Concentration of Serum Calcitriol Associated with Kidney Function Decline in Older Adults

Incident heart failure and decline in kidney function are often linked conditions; both are prevalent in older individuals and are associated with high morbidity and mortality. Previous studies have demonstrated an association between lower concentrations of 25-hydroxyvitamin D and progression of chronic kidney disease (CKD), heart failure, and mortality; diabetes, higher blood pressure, and inflammation are also key risk factors ... Read More »

Hypoglycemic-Related Hospitalizations Associated with Increased Post-ESRD Mortality

Thirty to 40% of patients with diabetes mellitus will develop chronic kidney disease (CKD), and 44% of cases of incident end-stage renal disease (ESRD) in the United States are associated with diabetic kidney disease. The annual mortality rate of diabetic patients with ESRD is greater than among those with other causes of ESRD, creating a need to identify modifiable risk ... Read More »

Lanreotide and Decline in Kidney Function in Patients with ADPKD

A 2017 review of epidemiology literature resulted in an estimated prevalence of autosomal dominant polycystic kidney disease (ADPKD) of approximately three to four per 10,000. Patients with ADPKD experience progressive cyst formation in both kidneys and loss of renal function. In the majority of affected patients, end-stage renal disease requiring renal replacement therapy (RRT), dialysis or kidney transplantation, occurs between ... Read More »

Supplementation with Omega-3 Polyunsaturated Fatty Acids to Prevent Vascular Access Failure

Worldwide, the most common renal replacement therapy is hemodialysis, best performed using a functioning arteriovenous vascular access; aestablishing and maintaining functional arteriovenous vascular access remains a major challenge associated with dialysis care. Dysfunction of arteriovenous fistula (AVF) and graft (AVG) leads to prolonged use of central venous catheters and is associated with repeat hospitalization and procedures as well as higher ... Read More »

Patient Perspectives on Chronic Kidney Disease Monitoring and Self-Management

Self-management is required of patients with chronic diseases to limit disease progression, including regular monitoring visits for provider assessment, feedback, and adjustments to the care plan. These self-management directives involve a shift from passive to active disease management for the patient and require shifts in provider to patient communication approaches. Enabling higher levels of patient engagement can be informed by ... Read More »

Temporal Artery Thermometer versus Hemodialysis Machine Internal Blood Monitoring

In many hemodialysis units, measuring pre-dialysis body temperature is a routine part of care. The gold standard for measurement of body temperature is the temperature of central (core) blood; however, in the majority of clinical settings, it is not feasible to use core blood temperature. In most cases, temperature is measured at other sites, such as oral, axillary, tympanic, or ... Read More »

High Comorbid Condition Burden Associated with Withdrawal from Dialysis Therapy

Over the past decade, annual rates of dialysis therapy initiation have been relatively stable. Dialysis patients are living longer than before, creating an interest in issues such as conservative care for end-stage renal disease (ESRD), palliative care in nephrology, and withdrawal from dialysis therapy. Withdrawal from dialysis therapy is a cause of death in ~10% to 20% of patients in ... Read More »

Patients with Advanced CKD Describe Emotional Impact of Their Illness and Treatment

Patients with advanced chronic kidney disease (CKD) have a high symptom burden and a high prevalence of comorbid conditions, as well as limited life expectancy. Studies designed to examine patients’ healthcare experiences suggest that patient concerns can be opposed to those of providers. The Institute of Medicine defines patient-centered care as “care that is respectful of and responsive to individual ... Read More »

Germline Mutations May be Prevalent in Patients with Renal Cell Carcinoma

Renal cell carcinoma (RCC) affects approximately 64,000 patients in the United States every year; it is one of the ten most frequently diagnosed cancers nationwide. On initial diagnosis, approximately 30% of patients present with locoregional (stage III) or metastatic disease. Clear cell RCC (ccRCC) is the most common subtype of RCC and is characterized by loss of function of the ... Read More »

Predictors of Early Technique Failure in Peritoneal Dialysis

Technique failure in peritoneal dialysis is a major complication of the modality and is associated with risk to patients. The first year on peritoneal dialysis is a particularly vulnerable period; just less than half of patients on peritoneal dialysis who experience technique failure do so within the first year of treatment. Published rates of early technique failure vary, but the ... Read More »