Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 2008
Haemodialysis patients with sleep apnoea syndrome experience increased central adiposity and altered muscular composition and functionality.
Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts. ⋯ Haemodialysis patients with sleep apnoea syndrome demonstrate poorer functional capacity, physical performance and muscle composition, compared to non-apneic dialysis patients. Overall, sleep apnoea appears to partly contribute to the total diminished functional capacity of haemodialysis patients.
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Nephrol. Dial. Transplant. · Jan 2008
A structured weight management programme can achieve improved functional ability and significant weight loss in obese patients with chronic kidney disease.
Kidney transplantation in obese patients [body mass index (BMI) >30 kg/m(2)] is associated with a poorer outcome, and these patients are therefore often excluded from transplant waiting lists. Conventional weight loss strategies based on a high fibre, low energy diet and exercise are often unsuitable in the chronic kidney disease (CKD) population. A comprehensive multidisciplinary weight management programme comprising a low fat, reduced energy diet, individual exercise prescription and pharmacotherapy with orlistat 120 mg tds, was initiated to determine whether obese patients with CKD could reach an acceptable weight for transplantation. ⋯ Preliminary experience from this multidisciplinary programme combining diet, exercise and orlistat suggests that significant weight loss and improved physical functioning can be achieved in obese CKD patients, potentially allowing them the opportunity of kidney transplantation and the associated benefits of this compared with long-term dialysis.
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Nephrol. Dial. Transplant. · Jan 2008
Pathological variants of focal segmental glomerulosclerosis in an adult Dutch population--epidemiology and outcome.
A working group has defined five subtypes of focal segmental glomerulosclerosis (FSGS) based on light microscopic assessment (Columbia classification). Limited information is available on the prognostic and therapeutic implications of this classification in a European population. We conducted a retrospective analysis in 93 adult patients with biopsy-proven FSGS to determine the clinical features and outcome of FSGS variants. ⋯ The collapsing variant was rare in our population. Renal survival and remission rates were higher in patients with the tip variant. Use of the classification scheme for FSGS may be clinically useful.