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1.
Kidney Int ; 101(3): 432-440, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35190029

RESUMEN

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Asunto(s)
Alfabetización en Salud , Educación en Salud , Personal de Salud , Humanos , Riñón , Estados Unidos
2.
Am J Nephrol ; 53(2-3): 87-95, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35287131

RESUMEN

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Asunto(s)
Educación en Salud , Alfabetización en Salud , Humanos , Riñón
3.
Nephrol Dial Transplant ; 37(4): 605-612, 2022 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-35142861

RESUMEN

The high burden of kidney disease, global disparities in kidney care and poor outcomes of kidney failure bring a concomitant growing burden to those affected, their families, caregivers and the community at large. Health literacy is the degree to which people and organizations have or equitably enable individuals to have the ability to find, understand and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with healthcare providers communicating and educating effectively in a co-designed partnership with those with kidney disease. For kidney policymakers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of healthcare. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance people's and providers' education; the World Kidney Day declares 2022 as the year of 'Kidney Health for All' to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of healthcare providers and health policymakers. By engaging in and supporting kidney health-centered policymaking, community health planning and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Asunto(s)
Educación en Salud , Alfabetización en Salud , Cuidadores , Personal de Salud , Humanos , Riñón
4.
Clin Nephrol ; 97(4): 195-205, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35218334

RESUMEN

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons' and providers' education; The World Kidney Day declares 2022 as the year of "Kidney Health for All" to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.


Asunto(s)
Educación en Salud , Alfabetización en Salud , Humanos , Riñón
5.
Kidney Int ; 99(2): 278-284, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33509344

RESUMEN

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.


Asunto(s)
Accesibilidad a los Servicios de Salud , Insuficiencia Renal Crónica , Diagnóstico Precoz , Promoción de la Salud , Humanos , Riñón , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/terapia
6.
Am J Nephrol ; 52(1): 1-7, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33662959

RESUMEN

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.


Asunto(s)
Cuidadores/psicología , Empoderamiento , Participación del Paciente , Insuficiencia Renal Crónica/psicología , Humanos , Insuficiencia Renal Crónica/terapia
7.
Transpl Int ; 34(3): 391-397, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33382133

RESUMEN

Living with CKD is associated with hardships for patients and their care partners. Empowering patients and care partners may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of 'Living Well with Kidney Disease' in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness programme for kidney disease patients, the need for prevention should be reiterated. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals and policy makers, applicable to both developed and developing countries.


Asunto(s)
Cuidadores , Insuficiencia Renal Crónica , Promoción de la Salud , Accesibilidad a los Servicios de Salud , Humanos , Riñón
8.
Clin Nephrol ; 95(3): 115-122, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33527892

RESUMEN

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.


Asunto(s)
Promoción de la Salud , Insuficiencia Renal Crónica , Cuidadores , Familia , Humanos , Participación del Paciente , Insuficiencia Renal Crónica/prevención & control , Insuficiencia Renal Crónica/terapia
9.
Clin Exp Nephrol ; 25(6): 567-573, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33721132

RESUMEN

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labelling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy-makers, applicable to both developed and developing countries.


Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Costo de Enfermedad , Riñón/fisiopatología , Participación del Paciente , Insuficiencia Renal Crónica/terapia , Prestación Integrada de Atención de Salud , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Humanos , Educación del Paciente como Asunto , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/fisiopatología , Insuficiencia Renal Crónica/psicología
10.
Blood Purif ; 50(1): 1-8, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32160626

RESUMEN

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.


Asunto(s)
Accesibilidad a los Servicios de Salud , Riñón , Prevención Primaria , Diálisis Renal , Insuficiencia Renal Crónica , Prevención Secundaria , Humanos , Riñón/patología , Riñón/fisiopatología , Insuficiencia Renal Crónica/patología , Insuficiencia Renal Crónica/fisiopatología , Insuficiencia Renal Crónica/prevención & control , Factores de Riesgo
11.
J Ren Nutr ; 31(6): 554-559, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34749903

RESUMEN

Living with chronic kidney disease is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of chronic kidney disease-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. World Kidney Day 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.


Asunto(s)
Cuidadores , Insuficiencia Renal Crónica , Promoción de la Salud , Humanos , Riñón , Participación del Paciente , Insuficiencia Renal Crónica/terapia
12.
Am J Nephrol ; 51(4): 255-262, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32160623

RESUMEN

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Tamizaje Masivo/organización & administración , Nefrología/organización & administración , Servicios Preventivos de Salud/organización & administración , Insuficiencia Renal Crónica/prevención & control , Prestación Integrada de Atención de Salud/organización & administración , Carga Global de Enfermedades , Educación en Salud/organización & administración , Política de Salud , Humanos , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/epidemiología , Factores de Riesgo , Prevención Secundaria/organización & administración
13.
Pediatr Transplant ; 24(6): e13724, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32388917

RESUMEN

Pediatric kidney transplantation is a multidisciplinary therapy that needs special consideration and experience. In this study, we aimed to present CUCH experience; over a 10-year period, as a specialized center of kidney transplantation in children. We studied 148 transplantations performed at a single center from 2009 to 2018. Pretransplant and follow-up data were collected and graft/patient survival rates were evaluated. A total of 48 patients developed at least one rejection episode during 688 patient-years of follow-up. Infections, recurrence of original disease, and malignancy were the most important encountered medical complications (20%, 2%, and 1.4%, respectively). One-year patient survival was 94.1%, while graft and patient survival was 91.9%. Graft/patient survival at 5, 7, and 9 years was 90%, 77%, and 58%, respectively. Infections were the main cause (69%) of mortality. Death with a functioning graft and CR were the main causes of graft loss (48% and 33%, respectively). Pediatric kidney transplantation in Egypt is still a challenging yet successful experience. Rejections and infections are the most frequent complications. Short-term outcomes surpass long-term ones and graft survival rates are similar to the international standard.


Asunto(s)
Trasplante de Riñón/métodos , Pediatría/métodos , Adolescente , Biopsia , Niño , Preescolar , Egipto/epidemiología , Femenino , Estudios de Seguimiento , Rechazo de Injerto , Supervivencia de Injerto , Humanos , Terapia de Inmunosupresión , Lactante , Estimación de Kaplan-Meier , Fallo Renal Crónico/cirugía , Masculino , Periodo Perioperatorio , Recurrencia , Estudios Retrospectivos , Resultado del Tratamiento
14.
Pediatr Nephrol ; 35(10): 1801-1810, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32588223

RESUMEN

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD are often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions-be it primary, secondary, or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, the management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase awareness of the importance of preventive measures throughout populations, professionals, and policy makers.


Asunto(s)
Carga Global de Enfermedades , Implementación de Plan de Salud , Accesibilidad a los Servicios de Salud/organización & administración , Insuficiencia Renal Crónica/terapia , Progresión de la Enfermedad , Política de Salud , Accesibilidad a los Servicios de Salud/normas , Humanos , Trasplante de Riñón/normas , Tamizaje Masivo/organización & administración , Tamizaje Masivo/normas , Diálisis Renal/normas , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/epidemiología , Prevención Secundaria/métodos , Prevención Secundaria/organización & administración
15.
Clin Nephrol ; 93(3): 111-122, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32017699

RESUMEN

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals, and policy makers.


Asunto(s)
Accesibilidad a los Servicios de Salud , Insuficiencia Renal Crónica/prevención & control , Análisis Costo-Beneficio , Diagnóstico Precoz , Educación en Salud , Humanos , Prevención Primaria , Insuficiencia Renal Crónica/diagnóstico , Prevención Secundaria
16.
Int J Immunogenet ; 47(6): 494-500, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32881306

RESUMEN

Given the uncertainty regarding the relationship between donor cells at microchimeric levels and its influence on graft function and clinical outcome, we explored the extent and importance of donor microchimerism in kidney transplantation. Twenty patients with chronic kidney disease who had received allografts from living donors were studied. We examined peripheral whole blood samples from the recipients one month after the transplant, applying mitochondrial DNA variant-specific polymerase chain reaction (PCR) to identify and quantify donor cells in relation to allograft function and survival during three years of follow-up. Higher quantities of donor-derived cell microchimerism in the peripheral blood correlated with better graft function in the early postoperative period at 1 month (R2  = .536, p = .001) and predicted improved graft function 1 year following the transplant (R2  = .430, p = .008). Furthermore, early post-transplant quantities of donor cell microchimerism were an important predictor of improved kidney function 3 years after transplantation (R2  = .397, p = .021). However, donor cell microchimerism failed to predict patient and graft survival after 3 years (odds ratio = 0.536, p = .860). Our findings suggest that donor cell microchimerism plays an immunoregulatory role in kidney transplantation and contributes to donor-specific immune hypo-responsiveness and graft acceptance.


Asunto(s)
Quimerismo , Trasplante de Riñón , Insuficiencia Renal Crónica/cirugía , Quimera por Trasplante , Adulto , Biomarcadores/metabolismo , Femenino , Estudios de Seguimiento , Rechazo de Injerto , Supervivencia de Injerto , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Donantes de Tejidos , Adulto Joven
17.
Am J Nephrol ; 49(3): 254-262, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30820003

RESUMEN

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Asunto(s)
Lesión Renal Aguda/epidemiología , Carga Global de Enfermedades , Accesibilidad a los Servicios de Salud/economía , Disparidades en Atención de Salud/economía , Insuficiencia Renal Crónica/epidemiología , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/economía , Lesión Renal Aguda/terapia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/economía , Insuficiencia Renal Crónica/terapia , Cobertura Universal del Seguro de Salud/tendencias
18.
Pediatr Nephrol ; 34(4): 541-548, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30758679

RESUMEN

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step toward achieving kidney health equity.


Asunto(s)
Países en Desarrollo , Salud Global , Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Enfermedades Renales/terapia , Terapia de Reemplazo Renal , Costo de Enfermedad , Países en Desarrollo/economía , Salud Global/economía , Salud Global/legislación & jurisprudencia , Costos de la Atención en Salud , Equidad en Salud , Política de Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Disparidades en Atención de Salud/economía , Disparidades en Atención de Salud/legislación & jurisprudencia , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/economía , Enfermedades Renales/epidemiología , Formulación de Políticas , Terapia de Reemplazo Renal/economía , Factores de Riesgo , Determinantes Sociales de la Salud , Cobertura Universal del Seguro de Salud
19.
Clin Nephrol ; 91(3): 129-137, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30704553

RESUMEN

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Asunto(s)
Lesión Renal Aguda/terapia , Equidad en Salud , Disparidades en Atención de Salud , Insuficiencia Renal Crónica/terapia , Lesión Renal Aguda/diagnóstico , Salud Global , Disparidades en el Estado de Salud , Humanos , Insuficiencia Renal Crónica/diagnóstico , Terapia de Reemplazo Renal
20.
Blood Purif ; 48(1): 32-39, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30836351

RESUMEN

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.


Asunto(s)
Costo de Enfermedad , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Enfermedades Renales/epidemiología , Política de Salud , Fuerza Laboral en Salud , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/terapia , Atención al Paciente/economía , Atención al Paciente/métodos , Terapia de Reemplazo Renal , Factores de Riesgo
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