399 research outputs found
CHRONIC KIDNEY DISEASE RAAS blockade and diastolic heart failure in chronic kidney disease
No full text<p>New data from Ahmed et al. show that discharge prescriptions for renin-angiotensin-aldosterone inhibitor therapy are associated with a significant reduction in all-cause mortality in elderly patients with diastolic heart failure and chronic kidney disease (CKD). These observational data support the case for prospective studies of RAAS blockade in patients with CKD and diastolic heart failure. Franssen, C. F. M. & Navis, G. Nat. Rev. Nephrol. 9, 190-192 (2013); published online 12 March 2013; doi:10.1038/nrneph.2013.39</p>
Les politiques d’aide à la jeunesse et de prévention
No full textLivret 5 du rapport "Les politiques publiques d'enfance et de jeunesse en Belgique francophone 1999-2020". André G., Bussi L., Franssen A., Verhoeven M., Gonzalez B., Rinschbergh F., Vaeremans E. UCL, USL-B, Agence Alter pour l'OEJAJ. Dépôt légal : D/2022/15470/0
Chronic kidney disease and neurological disorders: are uraemic toxins the missing piece of the puzzle?
Full text linkChronic kidney disease (CKD) perturbs the crosstalk with others organs, with the interaction between the kidneys and the heart having been studied most intensively. However, a growing body of data indicates that there is an association between kidney dysfunction and disorders of the central nervous system. In epidemiological studies, CKD is associated with a high prevalence of neurological complications, such as cerebrovascular disorders, movement disorders, cognitive impairment and depression. Along with traditional cardiovascular risk factors (such as diabetes, inflammation, hypertension and dyslipidaemia), non-traditional risk factors related to kidney damage (such as uraemic toxins) may predispose patients with CKD to neurological disorders. There is increasing evidence to show that uraemic toxins, for example indoxyl sulphate, have a neurotoxic effect. A better understanding of factors responsible for the elevated prevalence of neurological disorders among patients with CKD might facilitate the development of novel treatments. Here, we review (i) the potential clinical impact of CKD on cerebrovascular and neurological complications, (ii) the mechanisms underlying the uraemic toxins' putative action (based on pre-clinical and clinical research) and (iii) the potential impact of these findings on patient care
Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe-lessons for the future
Full text linkBACKGROUND: Early reports on the pandemic nature of coronavirus disease 2019 (COVID-19) directed the nephrology community to develop infection prevention and control (IPC) guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave. METHODS: We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between 1 March 2020 and 31 July 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dialysis centres. RESULTS: Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting. CONCLUSIONS: Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.sponsorship: Dutch Kidney Foundationstatus: Publishe
The clinical frailty scale as a triage tool for ICU admission of dialysis patients with COVID-19 - An ERACODA analysis
Full text linkSeveral guidelines recommend using the Clinical Frailty Scale (CFS) for triage of critically ill COVID-19 patients. This study evaluates the impact of CFS on intensive care unit (ICU) admission rate, and hospital- and ICU mortality rates in hospitalized dialysis patients with COVID-19
In Reply to 'Intravenous Iron, Inflammation, and Ventricular Dysfunction During Hemodialysis'
No full textDilatation tracheoscopy for laryngeal and tracheal stenosis in patients with Wegener’s granulomatosis
No full textWegener's granulomatosis (WG) frequently involves the subglottis and trachea and may compromise the upper airway. The objective of this study is to evaluate retrospectively the effect of treatment of subglottic stenosis (SGS) and tracheal stenosis (TS) by dilatation tracheoscopy (DT) in patients with WG. We performed a cohort study on all patients who underwent DT between February 2001 and September 2005 in our institution. From this cohort we identified a total of nine WG patients. In all patients, clinical, serological and histopathological data had been prospectively collected by a standardized protocol from the time point of diagnosis. In the nine patients that were identified with SGS or TS due to WG (eight women and one man), a total of 22 DT's were performed. Two patients needed a tracheostoma (one temporarily). The mean follow-up after the first DT was 25.4 +/- 14.1 months. Two patients did not experience a recurrence of SGS or TS. Six patients required a second DT without recurrence of local disease. The remaining patient underwent 8 DT's in a 4-year period. DT can offer a simple and repeatable solution to SGS and TS due to WG. Seven of the nine patients required more than one dilatation and some patients experience a functional restriction. One patient has a definitive tracheostoma
Autonomic Imaging: The Cardiorenal Axis
No full textIn this chapter, we discuss the pathophysiology of the various chronic cardiorenal interactions and their consequences on the sympathetic nervous system (SNS). Increased activity of SNS is observed in all stages of chronic renal disease. The chronic elevation of SNS activity is a major contributor of the complex pathophysiology of hypertension, heart failure, insulin resistance, sleep disorders, diuretic resistance, and progressive kidney disease. Overactivity of SNS contributes to the high incidence of cardiovascular events and cardiac mortality, especially in patients with end-stage renal failure. The dysfunction of sympathetic innervation can be visualized directly by use of [123 I]-metaiodobenzylguanidine ([123 I]-MIBG) scintigraphy.</p
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