Kidney Week 2018

Association of Acute Kidney Injury with Progression to Acute and Chronic Kidney Disease

San Diego—There are strong ties between acute kidney injury (AKI) and the pathogenesis of chronic kidney disease (CKD), and between AKI and increased risks for hospital readmission, progression to end-stage renal disease, and mortality. Acute kidney disease (AKD) is the bridge between AKI and CKD, and may represent a potentially modifiable stage in the progression of kidney disease. Kevin Ho, ... Read More »

Surprise Question Associated with Risk of Hospitalization in Patients with CKD

San Diego—Patients with chronic kidney disease (CKD) are at high risk for hospitalization. The surprise question (SQ), “Would you be surprised if this patient died within the next 12 months?,” is a provider-based subjective health measure. There have been studies examining the association between the SQ and the risk of mortality in patients with advanced CKD; however there are few ... Read More »

Consultations for Approval of Peripherally Inserted Central Catheters Examined

San Diego—Currently, guidelines advise against placement of peripherally inserted central catheters (PICCs) in stage 3 to 5 chronic kidney disease (CKD) without nephrology consultation in an attempt to preserve veins for creation of future arteriovenous fistula access for hemodialysis. Nephrology input is also often required for PICC placement for patients with acute kidney injury (AKI). There are no official guidelines ... Read More »

RAASi Continuation Rates in Medicare Patients Treated for Hyperkalemia

San Diego—For patients with high cardiovascular risk, maintaining renin-angiotensin-aldosterone system inhibitor (RAASi) therapy is critical. Patiromer, approved in 2015, is a sodium-free non-absorbed potassium-binder for treatment of hyperkalemia that has been shown to reduce recurrent hyperkalemia and allow patients to maintain RAASi therapy. Nihar Desai, MD, MPH, and colleagues recently conducted a retrospective cohort study designed to evaluate RAASi utilization ... Read More »

Patiromer in Patients with Hyperkalemia and Hyperphosphatemia

San Diego—Patiromer is a once-daily phosphate binder for the treatment of hyperkalemia; calcium is the counterexchange ion. Patients in the TOURMALINE trial were randomly assigned to patiromer 8.4 g four times a day with or without food for 4 weeks; doses were adjusted to achieve/maintain the target range of serum potassium (3.8-5.0 mEq/L). The primary end point (percentage of patients ... Read More »

Study Compares Indicators of Fluid Overload in Patients on Hemodialysis

San Diego—In patients receiving hemodialysis therapy, fluid overload is associated with increased mortality and is often undiagnosed. Diagnosis of fluid overload determined via physical examination, including systolic and diastolic blood pressure, lung crackles (rales), lower extremity edema, jugular venous distention (JVC), n-terminal pro-B-type natriuretic peptide (BNP), and findings on chest x-ray or thoracic computed tomography (CT). In addition, point-of-care ultrasound ... Read More »

Fluid Overload in Patients with AKI Requiring CRRT and Major Adverse Events

San Diego—In critically ill patients with acute kidney injury (AKI), there is an association between fluid overload and adverse outcomes. Connor W. Woodward, and colleagues recently conducted a study designed to examine the association between fluid overload and major adverse kidney events in patients with CKI requiring continuous renal replacement therapy (CRRT). Results of the single-center retrospective study were reported ... Read More »

Emergency Department Prediction Model for Acute Kidney Injury

San Diego—More than 50% of community-acquired acute kidney injury (AKI), an independent risk factor for mortality, are identified in the emergency department (ED). The ED is the primary route for acute hospital admissions. The facilitation of prompt medical assessment and treatment depends on accurate stratification of risk. David A. Foxwell, MD, and colleagues in Wales, United Kingdom, recently conducted a ... Read More »