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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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Adherence to medication in patients with chronickidneydisease: a systematic review of qualitative research Non-adherence to multipharmacological treatment increases the risk of morbidity, mortality and hospitalization. We know little about the perspective of patients with chronickidneydisease regarding factors influencing medicine taking. This study aimed to synthesize findings from qualitative studies of patients' experiences of factors that facilitate and hinder adherence to medication (...) . A systematic review of qualitative studies adhering to the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework. Systematic searches were conducted in several databases. We used thematic synthesis and the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach to assess the confidence of the evidence. Nineteen studies involving 381 patients with chronickidneydisease were included. We identified three analytical themes; logistics
What do epidemiological studies tell us about chronickidneydisease of undetermined cause in Meso-America? A systematic review and meta-analysis The aim of this systematic review is to examine the epidemiological knowledge and gaps in understanding of the potential causes of chronickidneydisease of undetermined cause (CKDu) in Meso-America.A systematic literature search of epidemiological studies of CKDu was conducted in PubMed, Embase and Web of Science from January 2000 to January 2017
Comparison of vegetarian versus animal-based low protein diets on estimated glomerular filtration rates in chronickidneydisease patients: a systematic review protocol. The objective of this review is to evaluate studies to determine the effect of a low-protein, vegetarian diet as compared to a low-protein, animal-based diet on estimated glomerular filtration rates (eGFR) in adults with chronickidneydisease (CKD).
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
Telehealth for the management of blood pressure in patients with chronickidneydisease: A systematic Review. Most patients with chronickidneydisease (CKD) fail to achieve blood pressure (BP) management as recommended. Meanwhile, the effects of promising intervention and telehealth on BP control in CKD patients remain unclear. We aimed to evaluate the efficacy of telehealth for BP in CKD non-dialysis patients.Databases including MEDLINE, EMBASE, CENTRAL, CNKI, Wanfang, VIP and CBM were
Association of serum sodium and risk of all-cause mortality in patients with chronickidneydisease: A meta-analysis and sysematic review. Studies on the association of dysnatraemia with all-cause mortality risk in chronickidneydisease (CKD) patients have yielded inconsistent results. This meta-analysis aimed to evaluate the association of hyponatremia or hypernatremia with all-cause mortality risk in CKD patients. An electronic literature search was performed in Web of Science, Pubmed
Health literacy and patient outcomes in chronickidneydisease: a systematic review. Limited health literacy affects 25% of people with chronickidneydisease (CKD), and may reduce self-management skills resulting in poorer clinical outcomes. By disproportionately affecting people with low socio-economic status and non-white ethnicity, limited health literacy may promote health inequity.We performed a systematic review of quantitative studies of health literacy and clinical outcomes among
Models of care for chronickidneydisease: a systematic review. Chronickidneydisease (CKD) is common and presents an increasing burden to patients and health services. However, the optimal model of care for patients with CKD is unclear. We systematically reviewed the clinical effectiveness of different models of care for the management of CKD.A comprehensive search of eight databases was undertaken for articles published from 1992 to 2016. We included randomized controlled trials (...) that assessed any model of care in the management of adults with pre-dialysis CKD, reporting renal, cardiovascular, mortality and other outcomes. Data extraction and quality assessment was carried out independently by two authors.Results were summarized narratively. Nine articles (seven studies) were included. Four models of care were identified: nurse-led, multidisciplinary specialist team, pharmacist-led and self-management. Nurse and pharmacist-led care reported improved rates of prescribing of drugs
Challenges associated with the management of gouty arthritis in patients with chronickidneydisease: a systematic review. As many as half of all patients with gouty arthritis have some degree of renal impairment. The goal of this systematic review is to provide physicians with a comprehensive examination of available data on the risks and benefits of gouty arthritis treatment options when used in patients with chronickidneydisease (CKD).We conducted a systematic literature review (...) to determine what information is available to guide treatment decisions in this patient population. PubMed was searched for English-language articles indexed through July 2011 containing the terms "gout" or "hyperuricemia" and synonyms for renal impairment in combination with drug names. Publications were deemed relevant if they reported results from clinical studies, case reports, or prescribing practices of the drug of interest in patients with gouty arthritis and CKD.Nonsteroidal anti-inflammatory drugs
Prognostic effect of high-flux hemodialysis in patients with chronickidneydisease. We investigated the prognostic effects of high-flux hemodialysis (HFHD) and low-flux hemodialysis (LFHD) in patients with chronickidneydisease (CKD). Both an electronic and a manual search were performed based on our rigorous inclusion and exclusion criteria to retrieve high-quality, relevant clinical studies from various scientific literature databases. Comprehensive meta-analysis 2.0 (CMA 2.0) was used
Cardiovascular disease, chronickidneydisease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment. High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronickidneydisease and diabetes. We estimated mortality from cardiovascular diseases, chronickidneydisease, and diabetes that was attributable to these four cardiometabolic (...) of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates.In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronickidneydisease, and diabetes
Nonalcoholic Fatty Liver Disease Increases Risk of Incident ChronicKidneyDisease: a Systematic Review and Meta-Analysis. Recent studies examined the prognostic impact of nonalcoholic fatty liver disease (NAFLD) on the risk of incident chronickidneydisease (CKD). However, the extent to which NAFLD may confer risk of incident CKD is uncertain. We performed a meta-analysis of relevant studies to quantify the magnitude of the association between NAFLD and risk of incident CKD.We searched PubMed
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
The Safety of Erythropoiesis-Stimulating Agents for the Treatment of Anemia Resulting from ChronicKidneyDisease. Chronickidneydisease (CKD) anemia treatment was revolutionized in the late 1980s with the introduction of recombinant human erythropoietin. This and related erythropoiesis-stimulating agents (ESAs) greatly benefited patients by decreasing debilitating symptoms, improving their quality of life, and freeing them from dependence on blood transfusions with their associated (...) complications such as infections, sensitization impeding transplantation, and secondary iron overload. However, even in the initial studies, untoward effects were noted in patients receiving ESAs, including worsening hypertension, seizures, and dialysis access clotting. Later, increased mortality, malignancy progression and even stroke were reported in renal patients. This review focuses on the safety issues of ESAs in CKD patients.
mortality and/or delay ESKD in patients with diabetes and chronickidneydisease (CKD) stages 3-5. In this subgroup, there might be an expedited need for renal replacement therapy (RRT) when RAAS-blocking agents are used. We conducted a meta-analysis of randomized controlled trials (RCTs) of at least 6-months duration in adult patients with diabetes who also have non-dialysis CKD stages 3-5. RCTs comparing single RAAS-blocking agents to placebo or alternative antihypertensive agents were included (...) Effect of renin-angiotensin-aldosterone system blockade in adults with diabetes mellitus and advanced chronickidneydisease not on dialysis: a systematic review and meta-analysis. The presumed superiority of renin-angiotensin-aldosterone system (RAAS)-blocking agents over other antihypertensive agents in patients with diabetes to delay development of end-stage kidneydisease (ESKD) has recently been challenged. In addition, there is ongoing uncertainty whether RAAS-blocking agents reduce
Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronickidneydisease. Chronickidneydisease (CKD) is an independent risk factor for atrial fibrillation (AF), which is more prevalent among CKD patients than the general population. AF causes stroke or systemic embolism, leading to increased mortality. The conventional antithrombotic prophylaxis agent warfarin is often prescribed for the prevention of stroke (...) , but risk of bleeding necessitates regular therapeutic monitoring. Recently developed direct oral anticoagulants (DOAC) are expected to be useful as alternatives to warfarin.To assess the efficacy and safety of DOAC including apixaban, dabigatran, edoxaban, and rivaroxaban versus warfarin among AF patients with CKD.We searched the Cochrane Kidney and Transplant Specialised Register (up to 1 August 2017) through contact with the Information Specialist using search terms relevant to this review. Studies
The Association of Serum Free Light Chains With Mortality and Progression to End-Stage RenalDisease in ChronicKidneyDisease: Systematic Review and Individual Patient Data Meta-analysis. To clarify the associations between polyclonal serum free light chain (sFLC) levels and adverse outcomes in patients with chronickidneydisease (CKD) by conducting a systematic review and individual patient data meta-analyses.On December 28, 2016, we searched 4 databases (MEDLINE, Embase, CINAHL, and PubMed (...) ) and conference proceedings for studies presenting independent analyses of associations between sFLC levels and mortality or progression to end-stage renaldisease (ESRD) in patients with CKD. Study quality was assessed in 5 domains: sample selection, measurement, attrition, reporting, and funding.Five prospective cohort studies were included, judged moderate to good quality, involving 3912 participants in total. In multivariable meta-analyses, sFLC (kappa+lambda) levels were independently associated
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
Effects of uric acid-lowering therapy in patients with chronickidneydisease: A meta-analysis. The effects of uric acid-lowering therapy in patients with chronickidneydisease (CKD) remain uncertain. Therefore, we undertook a systematic review and meta-analysis to investigate the effects of uric acid-lowering agents on major clinical outcomes of CKD.According to the pre-specified protocol that was registered with PROSPERO (No. CRD42016038030), we searched systematically in MEDLINE, EMBASE (...) , and the Cochrane Library for trials up to February 2016. Prospective, randomized, controlled trials assessing the effects of uric acid-lowering agents on cardiovascular and kidney outcomes in patients with CKD were included. Random-effects analytical methods were used.Sixteen eligible trials were identified, providing data for 1,211 patients with CKD, including 146 kidney failure events and 69 cardiovascular events. Uric acid-lowering therapy produced a 55% relative risk (RR) reduction (95% confidence interval