Kidney360最新文献

{"title":"High Treatment Burden and Low Quality of Life in Acute Kidney Injury Survivors: How Should We Respond?","authors":"Alvin H Moss","doi":"10.34067/KID.0000000713","DOIUrl":"10.34067/KID.0000000713","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":"6 5","pages":"680-682"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and Location of Sudden Cardiac Arrests in Hemodialysis Patients: Be Prepared for the Expected.","authors":"Patrick H Pun","doi":"10.34067/KID.0000000721","DOIUrl":"10.34067/KID.0000000721","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":"6 5","pages":"692-693"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodialysis Timing Influences Sleep Profile.","authors":"Mario Bonomini, Gianpaolo Reboldi","doi":"10.34067/KID.0000000768","DOIUrl":"10.34067/KID.0000000768","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":"6 5","pages":"686-688"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Nephrology Research with Natural Language Processing and Artificial Intelligence: A Case for More Comprehensive Symptom Documentation.","authors":"Rebecca J Allen, Alferso C Abrahams","doi":"10.34067/KID.0000000755","DOIUrl":"10.34067/KID.0000000755","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":"6 5","pages":"689-691"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists on 24-Hour Urine Parameters: A Retrospective Cohort Study.","authors":"Jennifer A Schaub, Mary K Oerline, Joseph J Crivelli, Naim M Maalouf, Sara L Best, John R Asplin, John M Hollingsworth, Vahakn Shahinian, Ryan S Hsi","doi":"10.34067/KID.0000000728","DOIUrl":"10.34067/KID.0000000728","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":"835-847"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the Assessment of GFR in Patients with Cancer.","authors":"Verônica T Costa E Silva, Fei Xiong, Lea Mantz, Meghan E Sise, Sandra M Herrmann, Abhijat Kitchlu","doi":"10.34067/KID.0000000736","DOIUrl":"10.34067/KID.0000000736","url":null,"abstract":"<p><p>Accurate assessment of GFR is key in patients with cancer to guide drug eligibility, adjust dosing of systemic therapy, and minimize the risks of undertreatment and systemic toxicity. Several aspects of GFR evaluation in patients with cancer have been unclear, such as the choice of the GFR estimating equation and the overall lack of data on the reliability of new filtration markers, such as cystatin C. This uncertainty has led to concerns that inaccurate GFR estimation may have a large effect on clinical practice and research. Recent data have brought important developments to the field. The new and timely Kidney Disease Improving Global Outcomes 2024 Clinical Practice Guideline for the Evaluation and Management of CKD raised important considerations and provided guidance on key aspects of GFR evaluation in patients with cancer. The guidelines cover valid estimating equations, incorporation of cystatin C in GFR estimation, drawbacks of using race in GFR estimation, and acknowledge that non-GFR determinants of filtration markers may be prominent in patients with cancer, reducing the accuracy of GFR estimating equations, prompting greater utilization of GFR measurement. The aim of this review is to summarize advances in GFR evaluation in patients with cancer considering the new Kidney Disease Improving Global Outcomes guidelines and other recent data.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":"861-870"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Centered Advance Care Planning in Dialysis: The HIGHWay (Honor Individual Goals and Hopes Way) Initiative.","authors":"Giselle M Rodriguez de Sosa, Mae Thamer, Elizabeth Anderson, Mark L Unruh, Dale E Lupu","doi":"10.34067/KID.0000000767","DOIUrl":"10.34067/KID.0000000767","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":"957-967"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Sodium Correction Rates in Patients with Severe Hyponatremia Treated with Hypertonic Saline with and without Proactive Desmopressin.","authors":"Zain AlShanableh, Anna Woodall, Michelle Chisdak, Jonathan G Yabes, Richard H Sterns, Steven D Weisbord, Helbert Rondon-Berrios","doi":"10.34067/KID.0000000830","DOIUrl":"https://doi.org/10.34067/KID.0000000830","url":null,"abstract":"<p><strong>Background: </strong>Co-administration of hypertonic saline 3% and desmopressin from the outset of treatment (\"DDAVP clamp\" or proactive desmopressin) has been suggested to prevent inadvertent overcorrection of hyponatremia, but its effectiveness and safety remain uncertain.</p><p><strong>Methods: </strong>We identified adult patients hospitalized between 7/1/18 and 6/30/23 at four University of Pittsburgh Medical Center hospitals with a plasma sodium ≤120 mEq/L at admission or during hospitalization who were treated with hypertonic saline. We compared outcomes between patients who were treated with proactive desmopressin and those who either did not receive desmopressin or received it using a reactive/rescue strategy.</p><p><strong>Results: </strong>A total of 184 patient admissions (57.6% female, mean age 60.6 years) met inclusion and exclusion criteria. Hyponatremia was chronic in 93.5% of patients; leading causes were SIAD (51.6%), hypovolemia (25.5%), and low solute intake (15.8%); and 20.1% had seizures. Cases treated with proactive desmopressin (n=44) were compared to cases treated without proactive desmopressin (n=140). Despite a lower baseline plasma sodium (110.2±6.3 vs. 115.2±7.2 mEq/L, p<0.001), correction by >8 mEq/L (6.8% vs. 27.1%, p=0.009) or >10 mEq/L (0% vs. 15%, p=0.014) within the first 24 hours was significantly less frequent in the proactive desmopressin group. Hospital mortality (6.8% vs. 6.4%, p>0.99), length of hospital (12.5 d vs. 11.7 d, p=0.624) and ICU stays (6 d vs. 5.5 d, p=0.578), fluid overload (9.1% vs.9.5%, p>0.99), and worsening of hyponatremia (2.3% vs. 1.5%, p>0.99) were similar in the two groups but plasma sodium was checked significantly more often in the proactive desmopressin group (20.9 vs. 17.4, p<0.001). No cases of osmotic demyelination syndrome and no deaths from cerebral edema were identified.</p><p><strong>Conclusions: </strong>Treating severe hyponatremia with hypertonic saline and proactive desmopressin was associated with lower rates of overcorrection without significant adverse events compared to hypertonic saline without proactive desmopressin.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving CKD Screening and Care in Diabetes Using Clinical Decision Support in a Large Healthcare System.","authors":"Ken J Park, Michalah K Tandy, Shaun Flerchinger, Kathryn J Glassberg, Frank Y Chen, Eric S Albright, Lisa J Nakashimada","doi":"10.34067/KID.0000000829","DOIUrl":"https://doi.org/10.34067/KID.0000000829","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend screening for chronic kidney disease (CKD) in patients with diabetes with annual urinary albumin creatinine (ACR) and serum creatinine (Scr). However, screening rates were low in Kaiser Permanente Northwest, a large integrated healthcare system. We implemented a quality improvement project using clinical decision support (CDS) tools to increase ACR and Scr testing. We examined whether increased CKD screening resulted in improvement in CKD quality metrics, specifically ACEi/ARB (Angiotensin converting enzyme inhibitors or angiotensin receptor blocker) and SGLT2i (sodium-glucose cotransporter 2 inhibitor) use.</p><p><strong>Methods: </strong>In May 2022, we implemented CDS tools to increase ACR/Scr testing consisting of automated lab ordering, best practice alerts (BPAs), and automated lab reminders to patients via letters, texts, and phone calls in tandem with provider education on best practice recommendations for CKD. A SGLT2i BPA targeting patients with type 2 diabetes with ACR > 300 mg/gm and eGFR ≥ 30 ml/min was rolled out in June 2022 and expanded to include patients with eGFR > 60 ml/min regardless of CKD diagnosis in February 2023. Trends were reviewed monthly using statistical process control charts and changes in slope using segmented regression analysis.</p><p><strong>Results: </strong>After three years, ACR/Scr testing done within one year increased from 35 to 72%. ACEi/ARB use increased slightly from 74% to 76% but nephrology co-management for high-risk CKD patients remained unchanged at 53%. The rate of SGLT2i use steadily increased by 0.6% each month up until 6 months after introduction of the BPA, after which the rate increased to 1.7%. Amongst patients not co-managed with nephrology, the adjusted rate of increase was 7% higher in the BPA group compared to patients with CKD in the non-BPA group.</p><p><strong>Conclusions: </strong>Our study shows that use of CDS tools improve CKD screening in patients with diabetes but with mixed results in CKD quality metrics.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Art and Science of Genetic Counseling in Nephrology.","authors":"Kelsie Bogyo, Natalie Vena, Hila Milo Rasouly","doi":"10.34067/KID.0000000825","DOIUrl":"10.34067/KID.0000000825","url":null,"abstract":"<p><p>The recognition that up to 10% of individuals with kidney diseases might obtain a genetic diagnosis has led to genetic testing becoming a critical component of nephrology practice. Genetic counselors have expertise in providing genomic services, which include genetic counseling and testing. They play a crucial role by helping patients estimate their genetic risks, understand the impact of results, and by coordinating follow-up care. Nephrologists are in a pivotal position to offer genomic services directly to their patients or to refer them to genetic counseling before or after genetic testing. Nephrologists should therefore be able to identify patients who would benefit most from these services. To effectively refer patients, nephrologists should be able to explain the genetic counseling process and its relevance to the patient. This review aims to help build a collaborative relationship between nephrologists and genetic counselors. It introduces and expands upon the topics genetic counselors cover during genetic counseling sessions, including how they support patients in understanding the implications of genetic findings, decision-making related to genetic testing, and the psychosocial aspects of living with a genetic diagnosis. By integrating genetic counseling into nephrology, patients with kidney diseases can receive comprehensive care tailored to their genetic and clinical needs.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}