Clinical journal of the American Society of Nephrology : CJASN
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Clin J Am Soc Nephrol · Apr 2012
The Duke Activity Status Index in patients with chronic kidney disease: a reliability study.
Exercise capacity is impaired at a younger age in CKD patients than in the general population. This study examined the reliability of the Duke Activity Status Index (DASI) questionnaire as a measure of exercise capacity in medically stable adults with stage 3-4 CKD (estimated GFR [eGFR], 15-59 ml/min per 1.73 m(2)). ⋯ The DASI questionnaire may be a reliable measure of exercise capacity in CKD patients, especially when eGFR is <35 ml/min per 1.73 m(2). Larger prospective studies are needed to determine its prognostic value.
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Clin J Am Soc Nephrol · Apr 2012
Use of electronic results reporting to diagnose and monitor AKI in hospitalized patients.
Many patients with AKI are cared for by non-nephrologists. This can result in variable standards of care that contribute to poor outcomes. ⋯ AKI is common in hospitalized patients and is associated with very poor outcomes. The successful implementation of electronic alert systems to aid early recognition of AKI across all acute specialties is one strategy that may help raise standards of care.
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Clin J Am Soc Nephrol · Mar 2012
Multicenter StudyKidney volume and functional outcomes in autosomal dominant polycystic kidney disease.
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency. ⋯ Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.
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Clin J Am Soc Nephrol · Mar 2012
Multicenter StudyPharmacokinetics and pharmacodynamics of piperacillin-tazobactam in 42 patients treated with concomitant CRRT.
Current recommendations for piperacillin-tazobactam dosing in patients receiving continuous renal replacement therapy originate from studies with relatively few patients and lower continuous renal replacement therapy doses than commonly used today. This study measured the pharmacokinetic and pharmacodynamic characteristics of piperacillin-tazobactam in patients treated with continuous renal replacement therapy using contemporary equipment and prescriptions. ⋯ There is significant patient to patient variability in pharmacokinetic/pharmacodynamic parameters in patients receiving continuous renal replacement therapy. Many patients did not achieve pharmacodynamic targets, suggesting that therapeutic drug monitoring might optimize therapy.
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ESRD is associated with substantial cognitive deficits but whether earlier kidney dysfunction predicts cognitive decline is less well defined. ⋯ A baseline urinary ACR ≥5 mg/g, a level not traditionally considered clinically significant, is independently associated with faster decline in cognitive function.