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Latest & greatest articles for chronic kidney disease
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ChronicKidneyDisease. The definition and classification of chronickidneydisease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m2, or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also (...) is measured either via exogenous markers (eg, DTPA, iohexol), or estimated using equations. Presence of proteinuria is associated with increased risk of progression of CKD and death. Kidney biopsy samples can show definitive evidence of CKD, through common changes such as glomerular sclerosis, tubular atrophy, and interstitial fibrosis. Complications include anaemia due to reduced production of erythropoietin by the kidney; reduced red blood cell survival and iron deficiency; and mineral bone disease
Metabolically Healthy Obesity and Development of ChronicKidneyDisease 27842407 2017 12 07 2018 12 02 1539-3704 165 10 2016 11 15 Annals of internal medicine Ann. Intern. Med. Metabolically Healthy Obesity and Development of ChronicKidneyDisease. 743 10.7326/L16-0407 Kahn Henry S HS From Centers for Disease Control and Prevention, Atlanta, Georgia. Pavkov Meda E ME From Centers for Disease Control and Prevention, Atlanta, Georgia. eng CC999999 Intramural CDC HHS United States Journal Article (...) Comment United States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2016 Mar 1;164(5):305-12 26857595 Ann Intern Med. 2016 Nov 15;165(10 ):744-745 27842405 Body Mass Index Humans Obesity Obesity, Metabolically Benign Renal Insufficiency, Chronic 2016 11 15 6 0 2016 11 15 6 0 2017 12 8 6 0 ppublish 27842407 2582915 10.7326/L16-0407 PMC5308792 NIHMS848359 Int J Obes (Lond). 2016 May;40(5):883-6 26841729 PLoS One. 2016 Jan 05;11(1):e0146057 26731527 Ann Intern Med. 2016 Mar 1;164(5):305-12
Sarcopenia, Obesity, and Mortality in US Adults With and Without ChronicKidneyDisease In pre-dialysis chronickidneydisease (CKD), the association of muscle mass with mortality is poorly defined, and no study has examined outcomes related to the co-occurrence of low muscle mass and excess adiposity (sarcopenic-obesity). Methods: We examined abnormalities of muscle and fat mass in adult participants of the National Health and Nutrition Examination Survey 1999-2004. We determined whether
Downregulation of AdipoR1 is Associated with increased Circulating Adiponectin Levels in Serbian ChronicKidneyDisease Patients Since the rise in plasma adiponectin levels in chronickidneydisease (CKD) patients has not yet been elucidated, we sought to investigate if patients on hemodialysis (HD) have altered expression of adiponectin receptors in peripheral blood mononuclear cells (PBMCs) compared to healthy subjects.This study included 31 patients with chronickidneydisease on HD and 33
Hypertension Control, Apparent Treatment Resistance, and Outcomes in the Elderly Population With ChronicKidneyDiseaseChronickidneydisease (CKD) is often associated with poor hypertension control and treatment resistance, but whether CKD modifies the effect of hypertension control on outcomes is unknown.We studied 10-year mortality and cardiovascular events according to hypertension control status and CKD (glomerular filtration rate <60 ml/min/1.73m2) in 4262 community-dwelling individuals
Tackling the Fallout From ChronicKidneyDisease of Unknown Etiology: Why We Need to Focus on Providing Peritoneal Dialysis in Rural, Low-Resource Settings 29142936 2018 11 13 2468-0249 2 1 2017 Jan Kidney international reports Kidney Int Rep Tackling the Fallout From ChronicKidneyDisease of Unknown Etiology: Why We Need to Focus on Providing Peritoneal Dialysis in Rural, Low-Resource Settings. 1-4 10.1016/j.ekir.2016.10.004 Nanayakkara Nishanthe N Department of Medicine, Teaching Hospital (...) , Kandy, Sri Lanka. Wazil A W M AWM Department of Medicine, Teaching Hospital, Kandy, Sri Lanka. Gunerathne Lishanthe L Department of Medicine, Renal Care and Research Unit, Girandurukotte, Sri Lanka. Dickowita Sewmini S Department of Medicine, Teaching Hospital, Kandy, Sri Lanka. Rope Robert R Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA. Ratnayake Charaka C Department of Medicine, Teaching Hospital, Kandy, Sri Lanka. Saxena Anjali
Timely Referral to Outpatient Nephrology Care Slows Progression and Reduces Treatment Costs of ChronicKidneyDiseases We present a new approach to evaluate the importance of ambulatory nephrology care in patients with chronickidneydisease (CKD).An anonymized health claims database of German insurance companies was searched in a retrospective analysis for patients with CKD using the codes of the International Classification of Diseases, 10th German modification. A total of 105,219 patients (...) with CKD were identified. Patients were assigned to the group "timely referral," when nephrology care was present in the starting year 2009, or initiated during the following 3 years in CKD1-4. Using frequency matching for age and gender, 21,024 of the late referral group were matched with the equal number of patients in the timely referral group. Hospital admission rates, total treatment costs, and kidney function (change in CKD stages, start of dialysis, mortality) were documented each year during
Interventions for chronickidneydisease in people with sickle cell disease. This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of any intervention in preventing or reducing kidney complications or CKD in people with SCD (including red blood cell transfusions, hydroxyurea and ACEI (either alone or in combination with each other)).
The Green Tea Polyphenol(â€”)-epigallocatechin-3-gallate and its beneficial roles in chronickidneydiseaseChronickidneydisease (CKD), a condition that affects around 10% of the population, has become a significant public health concern. Current therapeutic strategies to slow down the progression of CKD remain limited. Thus, it is urgent to develop new strategies to manage the patients with CKD. Work within the past decade has improved our understanding of the mechanisms contributing to CKD (...) . In particular, oxidative stress as well as inflammation appears to play a pivotal role in CKD progression. ()-Epigallocatechin-3-gallate (EGCG), the major catechin of green tea extract, is known as a powerful antioxidant and reactive oxygen species scavenger. Various studies have shown EGCG has a potential role in chronickidneydisease models. It is suggested that EGCG modulates cellular and molecular mechanisms via inflammation-related NF-кB and Nrf2 signaling pathway, as well as apoptosis-related ER
Depression in ChronicKidneyDisease and End-Stage RenalDisease: Similarities and Differences in Diagnosis, Epidemiology, andÂ Management Depression is highly prevalent and is associated with poor quality of life and increased mortality among adults with chronickidneydisease (CKD), including those with end-stage renaldisease (ESRD). However, there are several important differences in the diagnosis, epidemiology, and management of depression between patients with non-dialysis-dependent CKD
Evaluation of Renal Blood Flow in ChronicKidneyDisease Using Arterial Spin Labeling Perfusion Magnetic Resonance Imaging Chronickidneydisease (CKD) is known to be associated with reduced renal blood flow. However, data to-date in humans is limited.In this study, non-invasive arterial spin labeling (ASL) MRI data was acquired in 33 patients with diabetes and stage-3 CKD, and 30 healthy controls.A significantly lower renal blood flow both in cortex (108.4±36.4 vs. 207.3±41.8; p<0.001, d=2.52 (...) to separate healthy and CKD was estimated to be Cor_BF=142.9 and Med_BF=24.1.These results support the use of ASL in the evaluation of renal blood flow in patients with moderate level of CKD. Whether these measurements can identify subjects at risk of progressive CKD requires further longitudinal follow-up.
Iron (III) isomaltoside 1000 (Diafer) - iron deficiency in adults with chronickidneydisease (CKD) on dialysis 1 Published 13 February 2017 Re-submission iron III isomaltoside 1000 (contains 50mg iron per mL) (Diafer ® ), solution for injection SMC No. (1177/16) Pharmacosmos UK Limited 13 January 2017 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in Scotland (...) . The advice is summarised as follows: ADVICE: following a resubmission iron III isomaltoside 1000 5% (Diafer ® ) is accepted for use within NHS Scotland. Indication under review: For the treatment of iron deficiency in adults with chronickidneydisease (CKD) on dialysis, when oral iron preparations are ineffective or cannot be used. Iron III isomaltoside 1000 at a higher (10%) concentration has been shown to be non-inferior to another intravenous iron product in maintaining haemoglobin concentration
Efficacy of Folic Acid Therapy on the Progression of ChronicKidneyDisease: The Renal Substudy of the China Stroke Primary Prevention Trial The efficacy of folic acid therapy on renal outcomes has not been previously investigated in populations without folic acid fortification.To test whether treatment with enalapril and folic acid is more effective in slowing renal function decline than enalapril alone across a spectrum of renal function at baseline from normal to moderate chronickidney (...) was the progression of CKD, defined as a decrease in eGFR of 30% or more and to a level of less than 60 mL/min/1.73 m2 if the baseline eGFR was 60 mL/min/1.73 m2 or more, or a decrease in eGFR of 50% or more if the baseline eGFR was less than 60 mL/min/1.73 m2; or end-stage renaldisease. Secondary outcomes included a composite of the primary outcome and all-cause death, rapid decline in renal function, and rate of eGFR decline.Overall, 15 104 Chinese adults with a mean (range) age of 60 (45-75) years were
Lipidomic Signature of Progression of ChronicKidneyDisease in the ChronicRenal Insufficiency Cohort Human studies report conflicting results on the predictive power of serum lipids on progression of chronickidneydisease (CKD). We aimed to systematically identify the lipids that predict progression to end-stage kidney disease.From the ChronicRenal Insufficiency Cohort, 79 patients with CKD stage 2 to 3 who progressed to ESKD over 6 years of follow up were selected and frequency-matched
Relationship between occult hepatitis B virus infection and chronickidneydisease in a Chinese population-based cohort Previous studies have revealed inconsistent results regarding the association between occult hepatitis B virus (HBV) infection and chronickidneydisease (CKD). Therefore, we conducted a prospective cohort study to evaluate the association between occult HBV infection and CKD.A total of 4329 adults, aged 46.2 ± 13.7 years, without CKD at baseline were enrolled while undergoing (...) physical examinations. Occult HBV infection was defined as seropositivity for antibody to HBV core antigen. CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 ml·min-1·1.73 m-2) or presence of proteinuria ≥1+, assessed using a repeated dipstick method. eGFR was computed using the ChronicKidneyDisease Epidemiology Collaboration (CKD-EPI) equation.The prevalence of occult HBV infection was 8.1% (352/4329). During 5 years of follow-up, 165 patients (3.8%) developed CKD
Trends in Prevalence of ChronicKidneyDisease in the United States. Trends in the prevalence of chronickidneydisease (CKD) are important for health care policy and planning.To update trends in CKD prevalence.Repeated cross-sectional study.NHANES (National Health and Nutrition Examination Survey) for 1988 to 1994 and every 2 years from 1999 to 2012.Adults aged 20 years or older.Chronic kidneydisease (stages 3 and 4) was defined as an estimated glomerular filtration rate (eGFR) of 15 to 59 mL (...) /min/1.73 m2, estimated with the ChronicKidneyDisease Epidemiology Collaboration equation from calibrated serum creatinine measurements. An expanded definition of CKD also included persons with an eGFR of at least 60 mL/min/1.73 m2 and a 1-time urine albumin-creatinine ratio of at least 30 mg/g.The unadjusted prevalence of stage 3 and 4 CKD increased from the late 1990s to the early 2000s. Since 2003 to 2004, however, the overall prevalence has largely stabilized (for example, 6.9% prevalence
Association of Fibroblast Growth Factor 23 With Atrial Fibrillation in ChronicKidneyDisease, From the ChronicRenal Insufficiency Cohort Study Levels of fibroblast growth factor 23 (FGF23) are elevated in chronickidneydisease (CKD) and strongly associated with left ventricular hypertrophy, heart failure, and death. Whether FGF23 is an independent risk factor for atrial fibrillation in CKD is unknown.To investigate the association of FGF23 with atrial fibrillation in CKD.Prospective cohort (...) study of 3876 individuals with mild to severe CKD who enrolled in the ChronicRenal Insufficiency Cohort Study between June 19, 2003, and September 3, 2008, and were followed up through March 31, 2013.Baseline plasma FGF23 levels.Prevalent and incident atrial fibrillation.The study cohort comprised 3876 participants. Their mean (SD) age was 57.7 (11.0) years, and 44.8% (1736 of 3876) were female. Elevated FGF23 levels were independently associated with increased odds of prevalent atrial fibrillation
Implantation of Autologous Selected Renal Cells in Diabetic ChronicKidneyDisease Stages 3 and 4â€”Clinical Experience of a â€œFirst in Humanâ€ Study Animal models of chronickidneydisease demonstrate that a redundant population of therapeutically bioactive selected renal cells (SRCs) can be delivered to the kidney through intraparenchymal injection and arrest disease progression. Direct injection of SRCs has been shown to attenuate nuclear factor-κB, which is known to drive tissue (...) inflammation, as well as the transforming growth factor-β-mediated plasminogen activator inhibitor-1 response that drives tissue fibrosis.We present experience from the first-in-human clinical study with SRCs. Seven male type 2 diabetic patients (63 ± 2 years of age) with chronickidneydisease stage 3 to 4 (estimated glomerular filtration rate 25 ± 2 ml/min) were recruited. After blood and urine sampling, iohexol clearance, magnetic resonance imaging, and renal scintigraphy, patients underwent ultrasound
Grape seed powder improves renal failure of chronickidneydisease patients Chronickidneydisease (CKD) is a syndrome characterized by progressive and irreversible deterioration of renal function linked to slow destruction of renal parenchyma, eventually terminating in death when sufficient number of nephrons are damaged. Oxidative stress is commonly observed in CKD patients resulting from an imbalance between overproduction of reactive oxygen species (ROS) and impairment of defence mechanisms (...) . Grape seed extract (GSE) is a polyphenolic mixture exhibiting antioxidant and anti-inflammatory properties. We conducted an interventional pilot study of supplementation with GSE capsules (GSE group, n = 23) or placebo (control group, n = 10) on CKD patients. Blood and urine samples were collected at baseline and after a six-month-long supplementation period to determine some renal function biomarkers, as well as antioxidant, anti-inflammatory and haematological parameters. GSE improved glomerular