In The Loop

Surgery Is Better than Bisphosphonates for Preventing Fractures in Patients with Hyperparathyroidism

Among 6272 people diagnosed with hyperparathyroidism between 1995 and 2010, there were 56 hip fractures per 1000 people after 10 years among those not treated for hyperparathyroidism. Among those who had parathyroid surgery, there were just 20 fractures per 1000 people. Surprisingly, the hip fracture rate was highest among those taking bisphosphonates, at 86 fractures per 1000 patients. Similar results were seen for bone fractures of all types.

Hospitalizations of Children with Pulmonary Hypertension on the Rise

Hospitalizations for pulmonary hypertension (PH) in US children doubled from 1 in 1000 in 1997 to 1 in 500 in 2012, according to a Pediatrics analysis of a national administrative database of pediatric hospital discharges. Inflation-adjusted national charges for PH hospitalizations rose from $926 million in 1997 to $3.12 billion in 2012. Mortality decreased from 11.3% of hospitalizations in 1997 to 5.9% in 2012. Patients without congenital heart defects accounted for 56.4% of PH hospitalizations in 2012.

Living Donor Kidney Transplant Chain is Longest on Record

On August 6–7, a living-donor kidney transplant chain that began on December 5, 2013, reached a record milestone of 51 transplants at the University of Alabama at Birmingham (UAB). The chain of transplants involved people from 11 states, and was started by an altruistic donation from Paula Kok. In all, there have been 102 total surgeries since, which included 51 nephrectomies and 51 transplants. Jayme Locke, MD, surgical director of the Incompatible Kidney Transplant Program in UAB’s School of Medicine, said that since Ms.

Recipients of Kidney Retransplantation Face Increased Risk of Renal Cell Carcinoma

In a study that examined cancer risk in recipients of kidney retransplantation, investigators found that overall cancer risk did not differ in retransplants compared with primary recipients.; hHowever, renal cell carcinoma occurred in excess among retransplants, with an adjusted incidence rate ratio of 2.03. The researchers noted that this increased risk may be explained by the presence of acquired cystic kidney disease, which is more likely to develop with additional time with kidney disease and time spent on dialysis waiting for retransplantatio

Drugs Used to Treat High BP May be Linked with Lower Alzheimer’s Risk

People genetically predisposed to have high systolic blood pressure may be at decreased risk of developing Alzheimer’s disease (AD). In a recent study, investigators identified causal associations between potentially modifiable risk factors and AD risk by analyzing genetic data from 17,008 individuals with AD and 37,154 controls.

Guideline Addresses How to Manage Dyslipidemia to Reduce Heart Disease Risk

A new report summarizes the recommendations of the US Department of Veterans Affairs and Department of Defense on managing dyslipidemia to reduce cardiovascular disease risk in adults, focusing on elimination of treatment targets, additional tests for risk prediction, primary and secondary prevention, and laboratory testing. The guideline recommends additional tests to refine risk only when the rationale is clear and recommends shared decision-making to determine the benefits and harms of each medication once the patient's 10-year risk has been determined.

Parathyroidectomy Halts Kidney Function Decline in Patients with Hyperparathyroidism and Kidney Disease

In a retrospective study of patients with both primary hyperparathyroidism and renal disease, parathyroidectomy stopped the progression of kidney function decline. After parathyroidectomy, eGFR did not change in patients with eGFR <60 mL/min/1.73 m2, whereas it was significantly reduced in patients with higher eGFR. Presurgical kidney function was the most relevant predictor of kidney function change after parathyroidectomy in the 109-patient study.

Sugar-Sweetened Drinks Linked to More than 180,000 Deaths Each Year

Researchers estimate that worldwide, 184,000 deaths per year are attributable to consumption of sugar-sweetened beverages (SSBs): 133,000 from diabetes, 45,000 from cardiovascular disease, and 6450 from cancers. Five percent of such deaths occurred in low-income, 70.9% in middle-income, and 24.1% in high-income countries. Proportional mortality due to SSB consumption ranged from <1% in Japanese >65 years old to 30% in Mexicans <45 years old, and 8.5 million disability-adjusted life years were related to SSB intake.

Program Seeks to Integrate Tissue Chips that Mimic Human Organ Functions

Researchers are working to refine 3-D human tissue chips and to combine them into an integrated system. Fifteen NIH institutes and centers are involved in coordinating the effort, which is called the Tissue Chip for Drug Screening program. One collaborative effort will share resources and expertise for the heart, blood vessel, and liver tissue chips.

Proteasome Inhibitor May Help Prevent Organ Rejection

A new study shows that bortezomib, a proteasome inhibitor that is already approved by the FDA for treatment of multiple myeloma, reduces HLA antibodies in patients with CKD to a greater extent than traditional methods employing intravenous immunoglobulin. A 51.5% reduction in immunodominant antibodies was observed at 28 days with bortezomib treatment (1.3 mg/m2) and reductions increased with higher bortezomib dosing densities. Nineteen out of 44 treated patients (43.2%) were transplanted with low acute rejection rates (18.8%) and donor-specific antibody formation (12.5%).

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