Talk:Chronic kidney disease

Diabetic nephropathy

Newer therapy to stop the progression of diabetic nephropathy are imminent. A protein kinase C beta inhibitor, Ruboxistaurin, may be useful in arresting the progression of diabetic nephropathy and decreasing proteinuria. 71.104.222.228 18:51, 10 February 2006 (UTC)

Should this not go on diabetic nephropathy? JFW | T@lk 23:31, 11 February 2006 (UTC)

I'm not sure. I'm thinking the new evidence implies damage is done due to a hyper reninaemic state potentiated by a nephrotic syndrome.. i.e DN causes greater damage by Hypertensive damage to kidney. Hence ESRD rather than hypoalbumineamia or whatever. In any case I'm not sure that the research for

hard endpoints like ESRD is back for ARBs and that should be taken out of the article until it is cited properly. Markjohndaley 18:54, 7 May 2007 (UTC)

Should there be a Feline or Veterinary CRF entry?

I notice that there are links to Feline CRF websites on this page. Should there be a Veterinary entry or a Feline entry separate from this human-oriented one? Things would be very confusing if this entry started talking about Sub-Q and Azodyl, and it's confusing that this entry talks about blood pressure and kidney replacement as well as dialysis since those aren't usual options for cats. I'll be happy to create the page or a subsection of this one. QuickieWiki 00:35, 19 June 2007 (UTC)

I came here to essentially ask the same question. Shinobu 18:24, 22 September 2007 (UTC)

www.kidney.org.uk site states that only 1 in 10 CKD sufferers every progress to the stage of needing a transplant / dialysis. Should this be included ?

What happened to CKD stage I (or CKD stages at all?)

Proteinuria, in the absence of a declining GFR, is indicative of CKD. Witness the stages of CKD, in which CKD I is described, highlighting patients with evidence of kidney injury, despite an as yet apparent bump in creatinine. —Gaff ^ταλκ 01:23, 18 October 2007 (UTC)

Comments on the new sections for CKD? and changes form CRF to CKD? and the use of stage 5 CKD rather than other terms including ESRD? There had been discussion prior to making these changes on the talk page Wikipedia talk:WikiProject Nephrology. Cheers, BillpSea 18:03, 21 October 2007 (UTC)

Epidemiology

www.kidney.org.uk site states that only 1 in 10 CKD sufferers every progress to the stage of needing a transplant / dialysis. Should this be included ? Prevalence in USA JFW | T@lk 07:10, 7 November 2007 (UTC)

I agree that this is a worthy section; I was thinking of another angle on prevalence Kidney trouble speeds up heart disease Those in stage 3 and 4 are far more likely to die of heart problems than progress to stage 5. I know there are better sources out there, I'll try to find one or more.BillpSea 07:45, 7 November 2007 (UTC)

measurements given

creatinine clearance is the most common measurement used, could an approx value be listed for each stage alongside the other type of measurement?Heby 00:08, 15 November 2007 (UTC)

"Formulaic estimates of clearances can provide better information than serum creatinine alone." Nephrology Dialysis Transplantation letterBillpSea 17:07, 15 November 2007 (UTC)

Vitamin D

Vitamin D does not consistently decrease PTH. Ouch. JFW | T@lk 14:03, 18 December 2007 (UTC)

No Oliguria/anuria

That there is no mention of oliguria/anuria is a bit worrying. Might try to change that, though. —KetanPanchal^taLK 12:47, 17 July 2008 (UTC)

make CKD stages in to a table so it pops off page better

see subject —Preceding unsigned comment added by 163.40.12.37 (talk) 18:06, 13 January 2011 (UTC)

Too may inaccuracies

For one, this article wrongly stated that only people with high blood pressure are on stage 5 but this is wrong because a lot of people have low blood pressure despite having less than 10% kidney function GFR!. Other available research; especially stem cell related kidney therapy has not been included in this article. — Preceding unsigned comment added by Alchewizzard (talk • contribs) 14:33, 4 February 2011 (UTC)

There is no such thing as stem cell related kidney therapy. JFW | T@lk 19:42, 5 February 2011 (UTC)

Yes there is Just check out these websites

http://pharmrev.aspetjournals.org/content/57/3/299.full

http://singularityhub.com/2009/06/05/giving-your-kidneys-a-makeover-stem-cells-cure-nephritis/

http://www.youtube.com/watch?v=e2thGgSJuMc

YOUR ARTICLE IS INACCURATE AND OUTDATED! — Preceding unsigned comment added by Alchewizzard (talk • contribs) 10:16, 11 October 2011 (UTC)

Stem cells may be promising, but at the moment there is no evidence that it works. Try in a few years, when someone's bothered doing a clinical trial. Word-of-mouth cases not published in the professional literature are simply not sufficient. JFW | T@lk 16:39, 11 October 2011 (UTC)

My review of this article

I am a health student at University of Washington. I am reviewing this article according to the instructions at WP:HealthReview.

I suggest changing the article in the following ways: It's important for people to know about adminsitering ESAs I think that this article could be improved by adding this statement: Don’t administer erythropoiesis-stimulating agents (ESAs) to chronic kidney disease (CKD) patients with hemoglobin levels greater than or equal to 10 g/dL without symptoms of anemia. Administering ESAs to CKD patients with the goal of normalizing hemoglobin levels has no demonstrated survival or cardiovascular disease benefit, and may be harmful in comparison to a treatment regimen that delays ESA administration or sets relatively conservative targets (9–11 g/dL). ESAs should be prescribed to maintain hemoglobin at the lowest level that both minimizes transfusions and best meets individual patient needs.

This reference supports the above statement: http://choosingwisely.org/wp-content/uploads/2012/04/5things_12_factsheet_Amer_Soc_Neph.pdf

Thank you for your attention.

(I am not a regular Wikipedia editor so if you post on my Wikipedia user page I may not get your message.)

(If you need help implementing any of these changes please go to WP:HealthReview and request support there, as I cannot help you.)

Thank you, I9is0 (talk) 22:34, 19 June 2012 (UTC)

We prefer referencing to review articles directly. I agree however with what you say. Doc James (talk · contribs · email) 05:36, 20 June 2012 (UTC)

Have found some refs that recommend 9-12 . PMID 19546410. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) Doc James (talk · contribs · email) 05:53, 20 June 2012 (UTC)

ACP guidance

The American College of Physicians has reviewed its guidelines: "Screening/monitoring/treatment of CKD1-3" - doi:10.7326/0003-4819-159-12-201312170-00726 JFW | T@lk 13:58, 22 October 2013 (UTC)

Mesoamerican nephropathy and "CKDu"

"CKDu" and "Chronic Kidney Disease of unknown origin" are common phrases in media and should be created as redirects to pertinent respective articles (here?). There is also some fairly recent coverage of what I believe is referring to Mesoamerican nephropathy: see the newly created stub Creatinina for sources. I don't think the popular sources in Creatinina explicitly use "Mesoamerican nephropathy", but since CKDu is more general than MeN, I've created Central American CKDu as a redirect, and Creatinina should follow. Please, someone with more knowledge and insight then I help create more redirects to help laypeople quickly find information. Thanks. --Animalparty-- (talk) 05:16, 13 June 2014 (UTC)

Chronic kidney disease of unknown etiology in Sri Lanka

There seems to be lots of recent research on CKDu in Sri Lanka, which should be expanded-upon under Epidemiology to more equitably represent geographic coverage (currently exclusively focused on North and Central America). Recent literature includes:

• Noble, A.; Amerasinghe, P.; Manthrithilake, H.; Arasalingam, S. 2014. Review of literature on chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. Colombo, Sri Lanka: International Water Management Institute (IWMI). 41p. (IWMI Working Paper 158). doi:10.5337/2014.206
• "Chronic Kidney Disease of Unknown Etiology in Agricultural Communities" (PDF). MEDICC Review. 16 (2): 9–15. 2014. {{cite journal}}: Unknown parameter |authors= ignored (help)
• Jayatilake, Nihal; Mendis, Shanthi; Maheepala, Palitha; Mehta, Firdosi R (2013). "Chronic kidney disease of uncertain aetiology: prevalence and causative factors in a developing country". BMC Nephrology. 14 (1): 180. doi:10.1186/1471-2369-14-180.{{cite journal}}: CS1 maint: unflagged free DOI (link)
• Wanigasuriya, K. (June 2012) "Aetiological factors of Chronic Kidney Disease in the North Central Province of Sri Lanka: A review of evidence to-date" (2012). Journal of the College of Community Physicians of Sri Lanka. Volume 17, No. 01, 15-20
• Athuraliya, Nimmi T C; Abeysekera, Tilak D J; Amerasinghe, Priyanie H; Kumarasiri, Ranjit; Bandara, Palitha; Karunaratne, Upul; Milton, Abul H; Jones, Alison L (10 August 2011). "Uncertain etiologies of proteinuric-chronic kidney disease in rural Sri Lanka" (PDF). Kidney International. 80 (11): 1212–1221. doi:10.1038/ki.2011.258.
• Wickremasinghe, AR; Peiris-John, RJ; Wanigasuriya, KP (2011). "Chronic kidney disease of unknown aetiology in the North Central Province of Sri Lanka: trying to unravel the mystery". The Ceylon medical journal. 56 (4): 143–6. PMID 22298206.
• Chandrajith, Rohana; Nanayakkara, Shanika; Itai, Kozuyoshi; Aturaliya, T. N. C.; Dissanayake, C. B.; Abeysekera, Thilak; Harada, Kouji; Watanabe, Takao; Koizumi, Akio (18 September 2010). "Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications" (PDF). Environmental Geochemistry and Health. 33 (3): 267–278. doi:10.1007/s10653-010-9339-1.
• Bandara, J.M.R.S.; Wijewardena, H.V.P.; Liyanege, J.; Upul, M.A.; Bandara, J.M.U.A. (2010). "Chronic renal failure in Sri Lanka caused by elevated dietary cadmium: Trojan horse of the green revolution". Toxicology Letters. 198 (1): 33–39. doi:10.1016/j.toxlet.2010.04.016. PMID 20430069.

Cheers, --Animalparty-- (talk) 19:34, 13 June 2014 (UTC)

Dpilat (talk) 18:18, 30 August 2014 (UTC)

GFR?

Hi Chaps (and chapettes),

the sentence 'Chronic kidney disease is identified by a blood test for creatinine." is not really up to date anymore. I would rather focus on the decline of GFR (which is used for NICE classification) then creatinine. — Preceding unsigned comment added by Dpilat (talk • contribs) 10:38, 30 August 2014 (UTC)

Dpilat (talk) 18:18, 30 August 2014 (UTC)

Research section

One of the refs in the research section seems to be a report of a conference paper. It's possible the following may be useful in that section after checking by a domain expert.

• Stefoni S, Cianciolo G, Baraldi O, Iorio M, Angelini ML (June 2014). "Emerging drugs for chronic kidney disease". Expert Opin Emerg Drugs. 19 (2): 183–99. doi:10.1517/14728214.2014.900044. PMID 24836744.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Fink HA, Ishani A, Taylor BC, Greer NL, MacDonald R, Rossini D, Sadiq S, Lankireddy S, Kane RL, Wilt TJ (January 2012). "Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment [Internet]". AHRQ Comparative Effectiveness Reviews. PMID 22439155. 11(12)-EHC075-EF.{{cite web}}: CS1 maint: multiple names: authors list (link)

RDBrown (talk) 10:00, 24 December 2014 (UTC)

Smoking

Renal_function#Chronic_kidney_disease_stages mentions this as CKD risk factor, why no mention on main article? 174.92.133.107 (talk) 23:56, 2 February 2015 (UTC)

Lead photo caption: Creatinine of 50 mg/dL

I am not a nephrologist, but I have never heard of a serum creatinine level that high. I wonder if the caption meant to say 5.0 mg/dL? El piel (talk) 21:29, 1 October 2015 (UTC)

How do we know that Chronic Kidney Disease exists?

I would like this article to cite some sources to explain how we know that Chronic Kidney Disease even exists as a disease entity, as it is described in the article. For instance, how do we know that the primary purpose of the kidneys is to remove toxins from the blood? How do we know that the presence of, say, high creatinine levels in a patient is indicative of kidney dysfunction and isn't a result of the body trying to accomplish some unrelated purpose? If we could demonstrate that manually removing these substances from the blood improved patient survival, then that would at least show that we're on the right track in assuming them to be in excess, but as far as I can see all the randomized trials on hemodialysis show a flat dose-response curve, survival-wise. Now, apparently the view of kidneys in Chinese medicine is quite different from the Western view - which doesn't mean that the Western view is wrong, but it makes me curious where the Western view originates and what work is being done to document and validate its many assumptions. I don't see any citations in this article which would help me unravel this mystery. 2602:30A:2E9C:80B0:0:0:0:3E8 (talk) 06:11, 11 November 2015 (UTC)

CKDUE

CKD of unknown etiology reviewed systematically doi:10.2215/​CJN.07500715 JFW | T@lk 22:05, 8 March 2016 (UTC)

Lancet

doi:10.1016/S0140-6736(16)32064-5 JFW | T@lk 09:35, 2 December 2016 (UTC)

Lancet seminar

doi:10.1016/S0140-6736(16)32064-5 JFW | T@lk 14:53, 24 March 2017 (UTC)

In other words, it's now published in the journal not just online. JFW | T@lk 14:53, 24 March 2017 (UTC)

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What is "adimprovevanced"?

This term is used in the article. I tried Googling it, but it only yielded similar sentences on the web. MOS:JARGON probably applies here. Dig _deeper ^talk 03:16, 15 March 2020 (UTC)

I'm assuming this word was a typo. Dig _deeper ^talk 18:31, 23 March 2020 (UTC)

"More alkaline" diet

I added some content based on PMID 28117137,[1] but although this is billed as a "review article" the single author writes "The approach used for this article has been based on personal observations of several hundred patients following an adapted LPD. These observations were not measured or quantified". I wondering whether it's really WP:MEDRS? Or is the claim I added suitably tentative for the source? Alexbrn (talk) 15:10, 1 May 2020 (UTC)

Does :NOTNEWS really apply to 4-month old studies?

I just had a contribution reverted on the basis of WP:NOTNEWS. From what I can tell, nothing in that policy mentions peer-reviewed studies - especially ones which study a deadly disease and have a huge sample size (so there's no reasonable way to describe it as insignificant). Moreover, the study I cited is more than 4 months old now. How much older must it get before its inclusion would be warranted? InformationToKnowledge (talk) 15:18, 31 August 2021 (UTC)

Per WP:MEDRS, secondary sources (review articles) are generally required to support medical claims. The source that you supplied (PMID 33904723) is primary. From a lay press standpoint, the source is not news, but from a scientific standpoint, it effectively is. It takes time for primary sources to be reviewed by independent, third parties. Boghog (talk) 05:25, 1 September 2021 (UTC)