Seminars in nephrology最新文献_第9页

Patient-Reported Experience Measures to Evaluate and Improve the Quality of Care in Nephrology 用于评估和提高肾脏病学医疗质量的 "患者体验报告"。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-05-01 DOI: 10.1016/j.semnephrol.2024.151551

Helen Munro Wild BSc, MSc, PhD, Amanda Busby BSc, MSc, Lucy Mackintosh BSc, MSc, David Wellsted BSc, PhD

{"title":"Patient-Reported Experience Measures to Evaluate and Improve the Quality of Care in Nephrology","authors":"Helen Munro Wild BSc, MSc, PhD, Amanda Busby BSc, MSc, Lucy Mackintosh BSc, MSc, David Wellsted BSc, PhD","doi":"10.1016/j.semnephrol.2024.151551","DOIUrl":"10.1016/j.semnephrol.2024.151551","url":null,"abstract":"<div><div>Patient experience is considered a pillar of high-quality care, integral to patient-centered care, but despite significant policy focus on patient-reported experience measures (PREMs), little is published regarding their development, use, or impact on clinical practice. In nephrology, PREMs are increasingly used in research to capture and quantify patients’ perceptions of their experiences with health care services. It has been shown that a negative patient experience impacts patients’ physical and psychological health, and a small but significant proportion of patients across a selection of settings report their experiences of health care as poor or suboptimal. Evidence of whether PREMs improve quality of care or support person-centered care in the clinical setting remains largely theoretical. Extensive effort has been invested to develop various PREMs for kidney services. Although little evidence linking PREM collection to meaningful change in delivery of care currently exists, work is underway. Early indications are that with the right facilitators, implementing PREMs in routine practice can help providers recognize where change is needed and galvanize transformation. The journey toward understanding the connection between PREM data and modifiable provider characteristics to target and enable change has started, but further evidence is needed. This article outlines the history of PREMs in nephrology and details their current use alongside implementation challenges. The use and benefits of PREMs are discussed before considering the evidence base for their impact on renal health care. Possible next steps for PREMs are suggested and best practices highlighted.</div></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 3","pages":"Article 151551"},"PeriodicalIF":2.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146218","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

Patient-Reported Outcome and Experience Measures to Advance Patient-Centered Research, Practice, and Policy in Nephrology 推动肾脏病学以患者为中心的研究、实践和政策的患者报告结果和体验措施。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-05-01 DOI: 10.1016/j.semnephrol.2024.151545

Allison Jaure PhD

引用次数: 0

Acute Kidney Injury and Subsequent Cardiovascular Disease: Epidemiology, Pathophysiology, and Treatment 急性肾损伤及其引发的心血管疾病：流行病学、病理生理学和治疗。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151515

{"title":"Acute Kidney Injury and Subsequent Cardiovascular Disease: Epidemiology, Pathophysiology, and Treatment","authors":"","doi":"10.1016/j.semnephrol.2024.151515","DOIUrl":"10.1016/j.semnephrol.2024.151515","url":null,"abstract":"<div>Cardiovascular disease poses a significant threat to individuals with kidney disease, including those affected by acute kidney injury (AKI). In the short term, AKI has several physiological consequences that can impact the cardiovascular system. These include fluid and sodium overload, activation of the renin-angiotensin-aldosterone system and sympathetic nervous system, and inflammation along with metabolic complications of AKI (acidosis, electrolyte imbalance, buildup of uremic toxins). Recent studies highlight the role of AKI in elevating long-term risks of hypertension, thromboembolism, stroke, and major adverse cardiovascular events, though some of this increased risk may be due to the impact of AKI on the course of chronic kidney disease. Current management strategies involve avoiding nephrotoxic agents, optimizing hemodynamics and fluid balance, and considering renin-angiotensin-aldosterone system inhibition or sodium-glucose cotransporter 2 inhibitors. However, future research is imperative to advance preventive and therapeutic strategies for cardiovascular complications in AKI. This review explores the existing knowledge on the cardiovascular consequences of AKI, delving into epidemiology, pathophysiology, and treatment of various cardiovascular complications following AKI.</div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 2","pages":"Article 151515"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288556","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

Revisiting Hypertension Treatment in Patients With Chronic Kidney Disease 重新审视慢性肾病患者的高血压治疗。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151514

引用次数: 0

Oral Anticoagulation Use in Individuals With Atrial Fibrillation and Chronic Kidney Disease: A Review 心房颤动和慢性肾病患者的口服抗凝药使用：综述。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151517

{"title":"Oral Anticoagulation Use in Individuals With Atrial Fibrillation and Chronic Kidney Disease: A Review","authors":"","doi":"10.1016/j.semnephrol.2024.151517","DOIUrl":"10.1016/j.semnephrol.2024.151517","url":null,"abstract":"<div>Atrial fibrillation (AF) is highly prevalent in patients with chronic kidney disease (CKD). It is associated with an increased risk of stroke, which increases as kidney function declines. In the general population and in those with a moderate degree of CKD (creatinine clearance 30-50 mL/min), the use of oral anticoagulation to decrease the risk of stroke has been the standard of care based on a favorable risk–benefit profile that had been established in seminal randomized controlled trials. However, evidence regarding the use of oral anticoagulants for stroke prevention is less clear in patients with severe CKD (creatinine clearance <30 mL/min) and those receiving maintenance dialysis, as these individuals were excluded from such large randomized controlled trials. Nevertheless, the direct oral anticoagulants have invariably usurped vitamin K antagonists as the preferred choice for oral anticoagulation among patients with AF across all strata of CKD based on their well-defined safety and efficacy and multiple pharmacokinetic benefits (e.g., less drug–drug interactions). This review summarizes the current literature on the role of oral anticoagulation in the management of AF among patients with CKD and highlights current deficiencies in the evidence base and how to overcome them.</div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 2","pages":"Article 151517"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0270929524000378/pdfft?md5=40cfca6fd75df660decc6c72f31b7fc5&pid=1-s2.0-S0270929524000378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923376","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

Kidney-Heart Interactions 肾与心脏的相互作用

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151511

引用次数: 0

Cardiac Devices and Kidney Disease 心脏设备与肾脏疾病。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151513

{"title":"Cardiac Devices and Kidney Disease","authors":"","doi":"10.1016/j.semnephrol.2024.151513","DOIUrl":"10.1016/j.semnephrol.2024.151513","url":null,"abstract":"<div>A growing variety of cardiac devices are available to monitor or support cardiovascular function. The entwined nature of cardiovascular disease and kidney disease makes the relationship of these devices with kidney disease a multifaceted question relating to the use of these devices in individuals with kidney disease and to the effects of the devices and device placement on kidney health. Cardiac devices can be categorized broadly into cardiac implantable electronic devices, structural devices, and circulatory assist devices. Cardiac implantable electronic devices include devices for monitoring and managing cardiac electrical activity and devices for monitoring hemodynamics. Structural devices modify cardiac structure and include valve prostheses, valve repair clips, devices for treating atrial septal abnormalities, left atrial appendage closure devices, and interatrial shunt devices. Circulatory assist devices support the failing heart or support cardiac function during high-risk cardiac procedures. Evidence for the use of these devices in individuals with kidney disease, effects of the devices on kidney health and function, specific considerations with devices in kidney disease, and important knowledge gaps are surveyed in this article. With the growing prevalence of combined cardiorenal disease and the increasing variety of cardiac devices, kidney disease considerations are an important aspect of device therapy.</div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 2","pages":"Article 151513"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957687","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

Contemporary Decongestive Strategies in Acute Heart Failure 急性心力衰竭的当代减充血策略。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151512

{"title":"Contemporary Decongestive Strategies in Acute Heart Failure","authors":"","doi":"10.1016/j.semnephrol.2024.151512","DOIUrl":"10.1016/j.semnephrol.2024.151512","url":null,"abstract":"<div>Congestion is the primary driver of hospital admissions in patients with heart failure and the key determinant of their outcome. Although intravenous loop diuretics remain the predominant agents used in the setting of acute heart failure, the therapeutic response is known to be variable, with a significant subset of patients discharged from the hospital with residual hypervolemia. In this context, urinary sodium excretion has gained attention both as a marker of response to loop diuretics and as a marker of prognosis that may be a useful clinical tool to guide therapy. Several decongestive strategies have been explored to improve diuretic responsiveness and removal of excess fluid. Sequential nephron blockade through combination diuretic therapy is one of the most used methods to enhance natriuresis and counter diuretic resistance. In this article, I provide an overview of the contemporary decongestive approaches and discuss the clinical data on the use of add-on diuretic therapy. I also discuss mechanical removal of excess fluid through extracorporeal ultrafiltration with a brief review of the results of landmark studies. Finally, I provide a short overview of the strategies that are currently under investigation and may prove helpful in this setting.</div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 2","pages":"Article 151512"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857682","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

Challenges and Strategies in Implementing Novel Kidney Protective and Cardioprotective Therapies in Patients With Diabetes and Kidney Disease 对糖尿病肾病患者实施新型肾脏保护和心脏保护疗法的挑战与策略

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151520

{"title":"Challenges and Strategies in Implementing Novel Kidney Protective and Cardioprotective Therapies in Patients With Diabetes and Kidney Disease","authors":"","doi":"10.1016/j.semnephrol.2024.151520","DOIUrl":"10.1016/j.semnephrol.2024.151520","url":null,"abstract":"<div>Chronic kidney disease (CKD) is highly prevalent, estimated to affect over 800 million people worldwide. Diabetes is a leading cause of kidney disease. Both diabetes and CKD are associated with a high risk of cardiovascular disease and related morbidity and mortality. Over the last several years, there has been a shift in focus toward integrating kidney and cardiovascular care, particularly in diabetes. Sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists have rapidly become cornerstones of kidney and cardiovascular risk-focused care in diabetes and CKD. However, present-day use of these agents is low, and disparities in use by race, ethnicity, age, sex, and comorbidities are apparent. Challenges in implementation of kidney protective and cardioprotective therapies include low rates of diabetes and CKD screening, lack of provider comfort and subspecialty reliance, inconsistencies across professional society guidelines, high rates of drug discontinuation, and prohibitive costs. Effective implementation of kidney protective and cardioprotective therapies necessitates a multifaceted approach and active engagement of patients, pharmacists, primary care providers, subspecialty providers, and health care system leaders as key stakeholders. Implementation efforts should be practical and incorporate collaborative, multidisciplinary team-based approaches. Successful implementation of kidney protective and cardioprotective therapies has the potential to improve overall health outcomes and ameliorate health care disparities.</div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":"44 2","pages":"Article 151520"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857946","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

New Insights on Cardiac Arrhythmias in Patients With Kidney Disease 肾病患者心律失常的新发现。

IF 2.8 3区医学

Seminars in nephrology Pub Date : 2024-03-01 DOI: 10.1016/j.semnephrol.2024.151518

引用次数: 0