Database : MEDLINE
Search on : renal and replacement and therapy [Words]
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[PMID]: 29523397
[Au] Autor:Blumberg N; Cholette JM; Pietropaoli AP; Phipps R; Spinelli SL; Eaton MP; Noronha SA; Seghatchian J; Heal JM; Refaai MA
[Ad] Address:Department of Pathology and Laboratory Medicine (Transfusion Medicine), University of Rochester Medical Center, Rochester, NY, USA. Electronic address: neil_blumberg@urmc.rochester.edu.
[Ti] Title:0.9% NaCl (Normal Saline) - Perhaps not so normal after all?
[So] Source:Transfus Apher Sci;, 2018 Feb 21.
[Is] ISSN:1473-0502
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Crystalloid infusion is widely employed in patient care for volume replacement and resuscitation. In the United States the crystalloid of choice is often normal saline. Surgeons and anesthesiologists have long preferred buffered solutions such as Ringer's Lactate and Plasma-Lyte A. Normal saline is the solution most widely employed in medical and pediatric care, as well as in hematology and transfusion medicine. However, there is growing concern that normal saline is more toxic than balanced, buffered crystalloids such as Plasma-Lyte and Lactated Ringer's. Normal saline is the only solution recommended for red cell washing, administration and salvage in the USA, but Plasma-Lyte A is also FDA approved for these purposes. Lactated Ringer's has been traditionally avoided in these applications due to concerns over clotting, but existing research suggests this is not likely a problem. In animal models and clinical studies in various settings, normal saline can cause metabolic acidosis, vascular and renal function changes, as well as abdominal pain in comparison with balanced crystalloids. The one extant randomized trial suggests that in very small volumes (2 l or less) normal saline is not more toxic than other crystalloids. Recent evidence suggests that normal saline causes substantially more in vitro hemolysis than Plasma-Lyte A and similar solutions during short term storage (24 hours) after washing or intraoperative salvage. There are now abundant data to raise concerns as to whether normal saline is the safest replacement solution in infusion therapy, red cell washing and salvage, apheresis and similar uses. In the USA, Plasma-Lyte A is also FDA approved for use with blood components and is likely a safer solution for these purposes. Its only disadvantage is a higher cost. Additional studies of the safety of normal saline for virtually all current clinical uses are needed. It seems likely that normal saline will eventually be abandoned in favor of safer, more physiologic crystalloid solutions in the coming years.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 18203 MEDLINE  
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[PMID]: 29505509
[Au] Autor:Xu L; Zhu Y; Yu J; Deng M; Zhu X
[Ad] Address:Department of Children's Critical Care Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Title:Nursing care of a boy seriously infected with Steven-Johnson syndrome after treatment with azithromycin: A case report and literature review.
[So] Source:Medicine (Baltimore);97(1):e9112, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined. PATIENT CONCERNS: A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression. DIAGNOSES: SJS often results from an allergy reaction response to a range of drugs. It is a clinical diagnosis suggested by fever and malaise followed by an extensive painful, nonblanching, macular rash that commonly progresses to blistering or sloughing, and mucositis. INTERVENTIONS: The boy was treated with continuous renal replacement therapy, anti-infection therapy, high-dose glucocorticoid treatment, and symptomatic treatment. OUTCOMES: The patient was recovered after 33 days of treatment. LESSONS: The current treatment is mainly symptomatic treatment, and for the patient, it is important to make skin care related well, included early out blisters at effusion, reducing skin ulceration of the mucosa area, keeping skin clean, removing mucosa secretion and blood clots, doing eye care related, preventing the complications, ensuring adequate intake of nutrition and warm and so on.
[Mh] MeSH terms primary: Anti-Bacterial Agents/adverse effects
Azithromycin/adverse effects
Skin Care/nursing
Stevens-Johnson Syndrome/nursing
[Mh] MeSH terms secundary: Child
Humans
Male
Pneumonia/drug therapy
Stevens-Johnson Syndrome/etiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009112

  3 / 18203 MEDLINE  
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[PMID]: 29376595
[Au] Autor:Usupbaev AC; Kurbanaliev RM; Chernetsova GS; Kolesnichenko IV; Sultanov BM; Myrzakanov NM; Zolotukhin AO; Vagner NA
[Ad] Address:M.T. Tynaliev Department of Urology and Andrology of pre- and postgraduate education. I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
[Ti] Title:[Experimental work: reconstruction of the pelvi-ureteric junction and ureter using testicular tunica vaginalis autograft].
[So] Source:Urologiia;(6):50-54, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:AIM: To evaluate the results of surgical reconstruction of the upper urinary tract using an autograft of testicular tunica vaginalis in experimental animals. MATERIALS AND METHODS: The article presents the results of partial replacement of the renal pelvis and ureter with an autograft in 25 male dogs. The grafts were harvested by resection of the parietal layer of the testicular tunica vaginalis, which was transplanted into the region of the pelvi-ureteric junction and the proximal ureter. The upper urinary tract was drained using a ureteral stent catheter. The results were evaluated at week 1 and months 1, 3 and six after the operation. The functional state of the kidneys and ureters was analyzed using excretory urography and ultrasound; the autograft biopsy specimens were examined histologically. RESULTS: In all cases, the viability of the autograft was completely preserved, there were no signs of secondary infection, necrosis and impaired patency in the anastomosis zone. Histological examination revealed signs of epithelialization, connective tissue substitution and neovasculogenesis in the implantation zone. CONCLUSION: The proposed surgical modality is an alternative method to restore normal urine flow in the upper urinary tract in obstructive urological diseases. The group of obstructive urological diseases was studied using the model of the strictures of the pelvi-ureteric junction in the intrarenal pelvis and ureteral strictures measuring up to 3-4 cm in length.
[Mh] MeSH terms primary: Pelvis/surgery
Reconstructive Surgical Procedures/methods
Ureter/surgery
[Mh] MeSH terms secundary: Animals
Autografts
Dogs
Female
Pelvis/diagnostic imaging
Ureter/diagnostic imaging
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180130
[St] Status:MEDLINE

  4 / 18203 MEDLINE  
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[PMID]: 27771423
[Au] Autor:Chrzan R; Panek W; Kuijper CF; Dik P; Klijn AJ; de Mooij KL; de Jong TP
[Ad] Address:Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands. Electronic address: r.chrzan@amc.nl.
[Ti] Title:Short-term Complications After Pyeloplasty in Children With Lower Urinary Tract Anomalies.
[So] Source:Urology;100:198-202, 2017 Feb.
[Is] ISSN:1527-9995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To investigate whether children with lower urinary tract (LUT) anomalies are at greater risk for postoperative complications after laparoscopic pyeloplasty stented with a double-J catheter (JJC). MATERIALS AND METHODS: Prospectively collected data of laparoscopic pyeloplasty (LP) performed between 2006 and 2015 were analyzed. Inclusion criteria are (1) toilet-trained child and (2) unilateral dismembered pyeloplasty stented with a JJC done by the same surgeon. Our pyeloplasty protocol includes cystoscopy and retrograde pyelography. JJC is left in for 3weeks. Asymptomatic patients with infravesical LUT anomalies (a-LUTA) and those with history of LUT symptoms (LUTS) were identified. Any short-term complication was classified according to Clavien-Dindo. Fisher's exact test was used for statistical analysis. RESULTS: Fifty-four children (mean 9.8 years) were included. Ten of 54 patients had LUTS. In 4 of those 10, anatomical infravesical anomaly was found during cystoscopy. Accidental urethral anomaly was found in 11 patients (a-LUTA). The control group (CG) consisted of 33 patients. Postoperative hospital stay ranged from 1 to 8 days (mean 2 days). Overall complication rate was 8 of 54 (14%). Grade 1 complications occurred in 3 patients in the CG. Five patients had grade 3 complications (2 needed replacement of bladder catheter, and 3 had diversion of the upper tract). Those problems occurred in 1 of 10 patients with LUTS and 3 of 11 patients with a-LUTA compared to 1 of 33 in the CG. This difference was statistically significant (P < .05). CONCLUSION: Careful history should be taken in toilet-trained children before pyeloplasty. If any infravesical abnormality is discovered, internal diversion should probably be avoided. Special attention must be paid to bladder function in the postoperative period.
[Mh] MeSH terms primary: Kidney Pelvis/surgery
Laparoscopy/adverse effects
Postoperative Complications/epidemiology
Reconstructive Surgical Procedures/adverse effects
Ureteral Obstruction/surgery
Urogenital Abnormalities/surgery
[Mh] MeSH terms secundary: Asymptomatic Diseases
Child
Cystoscopy
Female
Humans
Lower Urinary Tract Symptoms/etiology
Lower Urinary Tract Symptoms/surgery
Male
Stents
Ureteral Obstruction/etiology
Urography
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:161025
[St] Status:MEDLINE

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[PMID]: 29519954
[Au] Autor:Leaf DE; Siew ED; Eisenga MF; Singh K; Mc Causland FR; Srivastava A; Ikizler TA; Ware LB; Ginde AA; Kellum JA; Palevsky PM; Wolf M; Waikar SS
[Ad] Address:Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. DELEAF@partners.org.
[Ti] Title:Fibroblast Growth Factor 23 Associates with Death in Critically Ill Patients.
[So] Source:Clin J Am Soc Nephrol;, 2018 Mar 08.
[Is] ISSN:1555-905X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND OBJECTIVES: Dysregulated mineral metabolism is a common and potentially maladaptive feature of critical illness, especially in patients with AKI, but its association with death has not been comprehensively investigated. We sought to determine whether elevated plasma levels of the osteocyte-derived, vitamin D-regulating hormone, fibroblast growth factor 23 (FGF23), are prospectively associated with death in critically ill patients with AKI requiring RRT, and in a general cohort of critically ill patients with and without AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We measured plasma FGF23 and other mineral metabolite levels in two cohorts of critically ill patients ( =1527). We included 817 patients with AKI requiring RRT who enrolled in the ARF Trial Network (ATN) study, and 710 patients with and without AKI who enrolled in the Validating Acute Lung Injury biomarkers for Diagnosis (VALID) study. We hypothesized that higher FGF23 levels at enrollment are independently associated with higher 60-day mortality. RESULTS: In the ATN study, patients in the highest compared with lowest quartiles of C-terminal (cFGF23) and intact FGF23 (iFGF23) had 3.84 (95% confidence interval, 2.31 to 6.41) and 2.08 (95% confidence interval, 1.03 to 4.21) fold higher odds of death, respectively, after adjustment for demographics, comorbidities, and severity of illness. In contrast, plasma/serum levels of parathyroid hormone, vitamin D metabolites, calcium, and phosphate were not associated with 60-day mortality. In the VALID study, patients in the highest compared with lowest quartiles of cFGF23 and iFGF23 had 3.52 (95% confidence interval, 1.96 to 6.33) and 1.93 (95% confidence interval, 1.12 to 3.33) fold higher adjusted odds of death. CONCLUSIONS: Higher FGF23 levels are independently associated with greater mortality in critically ill patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 18203 MEDLINE  
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[PMID]: 29519284
[Au] Autor:Xu J; Zhao J; Jia X; Wang G
[Ad] Address:Graduate School of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China (Xu JM); Department of Respiratory, Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, China (Xu JM, Zhao J, Jia XM); Oncology Research Center, Xuzhou Medical University, Xuzhou 221000, Jiangsu, China (Wang G). Corresponding author: Zhao Jie, Email: 15005206612@163.com.
[Ti] Title:[Application of early continuous renal replacement therapy in the bundle treatment of severe pneumonia].
[So] Source:Zhonghua Wei Zhong Bing Ji Jiu Yi Xue;30(3):246-250, 2018 Mar.
[Is] ISSN:2095-4352
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To explore the role of early continuous renal replacement therapy (CRRT) in bundle treatment of severe pneumonia. METHODS: Seventy severe pneumonia patients admitted to respiratory intensive care unit (RICU) of Second Affiliated Hospital of Xuzhou Medical University from January 2013 to June 2017 were enrolled. The patients were randomly divided into routine treatment group and CRRT treatment group, with 35 patients in each group. All patients were treated with bundle therapy, and those in CRRT treatment group was treated with CRRT daily on the basis of conventional bundle therapy. The mode was continuous veno-venous hemofiltration (CVVH), lasting 8-24 hours at a time. On the day of admission and the treatment of 1, 3, 5, 7 days, the fasting venous blood was collected. Inflammatory stress and immune parameters including procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and CD4 cells were determined by enzyme linked immunosorbent assay (ELISA) or flow cytometer. The incidence of acute respiratory distress syndrome (ARDS) and mortality within 7 days were observed in the two groups. RESULTS: Seventy patients with severe pneumonia were enrolled. There was no significant difference in the serum PCT, IL-6, TNF-α or CD4 before treatment between the two groups. With the prolongation of treatment time, the PCT, IL-6 and TNF-α levels were gradually decreased, and the CD4 was gradually increased. Compared with routine treatment group, PCT and TNF-α in CRRT treatment group were significantly decreased since the 3rd day [PCT (µg/L): 3.11±1.28 vs. 3.76±1.42, TNF-α (ng/L): 98.61±11.58 vs. 119.47±12.38], and CD4 was significantly increased (0.39±0.03 vs. 0.35±0.03, all P < 0.05). The changes in IL-6 of CRRT treatment group was delayed, the statistical significance was found since the 5th day as compared with routine treatment group (ng/L: 35.43±12.39 vs. 52.86±10.78, P < 0.05). Compared with routine treatment group, the incidence of ARDS [11.43% (4/35) vs. 31.43% (11/35)] and mortality [0% (0/35) vs. 11.43% (4/35)] within 7 days in CRRT treatment group were significantly lowered (both P < 0.05). CONCLUSIONS: CRRT in the early stage of bundle therapy for severe pneumonia is not only suggested to remove inflammatory mediators and improve immune function, but an opportunity and effective way to reduce complications and delay rapid progression of severe pneumonia. It provides the opportunity and condition for comprehensive treatment.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.3760/cma.j.issn.2095-4352.2018.03.011

  7 / 18203 MEDLINE  
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[PMID]: 29428299
[Au] Autor:Roseman DS; Khan T; Rajas F; Jun LS; Asrani KH; Isaacs C; Farelli JD; Subramanian RR
[Ad] Address:Discovery Research, Alexion Pharmaceuticals, Inc., 75 Sidney Street, Cambridge, MA 02139, USA.
[Ti] Title:G6PC mRNA Therapy Positively Regulates Fasting Blood Glucose and Decreases Liver Abnormalities in a Mouse Model of Glycogen Storage Disease 1a.
[So] Source:Mol Ther;26(3):814-821, 2018 Mar 07.
[Is] ISSN:1525-0024
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Glycogen storage disease type Ia (GSD1a) is an inherited metabolic disorder caused by the deficiency of glucose-6-phosphatase (G6Pase). GSD1a is associated with life-threatening hypoglycemia and long-term liver and renal complications. We examined the efficacy of mRNA-encoding human G6Pase in a liver-specific G6Pase mouse model (L-G6PC ) that exhibits the same hepatic biomarkers associated with GSD1a patients, such as fasting hypoglycemia, and elevated levels of hepatic glucose-6-phosphate (G6P), glycogen, and triglycerides. We show that a single systemic injection of wild-type or native human G6PC mRNA results in significant improvements in fasting blood glucose levels for up to 7 days post-dose. These changes were associated with significant reductions in liver mass, hepatic G6P, glycogen, and triglycerides. In addition, an engineered protein variant of human G6Pase, designed for increased duration of expression, showed superior efficacy to the wild-type sequence by maintaining improved fasting blood glucose levels and reductions in liver mass for up to 12 days post-dose. Our results demonstrate for the first time the effectiveness of mRNA therapy as a potential treatment in reversing the hepatic abnormalities associated with GSD1a.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review

  8 / 18203 MEDLINE  
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[PMID]: 29337172
[Au] Autor:Riddersholm S; Kragholm K; Mortensen RN; Hansen SM; Wissenberg M; Lippert FK; Torp-Pedersen C; Christiansen CF; Rasmussen BS
[Ad] Address:Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Denmark; Clinical Institute, Aalborg University, Denmark. Electronic address: s.riddersholm@rn.dk.
[Ti] Title:Organ support therapy in the intensive care unit and return to work in out-of-hospital cardiac arrest survivors-A nationwide cohort study.
[So] Source:Resuscitation;, 2018 Jan 11.
[Is] ISSN:1873-1570
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:AIM: With increased survival after out-of-hospital cardiac arrest (OHCA), impact of the post-resuscitation course has become important. Among 30-day OHCA survivors, we investigated associations between organ support therapy in the Intensive Care Unit (ICU) and return to work. METHODS: This Danish nationwide cohort-study included 30-day-OHCA-survivors who were employed prior to arrest. We linked OHCA data to information on in-hospital care and return to work. For patients admitted to an ICU and based on renal replacement therapy (RRT), cardiovascular support and mechanical ventilation, we assessed the prognostic value of organ support therapies in multivariable Cox regression models. RESULTS: Of 1087 30-day survivors, 212 (19.5%) were treated in an ICU with 0-1 types of organ support, 494 (45.4%) with support of two organs, 26 (2.4%) with support of three organs and 355 (32.7%) were not admitted to an ICU. Return to work increased with decreasing number of organs supported, from 53.8% (95% CI: 49.5-70.1%) in patients treated with both RRT, cardiovascular support and mechanical ventilation to 88.5% (95% CI: 85.1-91.8%) in non-ICU-patients. In 732 ICU-patients, ICU-patients with support of 3 organs had significantly lower adjusted hazard ratios (HR) of returning to work (0.50 [95% CI: 0.30-0.85] compared to ICU-patients with support of 0-1 organ. The corresponding HR was 0.48 [95% CI: 0.30-0.78] for RRT alone. CONCLUSIONS: In 30-day survivors of OHCA, number of organ support therapies and in particular need of RRT were associated with reduced rate of return to work, although more than half of these latter patients still returned to work.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  9 / 18203 MEDLINE  
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[PMID]: 29315472
[Au] Autor:Mokart D; Saillard C; Zemmour C; Bisbal M; Sannini A; Chow-Chine L; Brun JP; Faucher M; Boher JM; Toiron Y; Chabannon C; Borg JP; Gonçalves A; Camoin L
[Ad] Address:Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmettes, Marseille, France.
[Ti] Title:Early prognostic factors in septic shock cancer patients: a prospective study with a proteomic approach.
[So] Source:Acta Anaesthesiol Scand;62(4):493-503, 2018 Apr.
[Is] ISSN:1399-6576
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Organ failures are the main prognostic factors in septic shock. The aim was to assess classical clinico-biological parameters evaluating organ dysfunctions at intensive care unit admission, combined with proteomics, on day-30 mortality in critically ill onco-hematology patients admitted to the intensive care unit for septic shock. METHODS: This was a prospective monocenter cohort study. Clinico-biological parameters were collected at admission. Plasma proteomics analyses were performed, including protein profiling using isobaric Tag for Relative and Absolute Quantification (iTRAQ) and subsequent validation by ELISA. RESULTS: Sixty consecutive patients were included. Day-30 mortality was 47%. All required vasopressors, 32% mechanical ventilation, 33% non-invasive ventilation and 13% renal-replacement therapy. iTRAQ-based proteomics identified von Willebrand factor as a protein of interest. Multivariate analysis identified four factors independently associated with day-30 mortality: positive fluid balance in the first 24 h (odds ratio = 1.06, 95% CI = 1.01-1.12, P = 0.02), severe acute respiratory failure (odds ratio = 6.14 95% CI = 1.04-36.15, P = 0.04), von Willebrand factor plasma level > 439 ng/ml (odds ratio = 9.7, 95% CI = 1.52-61.98, P = 0.02), and bacteremia (odds ratio = 6.98, 95% CI = 1.17-41.6, P = 0.03). CONCLUSION: Endothelial dysfunction, revealed by proteomics, appears as an independent prognostic factor on day-30 mortality, as well as hydric balance, acute respiratory failure and bacteremia, in critically ill cancer patients admitted to the intensive care unit. Endothelial failure is underestimated in clinical practice and represents an innovative therapeutic target.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1111/aas.13060

  10 / 18203 MEDLINE  
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[PMID]: 28741051
[Au] Autor:Hoshino J; Nagai K; Kai H; Saito C; Ito Y; Asahi K; Kondo M; Iseki K; Iseki C; Okada H; Kashihara N; Narita I; Wada T; Combe C; Pisoni RL; Robinson BM; Yamagata K
[Ad] Address:Nephrology Center, Toranomon Hospital, Tokyo, Japan.
[Ti] Title:A nationwide prospective cohort study of patients with advanced chronic kidney disease in Japan: The Reach-J CKD cohort study.
[So] Source:Clin Exp Nephrol;22(2):309-317, 2018 Apr.
[Is] ISSN:1437-7799
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:BACKGROUND: Epidemiology and outcomes of Japanese patients with advanced chronic kidney disease (CKD)-an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m -has remained largely unexamined. METHODS: We conducted a nationwide survey to determine the distribution of Japanese CKD patients, and are conducting a cohort study of these patients. A questionnaire eliciting details about facilities and their CKD practices was sent to all clinics/hospitals with nephrologists. Based on the survey results, we recruited 2400 advanced CKD patients receiving nephrologist care from at least 30 representative facilities throughout Japan, selected randomly with stratification by region and facility size. Through patient questionnaires and nephrologist-practice surveys aligned with the international CKD Outcomes and Practice Patterns Study (CKDopps), we shall annually or semi-annually collect patient, physician and clinic data prospectively, detailing CKD practices for 5 years, with a primary outcome of death or renal replacement therapy initiation, and secondary outcomes being decline of eGFR by 30% or 50%, CKD progression to CKD G5, or a cardiovascular event. RESULTS: Of 790 eligible, responding facilities, 330 (41.8%) treat ≥80 advanced CKD patients in the average 3-month period. Regional distribution of these facilities is similar to that of persons in the general population. Hence, the 30 facilities selected for data collection appear to be geographically representative in Japan. CONCLUSIONS: Our study will enhance understanding of various CKD practices and biological data associated with CKD progression, and allow international comparisons using the CKDopps platform. This will provide evidences to improve the health and quality of life for patients with advanced CKD.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s10157-017-1453-2


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