NephrologyNow The Ultimate Guide to Kidney Disease Research

This article reviews the therapeutic options to delay the progression of chronic kidney disease.  

This prospective multicentre Canadian study followed 369 dialysis patients for an average of 1.3 years (224 patients chose PD and 145 chose HD).  The authors found that the PD group required fewer access interventions to maintain dialysis access (2.5 versus 3.1 interventions per patient, adjusted odds ratio of 0.79 for PD versus HD, P = [...]

This double-blind multicentre RCT studied the effectiveness of topical Polysporin Triple ointment as compared to mupirocin to peritoneal dialysis catheter exit sites.  Twice the number of patients experienced redness at the exit site in the Polysporin Triple group (14 versus 6, P=0.10) with a higher rate of fungal exit site infection (0.07 versus 0.01; P=0.02) [...]

BENEFIT is a randomized controlled trial comparing two different doses of belatacept, a costimulatory blocker, to standard therapy with cyclosporine in de novo kidney transplant patients. Earlier results from this study showed a higher acute rejection rate with belatacept. Nonetheless, at three years, renal function was significantly better in belatacept-treated patents.

Insertion of a double-J stent into the transplant ureter at the time of surgery reduces the risk of ureteric stricture. In this single-centre study, the decision to insert a ureteral stent or not was made by surgeons at the time of transplantation. There was a significant reduction in the risk of stricture, but only in [...]

Membranoproliferative glomerulonephritis type II, or dense deposit disease, is a rare type of renal disease caused by excessive complement deposition in the kidney. It is also associated with a high rate of recurrence post-transplant. In this case report, a patient developed recurrent dense deposit disease shortly after transplant. Despite aggressive treatment, renal function worsened and [...]

This observational study assessed a) the association between testosterone levels and hemoglobin in nondialysed CKD Stages 1-5 ESA-naive male patients as well as the association between testosterone levels and ESA dose in ESA-treated males undergoing hemodialysis.  CKD patients with lower testosterone values were 5.3 times more likely to be anemic.  In patients undergoing HD, higher [...]

This analysis of observational DOPPS data examined the impact of reduced dialysate sodium on clinical outcomes.  While lowering dialysate sodium was associated with lower interdialytic weight gain, it was also associated with increased hospitalization.  No mortality benefit was associated with reduced dialysate sodium.

In the wake of the termination of the Altitude study, this meta-analysis identifies an increase risk of hyperkalemia but not acute kidney injury in the combination of aliskiren and angiotensin converting enzyme inhibitors or angiotensin receptor blockers.

The impact of sodium intake on clinical outcomes has recently come under some scrutiny and the topic is surrounded by debate.  In this retrospective analysis of the REIN study, patients with non-diabetic CKD who had high dietary salt (>14 g daily) had a blunted antiproteinuric effect from ACE inhibitor therapy and increase the risk for [...]

This review discusses the role of diuretics and ultrafiltration in acute decompensated heart failure.

FSGS accounts for appoximately 40% of adult nephrotic syndrome.  This review provides an approaches to the diagnosis and management of this disease.

Voclosporin is a new calcineurin inhibitor being assessed for transplantation. In this dose-ranging non-inferiority trial, three therapeutic levels of voclosporin were compared to tacrolimus in new renal transplant recipients. The incidence of acute rejection was similar in all voclosporin groups compared to tacrolimus. The incidence of diabetes increased in the higher-dose voclosporin group. Further studies [...]