Cover Stories

Sodium Zirconium Cyclosilicate for Management of Predialysis Hyperkalemia

Renal potassium excretion is severely reduced in patients with end-stage renal disease (ESRD), requiring hemodialysis or peritoneal dialysis to maintain normal serum potassium levels. However, despite receiving dialysis, many patients experience persistent predialysis hyperkalemia, a condition that is potentially life-threatening and associated with cardiac arrhythmias and death. There is an association between a serum potassium concentration of ≥5.6 mmol/L and ... Read More »

Sevelamer Carbonate Effects on Patients with CKD and Proteinuria

Although chronic kidney disease (CKD) has reached epidemic proportions worldwide, the factors associated with progression of the disease are not completely understood. The best predictor of decline in glomerular filtration rate (GFR) in the long term is proteinuria. Interventions designed to achieve remission of proteinuria, i.e., optimal renin-angiotensin system (RAS) blockade, slow progressive loss of kidney function in patients with ... Read More »

Predicting Long-Term Outcomes in Immunoglobulin A Nephropathy

Worldwide, immunoglobulin A (IgA) nephropathy (IgAN) is one of the most common types of primary glomerulonephritis; in Asian regions, IgA accounts for ~45.3% of cases of primary glomerulonephritis. Clinical presentation of IgAN varies widely, from isolated hematuria to rapid progression to kidney failure. Patients may also present with a variety of histologic lesions, from mild mesangial hypercellularity to crescentic glomerulonephritis ... Read More »

Anxiety Associated with Mortality and Hospitalization in Patients on Dialysis

Patients with end-stage renal disease on maintenance dialysis have a high prevalence of mood disorders, most commonly depressive and anxiety disorders. When using a cutoff value in self-report questionnaires, the prevalence for anxiety symptoms ranges from 39% to 53%, and for depressive symptoms, the range is from 37% to 42%. These symptoms have an impact on a patient’s quality of ... Read More »

Postdialysis Hypokalemia and All-cause Mortality in Patients on Hemodialysis

Among patients on hemodialysis, the mortality rate is 13.6 per 100 person-years, higher than in the general population. Sudden cardiac death is the leading cause of death in patients on hemodialysis, caused primarily by hyperkalemia, making serum potassium of particular interest in the management of dialysis patients. Serum potassium levels during dialysis are determined on the basis of the predialysis ... Read More »

Volume Overload and Survival in Patients on Peritoneal Dialysis

Patients on peritoneal dialysis receive individualized dialysis prescription by combining various techniques (automated versus manual), dialysis solutions (tonicity, biocompatibility, type of osmotic agent), and number and duration of dwells. The goal is to optimize maintenance of residual kidney function, preserve the peritoneal membrane, and control uremic symptoms, volume, and nutritional status, all designed to prolong technique and patient survival. In ... Read More »

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 »