Archive for November, 2009

November 29, 2009

Retraction—Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial

The COOPERATE study had previously been looked upon as providing support for combination ACE inhibitor and ARB therapy in proteinuric patients with non-diabetic kidney disease. After an initial letter of concern, the Lancet has retracted the paper after the results of an academic investigation indicated serious concerns surrounding this publication.  These include that the trial had […]

3 Comments Posted in Chronic Kidney Disease, RAS Blockade
November 22, 2009

Revascularization versus Medical Therapy for Renal-Artery Stenosis

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This randomized, non-blinded study of patients with renovascular disease compared renal artery revascularization plus medical therapy vs medical therapy alone.  Those in the revascularization arm experience an increased rate of serious complications with no reduction in pre-defined clinical endpoints.

1 Comment Posted in Renal Artery Stenosis, Vascular Disease/Calcification
November 22, 2009

Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients

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This multicenter, randomized trial compared the effect of CRRT, delivered at two different levels of intensity (40 ml/kg vs 25 ml/kg), on 90-day mortality among critically ill patients with acute kidney injury. Treatment with higher-intensity continuous renal-replacement therapy did not reduce mortality at 90 days.

Comments Off on Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients Posted in Acute Kidney Injury, Critical Care
November 22, 2009

Effective population-wide public health interventions to promote sodium reduction

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This article reviews the evidence relating dietary sodium and health.  As well, it details public health strategies to reduce population dietary salt intake.

Comments Off on Effective population-wide public health interventions to promote sodium reduction Posted in Hypertension
November 22, 2009

Cardiovascular and noncardiovascular mortality among patients starting dialysis.

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This study evaluated whether the high overall mortality in patients starting dialysis is a consequence of increased cardiovascular mortality risk only or whether noncardiovascular mortality is equally increased. In this analysis, patients starting dialysis were found to have an increased risk of death not specifically caused by excess cardiovascular mortality.

Comments Off on Cardiovascular and noncardiovascular mortality among patients starting dialysis. Posted in Hemodialysis, Peritoneal Dialysis, Vascular Disease/Calcification
November 22, 2009

Functional status of elderly adults before and after initiation of dialysis.

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This paper demonstrates that among nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status.

1 Comment Posted in Chronic Kidney Disease, Hemodialysis
November 22, 2009

Strict Blood-Pressure Control and Progression of Renal Failure in Children

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This randomized controlled trial confirms the long-term renoprotective effect of intensified blood-pressure control among children treated with high dose angiotensin-converting-enzyme (ACE) inhibitor.

Comments Off on Strict Blood-Pressure Control and Progression of Renal Failure in Children Posted in Hypertension, Pediatric Nephrology
November 22, 2009

8th Annual Prevention in Renal Disease

Free Content from the 8th Annual Prevention in Renal Disease Conference

Comments Off on 8th Annual Prevention in Renal Disease Posted in Educational Resource
November 22, 2009

FDA Byetta (exenatide) Associated with Risk of Renal Failure

FDA notified healthcare professionals of revisions to the prescribing information for Byetta (exenatide) to include information on post-marketing reports of altered kidney function, including acute renal failure and insufficiency. Byetta, an incretin-mimetic, is approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Comments Off on FDA Byetta (exenatide) Associated with Risk of Renal Failure Posted in Acute Kidney Injury, General Nephrology
November 22, 2009

KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary.

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These evidence-based clinical practice guidelines for renal transplant recipients cover all aspects of care, including immunosuppression, infections, cardiovascular disease, malignancy and other post-transplant complications. Recommendations are graded as to the strength of the evidence and the strength of the recommendation.

1 Comment Posted in Clinical Practice Guidelines, Renal Transplantation
November 22, 2009

Proteinuria-Reducing Effects of Tonsillectomy Alone in IgA Nephropathy Recurring After Kidney Transplantation

IgA nephropathy commonly recurs post-transplant, causing proteinuria, and in some cases, graft dysfunction and failure. In this study, patients with IgA nephropathy underwent protocol biopsies to detect recurrence. Tonsillectomy was offered to patients with significant proteinuria who did not respond to RAS inhibition. Proteinuria significantly decreased in those patients who agreed to tonsillectomy.

1 Comment Posted in Renal Transplantation
November 22, 2009

Immunosuppressant Therapy Adherence and Graft Failure Among Pediatric Renal Transplant Recipients

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Pediatric patients are a high-risk group for medication nonadherence post-transplant. This retrospective study used US Medicare prescription claims for immunosuppressive medications to assess the degree of non-adherence, and showed longer graft survival in adherent patients.

Comments Off on Immunosuppressant Therapy Adherence and Graft Failure Among Pediatric Renal Transplant Recipients Posted in Pediatric Nephrology, Renal Transplantation
November 22, 2009

Reduced Dose Rabbit Anti-Thymocyte Globulin Induction for Prevention of Acute Rejection in High-Risk Kidney Transplant Recipients

Thymoglobulin is the most powerful agent available to reduce the incidence of acute rejection, but is associated with a higher risk of infections and malignancy. This retrospective study compared two doses of thymoglobulin in patients at moderate risk of rejection. Both doses were equally effective at rejection prophylaxis, with no difference in infectious complications.

Comments Off on Reduced Dose Rabbit Anti-Thymocyte Globulin Induction for Prevention of Acute Rejection in High-Risk Kidney Transplant Recipients Posted in Renal Transplantation