Practice Pointers

What changes in proteinuria occur during normal pregnancies?

How frequent is pregnancy in ESRD? What are the current outcomes?

One disease or many?

IgA nephropathy (IgAN) is well identified by dominant IgA glomerular deposits; however, this immunohistologic entity can be an asymptomatic chance finding or present with an extremely variable course. The variable clinical and histologic expressions are likely to be the result of genetic and environmental factors modulating common pathogenetic and progression mechanisms.

What is the current terminology for dysproteinemia-related kidney disease?

Which viruses cause glomerular disease?

IgA nephropathy (IgAN) is well identified by dominant IgA glomerular deposits; however, this immunohistologic entity can be an asymptomatic chance finding or present with an extremely variable course. The variable clinical and histologic expressions are likely to be the result of genetic and environmental factors modulating common pathogenetic and progression mechanisms.

This month, Kidney NewsEditorial Board member Edgar V. Lerma, MD, FASN, interviewed George Bakris, MD, FASN, FASH, FAHA, about recent SPRINT (Systolic Blood Pressure Intervention Trial) results. Dr. Bakris is professor of medicine and director of the ASH Comprehensive Hypertension Center at the University of Chicago Medicine.

KN: Why is the SPRINT study significant?

This month, Kidney News Editorial Board member Edgar V. Lerma, MD, FASN, interviewed George Bakris, MD, FASN, FASH, FAHA, about recent SPRINT (Systolic Blood Pressure Intervention Trial) results. Dr. Bakris is professor of medicine and director of the ASH Comprehensive Hypertension Center at the University of Chicago Medicine.

KN: Are we facing a higher incidence of nephrolithiasis?

Recent evidence suggests that over the past 4 decades, the incidence of kidney stones has increased in adults from 3.8 percent to 8.8 percent (1). In children, over the past 25 years, it has increased at a rate of 6 percent to 10 percent annually, reaching 50 cases per 100,000 adolescents (2).

Should ACEIs/ARBs be given to all diabetic patients?

The current guidelines are for angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blocking agents (ARBs) to be given to all diabetic patients without a contraindication if there is albuminuria, regardless of the presence of hypertension and independently of GFR.

Tushar J. Vachharajani

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Jack Work

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In this month’s issue, ASN Kidney News editorial board member Edgar Lerma interviewed Thomas Nevins, professor of pediatrics at the University of Minnesota Amplatz Children’s Hospital in Minneapolis, about nonadherence among patients—and care providers—in transplantation, dialysis, and kidney care in general.

What does the term nonadherence mean in nephrology?

Nephrologists in clinical practice take it for granted that when they arrive for morning rounds the hemodialysis machines will be set up and ready to go, with the water for the dialysate purified and inspected.

In fact, the level of water purity required to ensure patient safety has gradually evolved since hemodialysis was introduced many decades ago. The case study below, from a large community-based teaching hospital, illustrates how water quality can change unexpectedly, and the importance of rapid response to such changes to ensure patient safety.

Stuart Linas

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In this month’s issue, ASN Kidney News editorial board member Edgar Lerma interviewed Stuart Linas, MD, about the American Board of Internal Medicine (ABIM) Maintenance of Certification program for nephrologists. Linas is the Rocky Mountain Professor of Renal Research at the University of Colorado Denver School of Medicine.

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This month, Kidney News interviews Victor Gura, MD, developer of the wearable artificial kidney.

KN: Please tell us something about yourself.

How common is access rupture?

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What are some of the most important challenges facing nephrologists in prescribing dialysis therapy for their patients?

Sarah Prichard

Once estimated GFR (eGFR) indicates stage 3 or higher CKD (&lt;60 mL/min/1.73 m<sup>2</sup>), modification of drug dose, of dosing intervals, or of both should be considered.

In the January 2015 issue of ASN Kidney News:

  • New Guidance on Statin Use in Patients with CKD
  • Richard Lafayette, MD, FACP, Appointed Editor-in-Chief of ASN Kidney News
  • Kidney Watch 2015: A Look at the Year Ahead

Read the Dynamic Edition

How frequent is venous needle dislodgement?

How common is access rupture? According to data reported to the Centers for Medicare & Medicaid Services, fatal rupture of arteriovenous (AV) dialysis access accounts for close to 0.4 percent of all hemodialysis deaths, which translates into about one death per 1000 hemodialysis patient years. A recent retrospective review of cases reported to the medical examiner in the District of Columbia, Maryland, and Virginia suggested that there is significant underreporting of such deaths (1).

What are some of the most important challenges facing nephrologists in prescribing dialysis therapy for their patients? Ever since dialysis therapy has proved to be lifesaving, we have been challenged to decrease the mortality and increase the safety of the procedure (1). Advances in technology have led to increasingly complex equipment, resulting in a steep learning curve for both clinicians and patients alike.