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Daniel M. Keller

With the incidence and prevalence of cardiovascular disease (CVD) increasing worldwide and its connection to chronic kidney disease (CKD), the new president of the European Renal Association – European Dialysis and Transplant Association outlined in a news conference at the association’s 48th Congress in Prague several steps by which physicians can help to alleviate the personal and economic burdens of CVD. CVD is responsible for about 10 percent of all illness and 30 percent of all deaths in the world.

Raymond Vanholder, MD, PhD, professor of medicine at the University of Ghent and clinical head of the nephrology division of

Daniel M. Keller

Patients with advanced chronic kidney disease (CKD) and type 2 diabetes who took bardoxolone, a first-in-class oral antioxidant inflammation modulator, continued to show improvements in their estimated glomerular filtration rates (eGFR) at 52 weeks, mirroring results at 24 weeks that were presented at least year’s American Society of Nephrology meeting in Denver.

Speaking at the 48th Congress of the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) in Prague, David Warnock, MD, professor of medicine at the University of Alabama at Birmingham, told the congress that these latest results suggest that the drug may be useful for treating

Daniel M. Keller

Kidney transplant recipients with vitamin D deficiency who received vitamin D supplementation fared no better in the short term posttransplant than those who did not receive vitamin D. Supplementation may even have had adverse effects on the transplanted organs, a study shows.

Almost 90 percent of patients who receive renal allografts show a lack of vitamin D because of treatments with corticosteroids for immunosuppression as well as advice to avoid sun exposure because of an increased risk of cancer from immunosuppression. However, there has not been consensus about what to do for these patients.

Researchers led by Ursula Thiem, MD,

Daniel M. Keller

Optimal supportive therapy (SUP) can obviate the need for immunosuppression in treating progressive IgA nephropathy (IgAN), a new study shows. Among patients with biopsy-proven IgAN, SUP drove 30 percent of them into a low-risk category, slowing their loss of renal function and overcoming the benefits of immunosuppression.

For the prospective Supportive Versus Immunosuppressive Therapy for Progressive IgA Nephropathy (STOP-IgAN) trial, eligible adult patients at 32 nephrology centers underwent a 6-month run-in phase of SUP using antihypertensive, antiproteinuric (ACE inhibitor or angiotensin-receptor blocker), and statin medications as well as dietary counseling. Patients with persistent proteinuria >0.75 g/day at the end of

Daniel M. Keller

Exercise may benefit patients with end stage renal disease (ESRD) by improving their functional independence, resistance to disability, and survival of acute stressors.

Exercise is often broken down into endurance exercise, such as walking or running, and resistance exercise. Endurance exercise can be quantified as peak oxygen uptake or aerobic capacity. Resistance exercise is more about strength or muscle power.

Kathy Sietsema, MD, professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, and chief of respiratory and critical care medicine at Harbor-UCLA Medical Center in Torrance, Calif., explained that energy production in

Daniel M. Keller

Albuminuria is a stronger predictor of renal disease progression and cardiovascular (CV) morbidity and mortality than is glomerular filtration rate (GFR), said George Bakris, MD, in his talk at the two-day program “CKD and CVD from the Vascular Viewpoint: Merging Basic and Clinical Sciences to Optimize Treatment” at Renal Week. Bakris stressed the need to monitor and reduce proteinuria to maximize risk reduction and said that blood pressure control is a key element in therapy.

Bakris, professor of medicine and director of the Hypertensive Diseases Unit at the University of Chicago Pritzker School of Medicine, cited a study of 4421

Daniel M. Keller

Urban and rural physicians involved in kidney transplantation have different perceptions about various aspects of the procedure, including when it should be done in the course of end stage renal disease (ESRD) and for which patients. While several socioeconomic, racial, gender, geographic, and logistical factors have been explored previously to account for differences in transplantation rates, researchers at Pennsylvania State University College of Medicine in Hershey investigated physicians’ perceptions about transplantation as another possible explanation for the disparities.

Rural patients in general have a lower rate of being waitlisted or transplanted than their urban counterparts, said Hooman Hajian, MD, MPH,

Daniel M. Keller

Intensive glucose control with target HbA1c levels of 6.5 percent or less protects kidney function for patients with type 2 diabetes mellitus (T2DM), according to results of new analyses of the ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) study.

Because the risk of end stage kidney disease is 12-fold higher among patients with T2DM, and because renal disease is a strong independent predictor of cardiovascular risk, prevention and management of renal disease has to be a major effort in the care of patients with T2DM.

In the ADVANCE trial, 11,140 patients ≥55 years with T2DM

Daniel M. Keller

Nurse practitioners did as well as physicians when they were part of a multifactorial program to improve management of some cardiovascular (CV) risk factors. They lessened the need for physician visits for patients with chronic kidney disease (CKD) but were unable to modify lifestyle risk factors such as smoking, body weight, physical activity, or sodium intake.

Researchers performed the Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of Nurse Practitioners (MASTERPLAN) study to investigate whether a multifactorial intervention based on guidelines with the added support of specialized nurse practitioners to augment physician visits could reduce CV

Daniel M. Keller

Paricalcitol allowed the achievement of target parathyroid hormone levels better than cinacalcet in patients with secondary hyperparathyroidism (SHPT), a complication of chronic kidney disease (CKD). Both a vitamin D receptor activator such as paricalcitol and a calcimimetic such as cinacalcet effectively treat SHPT, which is characterized by elevated serum levels of intact parathyroid hormone (iPTH). Elevated iPTH levels can lead to skeletal and cardiovascular complications.

Speaking at the 48th Congress of the European Renal Association—European Dialysis and Transplant Association in Prague, Markus Ketteler, MD, of the division of nephrology at the Coburg Clinic in Coburg, Germany, told the congress that