Effects of the pandemic on adolescent and caregiver attitudes towards telemedicine use.

Background: Telemedicine use increased during the COVID-19 pandemic. We compared both adolescent/caregiver attitudes towards telemedicine pre- and intra-pandemic.

Materials And Methods: In a tertiary care setting with a large remote catchment area, we conducted qualitative analysis of structured interviews with dyads of 11 to 18-year-old patients and their caregivers using NVivo during the pandemic and compared the findings to our previous research [1].

Growth hormone therapy in HHRH.

Background: Hereditary Hypophosphatemic Rickets with Hypercalciuria (HHRH) ( gene, OMIM 241530) is an autosomal recessive disorder that results in a loss of function of the sodium-phosphate NPT2c channel at the proximal tubule. Phosphate supplementation rarely improves serum phosphate, hypercalciuria, nephrocalcinosis, 1,25(OH) vitamin D (1,25(OH)D) levels or short stature.

Methods: We describe Na MRI and the successful use of recombinant human growth hormone (rhGH) and Fluconazole to improve growth (possibly confounded by puberty) and hypercalciuria in a now 12-year-old male with HHRH (novel homozygous mutation, c.

Animal, Human, and Na MRI Imaging Evidence for the Negative Impact of High Dietary Salt in Children.

Purpose Of The Review: Conditions typically prevalent in adults such as hypertension, kidney stones, osteoporosis, and chronic kidney disease are increasing among adolescents and young adults (AYA). The purpose of this review is to describe the association of these conditions to a high salt diet among pediatric patients.

Recent Findings: We present animal, human, and Na MRI evidence associated with the negative impact of high dietary salt in children.

Management of severe polyuria in idiopathic Fanconi syndrome.

Background: Polyuria is a common problem in patients with tubular diseases, especially for those with CKD and high-output Fanconi syndrome. There are currently no guidelines on how to treat debilitating polyuria, in children or adults, and vasopressin is usually not effective.

Case-diagnosis/treatment: A 13-year-old female with idiopathic Fanconi syndrome and an eGFR of 69 mL/min/1.

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology.

Background: Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We compared both adolescent and caregiver (parent or guardian) attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness.

Principles responsible for trace element concentrations in chronic kidney disease.

Derangements of trace elements often occur in patients with renal failure and play a crucial role in chronic kidney disease. The natural history of trace element deposition with worsening chronic kidney disease has been poorly described. Some essential trace elements may get wasted (e.

Circulating Bacterial Fragments as Cardiovascular Risk Factors in CKD.

Cardiovascular disease (CVD) is a major cause of mortality and morbidity in patients with CKD. In the past decade, intestinal dysbiosis and altered gut epithelial barrier function are increasingly recognized in CKD. Uremic patients have slow intestinal transit time, impaired protein assimilation, and decreased consumption of dietary fiber.

Inflammation and Peritoneal Dialysis.

Inflammation is one of the well-recognized nontraditional risk factors that contributes to the excessive cardiovascular mortality in peritoneal dialysis (PD) patients. Serum C-reactive protein and interleukin-6 levels are common surrogate markers used to measure inflammatory burden and predict adverse clinical outcomes in PD patients. Causes of inflammation are complex and can be categorized into factors related to a decrease in renal function and factors related to dialysis.

Why Is Your Patient Still Short of Breath? Understanding the Complex Pathophysiology of Dyspnea in Chronic Kidney Disease.

Dyspnea is one of the most common symptoms associated with CKD. It has a profound influence on the quality of life of CKD patients, and its underlying causes are often associated with a negative prognosis. However, its pathophysiology is poorly understood.

Characterising haemodynamic stress during haemodialysis using the extrema points analysis model.

Background And Aims: It is becoming recognised that the process of haemodialysis (HD) itself induces circulatory stress that could be implicated in the observed higher rate of end-organ damage. We aimed to study the haemodynamic performance during HD using the extrema points (EP) analysis model, and to examine the determinants of the model and its relation to circulatory stress.

Methods: 63 incident HD patients were studied.

Exploring haemodynamics of haemodialysis using extrema points analysis model.

Background: Haemodialysis is a form of renal replacement therapy used to treat patients with end stage renal failure. It is becoming more appreciated that haemodialysis patients exhibit higher rates of multiple end organ damage compared to the general population. There is also a strong emerging evidence that haemodialysis itself causes circulatory stress.

Rationale and design of a multi-centre randomised controlled trial of individualised cooled dialysate to prevent left ventricular systolic dysfunction in haemodialysis patients.

Background: The main hypothesis of this study is that patients having regular conventional haemodialysis (HD) will have a smaller decline in cardiac systolic function by using cooler dialysate. Cooler dialysate may also be beneficial for brain function.

Methods/design: The trial is a multicentre, prospective, randomised, un-blinded, controlled trial.