January 28, 2012
Harel Z, Gilbert C, Wald R, Bell C, Perl J, Juurlink D, Beyene J, Shah PS. BMJ. 2012 Jan 9;344:e42
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.
January 28, 2012
Vegter S, Perna A, Postma MJ, Navis G, Remuzzi G, Ruggenenti P. J Am Soc Nephrol. 2012 Jan;23(1):165-73
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 [...]
December 22, 2011
Novartis announced the termination of the ALTITUDE study in high-risk patients with diabetes and renal impairment. The study was designed to determine if aliskiren could reduce cardiovascular and renal morbidity and mortality, compared with placebo, when added to conventional treatment (including ACEi or ARB). Based on the recommendation from the Data Monitoring committee, it was felt [...]
November 29, 2011
Heiwe S, Jacobson SH. Cochrane Database Syst Rev. 2011 Oct 5;(10):CD003236
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.
October 8, 2011
Vivante A, Afek A, Frenkel-Nir Y, Tzur D, Farfel A, Golan E, Chaiter Y, Shohat T, Skorecki K, Calderon-Margalit R. JAMA. 2011 Aug 17;306(7):729-36
This study linked an ESRD registry to retrospective medical data for persons aged 16-25 examined for military fitness. It showed that persistent asymptomatic microscopic hematuria was associated with an increased risk of ESRD, with an adjusted hazard ratio of 18.5 [95% CI, 12.4-27.6]. While the absolute risk of ESRD in patients with microscopic hematuria remains [...]
October 8, 2011
Winkelmayer WC, Liu J, Chertow GM, Tamura MK. Arch Intern Med. 2011 Aug 8;171(15):1371-8
This retrospective study failed to demonstrate significant improvements in 1-year survival rates after dialysis initiation despite a trend to earlier nephrology consultation in older adults with chronic kidney disease. The accompanying editorials ask questions about the role and benefit of predialysis care. Editorials Earlier Nephrology Consultation Is Not Associated With Improved Survival: Comment on “Predialysis [...]
August 5, 2011
Slagman MC, Waanders F, Hemmelder MH, Woittiez AJ, Janssen WM, Lambers Heerspink HJ, Navis G, Laverman GD, HOlland NEphrology STudy Group. BMJ. 2011 Jul 26;343:d4366
This small randomized trial including patients with non-diabetic nephropathy looked at the addition of dietary sodium restriction or angiotensin receptor blockade (or their combination), in patients receiving background treatment with angiotensin converting enzyme (ACE) inhibition at maximum dose. Dietary sodium restriction to a level recommended in guidelines was more effective than dual blockade for reduction [...]
June 24, 2011
Free full text available for several days only. This industry-sponsored phase 2 RCT examined the impact of bardoxolone methyl, an oral antioxidant inflammation modulator, on renal function in patients with CKD and diabetes. At 24 and 52 weeks, the intervention arms had improved eGFR compared to placebo. Hard clinical endpoints were not examined in this study.
June 16, 2011
Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, Wanner C, Krane V, Cass A, Craig J, Neal B, Jiang L, Hooi LS, Levin A, Agodoa L, Gaziano M, Kasiske B, Walker R, Massy ZA, Feldt-Rasmussen B, Krairittichai U, Ophascharoensuk V, Fellström B, Holdaas H, Tesar V, Wiecek A, Grobbee D, de Zeeuw D, Grönhagen-Riska C, Dasgupta T, Lewis D, Herrington W, Mafham M, Majoni W, Wallendszus K, Grimm R, Pedersen T, Tobert J, Armitage J, Baxter A, Bray C, Chen Y, Chen Z, Hill M, Knott C, Parish S, Simpson D, Sleight P, Young A, Collins R, SHARP Investigators. Lancet. 2011 Jun 25;377(9784):2181-92
The SHARP study was a large randomized controlled trial which assessed the efficacy and safety of the combination of simvastatin plus ezetimibe in patient with moderate-to-severe kidney disease. Consistent with Nephrology Now’s report on the trial results as presented at the 2010 ASN meeting, the intervention arm had a 17% relative risk reduction in major [...]
June 15, 2011
Barrett BJ, Garg AX, Goeree R, Levin A, Molzahn A, Rigatto C, Singer J, Soltys G, Soroka S, Ayers D, Parfrey PS. Clin J Am Soc Nephrol. 2011 Jun;6(6):1241-7
The CanPREVENT study was an unblinded randomized clinical trial that provided either usual care or nurse-coordinated and nephrologist-supported care for patient identified with CKD stages 3 and 4. While the clinical endpoints were no different between groups, the economic analysis published in the same issue of CJASN suggests the program was cost effective with better [...]
April 24, 2011
Tangri N, Stevens LA, Griffith J, Tighiouart H, Djurdjev O, Naimark D, Levin A, Levey AS. JAMA. 2011 Apr 20;305(15):1553-9
The Kidney Failure Risk Equation is described, which offers a robust prediction model to determine the probability of renal replacement therapy (dialysis or transplant) in patients with baseline GFR of 10-60 ml/min. The results were first presented at the recent World Congress of Nephrology and a point of care calculator was simultaneously released as part [...]
April 24, 2011
Peralta CA, Shlipak MG, Judd S, Cushman M, McClellan W, Zakai NA, Safford MM, Zhang X, Muntner P, Warnock D. JAMA. 2011 Apr 20;305(15):1545-52
This large prospective cohort study looked at the predictive power of adding cystatin C to the combination of creatinine and urine ACR. The study revealed improved predictive accuracy for all-cause mortality and end-stage renal disease.
April 24, 2011
Upadhyay A, Earley A, Haynes SM, Uhlig K. Ann Intern Med. 2011 Apr 19;154(8):541-8
In this systematic review of non-diabetics with chronic kidney disease, no overall advantage of a blood pressure target of less than 125/75 to 130/80 mm Hg was found compared to a target of <140/90 mm Hg. Lower-quality evidence suggests that a low target may be beneficial in subgroups with proteinuria greater than 300 to 1000 [...]
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