Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · May 2008
Multicenter Study Comparative StudyA comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients.
The Acute Dialysis Quality Initiative Group has published a consensus definition/classification system for acute kidney injury (AKI) termed the RIFLE criteria. The Acute Kidney Injury Network (AKIN) group has recently proposed modifications to this system. It is currently unknown whether there are advantages between these criteria. ⋯ Compared to the RIFLE criteria, the AKIN criteria do not materially improve the sensitivity, robustness and predictive ability of the definition and classification of AKI in the first 24 h after admission to ICU.
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Nephrol. Dial. Transplant. · May 2008
Multicenter StudyAgalsidase therapy in patients with Fabry disease on renal replacement therapy: a nationwide study in Italy.
In Fabry disease, end-stage renal disease (ESRD) and severe neurologic and cardiac complications represent the leading causes of late morbidity and mortality. A comprehensive Italian nationwide survey study was conducted to explore changes in cardiac status and renal allograft function in Fabry patients on renal replacement therapy (RRT) and enzyme replacement therapy (ERT). ⋯ Kidney transplantation should be the standard of care for Fabry patients progressing towards ESRD. Transplanted Fabry patients on ERT may do better than patients remaining on maintenance dialysis. Larger, controlled studies in Fabry patients with ESRD will have to demonstrate if ERT is able to change the trajectory of cardiac disease and can preserve graft renal function.
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Nephrol. Dial. Transplant. · Apr 2008
Multicenter Study Comparative StudyA multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients.
The Acute Dialysis Quality Initiative Working Group recently developed the RIFLE criteria, a consensus definition for acute kidney injury (AKI). We sought to evaluate the RIFLE criteria on the day of ICU admission in a large heterogenous population of critically ill patients. ⋯ In a large heterogenous cohort of critically ill patients, the RIFLE criteria classified >36% with AKI on the day of admission. For successive increases in severity of RIFLE category, there were increases in hospital mortality. The RIFLE criteria represent a simple tool for the detection and classification of AKI and for correlation with clinical outcomes.
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Nephrol. Dial. Transplant. · Aug 2007
Multicenter StudyBurnout in health care providers of dialysis service in Northern Italy--a multicentre study.
Few data are available regarding the prevalence of burnout among dialysis health care workers. Aims of the present study were to assess and compare burnout levels in a sample of nurses and physicians working in dialysis units, and to investigate their relationships with quality of life, in a cross-sectional observational study. ⋯ Although burnout is not a general problem in dialysis health care providers, a subgroup of them may be identified, who would benefit from supportive measures to prevent this condition. Nurses appeared more burned-out in the emotional exhaustion scale than physicians.
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Nephrol. Dial. Transplant. · Jul 2007
Multicenter StudyItchy skin--a clinical problem for haemodialysis patients.
Uraemic pruritus affects many patients receiving chronic dialysis therapy for end-stage renal disease. It is a distressing symptom which has a negative impact on quality of life (QoL) of the patients. The condition is also very frustrating for both patients and physicians since no effective treatment for relief of the itch has been demonstrated. The pathophysiological mechanisms of pruritus are mainly unknown despite several hypotheses presented. Recent concepts refer to changes in the opioidergic system and derangements of the immune system. ⋯ The self-reported prevalence of pruritus in HD patients is relatively high, 40-50%. Pruritus is associated with poor outcomes and a higher mortality risk, probably attributed to poor sleep quality. Better therapeutic treatments are needed for relief of distressing uraemic itching in HD patients.