Current Opinion in Nephrology and Hypertension最新文献_第9页

Potential utility of renal functional reserve testing in clinical nephrology. 肾功能储备检测在临床肾脏病学中的潜在应用。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-09-15 DOI: 10.1097/MNH.0000000000000930

Thomas F Mueller, Valerie A Luyckx

{"title":"Potential utility of renal functional reserve testing in clinical nephrology.","authors":"Thomas F Mueller, Valerie A Luyckx","doi":"10.1097/MNH.0000000000000930","DOIUrl":"10.1097/MNH.0000000000000930","url":null,"abstract":"Purpose of review: The aim of this review is to discuss the concept of renal functional reserve (RFR) and its potential relevance in clinical practice.Recent findings: The RFR is a measure of the change in glomerular filtration rate (GFR) from baseline to a peak value when the kidney is stimulated to increase its function. This concept has a strong physiologic basis in nephrology and the presence, magnitude or absence of RFR capacity may have prognostic significance in many clinical scenarios where individuals are at risk of hyperfiltration or kidney dysfunction. Unlike in other medical specialties, where organ reserve function is reliably measurable and used routinely, measurement of RFR in nephrology has not been integrated into clinical care. Methodologic challenges including standardization of methods to stimulate GFR and the ability of measures of GFR to discriminate acute dynamic changes in GFR upon kidney stimulation have hampered the robustness and use of RFR measurements in research and clinical care.Summary: Given the emergence of many new disease-modifying therapies in nephrology, it is imperative that we move forward and develop more robust tools to further our understanding of kidney physiology and pathophysiology, such as the RFR, which should be integrated into research and clinical care to support optimal personalization of therapeutic kidney care strategies.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10243480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic testing in the evaluation of recipient candidates and living kidney donors. 评估受体候选者和活体肾脏捐献者的基因检测。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-10-12 DOI: 10.1097/MNH.0000000000000934

Brian K Lee, Christie P Thomas

{"title":"Genetic testing in the evaluation of recipient candidates and living kidney donors.","authors":"Brian K Lee, Christie P Thomas","doi":"10.1097/MNH.0000000000000934","DOIUrl":"10.1097/MNH.0000000000000934","url":null,"abstract":"Purpose of review: The aim of this study is to provide an overview of the role of genetic testing in the evaluation of kidney transplant candidates and living donors who may be at risk for heritable kidney disease. We focus our discussion on monogenic diseases, excluding renal diseases that have complex polygenic influences. Adoption of new technologies such as next-generation sequencing (NGS) with comprehensive gene panels has greatly enabled access to genetic testing recently; yet transplant professionals rarely receive adequate training in clinical genetics. In addition to a broad discussion of genetic testing, we hope to illustrate the thought processes and resources used in clinical genetic evaluation of recipient candidates and donors.Recent findings: Targeted renal genetic panels, whole exome and genome sequencing have greatly expanded our ability to test for pathogenic variants. Testing methods, analytic tools and the subsequent interpretation by the testing laboratory and treating physician impacts patient management and clinicians may lack the resources to practice in this new era of genomic medicine.Summary: The expansion of genomics into transplant medicine can provide improved diagnosis in transplant candidates and potentially disease prediction in living donors. Transplant professionals need to be familiar with emerging trends, promises and limitations of NGS-based testing.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers to home dialysis and kidney transplantation for socially disadvantaged individuals. 社会弱势群体家庭透析和肾移植的障碍。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-10-19 DOI: 10.1097/MNH.0000000000000939

Katherine Rizzolo, Jenny I Shen

{"title":"Barriers to home dialysis and kidney transplantation for socially disadvantaged individuals.","authors":"Katherine Rizzolo, Jenny I Shen","doi":"10.1097/MNH.0000000000000939","DOIUrl":"10.1097/MNH.0000000000000939","url":null,"abstract":"Purpose of review: People with kidney disease facing social disadvantage have multiple barriers to quality kidney care. The aim of this review is to summarize the patient, clinician, and system wide factors that impact access to quality kidney care and discuss potential solutions to improve outcomes for socially disadvantaged people with kidney disease.Recent findings: Patient level factors such as poverty, insurance, and employment affect access to care, and low health literacy and kidney disease awareness can affect engagement with care. Clinician level factors include lack of early nephrology referral, limited education of clinicians in home dialysis and transplantation, and poor patient-physician communication. System-level factors such as lack of predialysis care and adequate health insurance can affect timely access to care. Neighborhood level socioeconomic factors, and lack of inclusion of these factors into public policy payment models, can affect ability to access care. Moreover, the effects of structural racism and discrimination nay negatively affect the kidney care experience for racially and ethnically minoritized individuals.Summary: Patient, clinician, and system level factors affect access to and engagement in quality kidney care. Multilevel solutions are critical to achieving equitable care for all affected by kidney disease.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Climate crisis and nephrology: a review of climate change's impact on nephrology and how to combat it. 气候危机与肾脏病学：气候变化对肾脏病学的影响以及如何应对的综述。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-11-01 DOI: 10.1097/MNH.0000000000000942

Leonie Dupuis, Aarushi Varshney, Jason Patel, Shivam Joshi

{"title":"Climate crisis and nephrology: a review of climate change's impact on nephrology and how to combat it.","authors":"Leonie Dupuis, Aarushi Varshney, Jason Patel, Shivam Joshi","doi":"10.1097/MNH.0000000000000942","DOIUrl":"10.1097/MNH.0000000000000942","url":null,"abstract":"Climate change is worsening with tangible effects on our healthcare system. This review aims to examine the repercussions of the climate change on nephrology and explore potential strategies to mitigate its impact. This review examines dialysis's environmental impact, resource recycling methods, and plant-based diets for kidney health. Recent research highlights the advantages of plant-based diets in managing and preventing chronic kidney disease (CKD) and its complications. Integrating these practices can significantly lessen the environmental impact of nephrology.Purpose of review: The aim of this study is to discuss the bidirectional relationship of climate change and kidney disease and the impact of nephrology on climate change and to discuss potential solutions.Recent findings: Each dialysis session consumes significant amounts of resource; reusing them will aid the environment. Plant-based diets slow renal disease and have a lower carbon footprint, making them ecologically friendly.Summary: Climate change is a growing threat to population health and healthcare. Rising temperatures raise the risk of kidney problems. Dialysis treatments also impact the environment through its high resource requirements while generating high volumes of waste and greenhouse gases. Opportunities exist to reduce the environmental impact of dialysis treatments. Plant-based diets serve to benefit both kidney disease and the environment.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Roadmaps to green nephrology: a mediterranean point of view. 绿色肾病学路线图：地中海观点。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-11-02 DOI: 10.1097/MNH.0000000000000943

Mohamed Ben Hmida, Massimo Torreggiani, Nathan Berman-Parks, Mario Salomone, Giorgina Barbara Piccoli

{"title":"Roadmaps to green nephrology: a mediterranean point of view.","authors":"Mohamed Ben Hmida, Massimo Torreggiani, Nathan Berman-Parks, Mario Salomone, Giorgina Barbara Piccoli","doi":"10.1097/MNH.0000000000000943","DOIUrl":"10.1097/MNH.0000000000000943","url":null,"abstract":"Purpose of review: Green nephrology is a movement whose aim is to find ways to reduce the environmental impact of kidney care. The question is of particular concern in this field since haemodialysis is one of the major contributors to waste generation, energy use and water consumption in healthcare. Although several ways for improving sustainability have been advocated, they are all context sensitive. This review aims to analyse the interventions that have been proposed to improve the ecologic sustainability and reduce the carbon footprint of nephrology care adapting to specific settings, and taking advantage of local expertise.Recent findings: Green hospitals are becoming a reality in several high-income settings, thanks to new building guidelines, with greater awareness of climate change and users' demands. Water saving is feasible, and is increasingly done, in different ways (improving hardware, reducing and adapting dialysate flows). Recycling noncontaminated plastic waste is feasible, but is still rarely performed. However, ecological transition has been slow even in high-income countries, while in low and middle-income countries lack of resources limit the ability to cope with the planet's urgent needs. Conversely, where man-power cost is low, some time-consuming tasks, such as separation of various components for recycling may be affordable. Theoretically, implementation of all clinical tasks aiming to avoid or retard dialysis, should be a priority.Summary: There is no single roadmap for achieving green nephrology. Each setting should start from those feasible interventions most in line with its specific needs and priorities.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current approaches to overcome recurrent focal segmental glomerulosclerosis after kidney transplantation. 目前克服肾移植后复发性局灶性节段性肾小球硬化的方法。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI: 10.1097/MNH.0000000000000946

Syeda Behjat Ahmad, Yonatan Peleg, Wooin Ahn

引用次数: 0

Sodium-glucose cotransporter 2 inhibitors and cardiorenal outcomes in kidney transplantation. 钠-葡萄糖共转运蛋白2抑制剂与肾移植的心肾预后。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-01-01 Epub Date: 2023-11-06 DOI: 10.1097/MNH.0000000000000948

Gauranga Mahalwar, Roy O Mathew, Janani Rangaswami

{"title":"Sodium-glucose cotransporter 2 inhibitors and cardiorenal outcomes in kidney transplantation.","authors":"Gauranga Mahalwar, Roy O Mathew, Janani Rangaswami","doi":"10.1097/MNH.0000000000000948","DOIUrl":"10.1097/MNH.0000000000000948","url":null,"abstract":"Purpose of review: This review aims to explore the current evidence regarding cardiovascular and kidney outcomes in patients who undergo treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2i) post kidney transplantation.Recent findings: Summary findings from individual studies included in this review showed largely favorable results in the kidney transplant recipients (KTRs) being treated with SGLT2i.These outcomes included parameters such as allograft function, glycemic control, proteinuria, blood pressure, weight loss and safety profile, among others. Almost all the studies reported an initial 'dip' in eGFR, followed by recovery, after the initiation of SGLT2i treatment. None of the studies reported significant interaction of SGLT2i with immunosuppressive medications. The most common adverse effects noted in these studies were infection-related including UTI and genital mycosis. None of the studies reported acute graft rejection attributable to SGLT2i therapy.Summary: SGLT2i can play a significant role in improving health outcomes in KTRs. However, clinical trials with larger representation of KTRs longer follow-up period are needed to draw more substantial conclusions.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Onconephrology: mitigation of renal injury in chemotherapy administration. 肿瘤肾脏病学：减轻化疗对肾脏的损伤。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2023-12-15 DOI: 10.1097/mnh.0000000000000960

Umut Selamet, Rebecca S Ahdoot, Reed Salasnek, Lama Abdelnour, Ramy M Hanna

引用次数: 0

Oh, My Gut! New insights on the role of the gastrointestinal tract and the gut microbiome in chronic kidney disease-mineral and bone disorder. 哦，我的肠道关于胃肠道和肠道微生物群在慢性肾病-矿物质和骨骼紊乱中的作用的新见解。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2023-12-14 DOI: 10.1097/mnh.0000000000000961

Seyedeh Nooshan Mirmohammadali, Kathleen M Hill Gallant, Annabel Biruete

引用次数: 0

Editorial introduction. 编辑简介。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2023-11-01 Epub Date: 2023-09-28 DOI: 10.1097/MNH.0000000000000925

引用次数: 0