Archive for the ‘Chronic Kidney Disease’ Category

February 12, 2010

Pediatrics: Blood pressure target for renoprotection in children

Mak RH, Flynn J, Bakris G.   Nat Rev Nephrol.   2010 Feb;6(2):67-8

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.
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No Comments Posted in Chronic Kidney Disease, Hypertension, Pediatric Nephrology
February 12, 2010

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

Szczech LA, Barnhart HX, Sapp S, Felker GM, Hernandez A, Reddan D, Califf RM, Inrig JK, Patel UD, Singh AK.   Kidney Int.   2010 Feb;77(3):239-46

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 [...]

No Comments Posted in Anemia, Chronic Kidney Disease
February 12, 2010

Toxic Nephropathies: Core Curriculum 2010

Perazella MA.   Am J Kidney Dis.   2010 Feb;55(2):399-409

This addition to the AJKD Core Curriculum series reviews “Toxic Nephropathies”.
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No Comments Posted in Chronic Kidney Disease, Review
February 12, 2010

The Management of Diabetic Neuropathy in CKD

Pop-Busui R, Roberts L, Pennathur S, Kretzler M, Brosius FC, Feldman EL.   Am J Kidney Dis.   2010 Feb;55(2):365-85

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.
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2 Comments Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists, Review
January 11, 2010

Does TREAT Give the Boot to ESAs in the Treatment of CKD Anemia?

Singh AK.   J Am Soc Nephrol.   2010 Jan;21(1):2-6

This editorial by Dr. Ajay Singh discusses the implications of TREAT in the context of the existing evidence base on the management of anemia due to chronic kidney disease.
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No Comments Posted in Anemia, Chronic Kidney Disease, Editorial
January 11, 2010

Stage IV Chronic Kidney Disease

Abboud H, Henrich WL.   N Engl J Med.   2010 Jan 7;362(1):56-65

This NEJM clinical practice article highlights the management of chronic kidney disease with a look at supporting evidence and review of formal guidelines.
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No Comments Posted in Chronic Kidney Disease, Review
January 11, 2010

Carotid Endarterectomy Benefits Patients with CKD and Symptomatic High-Grade Stenosis

Mathew A, Eliasziw M, Devereaux PJ, Merino JG, Barnett HJ, Garg AX, North American Symptomatic Carotid Endarterectomy Trial (NASCET) Collaborators.   J Am Soc Nephrol.   2010 Jan;21(1):145-52

This re-analysis of data from the North American Symptomatic Carotid Endarterectomy Trial showed that patients with stage 3 CKD and symptomatic high-grade carotid stenosis gained a large benefit in stroke risk reduction after endarterectomy.
Free full text access kindly provided by the American Society of Nephrology.
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No Comments Posted in Chronic Kidney Disease, Vascular Disease/Calcification
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

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

Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE.   N Engl J Med.   2009 Oct 15;361(16):1539-47

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.
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1 Comment Posted in Chronic Kidney Disease, Hemodialysis
October 31, 2009

A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease

This randomized, double-blind, placebo-controlled trial compared a strategy of initiating darbepoetin alfa at a threshold hemoglobin of 11.0 g per deciliter, with a goal of 13 g per deciliter, versus placebo, with rescue darbepoetin alfa when Hb fell below 9.0 g per deciliter. Patients studied included those with diabetes, CKD (defined as GFR 20-60 ml/min) and anemia. No difference [...]

2 Comments Posted in Anemia, Chronic Kidney Disease
October 31, 2009

Treatment of Anemia in Chronic Kidney Disease — Strategies Based on Evidence

This editorial provides insight into the interpretation of the TREAT study, “A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease”.
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1 Comment Posted in Anemia, Chronic Kidney Disease
October 18, 2009

ASN Podcast on eGFR Measurement

This podcast, produced by the American Society of Nephrology, discusses the pros and cons of eGFR measurement.
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1 Comment Posted in Chronic Kidney Disease, Educational Resource
October 18, 2009

Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease

Lo LJ, Go AS, Chertow GM, McCulloch CE, Fan D, Ordoñez JD, Hsu CY.   Kidney Int.   2009 Oct;76(8):893-9

This study shows that in a large, community-based cohort of patients (from the Kaiser Permanente database) with pre-existing normal or near normal kidney function, an episode of dialysis-requiring ARF was a strong independent risk factor for a long-term risk of progressive CKD and mortality.
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No Comments Posted in Acute Renal Failure, Chronic Kidney Disease
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