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Article ; Online: Commentary on the NICE guideline on renal replacement therapy and conservative management.

Kharbanda, Kunaal / Iyasere, Osasuyi / Caskey, Fergus / Marlais, Matko / Mitra, Sandip

2021 Volume 22, Issue 1, Page(s) 282

Abstract: Background: NICE Guideline NG107, "Renal replacement therapy and conservative management" (Renal replacement therapy and conservative management (NG107); 2018:1-33) was published in October 2018 and replaced the existing NICE guideline CG125, "Chronic ... ...

Abstract	Background: NICE Guideline NG107, "Renal replacement therapy and conservative management" (Renal replacement therapy and conservative management (NG107); 2018:1-33) was published in October 2018 and replaced the existing NICE guideline CG125, "Chronic Kidney Disease (Stage 5): peritoneal dialysis" (Chronic kidney disease (stage 5): peritoneal dialysis \| Guidance \| NICE; 2011) and NICE Technology Appraisal TA48, "Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure"(Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure (Technology appraisal guideline TA48); 2002) The aim of the NICE guideline (NG107) was to provide guidance on renal replacement therapy (RRT), including dialysis, transplant and conservative care, for adults and children with CKD Stages 4 and 5. The guideline is extremely welcomed by the Renal Association and it offers huge value to patients, clinicians, commissioners and key stakeholders. It overlaps and enhances current guidance published by the Renal Association including "Haemodialysis" (Clinical practice guideline: Haemodialysis; 2019) which was updated in 2019 after the publication of the NICE guideline, "Peritoneal Dialysis in Adults and Children" (Clinical practice guideline: peritoneal Dialysis in adults and children; 2017) and "Planning, Initiation & withdrawal of Renal Replacement Therapy" (Clinical practice guideline: planning, initiation and withdrawal of renal replacement therapy; 2014) (at present there are no plans to update this guideline). There are several strengths to NICE guideline NG107 and we agree with and support the vast majority of recommendation statements in the guideline. This summary from the Renal Association discusses some of the key highlights, controversies, gaps in knowledge and challenges in implementation. Where there is disagreement with a NICE guideline statement, we have highlighted this and a new suggested statement has been written.
MeSH term(s)	Adult ; Child ; Conservative Treatment/methods ; Conservative Treatment/standards ; Glomerular Filtration Rate ; Humans ; Practice Guidelines as Topic ; Renal Insufficiency, Chronic/therapy ; Renal Replacement Therapy/methods ; Renal Replacement Therapy/standards
Language	English
Publishing date	2021-08-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-021-02461-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cognitive function before and after dialysis initiation in adults with chronic kidney disease-a new perspective on an old problem?

Iyasere, Osasuyi / Brown, Edwina A

Kidney international

2017 Volume 91, Issue 4, Page(s) 784–786

Abstract: The impact of dialysis on cognitive trends is uncertain. Kurella Tamura et al. evaluated cognitive trajectories in 212 participants from the Chronic Renal Insufficiency Cohort study and found that dialysis initiation was associated with a decline in ... ...

Abstract	The impact of dialysis on cognitive trends is uncertain. Kurella Tamura et al. evaluated cognitive trajectories in 212 participants from the Chronic Renal Insufficiency Cohort study and found that dialysis initiation was associated with a decline in executive function. This is consistent with a cerebrovascular basis for cognitive impairment in patients with renal disease. However, larger corroborative studies are needed while targets for intervention are identified to ameliorate dialytic effects on cognitive function.
Language	English
Publishing date	2017-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2017.01.022
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Article: Cognitive function and advanced kidney disease: longitudinal trends and impact on decision-making.

Iyasere, Osasuyi / Okai, David / Brown, Edwina

Clinical kidney journal

2017 Volume 10, Issue 1, Page(s) 89–94

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2017-01-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfw128
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Zs.A 6587: Show issues

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Article ; Online: The Case | Microangiopathic hemolytic anemia in a young female.

Selvaskandan, Haresh / Karavadra, Minal / Paramesparan, Kethesparan / Glasby, Michael / Iyasere, Osasuyi

Kidney international

2019 Volume 95, Issue 5, Page(s) 1277–1278

MeSH term(s)	Embolization, Therapeutic/methods ; Endovascular Procedures/methods ; Female ; Humans ; Hypertension/etiology ; Hypertension/surgery ; Kidney/abnormalities ; Kidney/blood supply ; Kidney/diagnostic imaging ; Magnetic Resonance Angiography ; Purpura, Thrombotic Thrombocytopenic/etiology ; Purpura, Thrombotic Thrombocytopenic/surgery ; Renal Artery/diagnostic imaging ; Renal Artery/surgery ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2019-03-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2018.11.020
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Zs.A 797: Show issues

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Article ; Online: Mortality in the Elderly on Dialysis: Is This the Right Debate?

Iyasere, Osasuyi / Brown, Edwina A

Clinical journal of the American Society of Nephrology : CJASN

2015 Volume 10, Issue 6, Page(s) 920–922

MeSH term(s)	Female ; Humans ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/therapy ; Male ; Peritoneal Dialysis/mortality ; Renal Dialysis/mortality
Language	English
Publishing date	2015-05-04
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.03650415
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Zs.A 6584: Show issues

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Article ; Online: The impact of amino acid dialysate on anthropometric measures in adult patients on peritoneal dialysis: A systematic review and meta-analysis.

Iyasere, Osasuyi / Nagar, Ravi / Jesus-Silva, Jorge Antonio / Pepereke, Shingai / MacConaill, Kateryna / Eid, Ahmed / Major, Rupert W

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

2021 Volume 42, Issue 3, Page(s) 314–323

Abstract: Background: Glucose-containing dialysate underpins peritoneal dialysis (PD) therapy. However, its use is associated with amino acid loss in the dialysis effluent, a risk factor for protein-energy wasting (PEW) in PD patients. Amino acid-based dialysis ... ...

Abstract	Background: Glucose-containing dialysate underpins peritoneal dialysis (PD) therapy. However, its use is associated with amino acid loss in the dialysis effluent, a risk factor for protein-energy wasting (PEW) in PD patients. Amino acid-based dialysis solutions (AAD) may ameliorate this loss. However, the evidence of clinical benefit in preventing PEW is unclear. The aim of this review was to assess the effect of AAD versus standard dialysis solutions (STD) on anthropometric measures and serum albumin. Methods: Studies up until 30 September 2020 were identified from databases including MEDLINE and Embase, using a prespecified protocol (PROSPERO - CRD42020209581). Studies evaluating adults on PD were included. Data pertaining to muscle mass (primary outcome), other anthropometric measures and serum albumin were extracted. A meta-analysis of the eligible studies was conducted. Results: A total of 6945 abstracts were reviewed, from which 14 studies (9 randomised and 5 non-randomised) were included. There was no significant difference in any of the anthropometric measures, between AAD and STD during follow-up. Serum albumin at 6 months was statistically lower with AAD compared to STD [mean difference = -0.89 (95%CI -1.77 to -0.01, Conclusions: AAD may not alter anthropometric measures when compared to STD. The impact on serum albumin is uncertain, with an estimated difference that is unlikely to be of clinical value. These findings should be cautiously interpreted due to low quality of the evidence. Robust studies are needed to address the limitations in evidence.
MeSH term(s)	Adult ; Humans ; Amino Acids ; Dialysis Solutions/chemistry ; Peritoneal Dialysis/adverse effects ; Peritoneal Dialysis/methods ; Serum Albumin/metabolism
Chemical Substances	Amino Acids ; Dialysis Solutions ; Serum Albumin
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	645010-6
ISSN	1718-4304 ; 0896-8608
ISSN (online)	1718-4304
ISSN	0896-8608
DOI	10.1177/08968608211035964
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Zs.A 1936: Show issues

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Article ; Online: Determinants of quality of life in advanced kidney disease: time to screen?

Iyasere, Osasuyi / Brown, Edwina A

Postgraduate medical journal

2014 Volume 90, Issue 1064, Page(s) 340–347

Abstract: The incidence of older patients with end stage renal disease is on the increase. This group of patients have multiple comorbidities and a high symptom burden. Dialysis can be life sustaining for such patients. But it is often at the expense of quality of ...

Abstract	The incidence of older patients with end stage renal disease is on the increase. This group of patients have multiple comorbidities and a high symptom burden. Dialysis can be life sustaining for such patients. But it is often at the expense of quality of life, which starts to decline early in the pathway of chronic kidney disease. Quality of life is also important to patients and is a major determinant in decisions regarding renal replacement. As a result, validated patient-reported outcome measures are increasingly used to assess quality of life in renal patients. Cognitive impairment, depression, malnutrition and function decline are non-renal determinants of quality of life and mortality. They are under-recognised in the renal population but are potentially treatable, if not preventable. This review article discusses aetio-pathogenesis, prevalence and impact of these four outcomes, advocating regular screening for early identification and management.
MeSH term(s)	Cognition Disorders/diagnosis ; Cognition Disorders/physiopathology ; Comorbidity ; Depression/diagnosis ; Depression/physiopathology ; Disease Progression ; Female ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/psychology ; Male ; Malnutrition/diagnosis ; Malnutrition/physiopathology ; Mass Screening ; Prevalence ; Quality of Life ; Renal Dialysis/psychology ; Severity of Illness Index
Language	English
Publishing date	2014-03-24
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2013-132251
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Article ; Online: Peritoneal or hemodialysis for the frail elderly patient, the choice of 2 evils?

Brown, Edwina A / Finkelstein, Frederic O / Iyasere, Osasuyi U / Kliger, Alan S

Kidney international

2017 Volume 91, Issue 2, Page(s) 294–303

Abstract: Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal ... ...

Abstract	Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities. Hemodialysis in the older age group can be complicated by intradialytic hypotension, prolonged time to recovery, and vascular access-related problems. Peritoneal dialysis can be difficult for older patients with impaired physical or cognitive function and can become a considerable burden. Use of incremental dialysis, changes in hemodialysis frequency, and delivery and use of assistance for peritoneal dialysis can ameliorate quality of life for older patients. Understanding each individual's goals of care in the context of his or her life experience is particularly important in the elderly, when overall life expectancy is relatively short, and life experience or quality of life may be the priority. Indeed, some patients select the option of no dialysis or conservative care. With multifaceted assessments of care, physicians should be able to give individual patients the ability to select and continue to make the best decisions for their care.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Clinical Decision-Making ; Frail Elderly ; Geriatric Assessment ; Humans ; Kidney Diseases/diagnosis ; Kidney Diseases/mortality ; Kidney Diseases/therapy ; Life Expectancy ; Patient Selection ; Peritoneal Dialysis/adverse effects ; Peritoneal Dialysis/mortality ; Predictive Value of Tests ; Quality of Life ; Renal Dialysis/adverse effects ; Renal Dialysis/mortality ; Risk Assessment ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2017-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2016.08.026
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Article ; Online: Novel Colorimetric and Light Scatter Methods to Identify and Manage Peritoneal Dialysis-Associated Peritonitis at the Point-of-Care.

Govindji-Bhatt, Nishal / Kennedy, Stephnie M / Barker, Michael G / Kell, Darren / Henderson, Duncan / Goddard, Nicholas / Garcia, Ana Yepes / Milner, Adam S / Willett, Tom / Griffiths, Ryan / Foster, Peter / Kilgallon, William / Cant, Rachel / Knight, Christopher G / Lewis, David / Corbett, Richard / Akbani, Habib / Woodrow, Graham / Sood, Bhrigu /

Iyasere, Osasuyi / Davies, Simon / Qazi, Junaid / Vardhan, Anand / Gillis, Laura / Wilkie, Martin / Dobson, Curtis B

Kidney international reports

2023 Volume 9, Issue 3, Page(s) 589–600

Abstract: Introduction: Peritoneal dialysis (PD)-related peritonitis (PDRP) is a common cause of transfer to hemodialysis, patient morbidity, and is a risk factor for mortality. Associated patient anxiety can deter selection of PD for renal replacement therapy. ... ...

Abstract	Introduction: Peritoneal dialysis (PD)-related peritonitis (PDRP) is a common cause of transfer to hemodialysis, patient morbidity, and is a risk factor for mortality. Associated patient anxiety can deter selection of PD for renal replacement therapy. Diagnosis relies on hospital laboratory tests; however, this might be achieved earlier if such information was available at the point-of-care (POC), thereby significantly improving outcomes. The presence of culturable microbes and the concentration of leukocytes in effluent both aid peritonitis diagnosis, as specified in the International Society for Peritoneal Dialysis (ISPD) diagnostic guidelines. Here, we report the development of 2 new methods providing such information in simple POC tests. Methods: One approach uses a tetrazolium-based chemical reporting system, primarily focused on detecting bacterial contamination and associated vancomycin-sensitivity. The second approach uses a novel forward light-scatter device (QuickCheck) to provide an instant quantitative cell count directly from PD patient effluent. Results: The tetrazolium approach detected and correctly distinguished laboratory isolates, taking 10 hours to provide non-quantitative results. We compared the technical performance of the light scatter leukocyte counting approach with spectrophotometry, hemocytometer counting and flow cytometry (Sysmex) using patient effluent samples. QuickCheck had high accuracy (94%) and was the most precise (coefficient of variation <4%), showing minimal bias, overall performing similarly to flow cytometry. Conclusion: These complementary new approaches provide a simple means to obtain information to assist diagnosis at the POC. The first provides antibiotic sensitivity following 10 hours incubation, whereas the second optical approach (QuickCheck), provides instant accurate total leukocyte count.
Language	English
Publishing date	2023-12-30
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2023.12.021
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Article: Urinary tract obstruction.

Iyasere, Osasuyi / Xu, Gang / Harris, Kevin

British journal of hospital medicine (London, England : 2005)

2013 Volume 73, Issue 12, Page(s) 696–700

MeSH term(s)	Humans ; Kidney/diagnostic imaging ; Kidney/physiopathology ; Kidney Diseases/etiology ; Magnetic Resonance Imaging ; Ultrasonography ; Ureteral Obstruction/diagnosis ; Urethral Obstruction/diagnosis ; Urologic Diseases/diagnosis ; Urologic Diseases/etiology ; Urologic Diseases/physiopathology
Language	English
Publishing date	2013-03-15
Publishing country	England
Document type	Journal Article ; Review
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2012.73.12.696
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