Nephrology Commons^™

Mtor Inhibitors Induce Erythropoietin Resistance In Renal Transplant Recipients, Reece Jefferies, Harish Puttagunta, Anoushka Krishnan, Ashley Irish, Ramyasuda Swaminathan, John K. Olynyk

Research outputs 2022 to 2026

Aim: To elucidate the role of mTOR inhibitors on iron, hepcidin and erythropoietin-mediated regulation of hemopoiesis in stable renal transplant recipients (RTR). Background: Impaired hemopoiesis is common following renal transplantation managed using mTOR inhibitors. The mechanisms responsible are uncertain but include direct effects on iron, hepcidin or erythropoietin-mediated hemopoiesis. Methods: We conducted a single center prospective case-control study of 26 adult RTR with stable allograft function. RTR received stable mTOR dosing (cases, 11/26 [42%]) or stable tacrolimus dosing (controls, 15/26 [58%]). Baseline demographics, full blood count, renal function, iron studies, hepcidin-25, Interleukin-6 (IL-6) and erythropoietin (EPO) levels were determined. Results: …

Cystatin C And Risk Of New-Onset Depressive Symptoms Among Individuals With A Normal Creatinine-Based Estimated Glomerular Filtration Rate: A Prospective Cohort Study, Li Haibin, Wang Anxin, Qi Gao, Guo Jin, Li Xia, Wei Wang, Xiang Yutao, Guo Xiuhua

Research outputs 2014 to 2021

The association between cystatin C and depressive symptoms in the general population has not been thoroughly elucidated to date. We investigated the association of cystatin C with new-onset depressive symptoms among individuals with normal creatinine-based estimated glomerular filtration rates (eGFR). In the China Health and Retirement Longitudinal Study, 5111 participants without depressive symptoms or renal dysfunction (eGFR < 60 ml/min/1.73 m

Can A Renal Nurse Assess Fluid Status Using Ultrasound On The Inferior Vena Cava? A Cross-Sectional Interrater Study: Ultrasound On The Inferior Vena Cava, Ulrich Steinwandel, Nicholas Gibson, Amanda Towell, James Rippey

Research outputs 2014 to 2021

Introduction: Ultrasound of the inferior vena cava (IVC-US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis.

Methods: After receiving theoretical training and performing 100 training scans, a renal nurse performed 60 ultrasound …

Measuring The Prevalence Of Intradialytic Hypotension In A Satellite Dialysis Clinic: Are We Too Complacent?, Ulrich Steinwandel, Nick Gibson, Mandy Towell-Barnard, Richard Parsons, James J. R. Rippey, Johan Rosman

Research outputs 2014 to 2021

Aims and objectives

To measure the prevalence of symptomatic (S‐IDH) and asymptomatic intradialytic hypotension (A‐IDH) or postdialysis overhydration in a satellite haemodialysis clinic in Western Australia.

Background

Intradialytic hypotension is one of the most common side effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastrointestinal tract.

Design

Observational study on a retrospective 3‐month period of nursing recorded fluid‐related adverse events.

Methods

Data collection on the …

Ultrasound Measurements On The Inferior Vena Cava By Renal Nursing Staff For Assessment And Management Of Intravascular Volume Status In Haemodialysis Patients, Ulrich Steinwandel

Theses: Doctorates and Masters

Title: Ultrasound measurements on the inferior vena cava (IVC-US) by renal nursing staff for assessment and management of intravascular volume status in haemodialysis patients.

Aims: The primary aim of this thesis was to provide evidence that renal nurses could safely and efficiently perform IVC-US on haemodialysis patients to obtain objective assessment of intravascular volume status and potentially reduce adverse events and morbidity. The secondary aims for this study were: (1) conduct a systematic literature review to identify evidence if renal nurses have previously used this method for intravascular volume assessment; (2) teach a renal nurse through a staged educational programme, …

Use Of Ultrasound By Registered Nurses—A Systematic Literature Review, Ulrich Steinwandel, Nicholas Gibson, James Charles Rippey, Amanda Towell, Johan Rosman

Research outputs 2014 to 2021

Background:

In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse.

Aim:

This paper examines the existing literature in regards to the use of …

Review Of Kidney Disease Among Indigenous People, Sasha A. Stumpers, Neil J. Thomson

Research outputs 2013

Kidney disease is a significant health problem for all Australians, but severe kidney disease is more common among Indigenous people than among non- Indigenous people. In particular, the prevalence of chronic kidney disease (CKD) and the overall levels of end-stage kidney disease (ESKD) among Aboriginal and Torres Strait Islander peoples are consistently reported as significantly higher than among other Australians. Information on CKD among Indigenous Australians is available from self-reported survey data, as well as from community-based studies and screening programs [10-20] but the main focus in the literature has been on ESKD. The incidence of ESKD is especially high …