Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Dec 2008
ReviewSupport interventions for caregivers of people with chronic kidney disease: a systematic review.
A growing number of patients with chronic kidney disease (CKD) rely on non-professional healthcare providers, such as family and friends, to manage their long-term condition throughout the trajectory of CKD. These informal caregivers can experience stress, depression, lack of confidence and poor quality of life. Yet, the needs of caregivers are often neglected and under-prioritized. The objective of this review is to evaluate the effectiveness of interventions aimed at providing support to caregivers of people with CKD. ⋯ Despite the growing recognition of the burden and adverse effects of CKD on caregivers, no high-quality evidence is available about the effect of information or support interventions on the physical or psychosocial well-being of informal caregivers and the patients. More attention towards the development and evaluation of services that respond to the support and informational needs of caregivers is needed, and this may also lead to improved outcomes for patients.
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Nephrol. Dial. Transplant. · Dec 2008
Statin use is associated with early recovery of kidney injury after vascular surgery and improved long-term outcome.
Acute kidney injury (AKI) after major vascular surgery is an important risk factor for adverse long-term outcomes. The pleiotropic effects of statins may reduce kidney injury caused by perioperative episodes of hypotension and/or suprarenal clamping and improve long-term outcomes. ⋯ Statin use is associated with improved recovery from AKI after major surgery and has a beneficial effect on long-term survival.
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Nephrol. Dial. Transplant. · Dec 2008
The impact of automated eGFR reporting and education on nephrology service referrals.
Serum creatinine concentration is an unreliable and insensitive marker of chronic kidney disease (CKD). To improve CKD detection, the Australasian Creatinine Consensus Working Committee recommended reporting of estimated glomerular filtration rate (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD) formula with every request for serum creatinine concentration. The aim of this study was to evaluate the impact of automated laboratory reporting of eGFR on the quantity and quality of referrals to nephrology services in Southeast Queensland, Australia. ⋯ The introduction of automated eGFR calculation has led to an overall increase in referrals with a small but significant decrease in referral quality. The increase in referrals was seen predominantly in older and diabetic patients with stage 3 CKD and appeared to result in net benefit.
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Nephrol. Dial. Transplant. · Dec 2008
Stepwise increase in the prevalence of isolated systolic hypertension with the stages of chronic kidney disease.
Hypertension is common in patients with chronic kidney disease (CKD), and isolated systolic hypertension (ISH) accounts for most patients with inadequate blood pressure (BP) control. However, it remains unclear whether the prevalence of ISH would increase with the advancement of CKD. ⋯ The prevalence of ISH increased correspondingly with advanced stages of CKD, which may partially contribute to the increased cardiovascular mortality during the progress of CKD.