Nephrology
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People with chronic kidney disease have a shortened life expectancy and carry a high symptom burden. Research suggests that attending to renal patients' spiritual needs may contribute to an improvement in their quality of life. The aim of this qualitative study was to investigate the provision of spiritual care in New Zealand renal units from the perspective of specialists. ⋯ Most participants indicated they would attempt to provide some form of spiritual care, either directly or by referring the patient to appropriate services. However, participants generally demonstrated a lack of confidence in addressing a patient's spiritual needs.
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Randomized Controlled Trial Multicenter Study
Angiotensin-converting enzyme inhibitor usage and acute kidney injury: a secondary analysis of RENAL study outcomes.
Acute kidney injury (AKI) is associated with increased mortality. While angiotensin-converting enzyme inhibitors (ACEI) are known to slow progression of chronic kidney disease, their role in AKI remains unclear. ⋯ In the RENAL study cohort, the use of ACEI during the study was not common and, after adjustment for time-dependent covariates, was not significantly associated with reductions in mortality. Further assessment of the effect of ACEI use in AKI patients is needed.
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To investigate the potential effects of berberine on renal interstitial fibrosis (RIF) of obstructed kidneys in a unilateral ureteral obstruction (UUO) rat model. ⋯ Berberine treatment ameliorates RIF in a UUO rat model by inhibition of oxidative stress, inflammatory responses, and TGF-β1/pSmad3 signalling.
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Most laboratories are moving to report estimated glomerular filtration rates (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. However, data on the prevalence of chronic kidney disease (CKD) in the population and its economic impact have to date been modelled using data derived from the modification of diet in renal disease (MDRD) equation. Evaluating the impact of CKD-EPI on prevalence has important implications for referral patterns and health expenditure. ⋯ Introduction of routine eGFR reporting using the CKD-EPI formula will reduce the population prevalence of CKD. CKD-EPI reporting better identifies patients at risk of further decline in renal function. Improvement in the classification should reduce unnecessary costs related to surveillance and referral. The impact of ageing on renal function should be appreciated.