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Patient Perspectives on Self-Management Following Transplantation

Patients undergoing kidney transplantation experience better outcomes than those receiving maintenance hemodialysis. However, kidney transplant recipients must adhere to a complex and ongoing self-managed therapy regimen. Lack of adherence to medication regimen required following transplantation is the primary reason for transplant loss. Further, inadequate self-management undermines the benefits of transplantation and affects other health outcomes. Previous studies have demonstrated a ... Read More »

Tolvaptan Effective in Treatment of Hyponatremia in Patients in ICU

Hyponatremia, defined as serum sodium concentration ≤135 mmol/L, is the most common electrolyte disturbance in hospitalized patients, and is a risk factor for intensive care unit (ICU) and hospital mortality. In a large epidemiologic study, 14.5% of hospitalized patients presented with hyponatremia at admission and an additional 5% developed the condition during hospitalization. The increased risk of death in these ... Read More »

Response to Tolvaptan Larger for Fractional Free-Water Clearance in ADPKD Patients

Data from experimental studies suggest that arginine vasopressin (AVP) may have a key role in the pathophysiology of autosomal dominant polycystic kidney disease (ADPKD), a hereditary disease leading to formation of cysts, particularly in the kidneys, which results in enlargement of the kidney and loss of kidney function. Approximately half of patients with ADPKD require renal replacement therapy by 60 ... Read More »

Serum Phosphate Level and Socioeconomic Status Are Predictors of All-Cause Mortality in Patients with CKD

Cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) have been shown to be associated with disorders of mineral metabolism, including hyperphosphatemia. Both in individuals on chronic dialysis and in CKD patients not on maintenance dialysis, there are independent associations between serum phosphate level and cardiovascular and all-cause mortality. Proposed mechanisms for this association include endothelial dysfunction and ... Read More »

Correlations of Drug Effects on Biochemical and Mortality End Points

Surrogate outcomes key to evaluation of drug treatments in patients with chronic kidney disease (CKD) include levels of serum parathyroid hormone (PTH), phosphorus, and calcium. Suetonia C. Palmer, MBChB, PhD, and colleagues recently conducted a systematic review and meta-analysis to examine the evidence for possible correlation between drug effects on biochemical (PTH, phosphorous, and calcium) and all-cause and cardiovascular mortality ... Read More »

Perceptions of Quality of Life Benefits of Transplantation Affect Willingness to Undergo the Procedure

In the United States, there is racial disparity in access to kidney transplantation. African Americans in the United States are four times more likely to develop end-stage renal disease (ESRD) than whites, but are half as likely to undergo kidney transplantation. Further, according to researchers, even following referral for kidney transplantation, African Americans face barriers to being placed on the ... Read More »

Racial Disparities in Access to Kidney Transplantation among Children in Europe

In a recent study in Europe, there were differences in access to and outcomes of kidney transplantations depending on the race of the recipient. That was the primary finding of the study conducted by Lidwien A. Tjaden, MD, and colleagues. The researchers reported results of the study in the American Journal of Kidney Diseases [2016;67(2):293-301]. End-stage renal disease (ESRD) affects ... Read More »

Antihypertensive Medications and Risk of Hyperkalemia

San Francisco—There are few data on the association of outpatient medication use and the patterns and prevalence of hyperkalemia. Alex R. Chang, MD, MS, and colleagues recently conducted a study designed to evaluate the association between baseline antihypertensive medications and the frequency and pattern of mild (potassium >5 mmol/L) and severe hyperkalemia (>6 mmol/L) over a 2-year window. Results of ... Read More »

Diet Decreased Variation in Serum Potassium Levels in Hyperkalemic Patients

San Francisco—Among chronic kidney disease (CKD) patients with hyperkalemia taking renin-angiotensin-aldosterone system (RAAS) inhibitors, there was wide variation in levels of serum potassium in a recent study. The variation decreased following 24 hours on a 60 mEq potassium diet. Those were among the findings of the study conducted by David A. Bushinsky, MD, and colleagues reported during a poster session ... Read More »

Patiromer Safe and Effective in Reducing Serum Potassium Levels in Hyperkalemic Patients

Hyperkalemia, defined as serum potassium concentrations above the upper limit of normal (>5.0 mEq/L), is potentially life threatening. Patients with stage 3 or greater chronic kidney disease (CKD), and diabetes mellitus or heart failure, or both, being treated with renin-angiotensin-aldosterone system (RAAS) inhibitors are at the highest risk for the condition. Due to the limited utility of current options to ... Read More »