Oxford Desk Reference Nephrology

2021 ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Kidney Diseases ◽  
Medical Problems ◽  
Adult Kidney ◽  
Number Of Patients ◽  
The World ◽  
Patients Experience ◽  
Desk Reference

Written for the busy nephrologist and internist who need easy to access information on the diagnosis, investigation, and treatment of patients with kidney disease, the Oxford Desk Reference Nephrology is presented in a way that is not only easy to read and digest but also is detailed enough to allow an in depth understanding of the complex mix of metabolic, immunological, and genetic causes of both acute and chronic kidney disease. The kidneys are rarely affected by disease in isolation; the book comprehensively covers the multisystem disorders that require a multidisciplinary approach, including the cardiological, rheumatological, haematological, infectious, oncological, and urological aspects of kidney disease. In parallel, it extensively describes the myriad multisystem complications of progressive chronic kidney disease with practical advice on how these should be investigated and managed. The importance of understanding the evolution of kidney disease in children and young adults is covered, as in many parts of the world there is no distinction between adult and paediatric nephrology. Therefore, it is important that nephrologists have a sound grasp of both paediatric and adult kidney diseases. The number of patients with advanced kidney disease treated with a kidney transplant or receiving dialysis is increasing in all parts of the world. All nephrologists will manage patients on dialysis or who have a kidney transplant and all internists will encounter these patients. Thus, it is imperative that they have an understanding of these treatments and the commonly encountered medical problems such patients experience.

Management of advanced chronic kidney disease (CKD)

2021 ◽  
pp. 608-688
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dialysis Patients ◽  
Medical Problems ◽  
Advanced Chronic Kidney Disease ◽  
Conservative Care ◽  
Number Of Patients ◽  
Essential Components ◽  
The World ◽  
Patients Experience

The number of patients with advanced kidney disease requiring dialysis is increasing in all parts of the world. Managing patients as they transition onto dialysis and providing support and guidance as they make important treatment choices are essential components of a nephrologist’s job. Ensuring timely preparation for dialysis, allowing patients the opportunity to explore all options, including conservative care, and managing individual expectations of dialysis are increasingly important. All nephrologists will manage patients treated with dialysis and therefore it is imperative that they have a sound understanding of different dialysis modalities, how to assess the adequacy of dialysis, and the commonly encountered medical problems dialysis patients experience.

scholarly journals AFRAN guidelines on COVID-19 and the kidney

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Anthony Were
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Capital City ◽  
Central China ◽  
World Health ◽  
Immunosuppressed Patient ◽  
African Continent ◽  
Renal Complications ◽  
The World

COVID-19, a disease caused by the novel virus SARS-CoV-2, was declared a pandemic by the World Health Organization on 11 March 2020. It originated from Wuhan, the capital city of the Hubei province in central China. It has now spread to almost every country in the world and all the continents except Antarctica and has been associated with significant fatalities.COVID-19 infection has been documented in 47 countries in Africa, with almost 85,000 cases and 2,760 deaths as at 16 May 2020. The mortality is significantly lower in Africa than elsewhere for reasons that are still unclear. In the typical case, a patient presents with fever or respiratory symptoms such as cough or difficulty in breathing, usually within 14 days of coming into contact with an infected person. Acute kidney injury may occur as part of multisystem involvement in the very ill patient and is often managed in the intensive care unit. Our patients with chronic kidney disease, including those on chronic dialysis, will easily get infected with SARS-CoV-2 if exposed, due to their immunosuppressed state. Similarly, the immunosuppressed patient who has received a kidney transplant requires special precautions to prevent and manage infection with SARS-CoV-2. The transplantation operation itself also requires clear guidelines to prevent coronavirus infection.The executive committee of the African Association of Nephrology (AFRAN) convened a special project committee of senior nephrologists from across the continent to develop guidelines relevant to the African continent on the management of the renal complications of COVID-19 and on the management of COVID-19 in patients with chronic kidney disease. The guidelines include recommendations on the prevention and management of COVID-19 in patients receiving kidney replacement therapy with haemodialysis, peritoneal dialysis or a kidney transplant. The article, titled ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’, is published on page 109 of this issue and represents an impressive collaboration by African nephrologists. These guidelines will be of practical value across the length and breadth of the African continent, from the well resourced to the most disadvantaged settings. The guidelines will also be of value to other parts of the world with respect to COVID-19 and the kidney. On behalf of AFRAN, I wish to congratulate the colleagues who contributed to the development of these guidelines. We are sure that the information they contain will greatly benefit the management of COVID-19 in Africa. Anthony WerePresident, African Association of Nephrology.

The child with kidney disease

2021 ◽  
pp. 433-489
Keyword(s):  
Young Adults ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Growing Up ◽  
Paediatric Nephrology ◽  
Adult Kidney ◽  
The World ◽  
Children And Young Adults

As adult nephrologists we recognize the importance of understanding the evolution of kidney disease in children and young adults. We also acknowledge that in many parts of the world there is no distinction between adult and paediatric nephrology and therefore it is important that nephrologists have a sound grasp of paediatric and adult kidney diseases. Transition from paediatric to adult nephrology services is a challenging time for many young adults living with kidney disease and ensuring adult nephrologists appreciate the multiple and often unique challenges growing up with kidney disease bring is an important component of nephrology practice. It is also important that as adult nephrologists we understand the spectrum of kidney diseases that affect children and young adults, which are often markedly different to those we encounter in adult practice.

P1854SOCIAL NETWORK AS A SOURCE OF HEALTH EDUCATION IN NEPHROLOGY: THE CASE OF RENAL HEALTH INSTAGRAM

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Marjan Askari ◽  
Diovana Dourado ◽  
Thiago Praça Brasil ◽  
Barbara Carneiro de Holanda ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Health Education ◽  
Health Information ◽  
Kidney Transplant ◽  
Kidney Diseases ◽  
Specific Information ◽  
Digital Platforms ◽  
Number Of Patients ◽  
The Subject

Abstract Background and Aims Chronic kidney disease (CKD) have been affecting a large number of patients worldwide and presents increasing numbers. Beyond professional intervention, it is extremely necessary to have patients’ involvement in treatment. One useful way to disseminate CKD knowledge is the social network, through which we can not only reach a large public interested on the posts, but also influence the routine quality of a CKD patient. The aim of this study is to present the creation of an Instagram profile named “Renal Health”, which focuses on providing specific information for patients with CKD to help them improve the quality of treatment results and maintain a healthy lifestyle, as well as to analyze the spontaneous comments and feedbacks received from its followers. Method The Renal Health project started in 2015, in Fortaleza, Brazil, aiming to create technological tools to help CKD patients cope with the disease and increase adherence to treatment. The research team has a multi-professional background, from Health, Information Technology, Computer Science and Communication fields, and also aims to create educational tools to increase health literacy focusing on kidney disease and its prevention. An Instagram profile (https://www.youtube.com/channel/UC3-GHeHAndcrRmbE4I_qE_w) have been created to provide people with access to these specialized contents. Within that context, we collected spontaneous comments and feedbacks from 4,229 followers from the Renal Health Instagram posts from June 2018 (when the profile was created) to December 2019. Results We have reached a total of 4,229 followers. There were 505 posts, 16 (3.16%) about medication, 65 (12.87%) about nutrition, 12 (2.3%) about physical exercise, 132 (26.13%) about kidney disease and comorbidities, 82 (16.23%) about CKD treatment, 61 (12.07%) about kidney transplant and organ donation, and 137 (27.12 %) about other subjects, including motivational messages. Of a total of 1,560 comments, we have identified 543 profiles, of these 88 (16.2%) were men, and 412 (75.8%) women, noting the prevalence of women among the comments made. Among those comments, 223 were regarding congratulations on the profile. We have identified 99 patients with kidney diseases, mainly CKD; 81 (81.81%) spontaneously reported their illnesses in their comments, being 46 (56.8%) on dialysis, 13 (16.4%) transplanted patients, 5 (6.7%) glomerulonephritis, 4 (4.9%) kidney stones and 4 (4.9%) renal cysts. In the group of 46 patients on dialysis, we have identified 105 comments, of which 14 were regarding the value of the information on the posts, followed by 71 comments on personal experiences on the subject and 20 comments containing questions about the topic, which we had prompt answered. Among the group of 13 renal transplanted patients, 12 comments demonstrated their happiness after the transplant and their experiences on the subject, and 1 comment containing a question about kidney transplant. We have also identified other health professionals interacting with the profile, declaring that it was helpful to guide their patients. Furthermore, this platform had crossed the borders, being identified comments by people from around the world, such as other South American countries, the Middle East and Europe. The most recent posts can be seen in Figure 1. Conclusion Through the analysis of the comments we noticed the possibility of better knowing the followers of the project, enabling the development of personalized information for each patient. Social networks, such as the Instagram, seem to be great tools for health education and interaction between health care team and patients. In addition, the use of digital platforms to share trusted health information can reach a broad audience.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

scholarly journals Beyond a Passive Conduit: Implications of Lymphatic Biology for Kidney Diseases

2020 ◽  
Vol 31 (6) ◽  
pp. 1178-1190 ◽  
Author(s):  
Daniyal J. Jafree ◽  
David A. Long
Keyword(s):  
Kidney Disease ◽  
Therapeutic Potential ◽  
Kidney Diseases ◽  
Transplant Rejection ◽  
Lymphatic Vessels ◽  
Renal Physiology ◽  
Clear Fluid ◽  
Adult Kidney ◽  
And Function ◽  
Development Structure

The kidney contains a network of lymphatic vessels that clear fluid, small molecules, and cells from the renal interstitium. Through modulating immune responses and via crosstalk with surrounding renal cells, lymphatic vessels have been implicated in the progression and maintenance of kidney disease. In this Review, we provide an overview of the development, structure, and function of lymphatic vessels in the healthy adult kidney. We then highlight the contributions of lymphatic vessels to multiple forms of renal pathology, emphasizing CKD, transplant rejection, and polycystic kidney disease and discuss strategies to target renal lymphatics using genetic and pharmacologic approaches. Overall, we argue the case for lymphatics playing a fundamental role in renal physiology and pathology and treatments modulating these vessels having therapeutic potential across the spectrum of kidney disease.

scholarly journals GENETIC KIDNEY DISEASES AS AN UNDERECOGNIZED CAUSE OF CHRONIC KIDNEY DISEASE: THE KEY ROLE OF INTERNATIONAL REGISTRY REPORTS

2021 ◽  
Author(s):  
Roser Torra ◽  
Mónica Furlano ◽  
Alberto Ortiz ◽  
Elisabet Ars
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Unknown Etiology ◽  
Correct Treatment ◽  
Monogenic Diseases ◽  
High Prevalence ◽  
Incorrect Diagnosis ◽  
Kidney Replacement Therapy

Abstract Inherited kidney diseases (IKDs) are among the leading causes of early-onset chronic kidney disease (CKD) and are responsible for at least 10–15% of cases of kidney replacement therapy (KRT) in adults. Pediatric nephrologists are very aware of the high prevalence of IKDs among their patients, but this is not the case for adult nephrologists. Recent publications have demonstrated that monogenic diseases account for a significant percentage of adult cases of CKD. A substantial number of these patients have received a non-specific/incorrect diagnosis or a diagnosis of CKD of unknown etiology, which precludes correct treatment, follow-up and genetic counseling. There are a number of reasons why genetic kidney diseases are difficult to diagnose in adulthood: a) adult nephrologists, in general, are not knowledgeable about IKDs, b) existence of atypical phenotypes, c) genetic testing is not universally available, d) family history is not always available or may be negative, e) lack of knowledge of various genotype–phenotype relationships, f) conflicting interpretation of the pathogenicity of many sequence variants.

Endocrine Aspects of Kidney Disease

2020 ◽  
Author(s):  
Marcin Adamczak ◽  
Piotr Kuczera ◽  
Andrzej Wiecek
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Serum Prolactin ◽  
Clinical Consequences ◽  
Synthesis And Degradation ◽  
Insulin Like Growth Factors

Kidneys play the major role in the synthesis and degradation of several hormones. Different coexisting conditions such as inflammation, malnutrition and metabolic acidosis and applied treatment may also cause endocrine abnormalities in chronic kidney disease (CKD) patients. A tendency towards decreased thyroxin and triiodothyronine with normal serum concentrations of reversed triiodothyronine (as opposed to other chronic non-thyroid, non-kidney diseases) and thyroid stimulating hormone are observed. As far as the somatotopic axis is concerned, in CKD normal serum concentration of growth hormone and its effector – the insulin-like growth factor are observed. Nevertheless, due to the phenomenon of GH/IGF-1 “resistance” CKD patients usually present a phenotype resembling GH deficiency. Serum prolactin concentrations are often elevated in CKD women and men. This leads to the dysregulation of the pituitary-gonadal axis causing hypogonadism and it’s clinical consequences regardless of patient’s gender. The alterations in hormones of gonadal origin caused by uremia, together with hyperprolactinemia lead to the development of sexual dysfunction and infertility in men and women. The alterations of thyroid, pituitary gland and gonads associated with CKD are discussed in this chapter. This review contains 4 tables, and 64 references. Keywords: chronic kidney disease, hypothyroidism, hyperthyroidism, growth hormone, recombinant human GH, insulin-like growth factors, hemodialysis

FEATURES OF CHRONIC KIDNEY DISEASE IN ELDERLY PATIENTS

2020 ◽  
pp. 113-120
Author(s):  
О. Н. Курочкина
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Clinical Situation ◽  
Chronic Glomerulonephritis ◽  
Hypertensive Nephropathy ◽  
Number Of Patients ◽  
Rate Of Decline ◽  
People Group ◽  
Group 1

Изучены особенности течения хронической болезни почек (ХБП) у пожилых пациентов на основании анализа регистра ХБП за 2015-2018 гг. В регистре 484 пациента, из них 231 (47,7%) мужчина, 253 (52,3%) женщины, средний возраст - 58,8±15,8 года. Пациенты были разделены на три группы: 1-я - 218 человек до 59 лет; 2-я - 207 человек 60-74 лет; 3-я - 59 человек 75 лет и старше. В 1-й группе ведущей причиной ХБП явился хронический гломерулонефрит -27,1%, во 2-й - хронический тубулоинтерстициальный нефрит (ТИН) - 21,7%, диабетическая нефропатия (ДН) - 20,8% и гипертоническая нефропатия - 15,9%; в 3-й - ТИН (27,1%), хронический пиелонефрит (ПН) - 15,9% и ДН (13,6%). С возрастом увеличивалась частота встречаемости ТИН ( р <0,1), ПН ( р <0,05), ишемической болезни почек ( р <0,05), подагрической нефропатии ( р <0,1). Среднее снижение СКФ - 3,99 мл/мин на 1,73 мза год наблюдения. Темп снижения СКФ в 1-й группе - 3,36±1,8 мл/мин на 1,73 мза год, во 2-й - 2,43±1,2 ( р <0,001 между 1-йи 2-й группой), в 3-й - 1,82±1,1 мл/мин на 1,73 мза год. Наблюдали отрицательную корреляцию с возрастом ( р <0,05). Формирование регистра больных с ХБП позволяет знать количество больных и причины ХБП у пациентов пожилого и старческого возраста, оценивать клиническую ситуацию, темпы снижения СКФ и выбирать лечебную тактику у этих пациентов. The purpose of the work is to study the characteristics of the course of chronic kidney disease in elderly patients based on the analysis of the register of chronic kidney disease (CKD) for 2015-2018. in the Department of Nephrology, the Komi Republican Clinical Hospital. There are 484 patients in the register, of whom 231 are men (47,7%), 253 women (52,3%). The average age is 58,8±15,8 years old. The patients were divided into 3 groups: persons under the age of 59 years old - 218 people (group 1); from 60 to 74 years old - 207 people (group 2); and over 75 years old - 59 people (group 3). Most patients are between the ages of 60 and 69 years old. In the 1 group, the chronic glomerulonephritis is the leading cause of CKD - 27,1%; in the 2 group - the chronic tubulo-interstitial nephritis (TIN) - 21,7%, the diabetic nephropathy (DN) - 20,8% and the hypertensive nephropathy - 15,9%; in the 3 group - TIN (27,1%), the chronic pyelonephritis (PN) (15,9%) and DN (13,6%). With increasing age, the incidence of TIN ( p <0,1), MO ( p <0,05), coronary kidney disease (IBP) ( p <0,05), gouty nephropathy ( p <0,1) were raised. The average reduction in GFR is 3,99 ml/min/1,73 m per year of observation. The rate of decline in GFR in the 1st group is 3,36±1,8 ml/min/1,73 m per year, in the 2 - 2,43±1,2 ( p <0,001 between group 1 and 2), in the 3 group - 1,82±1,1; with aging the negative correlation was observed ( p <0,05). 39 patients received hemodialysis, including: in the 1 group - 20 people (9%), in the 2 group - 18 (8,7%), in the 3 group - 1 patient (1,7%). Making the register of the patients with CKD allows us to know the number of patients and the causes of CKD among the patients of elderly and senile ages, to assess the clinical situation, the rate of decline in GFR and treatment tactics in these patients.

Sign in / Sign up

Export Citation Format

Share Document