June 10, 2009
Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, Buring J, Hennekens C, Kearney P, Meade T, Patrono C, Roncaglioni MC, Zanchetti A. Lancet. 2009 May 30;373(9678):1849-60
Nephrologists often see patients at elevated vascular risk and may consider using aspirin for primary or secondary prophylaxis. This meta-analysis confirms the known benefit of aspirin for secondary prophylaxis, but raises some questions as to the balance of risks and benefits for primary prophylaxis in the general population.
June 10, 2009
Dixon BS, Beck GJ, Vazquez MA, Greenberg A, Delmez JA, Allon M, Dember LM, Himmelfarb J, Gassman JJ, Greene T, Radeva MK, Davidson IJ, Ikizler TA, Braden GL, Fenves AZ, Kaufman JS, Cotton JR Jr, Martin KJ, McNeil JW, Rahman A, Lawson JH, Whiting JF, Hu B, Meyers CM, Kusek JW, Feldman HI, DAC Study Group. N Engl J Med. 2009 May 21;360(21):2191-201
This randomized controlled trial provides evidence that treatment with dipyridamole plus aspirin had a modest effect in reducing the risk of stenosis and improving the duration of primary unassisted patency of newly created grafts.
View the Accompanying editorial by C Lok
Antiplatelet therapy and vascular-access patency.
N Engl J Med. 2009 May 21;360(21):2240-2.
June 10, 2009
Mann JF, Schmieder RE, Dyal L, McQueen MJ, Schumacher H, Pogue J, Wang X, Probstfield JL, Avezum A, Cardona-Munoz E, Dagenais GR, Diaz R, Fodor G, Maillon JM, Rydén L, Yu CM, Teo KK, Yusuf S, for the TRANSCEND (Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) Investigators. Ann Intern Med. 2009 May 18;
This pre-specified subgroup analysis of the TRANSCEND study failed to show any significant benefit on renal outcomes between the intervention arm (using telmisartan) and placebo arm. This was not a study of chronic kidney disease patients, but rather examined patients with cardiovascular disease or diabetes, but without macroalbuminuria or heart failure.
June 10, 2009
Tonelli M, Hemmelgarn B, Reiman T, Manns B, Reaume MN, Lloyd A, Wiebe N, Klarenbach S. CMAJ. 2009 May 26;180(11):E62-71
This systematic review of 52 RCTs looked at the clinical efficacy and harms related to erythropoeisis-stimulating agents in the treatment of anemia related to cancer or chemotherapy (not renal failure). The study shows that ESAs improve quality of life and decrease blood transfusions, but with increased the risk of death and serious adverse events. The [...]
June 10, 2009
Marcén R, del Castillo D, Capdevila L, Fernandez-Fresnedo G, Rodrigo E, Cantarell C, Fernández-Rodriguez A, López-Oliva MO, Camps J, Aljama P, Ortuño J, Arias M. Transplantation. 2009 May 15;87(9):1340-6
This cross-sectional study shows the prevalence of CKD in a large cohort of patients. Complications of CKD, including anemia, hyperparathyroidism, and hyperlipidemia are common in transplant patients, and may increase with worsening renal function.
June 10, 2009
Saland JM, Ruggenenti P, Remuzzi G, Consensus Study Group. J Am Soc Nephrol. 2009 May;20(5):940-9
Some cases of hemolytic uremic syndrome are due to genetic mutations rather than E.Coli O157:H7 infection, and are associated with a high risk of recurrence post-kidney transplant. This article summarizes the results of a consensus conference on treatment of these patients, including the use of a combined liver/kidney transplantation in the setting of ESRD to [...]
June 10, 2009
Noël C, Abramowicz D, Durand D, Mourad G, Lang P, Kessler M, Charpentier B, Touchard G, Berthoux F, Merville P, Ouali N, Squifflet JP, Bayle F, Wissing KM, Hazzan M. J Am Soc Nephrol. 2009 Jun;20(6):1385-92
Previous comparisons of IL-2 receptor antibodies and thymoglobulin compared either low-risk patients, or patients at high risk due to long cold ischemia times. This trial enrolled patients at high immunologic risk (mean peak PRA around 70%). Thymoglobulin reduced the risk of biopsy-proven acute rejection, but this trial was not powered to look at differences in [...]
June 10, 2009
Lachmann N, Terasaki PI, Budde K, Liefeldt L, Kahl A, Reinke P, Pratschke J, Rudolph B, Schmidt D, Salama A, Schönemann C. Transplantation. 2009 May 27;87(10):1505-13
The presence of donor-specific antibodies is associated with an increased risk of graft loss. In this paper, the development of non-donor specific antibodies was also associated with worse graft outcomes, although not as bad as patients with donor-specific antibody. Whether treatment to reduce the production of antibody once it is established would improve graft outcomes [...]
June 9, 2009
Perl J, Bargman JM. Am J Kidney Dis. 2009 Jun;53(6):1068-81
This review highlights the evidence to support maintaining residual renal function and its impact on survival and quality of life of dialysis patients.
June 9, 2009
Brent J. N Engl J Med. 2009 May 21;360(21):2216-23
This clinical vignette reviews the indications of fomepizole in toxic ingestions from medical toxicology perspective.
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