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BMC Nephrology

Dino Gibertoni, Paola Rucci, Marcora Mandreoli, Mattia Corradini, Davide Martelli, Giorgia Russo, Elena Mancini, Antonio Santoro
BACKGROUND: A classification tree model (CT-PIRP) was developed in 2013 to predict the annual renal function decline of patients with chronic kidney disease (CKD) participating in the PIRP (Progetto Insufficienza Renale Progressiva) project, which involves thirteen Nephrology Hospital Units in Emilia-Romagna (Italy). This model identified seven subgroups with specific combinations of baseline characteristics that were associated with a differential estimated glomerular filtration rate (eGFR) annual decline, but the model's ability to predict mortality and renal replacement therapy (RRT) has not been established yet...
May 17, 2019: BMC Nephrology
Bodil Jahren Hjemås, Katrine Bøvre, Liv Mathiesen, Jonas Christoffer Lindstrøm, Kathrin Bjerknes
BACKGROUND: Adherence to phosphate binder treatment is important to prevent high serum phosphate level in chronic dialysis patients. We therefore wanted to investigate patient knowledge, beliefs about and adherence to phosphate binders among these patients and assess whether one-to-one pharmacist-led education and counselling enhance adherence and lead to changes in serum phosphate levels. METHODS: A descriptive, interventional, single arm, pre-post study was performed at a hospital in Norway, including chronic dialysis patients aged 18 years or more using phosphate binders...
May 17, 2019: BMC Nephrology
Jochen G Raimann, Samer R Abbas, Li Liu, Brett Larive, Gerald Beck, Peter Kotanko, Nathan W Levin, Garry Handelman
BACKGROUND: Reports on vitamin C in HD patients have shown effects of vitamin C deficiency in association with scurvy symptoms. Dialyzability of water soluble vitamins is high, and substantial losses in those who are dialyzed more frequently were hypothesized. The randomized FHN Daily Trial compared the effects of in-center HD six versus three times per week. We studied baseline correlations between vitamin C and potentially associated parameters, and the effect of more frequent HD on circulating vitamin C concentrations...
May 17, 2019: BMC Nephrology
Prakriti Shrestha, Christine E Haugen, Nadia M Chu, Ashton Shaffer, Jacqueline Garonzik-Wang, Silas P Norman, Jeremy D Walston, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: Inflammation is more common among African Americans (AAs), and it is associated with frailty, poor physical performance, and mortality in community-dwelling older adults. Given the elevated inflammation levels among end-stage renal disease (ESRD) patients, inflammation may be associated with adverse health outcomes such as frailty, physical impairment, and poor health-related quality of life (HRQOL), and these associations may differ between AA and non-AA ESRD patients. METHODS: One thousand three ESRD participants were recruited at kidney transplant evaluation (4/2014-5/2017), and inflammatory markers (interleukin-6 [IL-6], tumor necrosis factor-a receptor-1 [TNFR1], C-reactive protein [CRP]) were measured...
May 17, 2019: BMC Nephrology
Yiting Wang, Feng Chen, Jiali Wang, Yingwang Zhao, Fang Liu
BACKGROUND: Nephronophthisis (NPHP) is an autosomal recessive hereditary disease with highly variable clinical characteristics for which 20 genes (NPHP1-20) have been identified. NPHP1 is the major subtype leading to pediatric end-stage renal disease (ESRD). Reports of adult NPHP1 are rare. CASE PRESENTATION: Here, we report a 27-year-old male from a Chinese intermarriage family who was diagnosed as NPHP from clinical presentations and molecular genetic analysis by whole-exome sequencing...
May 16, 2019: BMC Nephrology
Ann-Kathrin Lederer, Dominic Haffa, Philipp Felgendreff, Frank Makowiec, Stefan Fichtner-Feigl, Roman Huber, Lampros Kousoulas
BACKGROUND: Physicians are faced with a growing number of patients after renal transplantation undergoing graft-unrelated surgery. So far, little is known about the postoperative restitution of graft function and the risk factors for a poor outcome. METHODS: One hundred one kidney transplant recipients undergoing graft-unrelated surgery between 2005 and 2015 were reviewed retrospectively. A risk analysis was performed and differences in creatinine, GFR and immunosuppressive treatment were evaluated...
May 16, 2019: BMC Nephrology
Emily L Tucker, Abigail R Smith, Mark S Daskin, Hannah Schapiro, Sabrina M Cottrell, Evelyn S Gendron, Peg Hill-Callahan, Alan B Leichtman, Robert M Merion, Stephen J Gill, Kayse Lee Maass
BACKGROUND: The effect of a kidney transplant on a recipient extends beyond the restoration of kidney function. However, there is limited qualitative analysis of recipient perspectives on life following transplantation, particularly in the United States. To understand the full patient experience, it is necessary to understand recipient views on life adjustments after kidney transplantation, medical management, and quality of life. This could lead to improvements in recipient care and sense of well-being...
May 16, 2019: BMC Nephrology
Ashish Kataria, Madan Gowda, Brian Paul Lamphron, Kabir Jalal, Rocco C Venuto, Aijaz A Gundroo
BACKGROUND: Increased morbidity and mortality are well documented in Status 7(inactive list) patients. Delays in transplantation secondary to prolonged periods on inactive status also negatively impacts transplant outcomes. We developed an effective system to reduce the proportion of status 7 patients on our kidney transplant waitlist. This can easily be reproduced by other transplant centers since concerns about Status 7 list size are commonplace. METHODS: Meetings of a dedicated status 7 focus group were undertaken biweekly beginning in April 2016, each lasting for 1 hour or less...
May 16, 2019: BMC Nephrology
Yoshifumi Moriyama, Masahiko Hara, Sae Aratani, Hideaki Ishikawa, Kenichi Kono, Masatake Tamaki
BACKGROUND: Reduced muscle strength and physical performance are prevalent in patients of maintenance hemodialysis (MHD), and deleterious changes in these parameters are associated with increased mortality. METHODS: This retrospective observational study included 306 patients, who received a 6-month resistance exercise program during hemodialysis, three times per week on an outpatient basis. The training protocol consisted of two sets of 10 repetitions of knee extension, hip abduction, and hip flexion, using an elastic band in a sitting or supine position...
May 16, 2019: BMC Nephrology
Michael Blankenburg, Anne-Kathrin Fett, Seline Eisenring, Gabriele Haas, Alain Gay
BACKGROUND: Steroidal mineralocorticoid receptor antagonists (MRAs) are recommended for the treatment of heart failure (HF) and resistant hypertension, both common comorbidities in patients with diabetes and chronic kidney disease (CKD). This study explored the clinical characteristics of, and steroidal MRA use in, patients with CKD with and without type 2 diabetes mellitus (T2D) and/or HF. METHODS: This retrospective cohort study used PharMetrics Plus US claims database data (October 2009-September 2014) to identify two patient populations aged ≥18 years with a first diagnosis of CKD or a first prescription for steroidal MRAs...
May 16, 2019: BMC Nephrology
L Caroti, C L Cirami, L Di Maria, A Larti, P Carta, E Dervishi, S Farsetti, A Tsalouchos, L Novelli, E E Minetti
BACKGROUND: Antineutrophil cytoplasmic antibody associated vasculitis (AAV) is a group of diseases associated in most cases with the presence of anti-neutrophil cytoplasmic antibodies (ANCAs). Rituximab- based remission induction has been proven effective in ANCA associated vasculitis but scarce data exist in forms with severe renal involvement. In this case series, we report the outcomes in patients with de novo or recurrent MPO-AAV and severe renal involvement treated with rituximab without cyclophosphamide (CYC)...
May 14, 2019: BMC Nephrology
Silje Småbrekke, Henrik Schirmer, Toralf Melsom, Marit Dahl Solbu, Bjørn Odvar Eriksen
BACKGROUND: Although the relationship between manifest chronic kidney disease and reduced cognitive function is well established, limited data exists on GFR and cognitive function in the general population. Both the brain and kidneys have low-impedance vascular beds, rendering them susceptible to damage from pulsatile blood flow. An association between mildly reduced GFR and cognitive function in the healthy general population may reveal early disease mechanisms underlying low-grade impairment of both organs as well as the possibility for intervention...
May 14, 2019: BMC Nephrology
Susan M Samuel, Allison Dart, Guido Filler, Martin Bitzan, Maury Pinsk, Cherry Mammen, Alberto Nettel-Aguirre, Maneka A Perinpanayagam, Tomoko Takano, Rahul Chanchlani, Michael Zappitelli
BACKGROUND: To assess reasons for continuing practice variation in the management of childhood nephrotic syndrome despite expert reviews and guidelines, we are conducting a longitudinal cohort study in children with glucocorticoid sensitive nephrotic syndrome. Objectives of this mid-study report are to describe patient and physician recruitment characteristics, glucocorticoid prescriptions, use of second line agents, biopsy practices, and adherence to study protocol. METHODS: Children with new onset nephrotic syndrome and providers are being recruited from all 12 pediatric nephrology centres across Canada with > 2½ years follow-up...
May 14, 2019: BMC Nephrology
Johanna Kuipers, Jurjen K Oosterhuis, Wolter Paans, Wim P Krijnen, Carlo A J M Gaillard, Ralf Westerhuis, Casper F M Franssen
BACKGROUND: There is increasing awareness that, besides patient survival, Quality of Life (QOL) is a relevant outcome factor for patients who have a chronic disease. In haemodialysis (HD) patients, intradialytic hypotension (IDH) is considered one of the most frequent complications, and this is often accompanied by symptoms. Several studies have investigated QOL in dialysis patients, however, research on the association between intradialytic symptoms and QOL is minimal. The goal of this study was to determine whether the occurrence of IDH has an influence on the perception of QOL...
May 14, 2019: BMC Nephrology
Stéphanie Clavé, Michel Tsimaratos, Mohamed Boucekine, Bruno Ranchin, Rémi Salomon, Olivier Dunand, Arnaud Garnier, Annie Lahoche, Marc Fila, Gwenaelle Roussey, Francoise Broux, Jérome Harambat, Sylvie Cloarec, Soraya Menouer, Georges Deschenes, Isabelle Vrillon, Pascal Auquier, Julie Berbis
BACKGROUND: To describe the quality of life of adolescents initiating haemodialysis, to determine the factors associated with quality of life, and to assess coping strategies and their impact on quality of life. METHODS: All adolescents initiating haemodialysis between September 2013 and July 2015 in French paediatric haemodialysis centres were included. Quality of life data were collected using the "Vécu et Santé Perçue de l'Adolescent et l'Enfant" questionnaire, and coping data were collected using the Kidcope questionnaire...
May 14, 2019: BMC Nephrology
Anja Gäckler, Sebastian Dolff, Hana Rohn, Johannes Korth, Benjamin Wilde, Ute Eisenberger, Anna Mitchell, Andreas Kribben, Oliver Witzke
BACKGROUND: The influence of pre- or postprandial administration on pharmacokinetics of cyclosporine is supposed to be less in gel-based formulations than in microemulsions. This study was designed to investigate the influence of a high-fat meal on the pharmacokinetic profile of the two cyclosporine containing formulations Ciclosporin Pro (gel-based emulsion) and Sandimmun®Optoral (microemulsion) in renal transplant recipients. METHODS: A randomized, open-label, repeated-measurement, comparative phase IV trial was conducted with two sequence groups for nutrition condition (fasting→fed, fed→fasting) and two treatment phases (Sandimmun® Optoral → Ciclosporin Pro), each covering both nutrition conditions...
May 14, 2019: BMC Nephrology
Bo Hyon Yun, Dong Jin Joo, Seok Kyo Seo, Si Hyun Cho, Young Sik Choi, Byung Seok Lee
BACKGROUND: Despite the good prognosis in patients with transplant organs, limited evidence is available on how immunosuppressants affect pregnancy. The aim of this study was to determine whether immunosuppressant use affects the pregnancy outcome and to identify whether there is any need to change the immunosuppressant before the patient tries to conceive. METHODS: This retrospective cohort study included women with previous kidney transplantation history who visited the Department of Obstetrics and Gynecology for either infertility or antenatal care between January 2005 and May 2016...
May 14, 2019: BMC Nephrology
Yingjing Shen, Peipei Fei
BACKGROUND: Hypercalcemia crisis is a complex disorder rarely induced by tertiary hyperparathyroidism, which clinically presents as nonsuppressible parathyroid hyperplasia with persistent increased PTH levels and hypercalcemia. It is one of the major risk factors of morbidity and mortality in end-stage renal disease. Parathyroidectomy should be in consideration in dialysis patients with severe hyperparathyroidism who are refractory to medical therapy. The implications and consequences of it, however, are not fully understood...
May 14, 2019: BMC Nephrology
Atsuko Uehara, Tomo Suzuki, Soichiro Hase, Hirofumi Sumi, Satoshi Hachisuka, Eisuke Fujimoto, Kouichirou Aida, Ryuto Nakazawa, Hideo Sasaki, Junki Koike, Tatsuya Chikaraishi, Yugo Shibagaki, Yuhji Marui
BACKGROUND: Unintentional renal artery occlusion after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm remains one of the most unfavorable complications. Renal salvage options include percutaneous transluminal renal artery angioplasty (PTRA) and open hepatosplenorenal bypass. However, the usefulness of kidney autotransplantation (AutoTx) remains unclear. CASE PRESENTATION: A 76-year-old woman with a right solitary kidney attributable to a left renal thromboembolism had previously undergone EVAR with a stent graft for an infrarenal aortic aneurysm, which led to ostial occlusion of the right renal artery...
May 14, 2019: BMC Nephrology
Minah Kim, Hong Sang Choi, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim, Chang Seong Kim
BACKGROUND: Nephrogenic diabetes insipidus (DI) secondary to a urinary tract obstruction is a rare condition. Herein, we report a case of partial nephrogenic DI due to obstructive uropathy in a patient with Castleman's disease. CASE PRESENTATION: A 78-year-old man underwent computed tomography (CT) at his local hospital because of persistent edema of the leg and polyuria (both lasting approximately 2 months); retroperitoneal fibrosis was detected on the CT scan...
May 14, 2019: BMC Nephrology
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