Findings

Hospitals acquiring surgical robots are more likely to perform guideline-recommended partial nephrectomy in patients with renal cancer, reports a study in Medical Care.

The researchers used payer data from seven states to identify nearly 21,600 nephrectomies performed in 2001, 2005, and 2008. Hospital-level rates of partial nephrectomy were analyzed in relation to the hospitals’ acquisition of a surgical robotic system. The association was adjusted for nephrectomy volume, year of surgery, and other hospital factors.

Available data support the “cautious expansion” of metformin use for patients with type 2 diabetes and mild to moderate chronic kidney disease (CKD), according to a systematic review in the Journal of the American Medical Association.

A literature search identified 65 publications providing data on the risk of lactic acidosis in metformin-treated patients with impaired renal function. Since its approval in 1994, metformin has been contraindicated for use in patients with “renal disease or renal dysfunction.”

For children with steroid-sensitive nephrotic syndrome, extending initial steroid therapy from 3 to 6 months does not affect the subsequent relapse rate, reports a trial in Kidney International.

The new oral potassium binder patiromer effectively lowers serum potassium levels in patients with chronic kidney disease (CKD) who are being treated with renin-angiotensin-aldosterone system (RAAS) inhibitors, reports a trial in the New England Journal of Medicine.

Among patients with similar characteristics, those starting peritoneal dialysis (PD) have higher survival through the first 2 or 3 years than do those starting hemodialysis (HD), reports a study in Kidney International.

Physiologic doses of cholecalciferol enable most hemodialysis patients to achieve recommended levels of vitamin D and other biochemical measures, reports a trial in the American Journal of Kidney Diseases.

For patients with suspected nephrolithiasis, clinical outcomes are similar when ultrasonography or computed tomography (CT) is used as the initial imaging test, according to a “real-world” trial published in the New England Journal of Medicine.

Co-trimoxazole is linked to an increased risk of sudden death among older patients taking an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), according to a report in the British Medical Journal.

Patients assigned to off-pump coronary artery bypass grafting (CABG) have a lower risk of acute kidney injury (AKI) but no reduction in the rate of reduced kidney function 1 year later, reports a study in the Journal of the American Medical Association.

Illicit drug abuse is associated with a “broad but unspecific” range of pathologic changes in the kidneys, according to a postmortem analysis in the American Journal of Kidney Diseases.

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