Online Exclusives

Serum Albumin and ESRD Outcomes in Patients Transitioning to Dialysis

Protein-energy wasting (PEW), characterized by metabolic and nutritional changes associated with depleted stores of protein and energy, is a strong predictor of mortality in patients with chronic kidney disease (CKD) and those on maintenance hemodialysis. Serum albumin, a protein synthesized by the liver, is affected by conditions related to nutrition (protein intake) and inflammation. Previous studies have identified hypoalbuminemia in ... Read More »

Serum Calcium Levels and Prognosis of Cerebral Hemorrhage in Hemodialysis Patients

Worldwide, stroke is a major cause of death and the leading cause of disability among patients on hemodialysis; the incidence of stroke in patients on hemodialysis is several times higher than in the general population. Compared with cerebral infarction, cerebral hemorrhage has a greater impact on patient prognosis. Risk factors for cerebral hemorrhage in hemodialysis patients have been identified, including ... Read More »

RAAS Activation and Renal Hemodynamic Function in Type 1 Diabetes Mellitus

There has been a decline in the rates of advanced chronic kidney disease (including end-stage renal disease) in patients with type 1 diabetes mellitus (T1DM); however, diabetic nephropathy remains relatively common. In patients with T1DM without diabetic nephropathy, the 20-year mortality risk is comparable to that of the general population, while the presence of diabetic nephropathy is associated with a ... Read More »

Cost-Effectiveness of Pneumococcal Vaccination among Patients Age 50 to 64 with CKD

Due to high morbidity and mortality risk, pneumococcal disease is a major public health concern. Vaccination against Streptococcus pneumoniae reduces the risk for pneumococcal disease by 30% to 50%, according to results of earlier studies. The vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Control and Prevention for all adults ≥65 ... Read More »

New Physical Activity Questionnaire Validated among Dialysis Patients

Patients with end-stage renal disease (ESRD) are often extremely sedentary. In a previous study that included healthy age-matched controls who reported no participation in regular physical activity, patients on maintenance hemodialysis were , on average, 35% less active over a 1-week period. Several large prospective cohort studies found an association between physical inactivity and higher mortality patients on hemodialysis and ... Read More »

Inflammation Biomarkers and Kidney Function Predict Atherosclerosis

Atherosclerosis, a chronic immunoinflammatory fibroproliferative disease, is characterized by lipid inflammation. Circulating levels of acute-phase proteins and proinflammatory cytokines are elevated in patients with chronic kidney disease (CKD). Results of previous population-based cohort studies of individuals in early stages of CKD and small studies of patients on dialysis therapy have suggested an association between inflammation and cardiovascular outcomes. Those results ... Read More »

Associations between Circulatory Iron Deficiency and Cardiac Remodeling in Patients Initiating Dialysis

For patients with end-stage renal disease (ESRD), the presence of cardiomyopathy is a predictor of poor prognosis. High prevalences of morphological and functional cardiac abnormalities have been observed in  patients with ESRD at the time of dialysis initiation. Previous studies have demonstrated that the risk of cardiothoracic ratio (CTR) >50% as a marker for cardiac remodeling is higher in patients ... Read More »

Intensive Blood Pressure Lowering Effects on Kidney Tubule Injury: A Subset Analysis of SPRINT Data

Numerous studies have documented the benefits of treatment of hypertension in lowering the risk for cardiovascular disease and all-cause mortality. However, according to Rakesh Malhotra, MD, MPH, and colleagues, the effects of lowering blood pressure on the progression of chronic kidney disease (CKD) are less certain, due to the higher risk for acute kidney injury (AKI) and increased rapid loss ... Read More »

Urine Volume in Patients with ADPKD Treated with the Vasopressin V2 Receptor Tolvaptan

Due to the formation of numerous cysts in both kidneys and progressive decline in kidney function, approximately 70% of patients with autosomal dominant polycystic kidney disease (ADPKD) face a need for renal replacement therapy (RRT). ADPKD is the most common inherited kidney disease and accounts for 10% of all patients currently dependent on RRT. Tolvaptan, a vasopressin V2 receptor antagonist ... Read More »