xian, Tingting Li, Ziyad Al-Aly
BACKGROUND AND OBJECTIVES: Experimental evidence suggests a role for monocytes in the biology of kidney disease progression; however, whether monocyte count is associated with risk of incident CKD, CKD progression, and ESRD has not been examined in large epidemiologic studies. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: We built a longitudinal observational cohort of 1,594,700 United States veterans with at least one eGFR during fiscal year 2004 (date of last eGFR during this period designated time zero) and no prior history of ESRD, dialysis, or kidney transplant...
April 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28356338/time-varying-association-of-individual-bp-components-with-egfr-in-late-stage-ckd
#11
Manish M Sood, Ayub Akbari, Doug Manuel, Marcel Ruzicka, Swapnil Hiremath, Deborah Zimmerman, Brenden McCormick, Monica Taljaard
BACKGROUND AND OBJECTIVES: The association of individual BP components with changes in eGFR in patients with late-stage CKD is unknown. The objectives of our study were to examine the associations of systolic BP, diastolic BP, and pulse pressure with continuous temporal changes in eGFR and an eGFR decline ≥30% in late-stage CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a retrospective cohort study (2010-2015) of patients with CKD in a multidisciplinary CKD clinic with an eGFR≤30...
March 29, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28348018/synergistic-interaction-of-hypertension-and-diabetes-in-promoting-kidney-injury-and-the-role-of-endoplasmic-reticulum-stress
#12
Zhen Wang, Jussara M do Carmo, Nicola Aberdein, Xinchun Zhou, Jan M Williams, Alexandre A da Silva, John E Hall
Diabetes mellitus and hypertension are major risk factors for chronic kidney injury, together accounting for >70% of end-stage renal disease. In this study, we assessed interactions of hypertension and diabetes mellitus in causing kidney dysfunction and injury and the role of endoplasmic reticulum (ER) stress. Hypertension was induced by aorta constriction (AC) between the renal arteries in 6-month-old male Goto-Kakizaki (GK) type 2 diabetic and control Wistar rats. Fasting plasma glucose averaged 162±11 and 87±2 mg/dL in GK and Wistar rats, respectively...
May 2017: Hypertension
https://www.readbyqxmd.com/read/28288249/association-of-intensive-blood-pressure-control-and-kidney-disease-progression-in-nondiabetic-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#13
Wan-Chuan Tsai, Hon-Yen Wu, Yu-Sen Peng, Ju-Yeh Yang, Hung-Yuan Chen, Yen-Ling Chiu, Shih-Ping Hsu, Mei-Ju Ko, Mei-Fen Pai, Yu-Kang Tu, Kuan-Yu Hung, Kuo-Liong Chien
Importance: The optimal blood pressure (BP) target remains debated in nondiabetic patients with chronic kidney disease (CKD). Objective: To compare intensive BP control (<130/80 mm Hg) with standard BP control (<140/90 mm Hg) on major renal outcomes in patients with CKD without diabetes. Data Sources: Searches of PubMed, MEDLINE, Embase, and Cochrane Library for publications up to March 24, 2016. Study Selection: Randomized clinical trials that compared an intensive vs a standard BP target in nondiabetic adults with CKD, reporting changes in glomerular filtration rate (GFR), doubling of serum creatinine level, 50% reduction in GFR, end-stage renal disease (ESRD), or all-cause mortality...
March 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28338771/blood-pressure-control-during-chronic-kidney-disease-progression
#14
Seulbi Lee, Hyung Jung Oh, Eun-Kyung Lee, Oesook Lee, Eunhee Ha, Seung-Jung Kim, Duk-Hee Kang, Kyu Bok Choi, Dong-Ryeol Ryu
BACKGROUND: Hypertension is a major cause of end-stage renal disease, and blood pressure (BP) control is crucial in patients with chronic kidney disease (CKD). However, it is generally inadequately controlled in CKD patients. We investigated the prevalence of CKD patients with inadequate BP control and its related factors, based on the CKD stage. METHODS: We analyzed the health examination sample cohort database, which consisted of the randomly selected participants among all the citizens who received the health examination provided by National Health Insurance Service of Korea in 2012 and 2013...
February 16, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28332473/correlation-analysis-of-renal-ultrasound-elastography-and-clinical-and-pathological-changes-in-patients-with-chronic-kidney-disease%C3%A2
#15
Lingyan Peng, Tingting Zhong, Qiuling Fan, Yanjun Liu, Xuemei Wang, Lining Wang
OBJECTIVE: To analyze the correlations of renal tissue elastography with clinical biochemical indicators and pathological changes in patients with chronic kidney disease (CKD) as well as to explore the potential for renal tissue elastography as a new, noninvasive method for the dynamic monitoring of renal disease progression, efficacy assessment, and prognosis evaluation. METHODS: Patients admitted to the Department of Nephrology of the First Affiliated Hospital of China Medical University from August 2014 to January 2015 who had undergone renal biopsies were selected...
March 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28288579/the-cost-effectiveness-of-using-chronic-kidney-disease-risk-scores-to-screen-for-early-stage-chronic-kidney-disease
#16
Benjamin O Yarnoff, Thomas J Hoerger, Siobhan K Simpson, Alyssa Leib, Nilka R Burrows, Sundar S Shrestha, Meda E Pavkov
BACKGROUND: Better treatment during early stages of chronic kidney disease (CKD) may slow progression to end-stage renal disease and decrease associated complications and medical costs. Achieving early treatment of CKD is challenging, however, because a large fraction of persons with CKD are unaware of having this disease. Screening for CKD is one important method for increasing awareness. We examined the cost-effectiveness of identifying persons for early-stage CKD screening (i.e., screening for moderate albuminuria) using published CKD risk scores...
March 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/27401688/the-substantial-loss-of-nephrons-in-healthy-human-kidneys-with-aging
#17
Aleksandar Denic, John C Lieske, Harini A Chakkera, Emilio D Poggio, Mariam P Alexander, Prince Singh, Walter K Kremers, Lilach O Lerman, Andrew D Rule
Nephron number may be an important determinant of kidney health but has been difficult to study in living humans. We evaluated 1638 living kidney donors at Mayo Clinic (MN and AZ sites) and Cleveland Clinic. We obtained cortical volumes of both kidneys from predonation computed tomography scans. At the time of kidney transplant, we obtained and analyzed the sections of a biopsy specimen of the cortex to determine the density of both nonsclerotic and globally sclerotic glomeruli; the total number of glomeruli was estimated from cortical volume×glomerular density...
January 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28223468/high-ambulatory-arterial-stiffness-index-is-an-independent-risk-factor-for-rapid-age-related-glomerular-filtration-rate-decline-in-the-general-middle-aged-population
#18
Bjørn Odvar Eriksen, Vidar Tor Nyborg Stefansson, Trond Geir Jenssen, Ulla Dorte Mathisen, Jørgen Schei, Marit Dahl Solbu, Tom Wilsgaard, Toralf Melsom
Arterial stiffness is a risk factor for cardiovascular and chronic kidney disease. However, the role of arterial stiffness as a predictor of the age-related glomerular filtration rate (GFR) decline in the general population remains unresolved because of difficulty in measuring GFR with sufficient precision in epidemiological studies. The ambulatory arterial stiffness index (AASI) is a proposed indicator of arterial stiffness easily calculated from ambulatory blood pressure. We investigated whether AASI could predict GFR decline measured as iohexol clearance in the general population...
February 21, 2017: Hypertension
https://www.readbyqxmd.com/read/28236138/progression-of-kidney-disease-in-elderly-stage-3-and-4-chronic-kidney-disease-patients
#19
Pradeep Arora, Kabir Jalal, Anu Gupta, Randolph L Carter, James W Lohr
PURPOSE: The prevalence of chronic kidney disease (CKD) has been rising steadily in the elderly population. We studied the rate of progression of CKD in this population and the factors associated with progression of CKD to better identify patients who are likely to progress to ESRD. METHODS: This was an observational study including 4562 patients older than 65 years with two outpatient estimated glomerular filtration rates (eGFRs) of <60 ml/min/1.73 m(2), at least 90 days apart with no intervening eGFR >60 ml/min/1...
February 24, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28241912/end-stage-renal-disease-outcomes-among-the-kaiser-permanente-southern-california-creatinine-safety-program-creatinine-surenet-opportunities-to-reflect-and-improve
#20
John J Sim, Michael Batech, Kim N Danforth, Mark P Rutkowski, Steven J Jacobsen, Michael H Kanter
OBJECTIVES: The Kaiser Permanente Southern California (KPSC) creatinine safety program (Creatinine SureNet) identifies and outreaches to thousands of people annually who may have had a missed diagnosis for chronic kidney disease (CKD). We sought to determine the value of this outpatient program and evaluate opportunities for improvement. METHODS: Longitudinal cohort study (February 2010 through December 2015) of KPSC members captured into the creatinine safety program who were characterized using demographics, laboratory results, and different estimations of glomerular filtration rate...
2017: Permanente Journal
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