Abstract:
Description:The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods:Development of the guideline update followed an explicit process of evidence review and appraisal. The approach adopted by the Work Group and the evidence review team was based on systematic reviews of relevant trials, appraisal of the quality of the evidence, and rating of the strength of recommendations according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Searches of the English-language literature were conducted through September 2015 and were supplemented with targeted searches through February 2017. Final modification of the guidelines was informed by a public review process involving numerous stakeholders, including patients, subject matter experts, and industry and national organizations. Recommendations:The update process resulted in the revision of 15 recommendations. This synopsis focuses primarily on recommendations for diagnosis of and testing for CKD-MBD and treatment of CKD-MBD that emphasizes decreasing phosphate levels, maintaining calcium levels, and addressing elevated parathyroid hormone levels in adults with CKD stage G3a to G5 and those receiving dialysis. Key elements include basing treatment on trends in laboratory values rather than a single abnormal result and being cautious to avoid hypercalcemia when treating secondary hyperparathyroidism.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Ketteler M,Block GA,Evenepoel P,Fukagawa M,Herzog CA,McCann L,Moe SM,Shroff R,Tonelli MA,Toussaint ND,Vervloet MG,Leonard MBdoi
10.7326/M17-2640subject
Has Abstractpub_date
2018-03-20 00:00:00pages
422-430issue
6eissn
0003-4819issn
1539-3704pii
2672941journal_volume
168pub_type
杂志文章,实务指引abstract:Background:The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M16-1536
更新日期:2017-06-20 00:00:00
abstract::Acute bronchitis is an acute cough illness in otherwise healthy adults that usually lasts 1 to 3 weeks. This review describes the pathophysiology of the condition and provides a practical approach to the evaluation and treatment of adults with uncomplicated acute bronchitis. Practical points to be made are:1. Respirat...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-133-12-200012190-00014
更新日期:2000-12-19 00:00:00
abstract:BACKGROUND:The appropriate roles for several diagnostic tests for coronary disease are uncertain. OBJECTIVE:To evaluate the cost-effectiveness of alternative approaches to diagnosis of coronary disease. DESIGN:Meta-analysis of the accuracy of alternative diagnostic tests plus decision analysis to assess the health ou...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-130-9-199905040-00003
更新日期:1999-05-04 00:00:00
abstract:BACKGROUND:Travelers' diarrhea causes substantial morbidity and postinfectious irritable bowel syndrome. OBJECTIVE:To evaluate nonabsorbable rifaximin for prevention of travelers' diarrhea. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Guadalajara, Mexico. PARTICIPANTS:U.S. students. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-10-200505170-00005
更新日期:2005-05-17 00:00:00
abstract::Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, symptom management, and end-of-life care is crucial. This article ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC201803060
更新日期:2018-03-06 00:00:00
abstract:BACKGROUND:Left bundle-branch block (BBB) is considered an important predictor of poor outcome in patients with acute myocardial infarction, but the consequences of right BBB are not well understood. OBJECTIVES:To 1) estimate the prevalence of left and right BBB in patients with myocardial infarction; 2) compare the c...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-129-9-199811010-00003
更新日期:1998-11-01 00:00:00
abstract::Sideroblastic anemia after treatment for Hogdkin's disease was seen in two patients 3 years after completion of radiation therapy and chemotherapy. This was followed in both by the development of myelomonoblastic leukemia. No evidence of recurrent Hodgkin's disease was present in either patient. Our observation sugges...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-5-625
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:Testing has been advocated for all persons with newly diagnosed colorectal cancer to identify families with the Lynch syndrome, an autosomal dominant cancer-predisposition syndrome that is a paradigm for personalized medicine. OBJECTIVE:To estimate the effectiveness and cost-effectiveness of strategies to i...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-155-2-201107190-00002
更新日期:2011-07-19 00:00:00
abstract:BACKGROUND:Sleep-related accidents often involve healthy young persons who are driving at night. Coffee and napping restore alertness, but no study has compared their effects on real nighttime driving performances. OBJECTIVE:To test the effects of 125 mL of coffee (half a cup) containing 200 mg of caffeine, placebo (d...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-144-11-200606060-00004
更新日期:2006-06-06 00:00:00
abstract::The coexistence of chronic idiopathic thrombocytopenic purpura and myasthenia gravis has been infrequently reported. We report another case and show the coexistence of autoantibodies to the platelet glycoprotein IIb and IIIa complex and the acetylcholine receptor. Autoantibody levels were followed during 8 weeks of tr...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-100-6-829
更新日期:1984-06-01 00:00:00
abstract::The 1986 False Claims Act Amendments authorize private citizens to sue on behalf of the U.S. government to recover federal funds from fraudulent recipients. The "relator" receives a share of any proceeds from a successful lawsuit. Originally enacted because of defense procurement scandals, this statute also applies to...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-114-12-1050
更新日期:1991-06-15 00:00:00
abstract::This article applies major economic concepts, such as supply, demand, monopoly, monopsony, adverse selection, and moral hazard, to central features of U.S. health care. These illustrations help explain some of the principal problems of health policy-high cost and the uninsured-and why solutions are difficult to obtain...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-1183
更新日期:2015-03-03 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract::Streptococcus pneumoniae causes substantial morbidity and mortality. Incidence and severity are increased among populations with some chronic diseases. The currently available polyvalent polysaccharide vaccine induces antibody production among immunologically competent recipients against the 14 serotypes responsible f...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-96-2-208
更新日期:1982-02-01 00:00:00
abstract::Hearing loss is highly prevalent and may significantly affect how we age. Although the population is aging, relatively few adults receive treatment for hearing loss. Internists are a critical partner to audiologists and otolaryngologists in caring for the adult population with hearing loss. This review provides a prim...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC202012010
更新日期:2020-12-01 00:00:00
abstract::Neuropathologic and neurochemical studies of older adults with Down's syndrome and those with Alzheimer's disease reveal striking similarities. Genetic studies indicate that near relatives of patients with Alzheimer's disease are at increased risk of developing Alzheimer's disease, and the risk appears to be age speci...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-4-566
更新日期:1985-10-01 00:00:00
abstract::Six patients with rheumatoid arthritis developed a syndrome resembling lupus erythematosus while being treated with penicillamine. All patients had previous mucocutaneous reactions to chrysotherapy. Manifestations included pleurisy in five of six patients, rashes in three, nephritis in two, and neurologic disturbances...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-5-659
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:Health care workers are at occupational risk for a vast array of infections that cause substantial illness and occasional deaths. Despite this, few studies have examined the incidence, prevalence, or exposure-associated rates of infection or have considered infection-specific interventions recommended to mai...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-125-10-199611150-00007
更新日期:1996-11-15 00:00:00
abstract:OBJECTIVE:To describe the diagnostic difficulties, response to therapy, and clinical features of lymphomatoid papulosis and the cumulative frequency of transformation to lymphoma. DESIGN:Case series. SETTING:University hospitals. METHODS:The records of 21 patients with lymphomatoid papulosis who were seen from 1986 ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-3-199502010-00009
更新日期:1995-02-01 00:00:00
abstract:Background:Central line-associated bloodstream infection (CLABSI) remains prevalent in hospitals in the United States. Objective:To evaluate the impact of a multimodal intervention in hospitals with elevated rates of health care-associated infection. Design:Pre-post observational evaluation of a prospective, national...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-3533
更新日期:2019-10-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the association between current non-aspirin nonsteroidal anti-inflammatory drug (NSAID) use and fatal peptic ulcers or upper gastrointestinal hemorrhage. DESIGN:Nested case control study using a linked Medicaid-death certificate database. SETTING:Tennessee Medicaid enrollees aged 60 and g...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-109-5-359
更新日期:1988-09-01 00:00:00
abstract:Background:A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose:To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources:Ov...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-2458
更新日期:2017-04-04 00:00:00
abstract::The 1950s witnessed prodigious growth in our knowledge of the chemical nature of the gene, the mechanisms by which the information inherent in its sequence of nucleotide units was conveyed to the cell's machinery for synthesizing proteins, and the mode of operation of that machinery. Watson and Crick raised the curtai...
journal_title:Annals of internal medicine
pub_type: 评论,历史文章,杂志文章
doi:10.7326/0003-4819-138-7-200304010-00016
更新日期:2003-04-01 00:00:00
abstract::Although the efficacy of hepatitis vaccine is well documented, the duration of immunity of healthy adults after vaccination is unknown. We studied 245 hospital employees 3 years after primary vaccination with hepatitis B vaccine to determine the prevalence of immunity indicated by levels of antibody to hepatitis B sur...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-2-185
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Although several agents are available to treat osteoporosis, the relative efficacy and toxicity of these agents when used to prevent fractures has not been well described. PURPOSE:To compare the benefits in fracture reduction and the harms from adverse events of various therapies for osteoporosis. DATA SOU...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-148-3-200802050-00198
更新日期:2008-02-05 00:00:00
abstract::In recent years there has been increasing attention to the appropriate interpretation of a clinical study. One special concern has been the difficulty inherent in interpreting studies that were not statistically significant: Was the sample size sufficient to detect a clinically important effect if, in fact, it existed...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-2-248
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Primary aldosteronism is a common cause of treatment-resistant hypertension. However, evidence from local health systems suggests low rates of testing for primary aldosteronism. OBJECTIVE:To evaluate testing rates for primary aldosteronism and evidence-based hypertension management in patients with treatmen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-4873
更新日期:2020-12-29 00:00:00
abstract:OBJECTIVE:To evaluate the safety and efficacy of all-trans retinoic acid to induce complete remission and to examine its effects on duration of remission and survival in patients with acute promyelocytic leukemia. DESIGN:Phase II evaluation and comparison with historical control patients. SETTING:Tertiary care cancer...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-120-4-199402150-00004
更新日期:1994-02-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the clinical variables affecting outcome after balloon aortic valvuloplasty. DESIGN:Longitudinal follow-up of consecutive case series. PATIENTS:Consecutive sample of 36 patients with severe calcific aortic stenosis, and without active infection or left ventricular mural thrombus. INTERVE...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-110-6-421
更新日期:1989-03-15 00:00:00
abstract::Smoking remains the leading cause of preventable death in the United States, yet it is still regarded by many as merely a bad habit. Most smokers want to quit but find it difficult. Behavioral counseling and pharmacotherapies are available, safe, and effective in the treatment of tobacco dependence. Nicotine replaceme...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-148-7-200804010-00012
更新日期:2008-04-01 00:00:00