scholarly journals Correction to: A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology

2018 ◽  
Vol 31 (5) ◽  
pp. 683-683
Author(s):  
Gianfranca Cabiddu ◽  
◽  
Donatella Spotti ◽  
Giuseppe Gernone ◽  
Domenico Santoro ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Best Practice ◽  
Position Statement ◽  
Italian Society ◽  
Study Group

scholarly journals A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. The Kidney and Pregnancy Study Group of the Italian Society of Nephrology

2018 ◽  
Vol 31 (5) ◽  
pp. 665-681 ◽  
Author(s):  
Gianfranca Cabiddu ◽  
◽  
Donatella Spotti ◽  
Giuseppe Gernone ◽  
Domenico Santoro ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Best Practice ◽  
Position Statement ◽  
Italian Society ◽  
Study Group

scholarly journals Erratum to: A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

2017 ◽  
Vol 30 (4) ◽  
pp. 619-619
Author(s):  
Gianfranca Cabiddu ◽  
Santina Castellino ◽  
Giuseppe Gernone ◽  
Domenico Santoro ◽  
Gabriella Moroni ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Best Practice ◽  
Position Statement ◽  
Study Group ◽  
Italian Study

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

2017 ◽  
Vol 30 (3) ◽  
pp. 307-317 ◽  
Author(s):  
Giorgina Barbara Piccoli ◽  
◽  
Gianfranca Cabiddu ◽  
Santina Castellino ◽  
Giuseppe Gernone ◽  
...  
Keyword(s):  
Best Practice ◽  
Position Statement ◽  
Study Group ◽  
Italian Study

scholarly journals A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

2016 ◽  
Vol 29 (3) ◽  
pp. 277-303 ◽  
Author(s):  
Gianfranca Cabiddu ◽  
Santina Castellino ◽  
Giuseppe Gernone ◽  
Domenico Santoro ◽  
Gabriella Moroni ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Best Practice ◽  
Position Statement ◽  
Study Group ◽  
Italian Study

scholarly journals Vascular Access Perspectives in Patients After Kidney Transplantation

2021 ◽  
Vol 8 ◽  
Author(s):  
Krzysztof Letachowicz ◽  
Mirosław Banasik ◽  
Anna Królicka ◽  
Oktawia Mazanowska ◽  
Tomasz Gołębiowski ◽  
...  
Keyword(s):  
Blood Flow ◽  
Kidney Transplantation ◽  
Vascular Access ◽  
Graft Function ◽  
Protective Measure ◽  
Study Group ◽  
Renal Transplant Recipients ◽  
Upper Arm ◽  
Surgical Closure ◽  
Proximal Forearm

Introduction: More attention has been paid to the influence of arteriovenous fistula (AVF) on the cardiovascular system. In renal transplant recipients, some beneficial effect of an elective vascular access (VA) ligation was observed in patients with a high AVF flow. However, this strategy is not widely accepted and is in contradiction to the rule of vasculature preservation for possible future access. The aim of our study is to elucidate the vascular access function and VA perspective in the kidney transplantation (KTx) population.Materials and Methods: KTx patients with a stable graft function were recruited to participate in this single center observational study (NCT04478968). The measurement of VA flow and vessel mapping for future vascular access was performed by a color Doppler ultrasound. The study group included 99 (63%) males and 58 (37%) females; the median age was 57 (IQR 48–64) years. The median time from the transplantation to the baseline visit was 94 (IQR 61–149) months. Median serum creatinine concentration was 1.36 (IQR 1.13–1.67) mg/dl.Results: Functioning VA was found in 83 out of 157 (52.9%) patients. The sites were as follows: snuffbox in six (7.2%), wrist in 41 (49.4%), distal forearm in 18 (21.7%), middle or proximal forearm in eight (9.6%), upper-arm AV graft in one (1.2%), and upper-arm AVFs in nine (10.8%) patients, respectively. Blood flow ranged from 248 to 7,830 ml/min; the median was 1,134 ml/min. From the transplantation to the study visit, 66 (44.6%) patients experienced access loss. Spontaneous thrombosis was the most common, and it occurred in 60 (90.9%) patients. The surgical closure of VA was performed only in six (4%) patients of the study group with a functioning VA at the time of transplantation. Access loss occurred within the 1st year after KTx in 33 (50%) patients. Majority (50 out of 83, 60.2%) of the patients with an active VA had options to create a snuffbox or wrist AVF on the contralateral extremity. In a group of 74 patients without a functioning VA, the creation of a snuffbox or wrist AVF on the non-dominant and dominant extremity was possible in seven (9.2%) and 40 (52.6%) patients, respectively. In 10 (13.1%) patients, the possibilities were limited only to the upper-arm or proximal forearm VA on both sides. Access ligation was considered by 15 out of 83 (18.1%) patients with a patent VA.Conclusions: In the majority of the patients, vascular access blood flow was below the threshold of the negative cardiovascular effect of vascular access. Creation of a distal AVF is a protective measure to avoid a high flow and preserve the vessels for future access. The approach to VA should be individualized and adjusted to the patient's profile.

AN INTERNATIONAL POSITION STATEMENT ON THE MANAGEMENT OF FRAILTY IN DIABETES MELLITUS: SUMMARY OF RECOMMENDATIONS 2017

2017 ◽  
pp. 1-11
Author(s):  
A.J. SINCLAIR ◽  
A. ABDELHAFIZ ◽  
T. DUNNING ◽  
M. IZQUIERDO ◽  
L. RODRIGUEZ MANAS ◽  
...  
Keyword(s):  
New England ◽  
American Medical ◽  
Best Practice ◽  
English Language ◽  
Quality Care ◽  
Position Statement ◽  
Evidence Based ◽  
Medicine Journal ◽  
Wide Range ◽  
International Experts

Aim: the the International Position Statement provides the opportunity to summarise all existing clinical trial and best practice evidence for older people with frailty and diabetes. It is the first document of its kind and is intended to support clinical decisions that will enhance safety in management and promote high quality care. Methods: the Review Group sought evidence from a wide range of studies that provide sufficient confidence (in the absence of grading) for the basis of each recommendation. This was supported by a given rationale and key references for our recommendations in each section, all of which have been reviewed by leading international experts. Searches for any relevant clinical evidence were generally limited to English language citations over the previous 15 years. The following databases were examined: Embase, Medline/PubMed, Cochrane Trials Register, Cinahl, and Science Citation. Hand searching of 16 key major peer-reviewed journals was undertaken by two reviewers (AJS and AA) and these included Lancet, Diabetes, Diabetologia, Diabetes Care, British Medical Journal, New England Journal of Medicine, Journal of the American Medical Association, Journal of Frailty & Aging, Journal of the American Medical Directors Association, and Journals of Gerontology – Series A Biological Sciences and Medical Sciences. Results: two scientific supporting statements have been provided that relate to the area of frailty and diabetes; this is accompanied by evidence-based decisions in 9 clinical domains. The Summary has been supported by diagrammatic figures and a table relating to the inter-relations between frailty and diabetes, a frailty assessment pathway, an exercise-based programme of intervention, a glucose-lowering algorithm with a description of available therapies. Conclusions: we have provided an up to date evidence-based approach to practical decision-making for older adults with frailty and diabetes. This Summary document includes a user-friendly set of recommendations that should be considered for implementation in primary, community-based and secondary care settings.

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