Archive for the ‘Internal Medicine for Nephrologists’ Category

June 16, 2011

The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial

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The SHARP study was a large randomized controlled trial which assessed the efficacy and safety of the combination of simvastatin plus ezetimibe in patient with moderate-to-severe kidney disease. Consistent with Nephrology Now’s report on the trial results as presented at the 2010 ASN meeting, the intervention arm had a 17% relative risk reduction in major […]

6 Comments Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists, Vascular Disease/Calcification
June 14, 2011

The Tumor Lysis Syndrome

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This review nicely summarizes tumor lysis syndrome and its renal complications.

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May 10, 2011

Intravenous Erythropoietin in Patients With ST-Segment Elevation Myocardial Infarction: REVEAL: A Randomized Controlled Trial

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This randomized controlled trial in non-CKD patients with STEMI examined the impact of a single intravenous bolus of epoetin alfa within 4 hours of PCI.  The intervention group did not have any reduction in infarct size and was associated with higher rates of adverse cardiovascular events. Should this trial impact how Nephrologists prescribe ESA in CKD […]

1 Comment Posted in Anemia, Internal Medicine for Nephrologists
March 15, 2011

Diuretic Strategies in Patients with Acute Decompensated Heart Failure

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Among patients with acute decompensated heart failure, there were no significant differences in global assessment of symptoms or in renal function when diuretic therapy was administered by bolus versus continuous infusion or at high dose verus low dose.

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February 8, 2011

Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies

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This review nicely summarizes the diagnosis and management of cognitive impairment and dementia in dialysis patients.

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August 20, 2010

Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease.

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Theses guidelines have been prepared by British Thoracic Society Standards of Care Committee and Joint Tuberculosis Committee. Free full text kindly provided through the British Thoracic Society website.

Comments Off on Guidelines for the prevention and management of Mycobacterium tuberculosis infection and disease in adult patients with chronic kidney disease. Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists
July 20, 2010

Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin – JUPITER Controversy A Critical Reappraisal

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This article critically reviews the trial JUPITER which reported a substantial decrease in the risk of cardiovascular diseases among patients without coronary heart disease and with normal or low cholesterol levels. Concern was expressed that the trial was flawed as it was discontinued (according to prespecified rules) after fewer than 2 years of follow-up, with […]

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February 12, 2010

The Management of Diabetic Neuropathy in CKD

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This indepth review looks at diabetic autonomic and peripheral neuropathy in patients with stages 4-5 CKD or ESRD undergoing dialysis. The evidence supporting the available therapeutic options and the challenges associated with providing adequate care as well as future directions for investigation are discussed.

2 Comments Posted in Chronic Kidney Disease, Internal Medicine for Nephrologists, Review
December 14, 2009

Contraindicated Medication Use in Dialysis Patients Undergoing Percutaneous Coronary Intervention

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This observational study identified that patients with renal failure undergoing PCI (percutaneous coronary intervention) frequently receive contraindicated anticoagulants such as enoxaparin and eptifibatide.  Such exposure was associated with an increased risk of in-hospital major bleeding.

Comments Off on Contraindicated Medication Use in Dialysis Patients Undergoing Percutaneous Coronary Intervention Posted in Internal Medicine for Nephrologists, Vascular Disease/Calcification
November 22, 2009

Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II–Receptor Blockers for Ischemic Heart Disease

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November 22, 2009

The intersection of risk and benefit: is warfarin anticoagulation suitable for atrial fibrillation in patients on hemodialysis?

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This article reviews the evidence for and against warfarin anticoagulation for atrial fibrillation in the hemodialysis population. Recommendations and techniques of risk stratification, based on the existing evidence, are offered and discussed.

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September 13, 2009

Influence of Renal Function on the Effects of Early Revascularization in Non-ST-Elevation Myocardial Infarction

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From Circulation: “Early invasive therapy is associated with greater 1-year survival in patients with non-ST-elevation myocardial infarction and mild-to-moderate renal insufficiency, but the benefit declines with lower renal function, and is less certain in those with renal failure or on dialysis.”

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September 13, 2009

Heparin-induced thrombocytopenia: a renal perspective

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From Nature.com: “Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome in which one or more clinical events, usually thrombocytopenia or thrombosis, are temporally related to heparin administration and caused by HIT antibodies. This Review examines HIT from a renal perspective, discussing manifestations of HIT in patients on renal replacement therapy, the recent association of HIT with […]

Comments Off on Heparin-induced thrombocytopenia: a renal perspective Posted in Clinical Nephrology, Internal Medicine for Nephrologists, Review