NephrologyNow The Ultimate Guide to Kidney Disease Research

This meta-analysis examining high-dose renal replacement therapy in acute kidney injury did not show any improvement in patient survival or recovery of renal function.

This landmark clinical trial randomized CKD patients to a strategy of early (GFR 10-14 ml/min) vs late (GFR 5-7 ml/min) initiation of dialysis.   After a median follow-up of 3.6 years, no difference was seen in mortality, cardiovascular events, infections, or complications of dialysis.  Careful note should be made that the majority of patient randomized to late [...]

This editorial provides insight into the interpretation of the article ‘A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis‘.

Since an RCT comparing survival on hemodialysis vs peritoneal dialysis will likely never be done, this article warrants highlighting. This matched-pair cohort study compared survival of incident hemodialysis and peritoneal dialysis patients by intention-to-treat analysis. 6337 patient pairs from a retrospective cohort of 98,875 adults who initiated dialysis in 2003 in the United States were [...]

While a small, single study trial, this RCT suggests that when inserting a femoral line for hemodialysis, ultrasound-guided insertion was superior and safer than the anatomical landmark-guided technique. Full text kindly provided by the American Society of Nephrology.

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.

This review discusses the role of statins in dialysis patients and offers insight into the interpretation of AURORA and the 4D study.

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 [...]

This next addition to the AJKD Core Curriculum series provides a detailed overview of the topic of “Home Hemodialysis, Daily Hemodialysis and Nocturnal Hemodialysis”.

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.

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.

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.

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 [...]