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Tracy Hampton

Toward the end of life, people undergoing maintenance dialysis often receive intensive treatments, and some may lack the cognitive capacity to make critical decisions about their care. Therefore, family members and trusted friends can play an important role in helping ensure that end-of-life care is aligned with patients' values, goals, and preferences. A new study published in the Clinical Journal of the American Society of Nephrology examined whether such close contacts have a good understanding of these patients' wishes (1).

For the study, investigators surveyed family members and close contacts in two US metropolitan areas to

Tracy Hampton

EEfforts are needed to limit radiation exposure. New research indicates that hemodialysis patients are exposed to unnecessarily high radiation doses that put them at increased risk for the development of cancer (De Mauri A, et al. Estimated radiation exposure from medical imaging in hemodialysis patients. (J Am Soc Nephrol, March 2011). The results add to a growing body of literature suggesting that many patients with chronic and recurrent medical problems receive potentially dangerous doses of radiation from medical imaging.

Too much radiation

Because of comorbidities, many kidney disease patients receiving hemodialysis undergo repeated imaging procedures for both diagnostic

Tracy Hampton

A new study indicates that not getting enough exercise can be fatal for kidney transplant patients.

“From our research we can conclude that a low level of physical activity is a new—and modifiable—risk factor for cardiovascular and all cause mortality in these patients,” said Dorien Zelle, of the University Medical Center Groningen, in the Netherlands, lead author of the Clinical Journal of the American Society of Nephrology (CJASN) study.

Intervention trials are needed to investigate whether increasing physical activity levels may improve outcomes after transplantation, she added.

The price of inactivity

Patients with advanced chronic kidney disease, particularly

Tracy Hampton

Preformed donor-specific antibodies contribute to transplant patients’ development of arteriosclerosis of the kidneys and may play a key role in organ rejection, according to research reported in the May Journal of the American Society of Nephrology.

The findings may change the way physicians think about the kidney rejection process and could even impact care related to cardiovascular diseases in general.

Attack of the antibodies

The detection and treatment of donor organ rejection has historically focused on T-cell-mediated processes, but recent research by a number of institutions has revealed that antibody-mediated rejection—which can occur when a transplant recipient mounts

Tracy Hampton

Many hemodialysis patients—especially those with lower education levels, African Americans, and veterans—do not understand the health information they need to make appropriate health decisions, according to findings of a recent report in Clinical Journal of the American Society of Nephrology (Green J, et al. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis).

“Health literacy may be particularly important to the care and outcomes of the more than 350,000 patients in the United States treated with chronic hemodialysis due to the complex nature of end stage renal disease management,” said lead author Jamie

Tracy Hampton

New research indicates that the success of a kidney transplant may rely in part on how the recipient and donor compare in terms of weight and sex. The findings, which are published in the Clinical Journal of the American Society of Nephrology, suggest that changes may be needed to current immunology-based protocols that match donors and recipients.

Several kidney transplantation studies have demonstrated that a smaller donor size relative to recipient is associated with a higher risk of graft loss, perhaps due to increased strain on the relatively smaller transplanted kidney. Very few studies have investigated the outcomes

Tracy Hampton

Anewly developed method to quantify living kidney donors’ risk of end stage renal disease (ESRD) postdonation may be helpful for individuals considering donation, for living donors wishing to understand their long-term risk, and for clinicians who monitor the long-term health of living donors. The risk calculator is described in a recent Journal of the American Society of Nephrology study.

Although research suggests there are minimal health consequences for individuals who donate a kidney, comprehensive studies are lacking. Long-term studies of living kidney donors have reported low rates of premature death and kidney failure (with an estimated overall ESRD

Tracy Hampton

Newly reported data representing nearly all US outpatient dialysis facilities reveal that most bloodstream infections in dialysis patients continue to occur in those with central venous catheters used for vascular access. The findings, which are published in a recent Clinical Journal of the American Society of Nephrology study, come from the first year of data used by the Centers for Medicare & Medicaid Services to assess facility performance based on bloodstream infections.

Increasing attention is being paid to reducing vascular access–related infections in dialysis patients. “Hemodialysis patients are at high risk for infections, which increase mortality, hospitalization, and

Tracy Hampton

Historically, there has been low use of palliative care in patients with acute kidney injury (AKI), even when requiring kidney replacement therapy, but does this trend hold true in patients with AKI who also have COVID-19? That's the question posed by a recent study in CJASN that analyzed New York University (NYU) Langone Health's electronic health data of COVID-19 hospitalizations between March 2, 2020, and August 25, 2020.

“This research is important because palliative care is often an untapped resource that can help patients and families cope with difficult situations. Serious acute illness is an overwhelming time for

Tracy Hampton

Although kidney transplantation is the optimal therapy after kidney failure for prolonging patient survival and improving quality of life, kidneys transplanted from deceased donors often do not function longer than 10 to 15 years. Therefore, many recipients must eventually receive a second transplant or undergo dialysis, with considerations such as the scarcity of donor organs and the immunological sensitization of transplant recipients factoring into decisions related to these options.

Because direct comparison of transplantation versus dialysis continuation through a randomized controlled trial is not feasible due to ethical, biological, and logistic reasons, investigators recently conducted a retrospective study that analyzed