Archive for the ‘Chronic Kidney Disease’ Category

May 29, 2016

Controversies Regarding Lipid Management and Statin Use for Cardiovascular Risk Reduction in Patients With CKD

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It is known that patients with chronic kidney disease are at increased risk of death from cardiovascular disease. This review nicely addresses the identification and management of lipid levels in patients with CKD and discusses the controversies regarding testing and treatment of lipid levels in this population.

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology
March 23, 2016

Multinational Assessment of Accuracy of Equations for Predicting Risk of Kidney Failure: A Meta-analysis.

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Thirty-one cohorts participating in the CKD Prognosis Consortium, including 721,357 participants with CKD stages 3 to 5 in more than 30 countries spanning 4 continents, were studied to evaluate the accuracy of the kidney failure risk equations.  During a median follow-up of 4 years of 721,357 participants with CKD, 23,829 cases kidney failure were observed. The original risk equations achieved excellent discrimination across all […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, General Nephrology
March 23, 2016

Vascular Access Type and Patient and Technique Survival in Home Hemodialysis Patients: The Canadian Organ Replacement Register.

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This registry-based retrospective observational cohort study assessed 1217 incident HHD patients in The Canadian Organ Replacement Register who had information for vascular access type (CVC vs AV access) within the first year of HHD therapy initiation.  The results showed that AV access use (n=694) was associated with lower risk for the composite event of death and technique failure (490 events; adjusted HR, 0.78; 95% CI, 0.64-0.94) and lower adjusted all-cause […]

No Comments Posted in Chronic Kidney Disease, Clinical Trial Results, Vascular Access
November 30, 2015

Serum Uric Acid and Risk of CKD in Type 2 Diabetes.

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This longitudinal study of a cohort of patients with type 2 diabetes from the database of the Italian Association of Clinical Diabetologists network. Urinary albumin excretion, GFR, and serum uric acid were available in 13,964 patients. They further assessed the association of serum uric acid quintiles with onset of CKD components by multinomial logistic regression model adjusting for potential confounders. At 4-year follow-up, the […]

No Comments Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, Diabetes
November 30, 2015

A randomized trial of intravenous and oral iron in chronic kidney disease.

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This trial randomly assigned patients with stage 3 and 4 CKD and IDA to either open-label oral ferrous sulfate (69 patients to 325 mg three times daily for 8 weeks) or intravenous iron sucrose (67 patients to 200 mg every 2 weeks, total 1 g). The trial was terminated early on the recommendation of an independent data and safety due to higher risk of serious […]

No Comments Posted in Chronic Kidney Disease, Clinical Trial Results, General Nephrology
November 10, 2015

Empagliflozin and Clinical Outcomes in Patients with Type 2 Diabetes and Chronic Kidney Disease

These are results as presented at the 2015 American Society of Nephrology Kidney Week. The effect of empagliflozin vs placebo on cardiovascular events and death was recently reported in the NEJM in Sep 2015, and shown to significantly reduce both the composite cardiovascular primary endpoint and death. During Kidney Week, the renal outcome of new […]

Comments Off on Empagliflozin and Clinical Outcomes in Patients with Type 2 Diabetes and Chronic Kidney Disease Posted in Chronic Kidney Disease, Diabetes, General Nephrology
September 21, 2015

Corticosteroids in IgA Nephropathy: A Retrospective Analysis from the VALIGA Study

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This retrospective study assessed 1147 patients with IgA nephropathy from the European Validation Study of the Oxford Classification of IgAN (VALIGA) cohort.  From this group as well a propensity matched cohort, the authors concluded that corticosteroids reduced proteinuria and the rate of renal function decline and increased renal survival even in patients with an eGFR < 50 […]

Comments Off on Corticosteroids in IgA Nephropathy: A Retrospective Analysis from the VALIGA Study Posted in Chronic Kidney Disease, Glomerulonephritis
September 21, 2015

Risk of Adverse Pregnancy Outcomes in Women with CKD

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With the increasing prevalence of CKD in pregnancy, it is important that both physicians and patients are aware of the risks.  In this Torino-Cagliari Observational Study (TOCOS), 504 pregnancies in women with CKD were compared with 836 low-risk pregnancies in women without CKD.  There were multiple pregnancy outcomes that were studied and divided into “general” […]

Comments Off on Risk of Adverse Pregnancy Outcomes in Women with CKD Posted in Chronic Kidney Disease, Pregnancy and Hypertension/Renal Disease
May 8, 2015

β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis

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This propensity-matched retrospective study showed that initiation of a high (atenolol, acebutolol, or metoprolol) versus low (bisoprolol or propranolol) -dialyzability β-blocker was associated with a higher risk of death in the following 180 days (relative risk, 1.4; 95% confidence interval, 1.1 to 1.8; P<0.01). This study does raise caution, but as the authors indicate, causality is […]

Comments Off on β-Blocker Dialyzability and Mortality in Older Patients Receiving Hemodialysis Posted in Chronic Kidney Disease, Clinical Nephrology, Hemodialysis
May 8, 2015

Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism

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This long-term follow-up study of dialysis patient treated with cinacalcet for 6-12 months showed improved PTH, biochemical markers as well as bone histology.  Of the 77 patients that underwent a second bone biopsy at 12 months, 20 had normal had a normal bone biopsy.  

Comments Off on Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism Posted in Bone Mineral Metabolism, Chronic Kidney Disease, Clinical Nephrology
May 8, 2015

IMAGES IN CLINICAL MEDICINE Lindsay’s Nails in Chronic Kidney Disease

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This image says it all.  An interesting nail bed finding in CKD.

Comments Off on IMAGES IN CLINICAL MEDICINE Lindsay’s Nails in Chronic Kidney Disease Posted in Chronic Kidney Disease, Clinical Nephrology
March 18, 2015

ESRD and Death after Heart Failure in CKD

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This retrospective study of a Toronto CKD population showed that heart failure hospitalizations were associated with a stepwise increase in the risk of ESRD and death before ESRD (adjusted hazard ratio of ESRD from 4.89 to 10.27 to 14.16 and the adjusted hazard ratio death before ESRD from 3.30 to 4.20 to 6.87 for one […]

Comments Off on ESRD and Death after Heart Failure in CKD Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, General Nephrology
January 24, 2015

Effect of Pentoxifylline on Renal Function and Urinary Albumin Excretion in Patients with Diabetic KidneyDisease: The PREDIAN Trial.

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This open-label prospective, randomized trial showed that pentoxifylline in addition to RAS inhibitors resulted in a smaller decrease in eGFR and great reduction of albuminuria at two years in Type 2 diabetics with stage 3-4 CKD.

1 Comment Posted in Chronic Kidney Disease, Clinical Nephrology, Clinical Trial Results, General Nephrology