Expanding Specialist Care and Enhanced Coordination for Chronic Kidney Disease Can Improve Outcomes, Lower Costs

Providing specialized medical care and coordination to patients whose kidneys are failing before they need dialysis treatment could save the U.S. health care system more than $1 billion annually.
Source: RAND - Category: Health Management Authors: Source Type: news

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Source: American Journal of Transplantation - Category: Transplant Surgery Authors: Tags: Editorial Source Type: research
AbstractA 57-year-old woman with pre-dialysis chronic kidney disease (CKD) was hospitalized because of fever and fatigue. On admission, increased inflammatory response and pyuria with bacteriuria were observed. Pyelonephritis was successfully treated with antibiotics, whereas her fatigue continued and she developed progressive hypercalcemia and hyponatremia; serum sodium level, 116  mEq/L and corrected serum calcium level, 13.4 mg/dL. Plasma concentrations of adrenocorticotropic hormone and cortisol and serum luteinizing hormone were under the detection level. Although the reaction of other anterior pituitary hor...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 8 November 2018Source: Journal of Trace Elements in Medicine and BiologyAuthor(s): Siyun Xiang, Qiman Jin, Fangyi Xu, Ying Yao, Wangqun Liang, Xuezhi Zuo, Ting Ye, Chenjiang YingAbstractThe present study aims to assess arsenic accumulation and explore its association with renal function and biomarkers of CVD risk in chronic kidney disease patients receiving continuous ambulatory peritoneal dialysis (CAPD). The serum was collected from 87 CAPD patients and 26 healthy subjects between 2015 and 2016. The arsenic concentration was measured by inductively coupled plasma mass spectrometer. Clin...
Source: Journal of Trace Elements in Medicine and Biology - Category: Biochemistry Source Type: research
Authors: Bucharles SGE, Wallbach KKS, Moraes TP, Pecoits-Filho R Abstract Hypertension (blood pressure> 140/90 mm Hg) is very common in patients undergoing regular dialysis, with a prevalence of 70-80%, and only the minority has adequate blood pressure (BP) control. In contrast to the unclear association of predialytic BP recordings with cardiovascular mortality, prospective studies showed that interdialytic BP, recorded as home BP or by ambulatory blood pressure monitoring in hemodialysis patients, associates more closely with mortality and cardiovascular events. Although BP is measured frequently in the dialys...
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
With the rising incidence of chronic kidney disease, there has been a steady growth of the hemodialysis (HD) and peritoneal dialysis (PD) population. Prevalence of obesity has also been on the rise. It has been proposed by some that obesity helps with survival in HD and possibly in PD patients —a concept called “Reverse Epidemiology.” Here, we attempt to explore this phenomenon in the HD and PD populations and see specifically if it is time to reverse this concept. A MEDLINE search was performed using search terms: obesity, body mass index, end-stage renal disease, HD, PD, renal dia lysis, mortality, surv...
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Authors: Tags: Review Article Source Type: research
The impact of glycemic control in diabetic patients with chronic kidney disease (CKD) who may or may not transition to dialysis remains uncertain, given recent interest in the conservative management of advanced CKD without dialysis therapy, which may benefit from alternative glycemic control strategies.
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Authors: Tags: Original Research Source Type: research
ConclusionsIn conclusion, a single 0.25  mg/kg dose of cinacalcet was evaluated to be a safe starting dose in these children aged
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Authors: Cucchiari D, Torregrosa JV Abstract Calciphylaxis, also known as calcific uraemic arteriolopathy, is a rare syndrome that typically causes skin necrosis and usually affects dialysis patients. Its pathogenesis is multifactorial and is the consequence of many factors causing ectopic calcifications in patients with chronic kidney disease, such as calcium-phosphate metabolism disorders, hyper- or hypo-parathyroidism, diabetes, obesity, systemic inflammation and the use of vitamin K antagonists, among others. From a clinical point of view, calciphylaxis may progress from painful purpura to extensive areas of sk...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Abstract CKD is common and frequently complicated with hypertension both predialysis and in ESKD. As a major modifiable risk factor for cardiovascular disease in this high-risk population, treatment of hypertension in CKD is important. We review the mechanisms and indications for the major classes of antihypertensive drugs, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-adrenergic blocking agents, dihydropyridine calcium channel blockers, thiazide diuretics, loop diuretics, mineralocorticoid receptor blockers, direct vasodilators, and centrally acting α-agonists....
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
In conclusion, dialysis using a polysulfone membrane did not appear to disrupt red blood cells or reduce their lifespan in patients with end ‐stage kidney disease.
Source: Therapeutic Apheresis and Dialysis - Category: Hematology Authors: Tags: Original Article Source Type: research
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