Preclinical gout is common in the patient with stage 3-5 chronic kidney disease. Relevance of musculoskeletal ultrasound
One in 10 patients with hyperuricemia may develop gout over time, with urate deposition sometimes asymptomatic. Recent reviews and guidelines support ultrasound (US) to assess asymptomatic hyperuricemic (AH) patients to detect gout lesions, showing double contour (DC) and tophus the highest specificities and positive predictive values. Hyperuricemia and gout are common in chronic kidney disease (CKD), especially with glomerular filtration rate (GFR) <60, and both are associated with worse prognosis, although treatment of AH in CKD is not yet recommended in all guidelines. US gout lesions have been found more frequently in AH (up to 35%) than in normouricemic (NU) patients, but evidence is scarce in CKD.
Renata, my nephrologist, can children's literature act as a tool to raise awareness and prevent kidney disease?
Interleukin-6 as a prognostic marker in acute kidney injury and its klotho-dependent regulation
In acute kidney injury (AKI), a strong inflammatory component is activated in response to the renal damage, and one of the main mediators behind this process is the pro-inflammatory interleukin 6 or IL-6. Beside to this phenomenon, there are also alterations in different components of mineral metabolism, such as those dependent on fibroblast growth factor (FGF)23 and the anti-ageing cofactor klotho. The aim of this work was to explore the association between renal function and systemic levels of IL-6, as well as FGF23 and klotho in the early stages of AKI, analysing the predictive capacity of IL-6 in early mortality associated with AKI.
What does the finding of amyloid casts in multiple myeloma mean?
Is it possible to reach the catheter target proposed by the guidelines? Reasons for catheter use in prevalent hemodialysis patients
Despite the recommendations of the clinical guidelines, the percentage of central venous catheters (CVC) continues to be above the recommended standards. We do not know whether the increasing use of catheters is due to unavoidable or avoidable factors and, in the latter case, it would be in our power to modify these results. The aim of this study was to analyze the causes that condition the use of CVC in a prevalent hemodialysis (HD) population in order to identify those modifiable factors on which to act in order to achieve the objectives of the guidelines.
Intradialysis hypertension, a diagnosis to be discovered
Intradialytic hypertension (IDH) is a poorly understood phenomenon with no consensus on its definition, etiology, or related factors, and there is limited evidence on its consequences.
Cost-effectiveness of sodium zirconium cyclosilicate for the treatment of hyperkalemia in patients with chronic kidney disease or heart failure in Spain
Hyperkalemia (HK) is an electrolyte disturbance in the concentration of potassium ions (K), whose risk increases in patients with chronic kidney disease (CKD) or heart failure (HF) and/or in patients being treated with renin-angiotensin-aldosterone system inhibitors (RAASi). The new oral K chelators offer a safe and effective treatment to maintain normokalemia in these patients. The objective of the analysis is to estimate the cost-effectiveness of sodium zirconium cyclosilicate (SZC) for the treatment of chronic HK in patients with CKD or HF versus standard treatment (calcium polystyrene sulfonate and lifestyle modifications) from the perspective of the Spanish National Health System.
Multidisciplinary Delphi consensus on challenges and key factors for an optimal care model in chronic kidney disease
Chronic kidney disease (CKD) is associated with high morbidity, burden, and resource utilization, and represents a major challenge for healthcare systems. The purpose of this study was to analyse the care patterns for these patients and to reach a consensus on the key factors that should be implemented for an optimal care model in CKD, through a multidisciplinary and integrative vision.
Bone and vascular effects of magnesium supplements in CKD patients (the MagicalBone Pilot Study)
The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC).
Mind the gap in kidney care: Translating what we know into what we do
Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.
Arteriovenous fistula in persistent left superior vena cava scenario
A rare case of PD-related cardiac tamponade after cardiac surgery
Gender distribution among editorial boards and authors of nephrology and urology journals
Risk factors for progression in patients with KDOQI stage 3 Chronic Kidney Disease (PROGRESER study)
The PROGRESER study is a multicentre, prospective, observational, 3-year follow-up study of a cohort of patients with stage 3 chronic kidney disease (CKD) from different nephrology departments of hospitals in the Spanish healthcare system. The primary study objective was to analyse risk factors for CKD progression, identifying possible differences between patients with and without diabetes mellitus (DM). The secondary objective was to analyse if the cardiovascular risk factors were also associated with CKD progression.
Remote patient monitoring and management in nephrology: A systematic review
Chronic kidney disease (CKD) is a global public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. According to European Kidney Health Alliance (EKHA) currently, 1 in 10 Europeans has chronic kidney disease (CKD) and it is predicted to be the fifth leading cause of death worldwide by 2040. The COVID-19, pandemic has further worsened the situation, with CKD being the number one risk factor for CKD mortality, ahead of lung and heart disease. In addition to rising mortality figures, treatments for kidney disease have not improved substantially over the past 50 years, leaving too many kidney patients with a poor quality of life and reduced life expectancy. This situation is associated with staggering aggregate annual costs amounting to €140 billion per year in Europe, more than the annual healthcare costs of cancer or diabetes. Many studies confirm that Information and Communication Technology intervention (ICT) in nephrology can be way to tackles this issue. The increased daily use of information and communication technologies (ICT) may lead to the need for healthcare professionals to monitoring patient remotely. Remote Patient Monitoring (RPM) have the potential to improve care for patients with kidney disease. RPM may provide a means to overcome some of the aforementioned barriers. RPM is a framework for monitoring patients at home by digital, wireless technology and extends the interactive contact of conventional clinical settings to include the patient's home. The hope is that these technologies would improve clinical outcomes through earlier recognition and correction of problems. Although few studies on telehealth in the dialysis population exist, studies do support its technical feasibility, which patient acceptance of this technology is very high, and that RPM may be able to improve outcomes in other co-morbid states shared by the ESKD population. According to Pan American Health Organization, CKD, also called kidney failure, describes the gradual loss of kidney function and is a worldwide public health problem, with adverse outcomes of kidney failure, CVD, and premature death. This study collects the papers concerning RPM and renal patient management using ICT intervention to analyze the results from considering the bioengineer's point of view. Our focus was on technology contribution. The aim of this study was to review and synthesize the available literature on the role of RPM in healthcare in nephrology. This systematic review was conducted to examine the content and results of publications on using RPM to improve the health care of patients with kidney disease, available to health care professionals (HCPs) and/or patients. The literature and our results confirm that in this field, RPM can allow cost reduction, improve the efficiency of healthcare resources, reduce human error, and overall improve the quality of life of kidney patients.
Alogliptin and tubulointerstitial nephritis: A potential complication
Prediabetes and CKD: Does a causal relationship exist
The relationship between diabetes and the development of kidney complications is well known, but the understanding of prediabetes and insulin resistance with impaired kidney function has been scarcely assessed. Various factors could explain this phenomenon, from the lack of standardization in the definitions of prediabetes, to the erratic and inconsistent evidence in large-scale epidemiological and cohort studies. It seems that the pathophysiological pathway of prediabetes could be related to inflammation and neurohormonal hyperactivation, factors present even before the onset of diabetes, which might be the main drivers of glomerular hyperfiltration, albuminuria, and impaired glomerular filtration rate. It is possible that existing treatments for the management of diabetes, as metformin or SGLT2 inhibitors may also be useful in patients with prediabetes with evidence of functional and structural kidney damage. The purpose of this review is to summarize the evidence regarding the relationship between prediabetes (preDM) and the development of CKD.
Thrombotic microangiopathy after parvovirus B19 infection treatment in a kidney transplant recipient. An uncommon presentation
Soluble αKlotho concentration in the inferior vena cava of patients with primary aldosteronism
Klotho, a key aging regulator, is predominantly expressed in the kidney. Various methods now enable the measurement of soluble αKlotho blood levels in humans. Limited studies have explored the renal origin of circulating αKlotho in humans.