February 9, 2017

Association between Preoperative Vascular Function and Postoperative Arteriovenous Fistula Development

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Arteriovenous fistula (AVF) maturation failure is the primary cause of dialysis vascular access dysfunction. To evaluate whether preoperative vascular functional properties predict postoperative AVF measurements, patients enrolled in the Hemodialysis Fistula Maturation Study underwent up to five preoperative vascular function tests (VFTs): flow-mediated dilation (FMD), nitroglycerin-mediated dilation (NMD), carotid-femoral pulse wave velocity, carotid-radial pulse wave […]

Leave a Comment! Posted in Clinical Nephrology, Hemodialysis, Vascular Access
February 9, 2017

Managing glomerular disease in pregnancy

This article reviews the pre-pregnancy counseling that women with glomerular-based diseases should ideally receive to allow them to make an informed decision about proceeding with a pregnancy as well as an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies.

Leave a Comment! Posted in Clinical Nephrology, Pregnancy and Hypertension/Renal Disease, Review
February 9, 2017

Dietary salt restriction is beneficial to the management of autosomal dominant polycystic kidney disease

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This is a post hoc analysis of the HALT-PKD clinical trials of renin-angiotensin blockade in patients with ADPKD showed that sodium restriction is beneficial in the management of ADPKD.      

Leave a Comment! Posted in Clinical Nephrology, Polycystic Kidney Disease
February 9, 2017

Residual Kidney Function Decline and Mortality in Incident Hemodialysis Patients

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This is a longitudinal cohort study of 6538 patients who started maintenance hemodialysis over a 4-year period (January 2007 through December 2010) and had available renal urea clearance (CLurea) data at baseline and 1 year after hemodialysis initiation.  This study  examined the association of annual change in renal CLurea rate with subsequent survival. The median (interquartile […]

Leave a Comment! Posted in Clinical Nephrology, Hemodialysis
February 9, 2017

AKI and Long-Term Risk for Cardiovascular Events and Mortality

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This systematic review and meta-analysis of 25 studies involving 254 408 patients assessed whether AKI associates with long-term cardiovascular disease. AKI associated with an 86% and a 38% increased risk of cardiovascular mortality and major cardiovascular events, respectively ([RR 1.86; 95% confidence interval (95% CI), 1.72 to 2.01] and [RR 1.38; 95% CI, 1.23 to […]

Leave a Comment! Posted in Acute Kidney Injury, Clinical Nephrology, General Nephrology
February 9, 2017

Rituximab for Severe Membranous Nephropathy: A 6-Month Trial with Extended Follow-Up

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This is a multicenter, randomized, controlled trial conducted at 31 French hospital. Patients with biopsy-proven PMN and nephrotic syndrome after 6 months of nonimmunosuppressive antiproteinuric treatment (NIAT) were randomly assigned to 6-month therapy with NIAT and 375 mg/m2 intravenous rituximab on days 1 and 8 (n=37) or NIAT alone (n=38). During the observational phase, remission rates […]

Leave a Comment! Posted in Clinical Nephrology, Clinical Trial Results, Glomerulonephritis
February 9, 2017

The Effect of Predialysis Fistula Attempt on Risk of All-Cause and Access-Related Death

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This is a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. The authors observed significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt in patients aged <65 years and in the first […]

Leave a Comment! Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, Hemodialysis, Vascular Access
February 9, 2017

Update on Nephrolithiasis: Core Curriculum 2016

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This core curriculum nicely review nephrolithiasis.  

Leave a Comment! Posted in AJKD Core Curriculum, Nephrolithiasis
February 9, 2017

DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease

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This trial looked Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 (N = 14,882).  3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile […]

1 Comment Posted in Clinical Nephrology, Clinical Trial Results, General Nephrology, Hypertension
February 9, 2017

Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis

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This systematic review included 150 trials with 31,631 participants and 4,182 contrast-induced AKI events assessing 12 different interventions. The conclusion was that high-dose statin plus NAC or high-dose statin alone were ranked the one/two for preventing contrast-induced AKI with no significant changes noted in metaregressions or subgroup and sensitivity analyses.  

Leave a Comment! Posted in Acute Kidney Injury, Contrast Nephropathy
November 19, 2016

Liraglutide and Renal Outcomes in Type 2 Diabetes: Results of the LEADER Trial

ASN 2016 High Impact Clinical Trial Johannes F. Mann, Kristine Brown Fandsen, Gilbert Daniels, Peter Kristensen, Michael Nauck, Steve Nissen, Stuart Pocock, Neil Poulter, Soren Rasmussen, William Steinberg, Mette Stockner, Bernard Zinman, Florian Baeres, Richard Bergenstal, Steve Marso, John Buse. Erlangen, Germany. Liraglutide, as compared to placebo, was studied in a RCT of 9340 high-risk […]

Leave a Comment! Posted in Clinical Trial Results, Conference Alert
November 19, 2016

Remote ischaemic preconditioning (RIPC) leads to sustained improvement in allograft function following live donor (LD) kidney transplantation: 5 year follow up in the REnal Protection Against Ischaemia Reperfusion in transplantation (REPAIR) study

ASN 2016 High Impact Clinical Trial Kristin Veighey, Jennifer Nicholas, Tim Clayton, Raymond Macallister Using 4 cycles of ischemia/reperfusion in the preoperative living donors, remote ischemic preconditioning (RIPC) was evaluated regarding its impact on post-tranplant outcomes.  The primary endpoint was iohexal GFR at 12 months and secondary endpoints were change in eGFR, graft loss or death. […]

Leave a Comment! Posted in Clinical Trial Results, Conference Alert
November 19, 2016

Efficacy and Safety of Sparsentan, a Dual Angiotensin II (Ang II) and Endothelin (ET) Type A Receptor Antagonist, in Patients with Focal Segmental Glomerulosclerosis (FSGS): A Phase 2 Trial (DUET)

High Impact Clinical Trials ASN 2016 Howard Trachtman, Peter J. Nelson, Radko Komers In the phase 2 DUET trial that included 96 patients with focal segmental glomerulosclerosis (FSGS), sparsentan, a dual angiotensin II and endothelin type A receptor antagonist, was evaluated to determine the impact on proteinuria. As compared to irbesartan, urinary protein excretion was […]

2 Comments Posted in Clinical Trial Results, Conference Alert