Archive for November, 2011

November 29, 2011

Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis

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This 3-year randomized controlled trial compared mycophenolate mofetil and azathioprine as maintenance therapy after induction of remission in lupus nephritis.  Mycophenolate mofetil was superior to azathioprine in achieving the primary end point, time to treatment failure, time to renal flare and time to rescue therapy  There was a trend to fewer serious adverse events in […]

Comments Off on Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis Posted in Lupus
November 29, 2011

Risk of Pneumocystis jiroveci pneumonia in patients long after renal transplantation

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Pneumocystis jiroveci pneumonia is a well-recognized complication after transplantation, and current guidelines recommend prophylaxis for three-six months post-transplant. In this study, nine patients who develop Pneumocystis pneumonia a median of 19 months post-transplant were compared to a group of control patients. Cases had significantly lower lymphocyte counts than controls, as well as lower CD4 counts, […]

Comments Off on Risk of Pneumocystis jiroveci pneumonia in patients long after renal transplantation Posted in Renal Transplantation
November 29, 2011

Screening and Follow-Up of Living Kidney Donors: A Systematic Review of Clinical Practice Guidelines

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Careful screening of potential living kidney donors is crucial to ensure that only appropriate patients are allowed to donate, and keep the risk of donation to a minimum. This systematic review found nine different sets of guidelines about living donor evaluation published over the last fifteen years. While there was broad agreement in most areas, […]

Comments Off on Screening and Follow-Up of Living Kidney Donors: A Systematic Review of Clinical Practice Guidelines Posted in Renal Transplantation
November 29, 2011

Treatment of Kidney Transplant Recipients With ACEi/ARB and Risk of Respiratory Tract Cancer: A Collaborative Transplant Study Report

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Meta-analyses in the general population have suggested that ACE-inhibitors and angiotensin receptor blockers may increase the risk of cancer, particularly lung cancer. In this report from the international Collaborative Transplant Study, use of ACE-I or ARB as associated with a statistically significant increased risk of lung cancer, but only in patients with a smoking history. […]

Comments Off on Treatment of Kidney Transplant Recipients With ACEi/ARB and Risk of Respiratory Tract Cancer: A Collaborative Transplant Study Report Posted in Renal Transplantation
November 29, 2011

Terminal Complement Inhibition Decreases Antibody-Mediated Rejection in Sensitized Renal Transplant Recipients

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There has been much interest in transplantation around eculizumab, a monoclonal antibody that blocks formation of the membrane attack complex of the complement cascade. In this single-centre, non-randomized study, patients with donor-specific antibody who were treated with eculizumab had a significantly lower rate of antibody-mediated rejection that a group of historical controls. There was also […]

Comments Off on Terminal Complement Inhibition Decreases Antibody-Mediated Rejection in Sensitized Renal Transplant Recipients Posted in Renal Transplantation
November 29, 2011

Cullen and Grey Turner signs in idiopathic perirenal hemorrhage

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This brief report describes and provide images of Cullen and Grey Turner signs in perirenal hemorrhage.

Comments Off on Cullen and Grey Turner signs in idiopathic perirenal hemorrhage Posted in Case Report
November 29, 2011

Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia

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This cohort study identified exposure to e-beam sterilized dialyzers as an etiologic agent contributing to significant post-dialytic thrombocytopenia.

Comments Off on Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia Posted in Hemodialysis
November 29, 2011

Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review

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Thirteen observational studies were included in this systematic review of pregnant women with chronic kidney disease (CKD).  Pregnant women on dialysis or with a history of transplantation were excluded.  Adverse maternal outcomes were reported in twelve studies were approximately five times higher in women with CKD.  These include gestational hypertension, preeclampsia and maternal mortality.  Adverse […]

Comments Off on Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review Posted in Pregnancy and Hypertension/Renal Disease
November 29, 2011

Exercise training for adults with chronic kidney disease.

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This systematic review identified evidence for significant beneficial effects of regular exercise on physical fitness, walking capacity, cardiovascular dimensions (e.g. BP and heart rate), health-related quality of life and some nutritional parameters in adults with chronic kidney disease.

Comments Off on Exercise training for adults with chronic kidney disease. Posted in Chronic Kidney Disease
November 29, 2011

Survival advantage of hemodialysis relative to peritoneal dialysis in patients with end-stage renal disease and congestive heart failure

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This prospective French Registry study finds that the adjusted hazard ratio for death in PD compared to the HD patients was significant at 1.48 for all enrolled patients started on dialysis with associated congestive heart failure.  Of note, congestive heart failure was determined subjectively (not by left ventricular ejection fraction), the PD group was older […]

Comments Off on Survival advantage of hemodialysis relative to peritoneal dialysis in patients with end-stage renal disease and congestive heart failure Posted in Hemodialysis, Peritoneal Dialysis
November 29, 2011

Current Therapy for IgA Nephropathy

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IgA nephropathy is a multi-faceted disease with many clinical presentations that are not always easy to manage.  This review nicely summarizes the therapeutic options using four clinical scenarios of patients with IgA nephropathy. Free full text kindly provided by the American Society of Nephrology

Comments Off on Current Therapy for IgA Nephropathy Posted in Glomerulonephritis
November 29, 2011

The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial

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This small randomized controlled trial comparing nocturnal home hemodialysis to conventional hemodialysis failed to show a benefit in any primary outcome (death or left ventricular mass, or, death or RAND Physical Health Composite). Patients in the nocturnal arm did have improved control of hyperphosphatemia and hypertension.

Comments Off on The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial Posted in Clinical Trial Results, Hemodialysis, Nocturnal Hemodialysis
November 29, 2011

Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis

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This study of twenty-three patients presenting or relapsing with ANCA-associated vasculitis were treated with two pulses of rituximab 2 weeks apart, six biweekly doses of cyclophosphamide and a tapering course of oral steroids. They were subsequently put on a maintenance regimen of low-dose steroids and azathioprine.  All patients achieved clinical remission within six weeks. Five […]

Comments Off on Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis Posted in Vasculitis