Review and Meta-Analysis to Assess Renal Outcomes with Intensive Blood Pressure Control

Patients with chronic kidney disease face increased risk of diabetes, cardiovascular morbidity, and mortality; nondiabetic CKD accounts for most of the incidence worldwide. Hypertension is strongly associated with the development of progression of nondiabetic CKD, and control of blood pressure can decrease the risk of decline in renal function and cardiovascular mortality. However, according to Wan-Chuan Tsai, MD, and colleagues ... Read More »

Three versus Four Daily Exchanges in Continuous Ambulatory Peritoneal Dialysis and Residual Kidney Function

Survival and quality of life for patients on dialysis are associated with residual kidney function. The preferred modality for preservation of residual kidney function is peritoneal dialysis, according to Hao Yan, MD, and colleagues in the department of nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University and Shanghai Center for Peritoneal Dialysis Research, Shanghai, China. The preservation of residual ... Read More »

Peritoneal Dialysis Compared with Hemodialysis in Infants Younger than One Year

Pediatric nephrologists face significant challenges in managing infants requiring maintenance dialysis. Factors such as difficulties feeding and maintaining fluid balance, growth failure, increased risk of infection, and possible comorbid conditions contribute to the management hurdles in children younger than 1 year. Due in part to these challenges, infants with kidney failure on maintenance dialysis have higher mortality rates than older ... Read More »

Appropriateness of Antibiotics Prescribed to Hemodialysis Patients

Worldwide, mortality and hospitalization in patients receiving maintenance hemodialysis are due, in part, to infection. Individuals in this patient population are also at risk of infections caused by multi-drug resistant organisms. Inappropriate use of antibiotics is a driver for the acceleration of antimicrobial resistance, giving rise to global efforts to optimize antimicrobial use. Patients in Australia receive maintenance hemodialysis in ... Read More »

Fall Injury Risk in Older Adults Increases after Dialysis Therapy Initiation

Among community-dwelling older adults, falls are the leading cause of injury-related hospitalizations and may lead to disability and death. More than one in three older adults fall each year, and nearly half of those falls result in injury. Earlier studies have demonstrated that serious fall injuries commonly occur among older adults with chronic kidney disease (CKD); higher levels of albuminuria ... Read More »

Associations between eGFR and Reduced Cognitive Function Stronger in Older Individuals

Reduced estimated glomerular filtration rate (eGFR) and albuminuria have both been shown to be associated with lower cognitive performance in older individuals. The association is not consistent, however. Reduced eGFR may lead to the accumulation of neurotoxins or it may represent lifetime exposure to cardiovascular disease (CVD) risk factors to CVD itself. Albuminuria may be a biomarker of generalized endothelial ... Read More »

Home Telemonitoring of Patients with Chronic Kidney Disease

Worldwide, the majority of healthcare expenditures are attributed to chronic illness. Management of patients with chronic illness involves multiple care providers, often at multiple locations. Coordination of care in the nephrology setting is particularly important; studies have documented that coordinating care between healthcare providers is associated with earlier nephrology referral, resulting in reduced morbidity, mortality, overall cost, and the number ... Read More »

Complications of Urgent-Start Peritoneal Dialysis

Peritoneal dialysis offers benefits to patients with end-stage renal disease (ESRD) in terms of lifestyle flexibility and preservation of residual kidney function. However, worldwide, most patients with uremia are treated with hemodialysis. Reasons for the underutilization of peritoneal dialysis include a low level of experience initiating the modality in patients with ESRD, particularly those with severe symptoms of uremia and ... Read More »

PCI versus Optimal Medical Management in Patients with Advanced Chronic Kidney Disease

Coronary artery disease is a common comorbidity in individuals with advanced chronic kidney disease (CKD). Patients with CKD and coronary artery disease may benefit from cardiovascular procedures, such as percutaneous coronary intervention (PCI), that require use of intravenous contrast. However, use of contrast dye may result in contrast-induced nephrology (CIN). In patients with advanced CKD, CIN may precipitate the need ... Read More »

Incidence of Renal Replacement Therapy in Elderly Patients in Nephrology Care

Recent estimates put the population prevalence of chronic kidney disease (CKD) in the United States at 13%. CKD affects patients of all ages, but there is a strong positive association of CKD with age; the prevalence of CKD among individuals >70 years of age is 50%. Among elderly patients diagnosed with stable CKD stage 3, management by the primary care ... Read More »