Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Mar 2024
Dietary salt intake in chronic kidney disease. Recent studies and their practical implications.
Epidemiological studies in the general population show that the level of dietary salt intake is associated with increases in blood pressure, cardiovascular events and mortality. Trial data show that reducing salt intake reduces blood pressure, cardiovascular events and mortality. On the basis of this evidence, the World Health Organization and other bodies recommend restricting salt intake. ⋯ However, these trials have typically used resource-intensive approaches to dietary salt reduction that are not suitable for routine clinical care and salt intake typically remains high in people with CKD. The OxSalt care bundle is a low-cost intervention that was demonstrated in the OxCKD1 trial to help people with CKD to lower their salt intake and could be applied in routine clinical practice.
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Endoscopic stenting is a commonly applied method of treatment in patients with malignant biliary strictures. It involves the use of self‑expandable metal stents (SEMSs) or plastic stents (PSs). ⋯ In patients with malignant strictures of the biliary tree SEMSs outperform PSs. SEMSs should be used as a treatment of choice for biliary drainage in that group of patients.
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Pol. Arch. Med. Wewn. · Mar 2024
24-hours urine metanephrines excretion in patients diagnosed with adrenal incidentaloma: impact of commonly used drugs on clinical decision.
Incidentaloma is an adrenal tumor detected during diagnostic imaging performed for extra‑adrenal causes. Evaluation of metanephrine concentrations in a 24‑hour urine collection can be a significant challenge in patients with multiple medications and comorbidities. ⋯ Many drug groups interfere with the measurement of urinary fractionated metanephrines. These interactions should be taken into account during interpretation of a hormonal evaluation, as they can be crucial for further management, especially for making a decision on surgical treatment.