Author Archives: nephuser

Patient Networks Promote Living Donor Transplantation Conversations

New Orleans—Ideas, attitudes, and behaviors are known to spread within social networks; however, there are few available data on the structure and influence of social networks within the framework of hemodialysis clinics. Avrum Gillespie, MD, and colleagues utilized a survey and observational data to examine the role of patient hemodialysis social networks and discussions of living donor kidney transplantation. Results ... Read More »

Nocturnal Hypertension in Pediatric Transplant Recipients

New Orleans—Pediatric kidney transplant recipients commonly exhibit nocturnal hypertension and non-dipper status during ambulatory blood pressure monitoring, both of which are associated with cardiovascular risk in adults. Christine B. Sethna, MD, and colleagues conducted an open label, blinded end point clinical trial to examine the chronotherapeutic alteration of anti-hypertensive medication on nocturnal hypertension and non-dipper status in a cohort of ... Read More »

Changes in Hospitalization in Transplant Recipients with CMV Infection

New Orleans—With increasing use of more aggressive immunosuppressive therapies, cytomegalovirus (CMV) infection has become a frequent complication of kidney transplantation. It is unclear how the burden of inpatient hospitalization related to CMV has changed over time in the United States. Neetika Garg, MD, and colleagues utilized the National Inpatient Sample 2004-2014 to identify hospitalizations with primary or secondary diagnosis of ... Read More »

BMI and the Risk of Graft and Patient Failure in Kidney Transplantation

New Orleans—Previous studies in kidney transplant recipients with high body mass index (BMI) have yielded conflicting results; some studies reported inferior outcomes compared with patients with lower BMI and others reported superior outcomes in patients with high BMI compared with lower BMI. Whether BMI is a significant independent risk factor for graft failure and patient death in the modern immunosuppressive ... Read More »

Citizenship Status and Outcomes after Kidney Transplantation

There are approximately 6000 undocumented immigrants in the United States with end-stage renal disease (ESRD), based on data from 2014. All US citizens with end-stage kidney disease are eligible for maintenance dialysis; however, care for undocumented immigrants is fragmented. Some states extend the eligibility for scheduled maintenance dialysis to that patient population; others provide dialysis only when the patient’s condition ... Read More »

Prediction Models for CKD Following AKI Developed and Validated

Hospitalized patients who experience acute kidney injury (AKI) are at increased risk for poor long-term outcomes. Results of studies conducted between 2008 and 2017 demonstrated that while usually reversible, in some patients AKI results in incomplete recovery of kidney function and in others accelerated loss of kidney function and an increased risk of chronic kidney disease (CKD). Current practice guidelines ... Read More »

Deprescribing Tool to Reduce Polypharmacy in Hemodialysis Patients

Polypharmacy is the “use of multiple medications or the use of more medications than are medically necessary.” There are associations between polypharmacy and decreased adherence to medication regimens as well as increased risk for adverse effects, falls, hospital admissions, and mortality. Among patients on maintenance hemodialysis, the estimated average number of medications is 12 per day, the highest pill burden ... Read More »

Identifying Rapid Progression in Patients with ADPKD

New Orleans—The most frequently inherited kidney disease is autosomal dominant polycystic kidney disease (ADPKD). The progressive cyst growth associated with ADPKD, combined with interstitial damage, causes progressive kidney failure; there is wide variation of the severity of ADPKD among this patient population. The European Medicines Agency has approved tolvaptan for adults with CKD stage 1 to 3 at baseline who ... Read More »

Effects of Patiromer on Markers of Mineral Metabolism

New Orleans—The TOURMALINE study examined the use of patiromer to treat patients with hyperkalemia. Patiromer is a non-absorbed potassium-binding polymer that is FDA approved for the treatment of hyperkalemia; it uses calcium as the counter-exchange ion. Results of the 4-week TOURMASLINE study demonstrated that, when given without food, once daily patiromer reduced serum potassium similarly to when given with food. ... Read More »

Allopurinol Lowers Uric Acid Levels in Adults with CKD Stage 3

New Orleans—There is an association between hyperuricemia and progression of kidney disease. Early data suggest that lowering serum uric acid in patients with kidney disease may slow progression. However, there are few data on whether lowering levels of serum uric acid improves markers of kidney damage in chronic kidney disease (CKD). Loni J. Perrenoud and colleagues at the University of ... Read More »