Mortality Risk in Elderly Patients Varies with Dialysis Modality

Clinical Journal of the American Society of Nephrology. 2015.10(6):983-993. Elderly patients with end-stage renal disease may he at high risk for death, but have a low chance of receiving kidney transplantation. The optimal choice between hemodialysis and peritoneal dialysis in this population has not been resolved. Seung Seok Han, MD, and colleagues at the Seoul National University College of Medicine, ... Read More »

T3 Syndrome Associated with Risk for Cardiovascular Complications

Clinical Journal of the American Society of Nephrology. 2015.10(6):975-982. It has been reported that there is a direct association between low triidothyronine (T3) syndrome and cardiovascular mortality in patients receiving hemodialysis. However, according to Tae Ik Chang, MD, and colleagues, there are few data on low T3 syndrome in patients on peritoneal dialysis. The researchers conducted a prospective, observational study ... Read More »

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 »

Phase 3 CRUISE Trials Find Triferic™ Maintains Hemoglobin without Increasing Ferritin

The phase 3 CRUISE trials, published in Nephrology Dialysis Transplantation, determined that Triferic™ administered via dialysate maintains hemoglobin concentration without increasing ferritin. The randomized, single-blind, placebo-controlled studies examined the safety and efficacy of Triferic™ compared with placebo in patients with chronic hemodialysis. In patients receiving Triferic™, the drug was added to the bicarbonate hemodialysis concentrate, while the placebo cohort receiving ... Read More »

PRIME Study Examines the Safety and Efficacy of Triferic™ in Patients with Chronic Hemodialysis

A recent PRIME study published in Kidney International found that Triferic™ (ferric pyrophosphate citrate) administered via dialysate reduced erythropoiesis-stimulating agent (ESA) requirement compared to placebo while maintaining hemoglobin. This 9-month, prospective, randomized, placebo-controlled, double-blind, multicenter trial sought to determine the safety and efficacy of Triferic™ in a total of 103 patients who were randomized to receive Triferic™ (n=52) or placebo ... 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 »