Archive for the ‘Clinical Nephrology’ Category

February 9, 2017

Association between Preoperative Vascular Function and Postoperative Arteriovenous Fistula Development

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Arteriovenous fistula (AVF) maturation failure is the primary cause of dialysis vascular access dysfunction. To evaluate whether preoperative vascular functional properties predict postoperative AVF measurements, patients enrolled in the Hemodialysis Fistula Maturation Study underwent up to five preoperative vascular function tests (VFTs): flow-mediated dilation (FMD), nitroglycerin-mediated dilation (NMD), carotid-femoral pulse wave velocity, carotid-radial pulse wave […]

No Comments Posted in Clinical Nephrology, Hemodialysis, Vascular Access
February 9, 2017

Managing glomerular disease in pregnancy

This article reviews the pre-pregnancy counseling that women with glomerular-based diseases should ideally receive to allow them to make an informed decision about proceeding with a pregnancy as well as an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies.

No Comments Posted in Clinical Nephrology, Pregnancy and Hypertension/Renal Disease, Review
February 9, 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 of renin-angiotensin blockade in patients with ADPKD showed that sodium restriction is beneficial in the management of ADPKD.      

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

Residual Kidney Function Decline and Mortality in Incident Hemodialysis Patients

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This is a longitudinal cohort study of 6538 patients who started maintenance hemodialysis over a 4-year period (January 2007 through December 2010) and had available renal urea clearance (CLurea) data at baseline and 1 year after hemodialysis initiation.  This study  examined the association of annual change in renal CLurea rate with subsequent survival. The median (interquartile […]

No Comments Posted in Clinical Nephrology, Hemodialysis
February 9, 2017

AKI and Long-Term Risk for Cardiovascular Events and Mortality

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This systematic review and meta-analysis of 25 studies involving 254 408 patients assessed whether AKI associates with long-term cardiovascular disease. AKI associated with an 86% and a 38% increased risk of cardiovascular mortality and major cardiovascular events, respectively ([RR 1.86; 95% confidence interval (95% CI), 1.72 to 2.01] and [RR 1.38; 95% CI, 1.23 to […]

No Comments Posted in Acute Kidney Injury, Clinical Nephrology, General Nephrology
February 9, 2017

Rituximab for Severe Membranous Nephropathy: A 6-Month Trial with Extended Follow-Up

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This is a multicenter, randomized, controlled trial conducted at 31 French hospital. Patients with biopsy-proven PMN and nephrotic syndrome after 6 months of nonimmunosuppressive antiproteinuric treatment (NIAT) were randomly assigned to 6-month therapy with NIAT and 375 mg/m2 intravenous rituximab on days 1 and 8 (n=37) or NIAT alone (n=38). During the observational phase, remission rates […]

No Comments Posted in Clinical Nephrology, Clinical Trial Results, Glomerulonephritis
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
February 9, 2017

DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease

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This trial looked Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 (N = 14,882).  3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile […]

1 Comment Posted in Clinical Nephrology, Clinical Trial Results, General Nephrology, Hypertension
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

Hospitalization Rates for Patients on Assisted Peritoneal Dialysis Compared with In-Center Hemodialysis

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This multicenter, retrospective cohort study by linked a quality assurance dataset to administrative health data in Ontario, Canada. The study included 872 patients in the in-center hemodialysis group and 203 patients in the assisted peritoneal dialysis group. Using an intention to treat approach, patients on assisted peritoneal dialysis had a similar hospitalization rate of 11.1 d/yr (95% confidence interval, 9.4 to 13.0) compared with 12.9 d/yr (95% confidence interval, 10.3 to 16.1) in the hemodialysis group (P=0.19). […]

No Comments Posted in Clinical Nephrology, Hemodialysis, Peritoneal Dialysis
November 11, 2016

Pathophysiology of Renal Tubular Acidosis: Core Curriculum 2016

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This core curriculum is a valuable resource in deconstructing the pathophysiology of renal tubular acidosis.        

No Comments Posted in AJKD Core Curriculum, Clinical Nephrology
November 11, 2016

The relatively poor correlation between random and 24-hour urine protein excretion in patients with biopsy-proven glomerular diseases

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This study measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease. The results show that in patients with glomerular disease and proteinuria, the urine protein creatinine ratio correlates only moderately with 24-hour urine protein excretion. The results were used to develop estimating equation to derive 24-hour urine protein excretion from random urine protein creatinine ratio values with improved precision. […]

No Comments Posted in Clinical Nephrology, General Nephrology, Glomerulonephritis