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 »

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 »

No Differences in Outcomes of HLA-Incompatible Living Donor Transplantation versus Other Models

New Orleans—Due to the shortage of available kidneys for transplantation, human leukocyte antigen (HLA)-incompatible living donor kidney transplantation is utilized to increase opportunity for sensitized end-stage renal disease patients. There are inconsistencies in outcomes associated with HLA-incompatible kidney transplantation, however. Data in the United States demonstrated better outcomes for patients undergoing HLA-incompatible kidney transplantation compared with HLA-compatible deceased donor transplantation ... Read More »

KDIGO Recommendations for Slowing CKD Progression

New Orleans—Several measures for prevention of progression of chronic kidney disease (CKD) were included in 2012 recommendations in guidelines from Kidney Disease Improving Global Outcomes. The measures include blood pressure control, use of renin-angiotensin system inhibitors (RASi), and dietary advice. There are few data on whether the recommendations are followed in current nephrology practice. Benedict Stengel, MD, and colleagues recently ... Read More »

AKI Common in Patients Treated for Cancer

New Orleans—There is an increased risk for acute kidney (AKI) among patients being treated for cancer; however, there have been limited studies on the incidence of AKI and risk factors in the current treatment era. Researchers in Canada conducted a population-level cohort study using linked administrative databases that included all patients who initiated systemic therapy, including chemotherapy and targeted agents, ... Read More »

Effectiveness of Tolvaptan in Patients with ADPKD

New Orleans—Researchers in Japan, led by Shigeo Horie, MD, recently conducted a study designed to examine the influence of genetic factors on the efficacy of treatment with tolvaptan in patients with approved autosomal dominant polycystic kidney disease (ADPKD). They reported results during a poster session at Kidney Week 2017 in a poster titled Pharmacogenomics of Tolvaptan’s Inhibitory Effect on Kidney ... Read More »

Kidney Injuries at a Level 1 Trauma Center

Orlando—Elmhurst Hospital Center at the Icahn School of Medicine in Queens, New York, is a level 1 trauma center. Approximately 3% of all trauma admissions at the center are renal trauma cases; among patients who sustain abdominal trauma, as many as 10% of trauma admissions involve renal trauma. Researchers at the center, led by Jayaramakrishna Depa, MD, conducted a retrospective ... Read More »