Acute kidney injury (AKI) may be more frequent in ultramarathon runners who take ibuprofen, according to a randomized controlled trial in Emergency Medicine Journal.
The study included 91 athletes participating in 50-mile ultramarathon races in desert environments. Runners were randomly assigned to take ibuprofen 400 mg or placebo tablets every 4 hours during their race. Incidence of AKI was compared between groups: “risk” was defined as a 1.5-fold increase in creatinine and “injury” as a twofold increase. Runner characteristics were similar between groups; in the ibuprofen group, average total dose was 1200 mg.
A revised Kidney Donor Risk Index (KDRI) incorporating APOL1 genotype rather than race improves prediction of allograft survival of kidneys from African American deceased donors, reports a study in American Journal of Transplantation.
The study included data on 622 African American deceased kidney donors from three southern US centers. The researchers used a series of models to analyze the impact of a revised KDRI substituting APOL1 genotype for race.
For all donors, mean current KDRI was 1.4930. With the revised KDRI, the risk score decreased to 1.2518 for 529 donors with no or one
Early diabetic kidney disease (DKD)—often clinically expressed as proteinuria—is associated with a 16-year reduction in life expectancy, reports a study from Taiwan in Kidney International.
The prospective cohort study included 512,700 adults participating in a comprehensive health surveillance study between 1994 and 2008. Of these, 9067 patients had early DKD, defined as stage 1 to 3 chronic kidney disease (CKD) based on estimated glomerular filtration rate and/or albuminuria. Another 50,977 patients had early CKD without diabetes and 18,388 had diabetes without CKD. Life expectancy was compared among groups and with the reference group of individuals who had neither
Glycated hemoglobin (HbA1c) levels may underestimate mean glucose level in African Americans with type 1 diabetes, reports a study in Annals of Internal Medicine.
The T1D Exchange Racial Differences Study Group analyzed data on 104 non-Hispanic black and 104 non-Hispanic white patients with type 1 diabetes, enrolled at 10 US centers. (Individuals with anemia or hemoglobinopathy were excluded.) All subjects were at least 8 years old and had had type 1 diabetes for at least 2 years. Mean glucose concentration was measured by continuous glucose monitoring, and racial differences in the relationship between glucose and HbA1c were assessed.
Particularly in interaction with donor age and pathway of death, total ischemic times of 14 hours or longer are associated with increased rates of adverse allograft outcomes in deceased donor kidney recipients, reports a study in Transplantation.
The researchers analyzed the impact of total ischemic time and graft outcomes in 7542 patients receiving their first deceased donor kidney transplant in Australia and New Zealand between 1994 and 2013. Total ischemic time included warm and cold ischemia: from the time of donor renal artery interruption/clamping to release of the renal artery clamp in the recipient. The authors hypothesized that donor
Especially in combination, quarter-dose medication regimens may provide a safe and effective alternative for blood pressure-lowering therapy, according to a meta-analysis in Hypertension.
A literature review identified 42 randomized trials of quarter-dose therapy with major classes of antihypertensive drugs. Comprising a total of 20,284 patients, all studies included at least one quarter-dose arm and one placebo and standard-dose monotherapy arm. On average, the studies were published 17 years ago. Data were pooled for meta-analysis of safety and efficacy outcomes.
On analysis of 36 comparisons with placebo, quarter-dose therapy was associated with a 4.7/2.4 mm Hg reduction in blood
The sodium content of packaged foods and beverages purchased by Americans has decreased substantially over the past several years, reports a study in JAMA Internal Medicine.
In the 2000–2014 Nielsen Home- scan Consumer Panel, a nationally representative sample of 172,042 US households used a barcode scanner to report all packaged food purchases. The researchers examined trends in the sodium content of purchased foods, and in the percentage of households buying products with optimal sodium density (1.1 mg/kcal or less).
During the period studied, the amount of sodium obtained from packaged foods and beverages decreased by 396 mg/d—from 2363 to
Pediatric nephrology centers vary in their use of growth hormone therapy for children with chronic kidney disease (CKD) and short stature, reports a study in BMC Nephrology.
The authors report an online survey distributed to US pediatric nephrologists, via the Midwest Pediatric Nephrology Consortium and the American Society of Pediatric Nephrology. Respondents were asked about their approach to recombinant human growth hormone (rhGH) therapy in short children with CKD. The analysis included 73 responses, 30 from small (4 or fewer pediatric nephrologists) and 43 from large practices. One-third of physicians and more than half of centers responded to
The roles of obesity and pre-existing kidney disease make it difficult to assess the true nature of the association between preeclampsia and end stage renal disease (ESRD), concludes a report in the American Journal of Kidney Diseases.
The researchers used the US Renal Data System to identify 34,581 women who gave birth in Olmsted County, Minn., between 1976 and 2010. Forty-four women with confirmed ESRD were matched for year of birth, age at first pregnancy, and parity to two controls. In the cases, median time from last pregnancy to ESRD onset was 17.7 years.
The percentage of Americans with normal body weight but cardiometabolic abnormalities is higher in racial/ethnic minority groups—especially South Asians and Hispanics, reports a study in Annals of Internal Medicine.
The researchers determined the prevalence of the metabolic abnormality but normal weight (MAN) phenotype and associated factors in five US racial/ethnic groups. Data on 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic adults were drawn from the Multi-Ethnic Study of Atherosclerosis; information on 803 South Asian subjects came from the Mediators of Atherosclerosis in South Asians Living in America study. The MAN phenotype was defined as