Findings

The mineralocorticoid receptor blocker spironolactone does not reduce the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery, concludes a trial in American Journal of Kidney Diseases.

Renal biopsy can be useful in establishing the correct diagnosis and treatment in patients with diabetes—a population with a high prevalence of nondiabetic renal disease (NDRD), according to a meta-analysis in Nephrology Dialysis Transplantation.

The researchers identified and analyzed data on the frequency of diabetic nephropathy, NDRD, and “mixed” forms of kidney disease among patients with diabetes. The analysis included data on 4876 patients undergoing renal biopsy, reported in 48 studies.

Patients with chronic kidney disease (CKD) need a “multimodal, person-centered framework” to support disease self-management, with a special focus on everyday strategies, according to a study in BMC Nephrology.

The cross-sectional survey study solicited Australian CKD patients’ views on their desires for support in self-management of their disease. Thirty-six patients filled out a paper survey at a primary care clinic, and another 61 patients completed an online survey.

Screening for elevated albuminuria and hypertension may identify a group of patients at increased risk of faster decline in kidney function, reports a study in Nephrology Dialysis Transplantation.

Treatment with fish oil and/or aspirin does not reduce the risk of arteriovenous fistula (AVF) failure, reports a randomized trial in JAMA Internal Medicine.

The “Omega-3 Fatty Acids (Fish Oils) and Aspirin in Vascular Access Outcomes in Renal Disease” (FAVOURED) study included 567 patients at 35 dialysis centers in Australia, Malaysia, New Zealand, and the United Kingdom. All patients had stage 4 or 5 chronic kidney disease and were undergoing surgical AVF creation.

For patients with diabetes—including but not limited to low-income patients—switching to high-deductible health plan (HDHPs) leads to major increases in emergency department visits for preventable acute diabetic complications, reports a study in JAMA Internal Medicine.

Among living kidney donors, the long-term risk of ESRD is close to doubled for those who are obese, reports a study in Kidney International.

The study included data on 119,769 living kidney donors, linked to Centers for Medicare & Medicaid Services data to determine ESRD status. There were 20,588 obese donors, body mass index (BMI) 30 kg/m2 or higher; and 58,004 nonobese donors. (The remaining 41,177 donors had missing data on BMI.) Postdonation risk of ESRD was compared between groups, with adjustment for potential confounders.

A growing understanding of the health and psychosocial risks associated with being a living kidney donor is helping drive innovations that will improve the informed consent process, according to recent research.

More than 1 billion people worldwide now have hypertension, with the highest levels now seen in low-income countries in south Asia and sub-Saharan Africa, according to a report in The Lancet.

The NCD Risk Factor Collaboration analyzed pooled data from 1479 studies that had measured blood pressure in 19.1 million adults. The researchers analyzed trends in mean systolic and diastolic blood pressure from 1975 to 2015, as well as the prevalence of raised blood pressure (140/90 mm Hg or higher) in 200 countries.

Among patients initiating dialysis, mortality is higher for those with a primary indication of volume overload or hypertension, suggests a study in the American Journal of Kidney Diseases.

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