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Kidney disease drug recommended by Nice 'may do more harm than good'

Exclusive: Little evidence that phosphate binders improve patient wellbeing, warn experts, while one type may contribute to increased risk of cardiovascular diseaseThe UK ’s drug guidelines body is recommending a type of medication to treat chronic kidney disease despite no firm evidence that it benefits patients – and some signs that the drugs may do more harm than good, experts have warned.Phosphate binders are commonly prescribed to lower blood phosphate levels in patients with advanced kidney disease, including those on dialysis. High phosphate has been linked to worse patient outcomes, including bone and muscle problems, a build-up of calcium in the blood vessels causing them to stiffen, and an increased death rate.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Drugs The National Institute for Health and Care Excellence (Nice) NHS Society Science Source Type: news

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Authors: Abdelraheem MB Abstract Acute kidney injury (AKI) is a relatively common condition, encountered in everyday paediatric clinical practice. It is an important cause of morbidity and mortality in children both inside and outside intensive care units. It is associated with prolonged hospital stay and progression to chronic kidney disease. The burden of AKI is particularly high in low- and middle-income countries where rural areas and smaller cities in the countryside predominate. Most of these areas suffer from poverty, poor sanitation, water quality and hygiene, lack of education and poor access to health car...
Source: Paediatrics and international child health - Category: Pediatrics Tags: Paediatr Int Child Health Source Type: research
Publication date: November 2017 Source:Advances in Chronic Kidney Disease, Volume 24, Issue 6 Author(s): Annabelle N. Chua, Bradley A. Warady Optimal care of the pediatric end-stage renal disease (ESRD) patient on chronic dialysis is complex and requires multidisciplinary care as well as patient/caregiver involvement. The dialysis team, along with the family and patient, should all play a role in choosing the dialysis modality which best meets the patient's needs, taking into account special considerations and management issues that may be particularly pertinent to children who receive peritoneal dialysis or hemodialysis....
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Publication date: November 2017 Source:Advances in Chronic Kidney Disease, Volume 24, Issue 6 Author(s): Sean A. Hebert, Rita D. Swinford, David R. Hall, Jason K. Au, John S. Bynon Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney fail...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Conclusions: In CKD patients impaired sleep quality increases BPV, might contribute to their disease progression and worsen prognosis. Searching for sleep problems in CKD patients could help planning their treatment of sleep problems contributing to CV risk reduction. Our data provide the rationale working hypothesis for the need of studies with larger number of patients aimed to demonstrate improved outcome of CKD progression and CV risk with the treatment also of sleep disorders.Kidney Blood Press Res 2017;42:804 –815
Source: Kidney and Blood Pressure Research - Category: Urology & Nephrology Source Type: research
Full blockade of renin-angiotensin-aldosterone system (RAAS) is believed to decrease morbidity and mortality of patients with chronic kidney disease. In non-dialysis patients, combined RAAS blockade with two different RAAS blockers caused more adverse events without improving survival, but its role in maintenance dialysis patients is still unclear. We conducted a systematic review and mediation analysis to investigate the efficacy and safety of combined RAAS blockade in dialysis patients.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
Background: Chronic kidney disease patients (CKD) undergoing hemodialysis (HD) may experience reduced inspiratory muscle strength, which may have repercussions on their performance of daily activities and quality of life.Objective: To identify protective factors against inspiratory muscle weakness in patients on HD.Methods: A cross-sectional study with 48 patients undergoing HD for at least one year, assessed in the interdialytic period to measure respiratory muscle strength, diaphragm thickness and mobility, and laboratory biochemistry. Patients were divided into groups with an¡d without inspiratory muscle weakness....
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Conclusion: Cognitive and behavioral aspects of fatigue improved after kidney transplantation, as well as functional capacity of kidney transplant recipient. The results suggest that perception of fatigue in this population can be associated with anxiety levels.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
We present a case of RCAD syndrome with a previously unreported mutation. A 49‐year‐old man with diabetes mellitus was admitted with worsening chronic kidney disease requiring haemodialysis. He developed recurrent, unexplained hypoglycaemia despite discontinuing insulin, making the diagnosis of type 1 diabetes mellitus questionable. He had detectable serum C‐peptide (742 pmol/L), and anti‐GAD and anti‐pancreatic islet cell antibodies were negative. Abdominal imaging revealed renal cortical cysts and atrophic pancreas. A significant family history of diabetes mellitus with renal disease was also established which ...
Source: Practical Diabetes - Category: Endocrinology Authors: Tags: Case report Source Type: research
We examined circulating AMH concentrations in young women with renal failure, determined associations with clinical characteristics, and compared AMH with age-matched healthy individuals. AMH was measured in 77 women: 26 had chronic kidney disease (CKD), 26 were on haemodialysis (HD), and 25 had a kidney transplant. Random AMH levels were highest in women on HD [HD 2.9 (1.1–5.2), CKD 1.6 (0.7–2.2), transplant 1.5 (1.0–4.2) ng/ml]. On multiple linear regression, AMH was 53% higher [95% CI 0.20–0.98, P = 0.002] in women on HD and decreased by 20% per 5-year increase in age (P < 0.001). AMH was 43% ...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
Abstract Cardiovascular diseases are the leading causes of mortality in patients with chronic kidney disease. Nitric oxide has a critical role in both endothelial dysfunction and the atherosclerosis process. We aimed to investigate the relationships between serum asymmetric dimethyl arginine (ADMA), LOX‐1, and Apelin‐13 levels, which are known to act over nitric oxide with endothelial dysfunction and cardiac morphology as well as with each other in hemodialysis patients. The study comprised a total of 120 patients (53 females and 67 males) receiving hemodialysis three times a week for at least 6 mo...
Source: Therapeutic Apheresis and Dialysis - Category: Hematology Authors: Tags: Original Article Source Type: research
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