22,902 results match your criteria Renal Failure Chronic and Dialysis Complications


Effectiveness of Bariatric Surgery in Increasing Kidney Transplant Eligibility in Patients with Kidney Failure Requiring Dialysis.

Obes Surg 2021 May 4. Epub 2021 May 4.

Department of Surgery, Houston Methodist Hospital, 6550 Fannin Street, Houston, TX, 77030, USA.

Purpose: Severe obesity can increase risk of complications after kidney transplantation. There is a paucity of literature on bariatric surgery outcomes in renal transplant candidates. The objective of this study was to analyze outcomes of bariatric surgery as a weight reduction strategy for patients with kidney failure to enhance eligibility for kidney transplantation. Read More

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Diabetic Ketoacidosis in Patients with End-stage Kidney Disease: A Review.

Oman Med J 2021 Mar 31;36(2):e241. Epub 2021 Mar 31.

Department of Medicine, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.

Diabetes mellitus is a highly prevalent disease. Chronic kidney disease is one of its chronic complications, and diabetic ketoacidosis is one of the most dreaded acute complications. The increasing prevalence of diabetes mellitus and renal failure has resulted in physicians increasingly encountering diabetic ketoacidosis in this complicated subgroup of patients. Read More

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Application of deep hypothermic circulatory arrest in open left chest aortic aneurysm repair.

J Thorac Cardiovasc Surg 2021 Mar 31. Epub 2021 Mar 31.

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Fla. Electronic address:

Objectives: Deep hypothermic circulatory arrest (DHCA) is often required for patients undergoing repair of descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm via left thoracotomy when proximal crossclamping is not feasible or when aneurysmal disease extends into the transverse aortic arch. Historical literature suggests higher complications rates due to the technical complexity of this approach; we examined outcomes with this approach at our center.

Methods: Between January 2008 and May 2018, 84 patients with DTAA or Crawford extent I thoracoabdominal aortic aneurysm underwent open repair. Read More

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Safety and Efficacy of Vadadustat for Anemia in Patients Undergoing Dialysis.

N Engl J Med 2021 04;384(17):1601-1612

From the Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin (K.-U.E.); the Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis (R.A.); Gonzalez M.D. and Aswad M.D. Health Care Services, Miami (A. Aswad); Clinical Research Consultants, Kansas City, MO (A. Awad); U.S. Renal Care, Plano (G.A.B.), Baylor University Medical Center, Baylor Heart and Vascular Hospital, Baylor Heart and Vascular Institute, Dallas (P.A.M.), Renal Associates, Division of Nephrology, University of Texas Health Science Center at San Antonio, San Antonio (P.P.), and the Section of Nephrology, Baylor College of Medicine, Houston (W.C.W.) - all in Texas; Praxis Medical Research, and the Department of Medicine, Division of General Practice, Faculdade de Medicina do ABC, São Paulo (M.R.B.); Akebia Therapeutics, Cambridge (Y.M.K.F., Z.K., B.J.M., W.L., D.L.V.), and the Division of Nephrology, Tufts Medical Center, Tufts University School of Medicine, Boston (M.J.S.) - both in Massachusetts; the Division of Nephrology, Department of Medicine, Hofstra Northwell School of Medicine, Great Neck (S.F.), and the Division of Nephrology, New York Presbyterian, Queens (B.S.) - both in New York; Nephrology Associates, Augusta (H.H.), and Emory University School of Medicine, Atlanta (J.T.) - both in Georgia; the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.J.); the Department of Medicine, Vanderbilt University Medical Center, Nashville (M.J.K.); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (K.M.); Stanford University School of Medicine, Palo Alto, CA (E.F.L., G.M.C.); the Department of Medicine, Memorial University, St. John's, NL, Canada (P.S.P.); Statistics Collaborative, Washington, DC (K.A.W., J.W.); and the Department of Kidney Transplantation-Dialysis Department, Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, Lodz, Poland (R.Z.).

Background: Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, a class of compounds that stimulate endogenous erythropoietin production.

Methods: We conducted two randomized, open-label, noninferiority phase 3 trials to evaluate the safety and efficacy of vadadustat, as compared with darbepoetin alfa, in patients with anemia and incident or prevalent dialysis-dependent chronic kidney disease (DD-CKD). The primary safety end point, assessed in a time-to-event analysis, was the first occurrence of a major adverse cardiovascular event (MACE, a composite of death from any cause, a nonfatal myocardial infarction, or a nonfatal stroke), pooled across the trials (noninferiority margin, 1. Read More

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Vadadustat in Patients with Anemia and Non-Dialysis-Dependent CKD.

N Engl J Med 2021 04;384(17):1589-1600

From Stanford University School of Medicine, Palo Alto, CA (G.M.C., E.F.L.); Renal Associates, San Antonio (P.E.P.), U.S. Renal Care, Plano (G.A.B.), Baylor University Medical Center, Baylor Heart and Vascular Hospital, Baylor Heart and Vascular Institute, Dallas (P.A.M.), and the Section of Nephrology, Baylor College of Medicine, Houston (W.C.W.) - all in Texas; Akebia Therapeutics, Cambridge (Y.M.K.F., S.B., Z.K., W.L., B.J.M., A.S., D.L.V.), and the Division of Nephrology, Tufts Medical Center, Tufts University School of Medicine, Boston (M.J.S.) - both in Massachusetts; the Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis (R.A.); Excellentis Clinical Trial Consultants, George, South Africa (S.A.); Bihor County Hospital Oradea, Oradea, Romania (G.B.); Qway Research, Hialeah, FL (F.P.C.); the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.G.J.); the Department of Medicine, Vanderbilt University Medical Center, Nashville (M.J.K.); Firma Clinical Research, Hunt Valley (T.L.), and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore (K.M.) - both in Maryland; the Department of Medicine, Memorial University of Newfoundland, St. John's, Canada (P.S.P.); the Division of Nephrology and Hypertension, University of North Carolina Kidney Center, Chapel Hill, and the W.G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury - both in North Carolina (P.R.-C.); the Division of Nephrology, New York-Presbyterian Queens, Flushing (B.S.); Firma Clinical Research, Chicago (C.T.); Emory University School of Medicine, Atlanta (J.T.); Statistics Collaborative, Washington, DC (K.A.W., J.W.); and the Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin (K.-U.E.).

Background: Vadadustat is an oral hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor, a class of drugs that stabilize HIF and stimulate erythropoietin and red-cell production.

Methods: In two phase 3, randomized, open-label, active-controlled, noninferiority trials, we compared vadadustat with the erythropoiesis-stimulating agent (ESA) darbepoetin alfa in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) not previously treated with an ESA who had a hemoglobin concentration of less than 10 g per deciliter and in patients with ESA-treated NDD-CKD and a hemoglobin concentration of 8 to 11 g per deciliter (in the United States) or 9 to 12 g per deciliter (in other countries). The primary safety end point, assessed in a time-to-event analysis, was the first major adverse cardiovascular event (MACE; a composite of death from any cause, nonfatal myocardial infarction, or nonfatal stroke), pooled across the two trials. Read More

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Fabry disease with cardiovascular manifestation in a patient with end-stage renal disease.

Cesk Patol 2021 ;57(1):49-52

Fabry disease is a rare X-linked hereditary storage disease caused by a mutation of the gene encoding alpha-galactosidase A. The clinical manifestation of the classical disease form is variable depending on the degree of individual organs involvement, including especially kidney, myocardium, central nervous system (CNS) and skin. We report a case of a 51-year-old man whose diagnostic manifestation was cardiac involvement leading to endomyocardial biopsy, which significantly contributed to the diagnosis. Read More

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Elective Resection of Symptomatic Arteriovenous Fistulae and Grafts in Patients with Functioning Renal Allografts at a High Volume Transplant Hospital.

Ann Vasc Surg 2021 Apr 24. Epub 2021 Apr 24.

Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

Objective: Patients with functioning renal allografts may need ligation of pre-existing hemodialysis conduits. Chronic immunosuppression for renal allografts may adversely affect wound healing and perioperative complications following these procedures. We sought to analyze outcomes following elective ligation and resection of symptomatic arteriovenous (AV) access in immunosuppressed patients with renal allografts no longer requiring dialysis at a high-volume renal transplant hospital. Read More

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[The technology of enhancement of detection of chronic renal diseases].

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2021 Mar;29(2):327-330

N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia.

The chronic kidney disease takes a special place among chronic non-communicable diseases because it is characterized by wide prevalence worldwide. However, its detection rate among Moscow adult population is 1%, though in the European countries this indicator is significantly higher and is made up on average to 6%. At the terminal stage of chronic kidney disease, quality of life of such patients decreases dramatically, that result in working capacity loss and disability. Read More

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Discontinuation of Hemodialysis After 8 Years in Favor of Toprak's Kidney Care in a Patient with End-Stage Kidney Disease.

Am J Case Rep 2021 Apr 25;22:e930857. Epub 2021 Apr 25.

Department of Medicine, Division of Internal Medicine, Balikesir University School of Medicine, Balikesir, Turkey.

BACKGROUND End-stage kidney disease patients who need hemodialysis for more than 3 months are less likely to be able to discontinue dialysis. Patient care, however, can play a role in improving kidney function. In this study, we showed that even a patient on hemodialysis for 8 years can discontinue or reduce the number of weekly dialysis sessions through kidney care. Read More

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Utility of the Beck Depression Inventory in Patients with Chronic Kidney Disease Stage 4 without Kidney Replacement Therapy.

Nephrol Nurs J 2021 Mar-Apr;48(2):147-167

Clinical Assistant Professor, Ashland University, Ashland, OH; and Dwight Schar College of Nursing and Health Sciences, Mansfield, OH.

Depression is undertreated in patients with chronic kidney disease (CKD) stage 4 without kidney replacement therapy (KRT), despite evidence showing its association with an increase in morbidity and mortality. Earlier and more adequate identification of patients with depression is needed. A quasi-experimental evidence-based project included 33 patients with CKD stage 4 not on KRT from a local nephrology office. Read More

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Using CPAP in COVID-19 patients outside of the intensive care setting: a comparison of survival and outcomes between dialysis and non-dialysis dependent patients.

BMC Nephrol 2021 04 21;22(1):144. Epub 2021 Apr 21.

Department of Nephrology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.

Background: SARS-CoV-2 (COVID-19) is a novel coronavirus associated with high mortality rates. The use of Continuous Positive Airway Pressure (CPAP) has been recognised as a management option for severe COVID-19 (NHS, Specialty guides for patient management during the coronavirus pandemic Guidance for the role and use of non-invasive respiratory support in adult patients with coronavirus (confirmed or suspected), https://www.nice. Read More

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Dialysis circuit clotting in critically ill patients with COVID-19 infection.

BMC Nephrol 2021 04 20;22(1):141. Epub 2021 Apr 20.

Department of Renal Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

Background: Coronavirus Disease 2019 (COVID-19) infection has been associated with a hypercoagulable state with increased reports of thrombotic events. Acute kidney injury requiring dialysis is common in critically ill patients and circuit clotting compromises efficacy of treatment. This study aims to analyze the circuit life and circuit clotting during continuous kidney replacement therapy (CKRT) and intermittent hemodialysis in patients with and without COVID-19. Read More

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Advances in the pharmacological management of bacterial peritonitis.

Expert Opin Pharmacother 2021 Apr 21:1-12. Epub 2021 Apr 21.

Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany.

Bacterial peritonitis is an infection with high mortality if not treated immediately. In the absence of an intraabdominal source of infection, bacterial peritonitis may arise in patients with liver cirrhosis, in patients on peritoneal dialysis (PD) for end-stage renal disease or in patients with tuberculosis. In patients with cirrhosis, bacterial peritonitis may trigger acute on chronic liver failure with substantial mortality despite optimal treatment. Read More

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Effects of a Knowledge-Translation Intervention on Early Dialysis Initiation: A Cluster Randomized Trial.

J Am Soc Nephrol 2021 Apr 15. Epub 2021 Apr 15.

Department of Medicine and Community Health Sciences, Libin Cardiovascular Institute, Calgary, Canada.

Background: The Initiating Dialysis Early and Late (IDEAL) trial, published in 2009, found no clinically measurable benefit with respect to risk of mortality or early complications with early dialysis initiation versus deferred dialysis start. After these findings, guidelines recommended an intent-to-defer approach to dialysis initiation, with the goal of deferring it until clinical symptoms arise.

Methods: To evaluate a four-component knowledge translation intervention aimed at promoting an intent-to-defer strategy for dialysis initiation, we conducted a cluster randomized trial in Canada between October 2014 and November 2015. Read More

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Hemodialysis shake-up on the front lines of the Covid-19 pandemic: the Treviglio Hospital experience.

G Ital Nefrol 2021 Apr 14;38(2). Epub 2021 Apr 14.

Nephrology and Dialysis Unit - Treviglio Hospital - ASST Bergamo Ovest, Italy.

The new coronavirus disease (Covid-19) pandemic in Italy formally started on 21st February 2020, when a 38-years old man was established as the first Italian citizen with Covid-19 in Codogno, Lombardy region. In a few days, the deadly coronavirus swept beyond expectations across the city of Bergamo and its province, claiming thousands of lives and putting the hospital in Treviglio under considerable strain. Since designated Covid-dialysis hospitals to centrally manage infected hemodialysis patients were not set up in the epidemic areas, we arranged to treat all our patients. Read More

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[Covid-19 vaccination and renal patients: overcoming unwarranted fears and re-establishing priorities].

G Ital Nefrol 2021 Apr 14;38(2). Epub 2021 Apr 14.

U.O. Nefrologia e Dialisi, Ospedale di Desio - ASST - Brianza, Desio, Italia.

The SARS-CoV-2 (Covid-19) has infected about 124 million people worldwide and the total amount of casualties now sits at a staggering 2.7 million. One enigmatic aspect of this disease is the protean nature of the clinical manifestations, ranging from total absence of symptoms to extremely severe cases with multiorgan failure and death. Read More

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Effect of peer support on improving self-management ability in peritoneal dialysis patients-a randomized controlled trial.

Ann Palliat Med 2021 Mar;10(3):3028-3038

Nursing Department of Wuxi People's Hospital, Wuxi, China.

Background: Peritoneal dialysis (PD) is an ideal method for the treatment of chronic kidney disease. Its survival rate and quality of life depend on the quality of dialysis. The quality of dialysis depends on the compliance of patients with drugs and dialysis treatment, the choice of diet, the detection of complications and the monitoring and management of the disease. Read More

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Percutaneous Transhepatic Vein Permcath: A Case Report.

Indian J Nephrol 2020 Nov-Dec;30(6):430-432. Epub 2020 Nov 19.

Interventional Radiology, Apollo Hospital, Jubillee Hills, Hyderabad, Telangana, India.

In patients with end-stage renal disease (ESRD), functional vascular access is like a lifeline. Among the patients undergoing hemodialysis, arteriovenous fistulas are done in most of them. However, in approximately 15% of these patients with multiple access failures, the use of tunneled dialysis catheters (TDC) for hemodialysis has become an integral component of treatment plans. Read More

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November 2020

Comparisons of postoperative outcomes after breast cancer surgery in patients with and without renal replacement therapy: a matched-pair cohort study using a Japanese nationwide inpatient database.

Breast Cancer 2021 Apr 10. Epub 2021 Apr 10.

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Background: Although patients receiving renal replacement therapy (RRT) have more comorbidities and higher mortality and morbidity risks than the general population, surgery during breast cancer treatment is crucial because of limitations in anticancer agents for patients with renal insufficiency. We aimed to compare the short-term postoperative outcomes between patients with and without RRT.

Methods: Patients who underwent surgery for stages 0-III breast cancer between July 2010 and March 2017 were retrospectively identified in a Japanese nationwide inpatient database and divided into those with RRT (RRT group, n = 1547) and those without RRT (control group, n = 364,047). Read More

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Dialysis disequilibrium on CKRT: avoiding the steep slippery slope.

Pediatr Nephrol 2021 Apr 9. Epub 2021 Apr 9.

Division of Nephrology, Seattle Children's Hospital, Seattle, WA, USA.

Background: Current guidelines for initiation of kidney replacement do not include specific recommendations for prescription parameters and monitoring.

Case Outline: A 16-year-old girl presented with kidney failure with creatinine of 19.8 mg/dL and BUN of 211 mg/dL. Read More

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Skull fracture and epidural hematoma caused by use of a Mayfield skull clamp in an adult patient with chronic hemodialysis: a case report.

J Med Case Rep 2021 Apr 9;15(1):154. Epub 2021 Apr 9.

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba-shi, Chiba, 260-8677, Japan.

Background: Mayfield skull clamps are widely used and indispensable in current neurosurgery. Complications such as skull fractures or intracranial hematoma from using a Mayfield skull clamp have largely been reported in the pediatric population, are likely related to the relative thinness of the skull, such as in patients with hydrocephalus, and are extremely rare in adults. Here, we report a case of skull fracture and epidural hematoma caused by a Mayfield skull clamp used for posterior decompression surgery in an adult patient with chronic hemodialysis. Read More

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Early onset calciphylaxis following acute kidney injury secondary to anti-glomerular basement membrane antibody disease.

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Nephrology and Hypertension, Albany Medical Center Hospital, Albany, New York, USA.

Calciphylaxis is commonly associated with end-stage renal disease (ESRD) and renal transplant. We present a rare case of early onset calciphylaxis in a patient presenting with acute kidney injury (AKI) secondary to anti-glomerular basement membrane (anti-GBM) antibody disease. A 65-year-old obese Caucasian woman with type 2 diabetes mellitus and hypertension presented with a 1-month history of painless gross haematuria and worsening lower extremity oedema. Read More

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Epidemiology of COVID-19 Infection in Hospitalized End-Stage Kidney Disease Patients in a Predominantly African-American Population.

Am J Nephrol 2021 7;52(3):190-198. Epub 2021 Apr 7.

Division of Renal Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

Background: End-stage kidney disease patients on dialysis are particularly susceptible to COVID-19 infection due to comorbidities, age, and logistic constraints of dialysis making social distancing difficult. We describe our experience with hospitalized dialysis patients with COVID-19 and factors associated with mortality.

Methods: From March 1, 2020, to May 31, 2020, all dialysis patients admitted to 4 Emory Hospitals and tested for COVID-19 were identified. Read More

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Microbiota, renal disease and renal transplantation.

World J Transplant 2021 Mar;11(3):16-36

Nephrology and Dialysis Unit, Saints Cosmas and Damian Hospital, Pescia 51017, Italy.

Aim of this frontier review has been to highlight the role of microbiota in healthy subjects and in patients affected by renal diseases with particular reference to renal transplantation. The microbiota has a relevant role in conditioning the healthy status and the diseases. In particular gut microbiota is essential in the metabolism of food and has a relevant role for its relationship with the immune system. Read More

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CD28null and Regulatory T Cells Are Substantially Disrupted in Patients with End-Stage Renal Disease Due to Diabetes Mellitus.

Int J Mol Sci 2021 Mar 15;22(6). Epub 2021 Mar 15.

Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, 56442 Thessaloniki, Greece.

Background: End-stage renal disease (ESRD) is associated with alterations in T-cell immunity, including increased CD28null and reduced regulatory T cells (Tregs). However, whether immune disturbances are due to ESRD or primary disease is not yet clear. As diabetes mellitus is the leading cause of ESRD, we evaluated its impact on the immune profile of ESRD patients. Read More

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Predialysis and Dialysis Therapies Differently Affect Nitric Oxide Synthetic Pathway in Red Blood Cells from Uremic Patients: Focus on Peritoneal Dialysis.

Int J Mol Sci 2021 Mar 17;22(6). Epub 2021 Mar 17.

Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University Chieti-Pescara, 66100 Chieti, Italy.

Red blood cells (RBCs) have been found to synthesize and release both nitric oxide (NO) and cyclic guanosine monophosphate (cGMP), contributing to systemic NO bioavailability. These RBC functions resulted impaired in chronic kidney disease (CKD). This study aimed to evaluate whether predialysis (conservative therapy, CT) and dialysis (peritoneal dialysis, PD; hemodialysis, HD) therapies used during CKD progression may differently affect NO-synthetic pathway in RBCs. Read More

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Interventions for weight loss in people with chronic kidney disease who are overweight or obese.

Cochrane Database Syst Rev 2021 Mar 30;3:CD013119. Epub 2021 Mar 30.

School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.

Background: Obesity and chronic kidney disease (CKD) are highly prevalent worldwide and result in substantial health care costs. Obesity is a predictor of incident CKD and progression to kidney failure. Whether weight loss interventions are safe and effective to impact on disease progression and clinical outcomes, such as death remains unclear. Read More

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The COVID-19 Epidemic: Management and Outcomes of Hemodialysis and Peritoneal Dialysis Patients in Stockholm, Sweden.

Kidney Blood Press Res 2021 26;46(2):250-256. Epub 2021 Mar 26.

Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Background: The COVID-19 outbreak has been associated with a high morbidity, mortality, and a risk of long-term sequelae, and patients with severe COVID-19 are at increased risk of acute kidney injury. CKD patients are at high risk of being exposed to COVID-19 and suffer complications and poor outcome. In Sweden, mitigation strategies did not include lockdown. Read More

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Hemodialysis Emergencies: Core Curriculum 2021.

Am J Kidney Dis 2021 05 23;77(5):796-809. Epub 2021 Mar 23.

MedStar Georgetown University Hospital, Washington, DC. Electronic address:

Since maintenance hemodialysis (HD) first became available in the United States in 1962, there has been tremendous growth in the population of patients with kidney failure. HD has become a routine treatment carried out in outpatient clinics, hospitals, nursing facilities, and in patients' homes. Although it is a complex procedure, HD is quite safe. Read More

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Impact of Impaired Kidney Function on Outcomes of Nigerians with COVID-9 Infection: Report of Two Cases from the University College Hospital, Ibadan.

West Afr J Med 2021 Mar;38(3):292-296

Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.

COVID-19 infection predominantly affects the respiratory system; however, other systems and organs are also affected. The kidneys are among the organs commonly affected by SARS-CoV-2 and this has been reported to be a predictor of increased severity, need for intensive care (ICU), admission, and death. We presented two cases of COVID-19 that were associated with co-morbidities that include diabetes mellitus, systemic hypertension and impaired kidney function. Read More

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