The risks of cardiovascular events and mortality are lowest with the combination of moderate sodium intake and higher potassium intake, concludes an international prospective cohort study in the British Medical Journal.
The “Prospective Urban Rural Epidemiology” (PURE) study enrolled more than 103,000 adults, aged 35 to 70, from 628 urban and rural communities in low-, middle-, and high-income countries. Twenty-four-hour urinary sodium and potassium excretion were estimated (as surrogates for intake) from morning fasting urine samples.
During a median follow-up of 8 years, 6.1% of patients died or experienced a cardiovascular event. Risks of these outcomes were assessed
A new serum test of calcification propensity provides useful information on the severity and progression of coronary artery calcification (CAC) in patients with chronic kidney disease, reports the American Journal of Kidney Diseases.
The prospective study included patients with stage 2 to 4 CKD, mean age 57.5 years, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Serum calcification propensity was measured as the transformation time from primary to secondary calciprotein particles (T50), with lower T50 values reflecting a higher calcification propensity. The analysis included baseline samples from 1274 patients and follow-up samples (average 3 years) from 780
To boldly restate the obvious, trials in anemia have provided surprising, controversial, and dramatic, practice-changing results for the last 20 years. The latest key trial to add to our knowledge on how to treat the anemia of kidney disease is the PIVOTAL trial (1).
The PIVOTAL trial compared higher-dose, proactive IV iron (400 mg monthly) to lower-dose, reactive iron (0 to 400 mg if ferritin <200 μg/L or TSAT <20%) on the risk of the composite endpoint of death, myocardial infarction, stroke, and congestive heart failure. The higher dose proactive arm was found to have a (first) non-inferior
Scientists are making strides in predicting occurrence of acute kidney injury (AKI) and in evaluating extensive data on patients who recover from AKI.
The Department of Veterans Affairs (VA) announced a year ago that it had signed a formal agreement with DeepMind to gather and analyze data on kidney disease and other conditions. Wired magazine caught up with the project’s status recently, and noted that it drew on about 700,000 medical records from veterans. The VA has been working with DeepMind (owned by Google’s parent company, Alphabet) to create software that tries to predict when patients might develop AKI.
Each year in the United States, more than 8000 hemodialysis patients die after experiencing sepsis or other serious infectious complications. Of those patients, the highest percentage have infections related to a central venous catheter. Other vascular access sites can also become infected and cause sepsis.
Infections caused by multidrug-resistant organisms are far more common in the dialysis population than in the general population and have a high rate of mortality. Influenza is common and can be deadly in patients receiving dialysis. It has recently been estimated that more than 1000 dialysis patients in the United States die annually of influenza-like
More than 2 million individuals die worldwide each year because they don’t have access to renal replacement therapy, a recent Lancet study suggested (1). In many low- and middle-income countries, patients cannot afford or don’t have access to dialysis or transplant, said Peter Kotanko, MD, research director at the Renal Research Institute in New York.
“There is clearly a great unmet need,” Kotanko said. “The main reason why dialysis is not delivered in these areas is because of the high cost.”
Now, mathematical modeling data suggest that it may be possible to use a healthy volunteer’s
One manufacturer has decided not to file for FDA approval of its renal cell carcinoma (RCC) treatment, while another manufacturer’s combination of RCC drugs has won European approval.
Aveo Oncology, based in Cambridge, MA, decided against filing a new drug application for tivozanib (brand name Fotivda) in the United States. The FDA had informed Aveo that it was unsatisfied with the drug’s overall survival data, and that the data failed to improve upon initial concerns the FDA had when it rejected the drug in 2013.
In that year, the FDA questioned the drug’s benefits because data showed that tivozanib failed
On August 10, 2018, the Centers for Medicare & Medicaid Services (CMS) published updated regulations for dialysis facilities (1). The CMS guidance encompasses several modalities, with a focus on the locations where dialysis services are provided.
The new guidance reaffirmed CMS’ recognition of dialysis in a nursing home setting, making revisions to the State Operations Manual (Chapter 2, ESRD Facilities), adding section 2271A, titled “Dialysis in Nursing Homes.” This action affirmed that Medicare-approved ESRD facilities may provide dialysis services to skilled nursing facility (SNF) residents in the nursing home within an approved home training and support modality. These
The number of patients with chronic kidney disease (CKD) increases steadily. However, the individual course of kidney disease may be variable, and accurate identification of patients who will definitely experience progression is challenging (1).
Established biomarkers for prediction of CKD progression are estimated GFR (eGFR) and albuminuria. In the Kidney Disease Improving Global Outcomes (KDIGO) guidelines, patients with CKD of different causes are categorized as having a low, moderate, high, or very high risk for kidney disease progression, according to their (baseline) eGFR and albuminuria (2). Nevertheless, in 1.7 million participants from 35 cohorts with 12,344
IgA nephropathy (IgAN) is a disease with a highly diverse course, and, as such, by definition has always required a personalized or stratified approach (call it “precision” if you like the term).
At one end of the extreme are patients with isolated hematuria, little to no proteinuria, and normal GFR and blood pressure, who have been considered to have “benign IgAN” in the past. Here, recent Swedish data with 20 to 25 years of follow-up show that about a third of these patients will experience spontaneous remission, another third to one-half have persistent urinary abnormalities but preserved GFR, and a