Archive for May, 2009

May 2, 2009

Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis.

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This study randomized 370 patients with class III to V lupus nephritis to MMF or intravenous cyclophosphamide during a 24-week induction period. Both groups received a tapering dose of prednisone. No difference in response rate was detected between groups.

Comments Off on Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. Posted in Lupus
May 2, 2009

Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function: A Randomized Trial.

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140 patients were randomized to determine the efficacy and safety of stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function. The study concluded that stent placement with medical treatment had no clear effect on progression of renal dysfunction and, therefore, favored a conservative approach with cardiovascular risk factor management without stenting.

Comments Off on Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function: A Randomized Trial. Posted in Chronic Kidney Disease, Renal Artery Stenosis
May 2, 2009

Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials.

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This meta-analysis of 53 previous randomized-controlled trials was done to compare erythopoietic agents plus red blood cell transfusions to transfusions alone in the management of anemia in patients with cancer. This study showed that treatment with erythropoiesis-stimulating agents resulted in increased mortality in patients with cancer.

Comments Off on Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials. Posted in Anemia, Internal Medicine for Nephrologists
May 2, 2009

Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody—associated vasculitis.

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This randomized controlled trial compared pulse versus oral cyclophosphamide for induction in ANCA vasculitis. No difference in efficacy was detected between the two arms but pulse treatment resulted in a reduced cumulative cyclophosphamide dose and caused fewer cases of leukopenia.

Comments Off on Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody—associated vasculitis. Posted in Vasculitis
May 2, 2009

A new equation to estimate glomerular filtration rate.

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This cross-sectional analysis of pooled data from multiple studies was used to develop and validate a new equation, the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation, to predict GFR. The CKD-EPI equation appears to be more precise and accurate than the MDRD Study equation, especially at higher GFRs. Click here to calculate CKD-EPI GFR

1 Comment Posted in Chronic Kidney Disease
May 2, 2009

Similar survival on automated peritoneal dialysis and continuous ambulatory peritoneal dialysis in a large prospective cohort.

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Patients on APD or CAPD at 3 mo after start of dialysis were selected from a prospective multicenter cohort study in incident dialysis patients (NECOSAD). The intention-to-treat design studied overall mortality. This study found no difference in overall mortality and technique failure for APD compared with CAPD in incident dialysis patients.

Comments Off on Similar survival on automated peritoneal dialysis and continuous ambulatory peritoneal dialysis in a large prospective cohort. Posted in Peritoneal Dialysis
May 2, 2009

An OPTN analysis of national registry data on treatment of BK virus allograft nephropathy in the United States.

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BK nephropathy is a relatively recently recognized infection post-transplant, and can lead to graft loss. This registry study is the largest to date assessing risk factors and timing of development of BK nephropathy post-transplant.

Comments Off on An OPTN analysis of national registry data on treatment of BK virus allograft nephropathy in the United States. Posted in Renal Transplantation
May 2, 2009

Effect of pamidronate on bone loss after kidney transplantation: a randomized trial.

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Post-transplant osteoporosis is a significant cause of morbidity. This randomized controlled trial demonstrated an improvement at both the hip and spine after treatment with five doses of pamidronate. However, this study was not powered to detect a difference in fracture rates, for which bone mineral density is only a surrogate endpoint.

Comments Off on Effect of pamidronate on bone loss after kidney transplantation: a randomized trial. Posted in Renal Transplantation
May 2, 2009

Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival of deceased donor kidney transplants.

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University of Wisconsin (UW) solution has been the standard solution used for cold preservation for many years, while HTK is a newer, less expensive solution which appears to have several characteristics which would reduce ischemia-reperfusion injury. However, in this study from the UNOS database, HTK solution was associated with a late increased risk of death-censored […]

Comments Off on Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival of deceased donor kidney transplants. Posted in Renal Transplantation
May 2, 2009

Prediction of the severity and outcome of acute tubular necrosis based on continuity of Doppler spectrum in the early period after kidney transplantation.

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This paper describes using the continuity of Doppler flow in the renal artery early post-transplant as a method to determine the severity of ATN. This method is promising, although this study is limited by the lack of biopsies to confirm that these ultrasound findings are in fact specific for ATN.

Comments Off on Prediction of the severity and outcome of acute tubular necrosis based on continuity of Doppler spectrum in the early period after kidney transplantation. Posted in Renal Transplantation
May 1, 2009

Lithium nephrotoxicity revisited.

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Comments Off on Lithium nephrotoxicity revisited. Posted in Chronic Kidney Disease, Review
May 1, 2009

Critical Care Nephrology: Core Curriculum 2009

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Comments Off on Critical Care Nephrology: Core Curriculum 2009 Posted in AJKD Core Curriculum, Critical Care
May 1, 2009

Vasculitis syndromes: which maintenance therapy for ANCA vasculitis?

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Comments Off on Vasculitis syndromes: which maintenance therapy for ANCA vasculitis? Posted in Review, Vasculitis