Cover Stories

Cause of CKD among Agricultural Workers in Central America Unknown

During the past two or three decades, a large number of young workers in the sugarcane fields in Central America have been diagnosed with end-stage renal disease (ESRD). During the same time period (2002), researchers in El Salvador also reported an upsurge in chronic kidney disease (CKD). A key finding of the report was that the patients with CKD and/or ... Read More »

Tonsillectomy Associated with Outcomes in Patients with Immunoglobin A Nephropathy

Worldwide, immunoglobulin A nephropathy (IgAN) is the most prevalent primary chronic glomerulonephritis and a major cause of end-stage renal disease (ESRD). IgAN is the cause of ESRD in up to 40% of affected patients. Among patients with IgAN who reach ESRD, the mortality rate increases 5-fold; cardiovascular events account for 45% of all deaths. The genetic risk for IgAN increases ... Read More »

Smartphone App for Remote Dietary Counseling in Kidney Disease

In patients with chronic kidney disease (CKD), there is risk of mortality associated with healthy dietary patterns. Nevertheless, not all patients receive counseling from a dietitian, due, in part, to dietitian availability, travel distance, and cost. Alex R. Chang, MD, MS, and colleagues recently conducted a study to examine the feasibility of telecounseling supported by a smartphone application to reduce ... Read More »

Patients with CKD and Diabetes Have High Rates of Cardiac Rhythm Abnormalities

The leading cause of morbidity and mortality in patients with chronic kidney disease (CKD) is cardiovascular disease. Patients with CKD are also at increased risk of cardiac rhythm abnormalities including atrial fibrillation and ventricular arrhythmias compared with the general population. Cardiac rhythm abnormalities lead to poor clinical outcomes, including higher rates of death and sudden cardiac death. Identification of preclinical ... Read More »

Cognitive Impairment Influences Likelihood for Transplant Listing

Patients with end-stage renal disease (ESRD) on dialysis and patients who have received a kidney transplant may experience cognitive impairment, negatively affecting activities of daily living, quality of life, regimen adherence, healthcare costs, morbidity, and mortality. The treatment of choice for ESRD is kidney transplantation, which is associated with improved survival and quality of life. Patients seeking to be put ... Read More »

Young Adults with ESRD at Increased Risk for Cardiovascular Disease and Mortality

In patients with end-stage renal disease (ESRD), including children and adults, cardiovascular disease (CVD) is a leading cause of morbidity and mortality. In individuals ≥45 years of age, 87% have developed CVD at the time of ESRD onset and approximately 50% of deaths are attributed to CVD. In children with ESRD in the United States, CVD-related mortality occurs in 23%; ... Read More »

NSAID Use and Risk of Kidney Disease in Active Young and Middle-Aged Adults

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the United States in both prescription and over-the-counter forms is widespread; more than 70 million prescriptions for NSAIDs are written each year. NSAID use in 2010 was estimated at more than 29 million US adult regular users; an increase of 41% from 2005. Self-reports of over-the-counter and prescription NSAID use revealed that 90% ... Read More »

Quality Improvement Project: Change in Routine Blood Work Intervals from 4 to 6 Weeks

Complications associated with long-term dialysis therapy include anemia, chronic kidney disease–mineral and bone disorder (CKD-MBD), and electrolyte abnormalities. Management and treatment of these complications requires regular surveillance blood work for patients on dialysis therapy. More frequent blood work results in closer monitoring of patients; however, differences in laboratory testing volumes among institutions have not been associated with clinical outcomes in ... Read More »

Dialysis Modality and Rates of Incident Atrial Fibrillation in Older Adults

Atrial fibrillation (AF), the most common sustained arrhythmia in the general population, is particularly common among patients with end-stage renal disease (ESRD). The prevalence of AF is as high as 10% among patients in the United States on hemodialysis. There is a steep increase in the percentage with age, reaching as high as 25% of patients ≥85 years of age. ... Read More »