Deutsche medizinische Wochenschrift
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This article provides an overview of treatment approaches for chronic kidney disease (CKD) in patients with IgA nephropathy (IgAN). IgAN is the most common primary glomerulonephritis and results from an autoimmune reaction to aberrantly glycosylated immunoglobulin A (IgA) antibodies. Although historically considered largely benign, it is now recognized that a significant percentage of patients develop dialysis-dependent kidney disease over the years. ⋯ Further promising medications are currently in clinical trials, including complement inhibitors and immunomodulators. These emerging therapies offer hope for significantly improving the prognosis of IgAN in the future. By presenting a comprehensive overview of current and potential future treatment strategies, this review aims to provide clinicians with up-to-date information to optimize the management of CKD in patients with IgAN.
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The number of people living with or after cancer is steadily increasing due to an ageing society and improved cancer treatment. However, once treatment has been completed, the consequences of the disease are often felt for a long time. These affect many different areas of life and often lead to a high level of suffering and need for care. Psycho-oncological support offers effective support for many of those affected.
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Dtsch. Med. Wochenschr. · Jan 2025
Review[Renal replacement therapy in Germany: An overview with a clinical focus].
In Germany, around 80000 people are currently dependent on permanent renal replacement therapy (RRT). Due to demographic developments and improvements in life expectancy, the prevalence will continue to increase even if the effects of newer pharmacological substances such as SGLT2 inhibitors and GLP1 agonists are promising in inhibiting progression. There are basically three different methods of renal replacement therapy and their variants: Kidney transplantation (KTX), peritoneal dialysis (PD), hemodialysis (HD)/hemodiafiltration (HDF). ⋯ PD and HD are considered to be equivalent in terms of mortality. Currently, HDF is increasingly coming back into focus after the last randomized controlled trial (CONVINCE trial) proved its superiority over conventional HD. Kidney transplantation is clearly superior to dialysis therapy in terms of life expectancy; according to a meta-analysis, the risk of death is reduced by around 55% in comparison.
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The examination of urine and its evaluation are central components in the diagnostic pathway for kidney diseases. Essential to this process is the correct analysis and interpretation of the urine sediment. A nephritic sediment indicates glomerular kidney disease with high specificity. This article explains the diagnosis, evaluation, and implications of a nephritic sediment.
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Dtsch. Med. Wochenschr. · Jan 2025
Review[(Over-)living with cancer: secondary malignancies (incl. genetics)].
Secondary malignancies (secondary cancers) are malignant diseases that occur at a certain time after cancer treatment. The malignant neoplasms can occur anywhere from 2 months to decades after cancer treatment. In addition, multiple tumor diseases can also develop due to a hereditary tendency to tumors. This article provides an overview of the causes, early detection and individual treatment.