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At least 19 recordsLinked to original sources
PubMed1984

[National plan for pediatric nephrology. Elaborated by the Nephrology Section of the Spanish Association of Pediatrics and by the Pediatric Nephrology Group of the Spanish Nephrology Association].

The document of the "National Program of Pediatric Nephrology" has been elaborated by Pediatric Group of Nephrologist of the Spanish Pediatric and Nephrology Associations. A methodical arrangement for the State has been included within the above mentioned document. Administrative, postgraduate training and medical care organization aspects are studied. Data concerning the distribution, profit of resources, number of the already existing and shortage of specialists, as well as those referring to accreditation of Centres and specialists, etc., have also been reviewed. A special attention has been paid to organization of end-stage renal disease treatment in children.

Accreditation↗
PubMedDate not supplied

Nephrology nurses in a new role: diagnostic and interventional nephrology.

Diagnostic and interventional nephrology is a growing subspecialty of nephrology. Increasingly, procedural care of nephrology patients is being managed by nephrologists trained in this area. As a result, new opportunities have been created for nephrology nurses as they assist these interventionists in the administration of care in diagnostic and interventional nephrology. This article describes the components of a diagnostic and interventional nephrology program, the initiation of such a program at a university center, and the role of nephrology nursing personnel in this rapidly developing area.

Academic Medical Centers↗
PubMed1999

Research priorities for nephrology nursing: American Nephrology Nurses' Association's Delphi Study.

The purpose of this study was to identify and prioritize research topics of importance for nephrology nursing and the American Nephrology Nurses' Association (ANNA). This was an explorative survey design using the Delphi technique. Nephrology nurses who are members of ANNA participated in the study. In Round 1 participants included 90 members of the Advanced Practice Special Interest Group. Round 2 participants were 537 nephrology nurses who attended the 28th ANNA National Symposium. Participants in Round 3 were 491 ANNA members who had at least a master's degree in nursing or another field. A three-round Delphi technique was used to solicit, identify, and prioritize problems for nephrology nursing research. In Round 1, 90 nurses identified problems in response to an open-ended question. These responses were analyzed and categorized into a 21-item research survey that was used for subsequent rounds. Round 2 participants rated each research question/topic on the survey on a 1 to 5 scale for level of importance. In addition, they were asked to identify the top-ranked research priorities from the 21 questions. In Round 3, the participants were asked to do the same as in Round 2. In addition, they indicated whether the research priority was primarily a nursing responsibility or a collaborative effort with other health care personnel. Based on 3 rounds of the Delphi study and analysis of both level of importance and rated-research priority, the five areas that were identified as research priorities are (a) nursing interventions to prevent vascular access infections, (b) nursing interventions to maintain vascular access patency, (c) educational needs of patients and families, (d) levels of nursing competence and the effect on patient outcomes, and (e) validation of nursing interventions to achieve patient outcomes. These research priorities provide direction for nephrology nursing research and the ANNA. This Delphi study represents a significant step for ANNA in its commitment to research.

Adult↗
PubMed2004

Update in nephrology. Highlights from the 36th Annual Meeting of the American Society of Nephrology.

The 36th Annual Meeting of the American Society of Nephrology, held in San Diego, California, USA, November 12-17, 2003, presented the newest advances in basic and clinical nephrology science. Several presentations and symposia discussed many new aspects of the management of type 2 diabetic nephropathy as well as the recent advances in the treatment of secondary hyperparathyroidism in chronic kidney disease patients with cinacalcet HCl, a calcimimetic agent. New drugs that are under development for the treatment of renal anemia, such as the continuous erythropoiesis receptor activator (CERA), or for the treatment of pure red cell aplasia, a rare but severe complication of the erythropoietic treatment, were considered. The long-term safety of i.v. iron replacement therapy was also analyzed. The recent results of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a large, multinational, observational study in hemodialysis patients were presented. Some complications of renal transplantation, recent advances in immunosuppressive agents and the experience of renal transplant in HIV patients recipients were also reviewed during the congress. The 36th Annual Meeting of the American Society of Nephrology offered the newest advances in basic and clinical nephrology science and was attended by more than 11,000 nephrologists from around the world. This year's sessions included 45 basic and clinical science symposia, 22 clinical nephrology conference sessions, 17 official symposia, as well as oral communications and poster sessions.

Anemia↗
PubMedDate not supplied

[Historical Archives of Italian Nephrology: Scientific ideas and projects carried out by the history of medicine and nephrology].

Some recent historical celebrations of modern Italian nephrology offer the opportunity to write about the meaning of the history of medicine and nephrology. First of all, the question "what do we learn from history" is wrongly phrased. It is from trying to learn about history, from the effort required to achieve a historical and epistemological perspective, that we may learn how people as individuals or as a group solved the problems of meeting their common human needs. Medicine is itself an eminently historical endeavour. There is history in medicine as well as history of medicine. According to Paracelsus, the history of medicine is medical science and medical science is essential history in the widest sense of the word. The word "history" embraces the concepts of human nature, the world in which human nature is revealed and the thoughts guiding it through life. If the history of medicine and nephrology is observed in all aspects of their evolution, we can see how it had a beneficial role on the work of physicians by reminding them that, prior to the light of achievement, the discovery of all medical principles is preceded by errors and doubts. We report on nephrological debates, controversies and achievements and we call attention to the need to focus on the present through the involvement of medical historians in the analysis of contemporary health policy issues and clinical methodology.

Biomedical Research↗
PubMedDate not supplied

[Historical archives of Italian nephrology: The history of instrumentation in nephrology. Part I: Theoretical bases].

Microscopes and artificial kidneys have greatly influenced both diagnosis and therapy of renal diseases. Nonetheless, in tracing the influence of instrumentation on nephrology, as revealed by daily activity, we have to recognise the influence of science upon medical instruments. It is for this reason that, besides strictly clinical factors, the scientific factors that contributed to the development of modern nephrology have received considerable attention. Nobody can use an artificial kidney without bearing in mind the contribution of many segments of science. Each segment has a hypothesis in its historical growth, development and decline. The notion that the advancement of science was made possible by the increasing reliance measurements and other quantitative procedure is hardly a novel one. Moreover, it is rather obvious that the experimental process and the use of instrumentation played an important role in the history of nephrology. Measurements, experiments and the use of instruments were interrelated and represented many phases of the improvements made in diagnosis and therapeutics. Naturally, in the history and epistemology of nephrology instrumentation we find conceptual mistakes and erroneous approaches to the biological reality. However, according to Popper's teachings, mistakes are good for science as they give an extra kick to its growth and development. Medical instrumentation is an assembly of scientific theories; it also controls medical theories and promotes the development of new ones. In addition, it changed our approach to the patient. In the pre-physical era, medical practice was almost entirely an intellectual process based on medical theories that the patient was not expected to understand. In the period of physical examinations the physician included the sensual dimension (oral and visual process) and made direct contact with the patient. In the instrumentation period we experience the third type of examination, in which the physician went back to the position of having less contact with the patient. This separation is reminiscent of the pre-physical diagnosis.

Computers↗
PubMed2003

The need for end-of-life care training in nephrology: national survey results of nephrology fellows.

Because of the high mortality rate of end-stage renal disease, nephrologists care for many dying patients. However, the education of nephrology fellows in palliative care has not been assessed. We surveyed second-year nephrology fellows to assess the quantity and quality of teaching they received in palliative medicine and also asked about their preparedness to manage patients at the end of life. A 63% survey response rate yielded 173 surveys for evaluation. Nearly all fellows (99%) agreed that physicians have a responsibility to help patients at the end of life; half thought it was very important to learn how to care for dying patients. On a 10-point scale in which 0 is no teaching and 10 is a lot of teaching, fellows reported significantly less teaching in end-of-life care (mean score, 3.8 +/- 2.6) than in managing a patient with distal renal tubular acidosis (mean score, 6.3 +/- 2.5) or on hemodialysis therapy (mean score, 8.9 +/- 1.5; all P < 0.0001). Specific palliative care content areas were taught infrequently; only 22% of fellows were taught how to tell a patient he or she is dying. Fellows who had contact with a palliative care specialist reported more education on end-of-life issues and believed they were better prepared to provide such care. Fellows' palliative care experiences during fellowship frequently occurred without attending nephrologist supervision; 32% of fellows had conducted 2 or fewer family meetings, and 26% of all family meetings occurred without an attending nephrologist. Fellows believed they were best prepared to manage a patient on hemodialysis therapy (mean score, 8.9 +/- 1) and least prepared to manage a patient at the end of life (mean score, 6.1 +/- 2; P < 0.0001). Our results show that most nephrology fellows believe they should learn how to care for dying patients, but most fellowship programs do not offer this training. Our study therefore suggests that training in palliative care be incorporated into fellowship program curricula.

Data Collection↗
PubMedDate not supplied

[Historical Archives of Italian Nephrology: The role of women in the history of Medicine and Nephrology].

The aim of the present survey of the history of medicine is to provide a series of succinct assessments of the role of women in the development of nephrology. The inadequate role played by women in some areas of medicine underlines the trend that considers health history as part of external history modulating the branches of science. If "external" or social history considers women's role as marginal in many segments of society, no wonder they play a marginal role in the history of medicine. Nonetheless, when women are offered the opportunity to map out new medical paths or handle new health systems they have always been excellent. Tratula, a doctor from Salerno's medical school, is just an example. Women have been excellent in nursing and popular medicine. Florence Nightingale (1823-1910), an English woman of rare ability and humanitarian enthusiasm, was the first to understand the role of women in organising nursing. In this area she had such a striking success that her method contributed to the founding of the first school of nursing in England and in the world. On the other hand, women doctors have had many difficulties in the medical area. The first modern woman to take her degree in medicine was Elisabeth Blackwell, who graduated from the Geneva Medical School of Western New York in 1849. She managed to open a private dispensary, which within a few years developed into a great hospital and training school for women. In the nephrology area a great Australian woman entered the universal history of medicine, Priscilla Kincaid-Smith. Her outstanding contribution was to improve the diagnosis and treatment of glomerulonephritis. Her positive attitude and the novelty of a woman being on the same scientific level as men, combined to secure her unique reputation in both her own country and the world. We hope that new social trends will develop in which women with scientific ideas will be able to completely express their medical ability and the tendency to eliminate the vestiges of old traditions will be reinforced through the granting of new scientific and academic opportunities. In Italian nephrology this tendency has been accelerating.

Australia↗
PubMedDate not supplied

[Historical Archives of Italian Nephrology. The history of instrumentation in nephrology. Part II: microscope and haemodialyzer].

Medicine in the technological era acquired many of the characteristics that concurrently marked other fields. So, by adopting procedures based on information obtained with instruments and devices, medicine developed an approach to illness that transformed it into a special form of technology. The collective effect of instrumentation deserves consideration and offers the historian opportunities for interpreting the interaction between physician and his patients in other than scientific and technological terms. The very construction of instruments and devices depends on the Author's ideas assembled with the basic theories of the time. For instance, at the end of the nineteenth century, when medical instruments became essential, the bacterial origin of diseases revolutionised their construction and application. In this context, the invention and use of the microscope became an outstanding feature of the clinical approach by disclosing the cellular universe. The microscope had become crucial in locating some major causes of physical suffering and death in man, and was considered the pre-eminent diagnostic instrument in medicine. In the nephrological field, the microscope drew the physician into a universe of physical changes that were concealed to the naked eye. The microscope made possible the verification of some of Bright's brilliant ideas, something that helped physicians classify glomerulonephritis. Many nephrologists confessed "how few things are established in this subject (nephrology) and how many more difficulties are established, we have learned by experience with the microscope". The modesty of this claim is striking. In nephrology, as in other fields, the admission of ignorance proved to be the beginning of wisdom. This wisdom, based on the admission of ignorance and assembled through the commitment and ingenuity of the pioneers of the dialysis treatment, led to the treatment of end-stage renal disease and the guarantee of success. The technique of haemodialysis has been enriched by the new lexicon, which expresses different ways and ideas on the removal of the solute.

Anatomy↗
PubMed2002

Recent advances in nephrology: highlights from the 35th annual meeting of the American society of nephrology.

The 35th Annual Meeting of the American Society of Nephrology, held in Philadelphia, Pennsylvania, United States (October 30 to November 4, 2002) presented the newest advances in basic and clinical nephrology science. Several presentations and symposia discussed the effects of various interventions and risk factors in clinical outcomes in dialysis patients. The recent evidences of pure red cell aplasia secondary to neutralizing antibodies against erythropoietin were also extensively discussed in a special symposium. Recent advances in the management of calcium phosphorus metabolism and secondary hyperparathyroidism, such as the clinical efficacy and safety of AMG-073, a new calcimimetic agent in the control of hyperparathyroidism in chronic kidney disease patients, or the use of sevelamer or lanthanum carbonate as phosphate binders, were presented. The results in animal models on improved sparing of renal function with rapamycin versus cyclosporin A represent a promising advance in renal transplantation. Finally, the recent discoveries with the newly identified disease gene PKHD1, which causes autosomal recessive polycystic kidney disease, were also presented at the meeting.

Anemia↗
PubMed1995

[Clinical nephrological care not associated with substitutive treatment: the current situation and future needs for outpatient nephrology consultations].

The activity of an out-patient nephrology service during a period lasting from January 1991 to December 1993 (both inclusive) was studied. During this period, an average of 531 patients per million population and year were looked after, with a prevalence of 1,949 p.m.p. of chronic patients. Eleven point six per cent of the patients were discharged and 2.6% initiated treatment with hemodialysis, deducting nonappearances after examination, 66.9% of the patients were referred to permanent follow-up. Sixty seven point five per cent of the patients were older than 40 years and 31.2%, older than 60. The most frequent causes of consultation were AHT (17.4%), nephroangiosclerosis (5.7%), renal lithiasis (16.8%), idiopathic glomerulonephritis (10.9%) and diabetic nephropathy (8.2%). Fifty eight point five per cent of the patients were susceptible of out-patient care, especially those seen due to hypertension and lithiasis. We conclude that a significant increase in the needs of specialized care may be forecasted for the next years, mainly for arterial hypertension. Most of these needs could be covered through out-patient nephrology services.

Adolescent↗
PubMedDate not supplied

Nephrology in the clinic and quality in nephrology.

The majority of patients with chronic kidney disease are followed-up in pre-dialysis clinics for a varying length of time, often for several years. The renal-team (physicians, nurses, dieticians, social assistants) intervenes on renal disease progression and educates the patient regarding the adjustments of his or her life-style to the limitations imposed by the disease. Pre-dialysis clinics are often overburdened and it is uncertain whether renal care should be based exclusively on renal teams, a difficult and costly option, or if it could be efficaciously organized by involving other health professionals. The Journal of Nephrology will maintain strong attention on these crucial issues for the future of nephrology.

Humans↗