Online Exclusives

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 »

Hospitalization and Emergency Department Visit Rates in Medicare Hemodialysis Patients

Orlando—Prevalent hemodialysis patients covered by Medicare have declining rates of hospitalization; however, rates of emergency department encounters and admissions for observation have increased. Researchers, led by David Gilbertson, recently conducted an analysis of concurrent trends of those acute encounters with the healthcare system in that patient population. Results of the analysis were reported during a poster session at the NKF ... Read More »

Hyponatremia in a Small Cell Lung Cancer Patient: A Case Study

Orlando—Patients with small cell lung cancer may develop euvolemic hyponatremia due to low solute intake, syndrome of inappropriate antidiuretic hormone secretion (SIADH), or renal salt wasting from a platinum-based alkylating agent. Renal tubular injury, salt-magnesium and potassium-wasting have been associated with cisplatin; carboplatin, with a relatively lower nephrotoxic profile, is considered a safer alternative. Omar Rabadi, MD, and colleagues presented ... Read More »

Admission Serum Potassium Level and In-Hospital Mortality

Orlando—Wisit Cheungpasitporn and colleagues at the Mayo Clinic in Rochester, Minnesota, recently conducted a single-center retrospective study designed to examine the relationship between serum potassium levels and in-hospital mortality. The study included all hospitalized patients at a tertiary referral hospital. Study results were reported during a poster session at the NKF 2017 Spring Clinical Meetings in a poster titled Admission ... Read More »

Sodium Bicarbonate Reduces Inter-Hemodialysis Potassium Gain

Chicago—One of the adverse effects of hemodialysis on clinical outcomes is associated with the intermittent nature of the therapy; increased mortality rates are related to long intervals between sessions. One reason for adverse effects of long intervals between therapy is high levels of potassium, however, according to researchers in the United Kingdom, low potassium levels post-hemodialysis can cause arrhythmias. Stella ... Read More »

Reduction in Pill Burden with Switch to Phosphate Binder Monotherapy

Orlando—Stuart M. Sprague, MD, and colleagues recently conducted an analysis of adult patients on hemodialysis who switched from baseline phosphate binder dual therapy with calcium acetate, sevelamer, or lanthanum carbonate to monotherapy with sucroferric oxyhydroxide as part of routine care. The analysis was designed to examine changes in serum phosphorus as well as pill burden for hemodialysis patients. The researchers ... Read More »