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Leukemia & Lymphoma Jun 2021Clinical trials may be inconsistent in their enrollment and reporting of patients with multiple myeloma (MM) who have renal insufficiency (RI). We performed a systematic... (Meta-Analysis)
Meta-Analysis
Clinical trials may be inconsistent in their enrollment and reporting of patients with multiple myeloma (MM) who have renal insufficiency (RI). We performed a systematic review of all MM randomized clinical trials (RCT) from 2005-2019 to evaluate reporting of prevalence, eligibility criteria and outcomes of patients with RI and MM. One-hundred and twenty-three RCTs were included. Only 30% of studies clearly reported on the proportion of patients who had RI. Only 68.2% reported eligibility criteria pertaining to RI, with no uniformity in the reported criteria. The relative risk (RR) of disease progression or death in patients with RI was higher than those without, RR of 1.20 (1.003-1.431) for relapsed/refractory and 1.07 (1.001-1.046) for newly diagnosed. There is inconsistent reporting and enrollment of patients with RI on MM RCT's. We advocate for higher enrollment of patients with RI and transparent reporting of their eligibility criteria and outcomes.
Topics: Humans; Multiple Myeloma; Randomized Controlled Trials as Topic; Renal Insufficiency
PubMed: 33416412
DOI: 10.1080/10428194.2020.1867725 -
Zeitschrift Fur Gerontologie Und... May 2021In addition to history taking and clinical examination, blood and serum values, a urine examination and ultrasound of the abdomen are helpful in the diagnostic... (Review)
Review
In addition to history taking and clinical examination, blood and serum values, a urine examination and ultrasound of the abdomen are helpful in the diagnostic clarification of renal insufficiency. The glomerular filtration rate (GFR) determines the severity of the renal insufficiency. It is estimated (eGFR) from the serum creatinine, the age and gender of the patient. The protein and albumin/creatinine ratios in the urine provide information on the etiology of renal insufficiency and are a measure of the patient's cardiovascular risk. A urine dipstick is used to screen for cellular components and should be supplemented with an investigation of the urine sediment if positive. Sonography is used to determine the size of the kidneys, morphological changes in the kidneys and to rule out urinary obstruction.
Topics: Aged; Creatinine; Glomerular Filtration Rate; Humans; Kidney; Renal Insufficiency; Renal Insufficiency, Chronic
PubMed: 33834262
DOI: 10.1007/s00391-021-01877-9 -
Clinical Journal of the American... May 2020
Topics: Cardiovascular Diseases; Humans; Renal Insufficiency; Renal Insufficiency, Chronic; Uromodulin
PubMed: 32298233
DOI: 10.2215/CJN.03580320 -
Nefrologia 2022Frailty is common in end stage renal disease (ESRD) and is a marker of poor outcomes. Its prevalence increases as chronic kidney disease (CKD) progresses. There are... (Review)
Review
Frailty is common in end stage renal disease (ESRD) and is a marker of poor outcomes. Its prevalence increases as chronic kidney disease (CKD) progresses. There are different measurement tools available to assess frailty in ESRD. The pathogenesis of frailty in ESRD is multifactorial including uraemia and dialysis related factors. In this current review, we discuss the importance of frailty, its pathogenesis, screening methods, prognostic implications and management strategies in context of ESRD.
Topics: Humans; Frailty; Kidney Failure, Chronic; Renal Dialysis; Renal Insufficiency, Chronic; Prognosis
PubMed: 36792307
DOI: 10.1016/j.nefroe.2021.05.008 -
Circulation Research Jan 2015
Topics: Animals; Female; Humans; Male; Methylamines; Microbiota; Renal Insufficiency; Renal Insufficiency, Chronic
PubMed: 25634968
DOI: 10.1161/CIRCRESAHA.114.305680 -
JAMA Feb 2024
Topics: Humans; Osteoporosis; Renal Dialysis; Renal Insufficiency
PubMed: 38241040
DOI: 10.1001/jama.2023.24072 -
American Journal of Nephrology 2019Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In...
Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.
Topics: Acute Kidney Injury; Global Burden of Disease; Health Services Accessibility; Healthcare Disparities; Humans; Renal Insufficiency, Chronic; Universal Health Insurance
PubMed: 30820003
DOI: 10.1159/000497540 -
South African Medical Journal =... Mar 2015
Topics: Foundations; Humans; Kidney Failure, Chronic; Renal Insufficiency, Chronic; South Africa
PubMed: 26301297
DOI: No ID Found -
Current Opinion in Pediatrics Apr 2018Despite abundant evidence in adults, the relationship between acute kidney injury (AKI) and chronic kidney disease (CKD) remains unanswered in pediatrics. Obstacles to... (Review)
Review
PURPOSE OF REVIEW
Despite abundant evidence in adults, the relationship between acute kidney injury (AKI) and chronic kidney disease (CKD) remains unanswered in pediatrics. Obstacles to overcome include the challenges defining these entities and the lack of long-term follow-up studies. This review focuses on pediatric populations at high-risk for AKI, the evidence of the long-term effect of AKI on renal health, and biomarkers to detect renal disease.
RECENT FINDINGS
AKI in critically ill children and neonates is common and independently associated with adverse outcomes. Patients with diabetes and sickle cell disease along with neonates with necrotizing enterocolitis have been identified as high-risk for AKI. Preterm birth and neonates with AKI have signs of renal dysfunction early in childhood. Urinary biomarkers may identify AKI and CKD earlier than traditional biomarkers, but more work is necessary to determine their clinical utility. Promising technological advances including the ability to determine nephron number noninvasively will expand our ability to characterize the AKI to CKD transition.
SUMMARY
AKI is common and associated with poor outcomes. It is probable that AKI is a harbinger to CKD in pediatric populations. However, we currently lack the tools to definitely answer this question and more research is needed.
Topics: Acute Kidney Injury; Biomarkers; Child; Child, Preschool; Critical Illness; Humans; Infant; Infant, Newborn; Prognosis; Renal Insufficiency, Chronic; Risk Factors
PubMed: 29389682
DOI: 10.1097/MOP.0000000000000587 -
American Journal of Physiology. Renal... May 2019Pathological changes in the heart or kidney can instigate the release of a cascade of cardiorenal mediators that promote injury in the other organ. Combined dysfunction... (Review)
Review
Pathological changes in the heart or kidney can instigate the release of a cascade of cardiorenal mediators that promote injury in the other organ. Combined dysfunction of heart and kidney is referred to as cardiorenal syndrome (CRS) and has gained considerable attention. CRS has been classified into five distinct entities, each with different major pathophysiological changes. Despite the magnitude of the public health problem of CRS, the underlying mechanisms are incompletely understood, and effective intervention is unavailable. Animal models have allowed us to discover pathogenic molecular changes to clarify the pathophysiological mechanisms responsible for heart-kidney interactions and to enable more accurate risk stratification and effective intervention. Here, this article focuses on the use of currently available animal models to elucidate mechanistic insights in the clinical cardiorenal phenotype arising from primary cardiac injury, primary renal disease with special emphasis of chronic kidney disease-specific risk factors, and simultaneous cardiorenal/renocardiac dysfunction. The development of novel animal models that recapitulate more closely the cardiorenal phenotype in a clinical scenario and discover the molecular basis of this condition will be of great benefit.
Topics: Acute Kidney Injury; Animals; Cardio-Renal Syndrome; Heart; Heart Failure; Kidney; Phenotype; Prognosis; Renal Insufficiency, Chronic; Risk Factors
PubMed: 30838876
DOI: 10.1152/ajprenal.00624.2017