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 »

MMF Effective in Maintaining Remission from Proliferative Lupus Nephritis

In the 10 years following a diagnosis of systematic lupus erythematosus, 20% to 75% of patients experience kidney involvement. In the 1950s, 5-year survival for patients with lupus erythematosus was <50%; due to improved immunosuppression and other medical therapies, the 5-year survival rate is now >90%. Lupus nephritis is now considered a chronic illness, giving the efficacy and safety of ... Read More »

Cost-Effectiveness of Vascular Access Referral Policies Varies by Age

The gold standard of vascular access for hemodialysis has long been an arteriovenous fistula (AVF). Use of an AVF for hemodialysis access is associated with lower mortality and morbidity as well as higher quality of life compared with access via an arteriovenous graft (AVG) or central venous catheter (CVC). Of late, there has been debate over the issue of whether ... Read More »

Determining the Burden of Acute Kidney Injury Using Large Databases

In a recent review, Simon Sawhney, MBChB, University of Aberdeen United Kingdom, and Simon D. Fraser, DM, University of Southampton, United Kingdom, presented a review of recent large database studies focusing on the epidemiology of acute kidney injury (AKI); the researchers also addressed the advantages and drawbacks of using routine health data in observational research. The review focused on three ... Read More »

Risks for Adverse Events in a Population of Patients with Advanced CKD

Patients with chronic kidney disease (CKD) are at high risk for adverse outcomes that can include end-stage renal disease, cardiovascular events, and death. Patients with lower estimated glomerular filtration rate (eGFR) and/or higher albuminuria are generally at higher risk. However, according to Morgan E. Grams, MD, PhD, and colleagues, the absolute risks for ESRD, cardiovascular disease, and death in patients ... Read More »

Risk of Hypoglycemia in Older Adults Stratified by eGFR

Patients with lower estimated glomerular filtration rates (eGFRs) are at higher risk for hypoglycemia, increasing the risk for cardiac and neurologic dysfunction and impaired quality of life. Higher concentration of urinary albumin has been identified as an independent risk factor for the development of hypoglycemia; older age and use of antihyperglycemic medications may also be risk factors. There are few ... Read More »