Canadian Journal of Kidney Health and Disease最新文献

{"title":"Barriers and Opportunities to Increase Utilization of Donor Kidneys After Death Determined by Circulatory Criteria Among Children and Adults: A Narrative Review.","authors":"Cal Robinson, Adrianna Douvris, Waleed Rahmani, Ayodele Odutayo, Sergi Clotet-Freixas, Ann Young","doi":"10.1177/20543581251382333","DOIUrl":"10.1177/20543581251382333","url":null,"abstract":"<p><strong>Purpose of review: </strong>Kidney transplantation is associated with survival benefit compared to dialysis. Yet, there is an unmet need for access to kidney transplantation within Canada and globally. Donation after death determined by circulatory criteria (DCC) has expanded access to kidney transplantation among the adult and pediatric population. However, there are concerns inherent to DCC kidneys, including warm ischemia time and ischemia-reperfusion injury (IRI). This narrative review aims to summarize relevant literature in this context, discuss potential opportunities to expand the use of DCC kidneys, and highlight knowledge gaps for further study.</p><p><strong>Sources of information: </strong>PubMed (Medline), the Canadian Institute for Health Information, and regulatory bodies for organ donation and transplantation.</p><p><strong>Methods: </strong>A focused review and critical appraisal of existing literature on the mechanisms of kidney IRI, consideration of sex in experimental studies relevant to DCC kidney transplantation, ex vivo perfusion strategies, and pediatric kidney transplant considerations.</p><p><strong>Key findings: </strong>DCC kidneys confer a higher risk of delayed graft function (DGF) due to prolonged warm ischemic time. However, long-term graft survival is generally comparable to that of kidneys from donors with death determined by neurologic criteria (DNC). Key barriers to expansion include the paucity of sex-balanced experimental studies on DCC graft preservation and outcomes and existing protocols for DCC donor selection, including thresholds for warm ischemia time. Ex vivo strategies including non-oxygenated and oxygenated hypothermic machine perfusion and normothermic ex vivo kidney perfusion are promising research areas. Improving DCC protocols to reduce kidney IRI has the potential to further expand access to DCC transplantation, including to the pediatric population.</p><p><strong>Limitations: </strong>This narrative review only included articles written in English. Study quality was not formally assessed. Discussion points were influenced by the author's areas of expertise.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251382333"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243924","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":"A Pragmatic Randomized Controlled Trial of a CKD-Specific Virtual Monitoring Platform to Minimize Adverse Outcomes in High-Risk CKD Patients: A Clinical Research Protocol.","authors":"Zahra Solati, Paul Komenda, Navdeep Tangri, Sakshi Saul, Clara Bohm, Thomas Ferguson, Drew Hager, Bryce Barr, Priyanka Mysore, Ingrid Hougen, Alejandro Meraz-Muñoz, Arsh K Jain, Paul Tam, Claudio Rigatto","doi":"10.1177/20543581251359736","DOIUrl":"10.1177/20543581251359736","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The transition from advanced Chronic Kidney Disease (CKD) to dialysis is a period of heightened vulnerability for many patients. Virtual monitoring of these patients could facilitate the communication of accurate and reliable data between patients and health care providers, helping to avoid unnecessary emergency department (ED) visits and facilitate more optimal dialysis starts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine whether the addition of the VIEWER (Virtual Ward Incorporating Electronic Wearables) platform to usual care will lead to a reduction in ED visits and hospitalizations and lead to an increase in perceived safety of virtual care among patients and providers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This study is a national, pragmatic, multicenter randomized controlled trial comparing usual care alone vs usual care plus the VIEWER virtual care platform in patients with advanced CKD. Given the nature of the intervention, patients and care providers will not be blinded; outcome assessment and statistical analysis will be blinded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Five CKD clinics in 2 Canadian provinces (Manitoba and Ontario).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Patients with advanced CKD not on dialysis (eGFR &lt;15 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, 2-year kidney failure risk &gt;40%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Participants randomized to the intervention group will be provided with the VIEWER platform, comprised of a wireless blood pressure (BP) monitor, weight scale, transcutaneous O&lt;sub&gt;2&lt;/sub&gt; sat (SpO2) monitor, wearable motion tracker, and mobile tablet running the VIEWER application. The intervention group will be trained to use the VIEWER platform to complete a daily self-assessment via the app (BP, weight, O&lt;sub&gt;2&lt;/sub&gt; saturation, step count) and weekly Edmonton Symptom Assessment System Revised (ESAS-r) survey. These assessments will be integrated into clinical decision-making in multidisciplinary kidney health clinics. Participants will use the VIEWER platform for 12 months (or until dialysis initiation) in addition to receiving usual care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Intention-to-treat (ITT) approach will be used to compare the primary outcome between 2 study groups. Time to primary and secondary outcomes will be assessed using univariate Cox proportional hazards models and a Kaplan-Meier analysis with a log-rank test. The primary outcome is the time to first hospital admission and/or ED visit. The control is usual care (no exposure to VIEWER platform).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Some individuals may face challenges with technology adoption, which could affect participation. Those without Internet access are limited in their ability to take part in this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study will help determine whether virtual monitoring in advanced CKD patients can reduce ED visits and hospitalization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;Clinicaltrials.gov; identi","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251359736"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243886","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":"Uptake of Goal-Directed Therapies in a Multidisciplinary and Interdisciplinary Cardiology-Renal-Endocrine Clinic: A Research Letter.","authors":"Jean-Philippe Ouimet, Mai Mohsen, Huajing Ni, Alanna Weisman, Jacob A Udell, David Z I Cherney","doi":"10.1177/20543581251380509","DOIUrl":"10.1177/20543581251380509","url":null,"abstract":"<p><p>The Cardiac and Renal Endocrine (C.a.R.E) clinic is an interdisciplinary clinic offering integrated care to complex patients with cardiovascular-kidney-metabolic syndrome. Previous data from the clinic demonstrated improvements in clinical parameters but provided limited information on the indicated usage of evidence-based therapies. We aimed to update baseline characteristics and clinical data of the C.a.R.E clinic cohort, with added information on the uptake of therapies and reasons for therapy non-use. We performed a retrospective chart review of patients seen in the C.a.R.E clinic between July 2014 and July 2024 with at least two documented clinic visits. Data from the first and last visits were compared to evaluate treatment uptake and changes in clinical parameters. A total of 125 patients met our inclusion criteria. There were significant improvements in low-density lipoprotein levels (1.61 mmol/L for last visit vs 1.82 mmol/L for first visit), blood pressure (BP) measurements, (median systolic BP of 126 mm Hg vs 130 mm Hg and median diastolic BP of 72 mm Hg vs 76 mm Hg), and proportion of patients achieving BP targets (60.0% vs 44.8%). Uptake of therapies significantly increased, including sodium-glucose cotransporter-2 inhibitors (59.2% vs 24.0%) and glucagon-like peptide-1 receptor agonists (30.4% vs 9.6%). The use of finerenone also increased (22.7% vs 3.0%) among the 66 patients whose last visit occurred after Health Canada approved finerenone. The C.a.R.E clinic demonstrates potential to improve therapy uptake and clinical outcomes in patients with cardiovascular-kidney-metabolic syndrome. However, consistent clinical documentation and innovative strategies are needed to further enhance the adoption of evidence-based therapies.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251380509"},"PeriodicalIF":1.5,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243944","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":"Autosomal Dominant Polycystic Kidney Disease and Idiopathic Arginine Vasopressin Deficiency: A Peculiar Case Report of Accelerated Kidney Function Decline.","authors":"Farah Wehbe, Mark Elliott, Myriam Farah","doi":"10.1177/20543581251378016","DOIUrl":"10.1177/20543581251378016","url":null,"abstract":"<p><p>Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic kidney disorder characterized by progressive cyst growth and kidney impairment. Arginine vasopressin deficiency (AVP-D) is a rare disorder resulting from reduced arginine vasopressin production, causing polyuria and thirst. The coexistence of ADPKD and AVP-D is rarely documented in the literature. We report what may be the first documented case of a patient diagnosed with ADPKD and idiopathic AVP-D. Initially managed with intranasal desmopressin, the patient's kidney function declined earlier than expected based on her ADPKD, progressing to kidney failure at a low total kidney volume (836 mL). This paradoxical outcome suggests that while AVP-D may have initially slowed cyst growth, her uncontrolled AVP-D likely contributed to kidney function decline, presumably due to recurrent volume depletion and acute kidney injuries. This case highlights the need for individualized AVP-D management in ADPKD patients and reiterates AVP's role in the complex pathophysiology of ADPKD progression.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251378016"},"PeriodicalIF":1.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198378","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":"Prevalence and Severity of Pruritus in Patients on Hemodialysis: A Cross-Sectional Study.","authors":"Hannah G McMaster, Rachel M Holden, Melissa Scott, Eduard Iliescu","doi":"10.1177/20543581251380541","DOIUrl":"10.1177/20543581251380541","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic kidney disease-associated pruritus (CKD-aP) is a distressing symptom associated with dialysis that negatively affects quality of life. Chronic kidney disease-associated pruritus is under-recognized due to a lack of clinical attention and symptom screening.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Assess the prevalence and severity of CKD-aP in a regional hemodialysis program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and patients: &lt;/strong&gt;All outpatients receiving in-center hemodialysis at the Kingston Health Sciences Centre.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Patients were asked to complete the Worst Itching Intensity Numerical Scale (WI-NRS), with moderate-to-severe pruritus classified as a score greater than 4, and the Self-Assessed Disease Severity (SADS) scale. Demographic, laboratory, and prescription data were extracted from patient medical records and patients were asked to self-report over-the-counter pruritus medications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Comparative differences in demographics and laboratory values at the time of determining the WI-NRS and SADS were analyzed using a Fisher's exact test with Bonferroni correction for categorical variables and the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test for continuous variables. Correlations between select variables and the WI-NRS score were assessed using linear regression analyses. Adjusted associations with moderate-to-severe CKD-aP were examined using odds ratios with corresponding 95% confidence intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 307 patients completed the WI-NRS and 302 completed the SADS. Fifty-seven percent of patients reported some degree of CKD-aP, 31% of patients had moderate-to-severe CKD-aP, and 9% reported interference with quality of life (patients in SADS group C). Patients with moderate-to-severe CKD-aP and those significantly affected by CKD-aP (patients in SADS group C) were more likely to use over-the-counter treatments than patients with mild or no CKD-aP (&lt;i&gt;P&lt;/i&gt; &lt; .0001) and patients in SADS group A (&lt;i&gt;P&lt;/i&gt; &lt; .0001), respectively. Of patients with moderate-to-severe CKD-aP and whose CKD-aP significantly affected their quality of life (patients in SADS group C), 42% and 11.11%, respectively, did not use any form of treatments. Patients with moderate-to-severe CKD-aP had significantly higher parathyroid hormone (PTH; 0.02) and phosphate (&lt;i&gt;P&lt;/i&gt; = .01). A higher body mass index (BMI) was associated with a greater WI-NRS score (&lt;i&gt;R&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.030, &lt;i&gt;P&lt;/i&gt; = .003). Of patients with moderate-to-severe CKD-aP, 24% reported significant debilitation (patients in SADS group C). Finally, adjusted associations were found between moderate-to-severe CKD-aP and the following variables: BMI (OR = 1.05, 95% CI = 1.01-1.09, &lt;i&gt;P&lt;/i&gt; = .02); serum phosphate (OR = 2.12, 95% CI = 1.15-4.00, &lt;i&gt;P&lt;/i&gt; = .02); being a current smoker (OR = 0.46, 95% CI = 0.20-0.95, &lt;i&gt;P&lt;/i&gt; = .04); and a serum phosph","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251380541"},"PeriodicalIF":1.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198453","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":"Vitamin D and Muscle Function in a Diverse Hemodialysis Cohort.","authors":"Sara Mahdavi, Katie Rosychuk, Hulya Taskapan, Paul Y Tam, Tabo Sikaneta","doi":"10.1177/20543581251365363","DOIUrl":"10.1177/20543581251365363","url":null,"abstract":"<p><strong>Background: </strong>Declines in skeletal muscle function and widespread vitamin D deficiency are common in individuals receiving hemodialysis (HD), yet the relationships among serum 25-hydroxyvitamin D (25(OH)D) concentrations, vitamin D supplementation, and muscle strength remain incompletely characterized in this population.</p><p><strong>Objective: </strong>To evaluate the associations between serum 25(OH)D concentrations, dietary vitamin D intake, supplementation status, and muscle strength in a multiethnic cohort of patients undergoing HD.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Two satellite HD centers in Toronto, Canada.</p><p><strong>Participants: </strong>Eighty-one adults receiving HD (mean age 58 years; 64% male) were enrolled following screening based on clinical and demographic inclusion and exclusion criteria.</p><p><strong>Measurements: </strong>Handgrip strength, measured via digital dynamometry, was the primary outcome and marker of muscle function. Serum 25(OH)D was quantified to assess biochemical vitamin D status. Three-day food and supplement logs were used to estimate dietary vitamin D intake and supplementation. Associations were assessed using multivariable linear and logistic regression, adjusting for age, sex, and dry weight.</p><p><strong>Results: </strong>Forty-seven percent of participants exhibited sex-specific weak handgrip strength, and 25% were vitamin D deficient (<27.5 nmol/L). Serum 25(OH)D concentrations were positively associated with handgrip strength (r = 0.298, <i>P</i> = .023), and vitamin D supplementation was similarly associated (r = 0.285, <i>P</i> = .025). Deficient serum 25(OH)D levels were associated with over five-fold increased odds of weak grip strength (odds ratio (OR) 5.33; 95% confidence interval (CI): 1.59-20.67; <i>P</i> = .009). Although dietary vitamin D intake was inadequate in 97% of participants, it was not independently associated with muscle strength. Participants who reported supplement use had significantly higher mean serum 25(OH)D concentrations than those who did not supplement.</p><p><strong>Limitations: </strong>This study's cross-sectional design and single geographic setting limit causal inference and broader generalizability. Self-reported dietary intake may be subject to recall error.</p><p><strong>Conclusions: </strong>Biochemically defined vitamin D deficiency and absence of vitamin D supplementation were associated with reduced muscle strength in patients receiving HD. These findings suggest that higher serum 25(OH)D concentrations may support better musculoskeletal function, in addition to other known benefits of higher serum vitamin D levels, in populations undergoing HD treatment.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251365363"},"PeriodicalIF":1.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191382","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":"Adapting a Self-Management Tool (My Kidneys My Health) to Meet the Needs of Diverse Canadian Populations: Program Report.","authors":"Maoliosa Donald, Sabrina Jassemi, Shannan Love, Gillian Crysdale, Dwight Sparkes, Maria Delgado, Laurinda Ferreira, Betty Pearson, Nancy Verdin, Kaitlin Ahrenholz, Violet March, Maureena Loth, Sarah Gil, Heather Beanlands, Aminu Bello, Sandra Dumanski, Janine Farragher, Lori Harwood, Allison Jaure, Joanne Kappel, Ellen Novak, Sharon Straus, Catherine Turner, Clare McKeaveney, Brenda R Hemmelgarn, Meghan J Elliott","doi":"10.1177/20543581251370922","DOIUrl":"10.1177/20543581251370922","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of program: &lt;/strong&gt;Our team co-developed &lt;i&gt;My Kidneys My Health&lt;/i&gt;, an online platform designed with patients with non-dialysis-dependent chronic kidney disease and care partners to provide tailored education and self-management support. While &lt;i&gt;My Kidneys My Health&lt;/i&gt; has seen increased use and positive user feedback since its development and launch in 2021, there are opportunities to improve its cultural relevance, accessibility, and usefulness for diverse populations. In this report, we describe our approach to addressing these elements by adapting &lt;i&gt;My Kidneys My Health&lt;/i&gt; content and knowledge mobilization strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Sources of information: &lt;/strong&gt;Patients and care partners in Canada have identified the lack of accessible, person-centered resources as a major barrier to effective self-management for non-dialysis-dependent chronic kidney disease. Digital heath tools can meet this need by delivering consistent, evidence-based education and support in a user-friendly format. Through our program of research with Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), we have co-developed &lt;i&gt;My Kidneys My Health&lt;/i&gt; through a series of patient-oriented research studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our program objectives are to (1) understand and address gaps in sexual health support for individuals with non-dialysis-dependent chronic kidney disease; (2) build relationships with Indigenous communities in Alberta to understand and share self-management learnings; and (3) improve accessibility to &lt;i&gt;My Kidneys My Health&lt;/i&gt; content for diverse populations. To guide the adaptation and implementation of &lt;i&gt;My Kidneys My Health&lt;/i&gt;, our team adopted the following Can-SOLVE CKD phase 2 pillars: (1) Implementation Science and Knowledge Mobilization, (2) Indigenous Cultural Competency, (3) Incorporation of Equity, Diversity, and Inclusion principles in Knowledge Mobilization and Implementation Efforts, and (4) Patient Engagement and Capacity Building. We used the Can-SOLVE CKD Pathway to Implementation and applied the Map2Adapt framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key findings: &lt;/strong&gt;Primary care and nephrology providers expressed readiness to integrate &lt;i&gt;My Kidneys My Health&lt;/i&gt; into clinical workflows, and collaborative partnerships with initiatives like Kidney Check enhanced knowledge sharing. We initiated relationship building with the Stoney Nakoda Tsuut'ina Tribal Council Ltd. Health Department (G4 Health), including in-person meetings with the health directors, and co-development of engagement packages and communications designed to reflect our culturally safe methodologies. We addressed accessibility barriers by updating website features and new printable materials on key self-management topics, with French translations. Results from our mixed methods sexual health study underscored the need for tailored, credible resources for people with non-dialysis-dependent chroni","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251370922"},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111975","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":"Assessing Cognition in Kidney Failure Using Virtual Reality Technology: A Clinical Research Protocol.","authors":"Malik I El-Feghi, George Worthen, David Clark, David Collister, Jad Issa, Ayodele Odutayo, Samuel Searle, Laura Sills, Nancy Verdin, Amanda J Vinson, Jo-Anne Wilson, Karthik Tennankore","doi":"10.1177/20543581251368777","DOIUrl":"10.1177/20543581251368777","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cognitive impairment is common in patients receiving dialysis and is associated with morbidity and mortality. Existing approaches to administering face-to-face cognitive screening assessments like the Montreal Cognitive Assessment (MoCA) may be challenging to undertake in dialysis. Virtual reality (VR) technology may be a novel way to assess cognitive function in patients on dialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In a cohort of patients undergoing hemodialysis, the primary objective of this study is to evaluate the test-retest reliability, diagnostic performance, and agreement of an MoCA, generated using VR-based cognitive testing, to a face-to-face MoCA. Secondary objectives are to (1) evaluate changes in cognitive function over time using the VR-generated MoCA, (2) examine associations between cognitive impairment and mortality or hospitalization, and (3) assess the usability of VR-based cognitive testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a prospective cohort study (conducted from 2025-2028).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Hemodialysis units affiliated with the Nova Scotia Health Renal Program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Incident (within 3 months of dialysis initiation) and prevalent patients receiving hemodialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Cognitive function will be assessed using the React Neuro VR Headset and the paper-based MoCA. The VR cognitive assessment will include tests such as Smooth Pursuit, Trail Making A/B, Letter/Category Fluency, Boston Naming, Stroop, and Digit Span (Forward/Backward). The results of these tests will be used to generate an MoCA score using device software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The VR cognitive tests and face-to-face MoCA assessments will be conducted at baseline and week 2, with the order of assessments randomly determined. Subsequent VR cognitive assessments will be conducted once every 3 months (up to 12 months). Agreement will be assessed using Cohen's kappa (dichotomizing the MoCA at &lt;24), and existing approaches for continuous MoCA scores. Test-retest reliability will be assessed using a similar approach comparing baseline and 2-week scores. Associations between the VR-generated MoCA and outcomes will be analyzed using appropriate regression methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;To date, we have recruited 84 patients, 75 of whom have completed at least their baseline assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Potential challenges in VR implementation and patient adaptation, as well as the loud and distracting dialysis environment, could impact performance in cognitive assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This proposed study aims to evaluate test-retest reliability, performance, and agreement between a VR-generated and face-to-face MoCA. The VR technology may provide a reliable alternative to traditional cognitive testing in dialysis patients. The findings can be used to assist in the early identification of patient","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251368777"},"PeriodicalIF":1.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079758","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":"Non-steroidal Anti-inflammatory Drug Prescriptions in Living Kidney Donors: A Retrospective Cohort Study.","authors":"Mikayla I Laube, Robert R Quinn, Pietro Ravani, Krista L Lentine, Alix Clarke, Rachel Jeong, Jason Bau, Ngan N Lam","doi":"10.1177/20543581251368782","DOIUrl":"10.1177/20543581251368782","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend that living kidney donors should avoid non-steroidal anti-inflammatory drugs due to their potential nephrotoxic effects. It is unclear if physicians are adhering to this recommendation.</p><p><strong>Objective: </strong>Our aim was to determine the proportion of living kidney donors that filled a non-steroidal anti-inflammatory drug prescription post-donation and the proportion with measurement of kidney function post-prescription.</p><p><strong>Design: </strong>We conducted a population-based, retrospective cohort study.</p><p><strong>Setting: </strong>We identified kidney donors in Alberta, Canada that had accessed the healthcare system in the outpatient, emergency department, or inpatient setting.</p><p><strong>Patients: </strong>Adult living kidney donors in Alberta, Canada who donated between 2002 and 2019.</p><p><strong>Measurements: </strong>We measured the number of non-steroidal anti-inflammatory drug prescriptions, type of prescribing physician, and evidence of post-prescription measurement of creatinine and potassium.</p><p><strong>Methods: </strong>We identified the proportion of donors who filled a non-steroidal anti-inflammatory drug prescription at least 1 year post-donation. We also assessed how many donors underwent laboratory testing for kidney function and potassium within 14 days following the first prescription.</p><p><strong>Results: </strong>Of the 759 living kidney donors included in our study, 273 (36%) had at least one non-steroidal anti-inflammatory drug prescription over a median follow-up of 7.2 years (interquartile range 3.5-11.5). The proportion of donors with at least one prescription in follow-up remained stable over time (~10% per year). Family physicians accounted for 66% of all non-steroidal anti-inflammatory drug prescriptions. Approximately, 10% of donors had measurements of serum creatinine or potassium post-prescription.</p><p><strong>Limitations: </strong>This study was limited by the inability to capture over-the-counter non-steroidal anti-inflammatory drug use, indication for the prescriptions, and indication for bloodwork being completed in the post-prescription period.</p><p><strong>Conclusions: </strong>Over one-third of living kidney donors are prescribed non-steroidal anti-inflammatory drugs despite current guideline recommendations, with only a minority undergoing post-prescription laboratory testing. Further research assessing outcomes following non-steroidal anti-inflammatory drug use is recommended to better inform optimal pain-management strategies for living kidney donors.</p>","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251368782"},"PeriodicalIF":1.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063564","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":"KRESCENT; 2005-2025 - 20 years! Editorial.","authors":"R Todd Alexander, Sunny Hartwig, Kevin D Burns, Mathieu Lemaire, Adeera Levin","doi":"10.1177/20543581251356409","DOIUrl":"10.1177/20543581251356409","url":null,"abstract":"","PeriodicalId":9426,"journal":{"name":"Canadian Journal of Kidney Health and Disease","volume":"12 ","pages":"20543581251356409"},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943946","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}