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Aninda Dibya Saha and Ana Konvalinka

Kidney transplantation is the optimal treatment for end stage kidney disease. There are two types of kidney donors—living or deceased—and their proportions vary in different countries. This summary focuses on the living and deceased donation of all organs in Canada, which uses a voluntary opt-in system, where an individual who is eligible to become an organ donor may choose to opt-in to a national or provincial registry.

The total number of kidney transplants performed in Canada in 2019, the last year with data available, was 1483 (1) (including 53 kidney-pancreas transplants but excluding Quebec). The number of total

Vishnu P. Parvathareddy

The global burden of chronic kidney disease (CKD) is increasing, and obesity is recognized as an independent risk factor for CKD. Healthy lifestyle changes are essential for long-term well-being and are proven to assist with weight loss and long-term weight maintenance. Even a moderate degree of weight loss decreases metabolic demands on the kidneys, reduces proteinuria, and potentially aids in delaying CKD progression. The benefits of different diets used for weight loss are uncertain in those with CKD. Thus, clinical practice guidelines recommend consumption of a healthy, balanced diet along with 150−300 min of moderate-intensity physical activity per week or

Hemant Mehta, Wasiyeeullah Shaikh, Sanjiv Jasuja, and Gaurav Sagar

The South East Asian region (SEAR) and South Asian countries (SACs) are divided as high and high-middle economies (HEs), low and lower-middle economies (LEs), and countries not classified due to lack of data (1) (Figure 1). The association between kidney disease and economic status is complex and directly affects therapeutic management. A rising burden of hypertension and diabetes mellitus in the region, with a high prevalence of smoking (11.8% in India), leads to the inter-related comorbidities for cardiovascular diseases and chronic kidney disease (CKD).

South Asia and Southeast Asia regional depiction based on economy

Eric Seaborg

If there is a better test, why not use it?

That is the question a group of nephrologists are asking directors of their laboratories about diagnosing metabolic acidosis. They are advocating that measuring a patient's urine ammonium level is more helpful than trying to estimate it from the urine anion gap (UAG).

More than 170 nephrologists signed a public letter making this request to “directors of clinical laboratories,” first published on Twitter as the introductory step in a campaign to make urine ammonium tests more available.

The letter notes that the test would be valuable “not only in the diagnosis

Karen Blum

Patients with chronic kidney disease have a high symptom burden that can impact their outlook on life and self-confidence to manage disease. With the recognition of these features, nephrology teams can offer targeted solutions to help patients improve their quality of life, according to a presentation at Kidney Week 2021.

More than 60% of patients receiving dialysis reported feeling depressed, worried, or frustrated in a recent survey (1), said Daniel Cukor, PhD, director of behavioral health at the Rogosin Institute in New York. “There's a really high emotional toll being a patient with end stage renal disease [ESRD],”

Bridget M. Kuehn

Kidney patients have long complained that the diet recommended for them is bland, tasteless, and hard to follow. But that old advice is being challenged by new research that may offer more palatable alternatives to old dietary approaches to managing kidney disease.

During the Diet and CKD [Chronic Kidney Disease]: What to Eat, When to Eat, How to Eat session at Kidney Week 2021, a panel of speakers highlighted evidence backing the health benefits of plant-based diets, time-restricted eating, and culturally sensitive dietary interventions for Black, Latinx, or Hispanic patients with kidney disease.

Rethinking diet dogma

Juan-Jesus Carrero, PhD Medicine,

For dialysis patients with ST-elevation myocardial infarction (STEMI), the benefits of percutaneous coronary intervention (PCI) are similar to those in non-dialysis patients, reports a study in the American Journal of Kidney Diseases.

Using the National Inpatient Sample, the researchers identified 413,500 adult hospitalizations for STEMI between 2016 and 2018. Of these, 4220 hospitalizations were for patients receiving dialysis—a rate of 1.07%. Dialysis patients with STEMI were older (65.2 versus 63.4 years), more likely to be women (42.4% versus 30.6%), and less likely to be White (41.1% versus 71.7%). Dialysis patients also had higher rates of comorbid cardiovascular and

Priyanka Athavale and Charlie M. Wray

Titrating blood pressure (BP) medications in the outpatient setting is one of the most fundamental practices in medicine. Unfortunately, managing hypertension in the inpatient setting may not be as evidence based or as straightforward as we think. For decades, our response to elevated BP in hospitalized patients has been to give intravenous or oral medications pro re nata (PRN). Although this intervention does a decent job at lowering BP to an acceptable range, the question of whether or not it is actually helping the patient, or more importantly not doing any harm, remains an important one.

A recent study in

Bridget M. Kuehn

Results from two major trials of sodium glucose co-transporter 2 (SGLT2) inhibitors, a class of drugs initially developed as a treatment for type 2 diabetes mellitus, add to evidence that the drugs may offer kidney-protecting benefits. The results were presented during the High-Impact Clinical Trials session at Kidney Week 2021.

The Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial found that the SGLT2 inhibitor dapagliflozin provided heart and kidney benefits regardless of the cause of underlying kidney disease. Results from the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Reduced Ejection Fraction (EMPEROR-Reduced) trial

In older and obese adults undergoing kidney transplantation, immunosuppression without the use of steroids is associated with a lower risk of posttransplant diabetes mellitus, suggests a study in Kidney Medicine (1).

The retrospective analysis included data on adult kidney-only transplant patients from 2005 to 2016 with Medicare billing claims, drawn from the US Renal Data System. Incidence of posttransplant diabetes was analyzed, including the impact of age and obesity (body mass index 30 kg/m2 or greater). The impact of immunosuppression was analyzed by inverse propensity weighting, with thymoglobulin (TMG) or alemtuzumab (ALEM) plus mycophenolic