Teaching renal physiology in the 21st century: focus on acid-base physiology
A thorough understanding of renal physiology, and in particular acid–base physiology, is essential for an understanding of nephrology. Difficulties in both teaching and learning this material are major impediments to attracting medical trainees into nephrology. Approaches to teaching renal physiology include collaborative learning, computer-based learning and laboratory-based learning. Computer-based learning applications are becoming increasingly popular and can be useful, but are most successful when they incorporate interactive components. Students also note that the presence of a live instructor remains desirable...
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Leehey, D. J., Daugirdas, J. T. Tags: EDUCATION Source Type: research
Frailty and comorbidity are independent predictors of outcome in patients referred for pre-dialysis education
Conclusion
A relatively simple frailty scale and comorbidity score could be used to predict survival and better inform the shared decision-making process for patients with advanced kidney disease. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Pugh, J., Aggett, J., Goodland, A., Prichard, A., Thomas, N., Donovan, K., Roberts, G. Tags: EDUCATION Source Type: research
Therapeutic drug monitoring of enteric-coated mycophenolate sodium by limited sampling strategies is associated with a high rate of failure
Conclusions
The risk of therapeutic drug monitoring failure with EC-MPS is >30% during the first 6 months of renal transplantation. Delayed pharmacokinetics was the main reason. In contrast, the risk of therapeutic drug monitoring failure was substantially lower with MMF. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Hougardy, J.-M., Maufort, L., Cotton, F., Coussement, J., Mikhalski, D., Wissing, K. M., Le Moine, A., Broeders, N., Abramowicz, D. Tags: TRANSPLANTATION Source Type: research
BK polyoma virus infection and renal disease in non-renal solid organ transplantation
In this report, we review the existing literature to highlight our current understanding of its incidence in NRSOT populations, the approaches to diagnosis and the potential treatment options. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Kuppachi, S., Kaur, D., Holanda, D. G., Thomas, C. P. Tags: TRANSPLANTATION Source Type: research
Improving vascular access outcomes: attributes of arteriovenous fistula cannulation success
Conclusions
Practice changes based on these results may improve cannulation, decrease complications and result in better outcomes for patients. Efforts to nurture positive patient experiences around cannulation may influence patient decision-making regarding fistula use. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Harwood, L. E., Wilson, B. M., Oudshoorn, A. Tags: DIALYSIS Source Type: research
Hemodialysis outcomes in a global sample of children and young adult hemodialysis patients: the PICCOLO MONDO cohort
Conclusions
The PICCOLO MONDO study has provided unique baseline and 1-year follow-up information on children and young adults receiving HD around the globe. This cohort has brought to light aspects of care in these age groups that warrant further investigation. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Ferris, M., Gibson, K., Plattner, B., Gipson, D. S., Kotanko, P., Marcelli, D., Marelli, C., Etter, M., Carioni, P., von Gersdorff, G., Xu, X., Kooman, J. P., Xiao, Q., van der Sande, F. M., Power, A., Picoits-Filho, R., Sylvestre, L., Westreich, K., Usvy Tags: DIALYSIS Source Type: research
Early changes in body weight and blood pressure are associated with mortality in incident dialysis patients
Conclusions
BW loss in the first weeks on dialysis is a strong and independent predictor of mortality. Low BP is also associated with mortality and is probably the consequence of underlying cardiovascular diseases. These early markers appear to be valuable prognostic factors. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Duranton, F., Duny, Y., Szwarc, I., Deleuze, S., Rouanet, C., Selcer, I., Maurice, F., Rivory, J.-P., Servel, M.-F., Jover, B., Brunet, P., Daures, J.-P., Argiles, A. Tags: DIALYSIS Source Type: research
Calcifying circulating cells: an uncharted area in the setting of vascular calcification in CKD patients
Vascular calcification, occurring during late-stage vascular and valvular disease, is highly associated with chronic kidney disease-mineral and bone disorders (CKD-MBD), representing a major risk factor for cardiovascular morbidity and mortality. The hallmark of vascular calcification, which involves both media and intima, is represented by the activation of cells committed to an osteogenic programme. Several studies have analysed the role of circulating calcifying cells (CCCs) in vascular calcification. CCCs are bone marrow (BM)-derived cells with an osteogenic phenotype, participating in intima calcification processes an...
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Cianciolo, G., Capelli, I., Cappuccilli, M., Schillaci, R., Cozzolino, M., La Manna, G. Tags: CKD-MBD Source Type: research
The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcification: ongoing randomized controlled trials
Conclusion
Vitamin K deficiency may be a modifiable cardiovascular risk factor in the haemodialysis population. Conversely, vitamin K antagonists may aggravate VC burden in haemodialysis patients. Several ongoing trials may provide an answer to these questions in the near future. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Caluwe, R., Pyfferoen, L., De Boeck, K., De Vriese, A. S. Tags: CKD-MBD Source Type: research
Does lower urine-specific gravity predict decline in renal function and hypernatremia in older adults exposed to psychotropic medications? An exploratory analysis
Conclusions
In psychotropic-exposed older adults, there appears to be a clinically important association between low USG and developing both hypernatremia and CKD. USG may be a useful surrogate measure for NDI-related outcomes in large administrative database studies, where ideal measures such as 24-h urine volume may not be available. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Sajadi, S., Yu, C., Sylvestre, J.-D., Looper, K. J., Segal, M., Rej, S. Tags: CHRONIC KIDNEY DISEASE Source Type: research
Safety concerns about intravenous iron therapy in patients with chronic kidney disease
Anaemia in chronic kidney disease (CKD) is managed primarily with erythropoiesis-stimulating agents (ESAs) and iron therapy. Following concerns around ESA therapy, intravenous (IV) iron is being administered more and more worldwide. However, it is still unclear whether this approach is safe at very high doses or in the presence of very high ferritin levels. Some observational studies have shown a relationship between either high ferritin level or high iron dose and increased risk of death, cardiovascular events, hospitalization or infection. Others have not been able to confirm these findings. However, they suffer from ind...
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Del Vecchio, L., Longhi, S., Locatelli, F. Tags: CHRONIC KIDNEY DISEASE Source Type: research
Can we routinely measure patient involvement in treatment decision-making in chronic kidney care? A service evaluation in 27 renal units in the UK
Conclusion
Our study shows the importance of assessing the feasibility of data collection in a chronic disease context prior to implementation in routine practice. Routine measurement of patient involvement in established kidney disease treatment decisions is feasible, but there are challenges in selecting the measure needed to capture experience of involvement, reducing variation in response rate by service and identifying when to capture experience in a service managing people's chronic disease over time. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Durand, M.-A., Bekker, H. L., Casula, A., Elias, R., Ferraro, A., Lloyd, A., van der Veer, S. N., Metcalfe, W., Mooney, A., Thomson, R. G., Tomson, C. R. V. Tags: CHRONIC KIDNEY DISEASE Source Type: research
Renal effects of BRAF inhibitors: a systematic review by the Cancer and the Kidney International Network
Advanced melanoma has been traditionally unresponsive to standard chemotherapy agents and used to have a dismal prognosis. Genetically targeted small-molecule inhibitors of the oncogenic BRAF V600 mutation or a downstream signaling partner (MEK mitogen-activated protein kinase) are effective treatment options for the 40–50% of melanomas that harbor mutations in BRAF. Selective BRAF and MEK inhibitors induce frequent and dramatic objective responses and markedly improve survival compared with cytotoxic chemotherapy. In the past decade after discovery of this mutation, drugs such as vemurafenib and dabrafenib have been...
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Wanchoo, R., Jhaveri, K. D., Deray, G., Launay-Vacher, V. Tags: ONCONEPHROLOGY Source Type: research
Minimal change disease onset observed after bevacizumab administration
This is a report of a patient with minimal change disease (MCD) onset after bevacizumab administration. A 72-year-old man with inoperable Grade 3 astrocytoma was treated with a combination of temozolomide and the vascular endothelial growth factor monoclonal antibody bevacizumab. After two biweekly treatments, he developed nephrotic syndrome. Despite cessation of bevacizumab, his renal function deteriorated and a renal biopsy disclosed MCD. Thereafter, he was started on high-dose oral prednisone and renal function immediately improved. Within weeks, the nephrotic syndrome resolved. Although rare, biologic agents can cause ...
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Hanna, R. M., Lopez, E., Wilson, J., Barathan, S., Cohen, A. H. Tags: GLOMERULONEPHRITIS Source Type: research
Necrotizing and crescentic glomerulonephritis with membranous nephropathy in a patient exposed to levamisole-adulterated cocaine
We report the first case, to our knowledge, of a patient with both microscopic polyangiitis manifest as a pauci-immune necrotizing and crescentic glomerulonephritis and concurrent MN in the setting of chronic cocaine abuse and presumed levamisole exposure, raising the hypothesis that levamisole was the causative agent in the development of this rare dual glomerulopathy. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - March 15, 2016 Category: Urology & Nephrology Authors: Carrara, C., Emili, S., Lin, M., Alpers, C. E. Tags: GLOMERULONEPHRITIS Source Type: research
