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Blood Pressure and Risk of Disease Progression

Clinical Journal of the American Society of Nephrology. 2015.10(6):934-940. The optimal blood pressure (BP) target to reduce adverse clinical outcomes in patients with chronic kidney disease (CKD) is not well defined. Shyamal Palit, MD, and colleagues conducted a study designed to examine the relationship between BP and death, cardiovascular events (CVEs), and progression of kidney disease in patients with advanced ... Read More »

RRT Intensity and Biomarkers in Critically Ill Patients

Clinical Journal of the American Society of Nephrology. 2015.10(6):926-933. Circulating plasma concentrations of inflammatory and apoptosis markers associated with subsequent dependence on renal replacement therapy (RRT) and death are higher in critically ill patients requiring RRT. However, according to Raghavan Murugan, MD, and colleagues, there are few data on whether there is an association between intensive dosing of RRT and ... Read More »

Rigorous Blood-Pressure Control Is Beneficial in Patients with Early ADPKD

In patients at early stages of autosomal dominant polycystic kidney disease (ADPKD), compared with standard blood-pressure control, rigorous blood-pressure control was associated with a slower increase in total kidney volume. That was one of the findings of a double-blind, placebo-controlled trial conducted recently by Robert W. Schrier, MD, and colleagues. The researchers reported study results in the New England Journal ... Read More »

Study Examines Performance of Tunneled Cuffed Catheters

A high rate of infection and thrombus-related dysfunction are complications associated with long-term use of tunneled cuffed catheters for hemodialysis. The NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) clinical guidelines discourage use of tunneled cuffed catheters due to the risk of infection, thrombosis, and fibrin sheath formation that may cause inadequate and/or irregular blood flow rates and the risk ... Read More »

Estimated GFR Surrogate End Points in CKD Trials

As part of an analysis done in conjunction with a workshop sponsored by the National Kidney Foundation and the US Food and Drug Administration (FDA), Tom Greene, PhD, and colleagues released findings in the American Journal of Kidney Diseases [2014;64(60:867-879]. The workshop, GFR Decline as an Endpoint for Clinical Trials in CKD, was held in 2012. An FDA accepted end ... Read More »

Lesser eGFR Declines as Alternative End Points in Trials of Progression of CKD

Results of a recent meta-analysis, combined with the report from the 2012 workshop, GFR Decline as an Endpoint for Clinical Trials in CKD, and three reviews from the workshop analytical group, provide support for the use of lesser declines in estimated glomerular filtration rate (eGFR) as a surrogate end point in trials of progression of chronic kidney disease (CKD). That ... Read More »

Progressive Loss of Kidney Function in HD Patients and Angiotensin Blockade

Among patients on hemodialysis (HD), treatment with irbesartan did not have significant affect on decline in glomerular filtration rate (GFR) or urine volume during 1 year of treatment. That was the primary finding of a study reported by Krista Dybtved Kjaergaard, MD, PhD, and colleagues in the American Journal of Kidney Diseases [2014;64(6):892-901]. All-cause mortality is 6.7 to 8.5 times ... Read More »

Can the Nephrologist Continue to Survive in Private Practice?

From the Editorial Board Kenneth A. Liss, DO Hypertension & Nephrology Associates Eatontown, New Jersey   I was honored to be asked to be a member of Nephrology Times editorial board because it represents a journal that plays an important role in educating nephrologists, fellows, and residents. In addition, unlike most members of editorial boards who represent some of the ... Read More »

Three Definitions for Incidence and Staging of AKI in Children

Clinical Journal of the American Society of Nephrology. 2015;10(4):554-561. Application of three definitions of acute kidney injury (AKI) resulted in differences in incidence and staging in AKI in children in an observational, electronic medical record(EMR)–enabled study conducted by Scott M. Sutherland, MD, and colleagues. There are several standardized definitions for AKI, but no consensus about which to use in children. ... Read More »

Biomarkers Associated with Rate of Incident Heart Failure

Journal of the American Society of Nephrology. 2015. 26(4):946-956. In a recent study, there was strong association between high-sensitivity troponin T (hsTnT and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and incident heart failure in individuals with mild to severe chronic kidney disease (CKD). These biomarkers are strong predictors of heart failure in the general population. Nisha Bansal, MD, MS, and colleagues ... Read More »