American Journal of Kidney Diseases最新文献

{"title":"Another Note of Caution for Spironolactone: Implications of the BARACK-D Study.","authors":"Akshat U Kumar, Dena E Rifkin","doi":"10.1053/j.ajkd.2024.12.002","DOIUrl":"10.1053/j.ajkd.2024.12.002","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Caregiver Burden Among Spouses of Patients With Kidney Failure: A Qualitative Study.","authors":"Esmee Driehuis, Imre Demirhan, Wanda S Konijn, Theodôr J F M Vogels, Namiko A Goto, Marjolein I Broese van Groenou, Marianne C Verhaar, Brigit C van Jaarsveld, Alferso C Abrahams","doi":"10.1053/j.ajkd.2024.11.005","DOIUrl":"https://doi.org/10.1053/j.ajkd.2024.11.005","url":null,"abstract":"<p><strong>Rationale & objective: </strong>Spousal caregivers participate extensively in the care of patients with kidney failure. Although previous studies suggested that these caregivers experience a high burden, a comprehensive understanding of the determinants of this burden and strategies to alleviate it are needed. Therefore, this study sought to explore the contributing and alleviating determinants of burden in spousal caregivers of patients with kidney failure.</p><p><strong>Study design: </strong>A qualitative interview study with 15 spousal caregivers.</p><p><strong>Setting & participants: </strong>Dutch-speaking, adult spousal caregivers were recruited and interviewed by the Dutch Kidney Patients Association for the Kidney Decision Aid.</p><p><strong>Analytical approach: </strong>A directed qualitative content analysis using the stress-appraisal model of caregiver burden as a framework to inform a disease-specific model on spousal caregiver burden for kidney failure that characterizes the impact of care provision on all aspects of spousal caregivers' lives, the burden associated with it, and possible mitigating factors.</p><p><strong>Results: </strong>Providing care for patients with kidney failure is complex and burdensome for spousal caregivers and results in many lifestyle changes, which is largely caused by kidney failure-specific tasks and the shifting responsibility for daily life tasks. Spouses identified disease-specific determinants of burden including the impact of kidney disease on afflicted spouses as well as the associated caregiver tasks, e.g., adjusting to dietary restriction and attending dialysis appointments. Dialysis options (e.g., the choice for home or in-center dialysis) were kidney failure-specific moderators of burden. Support of spousal caregivers by healthcare providers plays a key role in preventing overburdening.</p><p><strong>Limitations: </strong>Potential limited transferability owing to the study of only Dutch-speaking spouses willing to be interviewed and videotaped.</p><p><strong>Conclusions: </strong>This comprehensive overview of the contributing and alleviating determinants of burden experienced by spousal caregivers of patients with kidney failure highlights four principal areas; 1) personal and relational, 2) social environment, 3) healthcare, and 4) work and legislation, in which such burdens occur and may be alleviated.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanizing Nephrology: The Power of Social History","authors":"Rajiv Agarwal MD, MS","doi":"10.1053/j.ajkd.2024.04.014","DOIUrl":"10.1053/j.ajkd.2024.04.014","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Page A20"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Survival in Patients Receiving Hemodialysis Through Changes in Practice Patterns: Does This Apply to Your Country?","authors":"Anneke Kramer ,&nbsp;Rianne Boenink ,&nbsp;Vianda S. Stel","doi":"10.1053/j.ajkd.2024.09.002","DOIUrl":"10.1053/j.ajkd.2024.09.002","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 8-10"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Ankle-Brachial Index Ranges and Incident CKD in Diabetes: A Goldilocks Perspective on the “Just Right” Range","authors":"Houry Puzantian ,&nbsp;Raymond R. Townsend","doi":"10.1053/j.ajkd.2024.09.003","DOIUrl":"10.1053/j.ajkd.2024.09.003","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 11-13"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory Anomalies in the Basic Metabolic Panel: Core Curriculum 2025","authors":"Layana T. Takieddine ,&nbsp;Joe M. El-Khoury","doi":"10.1053/j.ajkd.2024.06.019","DOIUrl":"10.1053/j.ajkd.2024.06.019","url":null,"abstract":"<div><div>Laboratory testing plays an integral part in medical decision making. However, laboratory results can sometimes vary significantly, leading to anomalous outcomes that are not consistent with the clinical picture. These anomalies can occur even in the best of laboratories simply because the total testing process includes elements that are not totally under the laboratory’s control. For example, variations in patient preparation and sample collection procedures, as can happen at physician offices or patients receiving intravenous fluids, are major contributors to these anomalies. Therefore, physicians must remain aware of the causes of these anomalies so they can consider them when interpreting laboratory results and help implement solutions to mitigate them at their respective institutions. This Core Curriculum examines several instances where an understanding of preanalytical, analytical, and postanalytical variation is essential for detecting anomalies and providing proper patient care.</div></div>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 104-114"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142436112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in Kidney Disease: A Comprehensive Review to Advance Its Clinical and Research Applications","authors":"Devika Nair ,&nbsp;Christine K. Liu ,&nbsp;Rasha Raslan ,&nbsp;Mara McAdams-DeMarco ,&nbsp;Rasheeda K. Hall","doi":"10.1053/j.ajkd.2024.04.018","DOIUrl":"10.1053/j.ajkd.2024.04.018","url":null,"abstract":"<div><div>Frailty is a multisystem syndrome of decreased physiologic reserve that has been shown to strongly and independently predict morbidity and mortality. Frailty is prevalent in patients living with kidney disease and occurs earlier in individuals with kidney disease as compared to the general population. In this comprehensive review, we examine clinical and research applications of frailty in kidney disease populations. Specifically, we clarify the definition of frailty and address common misconceptions, review the mechanisms and epidemiology of frailty in kidney disease, discuss challenges and limitations in frailty measurement, and provide updated evidence related to risk factors for frailty, its associated adverse outcomes, and interventions. We further add to the literature in this topic by highlighting the potential applications of frailty measurement in the care of patients with kidney disease and conclude with our recommendations for future research related to this important syndrome.</div></div>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 89-103"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Coronary Artery Calcification and Risk of Clinical Events in CKD: The Chronic Renal Insufficiency Cohort Study","authors":"Ling Tian ,&nbsp;Byron C. Jaeger ,&nbsp;Julia J. Scialla ,&nbsp;Matthew J. Budoff ,&nbsp;Rupal C. Mehta ,&nbsp;Bernard G. Jaar ,&nbsp;Georges Saab ,&nbsp;Mirela A. Dobre ,&nbsp;Muredach P. Reilly ,&nbsp;Daniel J. Rader ,&nbsp;Raymond R. Townsend ,&nbsp;James P. Lash ,&nbsp;Philip Greenland ,&nbsp;Tamara Isakova ,&nbsp;Joshua D. Bundy","doi":"10.1053/j.ajkd.2024.06.018","DOIUrl":"10.1053/j.ajkd.2024.06.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Coronary artery calcification (CAC) progresses rapidly in people with chronic kidney disease (CKD) compared with the general population. We studied the association between CAC progression and higher risks of atherosclerotic cardiovascular disease (CVD), congestive heart failure, and all-cause mortality among adults with CKD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Prospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;1,310 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study who had at least 1 CAC scan with no prior history of CVD and with observed or imputed data on changes in CAC over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;Observed or imputed CAC progression, categorized as incident CAC among participants with 0 CAC on the baseline scan or progressive CAC when the baseline scan demonstrated CAC and there was an increase in CAC&lt;!--&gt; &lt;!--&gt;≥50 Agatston units per year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome&lt;/h3&gt;&lt;div&gt;Atherosclerotic CVD (myocardial infarction or stroke), congestive heart failure, and all-cause mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Cause-specific Cox proportional hazards regression, stratified by presence of CAC at baseline.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 545 participants without and 765 with prevalent CAC at baseline were included. During a mean 3.3 years between CAC assessments, 177 participants (32.5%) without baseline CAC developed incident CAC while 270 participants (35.3%) with baseline CAC developed a&lt;!--&gt; &lt;!--&gt;≥50 Agatston units per year increase in CAC. After multivariable adjustment, incident CAC was associated with 2.42-fold higher rate of atherosclerotic CVD (95% CI, 1.23-4.79) and 1.82-fold higher rate of all-cause mortality (95% CI, 1.03-3.22). Progressive CAC (≥50 units per year) was not associated with atherosclerotic CVD (HR, 1.42 [95% CI, 0.85-2.35]) but was associated with a 1.73-fold higher rate of all-cause mortality (95% CI, 1.31-2.28). Progressive CAC was not associated with incident heart failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Residual confounding and limited statistical power for some outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Among adults with CKD stages 2-4, CAC progression over a mean 3.3 years was associated with higher risk of atherosclerotic CVD and all-cause mortality. The associations were strongest among participants without CAC at baseline.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Prior research has shown that coronary artery calcification (CAC) is a marker of higher risk of heart disease and death. Less is known about how changes in CAC over time might affect risk, particularly among patients with kidney disease. In this study, participants with chronic kidney disease who developed CAC or had worsening CAC over time showed higher rates of heart attack, stroke, and death than those who did not develop CAC. These findings support the need for further ","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 67-77.e1"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999215","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":"Patterns in Emergency Clinician Management of Acute Kidney Injury","authors":"Jonathon Mitchell MS ,&nbsp;Michael R. Ehmann MD, MPH, MS ,&nbsp;Scott Levin PhD ,&nbsp;Xihan Zhao MS ,&nbsp;Steven Menez MD, MHS ,&nbsp;Chirag R. Parikh MBBS, PhD ,&nbsp;Eili Y. Klein MS, PhD ,&nbsp;Jeremiah S. Hinson MD, PhD","doi":"10.1053/j.ajkd.2024.05.017","DOIUrl":"10.1053/j.ajkd.2024.05.017","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 124-127"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient, Parental, and Health Professional Perspectives on Growth in Children With CKD","authors":"Justin G. Wu ,&nbsp;Chandana Guha ,&nbsp;Anastasia Hughes ,&nbsp;Luca G. Torrisi ,&nbsp;Jonathan C. Craig ,&nbsp;Aditi Sinha ,&nbsp;Allison Dart ,&nbsp;Allison A. Eddy ,&nbsp;Detlef Bockenhauer ,&nbsp;Hui-Kim Yap ,&nbsp;Jaap Groothoff ,&nbsp;Stephen I. Alexander ,&nbsp;Susan L. Furth ,&nbsp;Susan Samuel ,&nbsp;Simon A. Carter ,&nbsp;Amanda Walker ,&nbsp;Joshua Kausman ,&nbsp;Allison Jaure","doi":"10.1053/j.ajkd.2024.06.016","DOIUrl":"10.1053/j.ajkd.2024.06.016","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Growth failure is a common problem among children with chronic kidney disease (CKD). Reduced height is associated with psychosocial burden, social stigma, and impaired quality of life. This study describes the aspects of growth impairment that are most impactful from the perspectives of children with CKD, their parents, and health professionals.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Qualitative study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings &amp; Participants&lt;/h3&gt;&lt;div&gt;120 children with CKD (aged 8-21 years), 250 parents, and 445 health professionals from 53 countries who participated in 16 focus groups, 2 consensus workshops, and a Delphi survey.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;A thematic analysis of all qualitative data concerning growth from the Standardized Outcomes in Nephrology–Children and Adolescents (SONG-Kids) initiative.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 5 themes: diminishing psychological well-being (compared to and judged by peers, tired of explaining to others, damaging self-esteem), constrained life participation and enjoyment (deprived of normal school experiences, excluded from sports or competing at a disadvantage, impaired quality of life in adulthood); grappling with impacts of symptoms and treatment (difficulty understanding short stature and accessing help, lack of appetite, uncertainty regarding bone pains, medication side effects, burden of growth hormone treatment); facilitating timely interventions and optimizing outcomes (early indicator of disease, assessing management, maximizing transplant outcomes, minimizing morbidity); and keeping growth and health priorities in perspective (quality of life and survival of utmost priority, achieved adequate height).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Only English-speaking participants were included.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Impaired growth may diminish psychological well-being, self-esteem, and participation in daily activities for children with CKD. Balancing different treatments that can affect growth complicates decision making. These findings may inform the psychosocial support needed by children with CKD and their caregivers to address concerns about growth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Children with chronic kidney disease (CKD) are often much shorter than their peers and may experience poorer mental health and quality of life. To understand the specific important issues on how growth impairment affects these children, we collected qualitative data from the Standardized Outcomes in Nephrology–Children and Adolescents (SONG-Kids) initiative and analyzed perspectives on growth from patients, parents, and health professionals. These data revealed impaired psychological health, reduced enjoyment during school and sports, difficulty dealing with medication side effects and growth hormone treatment, and concerns related to tracking health status and kidney transplant o","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 1","pages":"Pages 14-24.e1"},"PeriodicalIF":9.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}