Findings

Prophylactic antibiotics lower the recurrence rate in children with vesicoureteral reflux (VUR) but do not affect the risk of renal scarring, concludes a randomized trial in the New England Journal of Medicine.

The multicenter trial included 607 children with VUR diagnosed after one or two episodes of urinary tract infection with fever. The median age was 12 months; 92 percent of the patients were girls.

For patients with nondiabetic chronic kidney disease (CKD), urinary sodium excretion rate is not associated with the long-term risk of kidney failure, reports a study in Kidney International.

Recent increases in obstetric acute renal failure are limited to women with hypertensive disorders of pregnancy, suggests a report in the British Medical Journal.

Older adults taking atypical antipsychotic drugs may be at increased risk of acute kidney injury (AKI), reports a study in the Annals of Internal Medicine.

A new product combining an angiotensin-receptor blocker (ARB) and a neprilysin inhibitor lowers mortality and hospitalization rates in patients with heart failure, compared with enalapril, concludes a trial in the New England Journal of Medicine.

For primary care patients with hypertension and cardiovascular risk factors, a blood pressure self-monitoring intervention—including self-titration of medications—yields greater reductions in systolic blood pressure at 1 year, concludes a randomized trial in the Journal of the American Medical Association.

Higher dietary acid load is associated with albuminuria and other risk factors for chronic kidney disease (CKD), according to a report in BMC Nephrology.

The study included data from 12,293 adults participating in National Health and Nutrition Examination Surveys between 1999 and 2004. Diet-dependent acid load was assessed in terms of estimated net acid excretion (NAEes), based on nutrient intake and body surface area. Associations of NAEes with advanced stages of CKD, albuminuria, and sociodemographic and clinical characteristics were assessed.

Many patients meeting the traditional criteria for “early care” for chronic kidney disease (CKD) do not receive adequate care just before renal replacement therapy (RRT) is begun, according to a study in Kidney International.

In patients with CKD, strict BP control—leading to a treated systolic BP (SBP) below 120 mm Hg—is associated with increased all-cause mortality, reports a study in JAMA Internal Medicine.

The vascular changes of antiphospholipid syndrome nephropathy involve activation of the mammalian target of rapamycin complex (mTORC) pathway, suggesting a potential benefit of sirolimus after kidney transplantation, according to a study in the New England Journal of Medicine.

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