Renal Week 2008

Renal Week 2008

Kidney function in obese kidney donors remains strong one year after donation, although long-term effects on renal function are uncertain, said Peter Reese and his colleagues at the University of Pennsylvania-Philadelphia at a Renal Week session.

As transplant centers work to maximize appropriate live donor transplantation, uncertainties remain concerning the potential risks of accepting kidneys from donors with obesity or other risk factors for future kidney disease. Also unclear are risks obese donors may face during and after the surgical procedure.

Urban and rural physicians involved in kidney transplantation have different perceptions about various aspects of the procedure, including when it should be done in the course of end stage renal disease (ESRD) and for which patients.

Wait times for kidney transplants throughout the United States vary widely, so that some individuals can receive a deceased donor’s kidney within just one year while others must wait up to a decade. Researchers are investigating the issues related to organ allocation inequities and are searching for ways to remedy them.

Kidney transplants lead to improved mental performance in people with kidney disease, new research shows.

Individuals with chronic kidney disease often suffer from cognitive impairment, but it is unclear to what extent outside factors such as age and medication play a role.

Women who want to bear children in the future need not worry about the risks of donating a kidney before pregnancy, researchers have found.

A newly developed equation provides more accurate estimates of glomerular filtration rate (GFR) than do other measures, according to new research. The equation is different from other measures because it was developed on the basis of findings from pooled databases, rather than from a single study.

Albuminuria is a stronger predictor of renal disease progression and cardiovascular (CV) morbidity and mortality than is glomerular filtration rate (GFR), said George Bakris, MD, in his talk at the two-day program “CKD and CVD from the Vascular Viewpoint: Merging Basic and Clinical Sciences to Optimize Treatment” at Renal Week. Bakris stressed the need to monitor and reduce proteinuria to maximize risk reduction and said that blood pressure control is a key element in therapy.

Older age and wasting are risk factors for severe bacterial infections among patients with stage 5 chronic kidney disease (CKD), according to findings from a study by researchers at the Karolinska Instutet in Stockholm. Patients with a central dialysis catheter at the initiation of dialysis were more prone to infection, and patients with a particular single nucleotide polymorphism in the gene for interleukin-1β (IL-1β) were at markedly increased risk.

Kidney stones are an important risk factor for chronic kidney disease (CKD), researchers found when they studied the records of all residents of Olmstead County, Minn., over a 20-year span.

Kidney stones are known to lead to CKD in patients with rare genetic diseases, but their role as a risk factor for CKD in the general population had been less clear. Researchers generally thought that complications of kidney stones only rarely cause CKD; however, few long-term studies looked at the question.

Uremic pruritis, or itch, can significantly diminish quality of life and interfere with sleep, work, and social interactions for a large proportion of hemodialysis patients, according to findings from two poster presentations at the ASN annual meeting.

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Exercise may benefit patients with end stage renal disease (ESRD) by improving their functional independence, resistance to disability, and survival of acute stressors.

Hemodialysis patients who were more physically active had less postdialysis fatigue (PDF) compared with less active patients in a study of patients undergoing maintenance hemodialysis thrice weekly. The amount of physical activity on the day after dialysis was most predictive of PDF, whereas the level of activity on the day of dialysis was not.

Depression is common among individuals on dialysis for kidney disease, but researchers have found that behavioral therapy can significantly improve these patients’ quality of life.

Patients undergoing hemodialysis are taxed both physically and mentally, and 20–30 percent become depressed. Many of these individuals are at increased risk of becoming hospitalized, developing other diseases, and even dying.

A combination of steroids and a blood pressure-lowering drug better prevents end stage renal disease (ESRD) than a blood pressure-lowering drug alone, researchers suggest.

Low levels of potassium in the diet may be as important a contributor to high blood pressure as high levels of sodium—especially among African-Americans—researchers have found.

“Lowering salt or sodium in the diet to lower blood pressure is relatively well known, but more publicity on increasing dietary potassium is needed,” said lead author Susan Hedayati, MD, at the University of Texas Southwestern Medical Center in Dallas and the Dallas VA Medical Center.

Drug-eluting stents provide the best one-year survival for patients with kidney disease who also must be treated for heart disease, but bypass surgery provides the best long-term survival, according to a study by Charles Herzog, MD, and Craig Solid, MS, of the Cardiovascular Special Studies Center at the United States Renal Data System (USRDS) in Minneapolis, Minn.