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Latest & greatest articles for chronic kidney disease
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Antihypertensive Medications and Change in Stages of ChronicKidneyDisease The goal of this study is to estimate the change in the relationships between use of five classes of antihypertensive medications and stages of ChronicKidneyDisease (CKD) in American adults treated for hypertension.The US National Health and Nutrition Examination Survey (NHANES) data sets 1999-2012 were used with the final analytical sample of 3,045 participants. Population prevalence estimates were calculated using (...) and in users of ARB in patients with albuminuria (p = 0.0031).Aggressive pharmacological management of hypertension with ARB as add-on therapy may have accelerated kidney damage in American adults. However, prospective longitudinal studies are needed to establish proper temporal sequence in this relationship.
Determinant factors for chronickidneydisease after partial nephrectomy The objective of this review is to evaluate the factors that determine the development or deterioration of ChronicKidneyDisease (CKD) after partial nephrectomy (PN). When current literature is reviewed, it is found that factors that influence renal function after partial nephrectomy, are multifactorial. Those are divided into pre-surgical factors, such as hypertension, diabetes mellitus, urolithiasis, obesity, metabolic (...) syndrome among others; intra-surgical factors, like the surgical technique used, the remaining healthy tissue, the experience of the surgeon, the time and type of ischemia among others. Lastly, post-surgical factors, also impose some influence on the post-surgical renal performance. It was also found that minimally invasive surgery, in addition to its known advantages, seems to offer a greater field of action in the future that will allow more nephrons preservation in any future surgical scenario
problems of nephrology is to improve quality of life and overall survival of patients with chronickidneydisease (CKD), the prevalence of which is steadily growing throughout the world. Therefore, the retardation of CKD progression and prevention of its complications, as well as the delay of renal replacement therapy (RRT) onset, are the primary medical and social-economical goal [ – ]. The rate of renal failure progression depends on a range of factors, and among them, nutritional status disorders (...) disorders in chronickidneydisease patients The International Society of Renal Nutrition and Metabolism (ISRNM) [ ] recommended the term “Protein-energy wasting (PEW)” to describe the state of decreased body stores of protein and energy in CKD patients and proposed a common nomenclature and diagnostic criteria for these alterations in the context of CKD. 3.1. Prevalence PEW in CKD PEW was traditionally considered for a long time as the problem of patients who receive RRT. Meanwhile, the results
Diagnosis, Evaluation, Prevention, and Treatment of ChronicKidneyDisease-Mineral and Bone Disorder: Synopsis of the KidneyDisease: Improving Global Outcomes 2017 Clinical Practice Guideline Update. The KidneyDisease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of ChronicKidneyDisease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline
anticoagulation in the preceding 120 days were excluded, as were patients requiring dialysis and recipients of renal transplants.Receipt of an anticoagulant prescription within 60 days of atrial fibrillation diagnosis.Ischaemic stroke, cerebral or gastrointestinal haemorrhage, and all cause mortality.6977 patients with chronickidneydisease and newly diagnosed atrial fibrillation were identified, of whom 2434 were on anticoagulants within 60 days of diagnosis and 4543 were not. 2434 pairs were matched using (...) Ischaemic stroke, haemorrhage, and mortality in older patients with chronickidneydisease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care. To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrial fibrillation and chronickidney disease.Propensity matched, population based, retrospective cohort analysis from January 2006 through
Anemia associated with chronickidneydisease (CKD) has been recognized over recent years as a powerful independent predictor of cardiovascular (CV) complications which is the main cause of mortality in CKD patients [ – ]. Numerous studies demonstrated the multifactorial causes of anemia in CKD. Some CKD patients have more severe anemia than it would be expected according to their degree of severity of renal insufficiency [ – ]. In these cases, it is necessary to consider other factors that may (...) was devoted to the analysis of the studies on early diagnosis of anemia, ability to minimize the factors contributing to its severity, timely treatment initiation, that have allowed improving CV and total outcomes, as well as reducing costs of hospital treatment of CKD patients with anemia. 4. Anemia in chronickidneydiseaseRenal anemia (defined as serum Hb levels <130 g/l for men and <120 g/l for women) is an obligatory complication of CKD progression [ , ], which is usually occurring when glomerular
decreases with declining renal function, resulting in less potency for glucose lowering in patients with kidneydisease. We investigated the effects of empagliflozin on clinical outcomes in patients with type 2 diabetes mellitus, established cardiovascular disease, and chronickidney disease.Patients with type 2 diabetes mellitus, established cardiovascular disease, and estimated glomerular filtration rate (eGFR) ≥30 mL·min-1·1.73 m-2 at screening were randomized to receive empagliflozin 10 mg (...) Empagliflozin and Clinical Outcomes in Patients With Type 2 Diabetes Mellitus, Established Cardiovascular Disease, and ChronicKidneyDisease Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduced cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus and established cardiovascular disease in the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients). Urinary glucose excretion with empagliflozin
Risk of stroke and bleeding in patients with heart failure and chronickidneydisease: a nationwide cohort study The aim of this study was to assess the prognostic value of chronickidneydisease (CKD) in relation to ischaemic stroke, intracranial haemorrhage, major bleeding, and all-cause death in heart failure patients without atrial fibrillation.In this observational cohort study, heart failure patients without atrial fibrillation were identified using Danish nationwide registries. Risk (...) of stroke, major haemorrhage, and death were calculated after 1 and 5 years to compare patients with and without CKD, ±dialysis [dialysis: CKD with renal replacement therapy (CKD-RRT); no dialysis: CKD-no RRT]. A total of 43 199 heart failure patients were included, among which 0.8% had CKD-RRT and 5.9% had CKD-no RRT. When compared with heart failure patients without CKD, both CKD-RRT and CKD-no RRT were associated with a higher 5 year rate of major bleeding (CKD-RRT: adjusted hazard ratio (aHR): 2.91
Impact of neuromuscular electrical stimulation on functional capacity of patients with chronickidneydisease on hemodialysis. Literature shows that patients undergoing hemodialysis present poor physical conditioning and low tolerance to exercise. They may also suffer from respiratory dysfunctions. The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation on pulmonary function and functional capacity of patients with chronickidneydisease (...) on hemodialysis.Forty adult patients with chronickidneydisease on hemodialysis were prospectively studied and randomized into two groups (control n = 20 and treatment n = 20). The treatment group underwent bilateral femoral quadriceps muscles electrical stimulation for 30 minutes during hemodialysis, three times per week, for two months. The patients were evaluated by pulmonary function test, maximum respiratory pressures, maximum one-repetition test, and six-minute walk test (6MWT), before and after
Evaluation of an individualized dose titration regimen of patiromer to prevent hyperkalaemia in patients with heart failure and chronickidneydisease Hyperkalaemia risk precludes optimal renin-angiotensin-aldosterone system inhibitor use in patients with heart failure (HF), particularly those with chronickidneydisease (CKD). Patiromer is a sodium-free, non-absorbed potassium (K+ )-binding polymer approved for the treatment of hyperkalaemia. In PEARL-HF, patiromer 25.2 g (fixed dose (...) ) prevented hyperkalaemia in HF patients with or without CKD initiating spironolactone. The current study evaluated the effectiveness of a lower starting dose of patiromer (16.4 g/day) followed by individualized titration in preventing hyperkalaemia and hypokalaemia when initiating spironolactone.This open-label 8-week study enrolled 63 patients with CKD, serum K+ 4.3-5.1 mEq/L, and chronic HF, who, based on investigator opinion, should receive spironolactone. Eligible patients started spironolactone 25
Cathepsin S As an Inhibitor of Cardiovascular Inflammation and Calcification in ChronicKidneyDisease Cardiovascular disease (CVD) is responsible for the majority of deaths in the developed world. Particularly, in patients with chronickidneydisease (CKD), the imbalance of calcium and phosphate may lead to the acceleration of both vascular and valve inflammation and calcification. One in two patients with CKD are reported as dying from cardiovascular causes due to the resulting acceleration (...) in the development of atherosclerosis plaques. In addition, CKD patients on hemodialysis are prone to aortic valve calcification and often need valve replacement before kidney transplantation. The lysosomal proteases, cathepsins, are composed of 11 cysteine members (cathepsin B, C, F, H, K, L, O, S, V, W, and Z), as well as serine proteases cathepsin A and G, which cleave peptide bonds with serine as the amino acid, and aspartyl proteases D and E, which use an activated water molecule bound to aspartate to break
Renal Thrombotic Microangiopathy After Hematopoietic Stem Cell Transplantation: InvolvementÂ ofÂ Chronic Graft-Versus-Host Disease 29854984 2019 02 26 2468-0249 3 3 2018 May Kidney international reports Kidney Int Rep Renal Thrombotic Microangiopathy After Hematopoietic Stem Cell Transplantation: Involvement of Chronic Graft-Versus-Host Disease. 743-747 10.1016/j.ekir.2017.12.013 Mii Akiko A Department of Nephrology, Nippon Medical School, Tokyo, Japan. Shimizu Akira A Department of Analytic (...) Human Pathology, Nippon Medical School, Tokyo, Japan. Kaneko Tomohiro T Department of Nephrology, Nippon Medical School, Tokyo, Japan. Nakayama Kazutaka K Department of Hematology, Nippon Medical School, Tokyo, Japan. Yamaguchi Hiroki H Department of Hematology, Nippon Medical School, Tokyo, Japan. Tsuruoka Shuichi S Department of Nephrology, Nippon Medical School, Tokyo, Japan. eng Case Reports 2018 01 05 United States Kidney Int Rep 101684752 2468-0249 2018 6 2 6 0 2018 6 2 6 0 2018 6 2 6 1
Protective effects of hydrogen sulfide on chronickidneydisease by reducing oxidative stress, inflammation and apoptosis The current study aimed to examine the renoprotective effects of long-term treatment with sodium hydrosulfide (NaHS), a prominent hydrogen sulfide donor, in 5/6 nephrectomy animal model. Twenty-four rats were randomly divided into 3 groups including sham-operated group (Sham), 5/6-nephrectomized group (5/6 Nx), and NaHS-treated group (5/6Nx+NaHS). NaHS (30 micromol/l (...) ) was added twice daily into the drinking water and renal failure was induced by 5/6 nephrectomy. Twelve weeks after surgical procedure, blood pressure, creatinine clearance (CCr), urine concentration of neutrophil gelatinase associated lipocalin (NGAL) and tissue concentration of malondialdehyde (MDA), superoxide dismutase (SOD), as well as renal morphological changes, apoptosis (cleaved caspase-3) and inflammation (p-NF-κB) were measured. Five-sixth nephrectomy induced severe renal damage as indicated
with diabetes mellitus and/or hypertension should be screened at least yearly for chronickidneydisease (CKD). • Screening for CKD may be considered for patients with: ? age >65 years old ? obesity ? cardiovascular disease ? metabolic syndrome ? drugs e.g. nephrotoxic drugs, long-term use of proton-pump inhibitors or analgesics ? family history of CKD or hereditary kidneydisease ? gout ? multisystem diseases with potential kidney involvement e.g. systemic lupus erythematosus ? structural renal tract (...) Reviewers x Algorithm 1 Screening and Investigations for xi ChronicKidneyDisease in Adults with Diabetes Algorithm 2 Screening and Investigations for xii ChronicKidneyDisease in Adults without Diabetes Algorithm 3 Evaluation of Haematuria in xiii ChronicKidneyDisease in Adults Algorithm 4 Treatment for ChronicKidneyDisease xiv in Adults 1. INTRODUCTION 1 2. RISK FACTORS 2 3 ASSESSMENT 4 3.1 Screening 4 3.2 Renal Function 6 3.3 Renal Ultrasound 7 3.4 Classification 8 4. INTERVENTIONS IN DELAYING
Nonalcoholic Fatty Liver Disease and the Risk of Incident ChronicKidneyDisease: A Meta-Analysis Nonalcoholic Fatty Liver Disease and the Risk of Incident ChronicKidneyDisease: A Meta-Analysis :: Science Publishing Group Please enter verification code | | | | | | | | | | Archive 2021, Volume 7 2020, Volume 6 2019, Volume 5 2018, Volume 4 2017, Volume 3 2016, Volume 2 2015, Volume 1 Special Issues / / / / Article Nonalcoholic Fatty Liver Disease and the Risk of Incident ChronicKidneyDisease (...) suggested the possible association between NAFLD and the risk of incident chronickidneydisease (CKD). However, the extent of this association remains unclear. Thus the present meta-analysis was conducted to better characterize this association. In the meta-analysis, a comprehensive search of the databases of MEDLINE, EMBASE, Web of Science and Cochran Library was carried out from inception through September 2017. All large observational studies that investigated the association between NAFLD
Lanthanum carbonate and sevelamer carbonate for treating hyperphosphataemia in patients with chronickidneydisease ACE Technology Guidances Sevelamer carbonate 800 mg tablet for the treatment of hyperphosphataemia in patients with chronickidneydisease who:>have persistent hyperphosphataemia despite optimising treatment with calcium-based phosphate binders; orcannot tolerate calcium-based phosphate binders due to hypercalcaemia.Subsidy statusSevelamer carbonate 800 mg tablet is recommended (...) rationale for the subsidy recommendations, and key clinical and economic evidence which informed their deliberations. Published on 01 Oct 2018 Last Updated on 01 Oct 2018 Guidance Recommendations The Ministry of Health's Drug Advisory Committee has recommended: Sevelamer carbonate 800 mg tablet for the treatment of hyperphosphataemia in patients with chronickidneydisease who: have persistent hyperphosphataemia despite optimising treatment with calcium-based phosphate binders; or cannot tolerate
Whole-Exome Sequencing in Adults With ChronicKidneyDisease: A Pilot Study. The utility of whole-exome sequencing (WES) for the diagnosis and management of adult-onset constitutional disorders has not been adequately studied. Genetic diagnostics may be advantageous in adults with chronickidneydisease (CKD), in whom the cause of kidney failure often remains unknown.To study the diagnostic utility of WES in a selected referral population of adults with CKD.Observational cohort.A major academic (...) syndrome characterized by lung, bone marrow, and liver fibrosis; these findings extend the phenotype of PARN mutations to renal fibrosis. In addition, review of the American College of Medical Genetics actionable genes identified a pathogenic BRCA2 mutation in a proband who was diagnosed with breast cancer on follow-up. The results affected clinical management in most identified cases, including initiation of targeted surveillance, familial screening to guide donor selection for transplantation
Derivation and External Validation of Prediction Models for Advanced ChronicKidneyDisease Following Acute Kidney Injury. Some patients will develop chronickidneydisease after a hospitalization with acute kidney injury; however, no risk-prediction tools have been developed to identify high-risk patients requiring follow-up.To derive and validate predictive models for progression of acute kidney injury to advanced chronickidney disease.Data from 2 population-based cohorts of patients (...) validated with data from a cohort of 2761 patients hospitalized in Ontario, Canada (June 2004-March 2012, with follow-up to March 2013).Demographic, laboratory, and comorbidity variables measured prior to discharge.Advanced chronickidneydisease was defined by a sustained reduction in eGFR less than 30 mL/min/1.73 m2 for at least 3 months during the year after discharge. All participants were followed up for up to 1 year.The participants (mean [SD] age, 66  years in the derivation and internal
Effect of Sertraline on Depressive Symptoms in Patients With ChronicKidneyDisease Without Dialysis Dependence: The CAST Randomized Clinical Trial. Major depressive disorder (MDD) is prevalent among patients with chronickidneydisease (CKD) and is associated with morbidity and mortality. The efficacy and adverse events of selective serotonin reuptake inhibitors in these patients are unknown.To determine whether treatment with sertraline improves depressive symptoms in patients with CKD (...) and MDD.The ChronicKidneyDisease Antidepressant Sertraline Trial (CAST) was a randomized, double-blind, placebo-controlled trial involving 201 patients with stage 3, 4, or 5 non-dialysis-dependent CKD, who were enrolled at 3 US medical centers. The Mini Neuropsychiatric Interview was used to establish MDD. The first participant was randomized in March 2010 and the last clinic visit occurred in November 2016.After a 1-week placebo run-in, participants were randomized to sertraline (n = 102) for 12 weeks