Nephrology
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Randomized Controlled Trial Comparative Study
Efficacy of self-monitoring of blood glucose versus retrospective continuous glucose monitoring in improving glycaemic control in diabetic kidney disease patients.
Patients with diabetic kidney disease (DKD) on anti-diabetic agents, are at greater risk of glycemic variations, both hypoglycemia and hyperglycemia. We aimed to compare glycemic control (using HbA1c) and hypoglycemia incidence in patients with Stage 3 DKD (eGFR 30-60 mL/min per 1.73 m2 ), receiving retrospective CGM-guided anti-diabetic therapy versus self-monitoring of blood glucose (SMBG) over 3 months. ⋯ In a pilot study of DKD patients, short-term episodic use of CGM reduced time spent in hyperglycaemia range without significantly increasing time-exposure to hypoglycaemia. However, both CGM and SMBG were equally effective in improving glycaemic control.
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Review Meta Analysis
Acute Kidney Injury and mortality prognosis in Acute Coronary Syndrome patients: A meta-analysis.
The aim of this study is to provide a robust estimate of mortality risk in acute coronary syndrome (ACS)-associated acute kidney injury (AKI) to inform clinical practice and policy. ⋯ Acute coronary syndrome-associated AKI is associated with more than a three-fold increase in early mortality and more than two-fold in long-term mortality.
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Comparative Study
Changing survival of people with myeloma and end stage kidney disease: A cohort study using Australian and New Zealand dialysis and transplant registry 1963-2013.
It is unclear whether recent advances in myeloma therapy have improved survival for all those with myeloma and end stage kidney disease (ESKD). ⋯ The proportion of people with myeloma and ESKD remains stable, but their survival has progressively improved in Australia and New Zealand. On starting ESKD treatment with myeloma, a 59 year old without diabetes on peritoneal dialysis can expect a 45% 5 year survival, where a 75-year-old diabetic on haemodialysis has 9% 5 year survival.
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To identify risk factors for acute kidney injury following major orthopaedic surgery. ⋯ We identified perioperative diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to be significantly associated with postoperative AKI. Further prospective studies are required to confirm this.
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Observational Study
Intravenous pulse cyclophosphamide and steroids induce immunological and clinical remission in New-incident and relapsing primary membranous nephropathy.
Primary membranous nephropathy is associated with progression to end stage renal diseasein some patients. Standard therapy with cyclical cyclophosphamide and corticosteroids can be associated with significant adverse effects. We aimed to assess immunological and clinical response with intravenous pulse cyclophosphamide and oral steroids in patients with severe nephrotic syndrome - in a prospective observational cohort study. ⋯ Pulse cyclophosphamide with oral steroids induced immunological and clinical partial remission at significantly reduced doses in primary membranous nephropathy.