Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 2009
Editorial Comment ReviewObstructive sleep apnoea: clinical signs, diagnosis and treatment.
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Nephrol. Dial. Transplant. · Jan 2009
Renal dysfunction in acute stroke: an independent predictor of long-term all combined vascular events and overall mortality.
Acute stroke is the third leading cause of death in western societies after ischemic heart disease and cancer. Although it is an emergency disease sharing the same atherosclerotic risk factors with ischemic heart disease, the association of renal function and stroke is poorly investigated. The present study aims at assessing renal function status in patients with acute stroke and investigate any prognostic significance on the outcome. ⋯ Renal function on admission appears to be a significant independent prognostic factor for long term mortality and new cardiovascular morbidity over a 10-year period.
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Nephrol. Dial. Transplant. · Jan 2009
Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life.
To date, the pathophysiology underlying symptoms in renal patients is still unclear. Symptom management research suggests that identification of related clusters of symptoms could provide insight into underlying determinants associated with multiple symptom experience. Theoretically, symptoms within a cluster could have a synergistic relationship. We aimed to identify symptom clusters in incident dialysis patients, and investigated associations between symptom clusters, clinical variables, functional status as measured by the Karnofsky Index and quality of life. ⋯ Symptom clustering does not explain the lack of meaningful associations between symptoms and clinical variables. Strong associations of symptom clusters with quality of life dimensions suggest that psychological factors could better explain symptom burden. Patients' perceptions of symptoms should be routinely assessed as part of clinical care to improve self-management strategies.
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Nephrol. Dial. Transplant. · Jan 2009
The great saphenous vein for central venous access and haemodialysis.
Utilising an open surgical technique the Great Saphenous vein in the proximal thigh can be used for the insertion of central venous catheters for haemodialysis. This approach is safe and efficacious, and may be performed under local or general anaesthesia. This technique is of particular importance in patients requiring vascular access for haemodialysis in whom the upper central veins are stenosed and the femoral vessels are not amenable to percutaneous cannulation. ⋯ The great saphenous vein offers an additional site for the insertion of central venous catheters. These data demonstrate equivalence in patency between this novel technique and percutaneous femoral vein cannulation.
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Nephrol. Dial. Transplant. · Jan 2009
Randomized Controlled Trial Multicenter StudyLongitudinal analysis of performance of estimated glomerular filtration rate as renal function declines in chronic kidney disease.
Numerous studies have assessed the accuracy of equations estimating glomerular filtration rate (eGFR) from serum creatinine in individuals with chronic kidney disease (CKD) in cross-sectional studies. Limited literature exists, however, on the consistency of performance of these equations in longitudinal studies as renal function declines. ⋯ GFR estimates are inexpensive and show an acceptable longitudinal performance for monitoring CKD patients with GFR <50 mL/min/1.73 m(2). Inaccuracies appear more substantial above this level of GFR, and care with interpretation is required.