Chronic metabolic acidosis is a common complication seen in advanced chronic kidney disease(CKD). There is currently no consensus on its management in the Republic of Ireland. Recent trials have suggested that appropr...Chronic metabolic acidosis is a common complication seen in advanced chronic kidney disease(CKD). There is currently no consensus on its management in the Republic of Ireland. Recent trials have suggested that appropriate active management of metabolic acidosis through oral alkali therapy and modified diet can have a deterring impact on CKD progression. The potential benefits of treatment include preservation of bone health and improvement in muscle function; however,present data is limited. This review highlights the current evidence,available primarily from randomised control trials(RCTs) over the last decade,in managing the metabolic acidosis of CKD and outlines ongoing RCTs that are promising. An economic perspective is also briefly discussed to support decision-making.展开更多
Coronavirus disease 2019(COVID-19)continues to affect millions of people around the globe.As data emerge,it is becoming more evident that extrapulmonary organ involvement,particularly the kidneys,highly influence mort...Coronavirus disease 2019(COVID-19)continues to affect millions of people around the globe.As data emerge,it is becoming more evident that extrapulmonary organ involvement,particularly the kidneys,highly influence mortality.The incidence of acute kidney injury has been estimated to be 30%in COVID-19 non-survivors.Current evidence suggests four broad mechanisms of renal injury:Hypovolaemia,acute respiratory distress syndrome related,cytokine storm and direct viral invasion as seen on renal autopsy findings.We look to critically assess the epidemiology,pathophysiology and management of kidney injury in COVID-19.展开更多
文摘Chronic metabolic acidosis is a common complication seen in advanced chronic kidney disease(CKD). There is currently no consensus on its management in the Republic of Ireland. Recent trials have suggested that appropriate active management of metabolic acidosis through oral alkali therapy and modified diet can have a deterring impact on CKD progression. The potential benefits of treatment include preservation of bone health and improvement in muscle function; however,present data is limited. This review highlights the current evidence,available primarily from randomised control trials(RCTs) over the last decade,in managing the metabolic acidosis of CKD and outlines ongoing RCTs that are promising. An economic perspective is also briefly discussed to support decision-making.
文摘Coronavirus disease 2019(COVID-19)continues to affect millions of people around the globe.As data emerge,it is becoming more evident that extrapulmonary organ involvement,particularly the kidneys,highly influence mortality.The incidence of acute kidney injury has been estimated to be 30%in COVID-19 non-survivors.Current evidence suggests four broad mechanisms of renal injury:Hypovolaemia,acute respiratory distress syndrome related,cytokine storm and direct viral invasion as seen on renal autopsy findings.We look to critically assess the epidemiology,pathophysiology and management of kidney injury in COVID-19.
