A pair of trials showed the diabetes medications linagliptin and bexagliflozin may be safe and effective at lowering blood sugar levels in diabetic patients with later stages of chronic kidney disease (CKD), according to late-breaking clinical trial results presented at Kidney Week 2018.
Other results presented at the late-breakers session tackled new strategies for treating anemia in dialysis patients and an intervention to reduce early dialysis. Another compared phosphate-binding medications.
Late CKD diabetes control
Although there are a growing number of medications available to manage blood glucose in patients with diabetes, finding one that is safe to use during the
When pregnancy is complicated by ESRD, symptoms and complications like anemia add to hypogonadism, lower libido, and poor self-image. As expected, the data show that about 84% of women with ESRD report sexual dysfunction, and only 35% of women report being sexually active. Hormonal imbalances result in anovulatory cycles. In addition, maintaining a pregnancy to near term has been a challenge for these women. Higher incidences of lost pregnancies, intrauterine growth restriction, small-for-date babies, and premature labor continue to be challenges faced by most pregnant women receiving dialysis.
However, in recent years, outcomes in pregnant women receiving dialysis
In dialysis patients with atrial fibrillation, the factor Xa inhibitor apixaban reduced the risk of major bleeding compared to warfarin in a nationwide sample, reports a study in Circulation.
Standard-dose apixaban is also associated with lower risks of thromboembolism and death compared to warfarin.
The introduction of direct oral anticoagulants has changed the approach to management of stroke risk in patients with atrial fibrillation. But the pivotal trials of these agents excluded atrial fibrillation patients with kidney failure. Some studies have reported adverse outcomes with dabigatran and rivaroxaban in this patient population. Standard-dose apixaban is approved for use
The global burden of kidney diseases is much higher than commonly reported, according to a notice recently issued by the American Society of Nephrology (ASN), European Renal Association—European Dialysis and Transplant Association (ERA-EDTA), and International Society of Nephrology (ISN).
“We estimate that over 850 million people worldwide have some form of kidney disease, which is roughly double the number of people who live with diabetes (422 million ) and 20 times more than the prevalence of cancer worldwide (42 million ) or people living with AIDS/HIV (36.7 million ),” the groups stated.
Tell us about your background. How long have you been with HHS?
I’ve spent the bulk of my career working to create a better healthcare system with the goals of reducing cost and increasing quality and patient satisfaction. Much of my focus has been on health IT and innovative technologies dealing with challenges like EHR usability and interoperability. But I also have experience using innovation to improve healthcare operations.
During the past year or so of my time at HHS, the Office of the Chief Technology Officer (CTO) has worked on a number of important initiatives including open data, innovation,
Fatigue is one of the most common symptoms reported by patients on dialysis, but there is little data to guide clinicians about how to manage it. A new initiative aims to change that by helping researchers routinely and consistently measure fatigue in their studies of dialysis-related care.
The Standardized Outcomes in Nephrology–Hemodialysis (SONG-HD) project was created to establish a standard set of measures that should be used in all studies enrolling patients receiving dialysis. Having such a standard set of measures used across clinical trials makes it easier to compare the results of different studies, explained Angela Ju, BSc, of
As a dialysis patient and peer coach, Caroline Wilkie knows how postdialysis fatigue and cramping can get in the way of socializing, work, or other responsibilities.
“A lot of us don’t plan things in advance because we never know how tired we’re going to be,” Wilkie said.
Her views and those of other patients with ESRD took center stage recently in a project led by ASN’s Kidney Health Initiative (KHI), a public–private partnership between ASN and the U.S. Food and Drug Administration (FDA), aimed at understanding which symptoms patients find most troubling. The project found that insomnia, fatigue, and cramping
Anitha Vijayan and on behalf of Nephrologists Transforming Dialysis Patient Safety
Imagine this scenario as a nephrologist.
Your patient with ESRD undergoing hemodialysis has newly diagnosed hepatitis C virus (HCV) infection. In addition to addressing the immediate medical issue, what is the next course of action? What are the reporting requirements for a new case of HCV infection? Are you required to report this case to state and federal public health agencies? How do you ensure your patient did not acquire the infection due to lapses in infection prevention and control measures at the dialysis facility?
This series of questions may not be at the forefront in the minds of nephrologists
Policymakers and public health officials are sounding the alarm about the opioid overdose crisis nationwide. More than 115 people die each day due to opioid-related drug overdoses, and the Department of Health and Human Services (HHS) Secretary Alex Azar has made combatting this epidemic one of his top priorities. White House and HHS officials have met with representatives of the American Society of Nephrology (ASN) and peer medical societies to discuss strategies to confront the epidemic and have also launched a public service campaign to help educate Americans about the highly addictive nature of opioids.
In April 2018, the U.S. Food and Drug Administration (FDA) approved the use of tolvaptan for the treatment of autosomal dominant polycystic kidney disease (PKD), allowing the United States to join most of the rest of the world in having the ability to deploy the first disease-specific therapy for PKD. Approval followed the release of results of the REPRISE trial, which demonstrated tolvaptan’s ability to meaningfully slow progression of stage 3 and 4 CKD over 12 months compared to placebo (1). The REPRISE study validated the results of the TEMPO trial, which initially provided strong