Clinical Journal of the American Society of Nephrology最新文献

{"title":"Providers' Experiences Discussing Care for Patients with Kidney Failure Who Forgo KRT: A National Qualitative Study.","authors":"Susan P Y Wong, Julie Chotivatanapong, Deborah Lee, Daniel Y Lam, Marieke S van Eijk","doi":"10.2215/CJN.0000000000000522","DOIUrl":"10.2215/CJN.0000000000000522","url":null,"abstract":"<p><strong>Background: </strong>Many nephrology providers express difficulty in discussing care options for patients who forgo KRT, which hampers their ability to help patients make decisions about their current and future treatment of kidney disease.</p><p><strong>Methods: </strong>We conducted a qualitative study using interviews with a national sample of nephrology providers (i.e., physicians and advanced practice providers) who participated in US professional societies between July and December 2022. We performed a thematic analysis of interviews to identify emergent themes reflecting providers' experiences discussing care for patients who forgo KRT.</p><p><strong>Results: </strong>There were 21 providers (age 54±13 years, female 81%, White 32%) who participated in interviews, of whom 43% were physicians and most (57%) practiced in academic settings. Three dominant themes emerged from interviews reflecting challenges to discussing the option to forgo KRT: (1) Inconsistent terminology: while providers sought to use terms to describe care for patients who forgo KRT that affirmed patients' decision, clearly conveyed that KRT would not be pursued, and were already familiar to patients and other providers, they disagreed about which terms satisfied these priorities; (2) blurred distinctions between KRT and its alternative: providers' descriptions of their care practices suggested that differences in their approaches to caring for patients who forgo KRT and those who are planning to pursue KRT could be opaque; and (3) deciphering patients' decision to forgo KRT: providers did not readily accept patients' expressed preferences to forgo KRT at face value and described using a variety of methods to assess whether patients would follow through with their decision.</p><p><strong>Conclusions: </strong>Providers used different, inconsistent terms to describe care for patients who forgo KRT. They disagreed about what this care entailed and were uncertain about what patients might mean when they express not wanting to undergo KRT.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relevance of Phytate for the Treatment of Chronic Kidney Disease.","authors":"Maryam Ekramzadeh, Kamyar Kalantar-Zadeh, Joel D Kopple","doi":"10.2215/CJN.0000000000000558","DOIUrl":"10.2215/CJN.0000000000000558","url":null,"abstract":"<p><p>Diets high in plant-based foods are commonly recommended for people with CKD. One putative advantage of these diets is reduced intestinal phosphate absorption. This effect has been ascribed to phytic acid (myoinositol hexaphosphoric acid) and its anion, phytate, that are present in many plant foods, particularly in the seeds, nuts, grains, and fruits of plants. This article reviews the structure and many actions of phytate with particular reference to its potential effects on people with CKD. Phytate binds avidly to and can reduce gastrointestinal absorption of the phosphate anion and many macrominerals and trace elements including iron, zinc, calcium, and magnesium. This has led some opinion leaders to label phytate as an anti-nutrient. The human intestine lacks phytase; hence, phytate is essentially not degraded in the small intestine. A small amount of phytate is absorbed from the small intestine, although phytate bound to phosphate is poorly absorbed. Clinical trials in maintenance hemodialysis patients indicate that intravenously administered phytate may decrease hydroxyapatite formation, vascular calcification, and calciphylaxis. Orally administered phytate or in vitro studies indicate that phytate may also reduce osteoporosis, urinary calcium calculi formation, and dental plaque formation. Phytate seems to have anti-inflammatory and antioxidant effects, at least partly because of its ability to chelate iron. Other potential therapeutic roles for phytate, not definitively established, include suppression of cancer formation, reduction in cognitive decline that occurs with aging, and amelioration of certain neurodegenerative diseases and several gastrointestinal and metabolic disorders. These latter potential benefits of phytate are supported by cell or animal research or observational studies in humans. Many of the above disorders are particularly common in patients with CKD. Definitive clinical trials to identify potential therapeutic benefits of phytate in patients with CKD are clearly warranted.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal and Daily Symptom Variation in Patients with End Stage Kidney Disease: An Ecological Momentary Assessment Study.","authors":"Cramer J Kallem, Alaa A Alghwiri, Jonathan Yabes, Sarah Erickson, Zhuoheng Han, Maria-Eleni Roumelioti, Jennifer L Steel, Manisha Jhamb, Mark Unruh","doi":"10.2215/CJN.0000000000000524","DOIUrl":"10.2215/CJN.0000000000000524","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine Output and Acute Kidney Injury in Neonates/Younger Children: A Prospective Study of Cardiac Surgery Patients with Indwelling Urinary Catheters.","authors":"Adriana Torres de Melo Bezerra Girão, Candice Torres de Melo Bezerra Cavalcante, Klebia Magalhães Pereira Castello Branco, Andrea Consuelo de Oliveira Teles, Alexandre Braga Libório","doi":"10.2215/CJN.0000000000000534","DOIUrl":"10.2215/CJN.0000000000000534","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Function and Mortality in Older Adults with Chronic Kidney Disease.","authors":"Christine K Liu, Gomathy Parvathinathan, Margaret R Stedman, Stephen L Seliger, Daniel E Weiner, Manjula Kurella Tamura","doi":"10.2215/CJN.0000000000000515","DOIUrl":"10.2215/CJN.0000000000000515","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Dialysis Access Together: A Multidisciplinary, Cross-Cutting, Patient-Centered Initiative.","authors":"Vandana Dua Niyyar, Gerald A Beathard, Gordon McLennan, Matthew A Sparks, Kristina Bryant, Cynthia Delgado, Nichole Jefferson, Joseph Kessler, Kerry Leigh, Susan Stark, Prabir Roy-Chaudhury","doi":"10.2215/CJN.0000000000000569","DOIUrl":"10.2215/CJN.0000000000000569","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Cardiac Autonomic Innervation in Postmortem Tissue from Individuals with Kidney Failure and Preserved Kidney Function.","authors":"Qandeel Soomro, Valeria Mezzano, Navneet Narula, Amy Rapkiewicz, Cynthia Loomis, David M Charytan","doi":"10.2215/CJN.0000000000000477","DOIUrl":"10.2215/CJN.0000000000000477","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How We Treat Dyslipidemia in Prolonged Nephrotic Syndrome.","authors":"Claudio Ponticelli, Lorenzo Arnaboldi, Gabriella Moroni, Alessia Fornoni","doi":"10.2215/CJN.0000000000000514","DOIUrl":"10.2215/CJN.0000000000000514","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disorders and Dementia Risk in Older Patients with Kidney Failure: A Retrospective Cohort Study.","authors":"Jane J Long, Yusi Chen, Byoungjun Kim, Sunjae Bae, Yiting Li, Babak J Orandi, Nadia M Chu, Aarti Mathur, Dorry L Segev, Mara A McAdams-DeMarco","doi":"10.2215/CJN.0000000000000504","DOIUrl":"10.2215/CJN.0000000000000504","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Myocardial Infarction and Chronic Kidney Disease: A Nationwide Cohort Study on Management and Outcomes from 2010 to 2022.","authors":"Ellen Linnea Freese Ballegaard, Erik Lerkevang Grove, Anne-Lise Kamper, Bo Feldt-Rasmussen, Gunnar Gislason, Christian Torp-Pedersen, Nicholas Carlson","doi":"10.2215/CJN.0000000000000519","DOIUrl":"10.2215/CJN.0000000000000519","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":null,"pages":null},"PeriodicalIF":8.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}