Archive for the ‘Vascular Disease/Calcification’ Category

March 23, 2016

Sevelamer Versus Calcium-Based Binders for Treatment of Hyperphosphatemia in CKD: A Meta-Analysis of Randomized Controlled Trials

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This meta-analysis included 25 studies with a total of 4770 participants, of which 88% were on hemodialysis.  The results show that for patients with CKD stages 3-5 using sevelamer have lower all-cause mortality compared with those using calcium based binders. However, due to the lack of placebo-controlled studies, the benefit of phosphate binders for patients with CKD stages 3-5 and not on […]

No Comments Posted in Bone Mineral Metabolism, Clinical Trial Results, Vascular Disease/Calcification
December 21, 2013

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

The full KDIGO lipid guidelines are available here.

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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.

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December 21, 2013

Evidence-Based Cardiology in Hemodialysis Patients.

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This paper reviews RCTs to evaluate management of cardiovascular disease in hemodialysis patients.

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July 25, 2013

The demise of calcium-based phosphate binders

This editorial provides commentary on the paper Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.

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July 25, 2013

Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.

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This meta-analysis looks at the effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease.  It has been updated from a 2009 meta-analysis (read it here) looking at the same question but with the benefit of additional clinical trial data.  Analysis of the trials that reported mortality showed a 22% […]

Comments Off on Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Posted in Bone Mineral Metabolism, Chronic Kidney Disease, Vascular Disease/Calcification
November 4, 2012

Effect of Cinacalcet on Cardiovascular Disease in Patients Undergoing Dialysis

In this randomized, placebo controlled trial, patients on hemodialysis with moderate-to-severe secondary hyperparathyroidism were randomized to receive either cinacalcet or placebo.   No difference was seen in the primary composite end point (time until death, myocardial infarction, hospitalization for unstable angina, heart failure, or a peripheral vascular event) between cinacalcet (48.2%) versus placebo (49.2%) HR 0.93; 95% CI, 0.85 to […]

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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.

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September 18, 2012

Lipid-Lowering Therapy in Persons With Chronic Kidney Disease: A Systematic Review and Meta-analysis.

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This meta-analysis of lipid lowering therapy (statin or statin + ezetimibe) in patients with chronic kidney disease (CKD) showed no benefit in renal outcomes but did show a decreased risk of cardiac mortality, cardiovascular events including revascularization and myocardial infarction.

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April 5, 2012

Comparing Cardiac Surgery in Peritoneal Dialysis and Hemodialysis Patients: Perioperative Outcomes and Two-Year Survival

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This small observational study suggests that PD patients who require cardiac surgery do not experience more complications or worse 2-year survival as compared to HD patients.  It also sugggests that 2-year survival for dialysis patients after cardiac surgery is acceptable.

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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
March 15, 2011

Antihypertensive Treatment and Secondary Prevention of Cardiovascular Disease Events Among Persons Without Hypertension: A Meta-analysis

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In this meta-analysis, antihypertensive treatment was associated with decreased risk of stroke, CHF, composite CVD events, and all-cause mortality in patients without hypertension, but with a clinical history of cardiovascular disease.

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March 15, 2011

Cardiovascular Disease Medications After Renal Transplantation: Results From the Patient Outcomes in Renal Transplantation Study

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Renal transplantation reduces the risk of cardiovascular events compared to dialysis, but these patients remain a high-risk group. This large international registry study shows that use of common cardioprotective agents such as antiplatelets agents, statins, beta-blockers, ACE-inhibitors and ARBs is lower than would be expected, although their use has increased over time. Whether increased use […]

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