{"title":"The challenges of geriatric nephrology managed care/disease management.","authors":"T I Steinman","doi":"10.1023/a:1008339317399","DOIUrl":"https://doi.org/10.1023/a:1008339317399","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 2","pages":"115-21"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008339317399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21380300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Managed care, geriatrics, and nephrology.","authors":"M G White","doi":"10.1023/a:1008326616045","DOIUrl":"https://doi.org/10.1023/a:1008326616045","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 3","pages":"183-6"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008326616045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21552686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D T Lowenthal, J Maruenda, J Chintanadilok, H Kallas, A Gabr
{"title":"The hypertensive elderly male with prostatism.","authors":"D T Lowenthal, J Maruenda, J Chintanadilok, H Kallas, A Gabr","doi":"10.1023/a:1008379301392","DOIUrl":"https://doi.org/10.1023/a:1008379301392","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 1","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008379301392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21299772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The excessive use of analgesics and non-steroidal antiinflammatory agents (NSAIDs) is strongly associated with an increased prevalence of chronic renal insufficiency, some cases requiring long term replacement therapy (dialysis/transplantation). Analgesic nephropathy (AN) is now a well defined entity characterized by papillary necrosis and/or chronic interstitial nephritis. The elderly are especially susceptible and more frequently use these medications. Although the overall incidence of AN is low considering the widespread usage and pain and suffering alleviated by their ready availability over-the-counter (OTC), the need, as public policy, to better protect our citizens by restricting free access to these drugs remains open to debate.
{"title":"Should the sale of analgesic mixtures and non-steroidal anti-inflammatory agents (NSAIDs) continue to be allowed as over-the-counter (OTC) medications?","authors":"R D Lindeman","doi":"10.1023/a:1008379800445","DOIUrl":"https://doi.org/10.1023/a:1008379800445","url":null,"abstract":"<p><p>The excessive use of analgesics and non-steroidal antiinflammatory agents (NSAIDs) is strongly associated with an increased prevalence of chronic renal insufficiency, some cases requiring long term replacement therapy (dialysis/transplantation). Analgesic nephropathy (AN) is now a well defined entity characterized by papillary necrosis and/or chronic interstitial nephritis. The elderly are especially susceptible and more frequently use these medications. Although the overall incidence of AN is low considering the widespread usage and pain and suffering alleviated by their ready availability over-the-counter (OTC), the need, as public policy, to better protect our citizens by restricting free access to these drugs remains open to debate.</p>","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 1","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008379800445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21300229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-01-01DOI: 10.1007/978-94-011-4088-1_9
J. Lewis
{"title":"Diabetic nephropathy in patients with type II diabetes.","authors":"J. Lewis","doi":"10.1007/978-94-011-4088-1_9","DOIUrl":"https://doi.org/10.1007/978-94-011-4088-1_9","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 3 1","pages":"167-75"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51696174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute renal failure in the elderly.","authors":"N Lameire, A Nelde, H Hoeben, R Vanholder","doi":"10.1023/a:1008322515136","DOIUrl":"https://doi.org/10.1023/a:1008322515136","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 3","pages":"153-65"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008322515136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21552683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The management of benign prostatic hyperplasia has undergone a rapid evolution over the past decade from a surgical emphasis to a medical emphasis. Great strides in the development of alpha-adrenergic blockers, 5 alpha-reductase inhibitors and a variety of phytotherapeutics have fueled this evolution. This article reviews the past, present and future of the medical management of benign prostatic hyperplasia.
{"title":"Medical management of benign prostatic hyperplasia.","authors":"A Chacon, M Monga","doi":"10.1023/a:1008308819463","DOIUrl":"https://doi.org/10.1023/a:1008308819463","url":null,"abstract":"<p><p>The management of benign prostatic hyperplasia has undergone a rapid evolution over the past decade from a surgical emphasis to a medical emphasis. Great strides in the development of alpha-adrenergic blockers, 5 alpha-reductase inhibitors and a variety of phytotherapeutics have fueled this evolution. This article reviews the past, present and future of the medical management of benign prostatic hyperplasia.</p>","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"9 1","pages":"39-48"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008308819463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21300236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lung cancer and drug-induced severe hyponatremia.","authors":"J Chintanadilok, H Kallas, D T Lowenthal","doi":"10.1023/a:1008339206912","DOIUrl":"https://doi.org/10.1023/a:1008339206912","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"8 3","pages":"161-5"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008339206912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21091522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RAOD is an important cause of progressive renal failure in the elderly population. We can expect to see an increasing incidence of this disease as the population ages. A non-invasive test for detecting this condition with a high degree of sensitivity and specificity has been developed, although the technique is sufficiently difficult that it is currently available in only a few specialized centers. Indications for intervention to preserve renal function are not clear. Application of stenting to renal artery lesions has lead some to advocate treatment of these lesions empirically when they are detected much as is done with coronary artery lesions in patients with ischemic heart disease. Given the present state of knowledge, this is not an unreasonable approach. However, not all lesions progress and their role in causing renal failure is not clear in all cases. Furthermore, intervention can cause worsening of renal failure in some cases and actually precipitate the need for dialysis. Several recommendations are reasonable based on this review. Patients over 50 starting dialysis with renal failure of unknown etiology should be screened for RAOD. Those with bilateral lesions should be offered an intervention. Patients with mild or moderate renal failure of unknown etiology over age 50 should also be screened. Those with bilateral lesions should be offered an intervention with conservative management for those with unilateral lesions. The later group should be monitored on a yearly basis for the development of contralateral lesions or significant bilateral renal atrophy. If either of these eventualities develop, intervention should be offered. These recommendations would have to be considered in the light of the possible need to perform an intervention for the treatment of hypertension.
{"title":"Ischemic nephropathy: an important cause of renal disease in the elderly.","authors":"V M Buckalew","doi":"10.1023/a:1008372602527","DOIUrl":"https://doi.org/10.1023/a:1008372602527","url":null,"abstract":"<p><p>RAOD is an important cause of progressive renal failure in the elderly population. We can expect to see an increasing incidence of this disease as the population ages. A non-invasive test for detecting this condition with a high degree of sensitivity and specificity has been developed, although the technique is sufficiently difficult that it is currently available in only a few specialized centers. Indications for intervention to preserve renal function are not clear. Application of stenting to renal artery lesions has lead some to advocate treatment of these lesions empirically when they are detected much as is done with coronary artery lesions in patients with ischemic heart disease. Given the present state of knowledge, this is not an unreasonable approach. However, not all lesions progress and their role in causing renal failure is not clear in all cases. Furthermore, intervention can cause worsening of renal failure in some cases and actually precipitate the need for dialysis. Several recommendations are reasonable based on this review. Patients over 50 starting dialysis with renal failure of unknown etiology should be screened for RAOD. Those with bilateral lesions should be offered an intervention. Patients with mild or moderate renal failure of unknown etiology over age 50 should also be screened. Those with bilateral lesions should be offered an intervention with conservative management for those with unilateral lesions. The later group should be monitored on a yearly basis for the development of contralateral lesions or significant bilateral renal atrophy. If either of these eventualities develop, intervention should be offered. These recommendations would have to be considered in the light of the possible need to perform an intervention for the treatment of hypertension.</p>","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"8 3","pages":"155-9"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008372602527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21091521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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