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Latest & greatest articles for chronic kidney disease
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on chronic kidney disease or other clinical topics then use Trip today.
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Effects of lower versus higher phosphate diets on fibroblast growth factor-23 levels in patients with chronickidneydisease: a systematic review and meta-analysis. Elevated fibroblast growth factor-23 (FGF23) levels increase the risk of cardiovascular diseases in patients with chronickidneydisease (CKD). We aimed to compare the effects of different dietary interventions, lower versus higher phosphate levels, on FGF23 in patients with CKD.We conducted electronic literature searches of Medline (...) the C-terminal FGF23 assay (SMD -0.05, 95% CI -0.67 to 0.57).Short-term dietary phosphate restriction tends to reduce FGF23 levels in patients with moderately decreased kidney function, and the FGF23-lowering effects tend to be more prominent when measured with the intact FGF23 assay.
Cinacalcet for Treatment of ChronicKidneyDisease-Mineral and Bone Disorder: A Meta-Analysis of Randomized Controlled Trials. Cinacalcet could decrease serum calcium, phosphate, and parathyroid hormone (PTH) in previous meta-analyses. However, the effect of cinacalcet on the new biomarkers such as fibroblast growth factor-23 (FGF-23), bone markers, and vascular calcification are still unestablished. We conducted a meta-analysis to examine the effects of cinacalcet on all laboratory (...) and clinical spectrums of chronickidneydisease-mineral bone disorders (CKD-MBD).A systematic literature search was conducted in MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov to identify randomized controlled trials (RCTs) comparing the effect of cinacalcet relative to standard treatment on CKD-MBD surrogate markers and clinical outcomes. Random-effect models were used to compute the weighted mean difference for continuous variables and the risk ratio for binary
A systematic review of direct oral anticoagulant use in chronickidneydisease and dialysis patients with atrial fibrillation. There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronickidneydisease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin.We conducted a systematic review
Characterizing Cardiac Involvement in ChronicKidneyDisease Using CMR-a Systematic Review. The aim of the review was to identify and describe recent advances (over the last 3 years) in cardiac magnetic resonance (CMR) imaging in patients with chronickidneydisease (CKD). We conducted a literature review in line with current guidelines.The authors identified 22 studies. Patients with CKD had left ventricular global and regional dysfunction and adverse remodeling. Stress testing with CMR (...) revealed a reduced stress-response in CKD patients. Native T1 relaxation times (as a surrogate markers of fibrosis) are elevated in CKD patients, proportional to disease duration. Patients with CKD have reduced strain magnitudes and reduced aortic distensibility.CMR has diagnostic utility to identify and characterize cardiac involvement in this patient group. A number of papers have described novel findings over the last 3 years, suggesting that CMR has potential to become more widely used in studies
kidney injury (AKI). A small, but significant, number of cases progress to end-stage renaldisease (ESRD) requiring dialysis or kidney transplant, which carries a major personal, social, and economic burden. Historically, CKD was considered to be a condition to be managed primarily by specialists. However, the introduction of laboratory reporting of the estimated glomerular filtration rate (eGFR) alongside serum creatinine values has improved the identification of people with CKD in primary care (...) to be considered when dosing patients with renal impairment? Medicines Q&A 167.6. February 2016. https://www.sps.nhs.uk/articles/what-factors-need-to-be-considered-when- dosing-patients-with-renal-impairment-2/. Accessed 2 May 2017. 9. Webster AC et al. ChronicKidneyDisease. Lancet 2016; 389(10075): 1238-1252. 10. Anonymous. Sick day rules in kidneydisease. Drug and Therapeutics Bulletin April 2015; 53(4) 11. National Institute for Health and Care Excellence. Acute kidney injury: prevention, detection
Use of the Kidney Failure Risk Equation to Determine the Risk of Progression to End-stage RenalDisease in Children With ChronicKidneyDisease The kidney failure risk equation (KFRE) has been shown to accurately estimate progression to kidney failure in adults with chronickidneydisease (CKD). Use of the KFRE in children with CKD, if accurate, would help to optimize planning for end-stage renaldisease (ESRD) care.To determine whether the KFRE adequately discriminates the risk of ESRD (...) in children with CKD.This retrospective cohort study included 603 children with an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2 in the ChronicKidneyDisease in Children study, a national multicenter observational study. Data were collected from January 1, 2005, through July 31, 2013, and analyzed from September 30, 2016, through September 8, 2017.The primary predictive factors were the 4-variable (age, sex, bedside Schwartz estimated glomerular filtration rate, and ratio of albumin
Multiple-frequency bioimpedance devices for fluid management in people with chronickidneydisease receiving dialysis: a systematic review and economic evaluation Multiple-frequency bioimpedance devices for fluid management in people with chronickidneydisease receiving dialysis: a systematic review and economic evaluation Multiple-frequency bioimpedance devices for fluid management in people with chronickidneydisease receiving dialysis: a systematic review and economic evaluation Scotland G (...) , Cruickshank M, Jacobsen E, Cooper D, Fraser C, Shimonovich M, Marks A & Brazzelli M 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 Scotland G, Cruickshank M, Jacobsen E, Cooper D, Fraser C, Shimonovich M, Marks A & Brazzelli M. Multiple-frequency bioimpedance devices for fluid management in people with chronickidneydisease receiving dialysis
Cost-Effectiveness of First-Line Sevelamer and Lanthanum versus Calcium-Based Binders for Hyperphosphatemia of ChronicKidneyDisease. Phosphate binders are used to treat hyperphosphatemia among patients with chronickidneydisease (CKD).To conduct an economic evaluation comparing calcium-free binders sevelamer and lanthanum with calcium-based binders for patients with CKD.Effectiveness data were obtained from a recent meta-analysis of randomized trials. Effectiveness was measured as life-years
Efficacy of febuxostat in hyperuricemic patients with mild-to-moderate chronickidneydisease: a meta-analysis of randomized clinical trials: A PRISMA-compliant article. To investigate the efficacy of febuxostat in hyperuricemic patients with chronickidneydisease (CKD), relevant randomized clinical trials (RCTs) were analyzed.We used PubMed, Medline, ISI Web of Science, CBMdisc, and Cochrane Library databases to conduct a systematic literature research. A fixed-effects model was used
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
Cinacalcet versus Placebo for secondary hyperparathyroidism in chronickidneydisease patients: a meta-analysis of randomized controlled trials and trial sequential analysis. To assess the efficacy and safety of cinacalcet on secondary hyperparathyroidism in patients with chronickidneydisease, Pubmed, Embase, and the Cochrane Central Register of Controlled Trials were searched until March 2016. Trial sequential analysis (TSA) was conducted to control the risks of type I and II errors (...) = 8388, n = 6116). Cinacalcet did not significantly reduce the incidence of fractures (RR = 0.58, 95% CI = 0.21-1.59, P = 0.29, TSA-adjusted 95% CI = 0.01-35.11, RIS = 76376, n = 4053). Cinacalcet reduced the incidence of parathyroidectomy, however, it did not reduce all-cause and cardiovascular mortality, and increased the risk of adverse events including hypocalcemia and gastrointestinal disorders.
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
Quality of Life of patients with chronickidneydisease in Iran: Systematic Review and Meta-analysis. Renaldiseases are among the major health problems around the world that cause major changes in patients' lifestyle and affect their quality of lives. The aim of this study was to evaluate the quality of life of patients with chronickidneydisease (CKD) in Iran through a meta-analysis.This study was conducted using authentic Persian and English keywords in the national and international (...) databases including IranMedex, SID, Magiran, IranDoc, Medlib, Science Direct, Pubmed, Scopus, Cochrane, Embase, Web of Science, and Medline. The data were analyzed using meta-analysis (random effects model). Heterogeneity of studies was assessed using I2 index. In this study, SF-36: 36-Item Short Form health-related quality of life (HRQOL), kidneydisease quality of life-SF (KDQOL-SF), KDQOL and KDQOL-SFTM questionnaires were used. Data were analyzed using STATA Version 11 software.A total of 17200
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
Betel nut chewing and the risk of chronickidneydisease: evidence from a meta-analysis. To investigate and quantify the potential association between betel nut chewing and the risk of chronickidneydisease (CKD).We searched five online databases including PubMed, EMBASE, ISI Web of Science, Wanfang and CNKI to identify observational studies that published prior to May, 1, 2017. The primary outcome was the association between betel nut chewing and CKD expressed as odds ratio
Person-Centered Integrated Care for ChronicKidneyDisease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. The effectiveness of person-centered integrated care strategies for CKD is uncertain. We conducted a systematic review and meta-analysis of randomized, controlled trials to assess the effect of person-centered integrated care for CKD.We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (from inception to April of 2016), and selected (...) quality of life (standardized mean difference, 0.02; 95% CI, -0.05 to 0.10). The effects on renal replacement therapy (RRT) (RR, 1.00; 95% CI, 0.65 to 1.55), serum creatinine levels (mean difference, 0.59 mg/dl; 95% CI, -0.38 to 0.36), and eGFR (mean difference, 1.51 ml/min per 1.73 m2; 95% CI, -3.25 to 6.27) were very uncertain. Quantitative analysis suggested that person-centered integrated care interventions may reduce all-cause hospitalization (RR, 0.38; 95% CI, 0.15 to 0.95) and improve BP
Lipid Management in ChronicKidneyDisease: Systematic Review of PCSK9 Targeting. Cardiovascular disease is the leading cause of death in patients with chronickidneydisease (CKD) and CKD is considered a coronary artery disease risk equivalent. So far, statins have been the mainstay of primary and secondary prevention of cardiovascular disease in the general population. However, their benefit on outcomes is limited and controversial in CKD patients and new therapeutic approaches to reduce (...) COMBO II studies demonstrated significant superiority of alirocumab on LDL-cholesterol lowering in comparison to placebo and ezetimibe, respectively, when added to statins, and case reports have shown efficacy in nephrotic syndrome. A detailed analysis of CKD subgroups in general population trials of anti-PCSK9 strategies addressing events is needed, given the limited efficacy of statins in CKD both in terms of lipid lowering and events, the high rate of statin non-compliance in these patients
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