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Latest & greatest articles for chronic kidney disease
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Effects of intensive blood pressure lowering on the progression of chronickidneydisease: a systematic review and meta-analysis Effects of intensive blood pressure lowering on the progression of chronickidneydisease: a systematic review and meta-analysis Effects of intensive blood pressure lowering on the progression of chronickidneydisease: a systematic review and meta-analysis Lv J, Ehteshami P, Sarnak MJ, Tighiouart H, Jun M, Ninomiya T, Foote C, Rodgers A, Zhang H, Wang H, Strippoli GF (...) , Perkovic V CRD summary This generally well-conducted review concluded that intensive blood pressure lowering regimens appeared to provide protection against kidney failure events in patients with chronickidneydisease, particularly among those with proteinuria; safety remained an uncertainty. The strength of evidence did not support strong conclusions on renal outcomes and the authors conclusions may be overly strong. Authors' objectives To assess the renal and cardiovascular effects of intensive
Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronickidneydisease: an updated systematic review and meta-analysis Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronickidneydisease: an updated systematic review and meta-analysis Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronickidneydisease: an updated systematic review and meta (...) -analysis Jamal SA, Vandermeer B, Raggi P, Mendelssohn DC, Chatterley T, Dorgan M, Lok CE, Fitchett D, Tsuyuki RT CRD summary This review concluded that non-calcium-based phosphate binders were associated with a decreased risk of all-cause mortality compared with calcium-based phosphate binders in patients with chronickidneydisease. This was a generally well-conducted review but the conclusions seem overly strong. Authors' objectives To update a prior meta-analysis that compared the effect of calcium
Evaluation and management of chronickidneydisease: synopsis of the kidneydisease: improving global outcomes 2012 clinical practice guideline. DESCRIPTION: The KidneyDisease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines in 2012 to provide guidance on the evaluation, management, and treatment of chronickidneydisease (CKD) in adults and children who are not receiving renal replacement therapy. METHODS: The KDIGO CKD Guideline Development Work Group
Chronickidneydisease: global dimension and perspectives. Chronickidneydisease is defined as a reduced glomerular filtration rate, increased urinary albumin excretion, or both, and is an increasing public health issue. Prevalence is estimated to be 8-16% worldwide. Complications include increased all-cause and cardiovascular mortality, kidney-disease progression, acute kidney injury, cognitive decline, anaemia, mineral and bone disorders, and fractures. Worldwide, diabetes (...) mellitus is the most common cause of chronickidneydisease, but in some regions other causes, such as herbal and environmental toxins, are more common. The poorest populations are at the highest risk. Screening and intervention can prevent chronickidneydisease, and where management strategies have been implemented the incidence of end-stage kidneydisease has been reduced. Awareness of the disorder, however, remains low in many communities and among many physicians. Strategies to reduce burden and costs related
Chronickidneydisease and cardiovascular risk: epidemiology, mechanisms, and prevention. Since the first description of the association between chronickidneydisease and heart disease, many epidemiological studies have confirmed and extended this finding. As chronickidneydisease progresses, kidney-specific risk factors for cardiovascular events and disease come into play. As a result, the risk for cardiovascular disease is notably increased in individuals with chronickidneydisease. When (...) adjusted for traditional cardiovascular risk factors, impaired kidney function and raised concentrations of albumin in urine increase the risk of cardiovascular disease by two to four times. Yet, cardiovascular disease is frequently underdiagnosed and undertreated in patients with chronickidneydisease. This group of patients should, therefore, be acknowledged as having high cardiovascular risk that needs particular medical attention at an individual level. This view should be incorporated
A Simple Tool to Predict End-Stage RenalDisease within 1 Year in Elderly Adults with Advanced ChronicKidneyDisease 23617782 2013 05 15 2013 07 09 2016 10 19 1532-5415 61 5 2013 May Journal of the American Geriatrics Society J Am Geriatr Soc A simple tool to predict end-stage renaldisease within 1 year in elderly adults with advanced chronickidneydisease. 762-8 10.1111/jgs.12223 To develop and validate a model to predict 1-year risk of end-stage renaldisease (ESRD) inelderly subjects (...) with advanced chronickidneydisease (CKD). Retrospective. Veterans Affairs Medical Center. Individuals aged 65 and older with CKD with an estimated glomerular filtration rate (eGFR) less than 30 mL/min per 1.73 m(2) . The outcome was ESRDwithin1 year of the index eGFR. Cox regression was used to develop a predictive model (Veterans Affairs (VA) risk score) that was validated in a separate cohort. Of the 1,866 participants in the developmental cohort, 77 developed ESRD. Riskfactors for ESRDinthe final
An angiotensin II receptor blocker-calcium channel blocker combination prevents cardiovascular events in elderly high-risk hypertensive patients with chronickidneydisease better than high-dose angiotensin II receptor blockade alone 23051740 2012 12 28 2013 06 17 2016 12 15 1523-1755 83 1 2013 Jan Kidney international Kidney Int. An angiotensin II receptor blocker-calcium channel blocker combination prevents cardiovascular events in elderly high-risk hypertensive patients with chronickidney (...) ) with chronickidneydisease (CKD) defined as an eGFR <60 ml/min per 1.73 m(2). Blood pressure was lower in the combined therapy than in the high-dose ARB cohort in both groups with and without CKD. In patients with CKD, significantly more primary events (a composite of cardiovascular events and noncardiovascular death) occurred in the high-dose ARB group than in the combination group (30 vs. 16, respectively, hazard ratio 2.25). Significantly more cerebrovascular and more heart failure events occurred
Meta-analysis: vitamin D compounds in chronickidneydisease. Meta-analysis: vitamin D compound... preview & related info | Mendeley E-mail address Password ( ) Remember me …or sign in with Search Main Navigation › Short URL Annals of Internal Medicine ( 2007 ) Volume: 147 , Issue: 12 , Pages: 840-853 PubMed: Available from or Find this paper at: Abstract BACKGROUND: Vitamin D compounds are widely used to prevent and treat secondary hyperparathyroidism. PURPOSE: To determine whether vitamin D (...) therapy improves biochemical markers of mineral metabolism and cardiovascular and mortality outcomes in chronickidneydisease. DATA SOURCES: MEDLINE (January 1966 to July 2007), EMBASE (January 1980 to July 2007), and Cochrane databases were searched without language restriction. STUDY SELECTION: Randomized, controlled trials of vitamin D compounds in chronickidneydisease were identified. DATA EXTRACTION: Two authors independently extracted data. DATA SYNTHESIS: Seventy-six trials were identified
Efficacy and safety of paricalcitol therapy for chronickidneydisease: a meta-analysis Efficacy and safety of paricalcitol therapy for chronickidneydisease: a meta-analysis Efficacy and safety of paricalcitol therapy for chronickidneydisease: a meta-analysis Cheng J, Zhang W, Zhang X, Li X, Chen J CRD summary The authors concluded that paricalcitol significantly reduced proteinuria and parathyroid hormone levels, with few adverse events, in patients with renaldisease. Other than (...) the possibility of language bias, this was a generally well-conducted review, but there were few trials, with short follow-up, and the authors' conclusions should be considered to be tentative. Authors' objectives To assess the safety and efficacy of paricalcitol (a vitamin D compound) for patients with chronickidneydisease. Searching MEDLINE, EMBASE, and Cochrane Renal Group Trials Register were searched up to 2010; search terms were reported. Reference lists of identified articles were searched. Abstracts
Peginesatide for anemia in patients with chronickidneydisease not receiving dialysis. 23343062 2013 01 24 2013 02 01 2015 11 19 1533-4406 368 4 2013 Jan 24 The New England journal of medicine N. Engl. J. Med. Peginesatide for anemia in patients with chronickidneydisease not receiving dialysis. 320-32 10.1056/NEJMoa1203166 Peginesatide is a peptide-based erythropoiesis-stimulating agent (ESA) that may have therapeutic potential for anemia in patients with advanced chronickidneydisease. We (...) safety end point was 1.32 (95% CI, 0.97 to 1.81) for peginesatide relative to darbepoetin, with higher incidences of death, unstable angina, and arrhythmia with peginesatide. The efficacy of peginesatide (administered monthly) was similar to that of darbepoetin (administered every 2 weeks) in increasing and maintaining hemoglobin levels. However, cardiovascular events and mortality were increased with peginesatide in patients with chronickidneydisease who were not undergoing dialysis. (Funded
Bardoxolone methyl in type 2 diabetes and stage 4 chronickidneydisease. 24206459 2013 12 26 2014 01 02 2016 12 15 1533-4406 369 26 2013 Dec 26 The New England journal of medicine N. Engl. J. Med. Bardoxolone methyl in type 2 diabetes and stage 4 chronickidneydisease. 2492-503 10.1056/NEJMoa1306033 Although inhibitors of the renin-angiotensin-aldosterone system can slow the progression of diabetic kidneydisease, the residual risk is high. Whether nuclear 1 factor (erythroid-derived 2 (...) )-related factor 2 activators further reduce this risk is unknown. We randomly assigned 2185 patients with type 2 diabetes mellitus and stage 4 chronickidneydisease (estimated glomerular filtration rate [GFR], 15 to <30 ml per minute per 1.73 m(2) of body-surface area) to bardoxolone methyl, at a daily dose of 20 mg, or placebo. The primary composite outcome was end-stage renaldisease (ESRD) ordeath from cardiovascular causes. The sponsor and the steering committee terminated the trial
KHA-CARI Guideline: Use of iron in chronickidneydisease patients Original Article KHA-CARI Guideline: Use of iron in chronickidneydisease patients ROB MACGINLEY, 1 ROWAN WALKER 2 and MICHELLE IRVING 3 1 Deakin University Medical School, Geelong, 2 Department of Renal Medicine, Alfred Hospital, Melbourne, Victoria, and 3 Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia Correspondence: Dr Rob MacGinley, Deakin University Medical School (...) , Pidgons Road, Waurn Ponds, Geelong, Vic. 3217, Australia. Email: email@example.com Accepted for publication 16 July 2013. Accepted manuscript online 23 July 2013. doi:10.1111/nep.12139 GUIDELINE RECOMMENDATIONS For: All chronickidneydisease (CKD) patients (CKD Stage 3–5; CKD Stage 5D (both peritoneal dialysis (PD) and haemodi- alysis (HD)). We recommend: a. That therapeutic iron be used to correct diagnosed iron de?ciency (1D). b. Parenteral iron (intravenous) is administered in prefer
ChronicKidneyDisease - Cardiovascular effects of blood pressure lowering in patients with CKD ________________________________________________________________________________________________________________________ Cardiovascular Disease May 2013 Page 1 of 15 Cardiovascular effects of blood pressure lowering in patients with chronickidneydisease Date written: May 2013 Author: Hiddo J. Lambers Heerspink, Toshiharu Ninomiya, Rachel Huxley, Vlado Perkovic GUIDELINES Chronickidneydisease (...) not requiring dialysis a. We recommend that blood pressure targets in people with chronickidneydisease (CKD) should be determined on an individual basis taking into account a range of patient factors (1C) including baseline risk, albuminuria level, tolerability and starting blood pressure levels. b. We suggest that most people with CKD should be treated to similar targets as the general population, such that most blood pressure readings are below 140/90 (2D). We suggest that most blood pressure readings
ChronicKidneyDisease - Cardiovascular disease: revascularisation ________________________________________________________________________________________________________________________ Cardiovascular Disease May 2013 Page 1 of 25 Cardiovascular disease: revascularisation Date written: May 2013 Author: Helen Pilmore GUIDELINES Chronickidneydisease not requiring dialysis a. We recommend that in patients with chronickidneydisease (CKD), end stage renal failure (ESRF) andafterkidney (...) transplantation, that guidelines for revascularisation of the general population be adhered to (1D). UNGRADED SUGGESTIONS FOR CLINICAL CARE Patients with evidence of coronary artery disease should be referred to a cardiologist for expert opinion (ungraded) Physicians should be aware that revascularisation of coronary arteries with coronary artery bypass graft (CABG) and percutaneous intervention (PCI) is associated with greater mortality and morbidity in patients with chronickidneydisease (CKD) and those
Screening for early chronickidneydisease ________________________________________________________________________________________________________________________ Early ChronicKidneyDisease July 2012 Page 1 of 32 Screening for early chronickidneydisease Date written: July 2012 Author: Nigel Toussaint GUIDELINES a. We recommend screening for chronickidneydisease (CKD) as it is an effective strategy to allow earlier detection and management to reduce the increasing burden of CKD (1C). b (...) in Figure 1 (1D). UNGRADED SUGGESTIONS FOR CLINICAL CARE There are no ungraded statements. IMPLEMENTATION AND AUDIT 1. Primary practice audits of how many patients with one or more CKD risk factors receive annual evaluation of eGFR, albuminuria and blood pressure. 2. Conduct and evaluate a screening program with respect to the prevention or reduction of renal events (including end-stage kidneydisease), cardiovascular events and mortality. BACKGROUND Chronickidneydisease (CKD) is a significant global
Risk factors for early chronickidneydisease ________________________________________________________________________________________________________________________ Early ChronicKidneyDisease July 2012 Page 1 of 41 Risk factors for early chronickidneydisease Date written: July 2012 Author: David Johnson EVIDENCE SUMMARY a. The following risk factors are associated with an appreciable (20%-40%) risk of CKD: ? Obesity ? Hypertension ? Diabetes mellitus ? Cigarette smoking ? Established (...) recommendations. BACKGROUND Chronickidneydisease (CKD) is a major public health problem in Australia and throughout the world. Based on data from the AusDiab study , it is estimated that over 1.7 million Australian adults have at least moderately severe kidney failure, defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m 2 . This pernicious condition is often not associated with significant symptoms or urinary abnormalities and is unrecognized in 80-90% of cases [1-3]. CKD