This document summarizes research on chronic kidney disease in children. It includes:
1) Mortality rates are much higher for children on dialysis compared to the general pediatric population, especially for certain demographic groups.
2) Common causes of chronic kidney disease in children include congenital abnormalities, genetic disorders, and diabetes.
3) Growth failure is a major complication and is associated with protein and calorie malnutrition as well as metabolic bone disease.
4) Treatment involves optimizing nutrition, managing acidosis and mineral disorders, and considering growth hormone therapy.
"End Stage Renal Disease:Common Problems and Possible Solutions". A review of Diabetes and hypertension and how they contribute to complications in the ESRD patient. Renal Care Partners offers state of the art hemodialysis on the campus of Palm Garden of West Palm Beach.
a precise presentation over CKD made for house officers/medical interns . It focuses over signs and symptoms and in-hospital management of resulting problems , material taken majorly from medscape, CMDT and oxford hand book
Chapter 12 Chronic Kidney Disease and DialysisKalvinSmith4
For DH Theory III, students must give a presentation on a specific module in the class. The purpose of these presentations is to inform students on how treat patients in a dental setting who may be compromised by a certain medical condition. I was tasked with presenting on chronic kidney disease and dialysis, as well as on sexually transmitted diseases. This is the presentation that I modified on CKD and dialysis.
"End Stage Renal Disease:Common Problems and Possible Solutions". A review of Diabetes and hypertension and how they contribute to complications in the ESRD patient. Renal Care Partners offers state of the art hemodialysis on the campus of Palm Garden of West Palm Beach.
a precise presentation over CKD made for house officers/medical interns . It focuses over signs and symptoms and in-hospital management of resulting problems , material taken majorly from medscape, CMDT and oxford hand book
Chapter 12 Chronic Kidney Disease and DialysisKalvinSmith4
For DH Theory III, students must give a presentation on a specific module in the class. The purpose of these presentations is to inform students on how treat patients in a dental setting who may be compromised by a certain medical condition. I was tasked with presenting on chronic kidney disease and dialysis, as well as on sexually transmitted diseases. This is the presentation that I modified on CKD and dialysis.
1-3. Electrolyte disorders: diagnosis and management. Tatyana Nastausheva (rus)KidneyOrgRu
IPNA-ESPN teaching course "Pediatric nephrology: Evidence-based statements and open questions", Moscow, Russia, October 22-24, 2013.
Symposium 1: WATER & ELECTROLYTE DISTURBANCES IN CHILDREN WITH CKD
Dyslipidemia in Chronic Kidney Diseases.pdfDr. Nayan Ray
Dyslipidaemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment
Slides Include:
1. Stages of CKD
2. Developments of atherogenesis
3. Lipoprotein in CKD
4. Drug Therapies
5.Summary KDIGO Guideline
Всемирный день почки 2016 в НИКИ им. академика Ю.Е. ВельтищеваKidneyOrgRu
9 марта 2016 г в конференц-зале Научно-Исследовательского Клинического Института имени академика Ю.Е. Вельтищева проведено праздничное мероприятие, посвященное Всемирному Дню Почки, который отмечается во всем мире с 2006 года по инициативе Международного Общества Нефрологов (http://www.worldkidneyday.org). Впервые в этом году Всемирный День Почки был посвящен детям с акцентом на ранней профилактике развития заболеваний почек.
Сотрудники отделения наследственных и приобретенных болезней почек представили для детей презентации об истории проведения праздника, распространенности заболеваний почек с рекомендациями здорового образа жизни для сохранения функций почек.
Было организовано праздничное веселое интерактивное представление для детей с участием Центра детского и юношеского творчества "Бибирево", театра-студии «Рампа», танцевально-акробатических студий «Овация» и «Альфа». Все дети получили праздничные подарки с символом Всемирного Дня Почки.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
8-2. Management of chronic renal failure. Isidro Salusky (eng)
1. Isidro B. Salusky, M.D.
Distinguished Professor of Pediatrics
Chief, Division of Pediatric Nephrology
Director, Clinical Translational Research Center
Associate Dean of Clinical Research
David Geffen School of Medicine at UCLA
5. % Annual mortality
100
Dialysis Population
10
1
GP Male
GP Female
GP Black
GP White
Dialysis Male
Dialysis Female
Dialysis Black
Dialysis White
0.1
0.01
0
25-34
35-44
45-54
55-64
65-74
75-84
>85
Age (yr)
NKF Task Force on Cardiovascular Disease. Am J Kidney Dis. 1998;32(suppl 3):S115.Sarnak MJ,
Levey AS. Am J Kidney Dis. 2000;35(suppl 1):S117-S131.
7. –Protein and Calorie Malnutrition
–Acidosis/Electrolyte Abnormalities
–Primary kidney disease
–Anemia
–Renal bone diseases
–Hormonal Factors
–Immunosuppressive Medications
8. GFR
Description
(mL/min/1.73 m2)
1
Kidney damage with
normal or GFR
90
2
Kidney damage with
mild GFR
60-89
3
Moderate
30-59
4
Severe
5
Kidney failure
Stage
GFR
GFR
15-29
15 or dialysis
K/DOQI: Evaluation, classification and stratification. AJKD 39: 2001
10. SAs
s of Anemia in CKD Patients (1 of 3)
• Renal insufficiency = EPO deficient state
Kidney
ency
Decreased
erythropoietin
production
production
etin
n of uremic
Erythroid
progenitor cells
Inhibition of
erythropoiesis
Bone
Bone
marrow
11. • EPO resistance
– Iron deficiency
– Hyperparathyroidism
– High dose ACE
inhibition
– Aluminum toxicity
– Antibodies to ESA
–
–
–
–
–
–
Inflammation
Folate/B12 deficiency
Hemoglobinopathies
Hemolysis
Chronic Blood Loss
Chronic infection
15. • Loss of appetite-may manifest early in the
course of kidney disease
• Spontaneous food intake decreases with
worsening kidney failure
• Calorie Malnutrition-seen during the first
years of life
• Protein Malnutrition-not frequently seen in
children with kidney failure
16. • Adequate caloric intake
– Infants-growth rates during this period are
correlated with calorie intake
• Nasogastric (NG) or Gastrostomy (G) Tube Feeding
– Older children- intake should not be less than 80%
of the Recommended Daily Allowance (RDA)
• Therapy with recombinant human growth
hormone
20. • North America: Oligo-anuric, high glucose exposure and
treatment with RhGH
• Europe: Biocompatible PD fluids
• Turkish: Lower serum albumin levels, higher serum P levels and use of
amino-acids containing solutions
• Latin America: Persistent residual renal function, higher use of
phosphate binders and lowest rate of NaCl supplementation
Rees L et al. JASN 22:2302, 2011
21. • Many congenital kidney diseases lead to
loss of electrolytes and decreased ability of
the kidneys to concentrate urine
• Infants with kidney failure due to renal
dysplasia-high urinary losses of sodium
• Metabolic acidosis- kidney function below
50%
• The specific effect of bicarbonate therapy
on growth in CKD remains to be defined
• Correction prior to treatment with rhGH
22. • Effects on bone remodeling and modeling
– Skeletal fracture and microfracture repair
– Bone deformities
– Growth retardation
• Relationship to:
– Osteopenia / osteoporosis
– Changes in bone mass over time during long-term dialysis
– Vascular calcifications
• Bone loss after renal transplantation and
cardiovascular disease
23. 100
Bone turnover
% of Subjects
80
PTH
60
40
20
0
2
3
CKD Stage
4
Wesseling-Perry K CJASN (2012) 7:146
29. A systemic disorder of mineral and bone metabolism due to
CKD manifested by either one or a combination of the
following:
– Abnormalities of calcium, phosphorus, PTH, or vitamin D
metabolism
– Abnormalities in bone
turnover, mineralization, volume, linear growth, or strength
– Vascular or other soft tissue calcification
Moe et al Kidney International 2006
30. • Patients with Stage 5 CKD are at high risk for vascular
calcification
• Vascular calcifications are present in almost 50% of
patients with stage 4 CKD and new dialysis patients
• Vascular calcification can be quantified
• Vascular calcification is associated with modifiable risk
factors
– Ca intake from calcium-based binders
– S-P, S-Ca and Ca P product
• Vascular calcification results in arterial stiffening and
increased pulse pressure and adynamic bone disease
31. Therapeutic Options for the Treatment of
CKD-MBD
Phosphate Binders
Calcitriol
Paricalcitol
D2-D3
1,25(OH)D
Doxercalciferol
Ca-Salts
Sevelamer:
Ca free – Metal Free
Lanthanum Ca:
Ca free - Metal +
Ergocalciferol
Calcimimetic
Drugs
Cinacalcet
32. Treatment
Stage
Treatment Target Range
3
KDIGO: Upper Limit of Normal* (2C)
KDOQI: 35-70 pg/mL
4
KDIGO: Upper Limit of Normal* (2C)
KDOQI: 70-110 pg/mL
5
KDIGO: Upper Limit of Normal* (2C)
KDOQI: 150-300 pg/mL
5D
KDIGO: 2 to 9 times Upper Limit of Normal (2C)
KDOQI: 150-300 pg/mL
Europe Children: 2 to 3 x upper Limit of Normal
*In patients with CKD stages 3-5 not on dialysis, in whom serum PTH is progressively rising and remains
persistently above the upper limit of normal for the assay despite correction of modifiable factors, treatment with
calcitriol or vitamin D analogs is suggested. (2C)
1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline
for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)
Kidney Int. 2009;76(suppl 113):S1-S130.
2. Adapted from National Kidney Foundation (NKF). KDOQI clinical practice guidelines for bone metabolism and disease in
chronic kidney disease. Am J Kidney Dis. 2003;42(4 suppl 3):S1-S201.