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Condition: Chronic Kidney Disease
Therapy: Dialysis

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Total 325 results found since Jan 2013.

Cognitive Impairment in Advanced Chronic Kidney Disease: The Canadian Frailty Observation and Interventions Trial.
CONCLUSIONS: Our study uncovered a high rate of unrecognized cognitive impairment in an advanced CKD population. This impairment is global, affecting all aspects of cognition and is likely vascular in nature. The longitudinal trajectory of cognitive function and its effect on dialysis decision-making and outcomes deserves further study. PMID: 27798938 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - October 31, 2016 Category: Urology & Nephrology Authors: Foster R, Walker S, Brar R, Hiebert B, Komenda P, Rigatto C, Storsley L, Prasad B, Bohm C, Tangri N Tags: Am J Nephrol Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Neurological complications in chronic kidney disease patients
Chronic kidney disease (CKD) is associated with a high prevalence of cerebrovascular disorders such as stroke, white matter diseases, intracerebral microbleeds and cognitive impairment. This situation has been observed not only in end-stage renal disease patients but also in patients with mild or moderate CKD. The occurrence of cerebrovascular disorders may be linked to the presence of traditional and non-traditional cardiovascular risk factors in CKD. Here, we review current knowledge on the epidemiological aspects of CKD-associated neurological and cognitive disorders and discuss putative causes and potential treatment. ...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Chillon, J.-M., Massy, Z. A., Stengel, B. Tags: REVIEWS - CLINICAL SCIENCE AND OUTCOME RESEARCH IN NEPHROLOGY Source Type: research

Erythropoietin corrects anaemia and reduces the risk of blood transfusion in people with chronic kidney disease, but has uncertain effects on other patient-level outcomes
Commentary on: Cody JD, Hodson EM. Recombinant human erythropoietin versus placebo or no treatment for the anaemia of chronic kidney disease in people not requiring dialysis. Cochrane Database Syst Rev 2016;(1):CD003266 Context Anaemia frequency and severity worsen with advancing chronic kidney disease (CKD) and are associated with quality-of-life (QOL) impairment, morbidity and mortality.1 Deficient renal erythropoietin production is a major cause and can be corrected by recombinant human erythropoietin (rhEPO) administration.1 This may improve clinical outcomes, including delaying dialysis. Conversely, rhEPO therapy caus...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Johnson, D. W. Tags: Clinical trials (epidemiology), Epidemiologic studies, Haematology (incl blood transfusion), Stroke, Hypertension, Venous thromboembolism, Renal medicine Therapeutics/Prevention Source Type: research

Pro: Reducing salt intake at population level: is it really a public health priority?
A reduction in salt intake reduces blood pressure, stroke and other cardiovascular events, including chronic kidney disease, by as much as 23% (i.e. 1.25 million deaths worldwide). It is effective in both genders, any age, ethnic group, and in high-, medium- and low-income countries. Population salt reduction programmes are both feasible and effective (preventive imperative). Salt reduction programmes are cost-saving in all settings (high-, middle- and low-income countries) (economic imperative). Public health policies are powerful, rapid, equitable and cost-saving (political imperative). The important shift in public heal...
Source: Nephrology Dialysis Transplantation - September 1, 2016 Category: Urology & Nephrology Authors: Cappuccio, F. P. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Five ‐year mortality outcomes in patients with chronic kidney disease undergoing percutaneous coronary intervention
ConclusionAmong patients undergoing PCI, lower GFR is associated with decreased long‐term survival. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - August 12, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Agam D. Patel, Mohammed Ibrahim, Rajesh V. Swaminathan, Irfan U. Minhas, Luke K. Kim, Prashanth Venkatesh, Dmitriy N. Feldman, Robert M. Minutello, Geoffrey W. Bergman, S. Chiu Wong, Harsimran S. Singh Tags: Coronary Artery Disease Source Type: research

Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials
Publication date: Available online 29 July 2016 Source:The Lancet Diabetes & Endocrinology Author(s): Cholesterol Treatment Trialists' (CTT) Collaboration Background Statin therapy is effective for the prevention of coronary heart disease and stroke in patients with mild-to-moderate chronic kidney disease, but its effects in individuals with more advanced disease, particularly those undergoing dialysis, are uncertain. Methods We did a meta-analysis of individual participant data from 28 trials (n=183 419), examining effects of statin-based therapy on major vascular events (major coronary event [non-fatal myoca...
Source: The Lancet Diabetes and Endocrinology - July 28, 2016 Category: Endocrinology Source Type: research

Phosphate-Binding Agents in Adults With CKD: A Network Meta-analysis of Randomized Trials
Conclusions There is currently no evidence that phosphate-binder treatment reduces mortality compared to placebo in adults with CKD. It is not clear whether the higher mortality with calcium versus sevelamer reflects whether there is net harm associated with calcium, net benefit with sevelamer, both, or neither. Iron-based binders show evidence of greater phosphate lowering that warrants further examination in randomized trials.
Source: American Journal of Kidney Diseases - July 22, 2016 Category: Urology & Nephrology Source Type: research

Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5
Conclusions CKD stages 3b to 5 increases the risk of mortality after TAVI and SAVR. In this subset of patients, SAVR was associated with somewhat better early and late survival. The risk of acute kidney injury was higher after SAVR. These findings suggest that CKD stages 3b to 5 does not contraindicate SAVR. Strategies to prevent severe acute kidney injury should be implemented with either SAVR or TAVI.
Source: The Annals of Thoracic Surgery - July 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Endostatin in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events and survival.
CONCLUSION: Endostatin levels are independently associated with incident CVE in CKD patients, but show limited prediction abilities for all-cause mortality and CVE above traditional and renal-specific risk factors. PMID: 27394925 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 6, 2016 Category: Internal Medicine Authors: Kanbay M, Afsar B, Siriopol D, Unal HU, Karaman M, Saglam M, Gezer M, Taş A, Eyileten T, Guler AK, Aydin İ, Oguz Y, Tarim K, Covic A, Yilmaz MI Tags: Eur J Intern Med Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes.
CONCLUSIONS: This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients. PMID: 27324524 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Patel HJ, Likosky DS, Pruitt AL, Murphy ET, Theurer PF, Prager RL Tags: Ann Thorac Surg Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes
Conclusions This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients.
Source: The Annals of Thoracic Surgery - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.
Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemosta...
Source: Polskie Archiwum Medycyny Wewnetrznej - June 2, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Ischaemic stroke in patients with atrial fibrillation with chronic kidney disease undergoing peritoneal dialysis
Conclusion In CKD patients on PD with AF, who had similar ischaemic stroke risk as non-CKD counterparts, warfarin therapy is associated with reduction in risk of ischaemic stroke without a higher risk of ICH.
Source: Europace - May 24, 2016 Category: Cardiology Authors: Chan, P.-H., Huang, D., Yip, P.-S., Hai, J., Tse, H.-F., Chan, T.-M., Lip, G. Y. H., Lo, W.-K., Siu, C.-W. Tags: Atrial fibrillation Source Type: research

Defining end-stage renal disease in clinical trials: a framework for adjudication
Unlike definition of stroke and myocardial infarction, there is no uniformly agreed upon definition to adjudicate end-stage renal disease (ESRD). ESRD remains the most unambiguous and clinically relevant end point for clinical trialists, regulators, payers and patients with chronic kidney disease. The prescription of dialysis to patients with advanced chronic kidney disease is subjective and great variations exist among physicians and countries. Given the difficulties in diagnosing ESRD, the presence of estimated GFR <15 mL/min/1.7 3m2 itself has been suggested as an end point. However, this definition is still a surrog...
Source: Nephrology Dialysis Transplantation - May 22, 2016 Category: Urology & Nephrology Authors: Agarwal, R. Tags: IDEAS, CONJECTURES AND REFUTATIONS Source Type: research