Archive for the ‘Clinical Nephrology’ Category

May 1, 2017

A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction

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In this open label, multicenter study conducted over 1-year follow-up randomized 34 adult patients with biopsy-proven IgA nephropathy and proteinuria >1 g/d, maintained on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with well controlled BP and eGFR<90 ml/min per 1.73 m2, to receive standard therapy or rituximab with standard therapy. median baseline serum creatinine level (range) was 1.4 (0.8-2.4) […]

No Comments Posted in Clinical Nephrology, General Nephrology, Glomerulonephritis
May 1, 2017

A Clinical Risk Prediction Tool for 6-Month Mortality After Dialysis Initiation Among Older Adults

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This study derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment using linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada. A 19-point risk score was developed for 6-month mortality that […]

No Comments Posted in Clinical Nephrology, Hemodialysis
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
May 1, 2017

ISPD Catheter-Related Infection Recommendations: 2017 Update

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The International Society of Peritoneal Dialysis updated recommendations on the catheter-related infections.          

No Comments Posted in Clinical Nephrology, Clinical Practice Guidelines, Peritoneal Dialysis
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