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Latest & greatest articles for chronic kidney disease
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Effects of Allopurinol on the Progression of ChronicKidneyDisease. Elevated serum urate levels are associated with progression of chronickidneydisease. Whether urate-lowering treatment with allopurinol can attenuate the decline of the estimated glomerular filtration rate (eGFR) in patients with chronickidneydisease who are at risk for progression is not known.In this randomized, controlled trial, we randomly assigned adults with stage 3 or 4 chronickidneydisease and no history of gout (...) who had a urinary albumin:creatinine ratio of 265 or higher (with albumin measured in milligrams and creatinine in grams) or an eGFR decrease of at least 3.0 ml per minute per 1.73 m2 of body-surface area in the preceding year to receive allopurinol (100 to 300 mg daily) or placebo. The primary outcome was the change in eGFR from randomization to week 104, calculated with the ChronicKidneyDisease Epidemiology Collaboration creatinine equation.Enrollment was stopped because of slow recruitment
The Management of ChronicKidneyDisease Management of ChronicKidneyDisease (CKD) (2019) - VA/DoD Clinical Practice Guidelines Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu (...) links. Get help from Veterans Crisis Line Locator Contact Search Contact Us Locator Get help from Veterans Crisis Line Search Enter your search text Button to start search More VA More VA Inside VA Budget and Performance Inside the Media Room National Observances Special Events » » » » » Management of ChronicKidneyDisease (CKD) (2019) VA/DoD Clinical Practice Guidelines Menu Menu Quick Links Enter ZIP code here Enter ZIP code here Management of ChronicKidneyDisease (CKD) (2019) Newly Updated
Global, regional, and national burden of chronickidneydisease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Health system planning requires careful assessment of chronickidneydisease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function (...) , for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout.The main data sources we used were published literature, vital registration systems, end-stage kidneydisease registries, and household surveys. Estimates of CKD burden were produced using a Cause
Disease Guideline, July 2019 Clinical Problem and Management Issues Chronickidneydisease (CKD) is an increasingly common clinical problem that raises a patient’s risk for developing several life-threatening medical conditions, including end- stage renaldisease (ESRD) and cardiovascular disease (CVD). Appropriate treatment can delay or prevent these adverse outcomes. However, CKD is often not recognized by clinicians or patients and as a result is often not optimally treated. Prevalence (...) indicating presence of abnormal kidney structure or function for 3 or more months can establish the diagnosis of CKD (Table 1). Ruling out acute (or acute on chronic) kidney injury involves clinical 13 UMHS ChronicKidneyDisease Guideline, July 2019 judgment in the clinical context of either estimated GFR (eGFR) 20% in eGFR, or an increase in serum creatinine = 0.3. During the initial evaluation of CKD, common causes and predisposing conditions for acutely decreased eGFR, including pre-renal and post
Association of Baclofen With Encephalopathy in Patients With ChronicKidneyDisease. At least 30 case reports have linked the muscle relaxant baclofen to encephalopathy in patients with chronickidneydisease (CKD).To compare the 30-day risk of encephalopathy in patients with CKD and newly prescribed baclofen at greater than or equal to 20 mg per day vs less than 20 mg per day. The secondary objective was to compare the risk of encephalopathy in baclofen users vs nonusers.Retrospective
Development of Risk Prediction Equations for Incident ChronicKidneyDisease. Early identification of individuals at elevated risk of developing chronickidneydisease (CKD) could improve clinical care through enhanced surveillance and better management of underlying health conditions.To develop assessment tools to identify individuals at increased risk of CKD, defined by reduced estimated glomerular filtration rate (eGFR).Individual-level data analysis of 34 multinational cohorts from the CKD (...) %) had a slope of observed to predicted risk between 0.80 and 1.25. Discrimination was similar in 18 study populations in 9 external validation cohorts; calibration showed that 16 of 18 (89%) had a slope of observed to predicted risk between 0.80 and 1.25.Equations for predicting risk of incident chronickidneydisease developed from more than 5 million individuals from 34 multinational cohorts demonstrated high discrimination and variable calibration in diverse populations. Further study is needed
Cases in Precision Medicine: APOL1 and Genetic Testing in the Evaluation of ChronicKidneyDisease and Potential Transplant. This article discusses potential indications for genetic testing in an African American patient with chronickidneydisease who is being evaluated for a kidney transplant. Two known risk variants in the APOL1 (apolipoprotein L1) gene predispose to kidneydisease and are found almost exclusively in persons of African ancestry. APOL1 risk variants are considered, including (...) whether clinicians should incorporate genetic testing in the screening process for living kidney donors. In addition to APOL1 testing, the role of diagnostic exome sequencing in evaluating potential transplant recipients and donors with a positive family history of kidneydisease is discussed.
ChronicKidneyDisease Diagnosis and Management: A Review. Chronickidneydisease (CKD) is the 16th leading cause of years of life lost worldwide. Appropriate screening, diagnosis, and management by primary care clinicians are necessary to prevent adverse CKD-associated outcomes, including cardiovascular disease, end-stage kidneydisease, and death.Defined as a persistent abnormality in kidney structure or function (eg, glomerular filtration rate [GFR] <60 mL/min/1.73 m2 or albuminuria ≥30 mg (...) per 24 hours) for more than 3 months, CKD affects 8% to 16% of the population worldwide. In developed countries, CKD is most commonly attributed to diabetes and hypertension. However, less than 5% of patients with early CKD report awareness of their disease. Among individuals diagnosed as having CKD, staging and new risk assessment tools that incorporate GFR and albuminuria can help guide treatment, monitoring, and referral strategies. Optimal management of CKD includes cardiovascular risk
Dietary Priority Screening for ChronicKidneyDisease: Clinical Effectiveness and Guidelines Dietary Priority Screening for ChronicKidneyDisease: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Dietary Priority Screening for ChronicKidneyDisease: Clinical Effectiveness and Guidelines Dietary Priority Screening for ChronicKidneyDisease: Clinical Effectiveness and Guidelines Last updated: January 14, 2019 Project Number: RB1297-000 Product Line: Research Type (...) : Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of dietary/nutrition priority screening tools for in-patients and outpatients with chronickidneydisease? What are the evidence-based guidelines for the use of dietary/nutrition prioritization tools for the delivery of nutritional therapy in the chronickidneydisease setting? Key Message One non-randomized study and three evidence based guidelines were identified regarding the use
Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C Virus Infection in ChronicKidneyDisease: Synopsis of the KidneyDisease: Improving Global Outcomes 2018 Clinical Practice Guideline. The KidneyDisease: Improving Global Outcomes (KDIGO) 2018 clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C virus (HCV) infection in chronickidneydisease (CKD) is an extensive update of KDIGO's 2008 guideline on HCV infection in CKD. This update
Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronickidneydisease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial. Spironolactone is effective at reducing blood pressure in patients with uncontrolled resistant hypertension. However, the use of spironolactone in patients with chronickidneydisease can be restricted by hyperkalaemia. We evaluated use of the potassium binder patiromer to allow more persistent use (...) of spironolactone in patients with chronickidneydisease and resistant hypertension.In this phase 2 multicentre, randomised, double-blind, placebo-controlled study, we enrolled participants aged 18 years and older with chronickidneydisease (estimated glomerular filtration rate 25 to ≤45 mL/min per 1·73 m2) and uncontrolled resistant hypertension from 62 outpatient centres in ten countries (Bulgaria, Croatia, Georgia, Hungary, Ukraine, France, Germany, South Africa, the UK, and the USA). Patients meeting all
Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and ChronicKidneyDisease in Primary and Secondary Cardiovascular Prevention Groups Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronickidneydisease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention).In CREDENCE (Canagliflozin and Renal Events in Diabetes (...) ]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome).Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronickidneydisease, including in participants who did not have previous cardiovascular disease.URL: https
eHealth interventions for people with chronickidneydisease. Chronickidneydisease (CKD) is associated with high morbidity and death, which increases as CKD progresses to end-stage kidneydisease (ESKD). There has been increasing interest in developing innovative, effective and cost-efficient methods to engage with patient populations and improve health behaviours and outcomes. Worldwide there has been a tremendous increase in the use of technologies, with increasing interest in using eHealth (...) interventions to improve patient access to relevant health information, enhance the quality of healthcare and encourage the adoption of healthy behaviours.This review aims to evaluate the benefits and harms of using eHealth interventions to change health behaviours in people with CKD.We searched the Cochrane Kidney and Transplant Register of Studies up to 14 January 2019 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through
.” International Journal of Women’s Health 8 (July): 273–85. Gonzalez Suarez, Maria L., Andrea Kattah, Joseph P. Grande, and Vesna Garovic. 2018. “RenalDisorders in Pregnancy: Core Curriculum 2019.” American Journal of KidneyDiseases: The Official Journal of the National Kidney Foundation, August. https://doi.org/10.1053/j.ajkd.2018.06.006. Hladunewich, Michelle A. 2017. “ChronicKidneyDisease and Pregnancy.” Seminars in Nephrology 37 (4): 337–46. Imbasciati, Enrico, Gina Gregorini, Gianfranca Cabiddu (...) in English (4 pages) 2. Entire guideline in Danish (35 pages) Summary of clinical recommendations: ChronicKidneyDisease and pregnancy: CKD Recommendations Level of evidence Recommendation Preconception Counselling in cooperation with a nephrologist and an obstetrician with special interest in nephrology A Level of renal impairment, presence of hypertension and proteinuria are the strongest prognostics for the outcome of the pregnancy as well as the risk of progression of renaldisease /progression
Tolvaptan (Jinarc ) for the treatment of chronickidneydisease - alteration of the specific conditions Tolvaptan (Jinarc ®) for the treatment of chronickidneydisease - alteration of the specific conditions | Report | National Health Care Institute You are here: Tolvaptan (Jinarc ®) for the treatment of chronickidneydisease - alteration of the specific conditions Search within English part of National Health Care Institute Search Tolvaptan (Jinarc ®) for the treatment of chronickidney (...) supportive care for ADPKD patients with chronickidneydisease (CKD) stages 1 to 3. For the effectiveness of tolvaptan in patients with CKD stage 3b, the evidence was scant. As a result, reimbursement is currently possible based on the following condition: Only for an insured person aged 18 years and older with autosomal dominant polycystic kidneydisease (ADPKD) with chronickidneydisease (CKD) in stages 1 to 3a at the start of the treatment, with evidence of rapidly progressing disease, and in line
Dialysate temperature reduction for intradialytic hypotension for people with chronickidneydisease requiring haemodialysis. Intradialytic hypotension (IDH) is a common complication of haemodialysis (HD), and a risk factor of cardiovascular morbidity and death. Several clinical studies suggested that reduction of dialysate temperature, such as fixed reduction of dialysate temperature or isothermal dialysate using a biofeedback system, might improve the IDH rate.This review aimed to evaluate (...) the benefits and harms of dialysate temperature reduction for IDH among patients with chronickidneydisease requiring HD, compared with standard dialysate temperature.We searched Cochrane Kidney and Transplant's Specialised Register up to 14 May 2019 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search