Kidney News

Kidney News

Features

Nephrology faces challenges. Clinically, other internal medicine specialties increasingly are managing diseases traditionally considered in the domain of the nephrologist.

Practice Pointers

Kidney News Editorial Board member Edgar Lerma, MD, FASN, interviewed George Bakris, MD, FASN, about clinicians’ experience with the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Hypertension Guidelines (1).

Findings

Nearly one-fourth of healthy adults participating in exome sequencing studies have “purportedly pathologic” variants associated with kidney and genitourinary diseases, according to a report in Annals of Internal Medicine.

Industry Spotlight

AstraZeneca (Cambridge, UK) is emphasizing its dedication to chronic kidney disease (CKD) and related conditions.

April 2017 Issue

The best chance to slow or reverse the progression of chronic kidney disease (CKD) is in CKD stage 1, when GFR is still preserved. The strategy in stage 1 CKD is to control comorbidities (treat to target) and to perform risk assessment and intervention for cardiovascular disease (1). Unfortunately, many patients, particularly those of minority extraction, do not get this early referral benefit, as noted in the previous section. Current evidence-based progression-specific treatment approaches in CKD include treating BP to acceptable goals, blockade of the renin-angiotensinogen aldosterone system (RAAS), and controlling metabolic acidosis. Trials of antioxidants by the use of bardoxolone, an inhibitor of oxidative stress that failed phase 3 clinical trials, was associated with worsened albuminuria and heart failure (2). Antagonists of inflammation, renal fibrosis, extracellular matrix deposition, and endothelin 1 have not yielded any meaningful clinical application. Interestingly, antagonists of the mineralocorticoid receptor have demonstrated reduced albuminuria but have been associated with high blood potassium levels, which may limit their use in patients with advanced CKD (3). Of the progression-specific treatment approaches, the RAAS system and BP control exhibit significant racial disparities, as detailed below.

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ASN Kidney News.

Established in 2009, ASN Kidney News has kept the kidney community informed of the latest clinical, scientific, and policy issues affecting kidney health professionals and patients with kidney disease.

Video Library

ASN Executive Director Tod Ibrahim discusses a variety of nephrology related topics.

ASN Executive Director Tod Ibrahim discusses a variety of nephrology related topics.

ASN Executive Director Tod Ibrahim discusses a variety of nephrology related topics. The American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.