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Nephrology Now

  • Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts
    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.Related Articles: Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function: A Randomized Trial. Effect of dipyridamole plus aspirin on hemodialysis graft [...]

  • Second Chances in Mineral Metabolism
    In this succinct editorial, Dr. Wolf reinforces the rationale for performing proper randomized controlled trials in bone mineral metabolism before changing clinical practice.  In addition, he provides insight into a first-in-class substudy of the ACHIEVE study which looks at the effects of cinacalcet and activated Vitamin D on FGF23 levels in ESRD. Free full text kindly [...]

  • Pediatrics: Blood pressure target for renoprotection in children
    This review summarizes results of the landmark ESCAPE trial, which has shown that lowering the blood pressure target to below the 50th percentile slows pediatric chronic kidney disease progression.Related Articles: Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio-Sis): an open-label randomised trial. Stage IV Chronic Kidney Disease Bicarbonate Supplementation Slows Progression of [...]

  • Secondary analysis of the CHOIR trial epoetin-|[alpha]| dose and achieved hemoglobin outcomes
    This interesting secondary analysis of the CHOIR trial demonstrates that patients achieving their assigned Hb target had better outcomes than those that did not achieve target.  Furthermore, those patients randomized to a higher Hb target, who actually reached that target, saw no increased risk.  This study raises the question whether it is the high dose [...]

  • Toxic Nephropathies: Core Curriculum 2010
    This addition to the AJKD Core Curriculum series reviews “Toxic Nephropathies”.Related Articles: Home Hemodialysis, Daily Hemodialysis, and Nocturnal Hemodialysis: Core Curriculum 2009 Interventional Nephrology: Core Curriculum 2009 Fomepizole for ethylene glycol and methanol poisoning. document.getElementById("post-1362-blankimage").onload(); © Nephrology Now editors for Nephrology Now, 2010. | Permalink | Add comment! | Add to del.icio.us Post tags:

  • AURORA: Is There a Role for Statin Therapy in Dialysis Patients
    This review discusses the role of statins in dialysis patients and offers insight into the interpretation of AURORA and the 4D study.Related Articles: Treatment of Anemia in Chronic Kidney Disease — Strategies Based on Evidence Lithium and chronic kidney disease Similar survival on automated peritoneal dialysis and continuous ambulatory peritoneal dialysis in a large prospective cohort. document.getElementById("post-1360-blankimage").onload(); © Nephrology Now [...]

  • The Management of Diabetic Neuropathy in CKD
    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.Related Articles: Retraction—Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic [...]

  • A Hemodialysis Patient With Muscle Cramps and Malaise After Virtual Colonoscopy
    Related Articles: Practical guidance for dialyzing a hemodialysis patient following acute brain injury. How Should Dialysis Fluid Be Individualized for the Chronic Hemodialysis Patient? – Sodium. Case Report, Hemodialysis: Atypical clinical presentation of H1N1 influenza in a dialysis patient document.getElementById("post-1356-blankimage").onload(); © Nephrology Now editors for Nephrology Now, 2010. | Permalink | Add comment! | Add to del.icio.us Post tags:

  • Water balance disorders after neurosurgery: the triphasic response revisited
    Related Articles: Lithium nephrotoxicity revisited. Hemolysis due to inadvertent hemodialysis against distilled water: Perils of bedside dialysate preparation. Renal Manifestations of Plasma Cell Disorders document.getElementById("post-1354-blankimage").onload(); © Nephrology Now editors for Nephrology Now, 2010. | Permalink | Add comment! | Add to del.icio.us Post tags:

  • Improved growth and cardiovascular risk after late steroid withdrawal: 2-year results of a prospective, randomized trial in paediatric renal transplantation
    Along with usual side effects of steroids is the impact on growth in pediatric patients. In this RCT, renal transplant recipients at least one year post-transplant were randomized to steroid continuation or withdrawal. Longitudinal growth was greater in the steroid withdrawal group. There were also improvements in blood pressure and HbA1c, with no graft losses [...]

  • Use of isoniazid chemoprophylaxis in renal transplant recipients
    Reactivation of tuberculosis post-transplant is a significant concern in countries where TB is endemic. This study randomized living-donor recipients to INH or not. Prophylaxis with INH significantly reduced the incidence of TB post-transplant, with very little hepatotoxicity.Related Articles: Humoral and Cellular Immune Responses after Influenza Vaccination in Kidney Transplant Recipients Subclinical Rejection in Stable Positive Crossmatch Kidney [...]

  • Diabetes Mellitus: A Risk Factor for Delayed Graft Function after Deceased Donor Kidney Transplantation
    This paired kidney analysis compared results of a transplantation where one recipient was diabetic and the other was not. In uni- and multivariate analyses, diabetes was associated with a significantly higher risk for DGF. The risk appeared to be greater in women rather than men. Whether the risk of diabetes is due to hyperglycemia itself [...]

  • Screening for De Novo Anti-Human Leukocyte Antigen Antibodies in Nonsensitized Kidney Transplant Recipients Does Not Predict Acute Rejection
    Several studies have shown the development of anti-donor HLA-antibodies after transplantation is a risk factor for graft loss, suggesting that antibodies should be monitored to identify patients at risk of immunologic events. In this study, patients were prospectively studied for the development of antibodies during the first year post-transplant. Anti-HLA antibodies developed at the same [...]

  • KidneyCasePlace
    Kidneycaseplace.com is a nephrology case-based educational platform that facilitates learning via CME live events and online modules. The goal of Kidneycaseplace is to advance education in nephrology and facilitate the sharing of best practices. Related Articles: Asymmetrical Dimethylarginine Is Associated with Renal and Cardiovascular Outcomes and All-cause Mortality in Renal Transplant Recipients Usual versus tight control of systolic [...]

  • Erythropoiesis-Stimulating Agents — Time for a Reevaluation
    This NEJM “Perspectives” article from the Food and Drug Administration discusses the data driving a need to re-evaluate the use of ESAs in the treatment of anemia due to chronic kidney disease.Related Articles: Stage IV Chronic Kidney Disease Does TREAT Give the Boot to ESAs in the Treatment of CKD Anemia? Benefits and harms of erythropoiesis-stimulating agents for [...]

  • Does TREAT Give the Boot to ESAs in the Treatment of CKD Anemia?
    This editorial by Dr. Ajay Singh discusses the implications of TREAT in the context of the existing evidence base on the management of anemia due to chronic kidney disease.Related Articles: Treatment of Anemia in Chronic Kidney Disease — Strategies Based on Evidence Erythropoiesis-Stimulating Agents — Time for a Reevaluation Stage IV Chronic Kidney Disease document.getElementById("post-1328-blankimage").onload(); © Nephrology Now editors for [...]

  • Stage IV Chronic Kidney Disease
    This NEJM clinical practice article highlights the management of chronic kidney disease with a look at supporting evidence and review of formal guidelines.Related Articles: Erythropoiesis-Stimulating Agents — Time for a Reevaluation Does TREAT Give the Boot to ESAs in the Treatment of CKD Anemia? KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary. document.getElementById("post-1326-blankimage").onload(); © Nephrology [...]

  • Prehypertension: epidemiology, consequences and treatment
    This review of prehypertension emphasizes the importance of diagnosing this entity early as a view to preventing cardiovascular outcomes in the population as a whole and not just those patients at high-risk.Related Articles: Cardiovascular and noncardiovascular mortality among patients starting dialysis. Daclizumab versus antithymocyte globulin in high-immunological-risk renal transplant recipients. HLA-Specific Antibodies Developed in the First Year Posttransplant [...]

  • Mycophenolate mofetil and intravenous cyclophosphamide are similar as induction therapy for class V lupus nephritis
    Results of two randomized trial using induction treatment with either MMF or intravenous cyclophosphamide were pooled in this article. At 24 weeks, the results show that both groups were similar with respect to percentage change in proteinuria and serum creatinine as end points when used to treat patients with class V lupus.Related Articles: Mycophenolate mofetil versus [...]

  • Carotid Endarterectomy Benefits Patients with CKD and Symptomatic High-Grade Stenosis
    This re-analysis of data from the North American Symptomatic Carotid Endarterectomy Trial showed that patients with stage 3 CKD and symptomatic high-grade carotid stenosis gained a large benefit in stroke risk reduction after endarterectomy. Free full text access kindly provided by the American Society of Nephrology.Related Articles: Staphylococcus aureus Infections in Hemodialysis: What a Nephrologist Should Know Liver-kidney [...]