Cover Stories

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After several months of a sudden, unforeseen shortage, the supply of peritoneal dialysis (PD) fluid is expected to return to normal by the end of March, when Baxter Healthcare says it will have more production capacity on line.

The wealth or poverty of patients’ communities often impacts the care they receive. Researchers recently discovered that this appears to be true for certain aspects of care for end stage renal disease (ESRD)—in particular, the use of an incident arteriovenous fistula (AVF) for hemodialysis vascular access.

To practicing nephrologists, few drugs are more familiar than sodium polystyrene sulfonate (SPS) (Kayexalate). Generally given in a premixed preparation with sorbitol, Kayexalate is widely used for the treatment of elevated potassium levels, with millions of doses prescribed every year. Despite recent safety concerns—including reports of colonic necrosis, leading to a safety warning from the U.S. Food and Drug Administration—SPS plus sorbitol continues to be available and prescribed.

Congress and the Obama administration took a historic step toward expanding access and improving health care for all Americans in passing health reform legislation last month. The most comprehensive health reform in decades, “The Patient Protection and Affordable Care Act (HR 3590),” was built upon through subsequent legislation “The Reconciliation Act of 2010 (HR 4872),” also passed by Congress and signed into law by President Obama last month.

Vitamin D deficiency is nearly universal in patients who have hypoalbuminemia (≤ 3.1 g/dL) and who start dialysis during the winter, a new study has found (Bhan I, et al. Clinical measures identify vitamin D deficiency in dialysis. Clin J Am Soc Nephrol 2010; 5:460-467).

Nephrectomy following failed kidney transplant can yield significant benefits for some patients.

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Researchers have genetically reprogrammed adult human kidney cells to become induced pluripotent stem (iPS) cells—a feat that may help in the study of kidney diseases and the development of novel therapies to treat them.

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The influenza vaccine is safe and lowers the risk of organ loss and death in kidney transplant recipients, a new study finds (Hurst FP et al., May Clin J Am Soc Nephrol). The findings suggest that concerns about the safety of the vaccine in transplant recipients are unwarranted and that the vaccine can provide clear benefits to these individuals.

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