Synthetic routes toward MOF nanomorphologies.

As metal–organic frameworks (MOFs) are coming of age, their structural diversity, exceptional porosity and inherent functionality need to be transferred into useful applications. Fashioning MOFs into various shapes and at the same time controlling their size constitute an essential step toward MOF-based devices. Moreover, downsizing MOFs to the nanoscale triggers a whole new set of properties distinguishing nanoMOFs from their bulk counterparts. Therefore, dimensionality-controlled miniaturization of MOFs enables the customised use of nanoMOFs for specific applications where suitable size and shape are key prerequisites. In this feature article we survey the burgeoning field of nanoscale MOF synthesis, ranging from classical protocols such as microemulsion synthesis all the way to microfluidic-based techniques and template-directed epitaxial growth schemes. Along these lines, we will fathom the feasibility of rationally designing specific MOF nanomorphologies—zero-, one- and two-dimensional nanostructures—and we will explore more complex “second-generation” nanostructures typically evolving from a high level of interfacial control. As a recurring theme, we will review recent advances made toward the understanding of nucleation and growth processes at the nanoscale, as such insights are expected to further push the borders of nanoMOF science

Additive-mediated size control of MOF nanoparticles

A fast synthesis approach toward sub-60 nm sized MOF nanoparticles was developed by employing auxiliary additives. Control over the size of HKUST-1 and IRMOF-3 particles was gained by adjusting the concentration and type of stabilizers. Colloidal solutions of the MOFs were used for the formation of optically homogeneous thin films by spin-coating

Monitoring and management of chronic kidney disease in ambulatory care – analysis of clinical and claims data from a population-based study

Background Although chronic kidney disease (CKD) is highly prevalent in the general population, little research has been conducted on CKD management in ambulatory care. Objective was to assess management and quality of care by evaluating CKD coding in ambulatory care, patient diagnosis awareness, frequency of monitoring and whether appropriate patients are referred to nephrology. Methods Clinical data from the population-based cohort Study of Health in Pomerania (SHIP-START) were matched with claims data of the Association of Statutory Health Insurance Physicians. Quality of care was evaluated according international and German recommendations. Results Data from 1778 participants (56% female, mean age 59 years) were analysed. 10% had eGFR < 60 ml/min/1.73m2 (mean age 74 years), 15% had albuminuria. 21% had CKD as defined by KDIGO. 20% of these were coded and 7% self-reported having CKD. Coding increased with GFR stage (G3a 20%, G3b 61%, G4 75%, G5 100%). Serum creatinine and urinary dip stick testing were billed in the majority of all participants regardless of renal function. Testing frequency partially surpassed recommendations. Nephrology consultation was billed in few cases with stage G3b-G4. Conclusion CKD coding increased with stage and was performed reliably in stages ≥ G4, while CKD awareness was low. Adherence to monitoring and referral criteria varied, depending on the applicability of monitoring criteria. For assessing quality of care, consent on monitoring, patient education, referral criteria and coordination of care needs to be established, accounting for patient related factors, including age and comorbidity. Trial registration This study was prospectively registered as DRKS00009812 in the German Clinical Trials Register (DRKS)

Diagnosis and management of non-dialysis chronic kidney disease in ambulatory care: a systematic review of clinical practice guidelines

Abstract Background Chronic kidney disease (CKD) is age-dependent and has a high prevalence in the general population. Most patients are managed in ambulatory care. This systematic review provides an updated overview of quality and content of international clinical practice guidelines for diagnosis and management of non-dialysis CKD relevant to patients in ambulatory care. Methods We identified guidelines published from 2012-to March 2018 in guideline portals, databases and by manual search. Methodological quality was assessed with the Appraisal of Guidelines for Research and Evaluation II instrument. Recommendations were extracted and evaluated. Results Eight hundred fifty-two publications were identified, 9 of which were eligible guidelines. Methodological quality ranged from 34 to 77%, with domains “scope and purpose” and “clarity of presentation” attaining highest and “applicability” lowest scores. Guidelines were similar in recommendations on CKD definition, screening of patients with diabetes and hypertension, blood pressure targets and referral of patients with progressive or stage G4 CKD. Definition of high risk groups and recommended tests in newly diagnosed CKD varied. Conclusions Guidelines quality ranged from moderate to high. Guidelines generally agreed on management of patients with high risk or advanced CKD, but varied in regarding the range of recommended measurements, the need for referrals to nephrology, monitoring intervals and comprehensiveness. More research is needed on efficient management of patients with low risk of CKD progression to end stage renal disease