“It Can’t Be the Dialysis that Kills the Child…” Partnering Pediatric Palliative Care with Care for Children with End-Stage Renal Disease (TH366)

As chronic kidney disease progresses to end-stage renal disease (ESRD), important discussions regarding when and if to initiate dialysis occur. ESRD affects more than 660,000 Americans, less than 10,000 (1.5%) of those are pediatric patients whose time on dialysis is typically meant as a bridge to transplant. In rare circumstances, comorbidities, such as multiorgan failure, progression of other life-threating medical conditions, congenital anomalies, and size restrictions limit pediatric candidates ’ access to transplant.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

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By RICHARD HOEHN, MD Experts claim we could have been better prepared when the COVID-19 pandemic struck in early 2020. With an annual budget of $400-700 million, the Strategic National Stockpile (SNS) is designed to respond to chemical, biological, and other disasters. Its $8 billion inventory included 13,000 ventilators and a limited supply of personal protective equipment, N95 masks, and medical supplies. This left state and local governments scrambling as the COVID-19 pandemic accelerated and the capacity of many hospitals was overwhelmed. Faced with immediate and visible death and suffering, leaders took drastic...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Economics Health Policy Healthcare spending Richard Hoen Source Type: blogs
Over $50 billion is spent on elderly patients with chronic kidney disease in the United States; with 1.5 times higher incidence of end stage renal disease (ESRD) in Asian Americans compared to Caucasians, there is a dire need to improve self-care and symptom management studies for this population. ESRD patients typically have a very short life expectancy and do not qualify for hospice benefits while they remain on dialysis or transplant lists. There are calls to strengthen palliative care for ESRD patients to help decrease distressing symptoms.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
In conclusion, our study demonstrated that Nrf2 deficiency promoted the increasing trend of autophagy during aging in skeletal muscle. Nrf2 deficiency and increasing age may cause excessive autophagy in skeletal muscle, which can be a potential mechanism for the development of sarcopenia. To What Degree is Chondrocyte Hypertrophy in Osteoarthritis Due to Cellular Senescence? https://www.fightaging.org/archives/2020/04/to-what-degree-is-chondrocyte-hypertrophy-in-osteoarthritis-due-to-cellular-senescence/ Senescent cells are large. They do not replicate, that function is disabled, but it is as if they go ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Purpose of review Cannabis (marijuana, weed, pot, ganja, Mary Jane) is the most commonly used federally illicit drug in the United States. The present review provides an overview of cannabis and cannabinoids with relevance to the practice of nephrology so that clinicians can best take care of patients. Recent findings Cannabis may have medicinal benefits for treating symptoms of advanced chronic kidney disease (CKD) and end-stage renal disease including as a pain adjuvant potentially reducing the need for opioids. Cannabis does not seem to affect kidney function in healthy individuals. However, renal function should b...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: CLINICAL NEPHROLOGY: Edited by David S. Goldfarb Source Type: research
Abstract CASE PRESENTATION: A 59-year-old man presented to the ED with a chief complaint of shortness of breath. His past medical history was significant for end-stage renal disease secondary to lithium toxicity, immunosuppression subsequent to cadaveric renal transplantation, bipolar disorder, and hypertension. His shortness of breath had begun 6 months previously and was initially intermittent; it then progressed to constant shortness of breath over the few weeks before presentation. He had no fever, hemoptysis, or chest pain. The patient was admitted to hospital for further evaluation. PMID: 31916972 ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Abstract OBJECTIVES: Health-related quality of life is increasingly used as an important measurement of treatment outcome. Here, quality of life parameters in renal transplant recipients were evaluated and compared with patients with chronic kidney disease on maintenance hemodialysis and with those who were not on dialysis. MATERIALS AND METHODS: This cross-sectional study included patients seen at a number of tertiary renal care hospitals (there were 15 renal transplant recipients, 20 patients on maintenance hemodialysis, and 28 patients with chronic kidney disease not on dialysis). Forty healthy individual ...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
We examined 9293 individuals from the Copenhagen General Population Study using nuclear magnetic resonance spectroscopy measurements of total cholesterol, free- and esterified cholesterol, triglycerides, phospholipids, and particle concentration. Fourteen subclasses of decreasing size and their lipid constituents were analysed: six subclasses were very low-density lipoprotein (VLDL), one intermediate-density lipoprotein (IDL), three low-density lipoprotein (LDL), and four subclasses were high-density lipoprotein (HDL). Remnant lipoproteins were VLDL and IDL combined. Mean nonfasting cholesterol concentration was 72‚...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Abstract Diabetes mellitus (DM) is a common disease in Oman as in rest of Gulf Cooperation Council where metabolic syndrome is of high prevalence. DM is a foremost risk factor for urinary tract infections (UTIs). It is also linked to more complicated infections such as emphysematous pyelonephritis (EPN), emphysematous pyelitis (EP), renal/perirenal abscess, emphysematous cystitis, xanthogranulomatous pyelonephritis, and renal papillary necrosis. The diagnosis of these cases is frequently delayed because the clinical manifestations are generic and not different from the typical triad of upper UTI, which include fev...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
ve; P Abstract INTRODUCTION: Increased levels of cardiac troponins (cTn) are a hallmark of acute myocardial infarction (AMI), along with symptoms and electrocardiographic (ECG) changes. Stably elevated cTn concentrations are frequently observed in asymptomatic patients with chronic kidney disease (CKD) and/or on hemodialysis (HD); the meaning of this elevation, as assessed by conventional techniques, remains unclear. Aim of our study was to evaluate the clinical significance of cTnI levels in asymptomatic HD patients by employing a newer high-sensitive cTnI (hs-cTnI) assay. METHODS: We enrolled 49 patients un...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
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