Abstract:
BACKGROUND:Three million people in the United States are estimated to have chronic kidney disease (CKD). Management of these CKD patients in the outpatient primary care clinic setting has not been well studied. HYPOTHESIS:Primary care management of CKD can be assessed and opportunities for improvement can be identified. METHODS:Management of CKD based on available published literature and guidelines was assessed in a single primary care site of an academic hospital with 23,000 annual visits and 8,300 patients. Charts of patients seen between October 1, 1997 and March 25, 1999 with an elevated SCr > or = 1.7 mg/dl on two separate measurements at least 6 months apart were reviewed for predefined indicators of CKD management. RESULTS:Assessment identified several aspects of CKD management to be suboptimal: control of blood pressure, use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, assessment of proteinuria, and renal consultation. Better management was found with respect to hemoglobin A1c measurement for diabetic patients. In general, CKD care was similar for diabetic and non-diabetic patients. CKD management was also similar regardless of level of creatinine clearance (> or = 50 vs. 50-30 vs. < or = 30 ml/min). CONCLUSION:CKD care can be measured in an outpatient academic primary care clinic and opportunities to improve were identified.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Israni A,Korzelius C,Townsend R,Mesler Ddoi
10.1159/000066296subject
Has Abstractpub_date
2003-01-01 00:00:00pages
47-54issue
1eissn
0250-8095issn
1421-9670pii
ajn23047journal_volume
23pub_type
杂志文章abstract::A variety of histologic changes have been observed in the kidneys of patients with light-chain deposition disease. We report 3 cases with kappa light chain deposition who presented with diverse clinical, histological, and ultrastructural features. All the cases were diagnosed by the presence of monoclonal kappa light ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167600
更新日期:1988-01-01 00:00:00
abstract::Thirty-one renal transplant recipients, submitted to treatment with cyclosporin in association with other immunosuppressive agents, were also treated for 9 months with two hydroxymethylglutaryl coenzyme A reductase inhibitors, simvastatin (10 mg/day) or pravastatin (20 mg/day), for concomitant hypercholesterolemia and...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013487
更新日期:1999-01-01 00:00:00
abstract::A patient with renal failure due to myeloma kidney and coincident digitalis intoxication due to prescribed daily digoxin administration was treated with digoxin-specific antibody fragments and plasmapheresis. Rapid response to therapy was noted, removal of digoxin-antidigoxin antibody complexes was confirmed, and prev...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168179
更新日期:1990-01-01 00:00:00
abstract::Collapsing glomerulopathy is a pattern of renal injury that is seen in association with human immunodeficiency virus (HIV) infection. Patients with this HIV-associated nephropathy (HIVAN) present nephrotic syndrome and rapid deterioration of the renal function. There is no proven effective therapy for HIVAN, and the m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065229
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND/AIMS:Cisplatin (CIS) induces nephrotoxicity partly through renal vasoconstriction and decreased glomerular filtration effects thought to involve adenosine acting on adenosine A(1) receptors (A1Rs). We studied the effect of the orally active, A1R antagonist tonapofylline (BG9928) on biochemical measures of re...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000248762
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:Three different apo E alleles (E2, E3 and E4) produce apo E isoproteins, which regulate the metabolism of lipoproteins. This study investigated the apo E polymorphisms as a prognostic factor for the development of diabetic nephropathy (DN). METHODS:A total of 525 type 2 diabetic patients were enrolled ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000324561
更新日期:2011-01-01 00:00:00
abstract::The purpose of our study was to investigate the feasibility of using lactate as a complete or partial substitute for acetate in hemodialysis solutions. Six patients, each serving as his own control, were dialyzed once against a dialysis solution containing 40 mM acetate, once against a dialysis solution containing 40 ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000167515
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/AIM:Nephropathy after ingestion of Chinese herbs is known as a rapidly progressive form of interstitial renal fibrosis after a slimming regimen containing aristolochic acid that was identified first in Belgium. Intake of traditional Chinese herbal medicines is very popular in Taiwan. So we looked for similar...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046647
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND/AIMS:Studies have shown that kidney injury molecule-1 (KIM-1) is upregulated in damaged renal proximal tubules. In this study, we examined KIM-1 expression in glomerular epithelial cells in diabetic glomerulopathy. METHODS:Renal histology, immunostaining and Western blot for protein level, and real-time PCR...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000330187
更新日期:2011-01-01 00:00:00
abstract:AIM:The relation of ambient temperature (AMT) and relative humidity to systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight (BW), and body weight gain between dialysis sessions (DeltaBW) was examined in hemodialysis patients by Fourier analysis. METHODS AND RESULTS:The authors recruited 144 dialy...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013538
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Increased mortality and morbidity are reported in association with high ultrafiltration rate (UFR) and with long dialysis recovery time (DRT). We studied the association between UFR and DRT. METHODS:This is a cross-sectional, observational study was conducted. Patients on thrice-weekly hemodialysis (HD) wit...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000476076
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000358496
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs frequently in the intensive care unit. A primary cause is renal ischemia/reperfusion (I/R) injury, during which excess reactive oxygen species (ROS) are produced. ROS subsequently damage renal cells, leading to the development of AKI. Here, we investigated whether renal I/R i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000327820
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Despite the significant morbidity and mortality attributable to cardiovascular disease (CVD), risk stratification remains an important challenge in the chronic kidney disease (CKD) population. We examined the discriminative ability of noninvasive measures of atherosclerosis, including carotid intima-media th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000342794
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Hypertension often accompanies chronic kidney disease (CKD), and diuretics are widely prescribed to reduce blood pressure (BP). Chlorthalidone (CTD) is a thiazide-like diuretic and an effective antihypertensive drug, yet little data exist to support its use in treating hypertension in individuals with advanc...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000508700
更新日期:2020-01-01 00:00:00
abstract::We describe an elderly women who died of renal failure secondary to spontaneous renal atheroembolic disease. The sole clinical clue to this diagnosis was a profound eosinophilia up to 19,100/mm3 and a relative eosinophil count of 80%. Renal atheroembolic disease should be a prominent consideration in any patient with ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168476
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND/AIMS:We examined the correlations between renal biopsy findings in Wegener's granulomatosis and renal function at baseline and 1 year in 22 patients who presented between 1988 and 1999. METHODS:Renal histology was independently reviewed by 2 pathologists who were masked to the clinical data. The primary out...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065283
更新日期:2002-09-01 00:00:00
abstract::The effects of cisplatin (5 mg/kg BW given intraperitoneally) on renal concentration mechanism were evaluated initially by clearance studies in rats 5-7 days after cisplatin administration and compared to normal rats. During hypotonic saline infusion, cisplatin rats showed a lower inulin clearance (0.56 +/- 0.07 vs. 1...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167938
更新日期:1989-01-01 00:00:00
abstract::Vascular access thrombosis is more common with polytetrafluoroethylene (PTFE) grafts than with native arteriovenous fistulae (AVF). Recent studies report an unexplained excess vascular access morbidity in women on hemodialysis. We studied 92 consecutive end-stage renal disease (ESRD) patients receiving their first per...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169135
更新日期:1997-01-01 00:00:00
abstract::A young woman presented with nephrotic syndrome due to membranous nephropathy and a localized form of giant lymph node hyperplasia (Castleman's disease) occurring as a large intra-abdominal mass. Five months after surgical removal of the mass, only mild proteinuria persisted. Twenty months later a second kidney biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168127
更新日期:1990-01-01 00:00:00
abstract::The use of Dacron cuff double-lumen permanent catheters for hemodialysis has become more common in the dialysis unit as patients await for creation or maturation of a permanent hemoaccess for various reasons. Placement of these catheters is often done by surgeons. Nephrologists skilled in the placement of temporary ce...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013425
更新日期:1999-01-01 00:00:00
abstract::We analyzed routine serum potassium concentration measurements and conditions temporally associated with abnormalities in potassium concentration in outpatients on chronic hemodialysis (136 nondiabetics, 36 diabetics) and continuous ambulatory peritoneal dialysis (16 nondiabetics, 10 diabetics). The following potassiu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167443
更新日期:1987-01-01 00:00:00
abstract::Administration of a single dose of 1,25-OH(2)D(3) can lower PTH levels for up to 4 days in chronic hemodialysis patients. Our purpose was to verify the effects of the same weekly dose of calcitriol per os given in one, two or three administrations, to patients on dialysis with secondary hyperparathyroidism. Thirty pat...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000046197
更新日期:2000-11-01 00:00:00
abstract::Dialysis patients have increased susceptibility to infection and this is, in part, due to impaired phagocytic and bactericidal activities of polymorphonuclear leukocytes (PMNL). The mechanisms responsible for the reduced phagocytosis are not known. Dialysis patients have elevated blood levels of parathyroid hormone (P...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168284
更新日期:1991-01-01 00:00:00
abstract::Skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046263
更新日期:2001-07-01 00:00:00
abstract::Forty-eight chronic hemodialysis patients were divided comparably into two groups (24 patients in each). Two micrograms of 1 alpha(OH)D3 was administered to one group for 3 months and its placebo to the other group. In the 1 alpha(OH)D3-treated group, serum total calcium increased from 7.82 +/- 0.11 (mean +/- SEM) to ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000167658
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Nephrology research is expanding, and harnessing the much-needed information and data for the practice of evidence-based medicine is becoming more challenging. In this study, we used the natural language processing and text mining approach to mitigate some of these challenges. METHODS:We analyzed 17,412 abs...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000504871
更新日期:2020-01-01 00:00:00
abstract::In 1828, Friedrich Wöhler, a German physician and chemist by training, published a paper that describes the formation of urea, known since 1773 to be a major component of mammalian urine, by combining cyanic acid and ammonium in vitro. In these experiments the synthesis of an organic compound from two inorganic molecu...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013463
更新日期:1999-01-01 00:00:00
abstract::Atherosclerotic diseases (ASD) are the major cause of mortality and morbidity in patients on hemodialysis (HD). To evaluate the significance and usefulness of atherogenic indices, we examined lipoprotein(a) (Lp(a)), remnant-like particles cholesterol (RLP.C), homocysteine (Hcy), cardiac troponin T (TnT), and ankle-arm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013566
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Hypercholesterolemia is one of the major manifestations of nephrotic syndrome. We have previously shown that nephrotic hypercholesterolemia is associated with and, in part, due to dysregulation of hepatic HMG-CoA reductase, acyl-CoA:cholesterol acyltransferase (ACAT) and cholesterol 7alpha-hydroxylase, as we...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000082510
更新日期:2004-11-01 00:00:00