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OALib Journal期刊

ISSN: 2333-9721

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匹配条件： “Kidney Disease Improving Global Outcomes” ，找到相关结果约1000条。
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Early Prediction of Acute Kidney Injury using Serum Phosphorus as a Biomarker in Pediatric Cardiac Surgical Patients
N Manjunatha,Naveen G Singh,PS Nagaraja,V Prabhakar,Vijitha Burra
- , 2018, DOI: 10.4103/aca.ACA_14_18
Abstract: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Therefore, we tested role of serum phosphorus in prediction of AKI as a biomarker after cardiac surgery in children
Impact of Daily Electronic Laboratory Alerting on Early Detection and Clinical Documentation of Acute Kidney Injury in Hospital Settings
Debbie Mallon,Gerard Brogan,James Crawford,Kendal Jensen,Tarush Kothari
- , 2018, DOI: 10.1177/2374289518816502
Abstract: Acute kidney injury, especially early-stage disease, is a common hospital comorbidity requiring timely recognition and treatment. We investigated the effect of daily laboratory alerting of patients at risk for acute kidney injury as measured by documented International Classification of Diseases diagnoses. A quasi-experimental study was conducted at 8 New York hospitals between January 1, 2014, and June 30, 2017. Education of clinical documentation improvement specialists, physicians, and nurses was conducted from July 1, 2014, to December 31, 2014, prior to initiating daily hospital-wide laboratory acute kidney injury alerting on January 1, 2015. Incidence based on documented International Classification of Diseases diagnosis of acute kidney injury and acute tubular necrosis during the intervention periods (3 periods of 6 months each: January 1 to June 30 of 2015, 2016, and 2017) were compared to one preintervention period (January 1, 2014, to June 30, 2014). The sample consisted of 269 607 adult hospital discharges, among which there were 39 071 episodes based on laboratory estimates and 27 660 episodes of documented International Classification of Diseases diagnoses of acute kidney injury or acute tubular necrosis. Documented incidence improved significantly from the 2014 preintervention period (5.70%; 95% confidence interval: 5.52%-5.88%) to intervention periods in 2015 (9.89%; 95% confidence interval, 9.66%-10.12%; risk ratio = 1.73, P < .001), 2016 (12.76%; 95% confidence interval, 12.51%-13.01%; risk ratio = 2.24, P < .001), and 2017 (12.49%; 95% confidence interval, 12.24%-12.74%; risk ratio = 2.19, P < .001). A multifactorial intervention comprising daily laboratory alerting and education of physicians, nurses, and clinical documentation improvement specialists led to increased recognition and clinical documentation of acute kidney injury
Prevalence and outcome of acute kidney injury, as defined by the new Kidney Disease Improving Global Outcomes guideline, in very low birth weight infants
Hassib Narchi,Maisa Al Malla,Mohammad Khassawneh,Mustafa AlAbdullatif,Nisha Viji Varghese
- , 2017, DOI: 10.5527/wjn.v6.i5.229
Abstract:
The Current State of Kidney Transplantation in Kenya: Challenges, Opportunities, and Future Directions  [PDF]
Christopher Owino, Ann Mutugi, Mathew Koech, Jie Tang
International Journal of Clinical Medicine (IJCM) , 2025, DOI: 10.4236/ijcm.2025.161005
Abstract: Kenya, a lower-middle-income country in East Africa, faces a rising burden of chronic kidney disease (CKD), with an estimated 12,500 individuals suffering from end-stage renal disease (ESRD). Renal transplantation—the preferred treatment option for ESRD, remains underutilized. Since the first transplant in 1978, seven centers have been established, with 829 transplants performed by 2022. Living-related renal transplants (LRRT) dominate, while deceased donor renal transplantation (DDRT) is yet to be implemented. Recent data show improved outcomes, with one-year graft survival rates up to 96%, but challenges such as acute rejection rates (32.8%) and limited donor outcome data persist. Barriers include high costs, limited insurance coverage, inadequate laboratory infrastructure, and a transplant workforce shortage. Efforts to establish DDRT programs are underway but are hampered by the absence of organ procurement systems and insufficient laboratory capabilities. Future priorities include reducing costs and expanded insurance coverage for transplant care. Investments in laboratory infrastructure, local tissue typing, and surgical training are essential. Strengthening international collaborations and public education campaigns can improve donor pools and transplantation access. Strategic policy reforms and resource allocation are vital to scaling up Kenya’s kidney transplant program and addressing the unmet needs of its ESRD population.
Comparing the association of GFR estimated by the CKD-EPI and MDRD study equations and mortality: the third national health and nutrition examination survey (NHANES III)
Tariq Shafi, Kunihiro Matsushita, Elizabeth Selvin, Yingying Sang, Brad C Astor, Lesley A Inker, Josef Coresh
BMC Nephrology , 2012, DOI: 10.1186/1471-2369-13-42
Abstract: We examined the association between eGFR and mortality among 16,010 participants of the Third National Health and Nutrition Examination Survey (NHANES III). Primary predictors were eGFRCKD-EPI and eGFRMDRD. Outcomes of interest were all-cause and cardiovascular disease (CVD) mortality. Improvement in risk categorization with eGFRCKD-EPI was evaluated using adjusted relative hazard (HR) and Net Reclassification Improvement (NRI).Overall, 26.9% of the population was reclassified to higher eGFR categories and 2.2% to lower eGFR categories by eGFRCKD-EPI, reducing the proportion of prevalent CKD classified as stage 3–5 from 45.6% to 28.8%. There were 3,620 deaths (1,540 from CVD) during 215,082 person-years of follow-up (median, 14.3？years). Among those with eGFRMDRD 30–59？ml/min/1.73？m2, 19.4% were reclassified to eGFRCKD-EPI 60–89？ml/min/1.73？m2 and these individuals had a lower risk of all-cause mortality (adjusted HR, 0.53; 95% CI, 0.34-0.84) and CVD mortality (adjusted HR, 0.51; 95% CI, 0.27-0.96) compared with those not reclassified. Among those with eGFRMDRD >60？ml/min/1.73？m2, 0.5% were reclassified to lower eGFRCKD-EPI and these individuals had a higher risk of all-cause (adjusted HR, 1.31; 95% CI, 1.01-1.69) and CVD (adjusted HR, 1.42; 95% CI, 1.01-1.99) mortality compared with those not reclassified. Risk prediction improved with eGFRCKD-EPI; NRI was 0.21 for all-cause mortality (p？<？0.001) and 0.22 for CVD mortality (p？<？0.001).eGFRCKD-EPI categories improve mortality risk stratification of individuals in the US population. If eGFRCKD-EPI replaces eGFRMDRD in the US, it will likely improve risk stratification.
O papel global do transplante renal
Garcia, Guillermo Garcia;Harden, Paul;Chapman, Jeremy;
Jornal Brasileiro de Nefrologia , 2012, DOI: 10.1590/S0101-28002012000100001
Abstract: world kidney day on march 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. the barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. these problems have solutions which involve the full range of societal, professional, governmental and political environments. world kidney day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.
Uremic Toxins and Clinical Outcomes: The Impact of Kidney Transplantation
Lynda Cheddani,Sophie Liabeuf,Ziad A. Massy
- , 2018, DOI: 10.3390/toxins10060229
Abstract: Non-transplanted and transplanted patients with chronic kidney disease (CKD) differ in terms of mortality and the risk of clinical events. This difference is probably due to the difference of both traditional and non-traditional risk factors. Uremic retention solutes may constitute important non-traditional risk factors in this population. In the present review, we selected a set of uremic toxins that have been associated with harmful effects, and are an appealing target for adjuvant therapy in CKD. For each toxin reviewed here, relevant studies were selected and the relationship with hard clinical outcomes of uremic toxins were compared between non-transplanted CKD patients and transplanted patients taking into account the level of glomerular filtration rate in these two situations
Standardised Outcomes in Nephrology—Polycystic Kidney Disease (SONG-PKD): study protocol for establishing a core outcome set in polycystic kidney disease
Albert C. M. Ong,Allison Tong,Angela Ju,Arlene Chapman,Armando Teixeira-Pinto,Benedicte Sautenet,Curie Ahn,Dongping Chen,Gopala Rangan,Helen Coolican,Jessica Ryan,Jonathan C. Craig,Juliana Tze-Wah Kao,Karine E. Manera,Lorraine A. Hamiwka,Martin Howell,Peter G. Kerr,Ron Gansevoort,Ronald Perrone,Talia Gutman,Tess Harris,Vicente Torres,Yeoungjee Cho,York Pei
- , 2017, DOI: 10.1186/s13063-017-2298-4
Abstract:
Characterizing the relationship between health utility and renal function after kidney transplantation in UK and US: a cross-sectional study
Neri Luca,McEwan Phil,Sennf？lt Karin,Baboolal Kesh
Health and Quality of Life Outcomes , 2012, DOI: 10.1186/1477-7525-10-139
Abstract: Background Chronic allograft nephropathy (CAN) occurs in a large share of transplant recipients and it is the leading cause of graft loss despite the introduction of new and effective immunosuppressants. The reduction in renal function secondary to immunologic and non-immunologic CAN leads to several complications, including anemia and calcium-phosphorus metabolism imbalance and may be associated to worsening Health-Related Quality of Life. We sought to evaluate the relationship between kidney function and Euro-Qol 5 Dimension Index (EQ-5Dindex) scores after kidney transplantation and evaluate whether cross-cultural differences exist between UK and US. Methods This study is a secondary analysis of existing data gathered from two cross-sectional studies. We enrolled 233 and 209 subjects aged 18–74 years who received a kidney transplant in US and UK respectively. For the present analysis we excluded recipients with multiple or multi-organ transplantation, creatinine kinase ≥200 U/L, acute renal failure, and without creatinine assessments in 3 months pre-enrollment leaving 281 subjects overall. The questionnaires were administered independently in the two centers. Both packets included the EQ-5Dindex and socio-demographic items. We augmented the analytical dataset with information abstracted from clinical charts and administrative records including selected comorbidities and biochemistry test results. We used ordinary least squares and quantile regression adjusted for socio-demographic and clinical characteristics to assess the association between EQ-5Dindex and severity of chronic kidney disease (CKD). Results CKD severity was negatively associated with EQ-5Dindex in both samples (UK: ρ= 0.20, p=0.02; US: ρ= 0.21, p=0.02). The mean adjusted disutility associated to CKD stage 5 compared to CKD stage 1–2 was Δ= 0.38 in the UK sample, Δ= 0.11 in the US sample and Δ= 0.22 in the whole sample. The adjusted median disutility associated to CKD stage 5 compared to CKD stage 1–2 for the whole sample was 0.18 (p<0.01, quantile regression). Center effect was not statistically significant. Conclusions Impaired renal function is associated with reduced health-related quality of life independent of possible confounders, center-effect and analytic framework.
Deleting Death and Dialysis: Conservative Care of Cardio-Vascular Risk and Kidney Function Loss in Chronic Kidney Disease (CKD)
Alberto Ortiz,Esmeralda Castillo-Rodriguez,Francis Verbeke,Griet Glorieux,Raymond Vanholder,Steven Van Laecke
- , 2018, DOI: 10.3390/toxins10060237
Abstract: The uremic syndrome, which is the clinical expression of chronic kidney disease (CKD), is a complex amalgam of accelerated aging and organ dysfunctions, whereby cardio-vascular disease plays a capital role. In this narrative review, we offer a summary of the current conservative (medical) treatment options for cardio-vascular and overall morbidity and mortality risk in CKD. Since the progression of CKD is also associated with a higher cardio-vascular risk, we summarize the interventions that may prevent the progression of CKD as well. We pay attention to established therapies, as well as to novel promising options. Approaches that have been considered are not limited to pharmacological approaches but take into account lifestyle measures and diet as well. We took as many randomized controlled hard endpoint outcome trials as possible into account, although observational studies and post hoc analyses were included where appropriate. We also considered health economic aspects. Based on this information, we constructed comprehensive tables summarizing the available therapeutic options and the number and kind of studies (controlled or not, contradictory outcomes or not) with regard to each approach. Our review underscores the scarcity of well-designed large controlled trials in CKD. Nevertheless, based on the controlled and observational data, a therapeutic algorithm can be developed for this complex and multifactorial condition. It is likely that interventions should be aimed at targeting several modifiable factors simultaneously
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