July 13, 2015

Transplant Immunology and Immunosuppression: Core Curriculum 2015

Hricik DE.   Am J Kidney Dis.   2015 Jun;65(6):956-66

This is a nice summary of transplant immunology and immunosuppression.

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July 13, 2015

Patient Safety Issues in CKD: Core Curriculum 2015

Wagner LA, Tata AL, Fink JC.   Am J Kidney Dis.   2015 Jul;66(1):159-69

This is a nicely summarize patient safety issues in CKD.

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July 13, 2015

Current treatment practice and outcomes. Report of the hyponatremia registry

Greenberg A, Verbalis JG, Amin AN, Burst VR, Chiodo Iii JA, Chiong JR, Dasta JF, Friend KE, Hauptman PJ, Peri A, Sigal SH.   Kidney Int.   2015 Jul;88(1):167-77

This report from the hyponatremia registry highlights the multifaceted and often clinically disparate approach to the management of hyponatremia.  Interestingly, most patients were discharged from hospital still hyponatremic.          

Leave a Comment! Posted in Clinical Nephrology, Fluid & Electrolytes, General Nephrology
July 13, 2015

A simple clinical tool to inform the decision-making process to refer elderly incident dialysis patients for kidney transplant evaluation

Dusseux E, Albano L, Fafin C, Hourmant M, Guérin O, Couchoud C, Moranne O.   Kidney Int.   2015 Jul;88(1):121-9

Using data from the French national prospective registry, the authors developed and validated a clinical screening score to identify ESRD patients over the age of 70 years with an acceptable prognosis and hence most suitable for kidney transplantation. This scoring card can be helping to the practicing nephrologist to select suitable patients over the age […]

Leave a Comment! Posted in Clinical Nephrology, Clinical Trial Results, Hemodialysis, Renal Transplantation
July 13, 2015

Long-term medical risks to the living kidney donor

Lam NN, Lentine KL, Levey AS, Kasiske BL, Garg AX.   Nat Rev Nephrol.   2015 Jul;11(7):411-9

This review nicely summarizes the studies that assess long-term medical outcomes for living kidney donors.  Although the focus is on the first 10 years, the authors also note that further studies need to be conducted to better assess risk in certain populations.        

Leave a Comment! Posted in Renal Transplantation, Review
July 13, 2015

A nephrology guide to reading and using systematic reviews of randomized trials

Badve SV, Palmer SC, Johnson DW, Strippoli GF.   Nephrol Dial Transplant.   2015 Jun;30(6):878-84

This article is designed to help the busy clinician understand how to best critically appraise methodology and understand results when reading nephrology systematic reviews.    

Leave a Comment! Posted in Clinical Nephrology, Clinical Trial Results
July 13, 2015

Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women

Singh N, Gandhi S, McArthur E, Moist L, Jain AK, Liu AR, Sood MM, Garg AX.   CMAJ.   2015 Jun 16;187(9):648-56

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.  

Leave a Comment! Posted in Clinical Nephrology, General Nephrology
July 13, 2015

Effect of Remote Ischemic Preconditioning on Kidney Injury Among High-Risk Patients Undergoing Cardiac Surgery A Randomized Clinical Trial

Zarbock A, Schmidt C, Van Aken H, Wempe C, Martens S, Zahn PK, Wolf B, Goebel U, Schwer CI, Rosenberger P, Haeberle H, Görlich D, Kellum JA, Meersch M, RenalRIPC Investigators.   JAMA.   2015 Jun 2;313(21):2133-41

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 […]

Leave a Comment! Posted in Acute Kidney Injury, Clinical Nephrology, Clinical Trial Results
July 13, 2015

Vasopressin Antagonists

Berl T.   N Engl J Med.   2015 Jun 4;372(23):2207-16

This is a nice review summarizes the literature on the vasopressin antagonists – both historically and clinically.    

Leave a Comment! Posted in Clinical Nephrology, Fluid & Electrolytes
July 13, 2015

Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis

Wong SP, Kreuter W, Curtis JR, Hall YN, O'Hare AM.   JAMA Intern Med.   2015 Jun;175(6):1028-35

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 […]

Leave a Comment! Posted in Clinical Nephrology, Hemodialysis
July 13, 2015

Treatment With Multiple Blood Pressure Medications, Achieved Blood Pressure, and Mortality in Older Nursing Home Residents The PARTAGE Study

Benetos A, Labat C, Rossignol P, Fay R, Rolland Y, Valbusa F, Salvi P, Zamboni M, Manckoundia P, Hanon O, Gautier S.   JAMA Intern Med.   2015 Jun;175(6):989-95

This longitudinal study of nursing home residents > 80 years of age showed a significant in interaction with <130 mmHg SBP and use of 2 more blood pressure lowering agents.  There was a comparatively higher risk of mortality (unadjusted hazard ratio [HR], 1.81; 95% CI, 1.36-2.41); adjusted HR, 1.78; 95% CI, 1.34-2.37; both P < .001) in these […]

Leave a Comment! Posted in Clinical Nephrology, Hypertension
May 8, 2015

Outcomes of Elderly Patients after Predialysis Vascular Access Creation

Lee T, Thamer M, Zhang Y, Zhang Q, Allon M.   J Am Soc Nephrol.   2015 Apr 8;

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 […]

Leave a Comment! Posted in Clinical Nephrology, Hemodialysis, Vascular Access
May 8, 2015

Outcomes of In-Hospital Cardiopulmonary Resuscitation in Maintenance Dialysis Patients

Saeed F, Adil MM, Malik AA, Schold JD, Holley JL.   J Am Soc Nephrol.   2015 Apr 23;

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 […]

Leave a Comment! Posted in Clinical Nephrology, Hemodialysis