Author Archives: Kerri Fitzgerald

Facilitating Transition of Care from Hospital Discharge to Outpatient Dialysis Unit

Orlando—The transition from hospital discharge to return to the dialysis unit is a vulnerable time for patients on maintenance hemodialysis. Unsafe transitions put patients at risk for adverse outcomes, visits to the emergency department (ED), and hospital readmission. At the University of Pennsylvania Hospital, 44% of dialysis patients discharged from the hospital had at least one ED visit within 30 ... Read More »

From the Chair: The New Mineral and Bone Disorder Guideline Update: Osteoporosis and Fracture Risk

Ajay K. Singh, MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts Fractures in chronic kidney disease (CKD) patients, particularly those that are elderly, have substantial morbidity and mortality. The Kidney Disease Improving Global Outcomes 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (KDIGO CKD-MBD)1, ... Read More »

Endovascular AVF May Be Viable Option for Vascular Access in Hemodialysis Patients

The recommended method of vascular access is the surgical creation of an arteriovenous fistula (AVF), a technique developed in 1966. At present, only 14% of patients with end-stage renal disease in the United States initiate hemodialysis with an AVF; in addition, prevalent use of AVFs is low in many regions worldwide. Factors contributing to underuse of AVF include long cumulative ... Read More »

Associated Costs Lower for Endovascular AVF Creation

Arteriovenous fistula (AVF) is the preferred access type, offering longer access survival, lower risk of mortality, and reductions in rate of infection. AVF also requires fewer interventions following successful maturation and use. Recent studies have suggested that maturation and maintenance of function may require two or more additional procedures following the initial AVF creation. Additional procedures notwithstanding, a proportion of ... Read More »

Initial Dialysis Session Duration Associated with Patient Outcomes

Following expansion of Medicare coverage to patients with end-stage renal disease (ESRD) 40 years ago, the average number of hours per hemodialysis session has decreased from 6 hours in 1973 to 3.5 to 4 hours in 2010. The decline is explained in part by the improved efficiency of dialyzers; however, there are few data on the clinical consequences of shorter ... Read More »

Risk of Hip Fracture and PPI Use in Kidney Transplant Recipients

Increased mortality, decreased mobility, and loss of independence are all associated with hip fracture. For patients with end-stage renal disease (ESRD), the risk of hip fracture is considerably elevated compared with that of the general population. The time immediately following kidney transplantation is particularly high-risk for hip fracture due to pre-existing chronic kidney disease and the associated mineral bone disease, ... Read More »

Safety and Efficacy of Belatacept as Immunotherapy in Kidney Transplant Recipients

Cyclosporine and tacrolimus, calcineurin inhibitors (CNIs), are commonly used as immunosuppressive therapy in patients who have undergone kidney transplantation. According to Josep M. Grinyó, MD, PhD, and colleagues in Buenos Aires, Argentina, those agents may be associated with patient comorbidity via nephrotoxicity and cardiovascular risk (hypertension, hypercholesterolemia, and diabetes mellitus), as well as transplant loss via chronic transplant injury. The ... Read More »

Tolvaptan Reduces Incidence of Kidney Pain in Patients with ADPKD

Patients with autosomal dominant polycystic kidney disease (ADPKD) often experience pain, a symptom reported early in the course of the disease. The pain associated with ADPKD can be severe and a challenge to manage as well as a complication that has an adverse effect on a patient’s quality of life. ADPKD-related acute pain may be caused by cyst hemorrhage, infection, ... Read More »