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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Dtsch. Med. Wochenschr. · Jan 2025
[(Surviving) life with cancer: the importance of sport and physical activity].
As the survival prognosis of cancer patients continues to improve, the improvement in quality of life during and after cancer treatment is becoming increasingly important 1. Exercise therapy has a positive effect on so-called "patient-reported outcomes" 2. The combination of endurance training and individualized strength training plays a particularly important role here. There is therefore a need for consistent and comprehensive implementation of quality-assured exercise therapy in everyday clinical practice.
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Dtsch. Med. Wochenschr. · Jan 2025
[Antibiotic prescribing trends in German acute care hospitals from 2012/13 through 2021/22].
An important prerequisite for ascertaining rational antibiotic prescribing is the availability and evaluation of antibiotic use data. In this study we report evolving trends of antibiotic use in German hospitals during the last decade. Using drug dispensing data from acute care hospital pharmacies, we calculated yearly antibiotic use density values for the period from 2012/13 through to 2021/22. ⋯ During the last decade, there was no increasing use of antibiotics in German acute care hospitals. We observed shifts in selected drug classes, in particular an increasing use of penicillins. The estimated hospital antibiotic consumption per population was slightly above the European average.
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Dtsch. Med. Wochenschr. · Jan 2025
[Chronic Kidney Disease: epidemiology, implications for clinical practice and equations for diagnosis].
The article is based, among other things, on the updated KDIGO guideline for the evaluation and management of chronic kidney disease, which was published in Kidney International in March 2024. Chronic kidney disease is one of the most common chronic diseases, with a prevalence of around 10%, not least due to demographic ageing. The incidence of chronic kidney disease is approximately twice that of diabetes and approximately 20 times higher than that of cancer. ⋯ A better understanding of age- and gender-specific differences means that personalized therapy approaches are becoming increasingly important. Clinicians should be aware of the limitations of the endogenous biomarkers creatinine and cystatin C for determining GFR. For Germany, the equations of the European Kidney Function Consortium (EKFC) are recommended for estimating GFR.