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Mashup Score: 10Risk of Major Adverse Cardiovascular Events in Home... : Clinical Journal of the American Society of Nephrology - 4 hour(s) ago
d continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and home hemodialysis (HD) with in-center HD patients. Methods: We included 968 patients who entered dialysis in the Helsinki-Uusimaa healthcare district in Finland from 2004 to 2017, of whom 162 were on CAPD, 229 on APD, 145 on home HD and 432 on in-center HD at day 90 from the start of dialysis. MACE was defined as acute myocardial infarction, stroke, or death due to cardiovascular disease. The cumulative incidence of the first MACE was calculated. Cox regression was used to compare risk of MACE between dialysis modalities with adjustment for potential confounding factors. Results: Of all 968 patients, 195 (20%) experienced a MACE during the entire follow-up and 62 (6%) during the first year of follow-up. The cumulative incidence of first MACE was similar in in-center HD and CAPD patients and higher than that in APD and home HD patients. After adjustment for possible confounders, the hazard ratio
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Mashup Score: 130How I Treat Rhabdomyolysis-Induced AKI? : Clinical Journal of the American Society of Nephrology - 5 hour(s) ago
An abstract is unavailable.
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Mashup Score: 42Exercise and Cognitive Function in Chronic Kidney Disease:... : Clinical Journal of the American Society of Nephrology - 7 day(s) ago
as particularly beneficial and that exercise did not substantially increase harms. Background People living with CKD are at higher risk of cognitive impairment. Exercise may improve cognitive function. This systematic review and meta-analysis of randomized controlled trials was completed to determine the efficacy and harms of exercise in improving cognitive function in people living with CKD. Methods A systematic literature review identified randomized controlled trials of people with any stage of CKD, with an intervention that exercised large-muscle groups, and with a validated outcome measure of cognitive function. First, harms were analyzed. Then a random-effects meta-analysis was completed with subsequent planned subgroup analyses to investigate heterogeneity between CKD stages and treatments; between different exercise types, durations, and intensities; and between different outcome methodologies. Finally, quality of evidence was rated. Results Nineteen trials randomized 1160 part
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Mashup Score: 57Bisphosphonate Use After Kidney Transplantation Is... : Clinical Journal of the American Society of Nephrology - 12 day(s) ago
bisphosphonates associates with lower incidence of non-vertebral fractures after kidney transplantation. Methods: We conducted a retrospective review for all Southern California Kaiser Permanente kidney transplant recipients with osteoporosis transplanted between 2000 and 2019. Baseline variables were collected. Those prescribed an oral bisphosphonate were compared to those who were not. The primary outcome was non-vertebral fracture. Chi square was used to evaluate categorical variables and Wilcoxson rank sum test for continuous variables. Propensity scores were generated to balance covariates in the bisphosphonate and non-bisphosphonate groups. Cause-specific hazard and sub distribution (Fine-Gray) methods were performed for competing risk analysis. Death censored graft survival was evaluated as a secondary outcome using standard Cox regression. Results: There were 489 patients included in the study, 203 of which were in the bisphosphonate group. The cause specific hazard model sugge
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Mashup Score: 13Neighborhood Socioeconomic Deprivation is Associated with... : Clinical Journal of the American Society of Nephrology - 13 day(s) ago
listing transplanted January 1st, 2010, to May 31st, 2022 (N=9,178) were included from the Scientific Registry of Transplant Recipients. Recipients were stratified into three groups according to Material Community Deprivation Index score, with greater score representing higher neighborhood socioeconomic deprivation. Outcomes were modeled using multivariable logistic regression and Cox proportional hazards models. Results: Twenty-four percent (N=110) of recipients from neighborhoods of high socioeconomic deprivation identified as being of Black race, versus 12% (N=383) of recipients from neighborhoods of low socioeconomic deprivation. Neighborhoods of high socioeconomic deprivation had a much greater proportion of recipients identifying as being of Hispanic ethnicity (67%, N=311), versus neighborhoods of low socioeconomic deprivation (17%, N=562). The hazard of graft loss was 55% higher (aHR 1.55, 95% CI: 1.24, 1.94) for recipients from neighborhoods of high versus recipients from low s
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Mashup Score: 138Prevalence and Outcomes of Chronic Kidney Disease... : Clinical Journal of the American Society of Nephrology - 20 day(s) ago
ransfer to HD. Methods: We analyzed a multicenter, international cohort of PD patients enrolled in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) from 2014-2022. Pruritus was assessed at entry into PDOPPS with a single-question Likert Scale capturing the extent to which patients were bothered by itch ranging from 1: Not at all, to 5: Extremely. The KDQOL-36 and the Centre for Epidemiological Studies Depression Scale assessed various PROs. Moderate to extreme pruritus was defined as a Likert scale score ≥3. The associations of pruritus with PROs were assessed using linear/logistic regression where appropriate. Death or HD transfer was assessed using multivariable Cox regression models. Results: Overall, 5535 patients from seven countries were included; 43% had moderate to extreme pruritus which was highest in Thailand (50%) and lowest in the United States (33%). The adjusted odds ratios (aOR) of moderate to extreme pruritus were higher for diabetes, low albumin, a
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Pruritus is common in hemodialysis patients. This study found that pruritus is highly prevalent in peritoneal dialysis and associated with poor health outcomes. https://t.co/geGp16GhT8 @BieberBrian @DWJohnsonNeph @home_dialysis @markrlambie @PD_Perls @tennankore @KRINS_1… https://t.co/5jPtIZWCMf https://t.co/4NZmxD9xJ2
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Mashup Score: 41Proteomic Analysis Uncovers Multi-Protein Signatures... : Clinical Journal of the American Society of Nephrology - 21 day(s) ago
in-depth analysis of 6596 proteins (SomaScan 7K) in 374 baseline plasma samples from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study to identify multi-protein signatures associated with the onset of albuminuria (urine albumin-to-creatinine ratio [UACR] ≥30 mg/g), a rapid decline in estimated glomerular filtration rate (eGFR) [annual eGFR decline >3 mL/min/1.73m2 and/or ≥3.3% at two consecutive visits], and hyperfiltration (≥135 mL/min/1.73m2 at two consecutive visits). Elastic net Cox regression with 10-fold cross-validation was applied to the top 100 proteins (ranked by p-value) to identify multi-protein signatures of time to development of DKD outcomes. Results: Participants in the TODAY study (14±2 years old, 63% female, 7±6 months diabetes duration) experienced high rates of early DKD: 43% developed albuminuria, 48% hyperfiltration, and 16% rapid eGFR decline. Increased levels of seven and three proteins were predictive of shorter time to develop al
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The onset of DKD in youth with type 2 diabetes mellitus often occurs early, leading to complications in young adulthood. This study sheds new light on proteomic changes early in the course of youth-onset type 2 diabetes that associate with DKD. https://t.co/jc3lOE1qbg… https://t.co/deuVTfUHSl https://t.co/p6Ouh3NUO5
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Mashup Score: 12Perspectives on Long-Term Follow-Up Among Living Kidney... : Clinical Journal of the American Society of Nephrology - 25 day(s) ago
semi-structured interviews with 12 living kidney donors. The survey was developed based on themes identified in the semi-structured interviews, guidance from the research and clinical teams, and feedback from pilot testing with six previous donors. Results: Most (73%) respondents received follow-up after the first donation year from a primary care provider, and 70% reported annual follow-up visits including blood and urine tests. Most (71%) received a follow-up reminder from their transplant center, and follow-up was higher (86% versus 68%) among those receiving reminders. Donors wanted specialist involvement if new health or kidney-related events occurred. Most (70%) were satisfied with their follow-up, and 66% endorsed annual life-long follow-up. Donors wanted more information about lifestyle and living donor outcomes and wanted to contribute to research to increase understanding of long-term donor health outcomes. Conclusions: Donors wanted annual lifelong follow-up including clinic
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Mashup Score: 85Incidence and Proportion of Primary Focal Segmental... : Clinical Journal of the American Society of Nephrology - 1 month(s) ago
large diverse patient population in the United States. Methods: A cross-sectional study (2010-2021) was performed within an integrated health system in patients (age ≥18yrs) with biopsy-proven FSGS. Among biopsies with FSGS as the first diagnosis on pathology report, chart reviews were performed to determine primary FSGS, defined as podocyte foot process effacement ≥80% on electron microscopy. The proportion of patients with primary FSGS and annual incidence rates (per 100,000 patient-years) were calculated. Standardized incidence rates were determined by age, sex, and race and ethnicity based on US population structure of the five-year (2018-2022) American Community Survey estimates. Results: We identified 3,838 patients with FSGS reported on biopsy. Among 1,502 with FSGS as the principal diagnosis, 637 met criteria for primary FSGS (mean [SD] age 55.5 years [17.9], 56.5% male, 35.6% Hispanic, 28.7% White, 17.9% Asian/Pacific Islander, and 16.0% Black). The mean standardized incidence
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Focal segmental glomerulosclerosis refers to a pattern of glomerular injury but also includes primary FSGS which is considered as an immune mediated glomerulopathy. This study found that Primary FSGS accounted for 16.6% of biopsy-proven FSGS. https://t.co/jSJ9a6tT6w @MinZhuo4 https://t.co/LxHb8zAilX
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Mashup Score: 59Diurnal and Daily Symptom Variation in Patients with End... : Clinical Journal of the American Society of Nephrology - 1 month(s) ago
between hemodialysis and non-hemodialysis days.Ecological momentary assessment can provide insights into the complex, dynamic symptom experiences of patients on hemodialysis. Background Patients with ESKD on hemodialysis experience a high symptom burden, which is compounded by unpredictable fluctuations in symptom severity. Few studies have used ecological momentary assessment to determine how symptoms vary over time. This study aimed to characterize the diurnal and day-to-day variability in symptoms among patients receiving hemodialysis. Methods Patients enrolled in the Technology-Assisted Collaborative Care trial rated the intensity of physical, cognitive, and mood symptoms using an automated telephone-administered version of the Daytime Insomnia Symptom Scale at four time points (morning, early afternoon, late afternoon, evening) for seven consecutive days at baseline. Confirmatory factor analysis was used to verify the original four-factor solution for the Daytime Insomnia Symptom
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Among dialysis patients, cardiovascular events are the leading cause of death. In this cohort, the risk of major adverse cardiovascular events (MACE) was comparable across in-center and home dialysis modalities. https://t.co/DIRcYPPdcs https://t.co/O02ozC16Re