The prevalence of CKDs among a cohort of CKD-prone African Canadians was greater than anticipated in that age group. CKD was more prevalent in women than in men, and older age was a negative predictor of CKD.
The cause(s) of CKDs seem to be multifactorial, involving different pathways which may be related and interacting with the genetic factor. The environmental factors such as diabetes, hypertension, hypertension-kidney diseases, and other factors also appear to be involved.
A significant proportion of patients with CKD die of unknown etiology. The data collected here are applicable to the whole United States population, therefore they can be used to estimate the burden of disease related to CKD in the US.
CKD is a frequent and disabling kidney disease. A high proportion of patients has chronic kidney disease when they are diagnosed with CKD, and CKD is a major cause of advanced end stage kidney disease.
Although it often seems as if the medical profession has come close to achieving the 'cure' of advanced chronic kidney diseases, its effectiveness is currently limited to the initial alleviation of their clinical manifestations.
The majority of treatments for CKD have high efficacy, mostly due to effective and tolerable dosing regimens, but the most prescribed medications may cause severe adverse events or lead to a less effective dosing regimen.
Results from a recent paper suggest that the main causative factor for prevalent CKD, regardless of the underlying causes of CKD, is long-term exposure to environmental toxins. For the primary prevention of CKD we suggest the substitution of traditional tobacco smoking with the use of herbal products or herbal cigarette.
The CKD-EPI equation overestimates eGFR for patients with severe chronic kidney diseases. However, the CKD-EPI equation has good clinical applicability and is probably not applicable for all patient groups. We conclude that it can be used to define stages of CKD and may be used for the clinical risk prediction in patients with CKD and also as a reference in clinical practice.
Community health navigation is as safe as usual care in selected patient populations, especially for low-risk patients with chronic kidney disease. Although no adverse events were noted, it appeared that navigation increased communication between primary care providers and patients.
The CHNP model effectively reduces disparities in diabetes care and reduces patient-centered diabetes care. The study did not support the CHNP model as a stand-alone intervention that increases participation in diabetes care and outcomes in the home setting.
Although navigation and CPN programs are widely used in many countries, they were used in combination with any other treatment in only 10% of studies. This raises the possibility that they may work synergistically. There has been speculation that CPN may have the potential to improve the quality of care by increasing awareness of patients' social and environmental needs that are otherwise missed by health professionals. To evaluate the effectiveness of CPN, well-designed randomized controlled trials are needed to determine whether such programs have any clinical effect on patient outcome (e.g., prolonging survival or improving patient-reported HRQOL).
The PHNN program in this study was proven successful in facilitating communication between the PHNN program and its participants regarding the course of the program and their treatment. Participants reported a high satisfaction rate with PHNN. With improvements in technology, patient-health navigator communication is easier than before.