Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Nov 2013
Underweight, overweight and obesity in paediatric dialysis and renal transplant patients.
The prevalence of childhood overweight is rising worldwide, but in children on renal replacement therapy (RRT) a poor nutritional status is still the primary concern. We aimed to study the prevalence of, and factors associated with, underweight and overweight/obesity in the European paediatric RRT population. Moreover, we assessed the evolution of body mass index (BMI) after the start of RRT. ⋯ Overweight and obesity, rather than underweight, are highly prevalent in European children on RRT. Short stature among graft recipients had a strong association with overweight, while underweight appears to be only a problem in infants. Our findings suggest that nutritional management in children receiving RRT should focus as much on the prevention and treatment of overweight as on preventing malnutrition.
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Nephrol. Dial. Transplant. · Nov 2013
Randomized Controlled Trial Multicenter StudyBaseline characteristics in the Bardoxolone methyl EvAluation in patients with Chronic kidney disease and type 2 diabetes mellitus: the Occurrence of renal eveNts (BEACON) trial.
Type 2 diabetes mellitus (T2DM) is the most important contributing cause of end-stage renal disease (ESRD) worldwide. Bardoxolone methyl, a nuclear factor-erythroid-2-related factor 2 activator, augments estimated glomerular filtration. The Bardoxolone methyl EvAluation in patients with Chronic kidney disease and type 2 diabetes mellitus: the Occurrence of renal eveNts (BEACON) trial was designed to establish whether bardoxolone methyl slows or prevents progression to ESRD. Herein, we describe baseline characteristics of the BEACON population. ⋯ The BEACON trial enrolled a population heretofore unstudied in an international randomized controlled trial. Enrolled patients suffered with numerous co-morbid conditions and exhibited multiple laboratory abnormalities, highlighting the critical need for new therapies to optimize management of these conditions.
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Nephrol. Dial. Transplant. · Nov 2013
ReviewObesity and nephrology: results of a knowledge and practice pattern survey.
Obesity, the largest epidemic of modern time, carries a markedly increased risk of type-2 diabetes, cancer, fatty liver, sleep apnea, hypertension, dyslipidemia and atherosclerotic cardiovascular disease. In addition, obesity increases the risk of chronic kidney disease (CKD) and its progression to end-stage renal disease (ESRD). There are limited data regarding the basic knowledge of nephrologists on how to assess and manage obesity in the setting of CKD. ⋯ The level of understanding of the intricacies of obesity in the setting of CKD needs improvement among nephrologists. Similarly, there is no consensus regarding weight management strategies in CKD patients with obesity. Studies are needed in this orphan area of renal research.
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Nephrol. Dial. Transplant. · Nov 2013
When do we need competing risks methods for survival analysis in nephrology?
Survival analyses are commonly applied to study death or other events of interest. In such analyses, so-called competing risks may form an important problem. ⋯ Conventional methods for survival analysis ignoring the competing event(s), such as the Kaplan-Meier method and standard Cox proportional hazards regression, may be inappropriate in the presence of competing risks, and alternative methods specifically designed for analysing competing risks data should then be applied. This problem deserves more attention in nephrology research and in the current article, we therefore explain the problem of competing risks in survival analysis and how using different techniques may affect study results.
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Nephrol. Dial. Transplant. · Nov 2013
Sensitization from transfusion in patients awaiting primary kidney transplant.
Sensitization to human leukocyte antigen (HLA) from red blood cell (RBC) transfusion is poorly quantified and is based on outdated, insensitive methods. The objective was to evaluate the effect of transfusion on the breadth, magnitude and specificity of HLA antibody formation using sensitive and specific methods. ⋯ Among prospective primary kidney transplant recipients, RBC transfusion results in clinically significant increases in HLA antibody strength and breadth, which adversely affect the opportunity for future transplant.