Online Exclusives

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 »

A Pilot Trial to Assess the Effectiveness of Screening for CKD among High Risk Patients

Currently, the value of screening for chronic kidney disease (CKD) is uncertain. Previous evidence suggests that in certain high-risk groups, screening may be cost-effective in reducing the burden of complications associated with CKD. More than 20 million adults in the United States are affected by CKD, defined by either of two readily available clinical tests: estimated glomerular filtration rate <60 ... Read More »

Utilization of rhGH Therapy in Children with CKD and Growth Impairment Varies

Despite advances in care for children with chronic kidney disease (CKD), growth impairment remains common in the population of pediatric CKD patients. Data from the North American Pediatric Renal Trials and Collaborative Studies CKD registry show that 36.9% had height standard deviation scores (SDS) <–1.88 at time of enrollment. In a recent study in North America among children with mild ... Read More »

Serum Phosphorus and Risk of Graft Failure or Mortality in Transplant Recipients

Orlando—Recipients of kidney transplants may be at risk for mild hyperphosphatemia, a putative risk factor for cardiovascular disease (CVD), loss of renal function, and mortality. There are few data available from large, multicenter cohorts of stable kidney transplant recipients that assess the relationships between serum phosphorus and the development of CVC outcomes, graft failure, or all-cause death. Basma Merhi, MD, ... Read More »

Peritoneal Dialysis Catheter for Urgent Start Dialysis vs Elective Start

Orlando—Previous studies have validated the successful use of percutaneous peritoneal dialysis catheters used in urgent-start dialysis. However, there are few data available on long-term outcomes of percutaneous peritoneal dialysis used for immediate dialysis. Ammar Almehmi, MD, and colleagues conducted a retrospective study designed to compare the outcomes of percutaneous peritoneal dialysis catheters that were used for urgent start versus elective ... Read More »

Variability of Rates of Hyperkalemia among Patients on Hemodialysis

Orlando—Patients with end-stage renal disease have a high prevalence of cardia arrhythmias and sudden death. Patients more commonly experience hyperkalemia during the long inter-dialytic period, creating an association with increased mortality. Bhupinder Singh, MD, and colleagues recently conducted a prospective, observational study designed to examine the incidence of hyperkalemia, defined as serum potassium >5.0 mEq/L, as well as hypokalemia, and ... Read More »