Findings

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Patients enrolled in major clinical trials of end stage kidney disease (ESKD) differ in key demographic and clinical characteristics, compared to the general population of dialysis patients, concludes a meta-analysis in JAMA Internal Medicine.

In patients with membranous nephropathy, rituximab is noninferior to cyclosporine in inducing remission, and superior in terms of maintaining proteinuria remission up to 2 years, reports a trial in The New England Journal of Medicine./kidneynews/11_9/18a/graphic/18af1.jpg

The sodium-glucose co-transporter 2 (SGLT2) inhibitor canagliflozin reduces cardiovascular and renal events in diabetic patients with chronic kidney disease—even those with no previous history of cardiovascular disease, according to a clinical trial report in Circulation.

Reducing the human and financial burden of progressive diabetic kidney disease (DKD) and ESKD stalled after the landmark trials of renin-angiotensin system inhibitors (RASi) in the early 2000s. The recent introduction of sodium glucose co-transporter 2 inhibitors (SGLT-2i) appears to reverse 20 years of stagnation in this area. This short review summarizes the key findings in this emerging success story of nephrology therapeutics.

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Contrary to current guidelines, peripherally inserted central catheters (PICCs) are used in a high percentage of hospitalized patients with chronic kidney disease (CKD), reports a study in Annals of Internal Medicine.

Only 1 out of 7 patients who initiate peritoneal dialysis (PD) in the United States are still on PD at 5 years’ follow-up, reports a study in the American Journal of Kidney Diseases.

Patients undergoing regular dialysis have overly optimistic expectations of their prognosis, according to a study in JAMA Internal Medicine.

The cross-sectional survey study included 996 patients receiving regular dialysis at 31 nonprofit facilities in two US metropolitan areas (Seattle and Nashville). The main outcome of interest was response to the question: “How long would you guess people your age with similar health conditions usually live?” Responses were classified as less than 5 years, 5 to 10 years, more than 10 years, or “not sure.”

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Lack of interest in the subject is the most common reason why medical students and residents say they wouldn’t want to pursue a career in nephrology, reports a survey study in the open-access journal BMC Nephrology.

Among patients who successfully lost weight in the Diabetes Prevention Program (DPP) study, long-term maintenance of weight loss is better for those initially assigned to metformin compared to a lifestyle intervention, reports a study in Annals of Internal Medicine.

In children with end stage kidney disease (ESKD), there is no specific level of renal function at which dialysis initiation leads to improved patient outcomes, concludes a registry study in Nephrology Dialysis Transplantation.

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