Abstract:
BACKGROUND:The success of guidelines depends largely on effective implementation and uptake in clinical practice. The Optimal Renal Anemia Management Assessment (ORAMA) study investigated the impact of European Best Practice Guideline (EBPG) prompting on patient outcomes. METHODS:ORAMA was a prospective, international, multicenter, cluster-randomized study. Fifty-three centers in eight European countries enrolled patients with chronic kidney disease stage V receiving chronic dialysis. Patients were either anemic (hemoglobin [Hb] <11 g/dL [110 g/L]) or treated with erythropoiesis stimulating agents and/or iron supplementation. Centers were randomized to two groups, with or without access to a computerized clinical decision support (CDS) system. In a post hoc analysis,patients were further subdivided into adherence or non-adherence of investigators to the EBPG regardless of CDS usage. Primary endpoint was the proportion of patients with Hb >11 g/ dL (110 g/L), reflecting hematological targets in the revised EPBG. RESULTS:In this population of 599 dialysis patients, hematological targets did not differ in the presence or absence of a CDS system. There was a general shift towards improved patient distribution by Hb categories while the width of the distribution curves remained unchanged. The proportion of patients with Hb >11 g/dL (110 g/L) was higher among adherers (79% and 84% with or without CDS use, respectively) than non-adherers (59% and 57%, respectively). CONCLUSIONS:ORAMA is the first international study to show that adherence to EBPG improved attainment of anemia indices. The availability of a CDS system did not affect anemia management.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Locatelli F,Covic A,Macdougall IC,Scherhag A,Wiecek A,ORAMA Study Group.subject
Has Abstractpub_date
2009-09-01 00:00:00pages
662-74issue
5eissn
1121-8428issn
1724-6059journal_volume
22pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Targeted screening interventions for chronic kidney disease (CKD) are increasingly being implemented in various community settings. However, the overall success of these programs is uncertain. Therefore, the aim of this review is to determine whether targeted screening is effective in detecting people with u...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0375-0
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:End stage renal disease (ESRD) is associated with a high incidence of cardiovascular disease and cancer. Patients undergoing hemodialysis show a reduced number and an impaired function of endothelial progenitor cells (EPCs), which in physiological conditions contribute to repair the vascular damage. In pat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:There have been many studies in recent years concerning the role of nitric oxide (NO) in acute renal failure (ARF). In this study, the effects of the inhibition or the induction of NO synthase (NOS) on gentamicin-induced ARF was investigated in isolated perfused rat kidneys. METHODS:Kidneys from male Spragu...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-09-01 00:00:00
abstract::Hypertension is a risk factor for cardiovascular and renal organ damage. Environmental conditions affect the development of high blood pressure (BP), although genetic influences are also important. Current international guidelines recommend reducing dietary sodium to no more than 100 mmol (about 2.4 g sodium or approx...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Previous in vitro experiments of human polycystic kidney disease (PKD) cells reported that caffeine is a risk factor for the promotion of cyst enlargement in patients with autosomal dominant PKD (ADPKD). The relentless progression of ADPKD inclines the majority of physicians to advocate minimization of caffe...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-017-0396-8
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Rituximab (RTX) is approved for remission induction in ANCA associated vasculitis (AAV). However, data on use of RTX in patients with severe renal disease is lacking. METHODS:We conducted a retrospective multi-center study to evaluate the efficacy and safety of RTX with glucocorticoids (GC) with and without...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.1007/s40620-015-0208-y
更新日期:2016-04-01 00:00:00
abstract::Hyperlipidaemia complicating the nephrotic syndrome is characterised by elevated levels of total and LDL cholesterol, often with hypertriglyceridaemia and low HDL cholesterol levels. The underlying mechanisms are complex but involve abnormalities of both lipoprotein synthesis and catabolism. Experience to date suggest...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2001-11-01 00:00:00
abstract::Page kidney was first described in animal experiments in 1939. In the 1950s and 1960s the human counterpart became evident. In this review we examine the modest literature on this rare but important renal/urological complication, summarize the clinical features, and discuss the best approach to diagnosis and managemen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To investigate the pregnancy outcomes for patients with stage 3-4 chronic kidney disease (CKD) and the effects of pregnancy on kidney function. METHODS:Clinical data of pregnant women with CKD in the Peking University First Hospital between January 1st 2005 and October 1st 2016 were retrospectively analysed....
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0509-z
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The therapeutic effects of immunosuppressive agents such as cyclosporin A, mycophenolate mofetil, rituximab and sirolimus on primary focal segmental glomerulosclerosis (FSGS) remain controversial. The present study was intended to review and analyze the treatment results of immunosuppressive agents for prima...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000092
更新日期:2012-09-01 00:00:00
abstract::Chyluria results from an abnormal connection between lymphatic bed and urinary tract, causing lymph leakage into the urine. The clinical picture often begins with the appearance of cloudy, milky urines accompanied by monolateral flank pain, malnutrition, weight loss and weakness. We report a case of chyluria that occu...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/JN.2011.8355
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:To report clinical symptoms and outcome of systemic paraphenylene diamine (PPD) intoxication. METHODS:Our study was retrospective. It was conducted over 6 yrs (1994-2000) in the medical intensive care unit (ICU) of a university hospital and it concerned 19 patients hospitalized for systemic PPD intoxication...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract::Membranous glomerulopathy (MGN) is a frequent cause for nephrotic syndrome in adults. In this overview, the basic pathogenic features of Heymann nephritis, a "classical" model of MGN in rats, are compared with those of human MGN. While the pathogenic antigen(s) of rat Heymann nephritis (the polyspecific receptor prote...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-11-01 00:00:00
abstract::Osteoporosis and chronic kidney disease (CKD) have both independently important potential impact on bone health. A significant number of patients with CKD stages 3a-5D have been shown to have low bone mineral density (BMD), leading to a strikingly elevated risk of fractures (mainly hip fractures) and higher associated...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0404-z
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND METHODS:Smoking is associated with hyperparathyroidism in the elderly general population and nicotine, the main component of tobacco smoke, stimulates PTH release in experimental models. Although smoking is a persisting problem in patients with end-stage renal disease (ESRD), the association between smok...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/JN.2011.7740
更新日期:2012-01-01 00:00:00
abstract:AIMS:Nonsteroidal anti-inflammatory drugs (NSAIDs) are the cornerstone of pain management. There are no detailed data on NSAIDs use in Poland, especially in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the frequency, circumstances, and causes of NSAIDs use as well as knowledge of th...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-016-0352-z
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Cardiovascular (CV) diseases are the main cause of death in maintenance hemodialysis (MHD) patients. Muscle wasting and physical function decline are common in MHD patients, and significantly impair their quality of life. These can result from abnormalities in cardiac function, which can be further worsened ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-015-0188-y
更新日期:2015-12-01 00:00:00
abstract::Dynamic progress in the basic sciences such as clinical chemistry exerted a great influence on the development of clinical science in medicine in the 19th century. We should rate Prof. Leon Marchlewski among the group of prominent foreign and Polish scientists working in that period. Marchlewski was born in 1869 in Wl...
journal_title:Journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.5301/JN.2011.6454
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:NKF K-DOQI clinical practice guidelines recommend a regular monitoring of vascular access (VA) through several methods, such as VA recirculation (AR). Assessment of AR is crucial to avoid inefficiency of hemodialysis (HD). A non-urea based method has been developed (ultrasound dilution Transonics Hemodialysi...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract::A 17-year-old boy was admitted to the hospital twice in a year for 2 episodes of hemolytic uremic syndrome (HUS). During these 2 HUS episodes he had diarrhea, decreased serum complement, decreased total protein and decreased serum albumin concentrations. We suggest that protein-losing enteropathy and hypocomplementemi...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:With improvements in technology, renal biopsies have become safer and could potentially be effectively carried out in the outpatient setting. The purpose of our study is to compare the safety and cost of performing outpatient versus inpatient renal biopsies at a single Northern California pediatric hospital....
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::Diabetic nephropathy (DN) is a common complication of Diabetes Mellitus (DM) Types 1 and 2, and prevention of end stage renal disease (ESRD) remains a major challenge. Despite its high prevalence, the pathogenesis of DN is still controversial. Initial glomerular disease manifested by hyperfiltration and loss of glomer...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0423-9
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The patient characteristics and course of HlV/AIDS-associated nephropathy (HIVAN) are presented for a national sample of end-stage renal disease (ESRD). METHODS:375,152 patients in the United States Renal Data System were initiated on ESRD therapy between 1 January 1992 and 30 June 1997 and analyzed in an h...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:The recent multicenter, randomized, open-label INDEPENDENT study demonstrated that sevelamer improves survival in new to hemodialysis (HD) patients compared with calcium carbonate. The objective of this study was to determine the cost-effectiveness of sevelamer versus calcium carbonate for patients new to HD...
journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s40620-014-0122-8
更新日期:2015-10-01 00:00:00
abstract::The term thin glomerular basement membrane disease (TBMD) refers to a condition characterised by thinning of the GBM at electron microscopy examination and, clinically, by isolated hematuria, frequently occurring in other family members, with no extra-renal manifestations. Progression towards chronic renal failure (CR...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::Highly concentrated marine polyunsaturated fatty acids (n-3 PUFA), affecting the lipids and lipophilic drugs metabolism, can interfere with cyclosporine (CyA) pharmacokinetics. This prospective, randomized and placebo-controlled, double-blind study involved 42 kidney graft recipients. From day +1, 21 pts (E) received ...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-03-01 00:00:00
abstract::The hallmark of IgA nephropathy (IgAN) is macroscopic hematuria coinciding with, or immediately following, a mucosal infection, usually of the upper respiratory airways. The role of mucosal pathogens has been proven in different experimental models. Mucosal (or innate) immunity acts through the recognition of pathogen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract::Replacement of dietary saturated fat with unsaturated fat has been recommended for prevention of cardiovascular disease (CVD) in the general population. Less is known of the health risks in individuals with chronic kidney disease (CKD), of a diet with an unhealthy fat profile, in general characterized by insufficient ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000284
更新日期:2013-11-01 00:00:00
abstract::Klaus Hierholzer (1929-2007) dissected various functions influenced by steroids in the distal tubule and showed that aldosterone in low doses reversed the sodium and potassium transport defect in adrenalectomized rats, through a rapid activation of Na+,K+-ATPase. Subsequent studies addressed the role of 11-beta-hydrox...
journal_title:Journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2009-11-01 00:00:00
abstract::There have been dramatic increases in the understanding of the molecular mechanisms involved in membranous nephropathy (MN) over the past 2 decades. Most of these have come directly from studies carried out in the Heymann nephritis models of MN in rats, which closely simulate the clinical and pathologic features of th...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2006-11-01 00:00:00