NephrologyNow The Ultimate Guide to Kidney Disease Research

This clinical practice guideline provides recommendations for best practice in creating peritoneal access.

It has previously been demonstrated that oral sodium bicarbonate slows GFR decline in patients with low GFR.  This 5-year RCT evaluated whether daily oral sodium bicarbonate slowed GFR decline in patients with hypertensive nephropathy with reduced but relatively preserved eGFR (mean 75 ml/min). The rate of eGFR decline was slower and eGFR was higher in [...]

This meta-analysis examining high-dose renal replacement therapy in acute kidney injury did not show any improvement in patient survival or recovery of renal function.

This case control study suggests that older patients taking ACEIs or ARBs have a major increase in the risk of hyperkalemia-associated hospitalization when using trimethoprim-sulfamethoxazole.

Early studies showed fewer new skin-cancers in patients randomized to sirolimus at the time of transplant. In this single-center trial, patients with a previous non-melanoma skin cancer were randomized to sirolimus or to continue on their current immunosuppression. There was fewer new skin cancers or premalignant lesions in the sirolimus group. This is a small [...]

Everolimus is an mTOR inhibitor, in the same family as sirolimus. Previous studies combining mTOR inhibitors with usual dosing of calcineurin inhibitors showed worse renal function and graft survival, despite  equal efficacy in preventing acute rejection as a calcineurin inhibitor/mycophenolic acid combination. In this RCT, everolimus at two different target levels was combined with low-dose [...]

Nephron mass plays an important role in providing adequate renal function, with loss of nephron mass a risk factor for later deterioration of renal function. In this study, a low ratio of the weight of the donor kidney before implantation to recipient weight was associated with worse long-term renal function and outcomes.

Kidneys obtained from donors after cardiac death (DCD) have been increasing over the last several years. DCD kidneys have a higher risk for delayed graft function compared to kidneys obtained from standard kidneys from brain-dead donors (DBD). In this analysis of transplantation in the Netherlands, patients receiving a DCD kidney had improved survival compared to [...]

This article critically reviews the trial JUPITER which reported a substantial decrease in the risk of cardiovascular diseases among patients without coronary heart disease and with normal or low cholesterol levels. Concern was expressed that the trial was flawed as it was discontinued (according to prespecified rules) after fewer than 2 years of follow-up, with [...]

This article highlights the findings of several key trials that were published in the field of chronic kidney disease in 2009.

This landmark clinical trial randomized CKD patients to a strategy of early (GFR 10-14 ml/min) vs late (GFR 5-7 ml/min) initiation of dialysis.   After a median follow-up of 3.6 years, no difference was seen in mortality, cardiovascular events, infections, or complications of dialysis.  Careful note should be made that the majority of patient randomized to late [...]

This editorial provides insight into the interpretation of the article ‘A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis‘.

This addition to the AJKD Core Curriculum series reviews nutritional considerations in the management of kidney disease.