Activity

Chronic kidney disease (CKD) is associated with a higher prevalence of depression, neuropathic pain and insomnia. These conditions are often treated pharmaceutically. In this study we aimed to determine the prevalence of chronic antidepressant use among CKD patients with and without kidney replacement therapy (KRT).

By using the Dutch health claims database, we were able to determine the prevalence, type and dosage of chronic antidepressant prescriptions in patients with CKD Stage G4/G5 without KRT (

=14905), patients on dialysis (

=3872) and patients living on a functioning graft (

=8796) and compared these to age-, sex- and socio-economic status (SES)-matched controls from the general population.

Our data show that the prevalence of chronic antidepressant prescription is 5.6%, 5.3% and 4.2% in CKD Stage G4/G5, dialysis and kidney transplant patients, respectively, which is significantly higher than in matched controls. Although our data revealed more prescriptions in female patients and in the age category 45-64 years, our data did not show any association between antidepressant prescriptions and SES. Selective serotonin reuptake inhibitors were the most prescribed drugs in all patient groups and controls. Tricyclic antidepressants were more often used in patients compared with controls.

This nationwide analysis revealed that chronic antidepressant prescription in the Netherlands is higher in CKD patients with and without KRT than in controls, higher in middle-aged patients and women, unrelated to socio-economic status and lower than chronic use reported in other countries.

This nationwide analysis revealed that chronic antidepressant prescription in the Netherlands is higher in CKD patients with and without KRT than in controls, higher in middle-aged patients and women, unrelated to socio-economic status and lower than chronic use reported in other countries.[This corrects the article DOI 10.1093/ckj/sfab148.].

Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). buy Wnt agonist 1 We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex.

CKD patients (≥65 years; estimated glomerular filtration rate≤20mL/min/1.73 m

) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off≤70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confoundaseline were associated with a higher mortality rate in men.Renal transplantation has become the gold-standard treatment for the majority of patients with established renal failure. Recent decades have seen significant progress in immunosuppressive therapies and advances in post-transplant management of recipients, resulting in improved graft and patient outcomes. However, the open technique of allograft implantation has stood the test of time, remaining largely unchanged. In a world where major advances in surgery have been facilitated by innovations in the fields of biotechnology and medical instrumentation, minimally invasive options have been introduced for the recipient undergoing kidney transplantation. In this review we present the evolution of minimally invasive kidney transplantation, with a specific focus on robot-assisted kidney transplant and the benefits it offers to specific patient groups. We also discuss the ethical concerns that must be addressed by transplant teams considering developing or referring to robotic programs.

Hyperkalaemia is an electrolyte abnormality associated with adverse clinical outcomes; however, few studies have investigated the relationship with patterns of hyperkalaemia over time. This study explored the impact of time spent in a hyperkalaemic state and variability of serum potassium (sK

) on major adverse cardiovascular events (MACE) and all-cause mortality in patients with chronic kidney disease (CKD), resistant hypertension, heart failure and diabetes.

Cohorts comprised adult patients diagnosed with CKD stage 3+, resistant hypertension, heart failure or diabetes, and/or renin-angiotensin-aldosterone system inhibitor prescription, between 1 January 2003 and 30 June 2018, from the UK Clinical Practice Research Datalink. Associations between percentage of follow-up spent in a hyperkalaemic state (sK

≥5.0mmol/L, ≥5.5mmol/L, ≥6.0mmol/L) or sK

variability (standard deviation above or below median standard deviation) and all-cause mortality or MACE were investigated.

For sK

≥5.0mmol/L, time spenortality was observed.

Patterns of hyperkalaemia, including time spent in hyperkalaemia and sK

variability, are associated with adverse clinical outcomes. Regular monitoring of sK

in high-risk populations in broader community, primary care and outpatient settings may enable guideline-recommended management of hyperkalaemia and help avoid adverse events.

Patterns of hyperkalaemia, including time spent in hyperkalaemia and sK+ variability, are associated with adverse clinical outcomes. Regular monitoring of sK+ in high-risk populations in broader community, primary care and outpatient settings may enable guideline-recommended management of hyperkalaemia and help avoid adverse events.Edge disturbance can drive liana community changes and alter liana-tree interaction networks, with ramifications for forest functioning. Understanding edge effects on liana community structure and liana-tree interactions is therefore essential for forest management and conservation. We evaluated the response patterns of liana community structure and liana-tree interaction structure to forest edge in two moist semi-deciduous forests in Ghana (Asenanyo and Suhuma Forest Reserves AFR and SFR, respectively). Liana community structure and liana-tree interactions were assessed in 24 50 × 50 m randomly located plots in three forest sites (edge, interior and deep-interior) established at 0-50 m, 200 m and 400 m from edge. Edge effects positively and negatively influenced liana diversity in forest edges of AFR and SFR, respectively. There was a positive influence of edge disturbance on liana abundance in both forests. We observed anti-nested structure in all the liana-tree networks in AFR, while no nestedness was observed in the networks in SFR. The networks in both forests were less connected, and thus more modular and specialised than their null models. Many liana and tree species were specialised, with specialisation tending to be symmetrical. The plant species played different roles in relation to modularity. Most of the species acted as peripherals (specialists), with only a few species having structural importance to the networks. The latter species group consisted of connectors (generalists) and hubs (highly connected generalists). Some of the species showed consistency in their roles across the sites, while the roles of other species changed. Generally, liana species co-occurred randomly on tree species in all the forest sites, except edge site in AFR where lianas showed positive co-occurrence. Our findings deepen our understanding of the response of liana communities and liana-tree interactions to forest edge disturbance, which are useful for managing forest edge.

The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (PD)-Rating Scale (QUIP-RS) was developed to assess the severity of impulsive and compulsive behaviors (ICBs) in PD. We aimed to validate the Japanese version of QUIP-RS and determine the characteristics of ICBs in Japan.

We translated the QUIP-RS into Japanese, back-translated it to English, and obtained confirmation from the original author that the questionnaire remained appropriate. The participants for the validation study were 161 PD patients, identified by continuous sampling at two institutions, who were diagnosed with ICBs through a semistructured interview and completed the QUIP-RS-J. Sensitivity, specificity, and cutoff values were calculated using receiver operating characteristic (ROC) curves. Interinstitutional reliability and test-retest reliability were also assessed for a subset of participants.

Twenty-six (16.1%) participants were diagnosed with ICB. The optimal cutoff value of the QUIP-RS-J total score was 6, with area under the curve (AUC) = 0.889 and sensitivity/specificity of 0.92/0.71. Each subscale also showed high AUC (0.89-1.00), sensitivity (0.92-1.00), and specificity (0.71-1.00). Compared with the English version, the optimal cutoff point for binge eating was higher and hypersexuality lower. The total score tended to be higher when described by an informant.

The present study validated the Japanese version of QUIP-RS. Use of QUIP-RS-J enables standardized assessment of ICBs and can be used in clinical research, including international multicenter studies.

The present study validated the Japanese version of QUIP-RS. Use of QUIP-RS-J enables standardized assessment of ICBs and can be used in clinical research, including international multicenter studies.

The studies about the correlation between bone mineral density (BMD) and coronary arterial calcification (CAC) were still controversial. The aim of this study was to conduct a meta-analysis to evaluate the association between BMD and CAC.

We systematically searched PubMed, Embase, Google scholar and Cochrane library for observational studies. We pooled odds ratio (OR) or correlation coefficient, and 95% confidence interval (CI) of the studies. Continuous data were pooled by mean difference (MD). Sub-group analysis was applied to investigate sources of heterogeneity. Funnel plots for publication bias was also performed.

Seventeen studies met the inclusion criteria. Pooled ORs for the prevalence of CAC in patients with low BMD versus patients with normal BMD was 2.11 (95% CI 1.11 – 4.02,

 = 0.02). The data pooled for comparing CAC score of low BMD and normal BMD patients is 33.77 (95% CI 23.77 – 43.77,

 = 0.000). The pooled ORs of multivariate logistic regression to predict the association were 1.00 (95% CI 0.92 – 1.10,

 = 0.95, age-adjusted), and 0.95 (95% CI 0.86 – 1.05,

 = 0.33, multivariable-adjusted). Cohort category and BMD assessment method were the main sources of heterogeneity.

Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.

Low BMD is associated with higher prevalence and severity of CAC, especially in postmenopausal women. But the relation is not significant after adjusting age and other confounding variables. Low BMD and CAC may be two independent processes with aging. More large-scale studies with high-quality design are still needed to increase the understanding of them.