Statin Therapy and Risk of Fracture: Results From the JUPITER Randomized Clinical Trial
This analysis of the JUPITER trialled showed that rosuvastatin did not reduce fracture risk in the enrolled patients with elevated hs-CRP levels. Furthermore, higher baseline hs-CRP levels were nor associated with an increased risk of fractures in both groups.
:
Elevated Fibroblast Growth Factor 23 is a Risk Factor for Kidney Transplant Loss and Mortality
The Pattern of Excess Cancer in Dialysis and Transplantation
Vitamins C and E to Prevent Complications of Pregnancy-Associated Hypertension (Source: Nephrology Now)
Source: Nephrology Now - March 18, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Clinical Trial Results Source Type: research
Gestational Hypertension and Preeclampsia in Living Kidney Donors
This retrospective cohort study of living donors matched to healthy nondonors in Ontario, Canada showed that young women who donated a kidney were more likely to suffer from gestational hypertension or preeclampsia (OR for donors 2.4). There were no significant differences with respect to preterm birth or low birth weight.
:
Gestational Hypertension and Preeclampsia in Living Kidney Donors
Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review
Risk of End-Stage Renal Disease Following Live Kidney Donation (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Hypertension Pregnancy and Hypertension/Renal Disease Source Type: research
Con: Frequent haemodialysis for all chronic haemodialysis patients.
The flipside of this debated is showcased here with the authors taking a more “conservative” approach to the increasing frequency of dialysis debate.
:
Pro: Should we move to more frequent haemodialysis schedules?
Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Comorbid Disease?
Quality of Life and Survival in Patients with Advanced Kidney Failure Managed Conservatively or by Dialysis (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Hemodialysis Source Type: research
Effect of Pentoxifylline on Renal Function and Urinary Albumin Excretion in Patients with Diabetic KidneyDisease: The PREDIAN Trial.
This open-label prospective, randomized trial showed that pentoxifylline in addition to RAS inhibitors resulted in a smaller decrease in eGFR and great reduction of albuminuria at two years in Type 2 diabetics with stage 3-4 CKD.
:
Conversion of Long-Term Kidney Transplant Recipients From Calcineurin Inhibitor Therapy to Everolimus: A Randomized, Multicenter, 24-Month Study
Late Breaking Clinical Trials at ASN 2011 – FISH study and more
Association Between a Chloride-Liberal vs Chloride-Restrictive Intravenous Fluid Administration Strategy and Kidney Injury in Critically Ill Adults (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Clinical Trial Results General Nephrology Source Type: research
Effects of Blood Pressure Reduction in Mild Hypertension: A Systematic Review and Meta-analysis.
This meta-analysis reveals the medical therapy in managing grade 1 hypertension (140-159/90-99 mmHg) is likely to prevent stroke and death.
:
Systematic Review: Erythropoiesis-Stimulating Agents in Patients With Chronic Kidney Disease
Antihypertensive Treatment and Secondary Prevention of Cardiovascular Disease Events Among Persons Without Hypertension: A Meta-analysis
Treatment blood pressure targets for hypertension. (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hypertension Source Type: research
Pro: Should we move to more frequent haemodialysis schedules?
This article on the pro side of this debate summarizes the evidence supporting more frequent dialysis. The authors how longer interdialytic intervals may be associated with elevated cardiovascular risk and how this risk may be mitigated with more frequent dialysis.
:
Long Interdialytic Interval and Mortality among Patients Receiving Hemodialysis
Con: Frequent haemodialysis for all chronic haemodialysis patients.
Effect of frequent hemodialysis on residual kidney function (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Hemodialysis Source Type: research
Diagnostic and Predictive Accuracy of Blood Pressure Screening Methods With Consideration of Rescreening Intervals: An Updated Systematic Review for the U.S. Preventive Services Task Force.
This task force shows the evidence that supports using ambulatory blood pressure monitoring as the reference standard for confirming elevated office blood pressure. This will serve to confirm elevated blood pressure and avoid misdiagnosis and/or overtreatment.
:
Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials
Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial
Effect of lower sodium intake on health: systematic review and meta-analyses (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hypertension Source Type: research
Effect of Low Versus High Dialysate Sodium Concentration on Blood Pressure and Endothelial-Derived Vasoregulators During Hemodialysis: A Randomized Crossover Study.
This interesting study looked at the effect of dialysate sodium concentrations (low (5 mEq/L below serum sodium) versus high (5 mEq/L above serum sodium)) and the effect on blood pressure during dialysis. The results showed that low sodium dialysate significantly decreased systolic BP and ameliorated intradialytic hypertension. However, longer studies are needed to determine the long-term effects.
:
Dialysate Sodium Concentration and the Association with Interdialytic Weight Gain, Hospitalization, and Mortality
Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Ca...
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Fluid & Electrolytes Hemodialysis Source Type: research
Risk of adverse events among older adults following co-prescription of clarithromycin and statins notmetabolized by cytochrome P450 3A4.
Among older adults taking a statin not metabolized by CYP3A4 (rosuvastatin/pravastatin/fluvastatin), co-prescription of clarithromycin versus azithromycin was associated with a modest but statistically significant increase in the 30-day absolute risk of adverse outcomes, including AKI and admission with hyperkalemia.
:
Treatment of Kidney Transplant Recipients With ACEi/ARB and Risk of Respiratory Tract Cancer: A Collaborative Transplant Study Report
Novartis announces termination of ALTITUDE study
Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Acute Kidney Injury Internal Medicine for Nephrologists Source Type: research
Disorders of Plasma Sodium — Causes, Consequences, and Correction
:
Renal Manifestations of Plasma Cell Disorders
Target Level for Hemoglobin Correction in Patients With Diabetes and CKD: Primary Results of the Anemia Correction in Diabetes (ACORD) Study.
Long-term consequences of kidney donation. (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Fluid & Electrolytes Source Type: research
Angiotensin Blockade in Late Autosomal Dominant Polycystic Kidney Disease
This elegant double-blind, placebo-controlled trial shows the addition of an ARB in patients with ADPKD already on an ACE inhibitor did not alter the decline in estimated GFR. Based on this evidence, there seems to be no role for dual RAAS blockade in this population.
:
Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease
The safety of combining angiotensin-converting-enzyme inhibitors with angiotensin-receptor blockers in elderly patients: a population-based longitudinal analysis
Retraction—Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-d...
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Polycystic Kidney Disease Source Type: research
Metformin in Patients With Type 2 Diabetes and Kidney Disease: A Systematic Review
This review nicely summarizes the risks of metformin therapy in patients with mild to moderate chronic kidney disease. According to the authors, there is room for “cautious expansion” of use in this population.
:
Pediatrics: Blood pressure target for renoprotection in children
Perioperative acute kidney injury: risk factors, recognition, management, and outcomes
Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies (Source: Nephrology Now)
Source: Nephrology Now - January 24, 2015 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Diabetes Source Type: research
Hypertension
This is a comprehensive clinical overview of hypertension. Drawn from the ACP resources, it focusses on hypertension prevention, diagnosis, treatment, practice improvement, and patient information.
:
KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD–MBD)
Prevention in Renal Disease Conference 2009
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 - December 17, 2014 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Hypertension Source Type: research
Protein electrophoresis and immunofixation for the diagnosis of monoclonal gammopathies
This case-based article from the JAMA Diagnostic Test Interpretation series and has an associated quiz. It is designed to help the reader interpret diagnostic tests in the context of monoclonal gammopathies.
:
Common infections in kidney transplant recipients.
The Initiation of Renal-Replacement Therapy — Just-in-Time Delivery
Management of patients with acute hyperkalemia (Source: Nephrology Now)
Source: Nephrology Now - December 17, 2014 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology General Nephrology Source Type: research
Utility of renal biopsy in the clinical management of renal disease
This provocative article describes underutilization of kidney biopsies in the diagnosis and prognosis of renal disease. The authors state that kidney biopsies can aid in the better management of patients with renal disease at all stages.
:
Atypical Hemolytic–Uremic Syndrome
Expert guidelines for the management of alport syndrome and thin basement membrane nephropathy.
Indications for renal revascularization—the landscape after the ASTRAL study (Source: Nephrology Now)
Source: Nephrology Now - December 17, 2014 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology General Nephrology Glomerulonephritis Source Type: research
