Title: Mastering the Art of Literature Review on CKD with ⇒ StudyHub.

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of CKD literature can be daunting, given its complexity and vastness. That's where ⇒ StudyHub.vip
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Writing a literature review on CKD demands meticulous research, critical analysis, and proficient
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Journal of Kidney Diseases. 39(2 SUPPL. 1): S1-266. Baseline risk (without donating), risk
attributable to donation, and absolute risk (after donating) need to be considered. A 30% decline in
kidney function, assessed using this novel filtration marker, was strongly associated with ESRD.
Adeera Levin and Brenda Hemmelgarn drafted the manuscript. Our paper discusses current
literature on health literacy in kidney diseases. In many cases, the acceptable treatment and lifestyle
changes can help keep a person and their kidneys. Chronic kidney disease as a global public health
problem: approaches and initiatives — a position statement from Kidney Disease Improving Global
Outcomes. Data on study methodology and reporting of CKD prevalence results were independently
extracted by two researchers. As part of a national strategy that incorporates chronic disease
management, these guidelines serve as a starting point for ensuring optimal management of care for
these patients. You can download the paper by clicking the button above. It is categorized by the
level of kidney function, based on GFR, into stages 1 to 5, with each increasing number indicating a
more advanced stage of the disease, as defined by a declining GFR (Table 1). In addition, we have
included topics that do not have a substantial direct or indirect evidence base but are important for
practitioners and patients (e.g., preparation for care of end-stage renal disease and comprehensive
conservative management). In ESRD patients undergoing dialysis, plasma PTX3 levels were shown
to be more accurate than C-reactive protein (CRP), a traditional inflammatory marker, in predicting
all-cause mortality. Renal function and requirement for dialysis in chronic nephropathy patients on
long-term ramipril: REIN follow-up trial. The majority of studies did not report the sampling frame
used, and the response ranged from 10 to 87%. No part of this content may be reproduced or
transmitted in any form or by any means as per the standard guidelines of fair use. Rare mutations in
the UMOD gene were associated with hereditary autosomal-dominant tubulointerstitial diseases.
Most of these potentially new biomarkers identified from experimental studies may detect renal
injury earlier than traditional biomarkers. Mortality and target haemoglobin concentrations in anaemic
patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Detection of
chronic kidney disease in non-nephrology practices: an important focus for intervention. Moreover,
klotho has a pathophysiological role in ion disorders, and might be used as a marker of abnormal
phosphate and bone metabolism in these patients. There is a mixture of causes and the damage is
usually irreversible and can lead to ill health. We also use third-party cookies that help us analyze and
understand how you use this website. KIM-1 is a cellular receptor responsible for regulating immune
cell activity in response to viral infections. In this article, we define CKD staging and discuss five
complications associated with CKD: anemia, hyperlipidemia, nutrition, osteodystrophy, and
cardiovascular risk. In the absence of data with morbidity and mortality reduction supporting
phosphate binders that do not contain calcium (sevelamer and lanthanum), these agents cannot be
recommended. A proteomic approach identified an increased expression of serum IL-6 and TNF-.
Klotho deficiency is positively correlated with kidney function decline, even in CKD patients at
stages 1 and 2. Dietary modifications are recommended initially, 59 followed by therapy with
calcium-containing phosphate binders (calcium gluconate or calcium acetate). This review combines
current guidelines with all available literature in this field, trying to seek and establish the optimal
extended criteria.
A proteomic approach identified an increased expression of serum IL-6 and TNF-. Iron therapy is an
important component of anemia management. 54, 55 We recommend that the oral form of iron be
considered preferentially over the intravenous form. Furthermore, we need to develop and evaluate
risk scores for progression, such that resources can be appropriately directed to patients at greatest
risk of progression and not to those who simply have reduced kidney function or evidence of kidney
damage. In accordance with such findings, Qian et al. (2018) reported that changes in soluble klotho
could be used as indicators of CKD progression, since they correlated with changes in eGFR.
Baseline 15-year and lifetime ESKD risk estimates without donation were calculated using the risk
calculator for LKDCs assessed from two centres between 2007 and 2015. See Full PDF Download
PDF See Full PDF Download PDF See Full PDF Download PDF Loading Preview Sorry, preview is
currently unavailable. In a follow-up study of 527 adults with T1D, Bjornstad et al. (2018) reported
that only NGAL (and not KIM-1) was associated with urine albumin-to-creatinine ratio and incident
impaired GFR. Low protein diets for chronic kidney disease in non diabetic adults. In this review,
we outline recommendations from the guidelines on aspects of management of chronic kidney
disease, including targets for various abnormalities, strategies for treatment and the frequency of
follow-up based on the evidence available. Because chronic kidney disease shares common risk
factors with cardiovascular disease and diabetes, lifestyle modifications directed at smoking, obesity,
alcohol consumption, exercise and diet are important ( Box 4 ). Thus, live kidney donation is
essential for increasing the donor pool. RELATED TOPICS Biomarkers Medicine Humans Europe
Calibration Clinical Sciences Prevalence Adult Glomerular Filtration Rate See Full PDF Download
PDF About Press Blog People Papers Topics Job Board We're Hiring. The urinary levels of L-FABP
have been correlated with the degree of tubulointerstitial damage in renal biopsies. To browse
Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade
your browser. Comparisons across studies are hampered as CKD prevalence estimations are
influenced by study population characteristics and laboratory methods. Since its urinary excretion is
residual, the increase in these proteins has been proposed as potential serum markers of decreased
GFR, and also as markers of tubular damage if its urinary excretion is elevated. With decreasing
kidney function, starting doses for both ACEIs. It is also expressed in the renal tubular epithelial
cells and released in case of cell damage. Although individual retrospective or observational studies
and basic research have generated data that support the importance of anemia and lipid and mineral
metabolism abnormalities, it is critical that we better define the importance of these conditions for
each stage of chronic kidney disease. Journal of Kidney Diseases. 39(2 SUPPL. 1): S1-266. There is
a mixture of causes and the damage is usually irreversible and can lead to ill health. These aspects
include target blood pressure, initial drug therapy for proteinuric and nonproteinuric chronic kidney
disease, and treatment of hypertension in association with diabetes and large-vessel renal vascular
disease ( Box 1 ). This review combines current guidelines with all available literature in this field,
trying to seek and establish the optimal extended criteria. A meta-analysis of 13 studies comprising
5169 patients at all stages of CKD aimed to determine the relationship between circulating fetuin-A
levels and the risk for all-cause mortality. Waiting time on dialysis as the strongest modifiable risk
factor for renal transplant outcomes: a paired donor kidney analysis. However, awareness and
attention to chronic kidney disease have increased since the publication of this staging system and
the surrounding education. 7. The study of specific biomarkers would allow the identification of
kidney damage, namely, changes in renal function, tubulointerstitial damage, endothelial dysfunction
and inflammation, or cardiovascular risk (Fig 2). For patients without hypertension or diabetes, there
is insufficient evidence to determine the level of proteinuria at which to initiate therapy with an ACE
inhibitor or an angiotensin-receptor blocker. Estimation reports on prevalence, as well as on related
morbidity and mortality, confirmed the high socioeconomic burden of this disease particularly due to
progression to end-stage renal disease (ESRD) and association with cardiovascular disease (CVD).
Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and
quality of life: a randomized controlled trial.
A systematic review of sevelamer in ESRD and an analysis of its potential economic impact in
Canada and the United States. A comparison of CKD patients’ proteomic urinary profiles against
those of healthy controls demonstrated that using a panel of 273 CKD-specific peptides could
discriminate between the two groups. Nephrology: 4. Strategies for the care of adults with chronic
kidney disease. But opting out of some of these cookies may affect your browsing experience.
Correction of anemia with epoetin alfa in chronic kidney disease. Prevalence of chronic kidney
disease and decreased kidney function in the adult US population: Third National Health and
Nutrition Examination Survey. The identification of these small molecules could help in assessing the
multiple pathophysiological changes in CKD, since they might reflect early impairments in specific
pathways. Lee et al. (2016) demonstrated that the presence of diabetes in CKD patients induces
metabolic changes that are reflected in the levels of serum metabolites, such as arginine, N-acetyl-
glycoprotein, glutamine, alanine and leucine. A novel process for updating recommendations for
managing hypertension: rationale and methods. These recommendations ( Box 2 ) are not intended
to replace the Canadian Diabetes Association Guidelines 17 but rather to focus on aspects of care
specific to patients with chronic kidney disease. It is unlikely that a single biomarker can predict
CKD progression and identify the multiple pathophysiological processes involved in CKD
progression or the underfllying primary renal disease. Jakobsson, Lucas, Wegman, Program on Work,
Environment and Health in Central. The topics were chosen based on their importance in the
management of chronic kidney disease, as well as the existence of an evidence base. Mutluay et al.
(2019) conducted a study on 238 CKD patients at stages 3 and 4 and with ESRD in order to
compare fetuin-A levels between them. In fact, the potential economic impact in Canada may be
prohibitive. 60. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis.
Klotho deficiency is positively correlated with kidney function decline, even in CKD patients at
stages 1 and 2. The patient's primary care physician is an integral part of this team. 67 In conjunction
with the patient and family, the interdisciplinary team should develop a care plan that addresses the
physical, psychological and spiritual needs of the patient and his or her family and caregivers. In
cases where evidence did not exist, we provide the clinical practice recommendations along with the
rationale. No part of this content may be reproduced or transmitted in any form or by any means as
per the standard guidelines of fair use. The increase in ADMA was associated with both eGFR.
International Research Workshop on Mesoamerican Nephropathy, held in 2015, it. Due to its
molecular weight (130,000 Dalton), NAG cannot be filtered at the glomerulus; thus, increased
urinary concentrations of NAG are signs of proximal tubular damage. He has performed work on a
computer program for Genzyme for tracking outcome data related to calcium and phosphate
metabolism. It is now defined as the presence of kidney damage for a period greater than 3 months.
Additionally, Seliger et al. (2016) demonstrated in a group of older hypertensive patients with and
withoutCKD, that laser Doppler flowmetry-based measures of endothelial dysfunction and
microvascular reactivity are the strongest determinants of albuminuria, irrespective of diabetes status.
Therefore; an important focus of care for patients with chronic kidney disease includes management
of cardiovascular risk factors and other complications and life style modification. With regard to the
assessment of kidney function, 67% used a Jaffe assay, wherea. This section of the guidelines
highlights key aspects of the management of hypertension in patients with chronic kidney disease.
Kidney disease as a risk factor for development of cardiovascular. Grades B and C refer to studies of
lesser degrees of validity, including surrogate outcomes or extrapolation of study results to other
populations.
You can download the paper by clicking the button above. Learn about immunization
recommendations for pediatric patients with CKD, nephrotic syndrome, and renal transplant as well
as the importance of continued follow up and evaluation for these children. The effects of dietary
protein restriction and blood-pressure control on the progression of chronic renal disease. The urinary
levels of L-FABP have been correlated with the degree of tubulointerstitial damage in renal biopsies.
RELATED TOPICS Biomarkers Medicine Humans Europe Calibration Clinical Sciences Prevalence
Adult Glomerular Filtration Rate See Full PDF Download PDF About Press Blog People Papers
Topics Job Board We're Hiring. In this article, we define CKD staging and discuss five complications
associated with CKD: anemia, hyperlipidemia, nutrition, osteodystrophy, and cardiovascular risk.
However, awareness and attention to chronic kidney disease have increased since the publication of
this staging system and the surrounding education. 7. It is categorized by the level of kidney
function, based on GFR, into stages 1 to 5, with each increasing number indicating a more advanced
stage of the disease, as defined by a declining GFR (Table 1). But these treatment methods are not
affordable by most of the population. Zheng et al. (2018) demonstrated that serum klotho levels were
associated with the degree of mineral bone disorder in a group of 125 hemodialyzed patients. Injury
of the proximal tubular cells induces upregulation of the L FABP gene, leading to increased L-FABP
expression by these cells and, consequently, to an increase in the urinary L-FABP excretion. The
purpose of this section of the guidelines is to delineate the aspects of education, care and processes
that are necessary to optimize the preparation of these patients for renal replacement therapy ( Box 8
). Chronic kidney disease as a global public health problem: approaches and initiatives — a position
statement from Kidney Disease Improving Global Outcomes. Pentraxin 3 (PTX3) is produced by
resident and innate immunity cells in peripheral tissues and increases rapidly in response to primary
local activation of inflammation. Watson et al. (2019) developed a Kidney Injury Test (KIT) based
on the composite measurement and validafition of six biomarkers across a set of 397 urine samples
from patients with CKD, or with an increased risk for CKD. Over the last twenty years, several new
biomarkers were identified as promising candidates for CKD management. Nonetheless, the
complexity of this condition clearly requires a better understanding of the absolute and relative value
of identifying and treating the myriad clinical and laboratory abnormalities that occur in the context
of reduced kidney function. Upload Read for free FAQ and support Language (EN) Sign in Skip
carousel Carousel Previous Carousel Next What is Scribd. J., Leiva, R., Elinder, C., Leiva, S.,
Trujillo, Z., Trujillo, L., Soderberg. See Full PDF Download PDF See Full PDF Download PDF See
Full PDF Download PDF Loading Preview Sorry, preview is currently unavailable. Other markers,
such as NGAL, KIM-1 and L-FABP might be helpful in identifying early tubular damage, especially
in the creatinine-blind range, and before pathological and irreversible changes occur. The importance
of dietary calcium and phosphorous in the secondary hyperparathyroidism of patients with early
renal failure. Detection of chronic kidney disease in non-nephrology practices: an important focus for
intervention. Moreover, inflammation is a risk factor for CKD-associtated morbidity and may
contribute to cardiovascular mortality in CKD patients. Most importantly, the lack of evidence
should not foster further nihilism but rather encourage us to advocate for the design of and
enrollment into randomized control trials that answer questions relevant to this population. In a
follow-up study of 527 adults with T1D, Bjornstad et al. (2018) reported that only NGAL (and not
KIM-1) was associated with urine albumin-to-creatinine ratio and incident impaired GFR. Increased
levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-?) involved in the inflammantory
response predict poor outcome in patients with renal disease. Requirements for Successful
Completion: Complete the learning activity in its entirety and complete the online CNE evaluation.
Moreover, in ESRD patients, the lower levels of fetuin-A were associated with higher vascular
calcification scores and carotid intima-media thickness. However, in a prospective cohort study
comprising 250 patients at all CKD stages, NGAL was more strongly correlated with disease
progression in more advanced CKD stages than KIM-1 and NAG.
RELATED TOPICS Biomarkers Medicine Humans Europe Calibration Clinical Sciences Prevalence
Adult Glomerular Filtration Rate See Full PDF Download PDF About Press Blog People Papers
Topics Job Board We're Hiring. Iron therapy is an important component of anemia management. 54,
55 We recommend that the oral form of iron be considered preferentially over the intravenous form.
He has received honoraria for presentations from Ortho-Biotech, Amgen, Sanofi-Aventis, Bristol-
Myers Squibb, Biovail, Novartis, Abbott and Merck. Living donation raises ethical and legal issues
because donors voluntarily undergo a surgical procedure to remove a healthy kidney in order to help
another person. Comparisons across studies are hampered as CKD prevalence estimations are
influenced by study population characteristics and laboratory methods. It has been used as a marker
of cerebrospinal fluid leakage since it is an important constituent of cerebral spinal fluid and is in
much lower concentrations in blood. In the absence of data supporting fracture or mortality reduction
with metabolic control hard outcome, the working group considers best practice to be the
maintenance of normal calcium and phosphate levels and supplementation with active vitamin D if
parathyroid hormone levels are elevated. For patients without hypertension or diabetes, there is
insufficient evidence to determine the level of proteinuria at which to initiate therapy with an ACE
inhibitor or an angiotensin-receptor blocker. With the increased use of cystatin C, BTP and B2M,
GFR estimation is likely to undergo further improvements. Similarly, Maeda et al. (2015) showed
that L-FABP, as well as urinary albumin-to-creatinine ratio, could be useful in assessing
cardiovascular damage in T2D patients at CKD stages 1 and 2, since they correlated with the
elevation of cardiac markers and electrocar diogram abnormalities. Some evidence suggests that the
20-year incidence of gout is slightly higher among donors than among healthy nondonors. Care plans
may include detailed assessment (including venous mapping and avoidance of venipuncture or
blood pressure measurements on the nondominant arm to protect it for access creation). 64 At this
point, care should be coordinated by a nephrologist. Dozens of dysregulated peptides and
metabolites were identified by proteomic and metabolomic studies. Mesoamerican nephropathy
(MeN), however, there is much that remains unknown. The preferred method of screening for
proteinuria is a single random measurement of the ratio of urine protein to creatinine or of albumin to
creatinine. 36, 37 At present, population-based screening for proteinuria is not recommended. The
creation of an advance care planning process for patients with ESRD. Diligent BP control reduces
renal disease progression and. As part of a national strategy that incorporates chronic disease
management, these guidelines serve as a starting point for ensuring optimal management of care for
these patients. Furthermore, Hu et al. (2018) identified three serum metabolites (fumarate, allantoin,
and ribonate) associatted with all-cause mortality from 299 CKD patients. Atorvastatin in patients
with type 2 diabetes mellitus undergoing. Most of these potentially new biomarkers identified from
experimental studies may detect renal injury earlier than traditional biomarkers. Different studies
used as evidence that mild to moderate degrees of renal impairment are associated with increased
cardiovascular risk. This recent study highlights the association of PTX3 with multiple risk factors,
such as inflammation and malnutrition. Very recently, experiments in rats have shown the feasibility
of. Serum phosphate levels and mortality risk among people with chronic kidney disease.
Comparison of intravenous iron sucrose to oral iron in the treatment of anemic patients with chronic
kidney disease not on dialysis. Of the 2079 articles found, 152 fell within the scope of the review. In
addition, NGAL was the only predictor of ESRD and death. Although individual retrospective or
observational studies and basic research have generated data that support the importance of anemia
and lipid and mineral metabolism abnormalities, it is critical that we better define the importance of
these conditions for each stage of chronic kidney disease. Out of these, the cookies that are
categorized as necessary are stored on your browser as they are essential for the working of basic
functionalities of the website.