Online Exclusives

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 »

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 »