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  1. Article ; Online: Dietary Protein Restriction in Patients with Chronic Kidney Disease.

    Chang, Leslie L / Rhee, Connie M / Kalantar-Zadeh, Kamyar / Woodrow, Graham

    The New England journal of medicine

    2024  Volume 390, Issue 1, Page(s) 86–89

    MeSH term(s) Humans ; Diet, Protein-Restricted ; Dietary Proteins/metabolism ; Kidney/metabolism ; Kidney Failure, Chronic/diet therapy ; Renal Insufficiency, Chronic/diet therapy
    Chemical Substances Dietary Proteins
    Language English
    Publishing date 2024-01-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMclde2304134
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Opponent's comments.

    Woodrow, Graham

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2018  Volume 33, Issue 3, Page(s) 379–380

    MeSH term(s) Diet ; Humans ; Renal Insufficiency, Chronic
    Language English
    Publishing date 2018-02-22
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfx333a
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  3. Article ; Online: Con: The role of diet for people with advanced Stage 5 CKD.

    Woodrow, Graham

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2017  Volume 33, Issue 3, Page(s) 380–384

    Abstract: Restriction of dietary protein intake has been used in the management of chronic kidney disease (CKD) for many decades, yet remains controversial, with marked variations in its application in clinical practice. There is extensive literature on the ... ...

    Abstract Restriction of dietary protein intake has been used in the management of chronic kidney disease (CKD) for many decades, yet remains controversial, with marked variations in its application in clinical practice. There is extensive literature on the subject, with some expert opinion advocating the use of protein restriction based on the balance of the available evidence. The largest randomized trial of low-protein diets is the Modification of Diet in Renal Disease study. Despite multiple secondary analyses, the essential intention-to-treat analysis failed to demonstrate a benefit in the primary outcome of rate of decline of glomerular filtration rate. There are criticisms of many published studies and meta-analyses, including the likelihood of publication bias and unsuitable biochemical endpoints that may be affected by dietary restriction in the absence of effects on kidney function, leading to false positive findings. It is also uncertain whether any benefits observed in these often older studies would be derived in patients undergoing modern standards of CKD management, including blood pressure control and renin-angiotensin blockade. Thus it is unclear whether, even in the strictly controlled environment of a clinical study, low-protein diets significantly slow CKD progression. Important questions exist regarding the applicability of these diets in routine clinical practice. Even in carefully selected study populations with intensive dietetic input, adherence to low-protein diets is poor. It is likely that only a small minority of CKD patients in routine practice could adhere to these diets, and although risks of malnutrition arising from protein restriction are uncertain, they will be greater in less supervised care outside of studies.
    MeSH term(s) Diet, Protein-Restricted/methods ; Glomerular Filtration Rate ; Humans ; Prognosis ; Renal Dialysis/statistics & numerical data ; Renal Insufficiency, Chronic/diet therapy
    Language English
    Publishing date 2017-11-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfx294
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  4. Article ; Online: What are the factors underlying the variation in the use of peritoneal dialysis?

    Woodrow, Graham

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2013  Volume 28, Issue 3, Page(s) 501–504

    MeSH term(s) Humans ; Nephrology ; Peritoneal Dialysis/utilization ; Practice Patterns, Physicians' ; Referral and Consultation ; Renal Insufficiency, Chronic/mortality
    Language English
    Publishing date 2013-03
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfs376
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  5. Article ; Online: Volume status in peritoneal dialysis.

    Woodrow, Graham

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

    2011  Volume 31 Suppl 2, Page(s) S77–82

    Abstract: Fluid homeostasis is one of the fundamental roles of the kidney and a crucial aspect in clinical management of patients on peritoneal dialysis (PD). Volume status has an important impact on the outcome of PD patients. Fluid excess leads to accelerated ... ...

    Abstract Fluid homeostasis is one of the fundamental roles of the kidney and a crucial aspect in clinical management of patients on peritoneal dialysis (PD). Volume status has an important impact on the outcome of PD patients. Fluid excess leads to accelerated development of cardiovascular disease. Volume status may also impact on disorders and assessment of nutritional state. While ultrafiltration and residual urine volume have featured prominently in PD research, the importance of fluid intake and thirst in PD patients has received relatively little attention. Despite older studies suggesting that fluid overload is common in PD, current PD techniques can produce sufficient fluid removal to achieve good control of fluid, with associated cardiac benefits in PD patients. One of the major challenges is to apply these techniques to obtain ideal volume status in patients. Bioelectrical impedance analysis appears to be the most promising technique currently available to guide fluid management.
    MeSH term(s) Blood Pressure/physiology ; Body Composition/physiology ; Body Water/physiology ; Body Weight/physiology ; Drinking/physiology ; Electric Impedance ; Extracellular Fluid/chemistry ; Homeostasis/physiology ; Humans ; Intracellular Fluid/physiology ; Nutritional Status ; Peritoneal Dialysis/methods ; Serum Albumin/analysis ; Thirst/physiology ; Treatment Outcome ; Ultrafiltration ; Urea/pharmacokinetics ; Urination/physiology ; Urine ; Water-Electrolyte Balance/physiology ; Water-Electrolyte Imbalance/physiopathology
    Chemical Substances Serum Albumin ; Urea (8W8T17847W)
    Language English
    Publishing date 2011-02-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645010-6
    ISSN 1718-4304 ; 0896-8608
    ISSN (online) 1718-4304
    ISSN 0896-8608
    DOI 10.3747/pdi.2009.00178
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Body composition analysis techniques in the aged adult: indications and limitations.

    Woodrow, Graham

    Current opinion in clinical nutrition and metabolic care

    2009  Volume 12, Issue 1, Page(s) 8–14

    Abstract: Purpose of review: Body composition analysis allows division of the body into different compartments on the basis of differing physical properties. A variety of techniques are available for measuring body composition. This review describes the changes ... ...

    Abstract Purpose of review: Body composition analysis allows division of the body into different compartments on the basis of differing physical properties. A variety of techniques are available for measuring body composition. This review describes the changes that occur with increasing age, their significance and also the limitations of available body composition analysis techniques when applied to the elderly.
    Recent findings: Studies have shown the development of changes in body composition with ageing that have important consequences for health. Alterations in body fat content and particularly body fat distribution are associated with adverse metabolic effects and increased cardiovascular risk. Reduced skeletal muscle mass and strength (sarcopenia) are common in the elderly with important effects on function and outcome. A range of techniques are available for measuring body composition. However, changes in body composition with ageing, particularly altered composition of the constituents of fat-free mass, and changes in fat distribution, may lead to measurement errors with standard body composition assessment methodology.
    Summary: Measurement of body composition provides information of importance to health and function. Techniques used for assessment should be those unaffected by age-related changes in body composition, or those that have been adapted or validated in this age group. Particular roles of these techniques in the elderly include screening or surveillance of those at risk of malnutrition, and monitoring a range of chronic illnesses that are prevalent in older individuals.
    MeSH term(s) Absorptiometry, Photon ; Adipose Tissue ; Aged ; Aging/physiology ; Body Composition ; Chronic Disease ; Electric Impedance ; Geriatric Assessment/methods ; Humans ; Muscle, Skeletal/metabolism ; Muscular Atrophy/diagnosis ; Nutrition Assessment ; Obesity/diagnosis
    Language English
    Publishing date 2009-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0b013e32831b9c5b
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    Zs.A 5586: Show issues Location:
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  7. Article ; Online: Effectiveness of interpersonal psychotherapy for community living depressed women involved with the justice system.

    Black, Suzie / Bowyer, Debra / Graham, Patricia / Irvine Fitzpatrick, Linda / Pate, Kirsty / Woodrow, Amanda / Schwannauer, Matthias

    Criminal behaviour and mental health : CBMH

    2021  Volume 31, Issue 3, Page(s) 183–197

    Abstract: Background: Despite the prevalence of depression among women in the justice system, and its potentially significant consequences, there is a dearth of studies investigating psychological treatments for depression in this context, especially outside ... ...

    Abstract Background: Despite the prevalence of depression among women in the justice system, and its potentially significant consequences, there is a dearth of studies investigating psychological treatments for depression in this context, especially outside prison.
    Aims: Our aim was to gather preliminary data on whether individual interpersonal psychotherapy (IPT) is an acceptable and effective treatment for depression in women at an early stage in the justice system.
    Method: In this pilot study, IPT was offered to 24 depressed women following their first or second contact with the justice system. The women were assessed using a range of scales to quantify depression, anxiety, post-traumatic stress disorder (PTSD) and social support. Multilevel models were used to explore interactions between change in depression and other features given the multiplicity and complexity of problems. Details on engagement and attrition were also collected.
    Results: Therapy attrition was low, despite challenging life-circumstances and depression scores followed a linear trajectory with scores significantly decreasing over the time (β = -0.59, SE = 0.07, p < 0.001). Participants with more adverse life events, attachment related anxiety and lower social support had poorer outcomes.
    Conclusions and implications: Results are encouraging. More than half of the hard-to-reach women who were eligible did engage, and retention rates suggest the therapy was acceptable to them. Depression scores improved, and potential factors affecting treatment outcome were identified. A randomised controlled trial is now warranted, ensuring adequate supplementary support for women with dependants living on their own and without employment.
    MeSH term(s) Anxiety Disorders ; Female ; Humans ; Interpersonal Psychotherapy ; Pilot Projects ; Psychotherapy ; Stress Disorders, Post-Traumatic ; Treatment Outcome
    Language English
    Publishing date 2021-05-10
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2042697-5
    ISSN 1471-2857 ; 0957-9664
    ISSN (online) 1471-2857
    ISSN 0957-9664
    DOI 10.1002/cbm.2199
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Methodology of assessment of fluid status and ultrafiltration problems.

    Woodrow, Graham

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

    2007  Volume 27 Suppl 2, Page(s) S143–7

    Abstract: Loss of sodium and water excretion with disruption of volume homeostasis is a crucial abnormality of end-stage renal failure. Fluid management is a fundamental function of dialysis therapy, but studies show frequent occult fluid overload, hypertension, ... ...

    Abstract Loss of sodium and water excretion with disruption of volume homeostasis is a crucial abnormality of end-stage renal failure. Fluid management is a fundamental function of dialysis therapy, but studies show frequent occult fluid overload, hypertension, and cardiac dysfunction in peritoneal dialysis. A rigorous approach to fluid management in PD can achieve excellent fluid, hypertension, and cardiovascular results in clinical practice. The present article explores the reasons for fluid overload and poor ultrafiltration in peritoneal dialysis patients and discusses optimal assessment and management of these problems.
    MeSH term(s) Body Water/metabolism ; Homeostasis ; Humans ; Peritoneal Dialysis ; Renal Insufficiency/metabolism ; Renal Insufficiency/physiopathology ; Renal Insufficiency/therapy ; Sodium/metabolism ; Ultrafiltration ; Water-Electrolyte Imbalance/physiopathology ; Water-Electrolyte Imbalance/prevention & control
    Chemical Substances Sodium (9NEZ333N27)
    Language English
    Publishing date 2007-06-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645010-6
    ISSN 0896-8608
    ISSN 0896-8608
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  9. Article: Body composition analysis techniques in adult and pediatric patients: how reliable are they? How useful are they clinically?

    Woodrow, Graham

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

    2007  Volume 27 Suppl 2, Page(s) S245–9

    Abstract: Complex abnormalities of body composition occur in peritoneal dialysis (PD). These abnormalities reflect changes in hydration, nutrition, and body fat, and they are of major clinical significance. Clinical assessment of these body compartments is ... ...

    Abstract Complex abnormalities of body composition occur in peritoneal dialysis (PD). These abnormalities reflect changes in hydration, nutrition, and body fat, and they are of major clinical significance. Clinical assessment of these body compartments is insensitive and inaccurate. Frequently, simultaneous changes of hydration, wasting, and body fat content can occur, confounding clinical assessment of each component. Body composition can be described by models of varying complexity that use one or more measurement techniques. "Gold standard" methods provide accurate and precise data, but are not practical for routine clinical use. Dual energy X-ray absorptiometry allows for measurement of regional as well as whole-body composition, which can provide further information of clinical relevance. Simpler techniques such as anthropometry and bioelectrical impedance analysis are suited to routine use in clinic or at the bedside, but may be less accurate. Body composition methodology sometimes makes assumptions regarding relationships between components, particularly in regard to hydration, which may be invalid in pathologic states. Uncritical application of these methods to the PD patient may result in erroneous interpretation of results. Understanding the foundations and limitations of body composition techniques allows for optimal application in clinical practice.
    MeSH term(s) Absorptiometry, Photon ; Anthropometry/methods ; Body Composition/physiology ; Electric Impedance ; Humans ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/therapy ; Monitoring, Physiologic/methods ; Nutritional Status ; Pediatrics/methods ; Peritoneal Dialysis
    Language English
    Publishing date 2007-06-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645010-6
    ISSN 0896-8608
    ISSN 0896-8608
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  10. Article: Can we improve fluid balance and cardiovascular outcomes in peritoneal dialysis patients?

    Woodrow, Graham

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

    2006  Volume 26, Issue 1, Page(s) 49–52

    MeSH term(s) Cardiovascular Diseases/metabolism ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Humans ; Peritoneal Dialysis ; Prognosis ; Survival Rate/trends ; Water-Electrolyte Balance/physiology
    Language English
    Publishing date 2006-03-13
    Publishing country United States
    Document type Comment ; Journal Article ; Review
    ZDB-ID 645010-6
    ISSN 0896-8608
    ISSN 0896-8608
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