Understanding the Effects of Kidney Disease and Dialysis Treatment on Pharmacotherapy in Children

2019 ◽  
pp. 209-229
Author(s):  
Verena Gotta ◽  
Olivera Marsenic ◽  
Marc Pfister
Keyword(s):  
Kidney Disease ◽  
Dialysis Treatment

scholarly journals Where Are You Going, Nephrology? Considerations on Models of Care in an Evolving Discipline

2018 ◽  
Vol 7 (8) ◽  
pp. 199 ◽  
Author(s):  
Giorgina Piccoli ◽  
Conrad Breuer ◽  
Gianfranca Cabiddu ◽  
Angelo Testa ◽  
Christelle Jadeau ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Models Of Care ◽  
Scientific Model ◽  
Dialysis Treatment ◽  
Cost Constraints ◽  
Common Diseases ◽  
Nephrology Care ◽  
Immunologic Diseases

Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties. This paper proposes an interpretation of the different systems of nephrology care summarising the present choices into three not mutually exclusive main models (“scientific”, “pragmatic”, “holistic”, or “comprehensive”), and hypothesizing an “ideal-utopic” prevention-based fourth one. The so-called scientific model is built around kidney transplantation and care of glomerulonephritis and immunologic diseases, which probably pose the most important challenges in our discipline, but do not mirror the most common clinical problems. Conversely, the pragmatic one is built around dialysis (the most expensive and frequent mode of renal replacement therapy) and pre-dialysis treatment, focusing attention on the most common diseases, the holistic, or comprehensive, model comprehends both, and is integrated by several subspecialties, such as interventional nephrology, obstetric nephrology, and the ideal-utopic one is based upon prevention, and early care of common diseases. Each model has strength and weakness, which are commented to enhance discussion on the crucial issue of the philosophy of care behind its practical organization. Increased reflection and research on models of nephrology care is urgently needed if we wish to rise to the challenge of providing earlier and better care for older and more complex kidney patients with acute and chronic kidney diseases, with reduced budgets.

scholarly journals Características Clínicas, epidemiológicas y evolución de Pacientes con Enfermedad Renal Crónica estadío 5, del año 2005 al 2015 en el Hospital de Especialidades Pediátricas Omar Torrijos H. Panamá.

2018 ◽  
Vol 1 (38) ◽  
Author(s):  
Ariana Guerra ◽  
Basilio Dobras
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Situation ◽  
Chronic Dialysis ◽  
Dialysis Treatment ◽  
Evolution Characteristics ◽  
Specialty Hospital ◽  
Common Etiology ◽  
Male Sex ◽  
Epidemiologic Characteristics

<p>[Clinical and epidemiologic characteristics and evolution of patients with stage 5 Renal cronic disease, from year 2005 to 2015 at the Omar Torrijos H. Pediatric Hospital, Panama]</p><p>Resumen<br />Introducción: La incidencia y prevalencia de ERC-5 en niños ha ido en aumento. Es poco lo que se conoce respecto a la epidemiología de la ERC en niños y su manejo constituye un reto importante para los sistemas de salud. En Panamá no contamos con estudios que analicen la situación epidemiológica y clínica de niños con ERC. El objetivo del presente estudio es describir las características clínicas, epidemiológicas y evolución de pacientes pediátricos con enfermedad renal crónica estadio 5 atendidos en el servicio de Nefrología del hospital de Especialidades Pediátricas. Metodología: Se realizó un estudio observacional, descriptivo, retrospectivo, de los pacientes con enfermedad renal crónica estadio 5 atendidos en el Servicio de Nefrología del Hospital de Especialidades Pediátricas desde enero de 2005 a diciembre de 2015. Resultados: El promedio de edad al momento de la detección de la ERC-5 fue de 8.4 años. El sexo masculino predominó con una relación 1.4: 1. Predominó el grupo etario escolar de 6 a 10 años, y los adolescentes entre 11 a 15 años, con 14 casos cada uno. La incidencia anual fue de 3.0 casos, o 3.4 por millón de la población relacionada con la edad. La etiología más común fue la glomerulopatía 15 (44.1 %) Todos los pacientes tenían anemia y todos recibieron tratamiento dialítico crónico luego del establecimiento del diagnóstico mayormente diálisis peritoneal. Conclusión: Para Panamá, el promedio de edad al momento de la detección de la ERC-5 fue de 8.4 años, predominando el sexo masculino. La causa etiológica más común fue la glomerulopatía. Todos presentaban anemia al momento del diagnóstico y todos recibieron tratamiento dialítico crónico luego del establecimiento del diagnóstico, mayormente peritoneal.<br />Abstract<br />Introduction: The incidence and prevalence of CKD-5 in children has been increasing. Little is known about the epidemiology of CKD in children and its management constitutes a major challenge for health systems. In Panama, we do not have studies that analyze the epidemiological and clinical situation of children with CKD. The aim of the present study is to describe the clinical, epidemiological and evolution characteristics of pediatric patients with stage 5 chronic kidney disease treated in the Nephrology service of the Pediatric Specialty Hospital. Methodology: An observational, descriptive, retrospective study of patients with stage 5 chronic kidney disease treated at the Nephrology Service of the Pediatric Specialty Hospital from January 2005 to December 2015 was performed. Results: The average age at the time of The detection of CKD-5 was 8.4 years. The male sex predominated with a 1.4: 1 ratio. The school age group was predominantly between 6 and 10 years old, and adolescents between 11 and 15 years old, with 14 cases each. The annual incidence was 3.0 cases, or 3.4 per million of the population related to age. The most common etiology was glomerulopathy 15 (44.1%). All the patients had anemia and all received chronic dialysis treatment after the establishment of the diagnosis, mainly peritoneal dialysis. Conclusion: For Panama, the average age at the time of detection of CKD-5 was 8.4 years, predominantly male. The most common etiologic cause was glomerulopathy. All had anemia at the time of diagnosis and all received chronic dialysis treatment after the establishment of the diagnosis, mostly peritoneal.</p>

scholarly journals Survival Analysis of Chronic Kidney Disease Patients with Hemodialysis in West Java. Indonesia, Year 2007 - 2018

2020 ◽  
Vol 52 (3) ◽  
pp. 172-179
Author(s):  
Afiatin ◽  
Dwi Agustian ◽  
Kurnia Wahyudi ◽  
Pandu Riono ◽  
Rully M. A. Roesli
Keyword(s):  
Chronic Kidney Disease ◽  
Survival Analysis ◽  
Survival Rate ◽  
Kidney Disease ◽  
Demographic Data ◽  
Survival Rates ◽  
Treatment Quality ◽  
West Java ◽  
Dialysis Treatment ◽  
The Impact

The prevalence of chronic kidney disease on dialysis or CKD5D is increasing with a significant impact on disease burden in many countries. Patients are usually listed in the national renal registries, which report demographic data, incidence, prevalence, and outcome. The survival rate is an important outcome measure to characterize the impact of treatment in the CKD5 patient population in the national and international renal registries. Indonesian Society of Nephrology (InaSN) has the Indonesian Renal Registry program to collect data that was endorsed to monitor dialysis treatment quality in Indonesia. IRR releases an annual report, but there is no survival analysis yet. This study aimed to discover the five-year survival rate of CKD5D patients in West Java between 2007–2018 and its factor based on the IRR database. A retrospective cohort study was performed by gaining all patients' data from the IRR database, then data on all of the patients from West Java province who completed a 5-year follow-up on December 31, 2018. Kaplan-Meier analysis and Cox proportional hazard's model were used to analyze the risk factors. There were 3,199 data included in this study. In total, the 1, 2, 3, 4, and 5 year survival rates are 82%, 70%, 62%, 58%, and 55 %, respectively. Patients whose age is above 55 years and with unknown underlying kidney disease have a worse survival rate with a hazard ratio of 1.28 and 1.50, respectively. Further exploration of IRR data will provide better information on dialysis treatment in Indonesia.

scholarly journals FGF-23 and future cardiovascular events in patients with chronic kidney disease before initiation of dialysis treatment

2010 ◽  
Vol 25 (12) ◽  
pp. 3983-3989 ◽  
Author(s):  
S. Seiler ◽  
B. Reichart ◽  
D. Roth ◽  
E. Seibert ◽  
D. Fliser ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Dialysis Treatment ◽  
Initiation Of Dialysis ◽  
Fgf 23

scholarly journals Frequency of sarcopenia, cachexia, and associated factors in patients with chronic kidney disease in dialysis treatment

2020 ◽  
Author(s):  
Edilene Maria de Oliveira ◽  
Renata Pereira da Silva ◽  
Maria da Conceição Chaves de Lemos ◽  
Maria Goretti Pessoa de Araújo Burgos ◽  
Denise Maria Nascimento Costa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Associated Factors ◽  
Dialysis Treatment
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