| | This Month in AJKD
|
Refers to article:
|
|
Albuminuria and Dementia in the Elderly: A Community Study
, 13 May 2008
Joshua I. Barzilay, Annette L. Fitzpatrick, Jose Luchsinger, Sevil Yasar, Charles Bernick, Nancy S. Jenny, Lewis H. Kuller
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 216-226)
Abstract |
Full Text |
Full-Text PDF (223 KB)
|
Add-Ons
|
Kidney Function and Cognitive Impairment in US Adults: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
, 01 July 2008
Manjula Kurella Tamura, Virginia Wadley, Kristine Yaffe, Leslie A. McClure, George Howard, Rodney Go, Richard M. Allman, David G. Warnock, William McClellan
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 227-234)
Abstract |
Full Text |
Full-Text PDF (187 KB)
|
The Cognition–Kidney Disease Connection: Lessons From Population-Based Studies in the United States
Daniel E. Weiner
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 201-204)
Full Text |
Full-Text PDF (131 KB)
|
Racial Differences in the Competing Risks of Mortality and ESRD After Acute Myocardial Infarction
, 13 May 2008
Britt B. Newsome, William M. McClellan, Jeroan J. Allison, Paul W. Eggers, Shu-Cheng Chen, Allan J. Collins, Catarina I. Kiefe, Christopher S. Coffey, David G. Warnock
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 251-261)
Abstract |
Full Text |
Full-Text PDF (154 KB)
|
Racial Differences in Mortality and ESRD
Keith Norris, Rajnish Mehrotra, Allen R. Nissenson
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 205-208)
Full Text |
Full-Text PDF (77 KB)
|
Effect of Hyperosmolality on Vasopressin Secretion in Intradialytic Hypotension: A Mechanistic Study
, 19 June 2008
Kurakazu Shimizu, Takeshi Kurosawa, Teizo Sanjo
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 294-304)
Abstract |
Full Text |
Full-Text PDF (257 KB)
|
Intradialytic Hypotension: A New Insight to an Old Problem
William L. Henrich
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 209-210)
Full Text |
Full-Text PDF (51 KB)
|
Cognitive-Behavioral Therapy for Sleep Disturbance in Patients Undergoing Peritoneal Dialysis: A Pilot Randomized Controlled Trial
, 30 May 2008
Hung-Yuan Chen, Chih-Kang Chiang, Hsi-Hao Wang, Kuan-Yu Hung, Yue-Joe Lee, Yu-Sen Peng, Kwan-Dun Wu, Tun-Jun Tsai
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 314-323)
Abstract |
Full Text |
Full-Text PDF (249 KB)
|
Subjective and Objective Sleep Quality in Patients on Conventional Thrice-Weekly Hemodialysis: Comparison With Matched Controls From the Sleep Heart Health Study
, 10 July 2008
Mark L. Unruh, Mark H. Sanders, Susan Redline, Beth M. Piraino, Jason G. Umans, Hassan Chami, Rohit Budhiraja, Naresh M. Punjabi, Daniel Buysse, Anne B. Newman
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 305-313)
Abstract |
Full Text |
Full-Text PDF (120 KB)
|
Fatigue in Patients Receiving Maintenance Dialysis: A Review of Definitions, Measures, and Contributing Factors
, 24 June 2008
Manisha Jhamb, Steven D. Weisbord, Jennifer L. Steel, Mark Unruh
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 353-365)
Abstract |
Full Text |
Full-Text PDF (193 KB)
|
Cognitive Impairment and Kidney Disease  See Barzilay et al, pages 216-226; Kurella Tamura et al, pages 227-234; and Weiner, pages 201-204. As the proportion of elderly individuals in the US population rises, chronic diseases that affect the elderly are assuming increasing importance. These conditions include both chronic kidney disease (CKD) and cognitive impairment. In this issue, 2 large population-based studies explore the cognition–kidney disease connection: Barzilay et al examined the association between urine albumin-creatinine ratio (ACR) and cognitive impairment in individuals from the Cardiovascular Health Study (CHS) and found that with each doubling of urine ACR, the risk of mild cognitive impairment increased by 10% and dementia by 22%; and Kurella Tamura et al examined the association between estimated GFR and cognitive impairment in individuals from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and found that each 10-mL/min/1.73 m2 decrease in estimated GFR below 60 mL/min/1.73 m2 was associated with an 11% increased prevalence of impairment (OR, 1.11; 95% CI, 1.04 to 1.19). An editorial by Dr Weiner discusses the clinical implications of these findings. Race, Mortality, and ESRD See Newsome et al, pages 251-261; and Norris et al, pages 205-208. African Americans in the general population suffer from increased rates of cardiovascular and non-cardiovascular mortality in comparison to whites. Paradoxically, African Americans on maintenance dialysis have better survival rates than whites in most studies. In this issue, Newsome et al explore the interplay between race and survival in the Cooperative Cardiovascular Health Project. They evaluated data on over 125,000 Medicare beneficiaries older than 65 who were admitted to a hospital with acute myocardial infarction and assessed rates of ESRD or mortality over a 10-year period. Although African Americans comprised only 6.5% of the study population, they comprised 14.9% of the 2,161 patients progressing to ESRD (adjusted HR, 1.90 [95% CI, 1.78 to 2.03]). In addition, although African Americans had similar adjusted pre-ESRD mortality rates as whites, they were more likely than their white counterparts to die if the baseline GFR was greater than 60 mL/min/1.73 m2, and more likely to survive if the baseline GFR was below 60 mL/min/1.73 m2. An editorial by Dr Norris compares this finding with other existing studies on racial differences in mortality in ESRD, identifying factors which may contribute to these differences for further research. Intradialytic Hypotension See Shimizu et al, pages 294-304; and Henrich, pages 209-210. Administration of a small volume of hypertonic glucose or saline is an effective treatment for patients with intradialytic hypotension, though the exact mechanism behind how hypertonic solutions increase blood pressure is still unclear. In this issue, Shimizu et al examine whether increased arginine vasopressin (AVP) release in response to hypertonic solution may be the primary mechanism for blood pressure rise. In a nonrandomized trial, 42 hemodialysis patients were administered infusions of 20 mL of 10% saline, 20 mL of 50% glucose, 200 mL of 0.9% saline, or physiological doses of AVP during episodes of intradialytic hypotension. They conclude that treatment with the small-volume saline and glucose infusions appears to increase blood pressure by an increase in plasma osmolality and a subsequent rise in AVP concentration, while the large-volume saline infusion was required to cause a detectable increase in estimated plasma volume (plasma AVP levels were not affected). In addition, the AVP infusion increased blood pressure and plasma AVP to levels similar to the small-volume solutions. An editorial by Dr Henrich acknowledges that while the Shimizu et al report contains numerous limitations, the data is a welcome attempt to advance our understanding of how to prevent intradialytic hypotension. Sleep and CKD See Chen et al, pages 314-323; Unruh et al, pages 305-313; and Jhamb et al, pages 353-365. More than half of dialysis patients experience sleep disturbances, which may result in debilitating fatigue and can have a considerable effect on patient health-related quality of life. In this issue, 2 studies attempt to further our understanding of sleep disturbances in CKD. Chen et al investigated the effectiveness of cognitive behavioral therapy (CBT) in peritoneal dialysis patients by assessing changes in sleep quality using the Pittsburgh Sleep Quality Index, Fatigue Severity Scale, and inflammatory cytokines. They found that CBT may be effective for improving quality of sleep and decreasing fatigue and inflammatory cytokine levels. Unruh et al compared 46 in-center hemodialysis patients with 137 age-, sex-, BMI-, and race-matched controls participating in the Sleep Heart Health Study (SHHS) and found that hemodialysis patients were significantly more likely than controls to experience short sleep, decreased sleep efficiency, trouble getting back to sleep, and waking up too early. Also in this issue, Jhamb et al provide a review of the literature on fatigue in the dialysis population. PII: S0272-6386(08)01017-2 doi:10.1053/S0272-6386(08)01017-2 | |
|
FULL TEXT01017-2/journalimage?img=PIIS0272638608010172.gr1.lrg.gif&fig=&kwhquery=&issn=0272-6386&ishighres=false&allhighres=false&free=yes','journalimage');)
01017-2/journalimage?img=PIIS0272638608010172.gr2.lrg.gif&fig=&kwhquery=&issn=0272-6386&ishighres=false&allhighres=false&free=yes','journalimage');)
01017-2/journalimage?img=PIIS0272638608010172.gr3.lrg.gif&fig=&kwhquery=&issn=0272-6386&ishighres=false&allhighres=false&free=yes','journalimage');)
01017-2/journalimage?img=PIIS0272638608010172.gr4.lrg.gif&fig=&kwhquery=&issn=0272-6386&ishighres=false&allhighres=false&free=yes','journalimage');)