A nephrology guide to reading and using systematic reviews of randomized trials
This article is designed to help the busy clinician understand how to best critically appraise methodology and understand results when reading nephrology systematic reviews.
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Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin – JUPITER Controversy A Critical Reappraisal
Update in Nephrology: Evidence Published in 2010
Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis (Source: Nephrology Now)
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Clinical Trial Results Source Type: research
Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women
This population-based study of older woman (mean age > 79 years) in Ontario, Canada showed that lower eGFR (median 38 ml/min per 1.73 m2) vs higher eGFR (median 69 ml/min per 1.73 m2) was not associated with an increased risk of urinary tract infection treatment failure with nitrofurantoin.
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Frailty, Dialysis Initiation, and Mortality in End-Stage Renal Disease
Interleukin-2 Receptor Antibody Reduces Rejection Rates and Graft Loss in Live-Donor Kidney Transplant Recipients
Vascular Access Type and Patient and Technique Survival in Home Hemodialysis Patients: The Canadian Organ Replacement Register. (Source: Nephrology Now)
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology General Nephrology Source Type: research
Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women
This population-based study of older woman (mean age > 79 years) in Ontario, Canada showed that lower eGFR (median 38 ml/min per 1.73 m2) vs higher eGFR (median 69 ml/min per 1.73 m2) was not associated with an increased risk of urinary tract infection treatment failure with nitrofurantoin.
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Frailty, Dialysis Initiation, and Mortality in End-Stage Renal Disease
Interleukin-2 Receptor Antibody Reduces Rejection Rates and Graft Loss in Live-Donor Kidney Transplant Recipients
Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients (Source: Nephrology Now)
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology General Nephrology Source Type: research
Effect of Remote Ischemic Preconditioning on Kidney Injury Among High-Risk Patients Undergoing Cardiac Surgery A Randomized Clinical Trial
This very interesting multicentre Cleveland Clinic study looked at remote ischemic preconditioning (3 cycles of 5-minute ischemia and 5-minute reperfusion in one upper arm after induction of anesthesia) or sham remote ischemic preconditioning (control), both via blood pressure cuff inflation in high-risk patients undergoing cardiac surgery. These results show that ischemic preconditioning significantly reduced both the rate of acute kidney injury and the need for renal replacement.
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High-dose renal replacement therapy for acute kidney injury: Systematic review and meta-analysis.
Risk of acute kidney injury associat...
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Acute Kidney Injury Clinical Nephrology Clinical Trial Results Source Type: research
Vasopressin Antagonists
This is a nice review summarizes the literature on the vasopressin antagonists – both historically and clinically.
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Role of Vaptans in the Management of Hyponatremia
What’s new in hypertension 2010?
Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies (Source: Nephrology Now)
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Fluid & Electrolytes Source Type: research
Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis
This retrospective cohort study of Medicare beneficiaries showed that annual incidence of CPR in maintenance dialysis patients from 2000-2010 was 1.4 events per 1000 in-hospital days. 21.9% of CPR recipients survived to hospital discharge with a median postdischarge survival of 5.0 months. This valuable information should be used to help support patients during advance care planning discussions.
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Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis
Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Co...
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Source Type: research
Treatment With Multiple Blood Pressure Medications, Achieved Blood Pressure, and Mortality in Older Nursing Home Residents The PARTAGE Study
This study raises a cautionary note on “excess lowering” of blood pressure in this population.
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Propensity-Matched Mortality Comparison of Incident Hemodialysis and Peritoneal Dialysis Patients
ESRD and Death after Heart Failure in CKD
Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio-Sis): an open-label randomised trial. (Source: Nephrology Now)
Source: Nephrology Now - July 13, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hypertension Source Type: research
Outcomes of Elderly Patients after Predialysis Vascular Access Creation
A cohort of 3418 CKD patients ≥70 years who underwent predialysis AVF or AVG creation from 2004 to 2009 were assessed and followed. The results show that 67% of patients with predialysis AVF and 71% of patients with predialysis AVG creation initiated dialysis within 2 years of access placement, but the overall risk of dialysis initiation was modified by patient age and race. Only one half of patients initiated dialysis with a functioning AVF or AVG; 46.8% of AVFs were created <90 days before dialysis initiation. Catheter dependence at dialysis initiation was more common in patients receiving predial...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Vascular Access Source Type: research
Outcomes of In-Hospital Cardiopulmonary Resuscitation in Maintenance Dialysis Patients
This study using data from the Nationwide Inpatient Sample (2005-2011) compared data from 56 069 patients with ESRD who underwent in hospital CPR to 323 620 patients from the general population. After adjustment, patients with ESRD had higher odds of mortality (odds ratio, 1.24; 95% confidence interval, 1.11 to 1.3; P<0.001). Survival after CPR improved in the year 2011 compared with 2005 (31% versus 21%, P<0.001). Multivariate analysis also revealed that a greater proportion of patients with ESRD who survived were discharged to skilled nursing facilities.
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High-Efficiency Postdilution Online He...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Source Type: research
Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis
This important study helps us to understand the outcomes of in-hospital CPR from a Medicare registry in US adults receiving maintenance hemodialysis. The annual incidence of CPR for the overall cohort was 1.4 events per 1000 in-hospital days with a total of 21.9% CPR recipients surviving to hospital discharge. The median post discharge survival was 5 months.
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Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Comorbid Disease?
Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in ...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Source Type: research
Extended Daily Dialysis Versus Continuous Renal Replacement Therapy for Acute Kidney Injury: A Meta-analysis
This systematic review and meta-analysis shows that extended daily dialysis and continuous renal replacement therapy were associated with similar outcomes in the treatment of AKI in RCT data. The only evidence that EDD was associated with better mortality was from observational data which is potentially subject to bias.
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Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients
Hemodialysis and peritoneal dialysis are associated with similar outcomes for end-stage renal disease treatment in Canada
High-dose renal replacement therapy for acute kidney injury: Systematic review and meta-analysis. (...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Source Type: research
Long-term Effects of Frequent Nocturnal Hemodialysis on Mortality: The Frequent Hemodialysis Network (FHN) Nocturnal Trial
This is a long-term follow-up of the FHN Nocturnal trials. After a median follow-up of 3.7 years, the randomly assigned 87 patients to 1 year of 6 times a week nocturnal and 3 times per week hemodialysis were assessed. In the nocturnal arm, there were 2 deaths during the 12-month trial period and an additional 12 deaths during the extended follow-up. In the conventional arm, the numbers of deaths were 1 and 4, respectively. In the nocturnal dialysis group, the overall mortality HR was 3.88 (95% CI, 1.27-11.79; P=0.01). The authors caution the results due to a low mortality rate (0.03 deaths/patient-year) in th...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hemodialysis Nocturnal Hemodialysis Source Type: research
Continuous Proton Pump Inhibitor Therapy and the Associated Risk of Recurrent Clostridium difficileInfection
This retrospective cohort study found that patients on proton pump inhibitors were at higher risk of C. difficile infections after adjustment for other independent risk factors for recurrence. This important study highlights the importance of medication review – which suggests consideration of discontinuation of PPIs at the time of CDI diagnosis.
PMID:25730198
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Recipient Risk Factors Associated With Delayed Graft Function: A Paired Kidney Analysis
β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis
Ureteral Stents Are Associated With Reduced Risk of Ureteral Complications After Kidney Transp...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: General Nephrology Source Type: research
Continuous Proton Pump Inhibitor Therapy and the Associated Risk of Recurrent Clostridium difficileInfection
This retrospective cohort study found that patients on proton pump inhibitors were at higher risk of C. difficile infections after adjustment for other independent risk factors for recurrence. This important study highlights the importance of medication review – which suggests consideration of discontinuation of PPIs at the time of CDI diagnosis.
PMID:25730198
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Recipient Risk Factors Associated With Delayed Graft Function: A Paired Kidney Analysis
β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis
Ureteral Stents Are Associated With Reduced Risk of Ureteral Complications After Kidney Transp...
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: General Nephrology Source Type: research
β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis
This study does raise caution, but as the authors indicate, causality is different to determine as there was not random allocation of β-Blocker exposure.
PMID:
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Risk of acute kidney injury associated with the use of fluoroquinolones
Outcomes of In-Hospital Cardiopulmonary Resuscitation in Maintenance Dialysis Patients
Continuous Proton Pump Inhibitor Therapy and the Associated Risk of Recurrent Clostridium difficileInfection (Source: Nephrology Now)
Source: Nephrology Now - May 8, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Hemodialysis Source Type: research
