132 results on '"Bak Leong Goh"'
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2. 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) Guideline Update Implementation: Asia Summit Conference Report
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Angela Yee-Moon Wang, Tadao Akizawa, Sunita Bavanandan, Takayuki Hamano, Adrian Liew, Kuo-Cheng Lu, Dusit Lumlertgul, Kook-Hwan Oh, Ming-Hui Zhao, Samuel Ka-Shun Fung, Yoshitsugu Obi, Keiichi Sumida, Lina Hui Lin Choong, Bak Leong Goh, Chuan-Ming Hao, Young-Joo Kwon, Der-Cherng Tarng, Li Zuo, David C. Wheeler, Yusuke Tsukamoto, and Masafumi Fukagawa
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on Chronic Kidney Disease–Mineral and Bone Disorder (CKD–MBD) 2009 provided recommendations on the detection, evaluation, and treatment of CKD-MBD in patients CKD who are and are not undergoing dialysis. Because of the accumulation of evidence since this initial publication, the CKD-MBD Guideline underwent a selective update in 2017. In April 2018, KDIGO convened a CKD-MBD Guideline Implementation Summit in Japan with the key objective to discuss various barriers to the uptake and implementation of the CKD-MBD Guideline in 8 Asian countries/regions. These countries/regions were comparable according to their high-to-middle economic ranking assigned by the World Bank. The discussion took into account the availability of CKD-MBD medication therapies and government health policies that may influence reimbursement and practice patterns in the region. Most importantly, Summit participants developed a framework of multifaceted strategies aimed at overcoming barriers to guideline implementation. The Summit attendees suggested a shared decision-making approach between clinicians and patients in CKD-MBD management, as well as individualized care based on the treatment risk-benefit ratio. The Summit participants also discussed how KDIGO, as a guideline development organization, may work in partnership with local and national nephrology societies to provide education and facilitate implementation of the guideline by clinicians. The conclusions drawn from this Summit in Asia may serve as an important guide for other regions to follow. Keywords: bone mineral density, calcium, CKD, dialysis, hyperparathyroidism, hyperphosphatemia, KDIGO CKD-MBD Guideline
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- 2019
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3. Rapid decline of renal function in patients with type 2 diabetes with heavy proteinuria: a report of three cases
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Christopher Thiam Seong Lim, Nurul Zaynah Nordin, N. Z. Fadhlina, M. S. Anim, T. Kalaiselvam, W. Z. Haikal, and Bak Leong Goh
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Diabetes mellitus ,Rapid decliners ,Risk factors ,Proteinuria ,Tubulointerstitial inflammation traditional medications ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Although there is a large volume of literature regarding the definition and epidemiology of. Type 2 diabetes nephropathy (T2DN). There has been a paucity of data focused on the rate of transition of T2 DN. Based on our personal observation a certain percentage of our incident end stage renal disease (ESRD) patients from T2DN experienced a rapid decline of renal function. Their rapid decline nature of glomerular filtration rate (GFR) of 46 to 60 mL/min per 1.73m2 per year have far exceeded the KDIGO definitions of acute kidney injury (abrupt decrease in kidney function occurring over 7 days or less), acute kidney disease (acute or subacute damage and/or loss of kidney function for a duration of between 7 and 90 days after exposure to an acute kidney injury initiating event (Chawla et al Nat Rev Nephrol 241–57 2017) or even rapid decliner (eGFR declines > 5 mL/min per 1.73m2 per year) (Chawla et al Nat Rev Nephrol 241–57 2017; Andrassy Kidney Int 622–623 2013). Case presentation We describe here three cases of type 2 diabetic patients that have rapid renal deterioration with rate of decline 46 - 60 mL/min per 1.73m2 per year. All the patients are heavily nephrotic. All of the renal biopsies done showed the classical diabetic changes, hypertensive changes, diffuse tubulointerstitial damage, and interstitial nephritis. All of the patients admitted to taking various form of traditional medications in hope of curing their renal disease. Conclusion We wish to highlight that type 2 diabetics with massive nephrotic range proteinuria have enhanced risk of rapid renal function deterioration. The patients should be educated about the risks of rapid renal function deterioration when there is presence of heavy proteinuria. High grade proteinuria is likely to inflict the diffuse tubulointerstitial inflammation. The interstitial nephritis could be further worsened by traditional supplements consumption. Timely health education and advice must be undertaken to retard this unwanted rapid renal disease progression.
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- 2019
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4. Current clinical practice in adapted automated peritoneal dialysis (aAPD)—A prospective, non-interventional study
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Manel Vera, Bee Boon Cheak, Hana Chmelíčková, Sunita Bavanandan, Bak Leong Goh, Abdul Gafor Abdul Halim, Isabel Garcia, Martin Gajdoš, Rafael Alonso Valente, Tatiana De los Ríos, Saynab Atiye, Manuela Stauss-Grabo, and Emilio Galli
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Medicine ,Science - Abstract
Adapted automated peritoneal dialysis (aAPD), comprising a sequence of dwells with different durations and fill volumes, has been shown to enhance both ultrafiltration and solute clearance compared to standard peritoneal dialysis with constant time and volume dwells. The aim of this non-interventional study was to describe the different prescription patterns used in aAPD in clinical practice and to observe outcomes characterizing volume status, dialysis efficiency, and residual renal function over 1 year. Prevalent and incident, adult aAPD patients were recruited during routine clinic visits, and aAPD prescription, volume status, residual renal function and laboratory data were documented at baseline and every quarter thereafter for 1 year. Treatments were prescribed according to the nephrologist’s medical judgement in accordance with each center’s clinical routine. Of 180 recruited patients, 160 were analyzed. 27 different aAPD prescription patterns were identified. 79 patients (49.4%) received 2 small, short dwells followed by 3 long, large dwells. During follow-up, volume status changed only marginally, with visit mean values ranging between 1.59 (95% confidence interval: 1.19; 1.99) and 1.97 (1.33; 2.61) L. Urine output and creatinine clearance decreased significantly, accompanied by reductions in ultrafiltration and Kt/V. 25 patients (15.6%) received a renal transplant and 15 (9.4%) were changed to hemodialysis. Options for individualization offered by aAPD are actually used in practice for optimized treatment. Changes observed in renal function and dialysis efficiency measures reflect the natural course of chronic kidney disease. No safety events were observed during the study period.
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- 2021
5. Correction to: A multicentre, multi-national, double-blind, randomised, active-controlled, parallel-group clinical study to assess the safety and efficacy of PDA10 (Epoetin-Alfa) vs. Eprex® in patients with anaemia of chronic renal failure
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Soo Kun Lim, Bak Leong Goh, Ravindran Visvanathan, Su Hyun Kim, Jin Seok Jeon, Sung Gyun Kim, Jae Hyun Chang, Chun Soo Lim, and Zaki Morad
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Diseases of the genitourinary system. Urology ,RC870-923 - Published
- 2022
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6. Successful multigravid pregnancy in a 42-year-old patient on continuous ambulatory peritoneal dialysis and a review of the literature
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Thiam Seong Christopher Lim, Malini Shanmuganathan, Irene Wong, and Bak Leong Goh
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Peritoneal dialysis ,Pregnancy ,Adequacy ,Advance maternal age ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient’s pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis. Case presentation We report a successful elderly multigravid pregnancy, in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). Her pregnancy was detected early and she was closely managed by the nephrologist and obstetrician. She tolerated the same PD prescription throughout 36 weeks of pregnancy with daily ultrafiltration of 500-1500mls. Her blood pressure remained well controlled without the need of any antihypertensive medication. Her total Kt/V ranged from 1.93 to 2.73. Her blood parameters remained stable and she was electively admitted at 36 weeks for a trans-peritoneal lower segment caesarian section and bilateral tubal ligation. Conclusions At the age of 42, our case is the oldest reported successful pregnancy in a patient on peritoneal dialysis. With careful counselling and meticulous follow up, we have shown that woman in the early stage of end stage renal failure can successfully deliver a full term baby without any complications. Therefore, these women should not be discourage from conceiving even if they are in advanced maternal age for pregnancy.
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- 2017
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7. Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index
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Cheak, Bee Boon, Ahmad, Ghazali, Bak Leong, Goh, Soo Kun, Lim, Visvanathan, Ravindran, Yahya, Rosnawati, Bavanandan, Sunita, Morad, Zaki, Sualeheen, Ayesha, Khor, Ban-Hock, Balasubramanian, Gaiyal Villy, Sahathevan, Sharmela, Chinna, Karuthan, Mat Daud, Zulfitri Azuan, Khosla, Pramod, Abdul Gafor, Abdul Halim, and Karupaiah, Tilakavati
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- 2022
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8. COVID‐19 death and kidney disease in a multiracial Asian country
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Bak Leong Goh, Malini Shanmuganathan, Kalaiarasu Peariasamy, Nor Arisah Misnan, Suresh Kumar Chidambaram, Eddie Fook Sem Wong, Mohan Dass Pathmanathan, Kim Liong Ang, Hin Seng Wong, and Lena Lay Ling Yeap
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Adult ,Male ,kidney ,asian ,Racial Groups ,COVID-19 ,General Medicine ,Acute Kidney Injury ,Middle Aged ,malaysia ,Risk Factors ,Nephrology ,death ,Diabetes Mellitus ,Humans ,Female ,Hospital Mortality ,Prospective Studies ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies - Abstract
IntroductionCOVID-19 infection and kidney disease (KD) carry a considerable risk of mortality. Understanding predictors of death and KD may help improve management and patient outcome. MethodsThis is a prospective multi-centre observational study conducted in a multiracial Asian country to identify predictors of death and AKI in hospitalized COVID-19 patients from January to June 2020. ResultsA total of 6078 patients were included in this study. Mean age was 37.3(±16.8) years, 71% were male, 59.4% Malay, 6.7% Chinese, 2.3% Indian and 31.7% other ethnicities. Acute kidney injury (AKI) was seen in 3.5% of patients while 1.6% had pre-existing chronic kidney disease (CKD). Overall case fatality rate (CFR) was 1.3%. Patients with KD (AKI and CKD) had CFR of 20%. Many factors were associated with increased risk of death and AKI. However, significant predictors of death after adjustment for covariates were age (>70 years), Chinese ethnicity, diabetes mellitus (DM) and KD. Adjusted predictors of AKI were age (>51 years), DM and severity at presentation. Chinese were 2.58 times more likely to die (P=0.036) compared to Malay. Centre capacity to manage, ventilate and dialyze patients significantly influenced death. Among those with AKI, the most common symptoms were fever, cough, and dyspnea. They had lower absolute lymphocyte count, were more likely to be admitted to ICU, required more ventilation and longer hospitalization. ConclusionPatient and centre factors influence death and AKI among COVID-19 patients. This study also demonstrates death disparities across different racial groups and centre capacities in this multiracial Asian country.
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- 2022
9. Empagliflozin in Patients with Chronic Kidney Disease
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Herrington, William G, Staplin, Natalie, Wanner, Christoph, Green, Jennifer B, Hauske, Sibylle J, Emberson, Jonathan R, Preiss, David, Judge, Parminder, Mayne, Kaitlin J, Ng, Sarah Y A, Sammons, Emily, Zhu, Doreen, Hill, Michael, Stevens, Will, Wallendszus, Karl, Brenner, Susanne, Cheung, Alfred K, Liu, Zhi-Hong, Li, Jing, Hooi, Lai Seong, Liu, Wen, Kadowaki, Takashi, Nangaku, Masaomi, Levin, Adeera, Cherney, David, Maggioni, Aldo P, Pontremoli, Roberto, Deo, Rajat, Goto, Shinya, Rossello, Xavier, Tuttle, Katherine R, Steubl, Dominik, Petrini, Michaela, Massey, Dan, Eilbracht, Jens, Brueckmann, Martina, Landray, Martin J, Baigent, Colin, Haynes, Richard, The EMPA-KIDNEY Collaborative Group: Colin Baigent, Martin J Landray, Christoph Wanner, William G Herrington, Richard Haynes, Jennifer B Green, Sibylle J Hauske, Martina Brueckmann, Mark Hopley, Maximillian von-Eynatten, Jyothis George, Susanne Brenner, Alfred K Cheung, David Preiss, Zhi-Hong Liu, Jing Li, Laiseong Hooi, Wen Liu, Takashi Kadowaki, Masaomi Nangaku, Adeera Levin, David Cherney, Roberto Pontremoli, Aldo P Maggioni, Natalie Staplin, Jonathan Emberson, Stefan Hantel, Shinya Goto, Rajat Deo, Katherine R Tuttle, Michael Hill, Parminder Judge, Kaitlin J Mayne, Sarah Y A Ng, Xavier Rossello, Emily Sammons, Doreen Zhu, Peter Sandercock, Rudolf Bilous, Charles Herzog, Paul Whelton, Janet Wittes, Derrick Bennett, Patricia Achiri, Chrissie Ambrose, Cristina Badin, Jill Barton, Richard Brown, Andy Burke, Sebastian Butler, Rejive Dayanandan, Pia Donaldson, Robert Dykas, Lucy Fletcher, Kate Frederick, Hannah Kingston, Mo Gray, Emily Harding, Akiko Hashimoto, Lyn Howie, Susan Hurley, Ryonfa Lee, Nik Luker, Kevin Murphy, Mariko Nakahara, John Nolan, Michelle Nunn, Sorcha Mulligan, Akiko Omata, Sandra Pickworth, YanRu Qiao, Shraddha Shah, Karen Taylor, Alison Timadjer, Monique Willett, Liz Wincott, Qin Yan, Hui Yu, Louise Bowman, Fang Chen, Robert Clarke, Michelle Goonasekera, Waseem Karsan, Marion Mafham, Christina Reith, Mohammed Zayed, Ritva Ellison, Rowan Moys, Will Stevens, Kevin Verdel, Karl Wallendszus, Chris Bowler, Anna Brewer, Andy Measor, Guanguo Cui, Charles Daniels, Angela Field, Bob Goodenough, Ashley Lawson, Youcef Mostefai, Dheeptha Radhakrishnan, Samee Syed, Shuang Xia, Ruth Adewuyi-Dalton, Thomas Arnold, Anne-Marie Beneat, Anoushka Bhatt, Chloe Bird, Andrew Breach, Laura Brown, Mark Caple, Tatyana Chavagnon, Karen Chung, Sarah Clark, Luminita Condurache, Katarzyna Eichstadt, Marta Espino Obrero, Scarlett Forest, Helen French, Nick Goodwin, Andrew Gordon, Joanne Gordon, Cat Guest, Tina Harding, Michal Hozak, Matthew Lacey, David MacLean, Louise Messinger, Stewart Moffat, Martin Radley, Claire Shenton, Sarah Tipper, Jon Tyler, Lesley Weaving, James Wheeler, Elissa Williams, Tim Williams, Hamish Woodhouse, Angela Chamberlain, Jo Chambers, Joanne Davies, Denise Donaldson, Pati Faria-Shayler, Denise Fleming-Brown, Jennifer Ingell, Carol Knott, Anna Liew, Helen Lochhead, Juliette Meek, Isabel Rodriguez-Bachiller, Andrea Wilson, Patrick Zettergren, Rach AitSadi, Ian Barton, Alex Baxter, Yonghong Bu, Lukasz Danel, Sonja Grotjahn, Rijo Kurien, Michael Lay, Archie Maskill, Aleksandra Murawska, Rachel Raff, Allen Young, Rebecca Sardell, Vladimir Cejka, Marcela Fajardo-Moser, Christian Hartner, Doris Poehler, Janina Renner, Franziska Scheidemantel, Miya Bryant, Anita Hepditch, Cassandra Johnson, Erin Latore, Yolanda Miller, Lauren Price, Merilee Whalen, Ashleigh Wheeler, Jenny Ingell, Yu An, Yinghua Chen, Peiling Chen, Hao Dai, Hong Du, Fang Feng, Qing Guo, Libo Hou, Wuhanbilige Hundei, Binbin Jin, Yan Li, Jiamin Liu, Xia Song, Yanping Wang, Yanwu Yu, Ning Zhang, Lingshan Zhao, Hui Zhong, Cheng Beng Goh, Ye Mun Low, Soon Yi Sor, Farah Hanis Zulkipli, Sarojini Sivanandam, Natsuki Arai, Ai Fukasawa, Mizue Furukawa, Keisuke Habuki, Shoko Hayashi, Wakako Isari, Saki Kanegae, Maria Kawai, Reiki Kobayashi, Takako Kuramae, Chika Kuribayashi, Sawako Maeno, Satoshi Masumoto, Tomoko Morisaki, Minoru Oda, Kazue Sawada, Kenta Sugamori, Ayana Tatsuzawa, Aiko Tomita, Kazuyuki Yuasa, Hiroko Inazawa, Amanda Axler, Kerri Gallo, Ester Baldini, Barbara Bartolomei Mecatti, Francesca Bianchini, Martina Ceseri, Laura Cipressa, Gianna Fabbri, Andrea Lorimer, Donata Lucci, Sharang Ghavampour, Anja Knoppe, Hans Schmidt-Gurtler, Hubert Dumann, Sybille Merscher, Margret Patecki, Georg Rainer Schlieper, Anke Torp, Bianca Weber, Maja Zietz, Bernd Hohenstein, Urs Benck, Diliana Draganova, Thomas Weinreich, Lothar Wolf, Jasmine Gaidu, Hanna Reiner, Mandy Visnjic, Daniel Steffl, Marie Breitenfeldt, Annette Kraemer-Guth, Christine Braun, Simone Hagge, Michael Schomig, Stephan Matthias, Dominik Stoffler, Beate Schumacher, Thomas Sitter, Louise Fuessl, Julia Krappe, Jerome Loutan, Volker Vielhauer, Luciano Andriaccio, Magdalena Maurer, Bernhard Winkelmann, Martin Dursch, Linda Seifert, Linda Tenbusch, Julia Weinmann-Menke, Simone Boedecker, Wiebke Kaluza-Schilling, Daniel Kraus, Carina Krieger, Margit Schmude, Anne Schreiber, Ewelina Eckrich, Diethelm Tschope, Abdulwahab Arbi, Young Lee-Barkey, Bernd Stratmann, Natalie Prib, Sina Rolfsmeier, Irina Schneider, Lars Rump, Johannes Stegbauer, Christine Pötz, Mara Schemmelmann, Claudia Schmidt, Michael Koch, Sendogan Aker, Annika Küpper, Manuela Martin, Thiemo Pfab, Christian Albert, Michael Haase, Barbara Zander, Claudia Schneider-Danwitz, Wolfgang Seeger, Wolf-Adam Seeger, Britta Zemann, Christoph Stellbrink, Kristin Marx, Ekaterina Stellbrink, Britta Brettschneider, Stephanie Watson, Marion Iselt, Gerhard Klausmann, Inga-Nadine Kummer, Auguste Kutschat, Simone Streitenberger, Matthias Girndt, Silke Markau, Ina Girakossyan, Claudia Hanf, Joachim Beige, Ralph Wendt, Ulrike Schmidt, Andreas Schneider, Roland Veelken, Claudia Donhauser, Luis Becker, Nexhat Miftari, Ricarda Wolfling, Sarah Morlok, Christian Hugo, Alexander Paliege, Jens Passauer, Julian Stumpf, Annegret Fleischer, Kerstin Haaser, Bernhard Kraemer, Jan Jochims, Bernd Kruger, Claudia Foellinger, Anastassiya Reisler, Frank Strutz, Stefan Haack, Ursula Hohenstatt, Martin Busch, Konstantin Herfurth, Gunter Wolf, Rainer Paul, Hermann Haller, Jessica Kaufeld, Jan Menne, Elisabeth Bahlmann-Kroll, Angela Bergner, Horst Weihprecht, Aydin Er, Florian Sonntag, Elif Turan, Michael Wittmann, Franziska Klauser, Eva Voigt, Volker Schettler, Egbert Schulz, Madlen Rohnstock, Elke Schettler, Bernd Schroppel, Rene van Erp, Martin Kachele, Ulla Ludwig, Lena Schulte-Kemna, Waltraud Kmietschak, Elke Preiss, Martina Ruocco, Gunnar Heine, Martin Brzoska, Sebastian Gabel, Christina Büttner, Asma Sabarai, Bernhard Banas, Tobias Bergler, Yvonne Ehrl, Franz Putz, Antonia Schuster, Stefanie Kuhn, Torsten Schramm, Stefan Degenhardt, Gerhard Schmidt, Lea Weiland, Ulrike Giebeln-Hudnell, Jan Kielstein, Gabriele Eden, Brigitte Fuchs, Gina Morig, Manuela Winkler, Harald Darius, Charalampos Kriatselis, Carl-Philipp Roesch, Astrid Maselli, Dominik Alscher, Markus Ketteler, Moritz Schanz, Severin Schricker, Bianka Rettenmaier, Andrea Schwab, Pablo Pergola, Irene Leal, Melissa Cagle, Anna Romo, Anthony Torres, Sucharit Joshi, Kulli Barrett, Alexis Africano, Vicki Dodds, Dorleena Gowen, Ashlee Morris, Juan Fernandez, Guillermo Jimenez, Ricardo Viera, Kendaling Bruce, Ryan Barrios, Maylin Garcia, Kerelyn Garcia, Iradis Leal, David Tietjen, David Bains, Carlo Castillo, Genielle Brewer, Justin Davis, Natalie Freking, Brittany Golson, Sally Ham, Jesslyn Roesch, Pusadee Suchinda, Shameem Beigh, Usah Lilavivat, Joyce Bilton, Kim Bocchicchia, Jeffrey Turner, Neera Dahl, Aldo Peixoto, Yasemin Kavak, Lauren Liberti, Hari Nair, Nicolas Page, Stephanie Rosenberg, Kathryn Simmons, Tamara Isakova, Rebecca Frazier, Rupal Mehta, Anand Srivastava, Patrick Fox, Jonathan Hecktman, Alexander Hodakowski, Carlos Martinez, Rachel Phillips, Alexis Stevenson, Reem Mustafa, Kyle Jansson, Cassandra Kimber, Jason Stubbs, Ahmad Tuffaha, Sri Yarlagadda, Debbie Griffin, Elisabeth Laundy, Zhuo Tang, Radica Alicic, Ann Cooper, Lisa Davis, Ashwini Gore, Rebecca Goldfaden, Leslie Harvill, Lisa Hichkad, Barry Johns, Thomas Jones, Kayla Merritt, Jennifer Sheldon, Jennifer Stanfield, Lindsay Alexander, Kaitlyn Preston, Lindsey Wood, Rajesh Pradhan, Roger DeRaad, Kelli McIntosh, Louis Raymond, Michael Shepperd, Susan McLaughlin, Mary Seifert, Andrew Shepherd, Joseph Aiello, William Durham, Laurie Loudermilk, John Manley, Sabrina Burnette, Stephanie Evans, Tara Johnson, Lance Sloan, Judy Ann Acosta, Stacy Gillham, Katia Sloan, SueAnn Squyres, Michael Rocco, Amret Hawfield, Ben Bagwell, Lauren Richmond, Joseph Soufer, Subha Clarke, Amanda Aliu, Kristine Calabrese, Amanda Davis, Veronica Poma, Tracy Spinola, James Magee, Ricardo Silva, Rushab Choksi, Lorraine Dajani, John Evans, Anil George, Prasanth Krish, Gerard Martins, Mae Sheikh-Ali, David Sutton, Freda Driver, Abraham Hanburry, Laura Hume, Amber Hurst, Matthew Taddeo, Marla Turner, Veronica Yousif, Srinivasan Beddhu, Laith Al-Rabadi, Nikita Abraham, Amalia Caamano, Judy Carle, Victoria Gonce, Kaitlyn Staylor, Na Zhou, Shweta Bansal, Manoj Bhattarai, Kumar Sharma, Subrata Debnath, Aliseiya Garza, Chakradhar Velagapudi, Sergio Rovner, Javier Almeida, Pablo Casares, Verlaine Stewart-Ray, Rene Almaraz, Renata Dayrell, Ana Moncada, Ricardo Pulido, Roxana Rodriquez, Wasim Deeb, Kathryn DeGoursey, Rodel Gloria, Trevor Greene, Robert Miller, Edward Pereira, Miguel Roura, Debbie Domingo, Sasha Dorestin, William Hodge, Cathy Jackson, Deborah Lund, Katrina Taylor, Kenneth Boren, Brittany Cleveland, Sandra Gaiser, Mandeep Sahani, Logan Aldrich, Exodus Edmerson, Edmond Limon, Cole Valletta, Patricia Vasquez, Christopher Provenzano, Navkiranjot Brar, Heather Henderson, Bellovich Keith, Qur Khai, Quresh Khairullah, Gail Makos, Joel Topf, Sherry Gasko, Rosemarie Henschel, Kaitlin Knapp, Teresa Kozlowski, Paula LaFleur, Ashwathy Varughese, Hui Xue, Patricia Wu, Olga Arechiga, Shan Darbeau, Michael Fechter, Stephanie Martinez, Lenita Hanson, Nyla Cooper, Arelis Madera, Jay Cadorna, Rita Sheridan, Helen Sparks, Bradley Eilerman, Susanne Bodine, Wael Eid, Rebecca Flora, Amber Avery, Cashmere Hardy, Mihaela Biscoveanu, Steven Nagelberg, Tracey Cummins, Frederic Rahbari-Oskoui, Anju Oommen, Zohreh Forghani, Stacie Hitchcock, Darya Hosein, Diane Watkins, Minesh Patel, Anthony Lambert, Elizabeth Newman, Autumn Wood, Tammy Ross, Stephany Topping, Jeffrey Mulhern, Lorna Murphy, Ann Vasseur, Gregory Greenwood, Alexander Hadley, Denise Laurienti, Christopher Marshall, Nicholas McLean, Scott Satko, Brandy Caudill, Jacob Maris, Janice Rogers, Cindy Vanhoy, George Thomas, Georges Nakhoul, John O'Toole, Jonathan Taliercio, Leslie Cooperman, Marina Markovic, Barbara Tucky, Devasmita Dev, Alia Hasan, Hima Yalamanchili, Namita Jain, Lesley McNeil, Eric Wines, Jean Park, Adline Ghazi, Mia Hamm, Tejas Patel, Amy Mottl, Emily Chang, Vimal Derebail, Emmie Cole, Anne Froment, Sara Kelley, Jordan Osmond Foster, Vahid Mahabadi, Golriz Jafari, Anita Kamarzarian, Wendy Arriaga, Daisy Arteaga, Rosario Machicado, Genesis Naverrete, Prashant Kumar, Imran Nazeer, Karina Urquia, Tammi Glider, Vickie Jones, Savannah Rucker, Jennifer Wiley, Rahul Pandey, Jesus Arroyo, Harish Pariani, Mohammad Ahmad, Shahin Mozaffari, Erika Perez, Matthew Budoff, Sion Roy, Divya Birudaraju, Ahmed Ghanem, Sajad Hamal, Stephen Aronoff, Elisa Joye Petr, Richard Sachson, Jaime Wiebel, Sana Akram, Laurie Jones, Curtis Knight, Maurie Tarlac, Shahbaz Ahmed, Harold Szerlip, Akinwande Akinfolarin, Ankit Mehta, Shana Camp, Cindy Castro, Zanaida Cooper, Jessica Terry, Ahmed Awad, Bhavya Kothapalli, Ryan Lustig, Serine Alfaress, Hyder Jasim, Mary Parrigon, Dennis Karounos, Sadiq Ahmed, Maggie Berry, Ruth Oremus, Carlos Hernandez-Cassis, Elias Ugwu, Nazia Junejo, Nancy Suazo, Mark Segal, Amir Kazory, Sherry Brown, Tristan Daniels, Sofia Dayi, Renee Hogan, Kathy McCray, Jennifer Stickley, Mahboob Rahman, Mirela Dobre, Lavinia Negrea, Aparna Padiyar, Nishigandha Pradhan, Arash Rashidi, Nagaraju Sarabu, Vicki Donley, Tricia Young, Godson Oguchi, Judepatricks Onyema, Kahla Damianik, Jack Dienes, Judith Plummer-Morgan, Marilyn Roman, Mauver Skipper, Stacey-Ann Villaruel, Krystle Williams, Danny Sugimoto, Jeffrey Dugas, Ismeal Ahmed, Jamie Bhairoo, Dolores Rijos, Huzaifa Salim, Madita Gavrila, Kathryn Lafferty, Ria Rabara, Sally Ruse, Maria Weetman, James Bushnell, Albert Power, Alison Jenkins, Stefanie Jones, Amanda Scott, Cath Byrne, Mark Jesky, Alison Cowley, Emma McHaffie, Holly Waterfall, Jo Taylor, Laura Bough, Thomas Phillips, Barbara Winter-Goodwin, Sui Phin Kon, Iain MacDougall, Eirini Lioudaki, Sapna Shah, Claire Sharpe, Francisco Aguilar, Abegail Hernandez Pena, Conception Pugay, Amelia Te, Hugh Finn, Wasim Hanif, Samiul Mostafa, Alice Aitken, Katharine Draxlbauer, Evelina Grobovaite, Jennifer Kearney, Theresa McCarthy, Giorgio Gentile, Duncan Browne, Palanichamy Chellamuthu, Tabinda Dugal, Terri Chant, Laura Jones, Emily Laity, Megan Miners, James Muir, Elizabeth Swanson, Andrew Frankel, James Tomlinson, Marlon Alegata, Rashid Almasarwah, Anthoula Apostolidi, Maria Vourvou, Thomas Walters, Maarten Taal, Hari Dukka, Nitin Kolhe, Carly McDonald, Kelly White, Shiva Ugni, Smita Gunda, Rotimi Oluyombo, Vicki Brindle, Ping Coutts, Tracy Fuller, Evelyn Nadar, Suresh Ramadoss, Nichola Motherwell, Susannah Pajak, Louise Tonks, Sunil Bhandari, Richard Bodington, Adil Hazara, Dominic Fellowes, Christopher Wong, Christopher Goldsmith, Sherald Barnes, Ann Bennett, Claire Burston, Samantha Hope, Nicola Hunt, Lini Kurian, Richard Fish, Daniela Farrugia, Judy Lee, Emma Sadler, Hannah Turner, Christopher Hill, Henry Brown, Agnes Masengu, Peter Maxwell, Nina Bleakley, Hugh Murtagh, William Petchey, Vivian Yiu, Joanne Kellett, Angharad Williams, Helen Clarke, Victoria Carnall, Sarah Benyon, Caroline Blake, Stephanie Estcourt, Jane Piper, Neal Morgan, Carolyn Hutchinson, Teresa McKinley, Alastair Woodman, Judi Graham, Niall Leonard, John Smyth, Vicki Adell, Samantha Hagan, Ben Caplin, Amin Oomatia, Eleanor Damian, Toluleyi Sobande, Tim Doulton, Michael Delaney, Mahmoud Montasser, Jenny Hansen, David Loader, Angela Moon, Frances Morris, Smeeta Sinha, Chukwuma Chukwu, Amy Hudson, Diane Campbell, Melanie Kershaw, Stephanie Whittaker, Ayesha Irtiza-Ali, Farid Ghalli, Heba Nosseir, Allison Leslie, Kate Trivedi, Donald Fraser, Mohammad Alhadj Ali, Sian Griffin, Farah Latif, Justyna Witczak, Alexa Wonnacott, Lynda Jeffers, Yvette Webley, Paul Phelan, Eve Miller-Hodges, Ailsa Geddes, Margaret Glenwright, Amy Hunter, Thomas Pickett, Jim Moriarty, Linda Hill, Amanda Tyler, Waqar Ayub, Gail Evans, Sue Hewins, Davina Hewitt, Kerry Read, Samira Bell, Leanne Cosgrove, Rachel Craik, Shona Murray, Nitin Bhandary, Holly Coles, Rashmi Easow, Maya Joseph, Arif Khwaja, Yvonne Jackson, Angeline Mbuyisa, Rachel Sellars, Nihil Chitalia, Cynthia Mohandas, Anca Gherman, Charlotte 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Andrea, Pergola, Pablo, Leal, Irene, Cagle, Melissa, Romo, Anna, Torres, Anthony, Joshi, Sucharit, Barrett, Kulli, Africano, Alexi, Dodds, Vicki, Gowen, Dorleena, Morris, Ashlee, Fernandez, Juan, Jimenez, Guillermo, Viera, Ricardo, Bruce, Kendaling, Barrios, Ryan, Garcia, Maylin, Garcia, Kerelyn, Leal, Iradi, Tietjen, David, Bains, David, Castillo, Carlo, Brewer, Genielle, Davis, Justin, Freking, Natalie, Golson, Brittany, Ham, Sally, Roesch, Jesslyn, Suchinda, Pusadee, Beigh, Shameem, Lilavivat, Usah, Bilton, Joyce, Bocchicchia, Kim, Turner, Jeffrey, Dahl, Neera, Peixoto, Aldo, Kavak, Yasemin, Liberti, Lauren, Nair, Hari, Page, Nicola, Rosenberg, Stephanie, Simmons, Kathryn, Isakova, Tamara, Frazier, Rebecca, Mehta, Rupal, Srivastava, Anand, Fox, Patrick, Hecktman, Jonathan, Hodakowski, Alexander, Martinez, Carlo, Phillips, Rachel, Stevenson, Alexi, Mustafa, Reem, Jansson, Kyle, Kimber, Cassandra, Stubbs, Jason, Tuffaha, Ahmad, Yarlagadda, Sri, Griffin, Debbie, Laundy, Elisabeth, Tang, Zhuo, Alicic, Radica, Cooper, Ann, Davis, Lisa, Gore, Ashwini, Goldfaden, Rebecca, Harvill, Leslie, Hichkad, Lisa, Johns, Barry, Jones, Thoma, Merritt, Kayla, Sheldon, Jennifer, Stanfield, Jennifer, Alexander, Lindsay, Preston, Kaitlyn, Wood, Lindsey, Pradhan, Rajesh, Deraad, Roger, Mcintosh, Kelli, Raymond, Loui, Shepperd, Michael, Mclaughlin, Susan, Seifert, Mary, Shepherd, Andrew, Aiello, Joseph, Durham, William, Loudermilk, Laurie, Manley, John, Burnette, Sabrina, Evans, Stephanie, Johnson, Tara, Sloan, Lance, Ann Acosta, Judy, Gillham, Stacy, Sloan, Katia, Squyres, Sueann, Rocco, Michael, Hawfield, Amret, Bagwell, Ben, Richmond, Lauren, Soufer, Joseph, Clarke, Subha, Aliu, Amanda, Calabrese, Kristine, Davis, Amanda, Poma, Veronica, Spinola, Tracy, Magee, Jame, Silva, Ricardo, Choksi, Rushab, Dajani, Lorraine, Evans, John, George, Anil, Krish, Prasanth, Martins, Gerard, Sheikh-Ali, Mae, Sutton, David, Driver, Freda, Hanburry, Abraham, Hume, Laura, Hurst, Amber, Taddeo, Matthew, Turner, Marla, Yousif, Veronica, Beddhu, Srinivasan, Al-Rabadi, Laith, Abraham, Nikita, Caamano, Amalia, Carle, Judy, Gonce, Victoria, Staylor, Kaitlyn, Zhou, Na, Bansal, Shweta, Bhattarai, Manoj, Sharma, Kumar, Debnath, Subrata, Garza, Aliseiya, Velagapudi, Chakradhar, Rovner, Sergio, Almeida, Javier, Casares, Pablo, Stewart-Ray, Verlaine, Almaraz, Rene, Dayrell, Renata, Moncada, Ana, Pulido, Ricardo, Rodriquez, Roxana, Deeb, Wasim, Degoursey, Kathryn, Gloria, Rodel, Greene, Trevor, Miller, Robert, Pereira, Edward, Roura, Miguel, Domingo, Debbie, Dorestin, Sasha, Hodge, William, Jackson, Cathy, Lund, Deborah, Taylor, Katrina, Boren, Kenneth, Cleveland, Brittany, Gaiser, Sandra, Sahani, Mandeep, Aldrich, Logan, Edmerson, Exodu, Limon, Edmond, Valletta, Cole, Vasquez, Patricia, Provenzano, Christopher, Brar, Navkiranjot, Henderson, Heather, Keith, Bellovich, Khai, Qur, Khairullah, Quresh, Makos, Gail, Topf, Joel, Gasko, Sherry, Henschel, Rosemarie, Knapp, Kaitlin, Kozlowski, Teresa, Lafleur, Paula, Varughese, Ashwathy, Xue, Hui, Wu, Patricia, Arechiga, Olga, Darbeau, Shan, Fechter, Michael, Martinez, Stephanie, Hanson, Lenita, Cooper, Nyla, Madera, Areli, Cadorna, Jay, Sheridan, Rita, Sparks, Helen, Eilerman, Bradley, Bodine, Susanne, Eid, Wael, Flora, Rebecca, Avery, Amber, Hardy, Cashmere, Biscoveanu, Mihaela, Nagelberg, Steven, Cummins, Tracey, Rahbari-Oskoui, Frederic, Oommen, Anju, Forghani, Zohreh, Hitchcock, Stacie, Hosein, Darya, Watkins, Diane, Patel, Minesh, Lambert, Anthony, Newman, Elizabeth, Wood, Autumn, Ross, Tammy, Topping, Stephany, Mulhern, Jeffrey, Murphy, Lorna, Vasseur, Ann, Greenwood, Gregory, Hadley, Alexander, Laurienti, Denise, Marshall, Christopher, Mclean, Nichola, Satko, Scott, Caudill, Brandy, Maris, Jacob, Rogers, Janice, Vanhoy, Cindy, Thomas, George, Nakhoul, George, O'Toole, John, Taliercio, Jonathan, Cooperman, Leslie, Markovic, Marina, Tucky, Barbara, Dev, Devasmita, Hasan, Alia, Yalamanchili, Hima, Jain, Namita, Mcneil, Lesley, Wines, Eric, Park, Jean, Ghazi, Adline, Hamm, Mia, Patel, Teja, Mottl, Amy, Chang, Emily, Derebail, Vimal, Cole, Emmie, Froment, Anne, Kelley, Sara, Osmond Foster, Jordan, Mahabadi, Vahid, Jafari, Golriz, Kamarzarian, Anita, Arriaga, Wendy, Arteaga, Daisy, Machicado, Rosario, Naverrete, Genesi, Kumar, Prashant, Nazeer, Imran, Urquia, Karina, Glider, Tammi, Jones, Vickie, Rucker, Savannah, Wiley, Jennifer, Pandey, Rahul, Arroyo, Jesu, Pariani, Harish, Ahmad, Mohammad, Mozaffari, Shahin, Perez, Erika, Budoff, Matthew, Roy, Sion, Birudaraju, Divya, Ghanem, Ahmed, Hamal, Sajad, Aronoff, Stephen, Joye Petr, Elisa, Sachson, Richard, Wiebel, Jaime, Akram, Sana, Jones, Laurie, Knight, Curti, Tarlac, Maurie, Ahmed, Shahbaz, Szerlip, Harold, Akinfolarin, Akinwande, Mehta, Ankit, Camp, Shana, Castro, Cindy, Cooper, Zanaida, Terry, Jessica, Awad, Ahmed, Kothapalli, Bhavya, Lustig, Ryan, Alfaress, Serine, Jasim, Hyder, Parrigon, Mary, Karounos, Denni, Ahmed, Sadiq, Berry, Maggie, Oremus, Ruth, Hernandez-Cassis, Carlo, Ugwu, Elia, Junejo, Nazia, Suazo, Nancy, Segal, Mark, Kazory, Amir, Brown, Sherry, Daniels, Tristan, Dayi, Sofia, Hogan, Renee, Mccray, Kathy, Stickley, Jennifer, Rahman, Mahboob, Dobre, Mirela, Negrea, Lavinia, Padiyar, Aparna, Pradhan, Nishigandha, Rashidi, Arash, Sarabu, Nagaraju, Donley, Vicki, Young, Tricia, Oguchi, Godson, Onyema, Judepatrick, Damianik, Kahla, Dienes, Jack, Plummer-Morgan, Judith, Roman, Marilyn, Skipper, Mauver, Villaruel, Stacey-Ann, Williams, Krystle, Sugimoto, Danny, Dugas, Jeffrey, Ahmed, Ismeal, Bhairoo, Jamie, Rijos, Dolore, Salim, Huzaifa, Gavrila, Madita, Lafferty, Kathryn, Rabara, Ria, Ruse, Sally, Weetman, Maria, Bushnell, Jame, Power, Albert, Jenkins, Alison, Jones, Stefanie, Scott, Amanda, Byrne, Cath, Jesky, Mark, Cowley, Alison, Mchaffie, Emma, Waterfall, Holly, Taylor, Jo, Bough, Laura, Phillips, Thoma, Winter-Goodwin, Barbara, Phin Kon, Sui, Macdougall, Iain, Lioudaki, Eirini, Shah, Sapna, Sharpe, Claire, Aguilar, Francisco, Hernandez Pena, Abegail, Pugay, Conception, Te, Amelia, Finn, Hugh, Hanif, Wasim, Mostafa, Samiul, Aitken, Alice, Draxlbauer, Katharine, Grobovaite, Evelina, Kearney, Jennifer, Mccarthy, Theresa, Gentile, Giorgio, Browne, Duncan, Chellamuthu, Palanichamy, Dugal, Tabinda, Chant, Terri, Jones, Laura, Laity, Emily, Miners, Megan, Muir, Jame, Swanson, Elizabeth, Frankel, Andrew, Tomlinson, Jame, Alegata, Marlon, Almasarwah, Rashid, Apostolidi, Anthoula, Vourvou, Maria, Walters, Thoma, Taal, Maarten, Dukka, Hari, Kolhe, Nitin, Mcdonald, Carly, White, Kelly, Ugni, Shiva, Gunda, Smita, Oluyombo, Rotimi, Brindle, Vicki, Coutts, Ping, Fuller, Tracy, Nadar, Evelyn, Ramadoss, Suresh, Motherwell, Nichola, Pajak, Susannah, Tonks, Louise, Bhandari, Sunil, Bodington, Richard, Hazara, Adil, Fellowes, Dominic, Wong, Christopher, Goldsmith, Christopher, Barnes, Sherald, Bennett, Ann, Burston, Claire, Hope, Samantha, Hunt, Nicola, Kurian, Lini, Fish, Richard, Farrugia, Daniela, Lee, Judy, Sadler, Emma, Turner, Hannah, Hill, Christopher, Brown, Henry, Masengu, Agne, Maxwell, Peter, Bleakley, Nina, Murtagh, Hugh, Petchey, William, Yiu, Vivian, Kellett, Joanne, Williams, Angharad, Clarke, Helen, Carnall, Victoria, Benyon, Sarah, Blake, Caroline, Estcourt, Stephanie, Piper, Jane, Morgan, Neal, Hutchinson, Carolyn, Mckinley, Teresa, Woodman, Alastair, Graham, Judi, Leonard, Niall, Smyth, John, Adell, Vicki, Hagan, Samantha, Caplin, Ben, Oomatia, Amin, Damian, Eleanor, Sobande, Toluleyi, Doulton, Tim, Delaney, Michael, Montasser, Mahmoud, Hansen, Jenny, Loader, David, Moon, Angela, Morris, France, Sinha, Smeeta, Chukwu, Chukwuma, Hudson, Amy, Campbell, Diane, Kershaw, Melanie, Whittaker, Stephanie, Irtiza-Ali, Ayesha, Ghalli, Farid, Nosseir, Heba, Leslie, Allison, Trivedi, Kate, Fraser, Donald, Alhadj Ali, Mohammad, Griffin, Sian, Latif, Farah, Witczak, Justyna, Wonnacott, Alexa, Jeffers, Lynda, Webley, Yvette, Phelan, Paul, Miller-Hodges, Eve, Geddes, Ailsa, Glenwright, Margaret, Hunter, Amy, Pickett, Thoma, Moriarty, Jim, Hill, Linda, Tyler, Amanda, Ayub, Waqar, Evans, Gail, Hewins, Sue, Hewitt, Davina, Read, Kerry, Bell, Samira, Cosgrove, Leanne, Craik, Rachel, Murray, Shona, Bhandary, Nitin, Coles, Holly, Easow, Rashmi, Joseph, Maya, Khwaja, Arif, Jackson, Yvonne, Mbuyisa, Angeline, Sellars, Rachel, Chitalia, Nihil, Mohandas, Cynthia, Gherman, Anca, Kamundi, Charlotte, Olufuwa, Olumide, Mccafferty, Kieran, Adeleke, Adedolapo, Healy, Cara, Jeyarajah, Damini, Kinsella-Perks, Edward, Smith, Richard, Camilleri, Brian, Buckman, Carol, Finch, Jenny, Rivers, Vanessa, Connor, Andrew, Carr, Sheila, Shainberg, Lisa, Lewington, Andrew, Baker, Richard, Dorey, Suzannah, Tobin, Kay, Wheatley, Rosalyn, Banerjee, Debasish, Hull, Richard, Abat, Sharirose, Paul, Riny, Karim, Mahzuz, Htet, Zay, Tufail, Saad, Varma, Ravi, Convery, Karen, Fottrell-Gould, Deirdre, Hudig, Lisa, Tropman, Emily, Abdul-Samad, Thahir, Grace, Anne, Phipps, Marie, Suckling, Rebecca, Somalanka, Subash, Sood, Bhrigu, Swift, Pauline, Acheampong, Sarah, Ansu, Kwame, Augustin, Martia, Sampson, Anna, Vinall, Lynn, Wren, Kim, Wanninayake, Shamila, Wooding, Nichola, Edwards, Heather, Owen, Lydia, Bolton, Stephanie, Carson, Marion, Matthews, Michael, Brunskill, Nigel, Jesus-Silva, Jorge, Howson, Alex, Quashie-Akponeware, Mary, Tindall, Hilary, Nethaji, Chidambaram, Eldon, Helen, Patel, Rajan, Mark, Patrick, Rankin, Alastair, Sullivan, Michael, Forsyth, Kirsty, Mcdougall, Rowan, Dasgupta, Tanaji, Davies, Louisa, Ryder, Maggie, Grimmer, Philip, Macdonald, Clare, Webster, Mary, Newcastle, Newcastle, Ellam, Timothy, Wong, Edwin, Meshykhi, Christine, Webster, Andrea, Wilson, Peter, Vilar, Enric, Berdeprado, Jocelyn, Doctolero, Eunice, Wilkinson, Lily, Mccarroll, Frank, Ammar, Hesham, Kuan, Ying, Moran, Conor, Shivashankar, Girish, Campbell, Ryan, Glowski, Deborah, Mcdermott, Paula, Ali, Amar, Patel, Zuber, Bond, Christine, Whalley, Gillian, Zhang, Haitao, Yang, Liu, Zhang, Lihua, Kan, Tingting, Zhu, Ling, Zhao, Jinghong, Hou, Weiping, Wu, Jing, Cheng, Hong, Bian, Weijing, Zhao, Zhirui, Shao, Fengmin, Cao, Huixia, Jiao, Xiaojing, Niu, Peiyuan, Niu, Jianying, Chen, Yu, Zhang, Lihong, Zhu, Shenglang, Lin, Haiyan, Yao, Shaopeng, Chen, Jiehui, Jiang, Ying, Hu, Ying, Xiao, Huaying, Yang, Fuye, Zhang, Xinzhou, Guo, Baochun, Jin, Qiu, Liu, Lixia, Xiao, Xiangcheng, Xie, Yanyun, Meng, Ting, Xu, Chuanwen, Huang, Jie, Xu, Yanmei, Kong, Weixin, Wang, Xiaoliang, Liu, Qianpan, Wang, Xueying, Gao, Ming, Hu, Xiumei, Lu, Ying, Wang, Li, Peng, Kun, Wang, Wei, Gong, Qiuhong, Cai, Jianfang, Li, Xiaojue, Liu, Xuejiao, Zhou, Shuhan, Liu, Hong, Weng, Yao, Tang, Shuai, Yao, Yao, Zhao, Shi, Cheng, Chen, Wei, Wei, Li, Na, Aqashiah Mazlan, Sadanah, Zubaidah Bahtar, Alia, Katiman, Elliyyin, Othman, Noraini, Mushahar, Lily, Mazlan, Nurdiana, Sharafina Safiee, Nur, Ramasamy, Sarasa, Seng Wong, Hin, Ahmad Rosdi, Hajar, Zhao Zhi Tan, Esther, Fan Tay, Ju, Seng Teng, Kok, Yahaya, Hasnah, Jiun Liu, Wen, Wee Ee, Lik, Kay Leong Khoo, Kenneth, Mohd Yusoff, Yuana, Safhan Mohamad Nor, Fariz, Kamil Ahmad, Mohd, Ramli Seman, Mohd, Hui Hong Tan, Clare, Lui Sian Ngu, Laura, Yoke May Chan, Jaime, Peji, Javelin, Loong Loh, Chek, Yan Lee, Yee, Ramanaidu, Sridhar, Mean Thong, Kah, Hong Wong, Yik, Junus, Suria, Hua Ching, Chen, Faisal Asmee, Mohammad, Ruziana Ku Md Razi, Ku, Leong Low, Chun, Sze Bing Sim, Christopher, Duan Tham, Zhang, Kamila Abdullah, Noor, Meng Chen, Tai, Chieh Chan, Yong, Chang, Eason, Yean Kang, Huan, Quan Lee, Kai, Ann Lee, Sue, Kheng Lee, Aik, Vinathan, Jeevika, Abdul Cader, Rizna, Mustafar, Ruslinda, Kamaruzaman, Lydia, Mohd, Rozita, Ismail, Rahimah, Men Leong, Chong, Koon Low, Chee, Wei Wong, Liang, Adnan, Norlezah, Ibrahim, Sabariah, Zaimi Abdul Wahab, Mohamad, Bavanandan, Sunita, Shen Lim, Yik, Hazlina Wan Mohamad, Wan, Munirah Jaafar, Siti, Ashykeen Mohd Fauzi, Nur, Sudin, Aziee, Kun Lim, Soo, Chung Gan, Chye, Hing, Albert, Ahmad Faizal Alaidin Razali, Wan, Fong Liew, Yew, Bao Tyng Chan, Chelsia, Chih Cheng, Mei, Chen Ong, Yu, Meng Ong, Loke, Amalina Mohamed Affandi, Farah, Rahmat, Korina, Chai Peng, Ban, Amat, Masayu, Hadafi Ahmad, Nuzaimin, Yee Mah, Doo, Loon Tye, Yi, Azhari, Zaid, Nabilah Mohamad Zaini, Siti, Aidil Musa, Mohd, Ahmad Miswan, Norazinizah, Ramli, Rafizanur, Aziah Ahmad, Nor, Leong Goh, Bak, Izah Ahmad, Nurul, Huda Ibrahim, Fairol, Jian Ng, Tze, Shanmuganathan, Malini, Lian Tay, Li, Harun, Zaiha, Ramli, Salmi, 'Ain Yusof, Nurul, Abd Rahman, Rossenizal, Iqbal Abdul Hafidz, Muhammad, Hidayati Mohd Sharif, Nur, Yasmoon Awang, Irda, Nakashima, Eitaro, Imamine, Rui, Minatoguchi, Makiko, Miura, Yukari, Nakaoka, Miduki, Suzuki, Yoshiki, Yoshikawa, Hitomi, Shin, Koki, Fujita, Kanae, Iwasa, Misuzu, Sasajima, Haruka, Sato, Airi, Hamamoto, Yoshiyuki, Fujita, Yuki, Haraguchi, Takuya, Hyo, Takanori, Izumi, Kiyohiro, Komiya, Toshiyuki, Kubota, Sodai, Kurose, Takeshi, Kuwata, Hitoshi, Nakatani, Susumu, Oishi, Kaori, Okamoto, Saki, Okamura, Kaori, Takeoka, Jun, Tanaka, Nagaaki, Tanigaki, Katsuya, Toda, Naohiro, Watanabe, Koin, Komori, Hiromi, Kumuji, Rika, Takesada, Asako, Tanaka, Aya, Maruyama, Shoichi, Hasegawa, Tomonori, Ishiguro, Akiko, Ishimoto, Takuji, Ito, Kazuhiro, Kamimura, Yutaka, Kato, Noritoshi, Kato, Sawako, Kojima, Hiroshi, Kosugi, Tomoki, Maeda, Kayaho, Mizuno, Masasi, Saito, Shoji, Sato, Hitomi, Sato, Yuka, Suzuki, Yasuhiro, Tanaka, Akihito, Yasuda, Yoshinari, Hasegawa, Fujiko, Hayashi, Maiko, Higashi, Shizuka, Shimamura, Kaho, Sumi, Momoko, Tajima, Kazuki, Unekawa, Chimaki, Wakayama, Kana, Wakita, Yukiko, Otani, Takatoshi, Imai, Ayako, Kawashima, Sayaka, Kogure, Eri, Sato, Tomoe, Takezawa, Misato, Yoshida, Shinya, Araki, Hideo, Katsuda, Yuko, Konishi, Masahiro, Matsunaga, Takahiro, Oe, Masashi, Ogane, Kunihiro, Sakai, Masato, Takahashi, Tomoko, Yamano, Takahiro, Yokoyama, Takuya, Ito, Hitomi, Katayama, Masayo, Kuroda, Emi, Ikeda, Toru, Kojo, Takuma, Yoshidome, Etsuo, Mizumachi, Rieko, Yamamoto, Akane, Yamasaki, Narihisa, Yamasaki, Yoshihiko, Wada, Jun, Eguchi, Jun, Higuchi, Chigusa, Katayama, Akihiro, Kinomura, Masaru, Kitagawa, Masashi, Kitamura, Shinji, Miyamoto, Satoshi, Morinaga, Hiroshi, Nakatsuka, Atsuko, Nojima, Ichiro, Shikata, Kenichi, Sugiyama, Hitoshi, Tanabe, Katsuyuki, Tsuji, Kenji, Uchida, Haruhito, Watanabe, Mayu, Hashimoto, Chie, Kato, Takahiro, Yamamoto, Sayaka, Wada, Takehiko, Fukagawa, Masafumi, Hamano, Naoto, Koizumi, Masahiro, Komaba, Hirotaka, Nakagawa, Yosuke, Iwamoto, Michiyo, Masutani, Kosuke, Katanosaka, Akane, Kiyota, Mayu, Uchi, Hikari, Ueda, Yuka, Yamamoto, Sonoka, Nagasu, Hajime, Itano, Seiji, Iwakura, Tsukasa, Kadoya, Hiroyuki, Kanda, Eiichiro, Kashihara, Naoki, Kidokoro, Kengo, Kondo, Megumi, Sasaki, Tamaki, Satoh, Minoru, Tokuyama, Atsuyuki, Umeno, Reina, Wada, Yoshihisa, Yamamoto, Toshiya, Yamanouchi, Yu, Abe, Masumi, Inukai, Yoko, Ogawa, Wataru, Asahara, Shunichiro, Fujii, Hideki, Goto, Shunsuke, Hirota, Yushi, Hosooka, Tetsuya, Kono, Keiji, Nishi, Shinichi, Okada, Yuko, Sakaguchi, Kazuhiko, Sugawara, Kenji, Takahashi, Michiko, Takai, Tomoko, Tamori, Yoshikazu, Watanabe, Kentaro, Kitajima, Miyu, Nishi, Misaki, Wada, Junko, Ito, Yasuhiko, Kamiya, Hideki, Asai, Akimasa, Asai, Nao, Asano, Saeko, Banno, Shogo, Ejima, Yohei, Hase, Hanako, Hayami, Tomohide, Himeno, Tatsuhito, Ishikawa, Takahiro, Ito, Mayumi, Iwagaitsu, Shiho, Kasagi, Rina, Kato, Yoshiro, Kato, Makoto, Kato, Koichi, Katsuno, Takayuki, Kawai, Miyuka, Kinashi, Hiroshi, Kondo, Masaki, Koshino, Masako, Matsuoka, Naoya, Morishita, Yoshiaki, Motegi, Mikio, Nakamura, Jiro, Shimoda, Hiromi, Sugiyama, Hirokazu, Tsunekawa, Shin, Yamaguchi, Makoto, Takahashi, Kazuyo, Watada, Hirotaka, Funayama, Takashi, Furukawa, Yasuhiko, Gohda, Tomohito, Goto, Hiromasa, Kaga, Hideyoshi, Kanaguchi, Yasuhiko, Kanazawa, Akio, Kaneko, Kayo, Kano, Toshiki, Kihara, Masao, Kimura, Shogo, Kobayashi, Takashi, Maiguma, Masayuki, Makita, Yuko, Mano, Satoshi, Mita, Tomoya, Miyatsuka, Takeshi, Murakoshi, Maki, Muto, Masahiro, Nakata, Masami, Nakata, Junichiro, Nishida, Yuya, Nohara, Nao, Ogihara, Takeshi, Sato, Daisuke, Sato, Junko, Sato, Hiroaki, Suzuki, Yusuke, Suzuki, Ruka, Suzuki, Hitoshi, Takagi, Miyuki, Tamura, Yoshifumi, Uchida, Toyoyoshi, Ueda, Seiji, Asawa, Miki, Miyaji, Minako, Nagashima, Eri, Shibata, Yoshie, Yanagisawa, Eri, Yamauchi, Toshimasa, Hirakawa, Yosuke, Nishi, Hiroshi, Shojima, Nobuhiro, Horikawa, Satoko, Nakayama, Yukiko, Yamada, Naoko, Omori, Yuki, Yano, Shintaro, Ioka, Miyabi, Kuwabara, Nahoko, Nagano, Remi, Nozawa, Megumi, Osawa, Yumi, Maegawa, Hiroshi, Kume, Shinji, Araki, Shinichi, Miyazawa, Itsuko, Morino, Katsutaro, Kawai, Ikuko, Sobata, Masumi, Takaoka, Motoko, Iwaita, Yasushi, Udagawa, Takashi, Inamori, Ami, Kawase, Aya, Yamanaka, Aya, Shimano, Hitoshi, Fujita, Akiko, Iwasaki, Hitoshi, Kai, Hirayasu, Osaki, Yoshinori, Saito, Chie, Sekiya, Motohiro, Tsunoda, Ryoya, Yamagata, Kunihiro, Nakamura, Rikako, Yamada, Aiko, Ohsugi, Mitsuru, Awazawa, Motoharu, Bouchi, Ryotaro, Hashimoto, Shota, Hashimoto, Makiko, Hisatake, Tomoko, Ihana, Noriko, Ishizuka, Koko, Izumi, Kazuo, Kajio, Hiroshi, Kobayashi, Michi, Kodani, Noriko, Maruyama, Koji, Matsumoto, Michihiro, Matsushita, Maya, Nakamura, Tomoka, Sugiyama, Takehiro, Tanabe, Akiyo, Terakawa, Aiko, Ueki, Kojiro, Orimo, Yuko, Ozawa, Takako, Takahira, Eriko, Yamasaki, Yoshimitsu, Haneda, Masakazu, Tomita, Tadahiro, Akimoto, Saori, Fujimoto, Akihiro, Ishihara, Kenji, Murakami, Chiho, Nishiyama, Akiyo, Toyonaga, Yukiko, Uozumi, Kana, Yamaji, Yukihiro, Shigehara, Tetsuya, Okajyo, Jun, Shimizu, Yukihiro, Iwasaki, Shingo, Fukao, Yuki, Furusho, Megumi, Nunokawa, Shintaro, Katagiri, Hideki, Izumi, Tomohito, Kaneko, Keizo, Kodama, Shinjiro, Miyazaki, Mariko, Munakata, Yuichiro, Nagasawa, Tasuku, Oe, Yuji, Sugawara, Hiroto, Takahashi, Kei, Hirata, Kazushige, Inomata, Keiko, Otomo, Shoko, Uchida, Taeko, Yamashita, Chigusa, Kiyosue, Arihiro, Tamura, Ryota, Dube, Francoi, Bolduc, Marilene, Talbot, Marie-Christine, Cham, Leslie, Lai, Vesta, Tse, Josephine, Jolly, Shivinder, Duck, Tabbatha, Lyle, Scott, Epp, Rachel, Galloway, Camille, Haskett, Susan, Matvienko, Elizabeta, Paulsen, Liam, Moist, Louise, Lozon, Zabrina, Ramsey, Tina, Whitmore, Brittany, Al-Zeer, Bader, Macleod, Paula, O'Sullivan, Aoife, Sheriff, Zainab, Tholl, Sam, Pandey, Amritanshu, Armstrong, Samantha, Gebeyehu, Bethelihem, Toth, Patrick, Goldenberg, Ronald, Jahangiriesmaili, Mahsa, Sanguila, Shariff, Suresh, Neethi, Talsania, Tanvi, Zalunardo, Nadia, Agharazii, Mohsen, Roussel, Marie-Pier, Saillant, Annie, Samson, France, Bajaj, Harpreet, Bhavsar, Miken, Dhall, Parul, Dhillon, Gagandeep, Grewal, Bhupinder, Nimbkar, Taniya, Madore, Francoi, Marcotte, Guylaine, Steen, Oren, Bullen, Mathura, Raguwaran, Shayani, Valleteau, Andre, Langlois, Marie-France, Brown, Christine, Steele, Andrew, Garrity, Melissa, Ghate, Taneera, Robinson, Holly, Tolibas, Michael, Tailor, Chetna, Elliott, Lauren, McClary-Wright, Christine, Boreky, Fadia, Fikry, Sameh, Ali, Ayesha, Barot, Chintankumar, Basily, Wagdy, Saram, Thisun, Varad, Vinay, Khandwala, Hasnain, Aguilera, Alex, Alvarez, Patricia, Gill, Balwinder, Huda, Nazihah, Navivala, Aamir, Pinto, Daniel, Bevilacqua, Micheli, Fung, Elaine, Hernandez, Geraldine, Mann, Puneet, Saini, Jaskiran, Rabasa-Lhoret, Remi, Bovan, Danijela, Devaux, Marie, Barnini, Cecilia, Leoncini, Giovanna, Manco, Luca, Nobili, Giulia, Piemontese, Matteo, Aucella, Filippo, Grifa, Rachele, Totaro, Francesco, La Manna, Gaetano, Capelli, Irene, Cianciolo, Giuseppe, Lerario, Sarah, Zappulo, Fulvia, Rosati, Alberto, Fani, Filippo, Spatoliatore, Giuseppe, Gesualdo, Loreto, Pesce, Francesco, Russo, Maria, Zippo, Maria, Cafiero, Cesira, Motta, Daria, Bianco, Simona, Bilucaglia, Donatella, Messa, Piergiorgio, Pavone, Laura, Tripodi, Federica, Vettoretti, Simone, Fioretto, Paola, Carraro, Gianni, Farnia, Filippo, Postal, Anna, D'Amelio, Alessandro, Cardone, Antonio, Piccinni, Giovanni, Aloisi, Annalisa, Scolari, Francesco, Alberici, Federico, Guerini, Alice, Saccà, Chiara, Salviani, Chiara, Zani, Roberta, DE NICOLA, Luca, Garofalo, Carlo, Elena Liberti, Maria, Minutolo, Roberto, Pennino, Luigi, Polese, Lucio, Mené, Paolo, Barberi, Simona, Falcone, Clorinda, Russo, Francesco, Caroppo, Maurizio, Santorelli, Gennaro, Rivera, Rodolfo, Santoro, Domenico, Giuffrida, Alfio, Zirino, Fortunata, Calvi, Cristina, Estienne, Luca, Gambaro, Giovanni, Gangemi, Concetta, Ortalda, Vittorio, Pessolano, Giuseppina, Grandaliano, Giuseppe, Baccaro, Rocco, Ferraro, Pietro, Mangiacapra, Roberto, Melandri, Marco, Foligno, Nadia, Quartagno, Rita, Vezzoli, Giuseppe, Brioni, Elena, and Group, EMPA-KIDNEY Collaborative
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chronic renal disease ,empagliflozin ,empa-kidney ,General Medicine - Abstract
Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m2 of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; PConclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo. (Funded by Boehringer Ingelheim and others; EMPA-KIDNEY ClinicalTrials.gov number, NCT03594110. opens in new tab; EudraCT number, 2017-002971-24. opens in new tab.)
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- 2023
10. Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index
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Sualeheen, Ayesha, primary, Khor, Ban-Hock, additional, Balasubramanian, Gaiyal Villy, additional, Sahathevan, Sharmela, additional, Chinna, Karuthan, additional, Mat Daud, Zulfitri Azuan, additional, Khosla, Pramod, additional, Abdul Gafor, Abdul Halim, additional, Karupaiah, Tilakavati, additional, Cheak, Bee Boon, additional, Ahmad, Ghazali, additional, Bak Leong, Goh, additional, Soo Kun, Lim, additional, Visvanathan, Ravindran, additional, Yahya, Rosnawati, additional, Bavanandan, Sunita, additional, and Morad, Zaki, additional
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- 2022
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11. Peritoneal dialysis catheter insertion techniques by the nephrologist
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Bak Leong Goh and Christopher T. S. Lim
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peritoneal dialysis ,nephrology ,catheter insertion - Abstract
Peritoneal dialysis (PD) catheter is the lifeline of PD patients, and despite the overall strength of the PD program in many countries, PD catheter survival remains the major weakness of the program. The prompt and effective implantation of the PD catheter, as well as speedy management of complications arising from catheter insertion, remains crucial for the success of the program.
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- 2022
12. Clinical effectiveness of a Malaysian-manufactured CAPD product: A randomised trial
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Loke Meng Ong, Lily Mushahar, Wan Hasnul Halimi Wan Hassan, Lai Seong Hooi, Clare Hui-Hong Tan, Chin Tho Leong, Yew Fong Liew, Chek Loong Loh, Wen Jiun Liu, Zaiha Harun, Bak Leong Goh, Rafidah Abdullah, Shahnaz Shah Firdaus Khan, Fei Sia Chan, Sunita Bavanandan, Keng-Hee Koh, Mohd Kamil Ahmad, Wen Yao Mak, Korina Rahmat, Chen Hua Ching, Ghazali Ahmad, Yi Loon Tye, Hin Seng Wong, and Kok Seng Teng
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Adult ,medicine.medical_specialty ,Clinical effectiveness ,medicine.medical_treatment ,Ultrafiltration ,Renal function ,Peritonitis ,Peritoneal dialysis ,Peritoneal Dialysis, Continuous Ambulatory ,Internal medicine ,device defect ,Humans ,Medicine ,ultrafiltration rate ,Product (category theory) ,peritonitis ,business.industry ,General Medicine ,Kt/V ,medicine.disease ,Creatinine clearance ,Treatment Outcome ,peritoneal dialysis ,Nephrology ,plasticiser ,business - Abstract
Background:We compared the clinical effectiveness of a new peritoneal dialysis (PD) product with polyvinyl chloride-containing tubing (Stay Safe Link®, SSL) with the plastic-free alternative (Stay Safe®, STS) in patients on continuous ambulatory peritoneal dialysis (CAPD).Method:A multicentre, parallel, randomised, controlled, open-label, non-inferiority trial was conducted. Adult patients receiving CAPD were randomised in a 1:1 ratio to SSL or STS. The primary outcome was the rate of peritonitis after 1 year of follow-up.Results:A total of 472 subjects were randomised (SSL, n = 233; STS, n = 239). One subject in each group was excluded from the analysis as they withdrew consent before the first dialysis dose. Four hundred and seventy subjects (SSL, n = 232; STS, n = 238) were included in the modified intention-to-treat analysis. Non-inferiority between two groups was established as no significant difference was found in peritonitis rate (incident rate ratio: 0.91, 95% CI: 0.65–1.28). No significant difference was detected in weekly Kt/V ( p = 0.58) and creatinine clearance ( p = 0.55). However, the average ultrafiltration volume was significantly lower in SSL, with a mean difference of 93 ml ( p < 0.01). SSL also demonstrated a 2.57-times higher risk of device defect than STS (95% CI: 1.77–3.75).Conclusion:SSL was non-inferior in peritonitis rate compared to plastic-free STS over 1 year in patients requiring CAPD. There was no difference in the delivered dialysis dose, but there was a higher rate of device defects with SSL.
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- 2021
13. Circulating fatty acid profiles are associated with protein energy wasting in maintenance hemodialysis patients: a cross-sectional study
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PaTCH Investigators, Sharmela Sahathevan, Zulfitri Azuan Mat Daud, Kalyana Sundram, Sreelakshmi Sankara Narayanan, Ban-Hock Khor, Tilakavati Karupaiah, Pramod Khosla, Bak Leong Goh, Karuthan Chinna, Abdul Halim Abdul Gafor, Ghazali Ahmad, Zaki Morad, Mohammad Syafiq Md Ali, and Ayesha Sualeheen
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Adult ,Male ,medicine.medical_specialty ,Waist ,Science ,030232 urology & nephrology ,Serum albumin ,Nutritional Status ,Adipose tissue ,030204 cardiovascular system & hematology ,Article ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Renal Dialysis ,Fatty Acids, Omega-6 ,Protein Deficiency ,Internal medicine ,Fatty Acids, Omega-3 ,medicine ,Humans ,Nutrition ,Aged ,chemistry.chemical_classification ,Multidisciplinary ,biology ,business.industry ,Fatty acid ,Middle Aged ,medicine.disease ,Haemodialysis ,Cross-Sectional Studies ,Endocrinology ,chemistry ,biology.protein ,Homeostatic model assessment ,Medicine ,Female ,Waist Circumference ,business ,Body mass index ,Polyunsaturated fatty acid - Abstract
The metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55.2 ± 14.0 years and 54.3% males). Cross-sectional associations of TG-FAs with 13 markers were examined using multivariate linear regression adjusted for potential confounders. Higher levels of TG saturated fatty acids were associated with greater body mass index (BMI, r = 0.230), waist circumference (r = 0.203), triceps skinfold (r = 0.197), fat tissue index (r = 0.150), serum insulin (r = 0.280), and homeostatic model assessment of insulin resistance (r = 0.276), but lower malnutrition inflammation score (MIS, r = − 0.160). Greater TG monounsaturated fatty acid levels were associated with lower lean tissue index (r = − 0.197) and serum albumin (r = − 0.188), but higher MIS (r = 0.176). Higher levels of TG n-3 polyunsaturated fatty acids (PUFAs) were associated with lower MIS (r = − 0.168) and interleukin-6 concentrations (r = − 0.115). Higher levels of TG n-6 PUFAs were associated with lower BMI (r = − 0.149) but greater serum albumin (r = 0.112). In conclusion, TG monounsaturated fatty acids were associated with poor nutritional status, while TG n-3 PUFAs were associated with good nutritional status. On the other hand, TG saturated fatty acids and TG n-6 PUFAs had both favorable and unfavorable associations with nutritional parameters.
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- 2021
14. Peritoneal dialysis first policy in Hong Kong for 35 years: Global impact
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Philip Kam‐Tao Li, Wanhong Lu, Siu‐Ka Mak, Neil Boudville, Xueqing Yu, Ming Ju Wu, Yuk‐Lun Cheng, Christopher T. Chan, Bak Leong Goh, Na Tian, Kai Ming Chow, Sing Leung Lui, and Wai Kei Lo
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Nephrology ,Renal Dialysis ,Health Policy ,COVID-19 ,Hong Kong ,Humans ,Kidney Failure, Chronic ,General Medicine ,Pandemics ,Peritoneal Dialysis - Abstract
Peritoneal dialysis (PD) first policy has been established in Hong Kong since 1985. After 35 years of practice, the PD first policy in Hong Kong has influenced many countries around the world including governments, health ministries, nephrologists and renal nurses on the overall health policy structure and clinical practice in treating kidney failure patients using PD as an important dialysis modality. In 2021, the International Association of Chinese Nephrologists and the Hong Kong Society of Nephrology jointly held a symposium celebrating the 35 years of PD first policy in Hong Kong. In that symposium, experts and opinion leaders from around the world have shared their perspectives on how the PD first policy has grown and how it has affected PD and home dialysis practice globally. The advantages of PD during COVID-19 pandemic were highlighted and the use of telemedicine as an important adjunct was discussed in treating kidney failure patients to improve the overall quality of care. Barriers to PD and the need for sustainability of PD first policy were also emphasized. Overall, the knowledge awareness of PD as a home dialysis for patients, families, care providers and learners is a prerequisite for the success of PD first. A critical mass of PD regional hubs is needed for training and mentorship. Importantly, the alignment of policy and clinical goals are enablers of PD first program.
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- 2022
15. A mobile app for triangulating strategies in phosphate education targeting patients with chronic kidney disease in Malaysia: development, validation, and patient acceptance
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Lee, Fang Teong, Ban, Hock Khor, Purba, Kristo Radion, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Yahya, Rosnawati, Bavanandan, Sunita, Hi, Ming Ng, Sahathevan, Sharmela, Narayanan, Sreelakshmi Sankara, Mat Daud, Zulfitri Azuan, Khosla, Pramod, Karupaiah, Tilakavati, Lee, Fang Teong, Ban, Hock Khor, Purba, Kristo Radion, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Yahya, Rosnawati, Bavanandan, Sunita, Hi, Ming Ng, Sahathevan, Sharmela, Narayanan, Sreelakshmi Sankara, Mat Daud, Zulfitri Azuan, Khosla, Pramod, and Karupaiah, Tilakavati
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Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, and limiting dietary phosphate intake, but treatment barriers are poor patient compliance and low health literacy arising from low self-efficacy and lack of educational resources. This study describes developing and validating a phosphate mobile application (PMA). The PMA development based on the seven-stage Precaution Adoption Process Model prioritized titrating dietary phosphate intake with phosphate binder dose supported by educational videography. Experts (n = 13) first evaluated the PMA for knowledge-based accuracy, mobile heuristics, and clinical value. Adult HD patients validated the improved PMA using the seven-point mHealth App Usability Questionnaire (MAUQ). Patient feedback (n = 139) indicated agreement for ease of use (69.2%), interface and satisfaction (69.0%), and usefulness (70.1%), while 72.7% said they would recommend this PMA. The expectation confirmation for 25 PMA features ranged from 92.1% (lifestyle) up to 100.0% (language option); and the utilization rate of each feature varied from 21.6% (goal setting and feature-based log) to 91.4% (information on dietary phosphate and phosphate binder). The Conclusions: MyKidneyDiet-Phosphate Tracker PMA was acceptable to adult Malaysian HD patients as part of clinical phosphate management in low-resource settings.
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- 2022
16. Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial
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Lee, Fang Teong, Ban, Hock Khor, Hi, Ming Ng, Sahathevan, Sharmela, Purba, Kristo Radion, Narayanan, Sreelakshmi Sankara, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Yahya, Rosnawati, Bavanandan, Sunita, Wahab, Zaimi, Aqashiah Mazlan, Sadanah, Chinna, Karuthan, Morad, Zaki, Mat Daud, Zulfitri Azuan, Karupaiah, Tilakavati, Lee, Fang Teong, Ban, Hock Khor, Hi, Ming Ng, Sahathevan, Sharmela, Purba, Kristo Radion, Narayanan, Sreelakshmi Sankara, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Yahya, Rosnawati, Bavanandan, Sunita, Wahab, Zaimi, Aqashiah Mazlan, Sadanah, Chinna, Karuthan, Morad, Zaki, Mat Daud, Zulfitri Azuan, and Karupaiah, Tilakavati
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This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed.
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- 2022
17. Habitual Dietary Patterns of Patients on Hemodialysis Indicate Nutritional Risk
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Sunita Bavanandan, Rosnawati Yahya, Ayesha Sualeheen, Pramod Khosla, Soo Kun Lim, Ban-Hock Khor, Tilakavati Karupaiah, Sreelakshmi Sankara Narayanan, Zaki Morad, Mohammad Syafiq Md Ali, Ghazali Ahmad, Bak Leong Goh, Abdul Halim Abdul Gafor, Bee Boon Cheak, Zulfitri Azuan Mat Daud, Karuthan Chinna, Sharmela Sahathevan, Ravindran Visvanathan, and Gaiyal Viliy Balasubramanian
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Male ,0301 basic medicine ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,Nutritional Status ,Medicine (miscellaneous) ,Food group ,03 medical and health sciences ,0302 clinical medicine ,Healthy food ,Renal Dialysis ,Environmental health ,Humans ,Medicine ,education ,Life Style ,Nutritional risk ,Male gender ,Malay ,education.field_of_study ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Malaysia ,Nutritional status ,Middle Aged ,language.human_language ,Diet ,Cross-Sectional Studies ,Socioeconomic Factors ,Nephrology ,language ,Female ,Hemodialysis ,business - Abstract
This study aimed to (i) determine habitual dietary patterns of Malaysian patients on hemodialysis (HD) and (ii) examine their association with nutritional status.An à posteriori approach examined 3-day dietary recalls of 382 multiethnic Malaysian patients on HD, leading to short-listing of 31 food groups. Dietary patterns were derived through principal component analysis. Sociodemographic and lifestyle characteristics together with nutritional parameters were examined for associations with specific dietary patterns.Four dietary patterns emerged, namely, "Home Food," "Eating Out (EO)-Rice," "EO-Sugar sweetened beverages," and "EO-Noodle." Younger patients, male gender, Malay, and patients with working status were more likely to follow "EO-Rice" and "EO-Sugar sweetened beverages" patterns, while Chinese patients were more likely to consume "EO-Noodle" pattern (all P values .05). The EO frequency was directly associated with "EO-Rice" (P = .030), "EO-Sugar sweetened beverages" (P = .040), and "EO-Noodle" (P = .001) patterns. The highest tertile of the "Home Food" pattern related to higher handgrip strength (T3 = 21.3 ± 0.74 vs. 18.0 ± 0.73 kg, P = .006), higher serum albumin (T3 = 3.99 ± 0.04 vs. T1 = 3.84 ± 0.04 g/dL, P = .027), and lower Malnutrition-Inflammation Score (T3 = 4.9 ± 0.36 vs. T1 = 6.4 ± 0.34, P = .010), along with lower Diet Monotony Index (T3 = 29.0 ± 1.1 vs. T1 = 33.0 ± 1.0, P = .030). while "EO-Rice" and "EO-Sugar sweetened beverage" patterns were associated only with higher energy intake (all P values .001).These results indicated that a home-based diet inclusive of healthy food choices was associated with better nutritional status in this HD population.
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- 2020
18. Association of dietary patterns with serum phosphorus in maintenance haemodialysis patients: a cross-sectional study
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Zulfitri Azuan Mat Daud, Zaki Morad, PaTCH Investigators, Abdul Halim Abdul Gafor, Tilakavati Karupaiah, Ayesha Sualeheen, Sunita Bavanandan, Ban-Hock Khor, Angela Yee-Moon Wang, Bak Leong Goh, Karuthan Chinna, Pramod Khosla, and Sharmela Sahathevan
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Adult ,Male ,Cross-sectional study ,030232 urology & nephrology ,Physiology ,lcsh:Medicine ,Article ,Food group ,03 medical and health sciences ,chemistry.chemical_compound ,Hyperphosphatemia ,0302 clinical medicine ,Inorganic phosphate ,Renal Dialysis ,Humans ,Medicine ,Public Health Surveillance ,030212 general & internal medicine ,lcsh:Science ,Aged ,Nutrition ,Total protein ,Kidney diseases ,Multidisciplinary ,business.industry ,Maintenance haemodialysis ,lcsh:R ,Phosphorus ,Middle Aged ,Phosphate ,medicine.disease ,Diet ,Cross-Sectional Studies ,chemistry ,Nephrology ,Female ,lcsh:Q ,Serum phosphorus ,business ,Biomarkers - Abstract
Sources of dietary phosphate differentially contribute to hyperphosphatemia in maintenance haemodialysis (MHD) patients. This cross-sectional study in Malaysia investigated association between dietary patterns and serum phosphorus in MHD patients. Dietary patterns were derived by principal component analysis, based on 27 food groups shortlisted from 3-day dietary recalls of 435 MHD patients. Associations of serum phosphorus were examined with identified dietary patterns. Three dietary patterns emerged: Home foods (HFdp), Sugar-sweetened beverages (SSBdp), and Eating out noodles (EO-Ndp). The highest tertile of patients in HF (T3-HFdp) pattern significantly associated with higher intakes of total protein (p = 0.002), animal protein (p = 0.001), and animal-based organic phosphate (p dp patients had significantly higher intakes of total energy (p p p = 0.001). T3-EO-Ndp patients had significantly higher intakes of total energy (p = 0.033), total protein (p = 0.003), plant protein (p p = 0.009). T3-SSBdp patients had significantly higher serum phosphorus (p = 0.006). The odds ratio of serum phosphorous > 2.00 mmol/l was significantly 2.35 times higher (p = 0.005) with the T3-SSBdp. The SSBdp was associated with greater consumption of inorganic phosphate and higher serum phosphorus levels.
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- 2020
19. Validity of Ultrasound Imaging in Measuring Quadriceps Muscle Thickness and Cross‐Sectional Area in Patients Receiving Maintenance Hemodialysis
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Sreelakshmi Sankara Narayanan, Zulfitri Azuan Mat Daud, Sharmela Sahathevan, Tilakavati Karupaiah, Gild Rick Ong, Hi Ming Ng, Boon Cheak Bee, Abdul Kareem Meera Mohaideen, Bak Leong Goh, Ban-Hock Khor, Teik Hin Tan, Abdul Halim Abdul Gafor, Karuthan Chinna, and Chai Hong Yeong
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0303 health sciences ,Nutrition and Dietetics ,030309 nutrition & dietetics ,Intraclass correlation ,business.industry ,medicine.medical_treatment ,Ultrasound ,Quadriceps muscle ,Medicine (miscellaneous) ,Maintenance hemodialysis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030211 gastroenterology & hepatology ,In patient ,Tomography ,Hemodialysis ,medicine.symptom ,Nuclear medicine ,business ,Wasting - Abstract
BACKGROUND Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatient HD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT). METHODS Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot. RESULTS ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID, VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods. CONCLUSION The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HD patients.
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- 2020
20. Dialysis Care and Dialysis Funding in Asia
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Hung Chun Chen, Hyeong Cheon Park, Aida Lydia, Vivekanand Jha, Sanjib Kumar Sharma, Naoki Kashihara, Maria Gina C. Nazareth, Ehteshamul Hoque, Sydney C.W. Tang, Virithy Lun, Ariunaa Togtokh, Bak Leong Goh, Sakarn Bunnag, Mohammad Ghnaimet, Adrian Liew, Jackson Tan, and Xueqing Yu
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Asia ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,Developing country ,Health Services Accessibility ,Insurance Coverage ,Gross domestic product ,Hospitals, Private ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Renal Dialysis ,Universal Health Insurance ,Prevalence ,Per capita ,Humans ,Medicine ,Diabetic Nephropathies ,030212 general & internal medicine ,education ,Socioeconomics ,Developing Countries ,Socioeconomic status ,Dialysis ,Health policy ,education.field_of_study ,Hospitals, Public ,business.industry ,Developed Countries ,Health Care Costs ,Kidney Transplantation ,Transplantation ,Nephrology ,Kidney Failure, Chronic ,Health Expenditures ,business ,Procedures and Techniques Utilization - Abstract
Asia is the largest and most populated continent in the world, with a high burden of kidney failure. In this Policy Forum article, we explore dialysis care and dialysis funding in 17 countries in Asia, describing conditions in both developed and developing nations across the region. In 13 of the 17 countries surveyed, diabetes is the most common cause of kidney failure. Due to great variation in gross domestic product per capita across Asian countries, disparities in the provision of kidney replacement therapy (KRT) exist both within and between countries. A number of Asian nations have satisfactory access to KRT and have comprehensive KRT registries to help inform practices, but some do not, particularly among low- and low-to-middle-income countries. Given these differences, we describe the economic status, burden of kidney failure, and cost of KRT across the different modalities to both governments and patients and how changes in health policy over time affect outcomes. Emerging trends suggest that more affluent nations and those with universal health care or access to insurance have much higher prevalent dialysis and transplantation rates, while in less affluent nations, dialysis access may be limited and when available, provided less frequently than optimal. These trends are also reflected by an association between nephrologist prevalence and individual nations’ incomes and a disparity in the number of nephrologists per million population and per thousand KRT patients.
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- 2020
21. Developing the ethical framework of end-stage kidney disease care: from practice to policy
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Walter Douthat, Mohammed Rafique Moosa, Tushar Vachharajani, Elmi Muller, Tak Mao Chan, Ikechi G. Okpechi, Vivekanand Jha, Adrian Liew, Michele Trask, Evie Kendal, Ezequiel Bellorin-Font, Bak Leong Goh, Rolando Claure-Del Granado, FU Eke, Manisha Sahay, Dominique Martin, Somchai Eiam-Ong, Yewondwossen Tadesse Mengistu, Eric Rondeau, Aminu K. Bello, and Valerie A. Luyckx
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0301 basic medicine ,Ethical issues ,business.industry ,media_common.quotation_subject ,education ,030232 urology & nephrology ,Rationing ,Context (language use) ,Payment ,ISN public affair ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nursing ,Nephrology ,Health care ,Kidney replacement ,business ,Psychology ,End-stage kidney disease ,Ethical framework ,media_common - Abstract
Ethical issues relating to end-stage kidney disease (ESKD) care are increasingly being discussed by clinicians and ethicists but are still infrequently considered at a policy level or in the education and training of health care professionals. In most lower-income countries, access to kidney replacement therapies such as dialysis is not universal, leading to overt or implicit rationing of resources and potential exclusion from care of those who are unable to sustain out-of-pocket payments. These circumstances create significant inequities in access to ESKD care within and between countries and impose emotional and moral burdens on patients, families, and health care workers involved in decision-making and provision of care. End-of-life decision-making in the context of ESKD care in all countries may also create ethical dilemmas for policy makers, professionals, patients, and their families. This review outlines several ethical implications of the complex challenges that arise in the management of ESKD care around the world. We argue that more work is required to develop the ethics of ESKD care, so as to provide ethical guidance in decision-making and education and training for professionals that will support ethical practice in delivery of ESKD care. We briefly review steps that may be required to accomplish this goal, discussing potential barriers and strategies for success.
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- 2020
22. Global case studies for chronic kidney disease/end-stage kidney disease care
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Masaomi Nangaku, Valerie A. Luyckx, Hsiang-Hao Hsu, Somchai Eiam-Ong, Charlotte Osafo, Marcello Tonelli, Ahmed Twahir, Chih-Wei Yang, Guillermo Garcia Garcia, Kriang Tungsanga, Curie Ahn, Bak Leong Goh, Marie Richards, Jo-Ann Donner, Fan Fan Hou, Henry Mzingajira, Lianne Barnieh, Rhys Evans, Abdou Niang, Hasan Abu-Aisha, Sakarn Bunnag, David Harris, Gavin Dreyer, Laura Sola, Nick Richards, and Mignon McCulloch
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0301 basic medicine ,medicine.medical_specialty ,Modalities ,Scope (project management) ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,Context (language use) ,medicine.disease ,Variety (cybernetics) ,Transplantation ,ISN public affair ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nephrology ,medicine ,chronic kidney disease, end-stage kidney disease care, dialysis, transplantation ,Intensive care medicine ,business ,Kidney transplantation ,Dialysis ,Kidney disease - Abstract
The prevalence of chronic kidney disease and its risk factors is increasing worldwide, and the rapid rise in global need for end-stage kidney disease care is a major challenge for health systems, particularly in low- and middle-income countries. Countries are responding to the challenge of end-stage kidney disease in different ways, with variable provision of the components of a kidney care strategy, including effective prevention, detection, conservative care, kidney transplantation, and an appropriate mix of dialysis modalities. This collection of case studies is from 15 countries from around the world and offers valuable learning examples from a variety of contexts. The variability in approaches may be explained by country differences in burden of disease, available human or financial resources, income status, and cost structures. In addition, cultural considerations, political context, and competing interests from other stakeholders must be considered. Although the approaches taken have often varied substantially, a common theme is the potential benefits of multi-stakeholder engagement aimed at improving the availability and scope of integrated kidney care.
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- 2020
23. Establishing a Core Outcome Set for Peritoneal Dialysis: Report of the SONG-PD (Standardized Outcomes in Nephrology–Peritoneal Dialysis) Consensus Workshop
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Karine E. Manera, David W. Johnson, Jonathan C. Craig, Jenny I. Shen, Talia Gutman, Yeoungjee Cho, Angela Yee-Moon Wang, Edwina A. Brown, Gillian Brunier, Jie Dong, Tony Dunning, Rajnish Mehrotra, Saraladevi Naicker, Roberto Pecoits-Filho, Jeffrey Perl, Martin Wilkie, Allison Tong, Adeera Levin, Adrian Liew, Alfonso Cueto Manzano, Ali Abu Alfa, Alicia Neu, Amanda Baumgart, Amelie Bernier-Jean, Amy Kelly, Ana Figueiredo, Andrea Matus, Andrea Viecelli, Angela Ju, Anjali Saxena, Ankit Sharma, Annie-Claire Nadeau-Fredette, Armando Teixeira-Pinto, Asher Mendelson, Ayano Kelly, Bak Leong Goh, Benedicte Sautenet, Braden Manns, Brenda Hemmelgarn, Bruce Robinson, Camilla Hanson, Catherine Cheung, Chandana Guha, Charlotte Logeman, Cheuk-Chun Szeto, Claudia Rutherford, Daniel Schwartz, Daniel Sumpton, David Johnson, David Wheeler, Edwina Brown, Emma O’Lone, Eric Au, Eric Goffin, Fred Finkelstein, Georgi Abraham, Greg Germino, Helen Hurst, Hideki Kawanishi, Htay Htay, Hui Kim Yap, Isaac Teitelbaum, Jenny Chen, Jenny Shen, Joanna Neumann, Joanne Bargman, Johann Morelle, Jonathan Craig, Kajiru Gad Kilonzo, Karen Yeates, Karine Manera, Karolis Azukaitis, Kim Linh Van, Louese Dunn, Mahesh Krishnan, Mark Lambie, Martin Howell, Martin Schreiber, Matthew Oliver, Mauricio Rafael Sanabria, Melissa Nataatmadja, Monika Lichodziejewska-Niemierko, Nancy Verdin, Neelam Mann, Neil Boudville, Nicole Evangelidis, Nicole Scholes-Robertson, Peter Blake, Peter Nourse, Peter Tugwell, Philip Kam-Tao Li, Richard McGee, Robert Quinn, Sally Crowe, Samaya Anumudu, Sarah Bernays, Sarala Naicker, Scott Wilson, Sharon Nessim, Sharon Teo, Simon A. Carter, Simon Davies, Soheli Ahmed Sweety, Ted Toffelmire, Vanita Jassal, Vivekanand Jha, Viviane Calice da Silva, Wim Van Biesen, Wolfgang Winkelmayer, Yasuhiko Ito, Yong-Lim Kim, Zeeshan Butt, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques
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Nephrology ,Delphi Technique ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,030232 urology & nephrology ,Psychological intervention ,Disease ,patient-centered care ,outcomes ,Outcome (game theory) ,Peritoneal dialysis (PD) ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Outcome Assessment, Health Care ,technique survival ,Medicine ,PD failure ,030212 general & internal medicine ,Empowerment ,caregiver ,media_common ,cardiovascular disease (CVD) ,PD-related infection ,trials ,patient-reported outcome (PRO) ,3. Good health ,Research Design ,life participation ,Peritoneal Dialysis ,consensus workshop ,medicine.medical_specialty ,Consensus ,media_common.quotation_subject ,core outcome set ,Peritoneal dialysis ,03 medical and health sciences ,quality of life (QoL) ,nephrology research ,Internal medicine ,Humans ,Dialysis ,business.industry ,patient perspective ,mortality ,Family medicine ,trial design ,dialysis ,fatigue ,business - Abstract
International audience; Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD.
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- 2020
24. A Mobile App for Triangulating Strategies in Phosphate Education Targeting Patients with Chronic Kidney Disease in Malaysia: Development, Validation, and Patient Acceptance
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Lee-Fang Teong, Ban-Hock Khor, Kristo Radion Purba, Abdul Halim Abdul Gafor, Bak-Leong Goh, Boon-Cheak Bee, Rosnawati Yahya, Sunita Bavanandan, Hi-Ming Ng, Sharmela Sahathevan, Sreelakshmi Sankara Narayanan, Zulfitri Azuan Mat Daud, Pramod Khosla, and Tilakavati Karupaiah
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Health Information Management ,Leadership and Management ,nutrition ,mobile app ,hemodialysis ,hyperphosphatemia ,phosphorus ,phosphate binder ,Health Policy ,Health Informatics - Abstract
Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, and limiting dietary phosphate intake, but treatment barriers are poor patient compliance and low health literacy arising from low self-efficacy and lack of educational resources. This study describes developing and validating a phosphate mobile application (PMA). The PMA development based on the seven-stage Precaution Adoption Process Model prioritized titrating dietary phosphate intake with phosphate binder dose supported by educational videography. Experts (n = 13) first evaluated the PMA for knowledge-based accuracy, mobile heuristics, and clinical value. Adult HD patients validated the improved PMA using the seven-point mHealth App Usability Questionnaire (MAUQ). Patient feedback (n = 139) indicated agreement for ease of use (69.2%), interface and satisfaction (69.0%), and usefulness (70.1%), while 72.7% said they would recommend this PMA. The expectation confirmation for 25 PMA features ranged from 92.1% (lifestyle) up to 100.0% (language option); and the utilization rate of each feature varied from 21.6% (goal setting and feature-based log) to 91.4% (information on dietary phosphate and phosphate binder). The Conclusions: MyKidneyDiet-Phosphate Tracker PMA was acceptable to adult Malaysian HD patients as part of clinical phosphate management in low-resource settings.
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- 2022
25. Muscle Status Response to Oral Nutritional Supplementation in Hemodialysis Patients With Protein Energy Wasting: A Multi-Center Randomized, Open Label-Controlled Trial
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Sharmela Sahathevan, Tilakavati Karupaiah, Ban-Hock Khor, Birinder Kaur Sadu Singh, Zulfitri Azuan Mat Daud, Enrico Fiaccadori, Alice Sabatino, Karuthan Chinna, Abdul Halim Abdul Gafor, Sunita Bavanandan, Ravindran Visvanathan, Rosnawati Yahya, Zaimi Wahab, Bak-Leong Goh, Zaki Morad, Boon Cheak Bee, and Hin Seng Wong
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ultrasound imaging ,hemodialysis ,Nutrition and Dietetics ,protein energy wasting ,Nutrition. Foods and food supply ,quadriceps muscle ,Endocrinology, Diabetes and Metabolism ,TX341-641 ,oral nutritional supplementation ,nutrition counseling ,Nutrition ,Original Research ,Food Science - Abstract
Background: Muscle wasting, observed in patients with end-stage kidney disease and protein energy wasting (PEW), is associated with increased mortality for those on hemodialysis (HD). Oral nutritional supplementation (ONS) and nutrition counseling (NC) are treatment options for PEW but research targeting muscle status, as an outcome metric, is limited.Aim: We compared the effects of combined treatment (ONS + NC) vs. NC alone on muscle status and nutritional parameters in HD patients with PEW.Methods: This multi-center randomized, open label-controlled trial, registered under ClinicalTrials.gov (Identifier no. NCT04789031), recruited 56 HD patients identified with PEW using the International Society of Renal Nutrition and Metabolism criteria. Patients were randomly allocated to intervention (ONS + NC, n = 29) and control (NC, n = 27) groups. The ONS + NC received commercial renal-specific ONS providing 475 kcal and 21.7 g of protein daily for 6 months. Both groups also received standard NC during the study period. Differences in quadriceps muscle status assessed using ultrasound (US) imaging, arm muscle area and circumference, bio-impedance spectroscopy (BIS), and handgrip strength (HGS) methods were analyzed using the generalized linear model for repeated measures.Results: Muscle indices as per US metrics indicated significance (p < 0.001) for group × time interaction only in the ONS + NC group, with increases by 8.3 and 7.7% for quadriceps muscle thickness and 4.5% for cross-sectional area (all p < 0.05). This effect was not observed for arm muscle area and circumference, BIS metrics and HGS in both the groups. ONS + NC compared to NC demonstrated increased dry weight (p = 0.039), mid-thigh girth (p = 0.004), serum prealbumin (p = 0.005), normalized protein catabolic rate (p = 0.025), and dietary intakes (p < 0.001), along with lower malnutrition–inflammation score (MIS) (p = 0.041). At the end of the study, lesser patients in the ONS + NC group were diagnosed with PEW (24.1%, p = 0.008) as they had achieved dietary adequacy with ONS provision.Conclusion: Combination of ONS with NC was effective in treating PEW and contributed to a gain in the muscle status as assessed by the US, suggesting that the treatment for PEW requires nutritional optimization via ONS.
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- 2021
26. A multicentre, multi-national, double-blind, randomised, active-controlled, parallel-group clinical study to assess the safety and efficacy of PDA10 (Epoetin-alpha) vs. Eprex® in patients with anaemia of chronic renal failure
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Zaki Morad, Jae Hyun Chang, Soo Kun Lim, Ravindran Visvanathan, Sung Gyun Kim, Su Hyun Kim, Chun Soo Lim, Bak Leong Goh, and Jin Seok Jeon
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Nephrology ,medicine.medical_specialty ,business.industry ,Research ,Anaemia ,Diseases of the genitourinary system. Urology ,Double blind ,Haemodialysis ,Clinical research ,Erythropoietin ,Internal medicine ,PDA10 ,Epoetin alpha ,Medicine ,Chronic renal failure ,In patient ,Epoetin-α ,RC870-923 ,business ,Therapeutic equivalence ,medicine.drug - Abstract
Background Erythropoietin stimulating agent (ESA) has been standard of care in treating renal anaemia for the past 20 years. Many patients have limited access to ESA in view of long-term costs leading to suboptimal ESA dosage. Biosimilar epoetin is a potential cost-effective alternative to originator for optimal renal anaemia management. Objective To determine efficacy and safety of PDA10 in treating renal anaemia in haemodialysis patients, in comparison to the originator epoetin-α, Eprex®. Methods A phase 3, multicentre, multi-national, double-blind, randomised, active-controlled and parallel group study conducted over 40 weeks in Malaysia and Korea. End stage kidney disease patients undergoing regular haemodialysis who were on erythropoietin treatment were recruited. The study has 3 phases, which included a 12-week titration phase, followed by 28-week double-blind treatment phase and 24-week open-label extension phase. Results The PDA10 and Eprex® were shown to be therapeutically equivalent (p Conclusion This study has confirmed the therapeutic equivalence between PDA10 and Eprex® in terms of efficacy, dosage requirement and safety profile in haemodialysis patients with renal anaemia. Trial registration The study was registered with the National Medical Research Register (NMRR-13-400-16313). This study has been registered retrospectively with Clinical Research Information Service (CRiS), Republic of Korea on 25 March 2021.
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- 2021
27. Is malnutrition a determining factor of health-related quality of life in hemodialysis patients? A cross-sectional design examining relationships with a comprehensive assessment of nutritional status
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Bak Leong Goh, Tilakavati Karupaiah, Karuthan Chinna, Hi-Ming Ng, Zaki Morad, PaTCH Investigators, Pramod Khosla, Abdul Halim Abdul Gafor, S. Sahathevan, Zulfitri Azuan Mat Daud, Ayesha Sualeheen, Ban-Hock Khor, and Ghazali Ahmad
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Inflammation ,medicine.medical_specialty ,SF-36 ,Cross-sectional study ,business.industry ,medicine.medical_treatment ,Malnutrition ,Public Health, Environmental and Occupational Health ,Nutritional Status ,Overweight ,medicine.disease ,Cross-Sectional Studies ,Quality of life ,Renal Dialysis ,Internal medicine ,medicine ,Quality of Life ,Humans ,Phosphorus, Dietary ,Hemodialysis ,medicine.symptom ,Underweight ,business ,Wasting - Abstract
To identify relationships between health-related quality of life (HRQOL) and nutritional status in hemodialysis (HD) patients. Secondary data from a cross-sectional survey was utilized. HRQOL was assessed for 379 HD patients using the generic Short Form 36 (SF-36) and disease-specific Kidney-Disease Quality of Life-36 (KDQOL-36). Malnutrition was indicated by malnutrition inflammation score (MIS) ≥ 5, and presence of protein-energy wasting (PEW). The individual nutritional parameters included the domains of physical status, serum biomarkers, and dietary intake. Multivariate associations were assessed using the general linear model. MIS ≥ 5 was negatively associated with SF-36 scores of physical functioning (MIS
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- 2021
28. Polyvinyl chloride (PVC) and peritoneal dialysis (PD): Trivialisation of reality?
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Bak Leong Goh, Malini Shanmuganathan, and Kim Liong Ang
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Chromatography ,business.industry ,medicine.medical_treatment ,General Medicine ,Peritoneal dialysis ,Polyvinyl chloride ,chemistry.chemical_compound ,chemistry ,Peritoneal Dialysis, Continuous Ambulatory ,Nephrology ,medicine ,Humans ,business ,Polyvinyl Chloride ,Peritoneal Dialysis - Published
- 2021
29. Effectiveness of a Nutritional Mobile Application for Management of Hyperphosphatemia in Patients on Hemodialysis: A Multicenter Open-Label Randomized Clinical Trial
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Lee-Fang Teong, Ban-Hock Khor, Hi-Ming Ng, Sharmela Sahathevan, Kristo Radion Purba, Sreelakshmi Sankara Narayanan, Abdul Halim Abdul Gafor, Bak-Leong Goh, Boon-Cheak Bee, Rosnawati Yahya, Sunita Bavanandan, Zaimi Wahab, Sadanah Aqashiah Mazlan, Karuthan Chinna, Zaki Morad, Zulfitri Azuan Mat Daud, and Tilakavati Karupaiah
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mobile app ,nutrition education ,hemodialysis ,hyperphosphatemia ,phosphorus ,patient-centered care ,Medicine (miscellaneous) - Abstract
This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed.
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- 2022
30. Supplemental Material, sj-docx-1-ptd-10.1177_0896860821993954 - Clinical effectiveness of a Malaysian-manufactured CAPD product: A randomised trial
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Mak, Wen Yao, Leong, Chin Tho, Loke Meng Ong, Bavanandan, Sunita, Mushahar, Lily, Bak Leong Goh, Hin Seng Wong, Ghazali Ahmad, Yew Fong Liew, Ching, Chen Hua, Liu, Wen Jiun, Rahmat, Korina, Tan, Clare Hui-Hong, Mohd Kamil Ahmad, Hassan, Wan Hasnul Halimi Wan, Chan, Fei Sia, Zaiha Harun, Chek Loong Loh, Teng, Kok Seng, Tye, Yi Loon, Khan, Shahnaz Shah Firdaus, Keng-Hee Koh, Rafidah Abdullah, and Hooi, Lai Seong
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Medicine - Abstract
Supplemental Material, sj-docx-1-ptd-10.1177_0896860821993954 for Clinical effectiveness of a Malaysian-manufactured CAPD product: A randomised trial by Wen Yao Mak, Chin Tho Leong, Loke Meng Ong, Sunita Bavanandan, Lily Mushahar, Bak Leong Goh, Hin Seng Wong, Ghazali Ahmad, Yew Fong Liew, Chen Hua Ching, Wen Jiun Liu, Korina Rahmat, Clare Hui-Hong Tan, Mohd Kamil Ahmad, Wan Hasnul Halimi Wan Hassan, Fei Sia Chan, Zaiha Harun, Chek Loong Loh, Kok Seng Teng, Yi Loon Tye, Shahnaz Shah Firdaus Khan, Keng-Hee Koh, Rafidah Abdullah and Lai Seong Hooi in Peritoneal Dialysis International
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- 2021
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31. Muscle status response to oral nutritional supplementation in hemodialysis patients with protein energy wasting: a multi-center randomized, open label-controlled trial
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Sahathevan, Sharmela, Karupaiah, Tilakavati, Ban, Hock Khor, Singh, Birinder Kaur Sadu, Mat Daud, Zulfitri Azuan, Fiaccadori, Enrico, Sabatino, Alice, Chinna, Karuthan, Abdul Gafor, Abdul Halim, Bavanandan, Sunita, Visvanathan, Ravindran, Yahya, Rosnawati, Wahab, Zaimi, Bak, Leong Goh, Zaki Morad, Boon, Cheak Bee, Hin, Seng Wong, Sahathevan, Sharmela, Karupaiah, Tilakavati, Ban, Hock Khor, Singh, Birinder Kaur Sadu, Mat Daud, Zulfitri Azuan, Fiaccadori, Enrico, Sabatino, Alice, Chinna, Karuthan, Abdul Gafor, Abdul Halim, Bavanandan, Sunita, Visvanathan, Ravindran, Yahya, Rosnawati, Wahab, Zaimi, Bak, Leong Goh, Zaki Morad, Boon, Cheak Bee, and Hin, Seng Wong
- Abstract
Background: Muscle wasting, observed in patients with end-stage kidney disease and protein energy wasting (PEW), is associated with increased mortality for those on hemodialysis (HD). Oral nutritional supplementation (ONS) and nutrition counseling (NC) are treatment options for PEW but research targeting muscle status, as an outcome metric, is limited. Aim: We compared the effects of combined treatment (ONS + NC) vs. NC alone on muscle status and nutritional parameters in HD patients with PEW. Methods: This multi-center randomized, open label-controlled trial, registered under ClinicalTrials.gov (Identifier no. NCT04789031), recruited 56 HD patients identified with PEW using the International Society of Renal Nutrition and Metabolism criteria. Patients were randomly allocated to intervention (ONS + NC, n = 29) and control (NC, n = 27) groups. The ONS + NC received commercial renal-specific ONS providing 475 kcal and 21.7 g of protein daily for 6 months. Both groups also received standard NC during the study period. Differences in quadriceps muscle status assessed using ultrasound (US) imaging, arm muscle area and circumference, bio-impedance spectroscopy (BIS), and handgrip strength (HGS) methods were analyzed using the generalized linear model for repeated measures. Results: Muscle indices as per US metrics indicated significance (p < 0.001) for group × time interaction only in the ONS + NC group, with increases by 8.3 and 7.7% for quadriceps muscle thickness and 4.5% for cross-sectional area (all p < 0.05). This effect was not observed for arm muscle area and circumference, BIS metrics and HGS in both the groups. ONS + NC compared to NC demonstrated increased dry weight (p = 0.039), mid-thigh girth (p = 0.004), serum prealbumin (p = 0.005), normalized protein catabolic rate (p = 0.025), and dietary intakes (p < 0.001), along with lower malnutrition–inflammation score (MIS) (p = 0.041). At the end of the study, lesser patients in the ONS + NC group were diagnosed w
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- 2021
32. Response to 'Intraclass correlation coefficient and reliability of muscle mass measurements'
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Sahathevan, Sharmela, Khor, Ban Hock, Chai, Hong Yeong, Teik, Hin Tan, Mohaideen, Abdul Kareem Meera, Hi, Ming Ng, Ong, Gild Rick, Narayanan, Sreelakshmi Sankara, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Mat Daud, Zulfitri Azuan, Chinna, Karuthan, Karupaiah, Tilakavati, Sahathevan, Sharmela, Khor, Ban Hock, Chai, Hong Yeong, Teik, Hin Tan, Mohaideen, Abdul Kareem Meera, Hi, Ming Ng, Ong, Gild Rick, Narayanan, Sreelakshmi Sankara, Abdul Gafor, Abdul Halim, Bak, Leong Goh, Boon, Cheak Bee, Mat Daud, Zulfitri Azuan, Chinna, Karuthan, and Karupaiah, Tilakavati
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- 2021
33. Response to 'Intraclass Correlation Coefficient and Reliability of Muscle Mass Measurements'
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Hi Ming Ng, Gild Rick Ong, Abdul Halim Abdul Gafor, Zulfitri Azuan Mat Daud, Chai Hong Yeong, S. Sahathevan, Sreelakshmi Sankara Narayanan, Bak Leong Goh, Karuthan Chinna, Tilakavati Karupaiah, Teik Hin Tan, Boon Cheak Bee, Abdul Kareem Meera Mohaideen, and Ban-Hock Khor
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Nutrition and Dietetics ,business.industry ,Intraclass correlation ,Statistics ,Medicine (miscellaneous) ,Medicine ,Muscle mass ,business ,Reliability (statistics) - Published
- 2021
34. Association of Ultrasound-Derived Metrics of the Quadriceps Muscle with Protein Energy Wasting in Hemodialysis Patients: A Multicenter Cross-Sectional Study
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Sharmela Sahathevan, Ban-Hock Khor, Birinder Kaur Sadu Singh, Alice Sabatino, Enrico Fiaccadori, Zulfitri Azuan Mat Daud, Mohammad Syafiq Ali, Sreelakshmi Sankara Narayanan, Dina Tallman, Karuthan Chinna, Bak-Leong Goh, Abdul Halim Abdul Gafor, Ghazali Ahmad, Zaki Morad, Pramod Khosla, Tilakavati Karupaiah, and null on behalf of the PATCH Study (Malaysia) Investigators
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Male ,0301 basic medicine ,medicine.medical_specialty ,Cachexia ,protein energy wasting ,Cross-sectional study ,medicine.medical_treatment ,Urology ,lcsh:TX341-641 ,Logistic regression ,Protein-Energy Malnutrition ,Article ,03 medical and health sciences ,ultrasound imaging ,0302 clinical medicine ,Renal Dialysis ,medicine ,Humans ,030212 general & internal medicine ,Wasting ,Ultrasonography ,030109 nutrition & dietetics ,Nutrition and Dietetics ,hemodialysis ,business.industry ,quadriceps muscle ,Ultrasound ,Area under the curve ,Quadriceps muscle ,Protein energy wasting ,muscle wasting ,Middle Aged ,Cross-Sectional Studies ,Female ,Hemodialysis ,medicine.symptom ,business ,lcsh:Nutrition. Foods and food supply ,Food Science - Abstract
This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of rectus femoris (RF) and vastus intermedius (VI) muscles and cross-sectional area (CSA) of the RF muscle (RFCSA) were measured using US and compared with other physical measures. Associations of US indices with PEW were determined by logistic regression. Irrespective of gender, PEW vs non-PEW patients had smaller RF, VI muscles, and RFCSA (all p <, 0.001). US muscle sites (all p <, 0.001) discriminated PEW from non-PEW patients, but the RFCSA compared to bio-impedance spectroscopy had a greater area under the curve (AUC, 0.686 vs 0.581), sensitivity (72.8% vs 65.8%), and specificity (55.6% vs 53.9%). AUC of the RFCSA was greatest for PEW risk in men (0.74, 95% CI: 0.66&ndash, 0.82) and women (0.80, 95% CI: 0.70&ndash, 0.90) (both p <, 0.001). Gender-specific RFCSA values (men <, 6.00 cm2, women <, 4.47 cm2) indicated HD patients with smaller RFCSA were 8 times more likely to have PEW (AOR = 8.63, 95% CI: 4.80&ndash, 15.50, p <, 0.001). The US approach enabled discrimination of muscle wasting in HD patients with PEW. The RFCSA was identified as the best US site with gender-specific RFCSA values to associate with PEW risk, suggesting potential diagnostic criteria for muscle wasting.
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- 2020
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35. Strategic plan for integrated care of patients with kidney failure
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Simon J. Davies, Irma Tchokhonelidze, Aminu K. Bello, Ahmed Twahir, Gavin Dreyer, Shahrzad Ossareh, Edwina A. Brown, Robert J. Walker, Roberto Pecoits Filho, Elena Zakharova, Abdou Niang, Kamal D. Shah, Jo-Ann Donner, Gregorio T. Obrador, Valerie A. Luyckx, FU Eke, Nathan W. Levin, Fredric O. Finkelstein, David Harris, Tushar J. Vachharajani, Ali K. Abu Alfa, Brett Cullis, Mark Brown, Ikechi G. Okpechi, Yewondwossesn Tadesse Mengistu, Charles R. Swanepoel, David W. Johnson, Saraladevi Naicker, Carlos Zuniga, Mohammed Rafique Moosa, Guillermo Garcia Garcia, Vivekanand Jha, Brenda R. Hemmelgarn, Philip J. O'Connell, Elmi Muller, Marcello Tonelli, Rumeyza Kazancioglu, Bak Leong Goh, Arpana Iyengar, Fergus Caskey, Gloria Ashuntantang, Anthony J.O. Were, Chih-Wei Yang, Rachael L. Morton, Adrian Liew, Michele Trask, Mignon McCulloch, Dominique Martin, Fan Fan Hou, Karen Yeates, Laura Sola, and KAZANCIOĞLU, RÜMEYZA
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0301 basic medicine ,Nephrology ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Operations management ,UHC (universal health coverage) ,Dialysis ,Strategic planning ,conservative care ,advocacy ,training ,business.industry ,funding ,COVID-19 ,Integrated care ,kidney failure ,Coronavirus ,Transplantation ,030104 developmental biology ,dialysis ,business ,transplantation - Abstract
© 2020 International Society of NephrologyThere is a huge gap between the number of patients worldwide requiring versus those actually receiving safe, sustainable, and equitable care for kidney failure. To address this, the International Society of Nephrology coordinated the development of a Strategic Plan for Integrated Care of Patients with Kidney Failure. Implementation of the plan will require engagement of the whole kidney community over the next 5–10 years.
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- 2020
36. P0255THE SHORT TERM MATERNAL OUTCOME OF PREGNANT CHRONIC KIDNEY DISEASE PATIENTS
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Bak leong Goh, Mohammad Zulkarnain Bidin, Wee Ven Hing Weeven94@hotmail.com, Shao Wei Yong, Yun Jin Ong, and Christopher thiam seong Lim
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Nephrology ,Transplantation ,Pregnancy ,Creatinine ,medicine.medical_specialty ,Pediatrics ,Proteinuria ,business.industry ,Urinary system ,Renal function ,medicine.disease ,chemistry.chemical_compound ,Blood pressure ,chemistry ,Internal medicine ,medicine ,medicine.symptom ,business ,Kidney disease - Abstract
Background and Aims Pregnancy in chronic kidney disease (CKD) is associated with increased risk of adverse maternal outcomes and fetal outcomes. The risks are noticeable even in early stages of CKD. Despite the rising concern, there are few follow-up studies in this high-risk group. Method We followed up and analysed 538 pregnancies in 173 women with pre-existing of primary renal disease who were seen at a tertiary nephrology centre from January 2007 until December 2015. We sought to investigate the changes in laboratory and clinical parameters, maternal and fetal outcomes. Results Figure 1 showed the changes of parameters intra and post-partum period. Increase in weight (p=0.034, OR 1.135, 95% CI 1.01-1.276), antibiotics consumption (p=0.022, OR 0.088, 95% CI 0.011-0.0703), pregnancy-related hypertension (p=0.056, OR 0.161, 95% CI 0.025-1.05) and gromerulonephritis (p=0.049, OR 14.22, 95% CI 1.009- 200.52) were associated with worsening of proteinuria intra-pregnancy and post-pregnancy period. Age more than 30-year-old (p=0.024, OR 0.644, 95% CI 0.439-0.945), multiple pregnancies (p = 0.032, OR 14.4, 95% CI 1.25-165 , antibiotics usage (p=0.033, OR 27.59, 95% CI 1.302-585.169), diuretic usage (p=0.034, OR 0.003, 95% CI 1.26-0.646), pregnancy-related hypertension (p=0.06, OR 21.838, 95% CI 0.878-543.376) and proteinuria (> 1.5g/d) (p=0.025, OR 0.235 95% CI 0.067-0.717) and fetal complications such as fetal death (p=0.013, OR 3.608 95% CI 1.311-9.930) was associated with rapid renal function decline of 25-50% . Elevation of serum uric acid is associated with a higher risk of adverse fetal outcome (r=0.845 p=0.004). Conclusion Multiple pregnancies, antibiotic usage, pregnancy-related hypertension are strong predictors of rapid maternal rapid function decline. Pre-conception counselling, minimization of antibiotic usage and aggressive blood pressure monitoring and treatment should be part of the standard treatment for this high-risk population.
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- 2020
37. Clinical efficacy and feasibility of whey protein isolates supplementation in malnourished peritoneal dialysis patients: A multicenter, parallel, open-label randomized controlled trial
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SeeHoe Ng, Chee-Hee Se, Ghazali Ahmad, Ban-Hock Khor, Halim Abdul Gafor, Sunita Bavanandan, Tilakavati Karupaiah, Sharmela Sahathevan, Bak Leong Goh, and Karuthan Chinna
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Male ,Time Factors ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030232 urology & nephrology ,Gastroenterology ,Body Mass Index ,law.invention ,0302 clinical medicine ,Blood serum ,Peritoneal Dialysis, Continuous Ambulatory ,Randomized controlled trial ,Skin fold ,Risk Factors ,law ,Urea ,Medicine ,030212 general & internal medicine ,education.field_of_study ,Nutrition and Dietetics ,Hand Strength ,Middle Aged ,Treatment Outcome ,Female ,Kidney Diseases ,Nutritive Value ,Adult ,medicine.medical_specialty ,Population ,Nutritional Status ,Serum Albumin, Human ,Peritoneal dialysis ,03 medical and health sciences ,Internal medicine ,Humans ,education ,Dialysis ,Aged ,business.industry ,Malnutrition ,Continuous ambulatory peritoneal dialysis ,Malaysia ,Whey Proteins ,Dietary Supplements ,Quality of Life ,Feasibility Studies ,Energy Intake ,business ,Body mass index ,Biomarkers - Abstract
Poor dietary intake is commonly associated with malnutrition in the dialysis population and oral nutritional supplementation is strategized to redress dietary inadequacy. Knowledge on clinical efficacy of whey protein supplementation (WPS) as an option to treat malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients is limited.This multicenter, parallel, open-label, randomized controlled trial investigated the clinical efficacy of WPS in 126 malnourished CAPD patients with serum albumin40 g/L and body mass index (BMI)24 kg/mSeventy-four patients (n = 37 per group) completed the study. Significantly more IG patients (59.5%) achieved dietary protein intake (DPI) adequacy of 1.2 g/kg per ideal body weight (p 0.001) compared to CG (16.2%) although difference in the adequacy of dietary energy intake between groups was non-significant (p 0.05). A higher DPI paralleled significant increases in serum urea (mean Δ: IG = +2.39 ± 4.36 mmol/L, p = 0.002, d = 0.57 vs CG = -0.39 ± 4.59 mmol/L, p 0.05, d = 0.07) and normalized protein catabolic rate, nPCR (mean Δ: IG = +0.11 ± 0.14 g/kg/day, p 0.001, d = 0.63 vs CG = +0.001 ± 0.17 g/kg/day, p 0.05, d = 0.09) for IG compared to CG patients. Although not significant, comparison for changes in post-dialysis weight (mean Δ: +0.64 ± 1.16 kg vs +0.02 ± 1.36 kg, p = 0.076, d = 0.58) and mid-arm circumference (mean Δ: +0.29 ± 0.93 cm vs -0.12 ± 0.71 cm, p = 0.079, d = 0.24) indicated trends favoring IG vs CG. Other parameters remained unaffected by treatment comparisons. CG patients had a significant decline in QOL physical component (mean Δ = -6.62 ± 16.63, p = 0.020, d = 0.47). Using changes in nPCR level as a marker of WPS intake within IG, 'positive responders' achieved significant improvement in weight, BMI, skinfold measures and serum urea (all p 0.05), while such changes within 'negative responders' were non-significant (all p 0.05).A single macronutrient approach with WPS in malnourished CAPD patients was shown to achieve DPI adequacy and improvements in weight, BMI, skin fold measures, serum urea and nPCR level. CLINICAL TRIAL REGISTRY: www.clinicaltrials.gov (NCT03367000).
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- 2018
38. Aetiology, practice patterns and burden of end‐stage kidney disease in South Asia and South‐East Asia: A questionnaire‐based survey
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Sahay, Manisha, primary, Jasuja, Sanjiv, additional, Tang, Sydney Chi Wai, additional, Alexander, Suceena, additional, Jha, Vivekanand, additional, Vachharajani, Tushar, additional, Mostafi, Mamun, additional, Pisharam, Jayakrishnan K., additional, Jacob, Chakko, additional, Gunawan, Atma, additional, Bak Leong, Goh, additional, Thwin, Khin Thida, additional, Agrawal, Rajendra Kumar, additional, Vareesangthip, Kriengsak, additional, Tanchanco, Roberto, additional, Choong, Lina, additional, Herath, Chula, additional, Lin, Chih‐Ching, additional, Cuong, Nguyen The, additional, Haian, Ha Phan, additional, Akhtar, Syed Fazal, additional, Alsahow, Ali, additional, Rana, Devinder S., additional, Rajapurkar, Mohan M., additional, Kher, Vijay, additional, Verma, Shalini, additional, Ramachandran, Raja, additional, Bhargava, Vinant, additional, Puri, Sonika, additional, Sagar, Gaurav, additional, Bahl, Anupam, additional, Mandal, Sandeep, additional, Gupta, Ashwani, additional, and Gallieni, Maurizio, additional
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- 2020
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39. Intravenous iron and erythropoiesis‐stimulating agents in haemodialysis: A systematic review and meta‐analysis
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Hyeong Cheon Park, Bak Leong Goh, Iain C. Macdougall, Vanessa Stevens, Martin Tio, Timothy Robert Cushway, Hui Lin Choong, and Simon D. Roger
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Adult ,medicine.medical_specialty ,Dose ,Anemia ,Iron ,Population ,030232 urology & nephrology ,ESA ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Renal Dialysis ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Humans ,030212 general & internal medicine ,Dosing ,education ,Adverse effect ,epoetin ,education.field_of_study ,business.industry ,General Medicine ,Original Articles ,medicine.disease ,Surgery ,Clinical trial ,haemodialysis ,Nephrology ,meta‐analysis ,Injections, Intravenous ,intravenous iron ,Hematinics ,Original Article ,business ,Dialysis ,chronic kidney disease ,Kidney disease - Abstract
Aim Higher dosages of erythropoiesis‐stimulating agents (ESAs) have been associated with adverse effects. Intravenous iron is used to optimize ESA response and reduces ESA doses in haemodialysis patients; this meta‐analysis evaluates the magnitude of this effect. Methods A literature search was performed using MEDLINE, Embase and the Cochrane Collaboration Central Register of Clinical Trials from inception until December 2014, to identify randomized controlled trials of intravenous iron and ESA, in patients undergoing haemodialysis for end‐stage kidney disease. Dosing of IV iron in concordance with the Kidney Disease Improving Global Outcomes guidelines was considered optimal iron therapy. Results Of the 28 randomized controlled trials identified, seven met the criteria for inclusion in the meta‐analysis. Results of random‐effects meta‐analysis show a statistically significant weighted mean (95% CI) difference of −1733 [−3073, −392] units/week in ESA dose for optimal iron versus suboptimal iron. The weighted average change in ESA dose was a reduction of 23% (range −7% to −55%) attributable to appropriate dosing of intravenous iron. A comparison of intravenous iron versus oral iron/no iron (five trials) showed a greater reduction in ESA dose, although this did not reach statistical significance (weighted mean difference, 95% CI: −2,433 [−5183, 318] units/week). The weighted average change in ESA dose across the five trials was a reduction of 31% (range −8% to −55%). Conclusion Significant reductions in ESA dosing may be achieved with optimal intravenous iron usage in the haemodialysis population, and suboptimal iron use may require higher ESA dosing to manage anaemia., Summary at a Glance This review manuscript evaluated the magnitude of ESA dose reduction in relation to optimal or suboptimal iron treatment. Optimal iron therapy should allow reduction of ESA dosages, allowing a possible cost saving.
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- 2017
40. Clinical course after parathyroidectomy in adults with end-stage renal disease on maintenance dialysis
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Bak Leong Goh, Thevandra Kalaiselvam, Christopher Thiam Seong Lim, and Normayah Kitan
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Parathyroidectomy ,medicine.medical_specialty ,medicine.medical_treatment ,clinical course ,030232 urology & nephrology ,Urology ,morbidity ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Renal osteodystrophy ,030212 general & internal medicine ,Dialysis ,Transplantation ,Calciphylaxis ,business.industry ,medicine.disease ,mortality ,Nephrology ,Secondary hyperparathyroidism ,Hemodialysis ,business ,postparathyroidectomy ,Kidney disease - Abstract
Background Parathyroidectomy (PTX) is done in cases of secondary hyperparathyroidism from chronic kidney disease to improve renal osteodystrophy. Despite this widespread practice, clinical outcomes regarding the benefits of this procedure are still lacking. Most studies in the literature have opted to report the laboratory outcome instead. Our study aimed to evaluate the postoperative clinical course for patients who had undergone total PTX without autoimplantation. Methods and results All patients who underwent PTX between January 2010 and February 2014 in a tertiary referral center were included in this study and followed up for 12 months. Laboratory outcome parameters include various preoperative and postoperative serial measurements of laboratory parameters. Patients’ hospitalizations and mortality records post-PTX were also retrieved and recorded. In all, 90 patients were included in this study. The mean age was 48 ± 18 years. The majority of the patients (54.4%) were male and 90% were on hemodialysis. The mean duration of dialysis was 8.0 ± 5.0 years. Indications for PTX were symptomatic bone pain (95.6%), fractures (3.3%) and calciphylaxis (1.1%). Mean preoperative values for serum calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (iPTH) were 2.40 ± 0.23mmol/L, 1.92 ± 0.51 mmol/L, 689.60 ± 708.50 U/L and 311.90 ± 171.94 pmol/L, respectively. The majority (92.2%) had all four glands removed and 92.2% of the glands showed hyperplasic changes. One year after PTX, 90 patients (100%) had serum iPTH
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- 2017
41. Successful multigravid pregnancy in a 42-year-old patient on continuous ambulatory peritoneal dialysis and a review of the literature
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Bak Leong Goh, Irene Wong, Malini Shanmuganathan, and Thiam Seong Christopher Lim
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Adult ,Nephrology ,medicine.medical_specialty ,Advance maternal age ,medicine.medical_treatment ,Peritoneal dialysis ,030232 urology & nephrology ,Case Report ,Gravidity ,030204 cardiovascular system & hematology ,lcsh:RC870-923 ,03 medical and health sciences ,0302 clinical medicine ,Obstetrics and gynaecology ,Pregnancy ,Internal medicine ,Ambulatory Care ,Humans ,Medicine ,Advanced maternal age ,Renal Insufficiency, Chronic ,Intensive care medicine ,Dialysis ,Full Term ,business.industry ,Obstetrics ,Continuous ambulatory peritoneal dialysis ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Adequacy ,Pregnancy Complications ,Female ,business ,Live Birth - Abstract
Background For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient’s pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis. Case presentation We report a successful elderly multigravid pregnancy, in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). Her pregnancy was detected early and she was closely managed by the nephrologist and obstetrician. She tolerated the same PD prescription throughout 36 weeks of pregnancy with daily ultrafiltration of 500-1500mls. Her blood pressure remained well controlled without the need of any antihypertensive medication. Her total Kt/V ranged from 1.93 to 2.73. Her blood parameters remained stable and she was electively admitted at 36 weeks for a trans-peritoneal lower segment caesarian section and bilateral tubal ligation. Conclusions At the age of 42, our case is the oldest reported successful pregnancy in a patient on peritoneal dialysis. With careful counselling and meticulous follow up, we have shown that woman in the early stage of end stage renal failure can successfully deliver a full term baby without any complications. Therefore, these women should not be discourage from conceiving even if they are in advanced maternal age for pregnancy.
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- 2017
42. SAT-461 SINISTER RETRO-PERITONEAL HEMORRHAGE: WUNDERLICH SYNDROME
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Christopher Thiam Seong Lim, Bak Leong Goh, Nor Fadhlina Zakaria, A. Md Shah, and Wan Zul Haikal Wan Zukiman
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Peritoneal Hemorrhage ,medicine.medical_specialty ,Nephrology ,Wunderlich syndrome ,business.industry ,medicine ,medicine.disease ,business ,Surgery - Published
- 2020
43. Capturing and monitoring global differences in untreated and treated end-stage kidney disease, kidney replacement therapy modality, and outcomes
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Ikechi G. Okpechi, Harith M. Aljubori, Masaomi Nangaku, Laura Sola, Xueqing Yu, John Feehally, Rachael C. Walker, Ming-Hui Zhao, David W. Johnson, Robert J. Walker, Aminu K. Bello, Manisha Sahay, Ezequiel Bellorin-Font, Muhibur Rahman, Alfonso M. Cueto-Manzano, David Harris, Jo-Ann Donner, Qiang Yao, Bak Leong Goh, Rumeyza Kazancioglu, Allan J. Collins, Abdulkarim Saleh, Kitty J Jager, Fergus Caskey, Roberto Pecoits-Filho, and KAZANCIOĞLU, Rümeyza
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0301 basic medicine ,medicine.medical_specialty ,kidney replacement therapy ,editorial ,030232 urology & nephrology ,MEDLINE ,global health ,Kidney ,Health informatics ,03 medical and health sciences ,0302 clinical medicine ,Kidney Replacement Therapy ,end-stage kidney disease ,health information systems ,health services accessibility ,medicine ,Global health ,End-stage kidney disease ,Intensive care medicine ,Modality (human–computer interaction) ,Modalities ,business.industry ,registries ,medicine.disease ,ISN public affair ,030104 developmental biology ,Nephrology ,business ,Kidney disease - Abstract
A large gap between the number of people with end-stage kidney disease (ESKD) who received kidney replacement therapy (KRT) and those who needed it has been recently identified, and it is estimated that approximately one half to three quarters of all people with ESKD in the world may have died prematurely because they could not receive KRT. This estimate is aligned with a previous report that estimated that more than 3 million people in the world died each year because they could not access KRT. In this article, we discuss the reasons for the differences in treated and untreated ESKD, KRT modalities and outcomes, and present strategies to close the global KRT gap by establishing robust health information systems to guide resource allocation to areas of need, inform KRT service planning, enable policy development, and monitor KRT health outcomes.
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- 2019
44. Increasing access to integrated ESKD care as part of Universal Health Coverage
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Harith M. Aljubori, Ahmed Twahir, Fliss E M Murtagh, Guillermo Garcia Garcia, Karen Yeates, Gregorio T. Obrador, Rachael L. Morton, Shahrzad Ossareh, Roberto Pecoits Filho, Elena Zakharova, Kamal D. Shah, Abdou Niang, Rachael C. Walker, Ming-Hui Zhao, Manisha Sahay, Alfonso M. Cueto-Manzano, Cécile Couchoud, Rolando Claure-Del Granado, Walter Douthat, Brenda R. Hemmelgarn, Robert J. Walker, Brett Cullis, John Feehally, Marcello Tonelli, Marie Richards, David Harris, Michele Trask, Dominique Martin, Yuqing Chen, Laura Sola, Mona Alrukhaimi, Nathan W. Levin, Mohammad Ghnaimat, Yewondwassesn Tadesse Mengistu, Ikechi G. Okpechi, Sharon Andreoli, Carlos Zuniga, Muhibur Rahman, Wim Van Biesen, Fergus Caskey, Kitty J. Jager, Kriang Tungsanga, Daniel Schneditz, Alexander Zemchenkov, Adeera Levin, Edwina A. Brown, Vivekanand Jha, Anthony J.O. Were, Philip J. O'Connell, Vladimir Tesar, David W. Johnson, Elmi Muller, Saraladevi Naicker, Mark Brown, Georgi Abraham, Masaomi Nangaku, Xueqing Yu, Tak Mao Chan, Peter G. Blake, Valerie A. Luyckx, Rumeyza Kazancioglu, Fredric O. Finkelstein, Jeffrey Perl, Marla McKnight, Irma Tchokhonelidze, Gavin Dreyer, Gloria Ashuntantang, Bak Leong Goh, Adrian Liew, Harun Ur Rashid, Kamyar Kalantar-Zadeh, Mohamed H. Hassan, Allan J. Collins, Fan Fan Hou, Abdulkarim Saleh, Qiang Yao, Ali K. Abu Alfa, Fuad M. Ibhais, Cherian Varghese, Jo-Ann Donner, FU Eke, Tushar J. Vachharajani, Paul N. Harden, Somchai Eiam-Ong, Bassam Bernieh, Mohammed Rafique Moosa, Stefaan Claus, Charles R. Swanepoel, Sakarn Bunnag, Chih-Wei Yang, Eric Rondeau, Simon J. Davies, Ezequiel Bellorin-Font, Aminu K. Bello, and Mignon McCulloch
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0301 basic medicine ,CHRONIC KIDNEY-DISEASE ,030232 urology & nephrology ,Stakeholder engagement ,universal health coverage ,Conservative Treatment ,Global Health ,Health Services Accessibility ,Global Burden of Disease ,RC902 ,0302 clinical medicine ,Universal Health Insurance ,Health care ,end-stage kidney disease ,Medicine and Health Sciences ,Health Workforce ,DEVELOPING-COUNTRIES ,PERITONEAL-DIALYSIS ,training ,Health Policy ,STAGE RENAL-DISEASE ,Urology & Nephrology ,WEEKLY HEMODIALYSIS ,Renal Replacement Therapy ,Nephrology ,Health Occupations ,Workforce ,SURVIVAL ,Life Sciences & Biomedicine ,RATIONING DIALYSIS ,education ,Working Groups of the International Society of Nephrology’s 2nd Global Kidney Health Summit ,Context (language use) ,Patient Advocacy ,End stage renal disease ,03 medical and health sciences ,REPLACEMENT THERAPY ,Quality of life (healthcare) ,Nursing ,SUPPORTIVE CARE ,COMPARATIVE SURVIVAL ,Humans ,Developing Countries ,conservative care ,Government ,advocacy ,Science & Technology ,ESKD ,business.industry ,funding ,1103 Clinical Sciences ,R1 ,Transplantation ,COMPARATIVE ,Health Planning ,030104 developmental biology ,INCIDENT DIALYSIS PATIENTS ,Kidney Failure, Chronic ,dialysis ,business ,transplantation - Abstract
The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals from around the globe with diverse expertise and professional backgrounds. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle–income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across 8 themes: (i) estimates of ESKD burden and treatment coverage, (ii) advocacy, (iii) education and training/workforce, (iv) financing/funding models, (v) ethics, (vi) dialysis, (vii) transplantation, and (viii) conservative care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include improved data availability, integration of core registry measures and analysis to inform development of health care policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient, and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide.
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- 2019
45. Impact of Hyperuricemia on the Progression of Renal Disease among Patient in a tertiary renal center
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Christopher Thiam Seong Lim, Johnson Stanslas, Mohammad Zulkarnain Bidin, Anim Md Shah, and Bak Leong Goh
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Pharmacology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Pharmacology (medical) ,Center (algebra and category theory) ,Disease ,Hyperuricemia ,business ,medicine.disease - Published
- 2019
46. PERITONEAL DIALYSIS CATHETER SURVIVAL IN PATIENTS WITH PREVIOUS ABDOMINAL SURGERY
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Azrini AA, Fairol I, Bak Leong Goh, Lim, Christopher Thiam Seong, Haikal, Wan Zul Hafiz, Anim Shah, and Nor Fadhlina Zakaria
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- 2019
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47. Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial
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Hiddo J L Heerspink, Hans-Henrik Parving, Dennis L Andress, George Bakris, Ricardo Correa-Rotter, Fan-Fan Hou, Dalane W Kitzman, Donald Kohan, Hirofumi Makino, John J V McMurray, Joel Z Melnick, Michael G Miller, Pablo E Pergola, Vlado Perkovic, Sheldon Tobe, Tingting Yi, Melissa Wigderson, Dick de Zeeuw, Alicia Elbert, Augusto Vallejos, Andres Alvarisqueta, Laura Maffei, Luis Juncos, Javier de Arteaga, Gustavo Greloni, Eduardo Farias, Alfredo Zucchini, Daniel Vogel, Ana Cusumano, Juan Santos, Margaret Fraenkel, Martin Gallagher, Tim Davis, Shamasunder Acharya, Duncan Cooke, Michael Suranyi, Simon Roger, Nigel Toussaint, Carol Pollock, Doris Chan, Stephen Stranks, Richard MacIsaac, Zoltan Endre, Alice Schmidt, Rudolf Prager, Gert Mayer, Xavier Warling, Michel Jadoul, Jean Hougardy, Chris Vercammen, Bruno Van Vlem, Pieter Gillard, Adriana Costa e Forti, Joao Lindolfo Borges, Luis Santos Canani, Freddy Eliaschewitz, Silmara Leite, Fadlo Fraige Filho, Raphael Paschoalin, Jose Andrade Moura Neto, Luciane Deboni, Irene de Lourdes Noronha, Cintia Cercato, Carlos Alberto Prompt, Maria Zanella, Nelson Rassi, Domingos D'Avila, Rosangela Milagres, Joao Felicio, Roberto Pecoits Filho, Miguel Carlos Riella, Joao Salles, Elizete Keitel, Sergio Draibe, Celso Amodeo, Joseph Youmbissi, Louise Roy, Serge Cournoyer, Shivinder Jolly, Vincent Pichette, Gihad Nesrallah, Harpreet Singh Bajaj, Hasnain Khandwala, Ronnie Aronson, Richard Goluch, Paul Tam, Christian Rabbat, Gordon Bailey, Stephen Chow, Alvaro Castillo, Alfredo Danin Vargas, Fernando Gonzalez, Rodrigo Munoz, Vicente Gutierrez, Gonzalo Godoy, Hongwen Zhao, Zhangsuo Liu, Minghui Zhao, Xiaohui Guo, Benli Su, Shuxia Fu, Yan Xu, Jinkui Yang, Bingyin Shi, Guanqing Xiao, Wei Shi, Chuanming Hao, Changying Xing, Fanfan Hou, Qun Luo, Yuxiu Li, Linong Ji, Li Zuo, Song Wang, Zhaohui Ni, Guohua Ding, Nan Chen, Jiajun Zhao, Weiping Jia, Shengqiang Yu, Jian Weng, Gang Xu, Ping Fu, Shiren Sun, Bicheng Liu, Xiaoqiang Ding, Ivan Rychlik, Alexandra Oplustilova, Dagmar Bartaskova, Vaclava Honova, Hana Chmelickova, Martin Petr, Petr Bucek, Vladimir Tesar, Emil Zahumensky, Johan Povlsen, Kenneth Egstrup, Anna Oczachowska-Kulik, Peter Rossing, Jorma Lahtela, Jorma Strand, Ilkka Kantola, Catherine Petit, Christian Combe, Philippe Zaoui, Vincent Esnault, Pablo Urena Torres, Jean-Michel Halimi, Bertrand Dussol, Tasso Bieler, Klemens Budde, Frank Dellanna, Thomas Segiet, Christine Kosch, Hans Schmidt-Guertler, Isabelle Schenkenberger, Volker Vielhauer, Frank Pistrosch, Mark Alscher, Christoph Hasslacher, Christian Hugo, Anja Muehlfeld, Christoph Wanner, Ploumis Passadakis, Theofanis Apostolou, Nikolaos Tentolouris, Ioannis Stefanidis, Konstantinos Mavromatidis, Vasilios Liakopoulos, Dimitrios Goumenos, Konstantinos Siamopoulos, Vincent Yeung, Risa Ozaki, Samuel Fung, Kathryn Tan, Sydney Tang, Sing Leung Lui, Siu Fai Cheung, Seamus Sreenan, Joseph Eustace, Donal O'Shea, Peter Lavin, Austin Stack, Yoram Yagil, Julio Wainstein, Hilla Knobler, Josef Cohen, Irina Kenis, Deeb Daoud, Yosefa Bar-Dayan, Victor Frajewicki, Faiad Adawi, Loreto Gesualdo, Domenico Santoro, Francesco Marino, Andrea Galfre, Chiara Brunati, Piero Ruggenenti, Giuseppe Rombola, Giuseppe Pugliese, Maura Ravera, Fabio Malberti, Giuseppe Pontoriero, Teresa Rampino, Salvatore De Cosmo, Ciro Esposito, Felice Nappi, Cataldo Abaterusso, Giuseppe Conte, Vincenzo Panichi, Davide Lauro, Giovambattista Capasso, Domenico Russo, Jiichi Anzai, Motoji Naka, Keita Ato, Tetsuro Tsujimoto, Toshinori Nimura, Eitaro Nakashima, Tetsuro Takeda, Shinya Fujii, Kunihisa Kobayashi, Hideaki Iwaoka, Koji Nagayama, Hiroyuki Harada, Hajime Maeda, Rui Kishimoto, Tadashi Iitsuka, Naoki Itabashi, Ryuichi Furuya, Yoshitaka Maeda, Daishiro Yamada, Nobuhiro Sasaki, Hiromitsu Sasaki, Shinichiro Ueda, Naoki Kashihara, Shuichi Watanabe, Takehiro Nakamura, Hidetoshi Kanai, Yuichiro Makita, Keiko Ono, Noriyuki Iehara, Daisuke Goto, Keiichiro Kosuge, Kenichi Tsuchida, Toshiaki 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Isabel Garcia Mendez, Juan Navarro Gonzalez, Jose Herrero Calvo, Secundino Cigarran Guldris, Mario Prieto Velasco, Jose Ignacio Minguela Pesquera, Antonio Galan, Julio Pascual, Maria Marques Vidas, Judith Martins Munoz, Jose Rodriguez-Perez, Cristina Castro-Alonso, Josep Bonet Sol, Daniel Seron, Elvira Fernandez Giraldez, Javier Arrieta Lezama, Nuria Montero, Julio Hernandez-Jaras, Rafael Santamaria Olmo, Jose Ramon Molas Coten, Olof Hellberg, Bengt Fellstrom, Andreas Bock, Dee Pei, Ching-Ling Lin, Kai-Jen Tien, Ching-Chu Chen, Chien-Ning Huang, Ju-Ying Jiang, Du-An Wu, Chih-Hsun Chu, Shih-Ting Tseng, Jung-Fu Chen, Cho-Tsan Bau, Wayne Sheu, Mai-Szu Wu, Ramazan Sari, Siren Sezer, Alaattin Yildiz, Ilhan Satman, Betul Kalender, Borys Mankovskyy, Ivan Fushtey, Mykola Stanislavchuk, Mykola Kolenyk, Iryna Dudar, Viktoriia Zolotaikina, Orest Abrahamovych, Tetyana Kostynenko, Olena Petrosyan, Petro Kuskalo, Olga Galushchak, Oleg Legun, Ivan Topchii, Liliya Martynyuk, Vasyl Stryzhak, Svitlana 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(GKC), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Heerspink, H. J. L., Parving, H. -H., Andress, D. L., Bakris, G., Correa-Rotter, R., Hou, F. -F., Kitzman, D. W., Kohan, D., Makino, H., Mcmurray, J. J. V., Melnick, J. Z., Miller, M. G., Pergola, P. E., Perkovic, V., Tobe, S., Yi, T., Wigderson, M., de Zeeuw, D., Elbert, A., Vallejos, A., Alvarisqueta, A., Maffei, L., Juncos, L., de Arteaga, J., Greloni, G., Farias, E., Zucchini, A., Vogel, D., Cusumano, A., Santos, J., Fraenkel, M., Gallagher, M., Davis, T., Acharya, S., Cooke, D., Suranyi, M., Roger, S., Toussaint, N., Pollock, C., Chan, D., Stranks, S., Macisaac, R., Endre, Z., Schmidt, A., Prager, R., Mayer, G., Warling, X., Jadoul, M., Hougardy, J., Vercammen, C., Van Vlem, B., Gillard, P., Costa e Forti, A., Borges, J. L., Santos Canani, L., Eliaschewitz, F., Leite, S., Fraige Filho, F., Paschoalin, R., Moura Neto, J. A., Deboni, L., de Lourdes Noronha, I., Cercato, C., Prompt, C. A., Zanella, M., Rassi, N., D'Avila, D., Milagres, R., Felicio, J., Pecoits Filho, R., Riella, M. 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L., Cheung, S. F., Sreenan, S., Eustace, J., O'Shea, D., Lavin, P., Stack, A., Yagil, Y., Wainstein, J., Knobler, H., Cohen, J., Kenis, I., Daoud, D., Bar-Dayan, Y., Frajewicki, V., Adawi, F., Gesualdo, L., Santoro, D., Marino, F., Galfre, A., Brunati, C., Ruggenenti, P., Rombola, G., Pugliese, G., Ravera, M., Malberti, F., Pontoriero, G., Rampino, T., De Cosmo, S., Esposito, C., Nappi, F., Abaterusso, C., Conte, G., Panichi, V., Lauro, D., Capasso, G., Russo, D., Anzai, J., Naka, M., Ato, K., Tsujimoto, T., Nimura, T., Nakashima, E., Takeda, T., Fujii, S., Kobayashi, K., Iwaoka, H., Nagayama, K., Harada, H., Maeda, H., Kishimoto, R., Iitsuka, T., Itabashi, N., Furuya, R., Maeda, Y., Yamada, D., Sasaki, N., Sasaki, H., Ueda, S., Kashihara, N., Watanabe, S., Nakamura, T., Kanai, H., Makita, Y., Ono, K., Iehara, N., Goto, D., Kosuge, K., Tsuchida, K., Sato, T., Sekikawa, T., Okamoto, H., Tanaka, T., Ikeda, N., Tadika, T., Mukasa, K., Osonoi, T., Hirano, F., Nishimura, M., Yambe, Y., Tanaka, Y., Ujihara, M., Sakai, T., Imura, M., Umayahara, Y., Makino, S., Nakazawa, J., Yamaguchi, Y., Kashine, S., Miyaoka, H., Suzuki, K., Inoue, T., Nagai, S., Sato, N., Yamamoto, M., Taya, N., Fujita, A., Matsutani, A., Shibagaki, Y., Sato, Y., Yamauchi, A., Tsutsui, M., Ishiko, T., Kaneko, S., Azuma, N., Matsuda, H., Hashiguchi, Y., Onishi, Y., Tokui, M., Matsuhisa, M., Kiyosue, A., Shinoda, J., Ishikawa, K., Ahmad, G., Vijayasingham, S., Aziz, N. 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P., Tindall, H., Kalra, P., Mark, P., Patel, D., El-Shahawy, M., Bai, L., Nica, R., Lien, Y. -H., Menefee, J., Busch, R., Miller, A., Ahmed, A., Arif, A., Lee, J., Desai, S., Bansal, S., Bentsianov, M., Belledonne, M., Jere, C., Gaona, R., Greenwood, G., Brusco, O., Boiskin, M., Belo, D., Minasian, R., Atray, N., Lawrence, M., Taliercio, J., Pergola, P., Scott, D., Alvarez, G., Marder, B., Powell, T., Bakdash, W., Stoica, G., Mcfadden, C., Rendell, M., Wise, J., Jones, A., Jardula, M., Madu, I. -J., Varghese, F., Tulloch, B., Ahmed, Z., Hames, M., Nazeer, I., Shahid, N., John, R., Montero, M., Fitz-Patrick, D., Phillips, L., Guasch, A., Christofides, E., Gundroo, A., Amin, M., Bowman-Stroud, C., Link, M., Mulloy, L., Nammour, M., Lalwani, T., Hanson, L., Whaley-Connell, A., Herman, L., Chatha, R., Osama, S., Liss, K., Kayali, Z., Bhargava, A., Israel, E., Peguero-Rivera, A., Fang, M., Slover, J., Barengolts, E., Flores, J., Muoneke, R., Savin, V., Awua-Larbi, S., Levine, A., Newman, G., Golestaneh, L., Bohm, G., Reisin, E., Cruz, L., Weiss, R., Zieve, F., Horwitz, E., Chuang, P., Mersey, J., Manley, J., Graf, R., Bedros, F., Joshi, S., Frias, J., Assefi, A., O'Shaughnessy, A., Brantley, R., Minga, T., Tietjen, D., Kantor, S., Jamal, A., Guadiz, R., Hershon, K., Bressler, P., Kopyt, N., Cathcart, H., Bloom, S., Reichel, R., Nakhle, S., Dulude, E., Tarkan, J., Baker, P., Zeig, S., Moya Hechevarria, J., Ropero-Cartier, A., De la Calle, G., Doshi, A., Saba, F., Sligh, T., Shaw, S., Kumar, J., Szerlip, H., Bayliss, G., Perlman, A., Sakhrani, L., Gouge, S., Argoud, G., Acosta, I., Elder, J., Sensenbrenner, J., Vicks, S., Mangoo-Karim, R., Galphin, C., Leon-Forero, C., Gilbert, J., Brown, E., Ijaz, A., Butt, S., Markell, M., Arauz-Pacheco, C., Sloan, L., Alvarado, O., Jabbour, S., Simon, E., Rastogi, A., James, S., Hall, K., Melish, J., Dixon, B., Adolphe, A., Kovesdy, C., Beddhu, S., Solomon, R., Fernando, R., Levin, E., Thakar, C., Robey, B., Goldfarb, D., Fried, L., Maddukuri, G., Thomson, S., Annand, A., Kronfli, S., Kalirao, P., Schmidt, R., Dahl, N., Blumenthal, S., Weinstein, D., Ostergaard, O., Weinstein, T., Ono, Y., Yalcin, M., Karim, S., Pathology/molecular and cellular medicine, Diabetes Pathology & Therapy, and Diabetes Clinic
- Subjects
Male ,endothelin ,albuminuria ,nephropathy ,inhibition ,Diabetes Mellitus, Type 2/drug therapy ,Endocrinology, Diabetes and Metabolism ,Placebo-controlled study ,Administration, Oral ,030204 cardiovascular system & hematology ,Settore MED/13 - Endocrinologia ,chemistry.chemical_compound ,0302 clinical medicine ,ENDOTHELIN ,80 and over ,Diabetic Nephropathies ,030212 general & internal medicine ,Renal Insufficiency ,Chronic ,Aged, 80 and over ,Diabetic Nephropathies/blood ,General Medicine ,Middle Aged ,Atrasentan/administration & dosage ,Editorial Commentary ,Treatment Outcome ,Nephrology ,Creatinine ,Administration ,young adult ,Female ,medicine.symptom ,Glomerular filtration rate ,Type 2 ,Endothelin A Receptor Antagonists/administration & dosage ,medicine.drug ,Glomerular Filtration Rate ,Human ,Oral ,Adult ,medicine.medical_specialty ,ALBUMINURIA ,Endothelin A Receptor Antagonists ,NEPHROPATHY ,Urology ,INHIBITION ,Renal function ,Serum Albumin, Human ,Placebo ,Nephropathy ,03 medical and health sciences ,Young Adult ,Double-Blind Method ,Atresentan ,diabetes, chronic kidney disease ,medicine ,Diabetes Mellitus ,Aged ,Atrasentan ,Diabetes Mellitus, Type 2 ,Humans ,Renal Insufficiency, Chronic ,Serum Albumin ,business.industry ,Creatinine/blood ,medicine.disease ,Serum Albumin, Human/urine ,n/a OA procedure ,chemistry ,Albuminuria ,Renal Insufficiency, Chronic/blood ,business ,aged, 80 and over ,Kidney disease - Abstract
Background Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes.Methods We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18-85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR) 25-75 mL/min per 1.73 m(2) of body surface area, and a urine albumin-to-creatinine ratio (UACR) of 300-5000 mg/g who had received maximum labelled or tolerated renin-angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0.75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders) were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0.75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for >= 30 days) or end-stage kidney disease (eGFR = 90 days, chronic dialysis for >= 90 days, kidney transplantation, or death from kidney failure) in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials. gov, number NCT01858532.Findings Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325) or placebo group (n=1323). Median follow-up was 2.2 years (IQR 1.4-2.9). 79 (6.0%) of 1325 patients in the atrasentan group and 105 (7.9%) of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR] 0.65 [95% CI 0.49-0.88]; p=0.0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3.5%) of 1325 patients in the atrasentan group and 34 (2.6%) of 1323 patients in the placebo group (HR 1.33 [95% CI 0.85-2.07]; p=0.208). 58 (4.4%) patients in the atrasentan group and 52 (3.9%) in the placebo group died (HR 1.09 [95% CI 0.75-1.59]; p=0.65).Interpretation Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Copyright (C) 2019 Elsevier Ltd. All rights reserved.
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- 2019
48. DOES THE INFLAMMATORY MARKER NEUTROPHIL-TO-LYMPHOCYTE RATIO PREDICTS MORTALITY AND RENAL DECLINE?
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Zulkarnain, Mohammad, Anim Shah, Stanslas, Johnson, Bak Leong Goh, and Lim, Christopher Thiam Seong
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- 2019
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49. Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient:2019 Update
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John H. Crabtree, Kai-Ming Chow, Ahmed Kamel Abdel-Aal, Johan V. Povlsen, Edwina A. Brown, Victoria Briggs, Martin Wilkie, Bak Leong Goh, Ana Elizabeth Figueiredo, Badri Man Shrestha, Brett Cullis, and Frank J M F Dor
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Adult ,peritoneal catheter malfunction ,medicine.medical_specialty ,EXIT-SITE PRACTICES ,tunnel infection ,medicine.medical_treatment ,pericatheter leak ,Peritoneal dialysis catheter ,Catheterization ,Peritoneal dialysis ,Catheters, Indwelling ,peritoneal catheter implantation ,INFECTIOUS COMPLICATIONS ,Humans ,Medicine ,Tunnel infection ,DIVERTICULAR-DISEASE ,TISSUE-PLASMINOGEN ACTIVATOR ,catheter infection ,peritoneal catheter complications ,Science & Technology ,SINGLE-CUFF ,SURGICAL PLACEMENT ,business.industry ,1103 Clinical Sciences ,Equipment Design ,General Medicine ,Urology & Nephrology ,RANDOMIZED CONTROLLED-TRIAL ,Surgery ,LAPAROSCOPIC IMPLANTATION ,Nephrology ,Catheter-Related Infections ,TENCKHOFF CATHETER INSERTION ,Equipment Failure ,BREAK-IN PERIOD ,business ,Life Sciences & Biomedicine ,Peritoneal Dialysis - Abstract
The success of peritoneal dialysis (PD) as renal replacement therapy depends upon a safe, functional, and durable catheter access to the peritoneal cavity provided in a timely fashion. Catheter complications often lead to catheter loss and contribute to technique failure. With improvements in prevention and treatment of peritonitis, the impact of catheter-related infections and mechanical problems on PD technique survival has become more apparent. Guideline committees under the sponsorship of the International Society for Peritoneal Dialysis (ISPD) periodically update best practices for optimal peritoneal access (1–4). Recent advances in our understanding of the key aspects of providing successful placement and maintenance of peritoneal catheters compels the current update. Assessment of evidence for guidelines recommendations is made using a modification of the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system for classification of the level of evidence and grade of recommendations (5). Where scientific evidence is not available, recommendations are based on a consensus opinion. The bibliography supporting the recommendations is not intended to be comprehensive. When there are multiple similar reports on the same subject, the committee prefers to cite the more recent publications. Within each recommendation, strength is indicated as Level 1 (we recommend), Level 2 (we suggest), or not graded, and the quality of the supporting evidence is shown as A (high quality), B (moderate quality), C (low quality), or D (very low quality). The recommendations are not meant to be implemented indiscriminately in every instance but adapted as necessary according to local circumstances and the clinical situation. While many of the general principles presented here may be applied to pediatric patients, the focus of these guidelines is on adults. Clinicians who take care of pediatric PD patients should refer to the latest ISPD guidelines covering this patient group (6).
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- 2019
50. IS THERE ANY ASSOCIATION BETWEEN HYPOCALCEMIA, HYPERPHOSPHATEMIA AND HYPERKALEMIA AND RENAL DECLINE?
- Author
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Zulkarnain, Mohammad, Anim Shah, Stanslas, Johnson, Bak Leong Goh, and Lim, Christopher Thiam Seong
- Published
- 2019
- Full Text
- View/download PDF
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