Institute of Health Sciences, Universiti Brunei Darussalam; Department of Nephrology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam.
Published: July 2019
AI Article Synopsis
Article Abstract
Integrated multidisciplinary predialysis education (MPE) is usually provided to support and prepare the pre-end-stage renal disease (ESRD) patients before the initiation of renal replacement therapy (RRT). However, the impact of MPE is not known in our population, which is comprised patients of Asian origins and recipients of a totally subsidized health-care system. This research compared the survival probability, sociodemographic, and clinical characteristics of MPE patients and non-MPE patients (or crashlanders). A retrospective cohort study was conducted to investigate ESRD patients who started RRT in Brunei Darussalam from January 2013 to December 2014. Data were extracted from the computerized clinical database and dialysis records. A total of 351 new cases of ESRD patients who started on hemodialysis during the study period were included in the study. The median age was 56.0 years, with a slight male preponderance (56.6%). The MPE group was significantly older (P = 0.001) and more likely to have a history of diabetes mellitus (P = 0.013), ischemic heart disease (P = 0.014), and hypertension (P = 0.016). Despite being older and having more comorbidities (P = 0.028), MPE patients have a better survival probability (P = 0.028) and a 34% decreased risk of dying. Of those who died, older age (P = 0.001), higher serum creatinine (P = 0.01), and lower hemoglobin level (P = 0.017) were significant prognostic indicators. MPE before the initiation of RRT contributed to greater survival probability in near ESRD patients. The survival benefits were evident despite the presence of inherent risks (older age and presence of comorbidities) in the MPE population in comparison with the non-MPE cohort.
Arterio-ureteral fistula (AUF) is a rare condition affecting nearby adult-only patients. Patients usually present with hematuria, often starting as intermittent hematuria which frequently increases, and may lead to hemorrhagic shock. Without rapid diagnosis and prompt treatment, AUF can be lethal.
Department of Medical and Surgical Specialties, Radiological Science and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy.
Aims: Few data are available regarding the role of tricuspid annulus plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP), a measurement of right ventricular to pulmonary artery coupling, in patients with chronic heart failure and left ventricular systolic dysfunction.
Methods And Results: This retrospective single-centre study included outpatients with left ventricular systolic dysfunction (ejection fraction ≤ 50%) evaluated between January 2022 and December 2022. TAPSE/PASP was evaluated as a continuous variable and as tertiles according to its value on the first visit.
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain.
Methods: Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China.
Background: This real-world evidence study compared risks of cardiovascular events in hospital settings among patients with chronic kidney disease (CKD) with and without hyperkalemia.
Methods And Results: Adults with CKD stages 3b/4 with and without hyperkalemia were identified from Optum's deidentified Market Clarity Data (January 2016-August 2022). Patients with hyperkalemia were exact and propensity score matched to patients without hyperkalemia.
Unlabelled: Chronic kidney disease (CKD) is a global health problem, CKD is widespread in the world, on average it is detected in 10-13% of the adult population. Sedentary patients with CKD on dialysis have a higher risk of mortality. Despite the significant association of physical function with mortality in patients with CKD, physical function is not routinely assessed and exercise is not a component of the routine management of patients with CKD on dialysis.
