Patient and Caregiver Perspectives on Advance Care Planning

With advance care planning, patients are able to consider and communicate current and future treatment goals. For patients with kidney disease and their caregivers, advance care planning can be an emotionally charged process. Marcus Sellars, PGD Psych, and colleagues in Australia, conducted a qualitative study designed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and ... Read More »

Automated AKI Alert System Improves Patient Outcomes

Acute kidney injury (AKI) is associated with loss of kidney function and increased risk of mortality, yet there is no established universal treatment for AKI. Patients with AKI are treated with an individualized approach and avoidance of nephrotoxic events. It is clear that early detection of AKI events is key to improving outcomes; the role of the nephrologist is also ... Read More »

Higher Environmental Heat Associated with Risk of Acute Kidney Injury in a Northern Climate

Worldwide, increases in carbon dioxide emissions is leading to global warming, resulting in more frequent, more intense, and longer lasting heat waves. Underlying the pathogenesis of heat-related morbidity is multiple organ dysfunction; the kidneys appear to be particularly vulnerable. It is thought that acute kidney injury (AKI) during heat waves occurs primarily from volume contraction. Some ability to thermoregulate may ... Read More »

Insulin Sensitivity and Risk for Hyperfiltration in Youth with Type 2 Diabetes Mellitus

The leading cause of end-stage renal disease (ESRD) is diabetic kidney disease. Among children and adolescents with type 2 diabetes mellitus (T2DM), early diabetic kidney disease, including hyperfiltration and increased excretion of albumin, is common; progression occurs at “an alarming rate,” according to Peter Bjornstad, MD, and colleagues. In a small cohort of 46 adolescents with T2DM, the prevalence of ... Read More »

Alert System Reduces Odds of Overlooked AKI Events among Hospitalized Patients

Decline in kidney function and increased risk for mortality are closely associated with acute kidney injury (AKI). To date, there is no universal treatment for AKI, although several therapeutic and preventive interventions have been developed. It is widely accepted that early detection of AKI events is key to improving outcomes; the importance of nephrologist care is also well known in ... Read More »

A Review of Use of Phosphate Binders among US Dialysis Patients

In 2015, Medicare paid more than $1.5 billion for phosphate binders for patients on dialysis in the United States and for patients with chronic kidney disease (CKD). Previous analyses have shown that phosphate binders are the most commonly used medications for treatment of CKD-mineral and bone disorder (MBD). The analyses also demonstrated a faster increase in Part D costs for ... Read More »

Risk of VTE Increases with Albuminuria in Patients with Normal eGFRs

There is an increase in the risk of venous thromboembolism (VTE) in patients with chronic kidney disease (CKD) with elevated albuminuria or with low estimated glomerular filtration rate (eGFR). However, according to David Massicotte-Azarniouch, MD, and colleagues, it is unclear whether the increased risk of VTE associated with albuminuria differs by level of kidney function. Noting that clarifying the individual ... Read More »

Kidney Markers and Cognitive Impairment: SPRINT Study Baseline Data

Chronic kidney disease (CKD) among older adults affects as many as 26 million individuals in the United States. As the worldwide population ages, the prevalence of CKD increases, possibly reflecting the accompanying increase in cardiovascular risk factors such as hypertension, diabetes, and obesity. CKD stage 3 or 4 affects nearly 11% of individuals 60 to 69 years of age and ... Read More »

Risk of Bone Fracture Assessed Using Modified Creatinine Index

Individuals with chronic kidney disease (CKD) are at increased risk for bone fracture compared with the general population. Part of the reason for the increase in risk for patients with CKD is bone fragility, mediated by various complex pathologic states including CKD-mineral bone disorder and uremic osteoporosis. Previous epidemiologic studies have clarified the risk factors for bone fracture in this ... Read More »

Serum Potassium Level Varies by Race in Recent Observational Study

Potassium is essential for maintaining normal neuromuscular functioning, preserving fluid volumes in cells, and regulating blood pH. Out of normal range potassium levels are associated with an increased risk of all-cause and cardiovascular mortality, and cardiac arrhythmias and end-stage renal disease (ESRD). Recent studies have found that serum potassium levels are, on average, lower in African Americans compared with European ... Read More »