Cover Stories

Patient Survival Similar between Hemodialysis and Peritoneal Dialysis

The cost of caring for patients with end-stage renal disease (ESRD) is driven largely by the provision of maintenance, including costs related to dialysis. Healthcare costs for patients with ESRD in 2013 in the United States exceeded $25 million, approximately 7% of all Medicare expenditures (patients with ESRD made up <0.5% of the Medicare population in that year). Compared with ... Read More »

Survival of Pediatric Kidney Transplant Recipients with FSGS Improved from 1990 to 2009

One of the main causes of end-stage renal disease (ESRD) in children is focal segmental glomerulosclerosis (FSGS), the third most common diagnosis among pediatric kidney transplant recipients in the United States. Treatment of children with FSGS post-transplant is complicated by primary disease recurrence in 15% to 64% of patients, and is linked to increased risk for allograft loss. Loss of ... Read More »

Outcomes of Left Ventricular Assist Device Placement in Patients with ESRD

For patients with advanced heart failure, left ventricular assist devices (LVADs) are used as a bridge to heart transplant as well as destination therapy to prolong survival and improve quality of life. In results of the REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) trial, compared with medical therapy alone, survival was improved with placement ... Read More »

AKI and Increased Risk of Heart Failure in Hospitalized US Veterans

The incidence of acute kidney injury (AKI) in the US population is increasing. AKI is associated with poor long-term outcomes such as the development of chronic kidney disease (CKD) and death. There may also be an association between AKI and subsequent atherosclerotic cardiovascular disease. Patients with CKD commonly develop heart failure as a manifestation of cardiovascular disease; in patients with ... Read More »

Incident Atrial Fibrillation Increases Risk of Adverse Events in Patients with Decreased eGFR

Chronic kidney disease (CKD), a common medical problem with a high disease burden, is associated with increased risk for hospitalization, adverse cardiovascular outcomes, and death. The increased risks for adverse cardiovascular outcomes include an increase in the risk for atrial fibrillation (AF). Worldwide, AF affects approximately 33 million people and is the most common arrhythmia. The incidence of AF continues ... 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 »

More Intensive Blood Pressure Control Associated with Lower All-Cause Mortality Risk

Chronic kidney disease affects an estimated 26 million people in the United States and 200 million individuals worldwide. The risks for cardiovascular disease, progression to end-stage renal disease (ESRD), and mortality are increased in people with CKD. Hypertension is a risk factor for cardiovascular disease and there have been several studies designed to identify the optimal blood pressure target in ... Read More »

Biliary Tract Disease a Distinct Extrarenal Complication of ADPKD

The most common inherited kidney disease is autosomal dominant polycystic kidney disease (ADPKD), which is characterized by progressive enlargement of the kidneys with multiple bilateral cysts, leading to eventual loss of kidney function and development of end-stage renal disease in middle age. ADPKD is the primary diagnosis for 10% of patients on renal replacement therapy in the United Kingdom and ... Read More »