Archive for the ‘Chronic Kidney Disease’ Category

May 1, 2017

Pain Management in CKD: A Guide for Nephrology Providers

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This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Furthermore, providers are taught to assess clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects […]

No Comments Posted in Chronic Kidney Disease, Review
May 1, 2017

The Effect of Predialysis Fistula Attempt on Risk of All-Cause and Access-Related Death

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This study was designed to determine the proportion of access-related deaths in a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. There was significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt […]

No Comments Posted in Chronic Kidney Disease, Hemodialysis, Vascular Access
May 1, 2017

Dietary salt restriction is beneficial to the management of autosomal dominant polycystic kidney disease

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This is a post hoc analysis of the HALT-PKD clinical trials looked to determine if sodium restriction slows the progression of ADPKD. Linear mixed models examined whether dietary sodium affected rates of total kidney volume or change in estimated glomerular filtration rate (eGFR) in patients with an eGFR over 60 ml/min/1.73 m2 (Study A) or the […]

No Comments Posted in Chronic Kidney Disease, Polycystic Kidney Disease
May 1, 2017

Obesity increases the risk of end-stage renal disease among living kidney donors

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This study looked at the risk of ESRD associated with obesity at the time of donation among 119 769 live kidney donors in the United States with a maximum follow-up was 20 years. The estimated risk of ESRD 20 years after donation was 93.9 per 10 000 for obese; significantly greater than the 39.7 per 10 […]

No Comments Posted in Chronic Kidney Disease, General Nephrology, Renal Transplantation
May 1, 2017

Cigarette smoking and chronic kidney disease in the general population: a systematic review and meta-analysis of prospective cohort studies 

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This meta-analysis looked at 15 prospective cohort studies, including 65 064 incident CKD cases.  Compared with never-smokers, the summary relative risks of incident CKD were 1.27 (95% CI 1.19–1.35) for ever-smokers, 1.34 (95% CI 1.23–1.47) for current smokers and 1.15 (95% CI 1.08–1.23) for former smokers. The SRRs for end-stage renal disease development were 1.51 (95% […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology
February 9, 2017

The Effect of Predialysis Fistula Attempt on Risk of All-Cause and Access-Related Death

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This is a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. The authors observed significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt in patients aged <65 years and in the first […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, Hemodialysis, Vascular Access
November 11, 2016

The Risk of Major Hemorrhage with CKD

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This retrospective cohort study (2002-2010)  grouped 516,197 adults ≥40 years old by eGFR (≥90, 60 to <90, 45 to <60, 30 to <45, 15 to <30, or <15 ml/min per 1.73 m(2)) and urine albumin-to-creatinine ratio (ACR; >300, 30-300, or <30 mg/g) to examine incidence of hemorrhage. The 3-year cumulative incidence of hemorrhage increased 20-fold across declining eGFR […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, General Nephrology
November 11, 2016

Proton Pump Inhibitors and Risk of Incident CKD & Progression to ESRD

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The Department of Veterans Affairs national databases were used in this study to build a primary cohort of new users of PPI (n=173,321) and new users of histamine H2-receptor antagonists (H2blockers; n=20,270.  These patients were followed for over 5 years to ascertain renal outcomes. In adjusted Cox survival models, the PPI group, compared with the […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, General Nephrology
November 11, 2016

Efficacy of Folic Acid Therapy on the Progression of Chronic Kidney Disease The Renal Substudy of the China Stroke Primary Prevention Trial

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In this substudy of eligible China Stroke Primary Prevention Trial (CSPPT), 15 104 participants with an estimated glomerular filtration rate (eGFR) 30 mL/min/1.73 m2 or greater, were randomized to receive a single tablet daily containing 10 mg enalapril and 0.8 mg folic acid (n = 7545) or 10 mg enalapril alone (n = 7559). Overall, 15 104 Chinese adults with a mean (range) age of 60 (45-75) years were recruited; median follow-up […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology
August 14, 2016

Bariatric surgery is associated with improvement in kidney outcomes

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In this matched cohort study, 985 patients who underwent bariatric surgery were compared 985 patients that did not.  The mean 1-year weight loss was 40.4 kg in the surgery group compared with 1.4 kg in the matched cohort. In adjusted analyses, bariatric surgery patients had a 58% lower risk for an eGFR decline of ≥30% (hazard ratio 0.42, 95% confidence interval 0.32-0.55) […]

No Comments Posted in Chronic Kidney Disease, General Nephrology
August 14, 2016

Past Decline Versus Current eGFR and Subsequent ESRD Risk

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This CKD Prognosis Consortium study examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD.  5163 ESRD events were recorded in the 1,080,223 participants during a mean follow-up of 2.0 years. The results showed that current eGFR [30 versus 50 ml/min per 1.73 m(2) (a difference of 20 ml/min per 1.73 m(2)) associated with an adjusted hazard ratio […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, General Nephrology
August 14, 2016

Past Decline Versus Current eGFR and Subsequent Mortality Risk

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This is an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope among 1.2 million subjects within the CKD Prognosis Consortium. Over a 3-year antecedent period, compared with a slope of 0 ml/min per 1.73 m(2) per year, a slope of -6 ml/min per 1.73 m(2) per year was associated with adjusted hazard ratios for all-cause mortality of […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results
August 14, 2016

Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes

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  This randomized control trial of over 4000 high risk patients with Type 2 diabetes and eGFR > 30 ml/min, empagliflozin (a sodium-glucose cotransporter 2 inhibitor) when compared with placebo was associated with slower progression of kidney disease (12.7% vs 18.8% for worsening nephropathy and 1.5% vs 2.6% for doubling of serum creatinine) when added to the standard of care.  […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, Diabetes, General Nephrology