Effect of dual compared to no or single renin-angiotensin system blockade on risk of renal replacement therapy or death in predialysis patients: PREPARE-2 study

Clinical epidemiolog

Differences in Progression to ESRD between Black and White Patients Receiving Predialysis Care in a Universal Health Care System

Clinical epidemiolog

Uric acid: association with rate of renal function decline and time until start of dialysis in incident pre-dialysis patients

Clinical epidemiolog

Haemoglobin levels and health-related quality of life in young and elderly patients on specialized predialysis care

Clinical epidemiolog

Prevalence of Anemia and Its Impact on Mortality and Hospitalization Rate in Predialysis Patients

Background/Aim: Anemia is associated with increased mortality and morbidity in both early and very late stages of chronic kidney disease (CKD). The aim of this study was to assess whether anemia is a risk factor for mortality or hospitalization in CKD stage 4-5 predialysis patients not yet on dialysis. Methods: Incident predialysis patients were included between 1999 and 2001 and followed until January 2008 or death. Anemia was defined as mean hemoglobin (Hb) <= 11 g/dl in the 3 months before the start of predialysis. Associations were assessed by Cox regression, linear and logistic regression analysis. Results: A total of 472 patients were included (median follow-up time 12 months, 11% died, 79% started dialysis). Mean Hb was 11.2 g/dl (minimum 7.6, maximum 16.9). Forty-eight percent of patients had anemia at the start of predialysis care. The adjusted mortality risk (hazard ratio, 95% confidence interval) for anemic compared to nonanemic patients was 1.92 (1.04, 3.52). Anemia tended to be related to all-cause but not to non-dialysis-related hospitalization risk. Conclusion: At the start of predialysis care, 48% of patients had anemia. Anemia as defined in guideline targets is not associated with an increase in hospitalizations not related to renal replacement therapy, but is likely an important risk factor for mortality in predialysis patients. Copyright (C) 2010 S. Karger AG, Base

Towards a Better and Harmonized Education in Antimicrobial Stewardship in European Veterinary Curricula

Education in antimicrobial stewardship (AMS) in veterinary medicine is essential to foster responsible antimicrobial use and control of antimicrobial resistance (AMR) in animals. AMS is listed by the EU and international organizations among the basic ‘Day One Competences’ required of veterinary students upon graduation. Our aim was to evaluate the quality of education of European veterinary students in AMS. We distributed a 27-item survey addressing the perceptions of preparedness and acquired skills on key topics related to AMS to final-year veterinary students in Europe. We collected 3423 complete answers from 89 veterinary schools in 30 countries. Selection of treatment strategies and awareness of emerging AMR problems were markedly different between countries. Overall, only one in four students was familiar with guidelines for antimicrobial use. The students perceived a medium-high impact of veterinary antimicrobial use on AMR in humans. Notably, 75% of the students felt the need for improved teaching on AMS, half of which also demanded more teaching on general antimicrobial therapy. Our results highlight several possible strategies to improve the quality of education, ranging from a better link between clinical rotations and the theory taught in pre-clinical modules, to a more effective introduction into best practices for antimicrobial use

Proteinuria as a Risk Marker for the Progression of Chronic Kidney Disease in Patients on Predialysis Care and the Role of Angiotensin-Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Treatment

Nephrolog

Association Of Blood Pressure with the Start of Renal Replacement Therapy in Elderly Compared with Young Patients Receiving Predialysis Care

Clinical epidemiolog