Examining Short-Term Within-Person Variability in Clinical Markers of Kidney Function

Chronic kidney disease (CKD) is defined by abnormalities in glomerular filtration rate (GFR) and/or albuminuria; CKD affects approximately 10% of the US population. Endogenous plasma or serum filtration markers, most commonly creatinine, are used to estimate GFR; albuminuria is quantified by measuring urinary albumin concentration (UAC) or urinary albumin-creatinine ratio (UACR). There are well established reference ranges for estimated GFR ... Read More »

Limiting Interdialytic Weight Gain in Patients on Hemodialysis

Many patients on chronic hemodialysis therapy exceed the recommended values of interdialytic weight gain (IDWG) of 4.0% to 4.5% of dry weight; some have IDWG of 10% to 20%. There are associations between higher IDWG and increased risk of all-cause and cardiovascular death. IDWG has also been shown to be a risk factor for increased morbidity, including ventricular hypertrophy and ... Read More »

Dietary Implications of Renal Impairment and Levels of Toxic Metabolites

According to Michael Pignanelli, BMSc, and colleagues, variations in atherosclerosis burden can only be partly explained by traditional risk factors for coronary heart disease (CHD), and genetic variants may account for only 10.6% of heritability of CHD. Following treatment with usual care for traditional risk factors, the risk of cardiovascular events remains approximately 40%. There is an independent association between ... Read More »

Burden of Chronic Kidney Disease Increased and Varied by State from 2002 to 2016

Over the past 15 years, the United States has seen demographic, social, and epidemiologic changes; there have also been substantial increases in measures of sociodemographic development and exposure to risk factors for chronic kidney disease (CKD) over the same period. To date, there has not been a detailed quantitative analysis of the change in burden of CKD. Benjamin Bowe, MPH, ... Read More »

Vascular Access Selection in Elderly Patients Involves Tradeoffs

For patients receiving maintenance hemodialysis, vascular access provides a critical conduit for the delivery of blood to the extracorporeal circuit. More than 80% of patients initiating hemodialysis in the United States do so with a central venous catheter (CVC); most then undergo placement of a permanent vascular access, either an arteriovenous fistula (AVF) or graft (AVG). Until the AVF or ... Read More »

Consumption of Fruits and Vegetables Decrease Risk of Cardiovascular Mortality

San Diego—An international group of researchers, led by Camilo G. Sotomayor, conducted a prospective cohort study to examine the associations of consumption of fruits and vegetables following kidney transplantation and the risk of cardiovascular mortality. The study population included an extensively phenotyped cohort of renal transplant recipients with long-term follow-up. Results of the study were reported during a poster session ... Read More »

Neurocognitive Impairment in CKD in Children and Young Adults May Be Functional Rather than Structural

Children and adults with chronic kidney disease (CKD) often experience neurocognitive dysfunction. Children with CKD may have reduced performance in attention, memory, executive function, verbal and nonverbal reasoning, and spatial processing. Global cognitive performance may be reduced in adults with CKD; further, patients may experience specific cognitive impairments such as attention, memory and executive functioning, and dementia. There is relatively ... Read More »

Metabolic Abnormality and Obesity Associated with Rate of CKD Progression

Obesity, a worldwide major health problem, is associated with increased risk for type 2 diabetes mellitus, cardiovascular disease, cerebrovascular events, and malignancy, resulting in increased rates of cardiovascular and all-cause mortality. Studies have also demonstrated an increased risk of developing incident chronic kidney disease (CKD); however, it is unclear whether obesity itself worsens kidney function in patients with CKD. Results ... Read More »

Reduced eGFR Associated with Increased Sedentary Time in Canadian Study

In the general population, ≥50% of awake time is spent in sedentary activities. Studies have shown that sedentary behavior, independent of physical activity level, is a risk factor for adverse health outcomes, including increased risk for diabetes and all-cause and cardiovascular mortality, and higher rates for chronic disease. There is an association between increased sedentary time and lower health-related quality ... Read More »

Bundled Payment Reform Effects Rates of Vitamin D Therapy Initiation

Beginning in 1972, all patients in the United States with end-stage renal disease (ESRD) have been eligible for Medicare. The number of patients with ESRD requiring maintenance hemodialysis has increased from 16,000 to >400,000 in the years since. Individuals in that patient population represent <1% of all Medicare beneficiaries, but costs for those on maintenance hemodialysis account for 7.4% of ... Read More »