Perspectives on optimizing care of patients in multidisciplinary chronic kidney disease clinics

This article summarizes the key concepts discussed at the symposium from a patient and physician perspectives. Key messages include (1) understanding patient values and preferences is important as it provides a framework as to what to prioritize in multidisciplinary CKD clinic and provincial renal program models, (2) barriers to effective communication and education are common in the elderly, and adaptive strategies to limit their influence are critical to improve adherence and facilitate shared decision-making, (3) the use of standardized operating procedures (SOPs) improves efficiency and minimizes practice variability among health care practitioners, and (4) CKD scorecards with standardized system processes are useful in approaching variability as well as measuring and improving patient outcomes. Limitations The perspectives provided may not be applicable across centers given the differences in patient populations including age, ethnicity, culture, language, socioeconomic status, education, and multidisciplinary CKD clinic structure and function. Implications Knowledge transmission by collaborative interprovincial and interprofessional networks may play a role in facilitating optimal CKD care. Validation of system and clinic models that improve outcomes is needed prior to disseminating these best practices.
Source: Canadian Journal of Kidney Health and Disease - Category: Urology & Nephrology Source Type: research

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ConclusionIncreased urinary PGE2 from elevated SNGFR and consequently increased FFSS during early stage of CKD precedes overt microalbuminuria and is a biomarker for early hyperfiltration-induced injury in individuals with SFK.
Source: Prostaglandins and Other Lipid Mediators - Category: Lipidology Source Type: research
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Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
Conclusion: Cholecalciferol with adjustment in its dose, and obtaining normal serum levels is an excellent therapeutic alternative for the treatment of patients with CKD stage 3, and hypovitaminosis D. In the group of patients with GFR close to 30 mL/min, or lower values (stage 4), and with the presence of secondary hyperparathyroidism, the use of active form of vitamin D (calcitriol, paricalcitol) is recommended as the first therapeutic alternative. PMID: 31827333 [PubMed]
Source: International Journal of Nephrology and Renovascular Disease - Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research
Authors: Worthen G, Tennankore K Abstract Frailty has been defined as a state of increased vulnerability as a consequence of deficit accumulation. Frailty screening has not yet been widely implemented into routine nephrology care. Patients with chronic kidney disease (CKD) are at high risk of being frail, and frailty has been associated with worse outcomes in this population. Standard management of CKD, including initiation of renal replacement therapies, may have decreased benefit or potentially cause harm in the presence of frailty, and a variety of interventions for modifying frailty in the CKD population have b...
Source: International Journal of Nephrology and Renovascular Disease - Category: Urology & Nephrology Tags: Int J Nephrol Renovasc Dis Source Type: research
Advances in next-generation sequencing (NGS) techniques, including whole exome sequencing, have facilitated cost-effective sequencing of large regions of the genome, enabling the implementation of NGS in clinical practice. Chronic kidney disease (CKD) is a major contributor to global burden of disease and is associated with an increased risk of morbidity and mortality. CKD can be caused by a wide variety of primary renal disorders. In about one in five CKD patients, no primary renal disease diagnosis can be established. Moreover, recent studies indicate that the clinical diagnosis may be incorrect in a substantial number o...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
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Source: International Orthopaedics - Category: Orthopaedics Source Type: research
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Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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Source: Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
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