scholarly journals Patients with chronic kidney disease have poor perceived knowledge of treatment options

2009 ◽  
Vol 5 (2) ◽  
pp. 60-60
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Options ◽  
Perceived Knowledge

scholarly journals Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Huai Leng Pisaniello ◽  
Mark C. Fisher ◽  
Hamish Farquhar ◽  
Ana Beatriz Vargas-Santos ◽  
Catherine L. Hill ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Literature Review ◽  
Interleukin 1 ◽  
Treatment Options ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Clinical Trial Results ◽  
Gout Flare

AbstractGout flare prophylaxis and therapy use in people with underlying chronic kidney disease (CKD) is challenging, given limited treatment options and risk of worsening renal function with inappropriate treatment dosing. This literature review aimed to describe the current literature on the efficacy and safety of gout flare prophylaxis and therapy use in people with CKD stages 3–5. A literature search via PubMed, the Cochrane Library, and EMBASE was performed from 1 January 1959 to 31 January 2018. Inclusion criteria were studies with people with gout and renal impairment (i.e. estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) < 60 ml/min/1.73 m2), and with exposure to colchicine, interleukin-1 inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and glucocorticoids. All study designs were included. A total of 33 studies with efficacy and/or safety analysis stratified by renal function were reviewed—colchicine (n = 20), anakinra (n = 7), canakinumab (n = 1), NSAIDs (n = 3), and glucocorticoids (n = 2). A total of 58 studies reported these primary outcomes without renal function stratification—colchicine (n = 29), anakinra (n = 10), canakinumab (n = 6), rilonacept (n = 2), NSAIDs (n = 1), and glucocorticoids (n = 10). Most clinical trials excluded study participants with severe CKD (i.e. eGFR or CrCl of < 30 mL/min/1.73 m2). Information on the efficacy and safety outcomes of gout flare prophylaxis and therapy use stratified by renal function is lacking. Clinical trial results cannot be extrapolated for those with advanced CKD. Where possible, current and future gout flare studies should include patients with CKD and with study outcomes reported based on renal function and using standardised gout flare definition.

scholarly journals Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies

2008 ◽  
Vol 74 (9) ◽  
pp. 1178-1184 ◽  
Author(s):  
Fredric O. Finkelstein ◽  
Kenneth Story ◽  
Catherine Firanek ◽  
Paul Barre ◽  
Tomoko Takano ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Perceived Knowledge ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Association between gut dysbiosis and chronic kidney disease: a narrative review of the literature

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110532
Author(s):  
Zhe Feng ◽  
Ting Wang ◽  
Sheng Dong ◽  
Hongli Jiang ◽  
Jianzhong Zhang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Communicable Disease ◽  
Treatment Options ◽  
Narrative Review ◽  
Gut Dysbiosis ◽  
Significant Burden ◽  
Intestinal Ecology ◽  
The Relationship ◽  
Non Communicable Disease

Chronic kidney disease (CKD) is a serious non-communicable disease that poses a significant burden on healthcare and society. It is essential to devise new strategies to better treat patients with CKD. Research has illustrated that gut dysbiosis, describing an abnormal intestinal ecology, is closely associated with CKD. In this narrative review, we summarized the evidence of their mutual relationship and discussed the potential treatment options to correct gut dysbiosis in patients with CKD. Gut dysbiosis significantly increases the risk of CKD, especially in the older population. Gut dysbiosis also plays a role in CKD complications, such as hypertension, cardiovascular events, and cognitive dysfunction. The relationship between gut dysbiosis and CKD is bidirectional, and CKD itself can lead to changes in gut microecology. The usual therapies for CKD can also increase the incidence of gut dysbiosis. Meanwhile, probiotics and antibiotics are generally used to correct gut dysbiosis. Further studies are required to elaborate the association between gut dysbiosis and CKD, and more treatment options should be explored to prevent CKD in patients with gut dysbiosis.

scholarly journals Statin and anemia in chronic kidney disease (CKD): an experimental study

2018 ◽  
Vol 197 ◽  
pp. 07003 ◽  
Author(s):  
P N Cahyawati ◽  
A A S A Aryastuti ◽  
M B T Ariawan ◽  
N Arfian ◽  
Ngatidjan Ngatidjan
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hematological Parameters ◽  
Treatment Options ◽  
White Blood Cells ◽  
Hemoglobin Concentration ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Simvastatin Group ◽  
Group 5

Anemia is a common feature of chronic kidney disease (CKD). The current management of patients with anemia in CKD is controversial. These make anemia is one of the leading causes poor outcome in CKD patients. Our study focus to assess the effect of statin on hemoglobin level with an experimental model of CKD. We perform the animal model of CKD by subtotal nephrectomy procedure. A total of 20 male swiss was used in these study. All the animal divided into 4 groups: sham group (S), nephrectomy (Nx), simvastatin group 5 mg/kgBB (SV5), and simvastatin group 10 mg/kgBB (SV10). Hematological parameters (hemoglobin (Hb), white blood cells (WBC), red blood cell (RBC), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC)), and serum creatinine are measured at the end of the study. The hemoglobin levels in the Ux group decreased significantly compared with the S group (11.02 ± 0.46 vs 14.3 ± 0.15, p<0.0001). While in the SV group, statin administration led to an increase in hemoglobin levels compared with the Ux group but not statistically significant (SV5: 13.26±0.34; Sv10: 12.68±0.26). These results suggest that administration of statins in CKD may improve the condition of anemia by an unknown mechanism, while still requiring other treatment options to maximize the effect of therapy.

scholarly journals Cardiac Remodeling in Chronic Kidney Disease

Toxins ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 161 ◽  
Author(s):  
Nadine Kaesler ◽  
Anne Babler ◽  
Jürgen Floege ◽  
Rafael Kramann
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Remodeling ◽  
Mineral Metabolism ◽  
Treatment Options ◽  
Renin Angiotensin System ◽  
Cell Types ◽  
Current Treatment ◽  
Left Ventricular ◽  
Heart Functions

Cardiac remodeling occurs frequently in chronic kidney disease patients and affects quality of life and survival. Current treatment options are highly inadequate. As kidney function declines, numerous metabolic pathways are disturbed. Kidney and heart functions are highly connected by organ crosstalk. Among others, altered volume and pressure status, ischemia, accelerated atherosclerosis and arteriosclerosis, disturbed mineral metabolism, renal anemia, activation of the renin-angiotensin system, uremic toxins, oxidative stress and upregulation of cytokines stress the sensitive interplay between different cardiac cell types. The fatal consequences are left-ventricular hypertrophy, fibrosis and capillary rarefaction, which lead to systolic and/or diastolic left-ventricular failure. Furthermore, fibrosis triggers electric instability and sudden cardiac death. This review focuses on established and potential pathophysiological cardiorenal crosstalk mechanisms that drive uremia-induced senescence and disease progression, including potential known targets and animal models that might help us to better understand the disease and to identify novel therapeutics.

scholarly journals P0865A QUALITATIVE STUDY OF PATIENTS' PREFERENCE FOR THE TREATMENT OF ANAEMIA ASSOCIATED WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ana Filipa Alexandre ◽  
Antonia Morga ◽  
Kevin Marsh ◽  
Caitlin Thomas
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Oral Treatment ◽  
Treatment Options ◽  
Injection Pain ◽  
Primary Concern ◽  
Shortness Of Breath ◽  
Self Administration ◽  
Mode Of Administration

Abstract Background and Aims Anaemia is a common complication of chronic kidney disease (CKD) that is associated with fatigue, shortness of breath, and lethargy. CKD anaemia is commonly treated with oral or intravenous (IV) iron and IV or subcutaneous (SC) erythropoiesis-stimulating agents (ESAs). The objectives of this study were to understand patients’ experiences with CKD anaemia and their preferences related to treatment. Method Qualitative 60-minute semi-structured interviews were conducted with ESA-treated adult CKD patients with anaemia, either non–dialysis-dependent (ND) or dialysis-dependent (DD), and with practicing nephrologists in France, Germany, Spain, the UK, and Japan. The patients’ interviews, appropriately tailored for ND and DD patients, comprised three sections: 1) patients’ views on the burden of the disease and its treatment; 2) discussion of vignettes describing different treatment options; and 3) non-experimental choice questions between two hypothetical treatments including mode of administration, need for iron supplement, and risk of adverse events (AEs). Results A total of 51 patients were enrolled (ND, n=6 per country except for France [n=7]; DD [haemodialysis or peritoneal dialysis], n=4 per country). Two nephrologists per country were interviewed. The most commonly reported symptoms associated with anaemia were tiredness (ND, 77%; DD, 85%) and shortness of breath (ND, 42%; DD, 30%); these two symptoms were also reported by nephrologists, who considered clinical efficacy the most important aspect of treatment. In Japan, dizziness was the most common (n=5/6, 83%) symptom among ND patients. Anaemia symptoms were reported to negatively affect different aspects of patients’ lives, including the ability to carry out daily activities (ND, 61%; DD, 65%), work (ND, 42%; DD, 50%), and exercise (ND, 26%; DD, 30%). ESA treatments were perceived to be effective in improving patients’ symptoms and quality of life. Many patients had not experienced AEs associated with treatment and were not concerned about them, however patients who had experienced gastrointestinal (GI) AEs due to oral iron were sensitive to the risk of GI effects. Out of 23 ND patients who were asked, 19 (83%) preferred an oral treatment due to the convenience of administration, and to avoid injection pain and drug storage requirements associated with SC administration. Self-administering SC ESAs was a concern among Japanese ND patients, who often had a healthcare professional administer the medication. Haemodialysis patients (n=12), who often receive IV ESAs during their dialysis sessions, were less likely to prefer oral treatments due to lack of perceived convenience. Peritoneal dialysis patients (n=8), who often receive home dialysis and SC ESAs, preferred oral treatment to avoid self-administration and storage requirements, and to make travel easier. Limitations of the study included the small number of participants and amendments to the eligibility criteria implemented during data collection, including more relaxed requirements for blood pressure, blood transfusion, and insulin use. Conclusion Patients considered the available treatment options to effectively treat CKD anaemia. Besides efficacy, patients’ primary concern was the mode of administration of their medication, rather than safety considerations.

scholarly journals Targeting Hypoxia-Inducible Factors for the Treatment of Anemia in Chronic Kidney Disease Patients

2017 ◽  
Vol 45 (3) ◽  
pp. 187-199 ◽  
Author(s):  
Francesco Locatelli ◽  
Steven Fishbane ◽  
Geoffrey A. Block ◽  
Iain C. Macdougall
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Metabolism ◽  
Treatment Options ◽  
Prolyl Hydroxylase ◽  
Hypoxia Inducible Factors ◽  
Anemia Management ◽  
Safety Considerations ◽  
Hif Pathway ◽  
Hif Prolyl Hydroxylase

Background: Anemia, a common complication of chronic kidney disease (CKD), has previously been attributed primarily to decreased production of erythropoietin. More recently, it has become apparent that the etiology of anemia involves several other factors, most notably dysfunctional iron metabolism, mediated via increased hepcidin activity and reduced clearance. Current management of anemia in patients with advanced CKD is based on erythropoiesis-stimulating agents and iron supplementation, along with red blood cell transfusions when necessary; however, safety considerations associated with these therapies highlight the need to pursue alternative treatment options targeting other mechanisms such as hypoxia-inducible factors (HIFs) that act as central regulators of erythropoiesis by coordinating a series of graded hypoxic responses. Summary: This review discusses the discovery of the HIF pathway and its regulation via HIF prolyl hydroxylase enzymes in the context of erythropoiesis and iron metabolism. The rationale for targeting this pathway and the clinical development of HIF prolyl hydroxylase inhibitors are reviewed, with a commentary on the potential implications of this class of agents in CKD anemia management. Key Messages: Pharmacologic activation of the HIF pathway results in a transient pseudo-hypoxic state that stimulates erythropoiesis in CKD patients with anemia. Results from clinical studies of a number of HIF prolyl hydroxylase inhibitors are increasingly available and provide support for the continued evaluation of the risk-benefit ratio of this novel therapeutic approach to the treatment of anemia in CKD.

scholarly journals Clinician views of patient decisional conflict when deciding between dialysis and conservative management: Qualitative findings from the PAlliative Care in chronic Kidney diSease (PACKS) study

2017 ◽  
Vol 31 (10) ◽  
pp. 921-931 ◽  
Author(s):  
Helen Noble ◽  
Kevin Brazil ◽  
Aine Burns ◽  
Sarah Hallahan ◽  
Charles Normand ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Palliative Care ◽  
United Kingdom ◽  
Kidney Disease ◽  
Conservative Management ◽  
Treatment Options ◽  
Decisional Conflict ◽  
The United Kingdom ◽  
The Impact

Background: Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care). Aim: To explore clinician views on decisional conflict in patients with end-stage kidney disease. Design: Interpretive, qualitative study. Setting and participants: As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom. Interviews took place between April 2015 and October 2016 and a thematic analysis of the interview data was undertaken. Results: Three major themes with associated subthemes were identified. The first, ‘Frequent changing of mind regarding treatment options’, revealed how patients frequently altered their treatment decisions, some refusing to make a decision until deterioration occurred. The second theme, ‘Obligatory beneficence’, included clinicians helping patients to make informed decisions where outcomes were uncertain. In weighing up risks and benefits, and the impact on patients, clinicians sometimes withheld information they thought might cause concern. Finally, ‘Intricacy of the decision’ uncovered clinicians’ views on the momentous and brave decision to be made. They also acknowledged the risks associated with this complex decision in giving prognostic information which might be inaccurate. Limitations: Relies on interpretative description which uncovers constructed truths and does not include interviews with patients. Conclusion: Findings identify decisional conflict in patient decision-making and a tension between the prerequisite for shared decision-making and current clinical practice. Clinicians also face conflict when discussing treatment options due to uncertainty in equipoise between treatments and how much information should be shared. The findings are likely to resonate across countries outside the United Kingdom.

scholarly journals Relationship between xerosis and pruritus in patients with chronic kidney disease

2017 ◽  
Vol 71 (0) ◽  
pp. 0-0
Author(s):  
Katarzyna Kiliś-Pstrusińska ◽  
Elżbieta Wojtowicz-Prus ◽  
Jacek Szepietowski
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Treatment Options ◽  
Skin Lesions ◽  
Chronic Kidney Diseases ◽  
Skin Changes ◽  
Uremic Pruritus ◽  
Common Skin

Xerosis and pruritus are the most common skin disorders in patients with chronic kidney diseases (CKD). The prevalence and intensity of those skin changes are higher in patients undergoing dialysis, independent of its type, compared to patients treated conservatively. However, they can occur even in the early stages of CKD and be very bothersome for the sufferers. The problem of dry skin in CKD patients, its characteristics, reasons and relationship between xerosis and pruritus have been described. The current views on the pathogenesis of chronic kidney disease-associated pruritus (CKD-P), formerly known as uremic pruritus, have been discussed. This article summarizes the available treatment options for CKD-P, including both topical and systemic therapies. The authors direct attention to the need for skin lesions treatment in order to prevent their progression and to improve the quality of patients’ life.

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