NephrologyNow The Ultimate Guide to Kidney Disease Research

Theses guidelines have been prepared by British Thoracic Society Standards of Care Committee and Joint Tuberculosis Committee. Free full text kindly provided through the British Thoracic Society website.

It has previously been demonstrated that oral sodium bicarbonate slows GFR decline in patients with low GFR.  This 5-year RCT evaluated whether daily oral sodium bicarbonate slowed GFR decline in patients with hypertensive nephropathy with reduced but relatively preserved eGFR (mean 75 ml/min). The rate of eGFR decline was slower and eGFR was higher in [...]

This case control study suggests that older patients taking ACEIs or ARBs have a major increase in the risk of hyperkalemia-associated hospitalization when using trimethoprim-sulfamethoxazole.

This addition to the AJKD Core Curriculum series reviews nutritional considerations in the management of kidney disease.

In this small RCT of 12 months duration, octreotide slowed the progressive increase in liver and kidney volume in patients with polycystic kidney disease and polycystic liver disease.  While the findings are encouraging and consistent with other studies, longer and larger clinical trials will be necessary to establish the long-term safety and efficacy of somatostatin [...]

This RCT examined compared a strategy of homocysteine reduction using folic acid, vitamin B6, and vitamin B12 versus placebo in patient with diabetic nephropathy. The active therapy arm experienced a greater decrease in GFR and an increase in vascular events.

This systematic review of interventions for bone disease in children with CKD concludes that all examined vitamin D formulations reduce PTH levels and that sevelamer as compared to calcium-based binders reduced serum calcium and hypercalcemic events. However, no reduction in hard clinical endpoints was identified.

The ACCOMPLISH trial concluded that initial antihypertensive therapy with benazepril plus amlodipine was superior to benazepril plus hydrochlorothiazide in reducing cardiovascular morbidity and mortality. This pre-specified secondary analysis showed a reduction in progressive chronic kidney disease, defined as a doubling of serum creatinine concentration or development of end-stage renal disease, with an event rate of [...]

This concise review discusses enzyme replacement therapy in Fabry Nephropathy. Full text kindly provided by the American Society of Nephrology.

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.

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 [...]

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

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.