Renal function in patients with intestinal failure receiving home parenteral support.

BACKGROUND: Progressive renal impairment, given by an annual decline in estimated glomerular filtration rate (eGFR), has been described in patients with intestinal failure (IF) receiving home parenteral support (HPS). The objective of this study was to examine changes in eGFR over 5 years following initiation of HPS treatment and to identify potential risk factors for loss of renal function. METHOD: This retrospective database study investigates eGFR changes in nonmalignant IF patients discharged with HPS from Rigshospitalet, Copenhagen, in an 8-year period. RESULTS: One year after HPS initiation, mean eGFR decreased by 15.3 ml/min/1.73 m2 . Paired t-test showed a decline of 15.0 ml/min/1.73 m2 (95% CI, -18.3 to -11.6; P < .0001). Over the following years, eGFR continued to decrease but at insignificant lower rates. Decreased eGFR was associated with increasing age, female sex, increasing body weight, diabetes at HPS initiation, and a high requirement of HPS volume. CONCLUSION: In nonmalignant IF patients, the decrease of eGFR was mainly seen during the first year of HPS. This may be due to a higher risk of dehydration and possibly secondary hyperaldosteronism leading to renal damage following the onset of IF. However, the decrease in eGFR may also represent a higher production of creatinine due to a beneficial increase of muscle mass in the initial recovery phase. In general, once the patients were stabilized, the eGFR decline followed a physiological course resembling the background population. Patients with diabetes or high HPS volume needs seem to be more vulnerable and may require special attention.

The prevalence of atopic dermatitis in adults: systematic review on population studies.

Atopic dermatitis (AD) is a common multifactorial skin disease occurring primarily in young children. AD has increased in prevalence over the past decades, but little knowledge exists on the prevalence of AD in adults. Herein, published estimates of the point-prevalence and one-year prevalence of AD in adults are reviewed in the context of various study characteristics such as the age and gender distribution of the populations, sampling methods, study design, and geographical area of origin. In total, 14 different population studies reporting the prevalence of AD in adults in 17 countries were identified. There was a substantial between-country variation in both the point-prevalence (1.6 to 11.5%) and one-year prevalence (2.2 to 17.6%) of AD with heterogeneity explained partly by gender, age, geography, study design, and diagnostic criteria.