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2. Assessment of kidney function : clinical indications for measured GFRNatalie Ebert, Sebastjan Bevc, Arend Bökenkamp, Francois Gaillard, Mads Hornum, Kitty Jager, Christophe Mariat, Bjørn Odvar Eriksen, Runolfur Palsson, Andrew D. Rule, 2021, review article Abstract: In the vast majority of cases, glomerular filtration rate (GFR) is estimated using serum creatinine, which is highly influenced by age, sex, muscle mass, body composition, severe chronic illness and many other factors. This often leads to misclassification of patients or potentially puts patients at risk for inappropriate clinical decisions. Possible solutions are the use of cystatin C as an alternative endogenous marker or performing direct measurement of GFR using an exogenous marker such as iohexol. The purpose of this review is to highlight clinical scenarios and conditions such as extreme body composition, Black race, disagreement between creatinine- and cystatin C–based estimated GFR (eGFR), drug dosing, liver cirrhosis, advanced chronic kidney disease and the transition to kidney replacement therapy, non-kidney solid organ transplant recipients and living kidney donors where creatinine-based GFR estimation may be invalid. In contrast to the majority of literature on measured GFR (mGFR), this review does not include aspects of mGFR for research or public health settings but aims to reach practicing clinicians and raise their understanding of the substantial limitations of creatinine. While including cystatin C as a renal biomarker in GFR estimating equations has been shown to increase the accuracy of the GFR estimate, there are also limitations to eGFR based on cystatin C alone or the combination of creatinine and cystatin C in the clinical scenarios described above that can be overcome by measuring GFR with an exogenous marker. We acknowledge that mGFR is not readily available in many centres but hope that this review will highlight and promote the expansion of kidney function diagnostics using standardized mGFR procedures as an important milestone towards more accurate and personalized medicine.
Keywords: biomarker, chronic kidney disease, clinical indications, creatinine, cystatin C, kidney function, measured glomerular filtration rate
Published in DKUM: 12.08.2024; Views: 52; Downloads: 9
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4. Single peritoneal dialysis centre observations of treatment adequacy, anemia treatment, inflammation, mineral bone disease, and peritonitis rate - in patients undergoing continuous ambulatory peritoneal dialysis versus automated peritoneal dialysisMaša Knehtl, Martin Hren, Nina Vodošek Hojs, Sebastjan Bevc, Radovan Hojs, Robert Ekart, 2017, original scientific article Keywords: peritonealna dializa, peritonitis, anemija, eritropoetin, mineralna kostna bolezen
Published in DKUM: 09.04.2024; Views: 197; Downloads: 12
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5. Atherosclerosis, epigenetic modifications, and arterial stiffnessNejc Piko, Robert Ekart, Sebastjan Bevc, Radovan Hojs, 2017, review article Keywords: ateroskleroza, epigenetika, togost arterij
Published in DKUM: 09.04.2024; Views: 218; Downloads: 19
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6. Subendocardial viability, ambulatory blood pressure monitoring and serum biomarkers for cardiovascular disease in chronic kidney patientsNejc Piko, Tajda Šrot Volavc, Nina Vodošek Hojs, Sebastjan Bevc, Radovan Hojs, Robert Ekart, 2019, original scientific article Keywords: arterijska togost, augmentacijksi indeks, kronična ledvičnabolezen, NT-proBNP, razmerje subendokardne viabilnosti miokarda
Published in DKUM: 04.04.2024; Views: 195; Downloads: 2
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7. The role of oxidative stress in kidney injuryNejc Piko, Sebastjan Bevc, Radovan Hojs, Robert Ekart, 2023, review article Abstract: Acute kidney injury and chronic kidney disease are among the most common non-communicable diseases in the developed world, with increasing prevalence. Patients with acute kidney injury are at an increased risk of developing chronic kidney disease. One of kidney injury’s most common clinical sequelae is increased cardiovascular morbidity and mortality. In recent years, new insights into the pathophysiology of renal damage have been made. Oxidative stress is the imbalance favoring the increased generation of ROS and/or reduced body’s innate antioxidant defense mechanisms and is of pivotal importance, not only in the development and progression of kidney disease but also in understanding the enhanced cardiovascular risk in these patients. This article summarizes and emphasizes the role of oxidative stress in acute kidney injury, various forms of chronic kidney disease, and also in patients on renal replacement therapy (hemodialysis, peritoneal dialysis, and after kidney transplant). Additionally, the role of oxidative stress in the development of drug-related nephrotoxicity and also in the development after exposure to various environmental and occupational pollutants is presented.
Keywords: acute kidney injury, acute tubular necrosis, chronic kidney disease, oxidative stress, reactive oxygen species
Published in DKUM: 19.03.2024; Views: 210; Downloads: 32
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8. Effects of differential time and difficulty weighting on the improvement of OSCE quality metricsMatic Mihevc, Klara Masnik, Tadej Petreski, Nejc Pulko, Sebastjan Bevc, 2022, original scientific article Keywords: OSCE, clinical skills, peer assessment, quality metrics, weighting, outliers
Published in DKUM: 17.01.2023; Views: 487; Downloads: 53
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9. Bioimpedanca, arterijska togost in krvni tlak pri bolnikih na peritonealni dializiLucijan Lučič Šrajer, Katharina Marko, 2021, final research report Keywords: peritonealna dializa, hiperhidracija, bioimpedanca, hitrost pulznega vala, krvni tlak, pljučni kometi
Published in DKUM: 07.02.2022; Views: 862; Downloads: 60
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10. Kronična ledvična bolezen in poznavanje ne farmakoloških ukrepov pri bolnikih s kroničnim srčnim popuščanjemRenata Lošić, 2021, master's thesis Abstract: Uvod: Pri bolnikih s kroničnim srčnim popuščanjem je kronična ledvična okvara zelo
pogosto prisotna. V zaključnem delu smo preučili vrednosti serumskega kreatinina in
ocenili ledvično funkcijo z oceno glomerulne filtracije po Chronic Kidney Disease
Epidemiology Collaboration enačbi pri bolnikih, ki se zdravijo v Ambulanti za srčno
popuščanje. Namen zaključnega dela je bil ugotoviti, kolikšna je pogostost in katere
stopnje je kronična ledvična bolezen pri bolnikih s kroničnim srčnim popuščanjem, ter
njihovo poznavanje nefarmakoloških ukrepov za izboljšanje zdravja.
Metode: Uporabili smo kvantitativno metodo raziskovanja. Za obdelavo in analizo
podatkov smo uporabili računalniške programe Microsoft Word, Microsoft Excel in SPSS
različica 20.
Rezultati: V raziskavo smo vključili 85 bolnikov. Po pregledu vrednosti serumskega
kreatinina smo ugotovili, da je imelo 30 % bolnikov povišano vrednost serumskega
kreatinina. Glede na oceno glomerulne filtracije je imelo kronično ledvično bolezen 37,6
% bolnikov. Pri več kot dveh tretjinah (72,9 %) bolnikov je bilo prepoznano slabše
delovanje ledvic. Ugotovili smo, da večina 97,6 % bolnikov dobro pozna nefarmakološke
ukrepe.
Razprava in sklep: Z oceno glomerulne filtracije lahko natančneje določimo stopnjo
kronične ledvične bolezni in tako prepoznamo slabše delovanje ledvic. Bolniki z dobrim
poznavanjem in upoštevanjem nefarmakoloških ukrepov že sami pripomorejo k
ugodnemu vplivu na potek zdravljenja in kakovost življenja. Pomembno vlogo pri
poznavanju nefarmakoloških ukrepov ima tudi medicinska sestra, saj v ambulanti
prevzema aktivno in samostojno vlogo pri izvajanju zdravstveno vzgojnega svetovanja.
Keywords: srčno popuščanje, ledvična bolezen, glomerulna filtracija, bolnik, nefarmakološki ukrepi, poznavanje nefarmakoloških ukrepov
Published in DKUM: 23.12.2021; Views: 1276; Downloads: 132
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