Archive for the ‘Internal Medicine for Nephrologists’ Category

March 23, 2016

Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis.

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This systematic review and meta-analysis of 19 trials included 44,989 participants,  with 2496 major cardiovascular events were recorded during a mean 3·8 years of follow-up.  Patients in the more intensive blood pressure-lowering treatment group had mean blood pressure levels of 133/76 mm Hg, compared with 140/81 mm Hg in the less intensive treatment group. Intensive blood pressure-lowering treatment achieved RR reductions for major cardiovascular events (14% [95% CI 4-22]), myocardial infarction […]

No Comments Posted in General Nephrology, Hypertension, Internal Medicine for Nephrologists
January 24, 2015

Risk of adverse events among older adults following co-prescription of clarithromycin and statins notmetabolized by cytochrome P450 3A4.

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 Among older adults taking a statin not metabolized by CYP3A4 (rosuvastatin/pravastatin/fluvastatin), co-prescription of clarithromycin versus azithromycin was associated with a modest but statistically significant increase in the 30-day absolute risk of adverse outcomes, including AKI and admission with hyperkalemia.

No Comments Posted in Acute Kidney Injury, Internal Medicine for Nephrologists
December 21, 2013

KDIGO 2013 Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease

The full KDIGO lipid guidelines are available here.

Comments Off on KDIGO 2013 Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease Posted in Chronic Kidney Disease, Clinical Practice Guidelines, Internal Medicine for Nephrologists, Vascular Disease/Calcification
December 21, 2013

Lipid Management in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2013 Clinical Practice Guideline

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This synopsis of the recently published KDIGO guidelines focuses on 8 recommendations related to assessment of lipid status and treatment with a statin-based regimen in adults.

Comments Off on Lipid Management in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2013 Clinical Practice Guideline Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists, Vascular Disease/Calcification
September 7, 2013

Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years

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This case-control study identified an association between >10 years of calcium-channel blockers use and a higher risk of ductal breast cancer. The associated editorial Calcium-Channel Blockers and Breast Cancer: A Hypothesis Revived discusses how this finding may be interpreted.

Comments Off on Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years Posted in Hypertension, Internal Medicine for Nephrologists
July 14, 2013

Antiplatelet Therapy in the Management of Cardiovascular Disease in Patients with CKD: What Is the Evidence?

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This review discusses gaps in knowledge related to the use of anti-platelet agents in patients with chronic kidney disease.

2 Comments Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists
July 14, 2013

Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage

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This randomized controlled trial compared two strategies of blood pressure management after spontaneous intracerebral hemorrhage. Patients were randomized intensive blood treatment to target a systolic BP of No difference was seen in the composite of death or major disability. However, a significantly lower modified Rankin scores was seen with intensive treatment (odds ratio for greater […]

1 Comment Posted in Hypertension, Internal Medicine for Nephrologists
November 25, 2012

Mortality of Dialysis Patients According to Influenza and Pneumococcal Vaccination Status

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This retrospective observational study showed that vaccination against influenza and pneumococcal disease is associated with improved survival in dialysis patients.

Comments Off on Mortality of Dialysis Patients According to Influenza and Pneumococcal Vaccination Status Posted in Hemodialysis, Internal Medicine for Nephrologists, Peritoneal Dialysis
September 18, 2012

Benefits and Harms of Statin Therapy for Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis

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This meta-analysis of statin therapy in patients with chronic kidney disease showed decreased mortality and cardiovascular events in patient with CKD, not yet on dialysis, but little or no effect in those on dialysis.

Comments Off on Benefits and Harms of Statin Therapy for Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis Posted in Internal Medicine for Nephrologists, Vascular Disease/Calcification
September 18, 2012

Stroke and Bleeding in Atrial Fibrillation with Chronic Kidney Disease

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This retrospective analysis indicates that atrial fibrillation results in an increased risk of bleeding as well as stroke/systemic thromboembolism in patients with chronic kidney disease. Warfarin was associated with reduced stroke or systemic thromboembolism in patients with CKD, while warfarin and aspirin were associated with an increased risk of bleeding.

Comments Off on Stroke and Bleeding in Atrial Fibrillation with Chronic Kidney Disease Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists
July 8, 2012

2012 infectious diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections.

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Nephrologists frequently encounter diabetic foot infections in their patients. This clinical practice guideline from the IDSA is a useful tool that supports management of this common problem.

Comments Off on 2012 infectious diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Posted in Diabetes, Internal Medicine for Nephrologists
January 28, 2012

Decongestive Treatment of Acute Decompensated Heart Failure: Cardiorenal Implications of Ultrafiltration and Diuretics

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This review discusses the role of diuretics and ultrafiltration in acute decompensated heart failure.

1 Comment Posted in Critical Care, Internal Medicine for Nephrologists, Review
December 22, 2011

Urinary Sodium and Potassium Excretion and Risk of Cardiovascular Events

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An observational analysis of cohorts from the ONTARGET and TRANSCEND trials looked at the association of urinary sodium and potassium with CV events and mortality. Sodium excretion and CV events showed a J-shaped relationship: sodium excretion of  < 3 g and >7 g per day was associated with an increased risk of CV events.  Risk […]

Comments Off on Urinary Sodium and Potassium Excretion and Risk of Cardiovascular Events Posted in Hypertension, Internal Medicine for Nephrologists