Abstract:
BACKGROUND:Chronic kidney disease (CKD) has been identified as a growing global burden and traditional health care systems are inadequate for the management of CKD patients. This paper describes an initiative to establish a renal management clinic (RMC) in China and discusses the challenges and opportunities in the management of CKD patients. SUBJECTS AND METHODS:We collected and analyzed the data for the first 1,000 CKD patients treated since the establishment of the RMC (from April 2006 to April 2007). They had CKD stages 1-4 and stage 5 (before dialysis), as described by the Kidney Outcome Quality Initiatives (KDOQI). They were managed at the RMC established at the Peking University Third Hospital, by a multidisciplinary team (nephrologists, nurses, and dietitians) who developed care plans, clinical pathways, and a multidimensional patient-education program. RESULTS:The most frequent causes of CKD among these 1,000 patient were glomerulonephritis (35%), hypertensive nephrosclerosis (19%), chronic interstitial nephritis (13%), and diabetic nephropathy (11%). Six percent of the patients had stage 1 CKD, 27% stage 2, 33% stage 3, 20% stage 4, and 13% had stage 5. Five hundred and fifty-four were male and 446 were female; mean age was 55 +/- 18.9 years (range 18-92 years). Seven hundred and seventy patients (77%) had hypertension; 400 patients (40%) had body mass index (BMI) equal to or higher than 25 kg/m(2); 180 (18%) had overt cardiovascular disease; 726 (72.6%) had low-density lipoprotein (LDL)-cholesterol higher than 2.6 mmol/l; 440 patients (44%) had hyperuriemia; and 274 patients (27.4%) had anemia (hemoglobin <110 g/l). Although the team is multidisciplinary, management of the patients in the RMC is undertaken mainly by nephrologists, whereas nurses and dietitians still do not play an important role. There are no family doctors in China and nephrologists are responsible for management of these patients' kidney disease and related complications. CONCLUSIONS:Our findings show that the prevalence of hypertension, diabetes mellitus, overweight. and hyperuricemia is high among Chinese CKD population. Nurses and dietitians do not yet play an important role in the present pattern of RMC. We believe that the present medical care model should be revised because it does not address the concerns of CKD patients and their need for lifestyle changes that would help them to cope with their chronic condition.
journal_name
Int Urol Nephroljournal_title
International urology and nephrologyauthors
Zhang AH,Zhong H,Tang W,Chen SY,He L,Wang S,Su CY,Lu XH,Wang Tdoi
10.1007/s11255-008-9450-8subject
Has Abstractpub_date
2008-01-01 00:00:00pages
1053-8issue
4eissn
0301-1623issn
1573-2584journal_volume
40pub_type
杂志文章abstract::The vesical stone formation due to intravesical mesh erosion of tension-free vaginal tape (TVT) is rare. In this report, a case of 48-year-old patient who underwent (TVT) elsewhere is discussed. The patient was presented with vesical stone and persistent stress urinary incontinence. Intravesical stone was detected by ...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-006-9080-y
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:This present study aims to investigate the relationship between laboratory parameters on admission and prognosis of coronavirus disease 2019 (COVID-19) in maintenance hemodialysis patients, as well as providing a theoretical basis for clinical evaluation of prognosis and corresponding intervention measures. ME...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02646-0
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:Comorbidity has a significant impact on the health status and treatment outcome of a patient. The Charlson comorbidity index (CCI) is a frequently used scoring system, which evaluates the prognosis based on the patient's comorbid conditions. The aim of this study was to evaluate the usefulness of CCI in predict...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02499-7
更新日期:2020-09-01 00:00:00
abstract::The paper deals with the authors' own experience in endoscopic treatment of urethrostenosis in males. Since 1980, 86 patients have been treated in this manner. Good results were obtained in 60 (70%) after one surgical procedure and in 18 (21%) after two operations. Two patients were operated upon by routine methods. W...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550611
更新日期:1988-01-01 00:00:00
abstract::A total of 42 neurologically normal children with different voiding problems have been studied urodynamically during the last 4 years. Seventeen patients had unstable bladder, with significantly decreased capacity. The degree of volume decrease depended on the severity of instability and on the type of micturition pro...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of age on nutrition indices in subjects on the same continuous ambulatory peritoneal dialysis (CAPD) schedule. METHODS:We analyzed 613 sets of clearance values and nutrition indices in 302 CAPD patients. Small solute clearances included urea clearance (Kt/Vurea) and creatinine clearance...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1023/a:1017579105158
更新日期:2001-01-01 00:00:00
abstract:AIM:To evaluate the infectious complications, microorganism distribution and antibacterial treatment in patients who underwent percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS:Three hundred and thirty-eight patients who were 17 years age or older who underwent PCNL between January 2001 and December 2002 have ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-9147-9
更新日期:2007-01-01 00:00:00
abstract::To evaluate cancer involvement of internal female genitalia of patients undergoing anterior exenteration for clinically organ confined transitional cell carcinoma of the bladder, and identify potential preoperative risk factors. Charts and anterior exenteration specimens from 54 women with clinically organ confined tr...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-006-9158-6
更新日期:2007-01-01 00:00:00
abstract:UNLABELLED:We examined renal function and urinary drainage of children with primary megaureter (PMU) in dependence on conservative or operative treatment. MATERIAL AND METHODS:The retrospective analysis covering the years 1994 to 2000 comprised children at an age of 0-7 years with 35 PMU. Sonography, dynamic MAG3 reno...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-005-3615-5
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:To analyse the incidence and management of emphysematous pyelonephritis (EPN) in North West London and examine factors that influence immediate and 6-month outcomes with the aim of guiding future management. METHODS:This work analyses EPN cases from the London North West Healthcare NHS Trust from October 2006 ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1706-8
更新日期:2017-12-01 00:00:00
abstract::Eight patients with benign prostatic hypertrophy (BPH), considered as a high risk for an operation because of severe accompanying disease, were treated with a self-retaining intraurethral catheter set. Two patients were judged unfit for operation (one because of severe cardiac failure, the other because of severe resp...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:Anastomotic stricture (AS) is a well-described complication of radical retropubic prostatectomy (RRP) despite all the refinements in surgical technique. We aimed to define and discuss the role of postoperative urinary drainage on AS development. PATIENTS AND METHODS:A total of 136 patients with localized pr...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-007-9309-4
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Glomerular hyperfiltration commonly associated with obesity is expected to improve postbariatric surgery. However, formula-based glomerular filtration rate (GFR) estimation in these patients is limited by body size confounders necessitating use of modified equations, the reliability of which remains uncertai...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0131-2
更新日期:2013-02-01 00:00:00
abstract::Reduced peritoneal clearances of creatinine and urate were demonstrated repeatedly in a patient with scleroderma and a patient with diabetes mellitus. Urea clearances were not significantly different from usual values. The findings suggest decreased peritoneal membrane permeability and/or area (if urea clearance is fl...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02082213
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To describe our experience with Hydro-Jet-assisted laparoscopic partial nephrectomy (LPN) with no renal arterial clamping in 35 patients with renal cell carcinoma. METHODS:Hydro-Jet technique was used to incise the renal parenchyma, dissect the intrarenal vessels and collecting system during the LPN procedur...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-014-0670-9
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:To investigate whether an elevated serum uric acid (SUA) level is an independent risk factor for rapid decline in renal function or new-onset chronic kidney disease (CKD) in a Chinese health checkup population. METHODS:A cohort study of 6495 Chinese individuals who underwent health checkups with normal estimat...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1732-6
更新日期:2018-03-01 00:00:00
abstract::In recent years, the role of trace elements in lithogenesis has received steadily increasing attention. It is well documented that some trace elements can influence the morphology and speed of the crystallization process. Zinc has been found in significant amounts in calcium stones relative or organic stones (uric aci...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-017-1784-7
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVES:To study the impact of radical tumour surgery in prostate and renal cell cancer patients on quality of life (QOL). METHODS:In 38 male patients suffering from organ-confined prostate or renal cell cancer, a prospective study was performed. For the evaluation of QOL, we used the EMPK (Erfassung multipler psyc...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02552179
更新日期:1997-01-01 00:00:00
abstract:PURPOSE:In low and middle- income countries, due to lack of financial resources, the number of patients receiving one or two hemodialysis (HD) sessions a week has increased, leading to a large number of complications. Protein-energy wasting (PEW) and overhydration (OH) are common complications; nevertheless, the eviden...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02697-3
更新日期:2021-01-04 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD). Epicardial adipose tissue (EAT) is an independent predictor of cardiovascular disease in the general population, and usually increases in the patients with cardiovascular disease risk. The change of EAT in...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02575-y
更新日期:2020-12-01 00:00:00
abstract::We present a case of migration of the left renal vein (LRV) stent into the right ventricle in a patient with nutcracker syndrome. After a failed attempt of percutaneous endovascular removal of the stent, the stent in the heart was removed by open cardiac surgery, another stent was placed into the LRV via a puncture in...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-008-9478-9
更新日期:2009-01-01 00:00:00
abstract::We report a case of a urothelial carcinoma with trophoblastic differentiation of the bladder that occured in a 23-year-old man. The patient presented with hematuria. Multiple papillary masses were resected transurethrally. Histopathologically, grade III urothelial cell carcinoma contained giant cells that were positiv...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1007/s11255-004-0859-4
更新日期:2004-01-01 00:00:00
abstract::Patients with metastatic prostate cancer respond to androgen withdrawal therapy, but progression to androgen independence is frequently observed. To clarify the predictor of response to endocrine therapy, the role of PSA changes and the prognosis of the patients were evaluated in 115 Japanese cases of prostate cancer ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1023/a:1014410026495
更新日期:2001-01-01 00:00:00
abstract::Using the materials of more than 200 scientific papers of recent years in this review it has been carried out analysis of the effectiveness and also discussed the merits and demerits of various methods of treatment of urinary stone diseases (USD). With this purpose, for the first time it has been carried out analysis ...
journal_title:International urology and nephrology
pub_type: 杂志文章,评审
doi:10.1023/a:1015282526252
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Although sleep complaints are commonly reported in persons with end stage renal disease (ESRD), little is known about the prevalence of sleep complaints in chronic kidney disease (CKD), and the relation of sleep quality to the severity of kidney disease. METHODS:We administered the Kidney Disease Quality of...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-004-4654-z
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:Fatigue and depressed mood are considered main impediments to physical activity in haemodialysis (HD) patients. A better understanding of their interrelationships is crucial to develop effective therapies. Moreover, measurement of daily physical activity (DPA) in HD patients is tricky, as it is usually assess...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02578-9
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To investigate whether stone dimension is a restrictive factor for ureterorenoscopic procedures. MATERIALS AND METHODS:A group of 416 patients who had undergone ureterorenoscopic pneumatic lithotripsy (URS-PL) for lower ureteral stones between January 1999 and June 2006 in our clinic had been evaluated retro...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-007-9278-7
更新日期:2008-01-01 00:00:00
abstract:PURPOSE:Sodium polystyrene sulfonate (SPS) is a cation-exchanging resin that has been widely used for several decades as first-line therapy of mild chronic hyperkalemia in patients with chronic kidney disease (CKD). However, evidence to prove the long-term tolerability and efficacy of SPS for the treatment of this cond...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1717-5
更新日期:2017-12-01 00:00:00
abstract::Gleason score has been identified as an important variable to predict disease extent and biologic behaviour of prostate cancer. However, the correlation between Gleason score of needle biopsy and surgical specimen is often poor. We studied 72 patients who underwent needle biopsy and radical prostatectomy to correlate ...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550548
更新日期:1998-01-01 00:00:00
abstract:PURPOSE:Our aim was to compare the different characteristics and outcomes of the Amplatz sheaths and single-step metallic dilators which were used for mini-PCNL procedure in a single institution. METHODS:Retrospective medical records of 236 patients who underwent mini-PCNL were reviewed and divided into Amplatz (n = 1...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-017-1516-z
更新日期:2017-04-01 00:00:00