1,721,090 research outputs found
Antiplatelet therapy for prevention of hemodialysis vascular access thrombosis and improving survival
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Management of cytotoxic chemotherapy in patients undergoing dialysis: a still unresolved issue of onconephrology
Full text linkThe incidence of tumors increases signifcantly in individuals with chronic kidney disease (CKD), particularly among those undergoing dialysis. This dialysis-associated condition not only impacts therapy but also infuences the prognosis of oncological patients, contributing to heightened mortality rates related to both cancer and non-cancer causes. Importantly, it stands as a primary factor leading to suboptimal utilization of therapies. Dosage adjustment for many types of chemotherapy is a necessity in patients with kidney impairment. However, due to a lack of comprehensive knowledge about the pharmacokinetic and pharmacodynamic properties of these drugs in dialysis, adjustments are often made empirically, and in many cases, chemotherapy is avoided altogether. In this review, we highlight the current challenges and gaps in knowledge, and emphasize the imperative need for dedicated research to establish evidence-based guidelines for chemotherapy management in this vulnerable patient population
Acute kidney injury in cancer patients
No full textBackground: Renal complications are a relevant clinical issue in patients with cancer; conversely, cancer in patients affected by kidney diseases is a growing problem mainly due to the aging of the general population. Onco-Nephrology is a novel subspecialty addressing these issues. Summary: Acute kidney injury (AKI) is an important cause of morbidity and mortality in cancer patients, and recognizes a number of different causes, which can impact, directly and indirectly, on kidney function. Furthermore, the appearance of AKI may have a tremendously negative impact on oncological treatments, often denying cancer patients active and life-prolonging treatments. Overall, patients with cancer are at risk of AKI, which could be caused by antineoplastic treatments, sepsis, metabolic disturbances, hematopoietic stem cell transplantation, primary thrombotic micro-angiopathies, and direct involvement of the kidney by hematological malignancies and also by solid cancer, in particular kidney and urothelial malignancies. Key Messages: (1) AKI is a frequent and increasing complication of cancer. (2) There is a bidirectional relationship between cancer and kidney disease, and in both cases, AKI is more likely to happen. (3) AKI in patients with cancer is associated with increased morbidity and mortality. (4) In cancer patients, a multidisciplinary approach and early intervention may reduce the incidence of AKI and its life-threatening consequences. (5) Onco-Nephrology is a growing area of nephrology that requires clinicians to have a better understanding of the renal complications of cancer including AKI
[Hyperphosphatemia in dialysis: which binder?]
No full textSeveral studies have evidenced the association between high serum phosphorus concentrations and adverse events especially in patients on dialysis. Recent K-DIGO guidelines suggest lowering elevated phosphate levels toward the normal range. This goal should be achieved by combining dietary counseling, optimizing dialysis procedures and prescribing phosphate binders. Despite the availability of several binders, the "ideal" phosphate binder that combines high efficacy, low pills burden, minimal side effects and low cost is still not available. In clinical practice it is crucial to reach a high patient's compliance to therapy. The pill burden is the most relevant factor contributing to low compliance. This is the case of phosphate binder therapy that represents almost 50% of total pills prescribed to patients on dialysis. It has been evidenced an association between pills of phosphate binder and poor control of phosphorus and PTH. In recent years sucroferric oxyhydroxide is available as a new phosphate binder. Its peculiarity is an high phosphate binding capability that requires prescription of low number of pills per day. This characteristic has been confirmed by several randomized controlled trials. These trials have also evidenced that sucroferric oxyhydroxide may cause some gastrointestinal side effects. There is an ongoing study to confirm in "the real world" the incidence of side effects reported by controlled trials
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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