Fast Reading of the KDIGO 2012: Guidelines for evaluation and management of chronic kidney disease in clinical practice

Kirsztajn, Gianna Mastroianni; Filho, Natalino Salgado; Draibe, Sérgio Antônio; Netto, Marcus Vinícius de Pádua; Thomé, Fernando Saldanha; Souza, Edison; Bastos, Marcus Gomes

doi:10.5935/0101-2800.20140012

Cited by 51 publications

(42 citation statements)

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“…The antecedents of chronic kidney disease (CKD) were determined based on 2 plasma creatinine measures at least 3 months prior to admission [7]. Other clinical and laboratory information was also obtained daily such as the following: the volume of 24 h diuresis, length of stay in the emergency care units (ECUs) before admission to the hospital, time for referral to nephrology support, cause of AKI (pre-renal, intrinsic, and post-renal), Acute Kidney Injury Network (AKIN) classification to assess the severity, antecedents of DM, hypertension, liver disease, and heart failure [7]. Patients were divided into 3 groups on the basis of age: 60–74, 75–89, and ≥90 years.…”

Section: Methodsmentioning

confidence: 99%

Acute Kidney Injury in Elderly Population: A Prospective Observational Study

Santos

Romani²,

Benvenutti³

et al. 2017

Nephron

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Background/Aims: Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. Methods: This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital. Clinical data were analyzed, which included RRT indication, referral time to nephrologist support, standby period in the emergency care units (ECU) before a transfer to an intensive care unit, staff criteria used to indicate palliative care, and the incidence of patients who stayed on chronic dialysis for at least 6 months after discharge. Results: The overall hospital mortality was 56.3%. Acute Kidney Injury Network (AKIN) 3 at the time of admission was significantly higher in patients who underwent RRT. Intrinsic AKI (p < 0.001), AKIN 3 (p < 0.001), RRT (p < 0.001), and increased length of stay in ECUs (p = 0.01) all had a significantly higher prevalence among non-survivors. On multivariate analysis, however, only renal aetiology (intrinsic AKI) was independently associated with mortality (OR 2.88; 95% CI [1.29–6.13]). Approximately 85% of the discharged patients (n = 125) were dialysis free and 36.4% of them who had a previous diagnosis of chronic kidney disease (CKD) upon admission had a worse renal function. Age, AKIN 3, RRT, prior history of CKD, diabetes mellitus, and the number of hemodialysis sessions showed to have an impact on dialysis dependence. Furthermore, 24 of 161 patients who had a dialysis indication were placed on palliative care. Conclusions: The severity of AKI and the need for RRT were risk factors for mortality and dependence on dialysis. Antecedents of CKD seem to be associated with a poor renal outcome following an AKI episode. Starting RRT had an impact on the clinical decision to enroll these patients into palliative care.

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Section: Methodsmentioning

confidence: 99%

Acute Kidney Injury in Elderly Population: A Prospective Observational Study

Santos

Romani²,

Benvenutti³

et al. 2017

Nephron

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“…[17] CKD was defined as either kidney damage or a decreased glomerular filtration rate of less than 60 mL/min/1.73 m 2 for at least 3 months. [18] Autoimmune disease was defined in patients diagnosed with systemic lupus erythematosus (SLE), adult-onset Still disease (AOSD), Sjögren syndrome, or Behçet disease .…”

Section: Methodsmentioning

confidence: 99%

The incidence and clinical characteristics by gender differences in patients with Kikuchi–Fujimoto disease

et al. 2017

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Kikuchi–Fujimoto disease (KFD) is a rare, self-limiting disorder that typically affects the cervical lymph nodes (LNs). Although initially described in young women, KFD also occurs in men. There are no reports on the clinical manifestations and characteristics of male KFD patients. Therefore, this study was conducted to assess the incidence of KFD among males, as well as the most frequent clinical characteristics of these patients. A retrospective, cross-sectional study was performed at a tertiary hospital of patients pathologically confirmed as having KFD from LN biopsy specimens. Clinical and laboratory data, and treatment outcomes of the enrolled patients, were analyzed by gender. A total of 254 patients diagnosed with KFD were enrolled. There were 189 females and 65 males (2.9:1). The mean age was 32.6 ± 11.3 years. Compared to the female patients, the males had more frequent manifestations of fever (48% vs 67%, P = 0.008), headache (9% vs 20%, P = 0.013), bilateral lymphadenopathy (31% vs 46%, P = 0.029), thrombocytopenia (14% vs 29%, P = 0.014), elevated C-reactive protein (CRP) (35% vs 78.4%, P < 0.001), elevated liver enzymes (15% vs 41%, P < 0.001), and elevated lactate dehydrogenase (LDH) (61% vs 80%, P = 0.021). Male patients had fewer autoimmune features (9% vs 2%, P = 0.043) and fewer positive antinuclear antibodies (32% vs 10%, P = 0.006). In this study, 25.6% of the enrolled patients were male, with a 2.9:1 female-to-male sex ratio. Male patients showed a distinctive profile characterized by a higher frequency of fever, headache, bilateral lymphadenopathy, and thrombocytopenia, as well as elevated liver enzymes, CRP, and LDH.

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“…Apesar de a hemodiálise ser descrita como um procedimento técnico que substitui a função renal, com indicações específicas (7) , existe necessidade de reflexão sobre a complexidade desse tratamento, inserido no cotidiano dos pacientes, uma vez que os profissionais de saúde que acompanham as mudanças que ocorrem diariamente e contribuem oferecendo apoio e esclarecendo dúvidas, para assim oferecer continuidade no autocuidado apoiado e maior conhecimento dos pacientes sobre a nova realidade.…”

Section: "Paciente Perde a Função Renal E Começa A Apresentar Sintomaunclassified

Learning culture in nephrology / Cultura de aprendizagem em nefrologia / La cultura del aprendizaje en nefrología

et al. 2016

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Objetivo: identificar conhecimento da equipe de enfermagem sobre cuidado com paciente em hemodiálise. Metodologia: trata-se de estudo qualitativo do tipo pesquisa ação, realizado com toda a equipe, 12 profissionais de enfermagem em clínica de hemodiálise, perguntas norteadoras, observação e registro foram usados na coleta, em junho de 2014, aprovação comitê de ética em pesquisa CAAE: 0422.0.045.000-11. Resultados: identificou-se a necessidade de ampliação do conhecimento sobre os cuidados com paciente em hemodiálise. Existe imprecisão na formulação de conceitos, características do tratamento e necessidade de ampliar conhecimento sobre a doença renal. Além da reduzida quantidade de profissionais que facilitem a aprendizagem e realizem orientações sobre o autocuidado no processo de adaptação com o tratamento hemodialítico. Conclusões: portanto, defende-se que os profissionais devam exercer a consciência crítica para o processo contínuo de formação para promover o cuidado apoiado.

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Fast Reading of the KDIGO 2012: Guidelines for evaluation and management of chronic kidney disease in clinical practice

Cited by 51 publications

References 0 publications

Acute Kidney Injury in Elderly Population: A Prospective Observational Study

Acute Kidney Injury in Elderly Population: A Prospective Observational Study

The incidence and clinical characteristics by gender differences in patients with Kikuchi–Fujimoto disease

Learning culture in nephrology / Cultura de aprendizagem em nefrologia / La cultura del aprendizaje en nefrología

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