Archive for February, 2010

February 12, 2010

Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts

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This important RCT concludes that in treatment of venous anastomotic stenosis of hemodialysis grafts, angioplasty plus placement of a stent provides better longer-term patency and freedom from repeat interventions than balloon angioplasty.

Comments Off on Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts Posted in Hemodialysis, Vascular Access
February 12, 2010

Second Chances in Mineral Metabolism

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In this succinct editorial, Dr. Wolf reinforces the rationale for performing proper randomized controlled trials in bone mineral metabolism before changing clinical practice.  In addition, he provides insight into a first-in-class substudy of the ACHIEVE study which looks at the effects of cinacalcet and activated Vitamin D on FGF23 levels in ESRD. Free full text […]

1 Comment Posted in Bone Mineral Metabolism
February 12, 2010

Pediatrics: Blood pressure target for renoprotection in children

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This review summarizes results of the landmark ESCAPE trial, which has shown that lowering the blood pressure target to below the 50th percentile slows pediatric chronic kidney disease progression.

Comments Off on Pediatrics: Blood pressure target for renoprotection in children Posted in Chronic Kidney Disease, Hypertension, Pediatric Nephrology
February 12, 2010

Secondary analysis of the CHOIR trial epoetin-|[alpha]| dose and achieved hemoglobin outcomes

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This interesting secondary analysis of the CHOIR trial demonstrates that patients achieving their assigned Hb target had better outcomes than those that did not achieve target.  Furthermore, those patients randomized to a higher Hb target, who actually reached that target, saw no increased risk.  This study raises the question whether it is the high dose […]

Comments Off on Secondary analysis of the CHOIR trial epoetin-|[alpha]| dose and achieved hemoglobin outcomes Posted in Anemia, Chronic Kidney Disease
February 12, 2010

Toxic Nephropathies: Core Curriculum 2010

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This addition to the AJKD Core Curriculum series reviews “Toxic Nephropathies”.

Comments Off on Toxic Nephropathies: Core Curriculum 2010 Posted in AJKD Core Curriculum, Chronic Kidney Disease, Review
February 12, 2010

AURORA: Is There a Role for Statin Therapy in Dialysis Patients

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This review discusses the role of statins in dialysis patients and offers insight into the interpretation of AURORA and the 4D study.

1 Comment Posted in Hemodialysis, Review
February 12, 2010

The Management of Diabetic Neuropathy in CKD

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This indepth review looks at diabetic autonomic and peripheral neuropathy in patients with stages 4-5 CKD or ESRD undergoing dialysis. The evidence supporting the available therapeutic options and the challenges associated with providing adequate care as well as future directions for investigation are discussed.

2 Comments Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists, Review
February 12, 2010

A Hemodialysis Patient With Muscle Cramps and Malaise After Virtual Colonoscopy

Comments Off on A Hemodialysis Patient With Muscle Cramps and Malaise After Virtual Colonoscopy Posted in Case Report, Fluid & Electrolytes
February 12, 2010

Water balance disorders after neurosurgery: the triphasic response revisited

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Comments Off on Water balance disorders after neurosurgery: the triphasic response revisited Posted in Case Report, Fluid & Electrolytes
February 12, 2010

Improved growth and cardiovascular risk after late steroid withdrawal: 2-year results of a prospective, randomized trial in paediatric renal transplantation

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Along with usual side effects of steroids is the impact on growth in pediatric patients. In this RCT, renal transplant recipients at least one year post-transplant were randomized to steroid continuation or withdrawal. Longitudinal growth was greater in the steroid withdrawal group. There were also improvements in blood pressure and HbA1c, with no graft losses […]

1 Comment Posted in Renal Transplantation
February 12, 2010

Use of isoniazid chemoprophylaxis in renal transplant recipients

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Reactivation of tuberculosis post-transplant is a significant concern in countries where TB is endemic. This study randomized living-donor recipients to INH or not. Prophylaxis with INH significantly reduced the incidence of TB post-transplant, with very little hepatotoxicity.

Comments Off on Use of isoniazid chemoprophylaxis in renal transplant recipients Posted in Renal Transplantation
February 12, 2010

Diabetes Mellitus: A Risk Factor for Delayed Graft Function after Deceased Donor Kidney Transplantation

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This paired kidney analysis compared results of a transplantation where one recipient was diabetic and the other was not. In uni- and multivariate analyses, diabetes was associated with a significantly higher risk for DGF. The risk appeared to be greater in women rather than men. Whether the risk of diabetes is due to hyperglycemia itself […]

Comments Off on Diabetes Mellitus: A Risk Factor for Delayed Graft Function after Deceased Donor Kidney Transplantation Posted in Renal Transplantation
February 12, 2010

Screening for De Novo Anti-Human Leukocyte Antigen Antibodies in Nonsensitized Kidney Transplant Recipients Does Not Predict Acute Rejection

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Several studies have shown the development of anti-donor HLA-antibodies after transplantation is a risk factor for graft loss, suggesting that antibodies should be monitored to identify patients at risk of immunologic events. In this study, patients were prospectively studied for the development of antibodies during the first year post-transplant. Anti-HLA antibodies developed at the same […]

Comments Off on Screening for De Novo Anti-Human Leukocyte Antigen Antibodies in Nonsensitized Kidney Transplant Recipients Does Not Predict Acute Rejection Posted in Renal Transplantation