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Latest & greatest articles for chronic kidney disease
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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
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
Benefits and Harms of Oral Anticoagulant Therapy in ChronicKidneyDisease: A Systematic Review and Meta-analysis. Effects of oral anticoagulation in chronickidneydisease (CKD) are uncertain.To evaluate the benefits and harms of vitamin K antagonists (VKAs) and non-vitamin K oral anticoagulants (NOACs) in adults with CKD stages 3 to 5, including those with dialysis-dependent end-stage kidneydisease (ESKD).English-language searches of MEDLINE, EMBASE, and Cochrane databases (inception (...) ), prevention of dialysis access thrombosis (8 trials), and cardiovascular disease other than AF (9 trials) were included. All but the 8 trials involving patients with ESKD excluded participants with creatinine clearance less than 20 mL/min or estimated glomerular filtration rate less than 15 mL/min/1.73 m2. In AF, compared with VKAs, NOACs reduced risks for stroke or systemic embolism (risk ratio [RR], 0.79 [95% CI, 0.66 to 0.93]; high-certainty evidence) and hemorrhagic stroke (RR, 0.48 [CI, 0.30 to 0.76
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
Long-term safety and efficacy of veverimer in patients with metabolic acidosis in chronickidneydisease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. Metabolic acidosis, a complication of chronickidneydisease, causes protein catabolism and bone demineralisation and is associated with adverse kidney outcomes and mortality. Veverimer, a non-absorbed, counterion-free, polymeric drug candidate selectively binds and removes hydrochloric acid from the gastrointestinal (...) lumen.We did a multicentre, randomised, blinded, placebo-controlled, 40-week extension of a 12-week parent study at 29 sites (hospitals and specialty clinics) in seven countries (Bulgaria, Georgia, Hungary, Serbia, Slovenia, Ukraine, and the USA). Eligible patients were those with chronickidneydisease (estimated glomerular filtration rate 20-40 mL/min per 1·73 m2) and metabolic acidosis (serum bicarbonate 12-20 mmol/L), who had completed the 12-week parent study, for which they were randomly assigned
2019LancetControlled trial quality: predicted high
Use of Peripherally Inserted Central Catheters in Patients With Advanced ChronicKidneyDisease: A Prospective Cohort Study. Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronickidneydisease (CKD).To describe the frequency of and characteristics associated with PICC use in hospitalized patients with stage 3b or greater CKD (glomerular filtration rate [GFR] <45 mL/min/1.73 m2
Oral anticoagulation in patients with chronickidneydisease: A systematic review and meta-analysis Data regarding the efficacy and safety of warfarin and non-vitamin K antagonist oral anticoagulant (NOAC) among patients with chronickidneydisease (CKD) remain scarce.Systematic review and meta-analysis of studies involving patients with CKD treated with oral anticoagulants were conducted to evaluate the following outcomes: ischemic stroke, intracerebral hemorrhage (ICH), combined ischemic
). However the frequency of measurement we recommend provides significant benefits in our opinion but has a weak evidence base due to a general lack of studies in this area(1D). This guideline is endorsed by The British Society for Paediatric Endocrinology and Diabetes (BSPED), The British Association for Paediatric Nephrology (BAPN) and The Paediatric Renal Interest Nutrition Group (PRING). Stages of ChronicKidneyDisease (CKD) 14 Stage GFR* Description Management 1 > 90 Normal Renal Function (...) and anthropometric and nutritional measurements in children with mild to moderate renal insufficiency: a report of the Growth Failure in Children with RenalDiseases study. J Paediatr. 1990; 116: S46 – 54 2. Norman LJ, Coleman JE, MacDonald 1A, Thomsett AM, Watson AR: Nutrition and Growth in relation to severity of renaldisease in children, Paediatric Nephrology 2000; 15, 259-65. 3. Kari JA, Gonzalez C, Lederman S, Shaw V, Rees L: Outcome and Growth of Infants with Severe ChronicRenal Failure. Kidney
energy wasting syndrome in chronickidneydisease: a consensus statement from the International Society of Renal Nutrition and Metabolism. Journal of Renal Nutrition 2013; 23: 77-90. 24. Koo JR, Park KY, Kim HJ, Che DW, Lee JS, Son BW, Rho JW. Depression in chronic haemodialysis patients: risk factors and effects on nutritional parameters. Journal of the American Society of Nephrology 1998; 9: 216A 25. Kopple JD, Greene T, Chumlea WC, Hollinger D, Maroni BJ, Merrill D, Scherch LK, Schulman G, Wang SR (...) Undernutrition in ChronicKidneyDisease Clinical Practice Guideline Undernutrition in ChronicKidneyDisease Authors: Dr Mark Wright Consultant Nephrologist, St J am es ’s University Hospital, Leeds Mrs Elizabeth Southcott Senior Specialist Renal Dietitian, St J a m es’s University Hospital, Leeds Dr Helen MacLaughlin, Consultant Dietitian, Kings College Hospital Mr Stuart Wineberg Patient Representative Final Version: June 2019 Review Date: June 2024 2 Endorsements The National Institute