AHA News: Opioid Meds Pose Danger to Kidney Disease Patients

WEDNESDAY, March 6, 2019 (American Heart Association News) -- Medication options can be limited for people with chronic kidney disease, which is why they often get prescribed opioids to help manage pain. But new research finds that opioids could...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news

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A 58-year-old man with type 1 diabetes mellitus (hemoglobin A1c level, 6.5% [reference range, 4.0%-5.6%]) complicated by diabetic nephropathy (chronic kidney disease stage 3A), retinopathy, and severe peripheral neuropathy presented to his local urgent care center with a 24-hour history of right dorsal midfoot erythema and mild pain. Two weeks previously, the patient sustained a right foot injury after falling out of bed. The patient had not experienced fevers, chills, night sweats, nausea, vomiting, or malaise but reported somewhat labile blood sugar levels that day with an afternoon glucose measurement of 170 mg/dL (refe...
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents ’ clinic Source Type: research
CONCLUSIONS: Caring for a child with CKD is an intense experience, with negative consequences, due to uncertainties about the future and the very care these children require. We need to do something to help these caregivers better manage care, as well as cope with their own feelings. PMID: 30806443 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
ConclusionsOur results provide evidence that PROMIS-57 and PROMIS-29 are highly reliable and valid instruments among kidney transplant recipients. We propose it as a valuable tool to assess important domains of the illness experience.
Source: Quality of Life Research - Category: Health Management Source Type: research
ConclusionsERT is a disease-specific treatment for patients with Fabry disease that may provide clinical benefits on several outcomes and organ systems. Better outcomes may be observed when treatment is started at an early age prior to the development of organ damage such as chronic kidney disease or cardiac fibrosis. Consolidated evidence suggests a dose effect. Data described in male patients, together with female and paediatric data, informs clinical practice and therapeutic goals for individualized treatment.
Source: Molecular Genetics and Metabolism Reports - Category: Genetics & Stem Cells Source Type: research
A 66-year-old white man with a medical history of chronic kidney disease (CKD) stage 3a (baseline creatinine level of 1.4 mg/dL; normal 0.74-1.35 mg/dL) with an estimated glomerular filtration rate of 52 mL/min per 1.73 m2 per the Chronic Kidney Disease Epidemiology collaboration equation, controlled type 2 diabetes mellitus with microalbuminuria, hypertension, hyperlipidemia, and medically complicated obesity (body mass index, 37) presented to his primary care clinic with episodes of orthostatic light-headedness that had been occurring for approximately 2 weeks.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' clinic Source Type: research
YJ Anupama, Praveen UpadhyayaIndian Journal of Nephrology 2019 29(1):46-49 Diabetic muscle infarction (DMI) is one of the unusual complications of poorly controlled diabetes. It is usually seen in association with other microvascular complications. This condition is reported rarely, probably due to it's under recognition. It is also seen in patients with chronic kidney disease and should be considered in patients presenting with acute onset of limb pain. Here we present two cases of DMI in dialysis patients and discuss the available literature to highlight the clinical characteristics of the cases. We also present a d...
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
Purpose of review Strong epidemiological and pathologic evidence associates NSAIDs with kidney disease, both acute and chronic. Hence, the usage of NSAIDs has decreased in patients with, or at risk for, chronic kidney disease (CKD). Coupled with this has been a rise in use of opioids and other non-NSAID alternatives, which do come with significant, and underrecognized, risk of nonrenal adverse events. We review the literature to understand if this shift is appropriate or deleterious. Recent findings NSAIDs do have a low but tangible risk in causing acute kidney injury, electrolyte imbalances, and increasing blood pres...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: CLINICAL NEPHROLOGY: Edited by David S. Goldfarb Source Type: research
As multiple different studies and surveys continue to illustrate, palliative and hospice medicine has failed to have an appropriate impact on the quality of life for the end-stage renal disease (ESRD) population. People with Chronic Kidney Disease (CKD) remain less likely to die at home, spend more time in the hospital and at higher costs in the last 3 months of life. (Kerr M et al, NDT, 2016).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
The current care of patients with advanced chronic kidney disease (CKD) and end stage renal disease (ESRD) in the U.S. is not patient-centered, nor does it utilize palliative care approaches to optimize patients ’ quality of life. In several recent studies, patients with ESRD compared to patients with other chronic diseases have received the most intensive treatments at the end of life including cardiopulmonary resuscitation, intensive care unit admission, mechanical ventilation, and feeding tube insertio n.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
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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