NephrologyNow The Ultimate Guide to Kidney Disease Research

This important RCT concludes that in treatment of venous anastomotic stenosis of hemodialysis grafts, angioplasty plus placement of a stent provides better longer-term patency and freedom from repeat interventions than balloon angioplasty.
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This review discusses the role of statins in dialysis patients and offers insight into the interpretation of AURORA and the 4D study.
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Previous studies have suggested that hemodialysis immediately before transplant surgery may increase the risk of delayed graft function. In this RCT, patients were randomized to be dialyzed or not pre-transplant; patients with a potassium > 5.0 were randomized to citrate or heparin
anticoagulation. There were no differences in the incidence of DGF, acute rejection or early [...]

This next addition to the AJKD Core Curriculum series provides a detailed overview of the topic of “Home Hemodialysis, Daily Hemodialysis and Nocturnal Hemodialysis”.
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This study evaluated whether the high overall mortality in patients starting dialysis is a consequence of increased cardiovascular mortality risk only or whether noncardiovascular mortality is equally increased. In this analysis, patients starting dialysis were found to have an increased risk of death not specifically caused by excess cardiovascular mortality.
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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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The purpose of this Canadian population-based cohort study was to assess the risk of chronic dialysis and all-cause mortality in individuals who experienced an episode of acute kidney injury requiring dialysis.   The authors concluded that acute kidney injury necessitating in-hospital dialysis was associated with an increased risk of chronic dialysis but not all-cause mortality.
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This paper compared the results of nocturnal hemodialysis patients at two centres with matched deceased and liver donor transplant patients. Patient survival on nocturnal hemodialysis was similar to deceased donor transplantation, but inferior to live-donor transplantation. This is only a registry analysis and not a RCT. In addition, the dialysis patients were Canadian, while the [...]

This study compared the use of dobutamine and dipyridamole in cardiac stress testing of patients on hemodialysis.  Although dobutamine induced more pronounced myocardial ischemia than dipyridamole in chronic hemodialysis patients, use of dipyridamole more accurately identifies patients at high risk for subsequent cardiac death or non-fatal CAD.
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This concise review provides a clinical perspective on Staphylococcus aureus infections in hemodialysis practice.  Free full text access kindly provided by the American Society of Nephrology.
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This randomized controlled trial provides evidence that treatment with dipyridamole plus aspirin had a modest effect in reducing the risk of stenosis and improving the duration of primary unassisted patency of newly created grafts.

View the Accompanying editorial by C Lok
Antiplatelet therapy and vascular-access patency.
N Engl J Med. 2009 May 21;360(21):2240-2.

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This review highlights the evidence to support maintaining residual renal function and its impact on survival and quality of life of dialysis patients.
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