Disease Guideline, July 2019 Clinical Problem and Management Issues Chronic kidney disease (CKD) is an increasingly common clinical problem that raises a patient’s risk for developing several life-threatening medical conditions, including end- stage renal disease (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 Chronic Kidney Disease 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

Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium-Based Contrast Agent: A Systematic Review and Meta-analysis Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium-Based Contrast Agent: A Systematic Review and Meta-analysis - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome (...) collection Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation JAMA Intern Med Actions 2019 Dec 9 [Online ahead of print] Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium

in HF patients and chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 . We conducted a systematic review evaluating the efficacy and safety of MRA in patients with HF and CKD. PubMed, Embase, and Cochrane Central databases were searched for relevant studies on patients with HF and reduced renal function (defined as eGFR <60 mL/min/1.73 m 2 ). Seven studies with 5,522 patients were included. We found 3 studies in patients with HFrEF, 1 study with HFpEF (...) Efficacy and Safety of Mineralocorticoid Receptor Antagonists in Patients With Heart Failure and Chronic Kidney Disease Efficacy and Safety of Mineralocorticoid Receptor Antagonists in Patients With Heart Failure and Chronic Kidney Disease - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily

Cases in Precision Medicine: APOL1 and Genetic Testing in the Evaluation of Chronic Kidney Disease and Potential Transplant. This article discusses potential indications for genetic testing in an African American patient with chronic kidney disease who is being evaluated for a kidney transplant. Two known risk variants in the APOL1 (apolipoprotein L1) gene predispose to kidney disease 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 kidney disease is discussed.

Chronic Kidney Disease Diagnosis and Management: A Review. Chronic kidney disease (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 kidney disease, 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 Chronic Kidney Disease: Clinical Effectiveness and Guidelines Dietary Priority Screening for Chronic Kidney Disease: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Dietary Priority Screening for Chronic Kidney Disease: Clinical Effectiveness and Guidelines Dietary Priority Screening for Chronic Kidney Disease: 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 chronic kidney disease? What are the evidence-based guidelines for the use of dietary/nutrition prioritization tools for the delivery of nutritional therapy in the chronic kidney disease 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 Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2018 Clinical Practice Guideline. The Kidney Disease: Improving Global Outcomes (KDIGO) 2018 clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C virus (HCV) infection in chronic kidney disease (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 chronic kidney disease (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 chronic kidney disease can be restricted by hyperkalaemia. We evaluated use of the potassium binder patiromer to allow more persistent use (...) of spironolactone in patients with chronic kidney disease and resistant hypertension.In this phase 2 multicentre, randomised, double-blind, placebo-controlled study, we enrolled participants aged 18 years and older with chronic kidney disease (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 Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, 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 chronic kidney disease, including in participants who did not have previous cardiovascular disease.URL: https

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis. Effects of oral anticoagulation in chronic kidney disease (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 kidney disease (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 chronic kidney disease. Chronic kidney disease (CKD) is associated with high morbidity and death, which increases as CKD progresses to end-stage kidney disease (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. “Renal Disorders in Pregnancy: Core Curriculum 2019.” American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation, August. https://doi.org/10.1053/j.ajkd.2018.06.006. Hladunewich, Michelle A. 2017. “Chronic Kidney Disease 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: Chronic Kidney Disease 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 renal disease /progression

Tolvaptan (Jinarc ) for the treatment of chronic kidney disease - alteration of the specific conditions Tolvaptan (Jinarc ®) for the treatment of chronic kidney disease - alteration of the specific conditions | Report | National Health Care Institute You are here: Tolvaptan (Jinarc ®) for the treatment of chronic kidney disease - alteration of the specific conditions Search within English part of National Health Care Institute Search Tolvaptan (Jinarc ®) for the treatment of chronic kidney (...) supportive care for ADPKD patients with chronic kidney disease (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 kidney disease (ADPKD) with chronic kidney disease (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 chronic kidney disease 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 chronic kidney disease 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 chronic kidney disease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. Metabolic acidosis, a complication of chronic kidney disease, 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 chronic kidney disease (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

Use of Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease: A Prospective Cohort Study. Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (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

Albuminuria-lowering effect of dapagliflozin alone and in combination with saxagliptin and effect of dapagliflozin and saxagliptin on glycaemic control in patients with type 2 diabetes and chronic kidney disease (DELIGHT): a randomised, double-blind, plac In patients with type 2 diabetes, intensive glucose control can be renoprotective and albuminuria-lowering treatments can slow the deterioration of kidney function. We assessed the albuminuria-lowering effect of the sodium-glucose co (...) groups. There were no new drug-related safety signals.Dapagliflozin with or without saxagliptin, given in addition to angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment, is a potentially attractive option to slow the progression of kidney disease in patients with type 2 diabetes and moderate-to-severe chronic kidney disease.AstraZeneca.Copyright © 2019 Elsevier Ltd. All rights reserved.

Oral anticoagulation in patients with chronic kidney disease: 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 chronic kidney disease (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 Chronic Kidney Disease (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 Renal Diseases 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 renal disease 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 Chronic Renal Failure. Kidney

energy wasting syndrome in chronic kidney disease: 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 Chronic Kidney Disease Clinical Practice Guideline Undernutrition in Chronic Kidney Disease 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