for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3031 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 3031 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 303, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 196, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 119, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 303, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 388, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 173, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 151, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 141, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Advances in Chronic Kidney Disease
  [SJR: 1.268]   [H-I: 45]   [8 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 1548-5595
   Published by Elsevier Homepage  [3031 journals]
  • Identifying Potential Biases in the Nephrology Literature
    • Authors: David Collister; Thomas Ferguson; Paul Komenda; Navdeep Tangri
      Pages: 273 - 282
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Thomas W. Ferguson, Navdeep Tangri
      Observational studies are common in the nephrology literature, particularly given the lack of large randomized trials. While these studies have identified important associations, potential biases, if unrecognized, can result in misinterpreted conclusions. In this review, we present an example of four potentially important biases (lead time bias, survivor bias, immortal time bias, and index event bias) that can result in inaccurate estimates of association between risk factors or treatments and outcomes. Recognition of these potential biases can help improve study design and interpretation.

      PubDate: 2017-04-13T15:42:44Z
      DOI: 10.1016/j.semnephrol.2016.05.004
       
  • The Tubulointerstitium: Dark Matter
    • Authors: Jerry Yee
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Jerry Yee


      PubDate: 2017-04-13T15:42:44Z
       
  • The Renal Tubulointerstitium
    • Authors: Cynthia Nast
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Cynthia C. Nast


      PubDate: 2017-04-13T15:42:44Z
       
  • Clinical Approach to Diagnosing Acute and Chronic Tubulointerstitial
           Disease
    • Authors: Mark Perazella
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Mark A. Perazella
      Tubulointerstitial diseases are a relatively common cause of acute and/or chronic kidney disease. Acute tubulointerstitial nephritis (ATIN) most commonly develops in patients exposed to various medications; however, it can occur from infections, autoimmune and systemic diseases, environmental exposures, and some idiopathic causes. Chronic tubulointerstitial nephritis may develop in patients with previous ATIN or may be the initial manifestation of an autoimmune, systemic, environmental, or metabolic process. It can be challenging for clinicians to differentiate the various causes of acute and chronic kidney disease. In particular, distinguishing ATIN from other causes of acute kidney injury, such as acute tubular necrosis or a rapidly progressive glomerulonephritis, is important as treatment and prognosis are often quite different. To this end, clinicians use clinical assessment, certain laboratory data, and various imaging tests to make a diagnosis. Unfortunately, most of these tests are insufficient for this purpose. As a result, kidney biopsy is often required to accurately diagnose ATIN and guide management. For chronic tubulointerstitial nephritis, kidney biopsy is needed less often as available therapies for this entity, with a few exceptions, are limited and primarily supportive.

      PubDate: 2017-04-13T15:42:44Z
       
  • Mechanisms of Drug-Induced Interstitial Nephritis
    • Authors: Rajeev Raghavan; Saed Shawar
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Rajeev Raghavan, Saed Shawar
      Drug-induced acute interstitial nephritis (DI-AIN) is a drug hypersensitivity reaction (DHR) that manifests 7 to 10 days after exposure to the culprit drug. DHRs account for fewer than 15% of reported adverse drug reactions. The kidneys are susceptible to DHR because: (1) the high renal blood flow whereby antigens are filtered, secreted, or concentrated, and (2) it is a major site of excretion for drugs and drug metabolites. More than 250 different drugs from various classes have been incriminated as causative agents of DI-AIN, the third most common cause of acute kidney injury in the hospital. DI-AIN must be differentiated from drug-induced nephrotoxic acute tubular necrosis because of their differing pathophysiology and treatment. DI-AIN begins with antigen processing and presentation to local dendritic cells. The dendritic cells activate T cells, and the subsequent effector phase of the immune response is mediated by various cytokines. Incriminated antigenic mechanisms include response to a conjugation product of the drug or its metabolite with a host protein (eg, beta-lactam or sulfonamide antibiotic) or the direct binding of the drug to a particular host allele to elicit a hypersensitivity response (eg, certain anti-epileptic drugs). If the offending drug is not identified and discontinued in a timely manner, irreversible fibrosis and chronic kidney disease will occur. The core structure of each drug or its metabolite is an antigenic determinant, and the host interaction is termed the structure-activity relationship. Differing structure-activity relationships accounts for effect, hypersensitivity, and cross-reactivity among and between classes. The essence of management of DI-AIN lies with the four sequential steps: anticipation, diagnosis, treatment, and prevention. Corticosteroids are used in the treatment of DI-AIN because of their potent anti-inflammatory effects on T cells and eosinophils. Anticipation and prevention require notifying the patient that DI-AIN is an idiosyncratic, hypersensitivity reaction that recurs on re-exposure, and the drug should be avoided.

      PubDate: 2017-04-13T15:42:44Z
       
  • Medication-Induced Interstitial Nephritis in the 21st Century
    • Authors: Cynthia Nast
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Cynthia C. Nast
      Interstitial nephritis is an immune mediated form of tubulointerstitial kidney injury that may occur secondary to drugs, autoimmune disease, infections, and hematologic disorders or as a reactive process. Drug-induced acute interstitial nephritis (DI-AIN) occurs in 0.5%-3% of all kidney biopsies and in 5%-27% of biopsies performed for acute kidney injury. Drugs are implicated in 70%-90% of biopsy-proved IN with a prevalence of 50% in less developed to 78% in more developed countries. DI-AIN typically is idiosyncratic because of a delayed hypersensitivity reaction, although some chemotherapeutic agents are permissive for immune upregulation and injure the kidney in a dose-related manner. Antibiotics are the most implicated class of medication in DI-AIN, followed by proton pump inhibitors, nonsteroidal anti-inflammatory agents, and 5-aminosalicylates. Diuretics, allopurinol, phenytoin and other anti-seizure medications, and H2 receptor antagonists are known offenders while chemotherapeutic agents are an under-recognized cause. The symptoms of DI-AIN are variable and often not specific; thus, kidney biopsy is required to make a firm diagnosis. The incidence of DI-AIN appears to be increasing, particularly in the elderly in whom kidney biopsy is underused, and identification of the offending agent may be complicated by polypharmacy. As rapid drug discontinuation may improve prognosis, the possibility of DI-AIN should always be considered in a patient with acute kidney injury.

      PubDate: 2017-04-13T15:42:44Z
       
  • Tubulointerstitial Injury and Drugs of Abuse
    • Authors: Arani Nanavati; Leal Herlitz
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Arani Nanavati, Leal C. Herlitz
      Drug abuse is widespread in many populations, and patients abusing illicit substances are at a significantly increased risk of kidney injury. The tubulointerstitial compartment is a common target of these nephrotoxic agents. This review will cover some of the common illicit drugs and will focus on the tubulointerstitial injuries seen in the setting of drug abuse. Agents addressed in this review are synthetic cannabinoids, “bath salts,” ecstasy, anabolic steroids, inhaled solvents, heroin, and cocaine. The most frequent biopsy findings are those of acute tubular necrosis and acute interstitial nephritis. Unfortunately, histology is often unable to sufficiently narrow the differential diagnosis and point to a single likely cause. A high suspicion for drug abuse as a potential cause of kidney injury is needed to identify the patients for whom this is the cause of their kidney failure. Toxicology screens are often of little use in identifying patients using emerging drugs of abuse.

      PubDate: 2017-04-13T15:42:44Z
       
  • Autosomal Dominant Tubulointerstitial Kidney Disease
    • Authors: Anthony Bleyer; Kendrah Kidd Martina Stanislav Kmoch
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Anthony J. Bleyer, Kendrah Kidd, Martina Živná, Stanislav Kmoch
      There are 3 major forms of autosomal dominant tubulointerstitial kidney disease (ADTKD): ADTKD due to UMOD mutations, MUC1 mutations, and mutations in the REN gene encoding renin. Lack of knowledge about these conditions contributes to frequent nondiagnosis, but with even limited knowledge, nephrologists can easily obtain a diagnosis and improve patient care. There are 3 cardinal features of these disorders: (1) the conditions are inherited in an autosomal dominant manner and should be considered whenever both a parent and child suffer from kidney disease; the presence of even more affected family members provides further support. (2) These conditions are associated with a bland urinary sediment, ruling out glomerular disorders. (3) There is a variable rate of decline in kidney function. The mean age of ESRD is approximately 45, but the range is from 17 to >75. ADTKD-UMOD is often but not always associated with gout in the teenage years. ADKTKD-REN is associated with signs of hyporeninemia: mild hypotension, mild hyperkalemia, anemia in childhood, and hyperuricemia and gout in the teenage years. The only clinical manifestation of ADTKD-MUC1 is slowly progressive CKD. Diagnosis should be made by genetic testing, and kidney biopsy should be avoided.

      PubDate: 2017-04-13T15:42:44Z
       
  • IgG4-Related Tubulointerstitial Nephritis
    • Authors: Pingchuan Zhang; Lynn Cornell
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Pingchuan Zhang, Lynn D. Cornell
      Immunoglobulin G4 (IgG4)–related disease (IgG4-RD) is a fibroinflammatory disorder that can involve nearly any organ. The disorder has increasingly become known as a distinct clinical entity during the last decade. IgG4-related tubulointerstitial nephritis (IgG4-TIN) is the most common manifestation of IgG4-RD in the kidney. Many patients with IgG4-TIN are diagnosed after IgG4-RD has been recognized in other organ systems, but the kidney may also be the first or only site involved. The presenting clinical features of IgG4-TIN are most commonly kidney insufficiency, kidney mass lesion(s), or both. On biopsy, IgG4-TIN shows a dense lymphoplasmacytic infiltrate, increased IgG4+ plasma cells, storiform fibrosis, and often tubular basement membrane immune complex deposits. Elevation of serum IgG4 often accompanies IgG4-RD; however, it is not specific in reaching the diagnosis. Like IgG4-RD in other organs, IgG4-TIN characteristically responds promptly to steroids, although there is a high relapse rate on discontinuation of immunosuppression. The pathogenesis of IgG4-RD is not understood.

      PubDate: 2017-04-13T15:42:44Z
       
  • Toward a Comprehensive Hypothesis of Chronic Interstitial Nephritis in
           Agricultural Communities
    • Authors: Carlos Manuel; Orantes-Navarro Miguel Laura Xavier Fernando Vela-Parada Marcelo Hernandez-Cuchillas
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Carlos Manuel Orantes-Navarro, Raúl Herrera-Valdés, Miguel Almaguer-López, Laura López-Marín, Xavier Fernando Vela-Parada, Marcelo Hernandez-Cuchillas, Lilly M. Barba
      Over the past 20 years, there has been an increase in chronic interstitial nephritis in agricultural communities (CINAC) not associated with traditional risk factors. This disease has become an important public health problem and is observed in several countries in Central America and Asia. CINAC predominantly affects young male farmers between the third and fifth decades of life with women, children, and adolescents less often affected. Clinically, CINAC behaves like a chronic tubulointerstitial nephropathy but with systemic manifestations not attributable to kidney disease. Kidney biopsy reveals chronic tubulointerstitial nephritis with variable glomerulosclerosis and mild chronic vascular damage, with the severity depending on sex, occupation, and CKD stage. The presence of toxicological, occupational, and environmental risk factors within these communities suggests a multifactorial etiology for CINAC. This may include exposure to agrochemicals, a contaminated environment, repeated episodes of dehydration with heat stress, and an underlying genetic predisposition. An understanding of these interacting factors using a multidisciplinary approach with international cooperation and the formulation of a comprehensive hypothesis are essential for the development of public health programs to prevent this devastating epidemic.

      PubDate: 2017-04-13T15:42:44Z
       
  • The Tubulointerstitial Pathophysiology of Progressive Kidney Disease
    • Authors: William Schnaper
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): H. William Schnaper
      Accumulating evidence suggests that the central locus for the progression of CKD is the renal proximal tubule. As injured tubular epithelial cells dedifferentiate in attempted repair, they stimulate inflammation and recruit myofibroblasts. At the same time, tissue loss stimulates remnant nephron hypertrophy. Increased tubular transport workload eventually exceeds the energy-generating capacity of the hypertrophied nephrons, leading to anerobic metabolism, acidosis, hypoxia, endoplasmic reticulum stress, and the induction of additional inflammatory and fibrogenic responses. The result is a vicious cycle of injury, misdirected repair, maladaptive responses, and more nephron loss. Therapy that might be advantageous at one phase of this progression pathway could be deleterious during other phases. Thus, interrupting this downward spiral requires narrowly targeted approaches that promote healing and adequate function without generating further entry into the progression cycle.

      PubDate: 2017-04-13T15:42:44Z
       
  • Treatment of Renal Fibrosis—Turning Challenges into Opportunities
    • Authors: Barbara Klinkhammer; Roel Goldschmeding Floege Peter Boor
      Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2
      Author(s): Barbara M. Klinkhammer, Roel Goldschmeding, Jürgen Floege, Peter Boor
      Current treatment modalities are not effective in halting the progression of most CKD. Renal fibrosis is a pathological process common to all CKD and thereby represents an excellent treatment target. A large number of molecular pathways involved in renal fibrosis were identified in preclinical studies, some of them being similar among different organs and some with available drugs in various phases of clinical testing. Yet only few clinical trials with antifibrotic drugs are being conducted in CKD patients. Here we review those clinical trials, focusing on agents with direct antifibrotic effects, with particular focus on pirfenidone and neutralizing antibodies directed against profibrotic growth factors and cell connection proteins. We discuss the potential reasons for the poor translation in treatment of renal fibrosis and propose possible approaches and future developments to improve it, eg, patient selection and companion diagnostics, specific and sensitive biomarkers as novel end points for clinical trials, and drug-targeting and theranostics.

      PubDate: 2017-04-13T15:42:44Z
       
  • National Kidney Foundation 2017 Spring Clinical Meetings Abstracts April
           18 – 22, 2017
    • Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2


      PubDate: 2017-04-13T15:42:44Z
       
  • Emotional Bonding in Recipients of Deceased Donor Kidney Transplants
           (DDRT): Associated Factors
    • Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2


      PubDate: 2017-04-13T15:42:44Z
       
  • Utilization of Patient Decision Support Tools and Processes: The Shared
           End-Stage Renal Patients Decision Making (SHERPA-DM) Project
    • Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2


      PubDate: 2017-04-13T15:42:44Z
       
  • Embracing Their Transformed Life: Husbands Living With Women On Dialysis
    • Abstract: Publication date: March 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 2


      PubDate: 2017-04-13T15:42:44Z
       
  • Nephrology and Telehealth: Now? or Now!
    • Authors: Sandeep Soman; Jerry Yee
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Sandeep S. Soman, Jerry Yee


      PubDate: 2017-04-13T15:42:44Z
       
  • A Fundamental Theorem of Telehealth
    • Authors: Clarissa Jonas; Diamantidis
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Clarissa Jonas Diamantidis


      PubDate: 2017-04-13T15:42:44Z
       
  • Managing CKD by Telemedicine: The Zuni Telenephrology Clinic
    • Authors: Andrew Narva; Gayle Romancito Thomas Faber Michael Steele Kenneth Kempner
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Andrew S. Narva, Gayle Romancito, Thomas Faber, Michael E. Steele, Kenneth M. Kempner
      Telemedicine has significant potential to extend nephrology consultation to rural and isolated communities. We describe a telenephrology clinic that has delivered ongoing consultative care from a nephrologist based at the National Institutes of Health in Bethesda, MD, to the Zuni Comprehensive Health Center in western New Mexico. Over the past 9 years, the clinic has conducted 1870 patient visits managing patients using a collaborative approach engaging a nurse case manager, nephrologist, primary clinicians, pharmacists, and community health nurses. A significant proportion of the care provided is directed toward patients with advanced kidney disease (estimated glomerular filtration rate <30 mL/min/1.73 m2). Although there are unique aspects to the Indian Health Service and to the Zuni community which is served by this clinic, this telemedicine clinic does serve as a demonstration that nephrologic consultative care can be delivered effectively and efficiently to rural high-risk communities using a collaborative and integrated model of care.

      PubDate: 2017-04-13T15:42:44Z
       
  • Telehealth in the Delivery of Home Dialysis Care: Catching up With
           Technology
    • Authors: Vinay Krishna; Kamesha Managadi Michael Smith Eric Wallace
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Vinay N. Krishna, Kamesha Managadi, Michael Smith, Eric Wallace
      Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education. Regulatory and reimbursement-related policies continue to present barriers that need to be overcome in operationalizing telehealth and widespread adoption of telehealth solutions. Although more quality evidence is needed to study the impact of telehealth on home dialysis outcomes and uptake, telehealth holds the promise of increasing access to care, improving quality of life, and improving quality of care for current and would be home dialysis patients.

      PubDate: 2017-04-13T15:42:44Z
       
  • Overview on the Challenges and Benefits of Using Telehealth Tools in a
           Pediatric Population
    • Authors: Patrick Brophy
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Patrick D. Brophy
      Telehealth in Pediatric Medicine presents many of the same benefits and challenges noted in adult-based medicine. In terms of health care delivery, the promise of improving access and reducing costs using telehealth in Pediatrics, particularly chronic care, is high. The ability to address clinician shortages and provide remote guidance for chronic care pathways from pediatric subspecialists to rural-based referring physicians is a developing model that represents a sustainable and cost-effective strategy to improve pediatric care. The adoption and implementation of consistent telehealth programs require a readjustment of current regulatory rules and a national discussion on reimbursement and compliance standards. Presently, state laws generally define the rules, whereby health systems or practices can use telehealth for patient care and education. Long-term telehealth program development depends on the ongoing value and use case provided by pediatric advocates for this emerging health care delivery model.

      PubDate: 2017-04-13T15:42:44Z
       
  • Targeting Access to Kidney Care Via Telehealth: The VA Experience
    • Authors: Susan Crowley; Justin Belcher Devasmita Choudhury Cassandra Griffin Raymond Pichler
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Susan T. Crowley, Justin Belcher, Devasmita Choudhury, Cassandra Griffin, Raymond Pichler, Brooks Robey, Rajeev Rohatgi, Bessie Mielcarek
      The Veterans Affairs (VA) is the largest integrated health care system in the United States and is responsible for the care of a population with a disproportionately high rate of CKD. As such, ensuring access to kidney health services is a VA imperative. One facet of the VA's strategy to reduce CKD is to leverage the use of teletechnology to expand the VA's outreach to Veterans with kidney disease. A wide array of teletechnology services have been deployed to both pull in Veterans and push out kidney health services to Veterans in their preferred health care venue. Teletechnology, thus, expands Veteran choice, facilitates their access to care, and furthers the goal of delivering patient-centered kidney specialty care. The VA has demonstrated the feasibility of virtual delivery of kidney specialty care services and education via synchronous and asynchronous approaches. The challenges ahead include determining the relative health care value of kidney telehealth services, identifying Veterans most likely to benefit from specific technologies and optimizing the adoption of effective kidney telehealth services by both providers and patients alike to ensure optimal and timely kidney health care delivery.

      PubDate: 2017-04-13T15:42:44Z
       
  • Telemedicine to Promote Patient Safety: Use of Phone-Based Interactive
           
    • Authors: Shoshana Weiner; Jeffery Fink
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Shoshana Weiner, Jeffery C. Fink
      CKD patients have several features conferring on them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired kidney function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated kidney function loss, acute kidney injury, ESRD, and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care. However, many CKD patients have limitations that hinder their use of telemedicine and access to the broad capabilities of health information technology. In this review, we summarize previous assessments of the pre-dialysis CKD populations' proficiency in using telemedicine modalities and describe the use of interactive voice-response system to gauge the safety phenotype of the CKD patient. We discuss the potential for expanded interactive voice-response system use in CKD to address the safety threats inherent to this population.

      PubDate: 2017-04-13T15:42:44Z
       
  • Telehealth Applications to Enhance CKD Knowledge and Awareness Among
           Patients and Providers
    • Authors: Delphine Tuot; Ebony Boulware
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Delphine S. Tuot, L. Ebony Boulware
      CKD affects 13% of the US adult population, causes excess mortality, and is associated with significant sociodemographic disparities. Optimal CKD management slows progression of disease and reduces cardiovascular-related outcomes. Resources for patients and primary care providers, major stakeholders in preventive CKD care, are critically needed to enhance understanding of the disease and to optimize CKD health, particularly because of the asymptomatic nature of kidney disease. Telehealth is defined as the use of electronic communication and telecommunications technology to support long-distance clinical health care, patient and professional health-related education, and public health and health administration. It provides new opportunities to enhance awareness and understanding among these important stakeholders. This review will examine the role of telehealth within existing educational theories, identify telehealth applications that can enhance CKD knowledge and behavior change among patients and primary care providers, and examine the advantages and disadvantages of telehealth vs usual modalities for education.

      PubDate: 2017-04-13T15:42:44Z
       
  • Medicare Telehealth Services and Nephrology: Policies for Eligibility and
           Payment
    • Authors: Stephanie Frilling
      Abstract: Publication date: January 2017
      Source:Advances in Chronic Kidney Disease, Volume 24, Issue 1
      Author(s): Stephanie Frilling
      The criteria for Medicare payment of telehealth nephrology services, and all other Medicare telehealth services, are set forth in section 1834(m) of the Social Security Act. There are just over 80 professional physician or practitioner services that may be furnished via telehealth and paid under Medicare Part B, when an interactive audio and video telecommunication system that permits real-time communication between a beneficiary at the originating site and the physician or practitioner at the distant site substitutes for an in-person encounter. These services include 16 nephrology billing codes for furnishing ESRD services for monthly monitoring and assessment and two billing codes for chronic kidney disease education. In recent years, many mobile health devices and other web-based tools have been developed in support of monitoring, observation, and collaboration for people living with chronic disease. This article reviews the statutory and program guidance that governs Medicare telehealth services, defines payment policy terms (e.g., originating site and distant site), and explains payment policies when telehealth services are furnished.

      PubDate: 2017-04-13T15:42:44Z
       
  • One Isn't the Loneliest of Numbers: N-of-1 Trials
    • Authors: Jerry Yee
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Jerry Yee


      PubDate: 2017-04-13T15:42:44Z
       
  • Translation of Evidence Into Clinical Practice
    • Authors: Donald Molony; Joshua Samuels
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Donald A. Molony, Joshua Samuels


      PubDate: 2017-04-13T15:42:44Z
       
  • Cognitive Bias and the Creation and Translation of Evidence Into Clinical
           Practice
    • Authors: Donald Molony
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Donald A. Molony
      The optimal translation of evidence into the clinical practice of nephrology follows validated evidence-based medicine (EBM) principles. Most importantly, the evidence-based medicine practitioner requires that the evidence, as much as possible, addresses in an unbiased manner clinical questions of importance to patients and reflects the truth. In this chapter, we evaluate how cognitive biases that affect medical decision making might systematically bias the overall management of patients with kidney disease and, thus, distort the observations about disease causation, prognosis, diagnosis, and management that are derived from analysis of administrative databases or electronic medical records of health care systems. These cognitive biases influence how questions are framed, how risk factors and health status are measured, how decisions are made, and what actions are implemented. We explore the nature of these biases and the possible places where such biases are most likely to distort clinical care and the collection of the data that is used to inform clinical practice in nephrology. To the extent that cognitive biases selectively modify diagnostic interrogations and therapeutic interventions in some patients, the resultant databases may provide a skewed picture of the health of the nephrology patient population and should be considered with some skepticism when exploited to achieve best practice.

      PubDate: 2017-04-13T15:42:44Z
       
  • Unique Study Designs in Nephrology: N-of-1 Trials and Other Designs
    • Authors: Joyce Samuel; Cynthia Bell
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Joyce P. Samuel, Cynthia S. Bell
      Alternatives to the traditional parallel-group trial design may be required to answer clinical questions in special populations, rare conditions, or with limited resources. N-of-1 trials are a unique trial design which can inform personalized evidence-based decisions for the patient when data from traditional clinical trials are lacking or not generalizable. A concise overview of factorial design, cluster randomization, adaptive designs, crossover studies, and n-of-1 trials will be provided along with pertinent examples in nephrology. The indication for analysis strategies such as equivalence and noninferiority trials will be discussed, as well as analytic pitfalls.

      PubDate: 2017-04-13T15:42:44Z
       
  • An Evidence-Based Approach to Conducting Systematic Reviews on CKD
    • Authors: Nandita Mani; Emily Ginier
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Nandita S. Mani, Emily Ginier
      With the growing need to integrate best evidence to inform clinical care, systematic reviews have continued to flourish. Although this type of review is integral to the synthesis of evidence-based information, systematic reviews are often conducted omitting well-established processes that ensure the validity and replicability of the study; elements of which are integral based on standards developed by the Cochrane Collaboration and the National Academy of Medicine. This review article will share best practices associated with conducting systematic reviews on the topic of CKD using an 8-step process and an evidence-based approach to retrieving and abstracting data. Optimal methods for conducting systematic review searching will be described, including development of appropriate search strategies and utilization of varied resources including databases, grey literature, primary journals, and handsearching. Processes and tools to improve research teams' coordination and efficiency, including integration of systematic review protocols and sophisticated software to streamline data management, will be investigated. In addition to recommended strategies for surveying and synthesizing CKD literature, techniques for maneuvering the complex field of Nephrology will also be explored.

      PubDate: 2017-04-13T15:42:44Z
       
  • Use of Surrogate Outcomes in Nephrology Research
    • Authors: Joshua Samuels
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Joshua Samuels
      Clinical trials are large and expensive and could require exceedingly long-term follow-up for subjects to reach clinically meaningful end points. To combat these methodologic issues, researchers sometimes use biomarkers as surrogate end points. A biomarker is an objectively measured characteristic that is indicative of some underlying phenomenon or process, while a surrogate is a biomarker that “takes the place” of a clinically meaningful outcome, usually earlier in the disease process. This paper reviews the history, strengths, and weaknesses of surrogate outcome use in clinical research and then discusses potential surrogate outcomes in nephrology research.

      PubDate: 2017-04-13T15:42:44Z
       
  • Observational Research Using Propensity Scores
    • Authors: Karthik Raghunathan; Bradley Layton Tetsu Ohnuma Andrew Shaw
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Karthik Raghunathan, J. Bradley Layton, Tetsu Ohnuma, Andrew D. Shaw
      In most observational studies, treatments or other “exposures” (in an epidemiologic sense) do not occur at random. Instead, treatments or other such interventions depend on several patient-related and patient-independent characteristics. Such factors, associated with the receipt vs nonreceipt of treatment, may also be—independently—associated with outcomes. Thus, confounding exists making it difficult to ascertain the true association between treatments and outcomes. Propensity scores (PS) represent an intuitive set of approaches to reduce the influence of such “confounding” factors. PS is a computed probability of treatment, a value that is estimated for each patient in an observational study and then applied (in a variety of ways such as matching, stratification, weighting, etc.) to reduce distortion in the true nature of the association between treatment (or any similar exposure) and outcomes. Despite several advantages, PS-based methods cannot account for unmeasured confounding, ie, for factors that are not being included in the computation of PS.

      PubDate: 2017-04-13T15:42:44Z
       
  • The ESRD Quality Incentive Program: The Current Limitations of Evidence
           
    • Authors: Louis Diamond; Andrew Howard
      Abstract: Publication date: November 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 6
      Author(s): Louis H. Diamond, Andrew D. Howard
      This article describes the current state of facilitating the integration of evidence into practice to support initiatives focused on patients with ESRD. We will use the Centers for Medicare and Medicaid Services (CMS) ESRD Quality Incentive Program (QIP) as an example, including a description of the health information infrastructure needed to support the translation of evidence into practice and some of the challenges encountered. The process from the generation of evidence to integration of this evidence into practice includes policy development leading to clinical practice guidelines, clinical performance measures, and clinical decision support tools. The ESRD QIP is the most mature program outside the hospital initiatives in the CMS Quality Payment Program and currently contains 16 measures. ESRD data to support these measures are aggregated at the dialysis facility level and reported through the CMS Consolidated Renal Operations in a Web-enabled Network (CROWNWeb) and the Centers for Disease Control and Prevention using the National Healthcare Safety Network. We review these measures and the health information infrastructure used to report the data, focusing on the inherent strengths and weaknesses of the ESRD QIP along with opportunities for improvement of the program.

      PubDate: 2017-04-13T15:42:44Z
       
  • Increasing Access to Kidney Transplantation: Easy as A-B-O
    • Authors: Jerry Yee
      Abstract: Publication date: September 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 5
      Author(s): Jerry Yee


      PubDate: 2017-04-13T15:42:44Z
       
  • The Struggle for Optimization of Long-Term Outcomes After Kidney
           Transplantation
    • Authors: Anita Patel; Millie Samaniego
      Abstract: Publication date: September 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 5
      Author(s): Anita K. Patel, Millie Samaniego


      PubDate: 2017-04-13T15:42:44Z
       
  • Current Status of Kidney Transplant Outcomes: Dying to Survive
    • Authors: Jeffrey Wang; Melissa Skeans Ajay Israni
      Abstract: Publication date: September 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 5
      Author(s): Jeffrey H. Wang, Melissa A. Skeans, Ajay K. Israni
      Kidney transplantation is associated with improved survival compared with maintenance dialysis. In the United States, post-transplant outcomes have steadily improved over the last several decades, with current 1-year allograft and patient survival rates well over 90%. Although short-term outcomes are similar to those in the international community, long-term outcomes appear to be inferior to those reported by other countries. Differences in recipient case mix, allocation polices, and health care coverage contribute to the long-term outcome disparity. This review presents the current status of kidney transplant outcomes in the United States and compares them with the most recent outcomes from Australia and New Zealand, Europe, and Canada. In addition, early trends after implementation of the new kidney allocation system in the United States and its potential impact on post-transplant outcomes are discussed.

      PubDate: 2017-04-13T15:42:44Z
       
  • Is Kidney Transplantation a Better State of CKD? Impact on Diagnosis
           and Management
    • Authors: Sandesh Parajuli; Dana Clark Arjang Djamali
      Abstract: Publication date: September 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 5
      Author(s): Sandesh Parajuli, Dana F. Clark, Arjang Djamali
      Patients with CKD are at increased risk for cardiovascular events, hospitalizations, and mortality. Kidney transplantation (KTx) is the preferred treatment for end-stage kidney disease. Although comorbidities including anemia and bone and mineral disease improve or are even halted after KTx, kidney transplant recipients carry higher cardiovascular mortality risk than the general population, as well as an increased risk of infections, malignancies, fractures, and obesity. When comparing CKD with CKD after transplantation (CKD-T), the rate of decline of estimated glomerular filtration rate (eGFR) is significantly lower in CKD-T. Higher rate of decline of eGFR has been associated with increased risk of mortality. However, due to the significant increased risk of mortality due to cardiovascular events, infections, and malignancies, many kidney transplant recipients may not benefit of decline in the rate of eGFR. Patients with CKD-T are a unique subset of patients with multiple traditional and transplant-specific risk factors. Proper management and appropriate preventive health measures may improve long-term patient and allograft survival in patients with CKD-T.

      PubDate: 2017-04-13T15:42:44Z
       
  • Immunosuppression Minimization and Avoidance Protocols: When Less Is Not
           More
    • Authors: Rohini Prashar; K.K. Venkat
      Abstract: Publication date: September 2016
      Source:Advances in Chronic Kidney Disease, Volume 23, Issue 5
      Author(s): Rohini Prashar, K.K. Venkat
      Kidney transplantation is well established as the best treatment option for end-stage kidney disease. It confers not only a better quality of life but also a significant survival advantage compared to dialysis. However, despite significant improvement in short-term kidney transplant graft survival over the past three decades, long-term graft survival remains suboptimal. Concerns about the possible contribution of chronic calcineurin inhibitor (CNI) nephrotoxicity to late allograft failure and other serious adverse effects of currently used immunosuppressive agents (especially corticosteroids) have led to increasing interest in developing regimens which may better preserve kidney allograft function and minimize other immunosuppression-related problems without increasing the risk of rejection. The availability of newer immunosuppressive agents has provided the opportunity to formulate such regimens. Approaches to this end include minimization, withdrawal, or avoidance of corticosteroids and CNIs. Currently, replacement of a CNI with a mammalian target of rapamycin inhibitor while continuing mycophenolate and discontinuation of corticosteroids within the first post-transplant week is being increasingly utilized. Belatacept-based, CNI-free immunosuppression is an emerging alternative approach to avoiding CNI-mediated nephrotoxicity. We also discuss the evolution, results, and pros and cons of corticosteroid- and CNI minimization protocols. Recent studies suggest that chronic alloimmune damage rather than chronic CNI nephrotoxicity is the major contributor to late kidney allograft failure. The implications of this finding for the use of CNI minimization protocols are also discussed.

      PubDate: 2017-04-13T15:42:44Z
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016