Online Exclusives

Hyponatremia Increases Risk of Fractures and Osteoporosis

Austin, Texas—Hyponatremia decreases bone density, possibly through osteoclast-mediated bone resorption, and is a risk factor for fragility fractures. Kalyani Murthy, MD, and colleagues recently conducted a systematic review and meta-analysis designed to examine the effects of hyponatremia on fractures and osteoporosis. They reported results of the analysis during a poster session at the NKF 2018 Spring Clinical Meetings in a ... Read More »

CRRT to Correct Severe Hyponatremia in AKI Prior to Liver Transplant

Austin, Texas—In patients receiving a liver transplant, preoperative hyponatremia and rapid perioperative shifts in serum sodium, outcomes postoperatively may be complicated, worsening outcomes. Due to the risk of hepatic encephalopathy and osmotic demyelination syndrome (ODS), serum sodium level <120 mEq/L is considered a contraindication to liver transplantation. Pretransplant management of cirrhotic patients to prevent and safely correct severe hyponatremia is ... Read More »

Dialysis Patients with Depressive Symptoms Have Higher Hospitalization Rates

Austin—It has been previously reported that in-center hemodialysis patients with depressive symptoms are less likely to remain adherent to dialysis treatment schedules and more likely experience hospital admission. Researchers for DaVita, Inc., led by Kathryn Aebel-Groesch, MSW, LCSW, recently conducted a study to identify the incidence of depression among patients on peritoneal dialysis and home dialysis and to examine the ... Read More »

Duration of Obesity Associated with Decrease in eGFR in Pediatric Cohort Study

According to Pierluigi Marzuillo, MD, PhD, and colleagues, the doubling in the prevalence of chronic kidney disease during the past two decades may, in part, be a result of the epidemic increase of obesity. Gaining an understanding of the pathophysiology of estimated glomerular filtration rate (eGFR) in childhood obesity could enable identification of pediatric patients exposed to factors that could ... Read More »

Predictive Value of Three Methods of Proteinuria Measurement in CKD Patients

Proteinuria is a marker of kidney damage, a risk factor for progression of chronic kidney disease (CKD) in patients with CKD, and a risk factor for cardiovascular events and mortality in patients with and without diabetes mellitus. The previously established gold standard for precise measurements of proteinuria is the timed 24-hour protein excretion. However, due to the inconvenience and inaccuracies ... Read More »

Identifying Rapid Progression in Patients with ADPKD

New Orleans—The most frequently inherited kidney disease is autosomal dominant polycystic kidney disease (ADPKD). The progressive cyst growth associated with ADPKD, combined with interstitial damage, causes progressive kidney failure; there is wide variation of the severity of ADPKD among this patient population. The European Medicines Agency has approved tolvaptan for adults with CKD stage 1 to 3 at baseline who ... Read More »

Effects of Patiromer on Markers of Mineral Metabolism

New Orleans—The TOURMALINE study examined the use of patiromer to treat patients with hyperkalemia. Patiromer is a non-absorbed potassium-binding polymer that is FDA approved for the treatment of hyperkalemia; it uses calcium as the counter-exchange ion. Results of the 4-week TOURMASLINE study demonstrated that, when given without food, once daily patiromer reduced serum potassium similarly to when given with food. ... Read More »

Allopurinol Lowers Uric Acid Levels in Adults with CKD Stage 3

New Orleans—There is an association between hyperuricemia and progression of kidney disease. Early data suggest that lowering serum uric acid in patients with kidney disease may slow progression. However, there are few data on whether lowering levels of serum uric acid improves markers of kidney damage in chronic kidney disease (CKD). Loni J. Perrenoud and colleagues at the University of ... Read More »

Predictors for Acute Kidney Injury Following Cardiac Surgery

Patients undergoing cardiac surgery may experience acute kidney injury (AKI), a common and serious complication. Nearly one in five patients undergoing cardiac surgery experience mild AKI, which is associated with a 19-fold increase in short-term mortality. Severe AKI, defined as requiring renal replacement therapy, occurs in 2% of patients; in those patients, mortality rates approach 20%. In addition to increased ... Read More »

Prediction Tool for Mortality Risk among Older Adults Includes Seven Variables

Maintenance dialysis is the most commonly utilized modality for renal replacement therapy among older adults. In Canada, the proportion of incident dialysis patients ≥65 years of age rose from 41.8% in 1994 to 53.5% in 2013. Older adults on dialysis are at increased risk for poor outcomes, including death; the mortality rate in that patient population is as much as ... Read More »