Patient and Graft Survival Rates in Octogenarians Undergoing Kidney Transplantation

Worldwide, the population is aging, leading to an increase in the number of individuals with chronic disease, including an increasing prevalence of older patients with end-stage renal disease (ESRD). The preferred treatment for patients with ESRD is kidney transplantation, which is relatively safe and provides survival advantage over dialysis for the majority of patients. Previous studies have demonstrated acceptable outcomes ... Read More »

Benefit-Risk Ratio of Mineralocorticoid Receptor Antagonists in Dialysis Patients Uncertain

Approximately two million people receive dialysis for end-stage renal disease worldwide. Among that patient population, the annual mortality rate is up to 20%; cardiovascular disease is the most common cause of death. Atherosclerotic disease, hypertension, and pressure-volume overload are thought to precipitate cardiac remodeling, in turn causing heart failure and arrhythmias. The mineralocorticoid aldosterone may play a key role in ... Read More »

Treatment-Induced Change in Left Ventricular Mass Invalid Surrogate End Point

One surrogate end point for cardiovascular outcomes in clinical trials is left ventricular mass (LVM). The use of LVM gained acceptance following secondary analyses of the HOPE (Heart Outcomes Prevention Evaluation) and LIFE (Losartan Intervention for End Point Reduction in Hypertension) trials. Those studies demonstrated that there was an association between regression of LVW and significant reduction in the risks ... Read More »

No Reduction in Kidney Failure-Free Days with Vasopressin for Septic Shock

According to estimates, there were more than 230,000 cases of septic shock leading to more than 40,000 deaths in the United States in 2015. While treating the underlying infection, the mainstay of cardiovascular resuscitation in septic shock is intravenous fluids and vasopressor treatment. The recommended first-line vasopressor is norepinephrine; however, there is increasing interest in the use of vasopressin as ... Read More »

Use of Antidepressants Associated with Increase in Risk of Hospitalization for Hyponatremia

Approximately one in eight older adults are affected by mood and anxiety disorders. Treatment for these disorders commonly involves use of second-generation antidepressants; more than 180 million prescriptions for those medications were dispensed in 2013 in the United States. Antidepressants are generally well tolerated; however, they carry the possibility of hyponatremia as a potential adverse effect. Hyponatremia has been associated ... Read More »

Patient-Targeted Education Increases Odds of Choosing Peritoneal Dialysis

There continues to be an increase in the prevalence of end-stage renal disease (ESRD), and while patients with kidney failure constitute <0.1% of the adult population, they account for 5% to 7% of healthcare costs in high-income countries. The high costs are driven largely by the cost of providing long-term dialysis. The two primary treatment options for patients who require ... Read More »

Effects of Statin Therapy on Renal Outcomes

Abnormal lipid metabolism is common among patients with chronic kidney disease (CKD). Results of experimental studies have demonstrated that dyslipidemia is causally associated with glomerular injury, resulting in glomerulosclerosis. In post hoc analyses of several previous trials, there was a significant association of dyslipidemia with increased risk for reduced kidney function or faster decline in estimated glomerular filtration rate (eGFR) ... Read More »

Serum Cystatin C as a Marker for AKI Diagnosis in Children

Among critically ill children, high rates of morbidity and mortality are associated with the development of acute kidney injury (AKI). AKI is a common complication among pediatric patients admitted to the intensive care unit (ICU). The origin of AKI in the pediatric population varies, ranging from simple dehydration, which is managed by volume repletion, to multifactorial causes in children who ... Read More »

Sodium Intake Not Associated with Progression of Chronic Kidney Disease

There is a higher mortality rate among individuals with chronic kidney disease (CKD) than in the general population and the rate increases as estimated glomerular filtration rate (eGFR) declines. A key therapeutic target in the treatment of CKD is preservation of kidney function and avoidance of end-stage renal disease. Recommendations aimed at preserving kidney function include control of dietary sodium ... Read More »

January/February 2017: Abstract Roundup

Chronic Kidney Disease Coffee Consumption and Risk of CKD International Journal of Clinical Practice. doi: 10.1111/ijcp.12919 Researchers, led by Karn Wijarnpreecha, MD, conducted a literature search and meta-analysis to assess the association between consumption of coffee and chronic kidney disease (CKD). The literature search included MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2016. Included studies ... Read More »