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Latest & greatest articles for chronic kidney disease
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Outpatient self-dialysis programs for patients with chronicrenalconditions: clinical and cost-effectiveness, safety, and guidelines Outpatient self-dialysis programs for patients with chronicrenalconditions: clinical and cost-effectiveness, safety, and guidelines Outpatient self-dialysis programs for patients with chronicrenalconditions: clinical and cost-effectiveness, safety, and guidelines CADTH Record Status This is a bibliographic record of a published health technology assessment (...) from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation CADTH. Outpatient self-dialysis programs for patients with chronicrenalconditions: clinical and cost-effectiveness, safety, and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response. 2014 Authors' conclusions One health technology assessment and one non-randomized study were identified regarding outpatient self-dialysis programs
KHA-CARI commentary on the KDIGO Clinical Practice Guideline for the management of blood pressure in chronickidneydisease Original Article Commentary on the KDIGO Clinical Practice Guideline for the management of blood pressure in chronickidneydisease MATTHEW A ROBERTS Department of Renal Medicine, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia Correspondence: Dr Matthew Roberts, Dept of Nephrology, Box Hill Hospital, Eastern Health, Level 2, 5 Arnold St (...) on cardiovascular and renal outcomes: A systematic review and meta-analysis. Plos Med. 2012; 9: e1001293. 2. Eckardt KU, Kasiske BL. Kidneydisease: Improving global outcomes. Nat. Rev. Nephrol. 2009; 5: 650–57. 3. KidneyDisease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO Clinical Practice Guideline for the Management of Blood Pressure in ChronicKidneyDisease. Kidney Int. (Suppl.) 2012; 2: 337–414. 4. Levin NW, Kotanko P, Eckardt KU et al. Blood pressure in chronickidneydisease
KHA-CARI commentary on the KDIGO Clinical Practice Guideline for lipid management in chronickidneydisease Commentary KHA-CARI commentary on the KDIGO Clinical Practice Guideline for Lipid Management in ChronicKidneyDisease SUETONIA C PALMER, 1,2 GIOVANNI FM STRIPPOLI 2,3,4,5,6 and JONATHAN C CRAIG 2,3 1 Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand; 2 Cochrane Renal Group, 3 Sydney School of Public Health, University of Sydney, Sydney, New South Wales (...) cholesterol with simvastatin plus ezetimibe in patients with chronickidneydisease (Study of Heart and Renal Protection): A randomised placebo-controlled trial. Lancet 2011; 377: 2181–92. 4. Fellstrom BC, Jardine AG, Schmieder RE et al. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N. Engl. J. Med. 2009; 360: 1395–407. 5. Eckardt K, Kasiske B. Kidneydisease: Improving global outcomes. Nat. Rev. Nephrol. 2009; 5: 650–57. 6. KidneyDisease: Improving Global Outcomes (KDIGO
Calcimimetics for secondary hyperparathyroidism in chronickidneydisease patients. Calcimimetic agents lower abnormal serum parathyroid hormone (PTH) levels in people who have chronickidneydisease (CKD), but the benefits and harms on patient-level outcomes are uncertain. Since this review was first published in 2006 showing that evidence for calcimimetics was largely restricted to biochemical outcomes, additional studies have been conducted. This is an update of a review first published (...) in 2006.To evaluate the benefits and harms of cinacalcet on patient-level outcomes in adults with CKD.MEDLINE, EMBASE, CENTRAL and conference proceedings were searched for randomised controlled trials (RCTs) evaluating any calcimimetic against placebo or another agent in adults with CKD (persistent albuminuria > 30 mg/g with or without reduced glomerular filtration rate (GFR) (below 60 mL/min/1.73 m²)). We updated searches to 7 February 2013 including the Cochrane Renal Group's Specialised Register
and effective assessment of the patient's condition • Optimize the use of therapy to reduce disease progression, reduce symptoms of CKD, and enhance patient functionality • Minimize preventable complications and morbidity • Emphasize the use of personalized, proactive, patient-driven care December 2014 Page 5 of 117 Background Chronickidneydisease is one of the most common serious medical conditions affecting adults in the United States (US). The Centers for Disease Control and Prevention (CDC) estimate (...) to display each step in the algorithm, and arrows connect the numbered boxes indicating the order in which the steps should be followed.  Rounded rectangles represent a clinical state or condition. Hexagons represent a decision point in the guideline, formulated as a question that can be answered Yes or No. Rectangles represent an action in the process of care. December 2014 Page 12 of 117 December 2014 Page 13 of 117 Recommendations # Recommendation Strength Evaluation for ChronicKidneyDisease
A modeled economic evaluation of sevelamer for treatment of hyperphosphatemia associated with chronickidneydisease among patients on dialysis in the United Kingdom A modeled economic evaluation of sevelamer for treatment of hyperphosphatemia associated with chronickidneydisease among patients on dialysis in the United Kingdom A modeled economic evaluation of sevelamer for treatment of hyperphosphatemia associated with chronickidneydisease among patients on dialysis in the United Kingdom (...) of hyperphosphataemia, associated with chronickidneydisease, in patients who had been receiving dialysis for an average of 38.2 months. Interventions The intervention was sevelamer carbonate (6.9g/day) for the initial treatment of hyperphosphataemia. The comparator was calcium-based phosphate binders, which were those most commonly used in the UK; it was assumed that 70% of patients received calcium acetate (5.3g/day) and 30% received calcium carbonate (4.9g/day). Location/setting UK/secondary care. Methods
[Biological therapies in the treatment of anaemia associated with chronickidneydisease: a comparison of efficacy and safety of different erythropoiesis-stimulating agents] Terapias biológicas en el tratamiento de la anemia asociada a insuficiencia renal crónica: eficacia y seguridad comparada entre los agentes estimuladores de la eritropoyesis [Biological therapies in the treatment of anaemia associated with chronickidneydisease: a comparison of efficacy and safety of different (...) erythropoiesis-stimulating agents] Terapias biológicas en el tratamiento de la anemia asociada a insuficiencia renal crónica: eficacia y seguridad comparada entre los agentes estimuladores de la eritropoyesis [Biological therapies in the treatment of anaemia associated with chronickidneydisease: a comparison of efficacy and safety of different erythropoiesis-stimulating agents] Abdel–Kader Martín, L; Castillo Muñoz, MA; Ubago Pérez, R; Vega Coca, MD; Rodríguez López, R Record Status This is a bibliographic
Effects of intensive blood pressure lowering on the progression of chronickidneydisease: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Evaluation and management of chronickidneydisease: synopsis of the kidneydisease: improving global outcomes 2012 clinical practice guideline. 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.The KDIGO CKD Guideline Development Work Group defined the scope
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
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
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 The OSCAR study was a multicenter, prospective randomized open-label blinded end-point study of 1164 Japanese elderly hypertensive patients comparing the efficacy of angiotensin II receptor blocker (ARB) uptitration to an ARB plus calcium channel blocker (CCB (...) ) combination. In this prospective study, we performed prespecified subgroup analysis according to baseline estimated glomerular filtration rate (eGFR) 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
insufficiency. Internal Medicine Journal. 2004; 34: 50-7. 10. Dunstan DW, Zimmet PZ, Welborn TA et al, Diabetes and related disorders in Australia 2000., in International Diabetes Institute. 2001: Melbourne. 11. Chen J, Muntner P, Hamm LL et al. The metabolic syndrome and chronickidneydisease in U.S. adults. Annals of Internal Medicine. 2004; 140: 167-74. 12. McCullough PA. Cardiovascular risk reduction and preservation of renal function in the early nephropathy patient. Advances in ChronicKidneyDisease (...) 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
regularly audit 25-hydroxyvitamin D levels and vitamin D supplementation in their practices. The association of these practices with clinical outcomes, such as chronickidneydisease mineral and bone disorder (CKD-MBD), cardiovascular events and renal function decline, should be evaluated. BACKGROUND The current guideline is focused on vitamin D therapy in CKD stages 1-3. Vitamin D deficiency is not uncommon in the general and CKD populations[1, 2] Common factors causing low serum vitamin D levels (...) Vitamin D therapy (supplementation) in early chronickidneydisease ____________________________________________________________________________________________________________ Early ChronicKidneyDisease July 2012 Page 1 of 12 Vitamin D therapy (supplementation) in early chronickidneydisease Date written: July 2012 Author: Maria Chan, David Johnson GUIDELINES a. We suggest vitamin D deficiency (25-hydroxyvitamin D 70 years – 15 µg (600 IU) (where 1µg = 40 IU) Note: Few foods contain
et al. ChronicKidneyDisease and Drinking Status in Relation to Risks of Stroke and Its Subtypes. Stroke. 2011; 42: 2531-37. 14. Cheng T-YD, Wen S-F, Astor BC et al. Mortality risks for all causes and cardiovascular diseases and reduced GFR in a middle-aged working population in Taiwan. Am J Kidney Dis. 2008; 52: 1051-60. 15. Chien K-L, Hsu H-C, Lee Y-T et al. Renal function and metabolic syndrome components on cardiovascular and all-cause mortality. Atherosclerosis. 2008; 197: 860-67. 16. Deo R (...) and results Cohen et al (2007)  153 Cohort 92 Participants with CKD were recruited from the George Washington University Medical Centre Outpatient Clinic. 61Controls consisted of general medicine outpatients without CKD. NA 69% of patients with chronickidneydisease experienced pain; 55% had disordered sleep. Depression, burden of illness and life satisfaction were associated with pain. Depression, burden of disease, social support and frequency of pain were associated with disordered sleep