Child ; Chronic Disease ; Humans ; Kidney Diseases ; Kidney Failure, Chronic ; Renal Insufficiency, Chronic

Child ; Chronic Disease ; Guidelines as Topic ; Humans ; Kidney Diseases ; therapy ; Kidney Failure, Chronic ; Nutritional Support ; Renal Insufficiency, Chronic

Child ; Chronic Disease ; Humans ; Kidney Diseases ; therapy ; Kidney Failure, Chronic ; therapy ; Nutritional Support ; Renal Insufficiency, Chronic ; therapy

Elderly population is growing in Korea along with increase in the prevalence of chronic diseases, such as chronic kidney disease. The proportion of elderly population aged 65 years or more among patients with incident end stage renal disease (ESRD) is increasing and has reached to 35.8% in 2011. Functional independence should be considered for management of elderly population with chronic disease because it is related to patient's quality of life and mortality. However, functional disability in the elderly is increasing with progression of renal dysfunction and initiation of dialysis. The renal replacement therapy could not make the elderly patients with ESRD avoid of functional disability and mortality. Considering that the mortality of the elderly with ESRD is dependent on the baseline co-morbid conditions and functional disability, the nephrologists and the geriatricians need to propose the proper guidelilnes for management of the elderly patients with ESRD in near future.
Aged ; Chronic Disease ; Dialysis ; Humans ; Kidney Failure, Chronic ; Korea ; Prevalence ; Quality of Life ; Renal Insufficiency, Chronic ; Renal Replacement Therapy

The kidneys are closely connected with several organs, including the liver, and can therefore be negatively affected when the liver is damaged. The most common cause of chronic liver disease is chronic viral hepatitis, resulting from either a hepatitis B virus (HBV) or a hepatitis C virus (HCV). Chronic viral hepatitis often progresses to cirrhosis and hepatocellular carcinoma. However, it can also lead to viral-associated glomerulopathies that can cause chronic kidney disease (CKD), which can then progress to end stage renal disease (ESRD). Additionally, patients with ESRD on hemodialysis are at risk for viral infections because HBV and HCV are hematogenously transmitted. Recently, treatments with oral nucleoside/nucleotide analogues and direct-acting antivirals have yielded excellent results in HBV- and HCV-infected patients with CKD. As a result, a new paradigm for the treatment of chronic viral infections in CKD patients has emerged. This review discusses viral-associated glomerulopathies, antiviral treatments of HBV and HCV infections in patients with CKD, and prevention strategies for the transmission of HBV and HCV in patients with ESRD.
Antiviral Agents ; Carcinoma, Hepatocellular ; Chronic Disease ; Fibrosis ; Hepacivirus ; Hepatitis ; Hepatitis B virus ; Humans ; Kidney Diseases ; Kidney Failure, Chronic ; Kidney ; Liver Diseases ; Liver ; Renal Dialysis ; Renal Insufficiency, Chronic

Child ; China ; Chronic Disease ; Congresses as Topic ; Humans ; Kidney Diseases ; prevention & control ; Kidney Failure, Chronic ; prevention & control ; Renal Insufficiency, Chronic ; prevention & control

OBJECTIVES: Health Avatar Beans was for the management of chronic kidney disease and end-stage renal disease (ESRD). This article is about the DialysisNet system in Health Avatar Beans for the seamless management of ESRD based on the personal health record. METHODS: For hemodialysis data modeling, we identified common data elements for hemodialysis information (CDEHI). We used ASTM continuity of care record (CCR) and ISO/IEC 11179 for the compliance method with a standard model for the CDEHI. According to the contents of the ASTM CCR, we mapped the CDHEI to the contents and created the metadata from that. It was transformed and parsed into the database and verified according to the ASTM CCR/XML schema definition (XSD). DialysisNet was created as an iPad application. The contents of the CDEHI were categorized for effective management. For the evaluation of information transfer, we used CarePlatform, which was developed for data access. The metadata of CDEHI in DialysisNet was exchanged by the CarePlatform with semantic interoperability. RESULTS: The CDEHI was separated into a content list for individual patient data, a contents list for hemodialysis center data, consultation and transfer form, and clinical decision support data. After matching to the CCR, the CDEHI was transformed to metadata, and it was transformed to XML and proven according to the ASTM CCR/XSD. DialysisNet has specific consideration of visualization, graphics, images, statistics, and database. CONCLUSIONS: We created the DialysisNet application, which can integrate and manage data sources for hemodialysis information based on CCR standards.
Chronic Disease ; Compliance ; Continuity of Patient Care* ; Fabaceae ; Health Information Management ; Health Records, Personal ; Humans ; Information Storage and Retrieval* ; Kidney Failure, Chronic ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Semantics

OBJECTIVES: The aim of the present study was to assess the frequency of use, and preferences regarding information and communication technologies (ICTs) among Ecuadorian patients with chronic kidney disease (CKD) undergoing hemodialysis. METHODS: We conducted an anonymous cross-sectional survey-based study from January 2016 to April 2017, involving 393 patients with end-stage renal disease from 9 hemodialysis centers, in which they rated their use and preferences of various ICTs through a modified version of the Michigan Questionnaire. The questionnaire collected information regarding demographics, patients' interest in obtaining health-related information through ICTs, and interest in using ICTs as a potential way to communicate with their healthcare providers. A chi-square test for association and adjusted regression analyses were performed. RESULTS: Among all patients who participated, 64.3% reported owning a cellphone, with less than a third reporting active Internet connection. The most used ICT for obtaining information about CKD and/or hemodialysis was web-based Internet, followed by YouTube. SMS was rated the highest to receive and seek health-related information, followed by Facebook. Younger age and higher levels of education were associated with a higher overall usage of ICTs. Finally, more than half of the patients reported interest in using WhatsApp for communicating with their healthcare providers. CONCLUSIONS: Understanding the preferences of ICTs among patients with CKD undergoing hemodialysis could help to improve their outcomes through the potential uses and benefits of ICTs. Further research is needed to assess their role in improving the care of patients with chronic diseases.
Anonyms and Pseudonyms ; Chronic Disease ; Cross-Sectional Studies* ; Demography ; Education ; Health Personnel ; Humans ; Internet ; Kidney Failure, Chronic ; Medical Informatics ; Michigan ; Renal Dialysis* ; Renal Insufficiency, Chronic* ; Social Media

Chronic kidney disease (CKD) is a broad term for diverse disorders affecting renal structure and function. The worldwide increase in the number of patients with CKD and consequent end-stage renal disease (ESRD) requiring renal replacement therapy is threatening to reach a global epidemic level. The economic burden is difficult to deal for both family and society. A change in the global approach to CKD from treatment of ESRD to much more aggressive primary and secondary prevention is therefore imperative. CKD can be detected with routine laboratory tests, and some treatments can prevent its development and slow disease progression, reduce complications of decreased glomerular filtration rate and risk of cardiovascular diseases, and improve survival and quality of life. In this article, I review the practical methods-including blood pressure control, anemia correction, management of mineral and bone disorders related with CKD-for the prevention of or slowing the progression of CKD. I also describe several essential drugs that are used frequently to treat the common complications of CKD.
Anemia ; Blood Pressure ; Cardiovascular Diseases ; Disease Progression ; Drugs, Essential ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic ; Quality of Life ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Secondary Prevention

OBJECTIVEWhether statins can slow down the progression of chronic kidney disease (CKD) remains controversial. We performed a meta-analysis to evaluate the effects of statin therapy on disease progression in adult patients with CKD who did not require dialysis therapy.

METHODSWe searched the electronic databases for relevant randomized controlled trials (RCTs) published by February 2015. Random-effects meta-analysis of RCTs was used to pool the renal outcomes of the patients.

RESULTSTwenty-eight studies (30 RCTs) involving a total of 45 688 participants were included in the analysis. Compared with the control groups, statins produced no effects in preventing end-stage renal disease (ESRD) [relative risks (RR) 0.98, 95% confidence intervals (CI): 0.91-1.05] and in reducing the risk of doubling of the serum creatinine level (RR 1.43, 95% CI: 0.26-7.79). Statin therapy was associated with a lowered risk of estimated glomerular filtration rate (eGFR) reduction by 25% or more (RR 0.91, 95% CI: 0.83-0.99) and delayed the reduction of eGFR [standardized mean differences (SMD) 0.04, 95% CI: 0.02-0.07]. In subgroup analyses, the benefit of statins on changes in eGFR was statistically significant in patients with moderate CKD (SMD 0.09, 95% CI 0.04-0.13). Among different statins, atorvastatin was associated with a beneficial effect on kidney function (SMD 0.10, 95% CI 0.03-0.17). Patients who received high-intensity statin therapy showed significant changes in eGFR (SMD 0.12, 95% CI: 0.02-0.21).

CONCLUSIONStatin therapies may not prevent ESRD or doubling of serum creatinine level, but can improve GFR or delay the reduction of GFR in CKD patients. The therapeutic effects are associated with the patients' baseline eGFR levels, statin types and therapy intensity.

Adult ; Disease Progression ; Glomerular Filtration Rate ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Kidney Failure, Chronic ; drug therapy ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic ; drug therapy