Articles tagged with Nephrology
The 2017 American Academy of Pediatrics guideline shows higher levels of proteinuria in children with hypertensive range blood pressure. Clinicians should re-calculate BP percentiles using the new guidelines to accurately diagnose and treat hypertension in pediatric chronic kidney disease.
Regular follow-up clinic visits with a nephrologist after hospital discharge significantly reduce mortality risk in patients with acute kidney injury (AKI). This study found that such visits, focusing on cardiovascular disease and kidney complications management, lead to lower mortality rates by 29% compared to standard care.
A study of 510 children with chronic kidney disease found that declining hemoglobin levels were associated with significant growth impairment even when above guideline-targeted levels. Lower hemoglobin values are linked to poorer growth, independent of kidney function and age.
Researchers found that a one-year increase in retinal age was associated with a 10% higher risk of incident kidney failure over 11 years. Retinal age gap, a non-invasive biomarker based on retinal imaging, may help identify people at elevated risk for kidney failure.
A large South Korean cohort study found a five-fold increased risk of chronic kidney disease (CKD) for adults with persistent hematuria. Associations were stronger in men compared to women.
Two new studies found that dialysis facilities owned by nephrologists may provide better care, with patients receiving home dialysis more often. Additionally, a shorter interval between dialysis and surgery was associated with improved post-surgery survival rates.
A higher urine-to-plasma urea ratio is associated with faster decline in eGFR and development of kidney failure in patients with common forms of CKD. This biomarker may improve risk prediction, particularly in low-cost, easily measurable assays.
Dr. Susan E. Quaggin, a leading expert in kidney health, has been recognized as one of seven Distinguished Scientists by the American Heart Association. Her groundbreaking research on transcription factor action and vascular endothelial growth factor has led to new insights into pre-eclampsia and kidney disease.
A study published in the New England Journal of Medicine found that new onset CKD rates are higher among Native Hawaiian/Pacific Islander, Black, American Indian/Alaska Native, and Hispanic/Latino populations compared to white persons with diabetes. The rate declined from 8% in 2015-2016 to 6.4% in 2019-2020.
Experts recognize obesity as a prime inducer of CKD and related adverse outcomes, emphasizing the need for bridging common ground between nephrology and obesity medicine. Strategies include recognizing obesity as a chronic disease with targeted treatments and trained clinical extenders to promote effective care.
Researchers found a significant association between extreme heat exposure and emergency room visits for acute kidney injury, kidney stones, and urinary tract infections. The impact of extreme heat exposure lasted up to a week, with stronger effects during transitional months.
A Swedish cohort study found that direct oral anticoagulants (DOACs) were associated with a lower risk of kidney function decline or kidney failure compared to vitamin K antagonists (VKA). DOACs also showed a lower risk of acute kidney injury.
Researchers at the University of Pittsburgh discovered that a cellular channel outside the kidneys plays a crucial role in maintaining healthy blood pressure levels. The study found that subtle mutations in this channel can influence blood pressure, providing a potential new target for existing medications.
A national US kidney disease registry found that 60% of participants were unaware of their kidney function level, hindering clinical trial recruitment. The National Kidney Foundation Patient Network aims to address this issue through real-world data collection and patient-centered research.
Anemia is common among adults with advanced kidney disease, associated with adverse outcomes and low eGFR levels. Effective iron supplementation is a low-risk intervention to address this issue, emphasizing the need for increased testing and treatment.
Reduced kidney function and increased urine albumin excretion are associated with brain volume reduction in regions typically affected by Alzheimer's disease and other dementia etiologies. Cognitive decline is common in patients with kidney disease, and this study provides new insights into the etiology and localization of brain damage.
The study found a significant decline in peritoneal dialysis-associated peritonitis rates over time, with consistent differences in risk by race and age. The decline suggests improvements in clinical practice and highlights the importance of uniform coding standards to identify additional risk factors.
A prespecified subgroup analysis of East Asian adults with lupus nephritis found that belimumab added to standard therapy improved kidney outcomes significantly. The study also showed no new safety concerns were raised in the subgroup.
A quality improvement program increased pneumococcal vaccination rates from 53% to 70% in adults aged 18-64 years with stage 4 and 5 chronic kidney disease. The intervention, which utilized electronic best practice alerts within the electronic medical record, improved vaccination rates primarily among this high-risk group.
A 12-month exercise program improved physical functioning and aerobic exercise capacity in adults with CKD stages G3b-4. The program, which included resistance and aerobic exercise, showed no significant impact on cardiovascular risk factors.
A new USC analysis found that the largest Medicare Advantage plans pay 27% more for outpatient dialysis treatment compared to traditional Medicare. This significant markup is attributed to the consolidation of the dialysis industry, with two large chains supplying over three-quarters of all dialysis services in the US.
A Mayo Clinic study found that diets rich in calcium and potassium can help prevent recurrent symptomatic kidney stones. Patients who experienced a first-time stone were more likely to experience recurrence if their diet was low in these nutrients.
A qualitative study highlights the importance of timely and balanced information exchange in shared decision-making for vascular access placement. This collaborative approach involves presenting choices, sharing personalized knowledge, and eliciting patients' values and preferences to strengthen treatment plans.
A new clinical model predicts hospital mortality and major adverse kidney events in critically ill patients with acute kidney injury. The proposed model exhibits good performance for outcome prediction, enabling timely interventions to promote kidney recovery.
Lumasiran, an RNA interference therapeutic, has been shown to reduce oxalate levels in patients with primary hyperoxaluria type 1 (PH1) who have relatively preserved kidney function. In the ILLUMINATE-C study, lumasiran resulted in substantial reductions in plasma oxalate with acceptable safety in patients on hemodialysis.
A long-term study of 3,926 adults with CKD found that higher levels of physical activity reduced the risk of atherosclerotic events, new-onset heart failure, and death. The association was strongest for incident peripheral arterial disease and reinforces current guideline recommendations.
A study found that over 60% of parents of children with kidney disease or hypertension are unsure or unwilling to vaccinate their child against COVID-19. Effective vaccines exist to protect children from COVID-19, and the findings highlight the need for clear communication to address parental concerns.
A novel AI-empowered robotic device successfully assisted in percutaneous nephrolithotomy—surgery for removing large kidney stones. The trial showed improved precision and reduced complications, with a significant reduction in needle punctures and puncture duration.
A study found that US adults receiving hemodialysis with high air pollution exposure have more heart attacks and strokes compared to those with low exposure. The strongest associations were noted among patients who were Asian, older, or had chronic lung disease at dialysis initiation.
A third dose of COVID-19 vaccine may be essential for kidney transplant patients in Japan to prevent severe disease and infection. Researchers found that only a third of patients developed sufficient antibodies after two doses, highlighting the need for additional protection.
Patients with primary glomerular diseases have a significantly higher risk of cardiovascular events, including coronary artery disease and stroke. The study found that inclusion of kidney-specific risk factors improved the prediction of cardiovascular events.
A protocol-based potassium supplementation strategy resulted in a longer time to the first peritonitis episode and a lower hazard ratio of peritonitis compared to reactive supplementation. This approach also improved PD-related outcomes by significantly reducing the risk of peritonitis.
Researchers at The University of Toledo found that low-dose lithium acts as a powerful anti-aging agent in the kidneys by blocking GSK3-beta, an enzyme associated with cellular aging. Studies showed improved kidney function and reduced albuminuria in mice and psychiatric patients treated with lithium.
Patients with mild to moderate kidney disease and kidney transplant recipients had a higher risk of cancer. They also faced a higher risk of dying from cancer, particularly from cancers such as bladder, kidney, and multiple myeloma, compared to those with normal kidney function.
Researchers have discovered a significant association between acute kidney injury and an increased risk of developing dementia in patients hospitalized with AKI. Early detection and monitoring may lead to improved outcomes for this high-risk population.
Dr. Kushani Jayasinghe, a nephrologist and trainee in clinical genetics, received the 2022 Richard King Award for her article on genomic testing in patients with suspected monogenic kidney disease. The award recognizes high-quality research published in Genetics in Medicine by trainees.
Dialysis facilities referred more incident patients, transplant centers evaluated more, but fewer were placed on the waitlist following KAS implementation. This led to a decline in overall waitlisting nationwide.
A new dialysis system can produce sterile, medical grade water in the home, providing an affordable option for patients with kidney failure. The Ellen Medical Devices Point-of-Care system has been tested and found suitable for use in peritoneal dialysis fluid production.
A cost-effectiveness analysis found that adherence promotion programs like MAPS reduce costs and improve outcomes for adolescent kidney transplant recipients. Strategies with similar costs to MAPS can still be cost-effective if they decrease rejection episodes by a small amount.
Young adults are disproportionately excluded from kidney transplantation, with only 1.8% of Black and 4.4% of Hispanic patients receiving the treatment compared to 10.9% of White patients within this age group. The study highlights the need for targeted interventions to address these disparities.
A new study published in JAMA Internal Medicine has found that gene variants increased the risk of acute kidney injury and death in African American veterans hospitalized with COVID-19. The study, which analyzed data from over 850,000 diverse veterans, identified APOL1 variants as a key contributor to this increased risk.
A study by Henry Ford Health System found that one in four patients who developed acute kidney injury (AKI) die within a year, emphasizing the urgent need for improved treatments. The study analyzed data from over 1.6 million U.S. Veterans hospitalized between 2008 and 2017, providing valuable insights into AKI-associated mortality.
Researchers in Japan evaluated the cost-effectiveness of adding dipstick hematuria screening to a mass health check-up program. The study found that including routine testing for hematuria would promote early detection and treatment, leading to cost savings and improved patient outcomes. This cost-effective approach has the potential t...
A new study reveals that infant kidney transplants offer improved survival rates and lower graft failure rates after the first year. Early transplantation avoids adverse effects of waste buildup on neurodevelopmental outcomes and growth.
A recent study found that the number of stage 3 AKI kidneys transplanted in the US has increased significantly over the last decade, yet 44% are still discarded. This highlights the need for further efforts to optimize the use of these organs and reduce waste.
Researchers have developed a gel that improves the formation of arteriovenous fistulas, a vital connection site for kidney failure patients undergoing dialysis. The gel helps reduce intimal hyperplasia and vein narrowing, leading to better blood flow and increased success rates.
Researchers found that cerebral palsy patients with low muscle mass often have inaccurately calculated kidney function, leading to missed diagnoses of advanced kidney disease. This association increases the risk of cardiovascular disease and mortality in this population.
A study published in the New England Journal of Medicine found that chlorthalidone significantly lowered blood pressure by 11mmHg in patients with stage 4 chronic kidney disease. The results also showed a 50% reduction in albuminuria, suggesting potential benefits for reducing kidney failure progression and hospitalizations.
Researchers found that certain urinary biomarkers, including neutrophil gelatinase-associated lipocalin and kidney injury molecule-1, were associated with increased risk of severe acute kidney injury or death in patients hospitalized with COVID-19. These biomarkers may help identify patients at high risk for adverse kidney outcomes.
A University of Queensland study found that people exposed to higher amounts of the insecticide Malathion have a 25% higher risk of kidney dysfunction. Chronic kidney disease is a permanent condition characterized by loss of renal function and is often associated with age, hypertension, and diabetes.
The National Kidney Foundation has released a research roadmap to accelerate innovations in treatment and increase understanding of kidney disease. The report calls for increased funding in preclinical science, genetics, health equity, and implementation science to tackle the most vexing challenges in kidney disease.
Researchers at Kaiser Permanente identified a blood cystatin C test as an alternative to estimate kidney function, eliminating the need for racial considerations. The study showed that this approach produces similarly accurate results and may promote equity for people of all racial and ethnic backgrounds.
Referral guidelines for nephrology care are shifting towards identifying patients at higher risk of kidney failure. A study using Veterans Health Administration data found that referring patients with a two-year risk of kidney failure above 1% would identify those at highest median risk.
Ongoing acute kidney injury in deceased donor kidneys is linked to lower long-term graft survival. Notably, abnormal serum creatinine values during procurement also negatively impact graft outcomes.
Climate change is linked to environmental factors causing 24% of global deaths, including chronic kidney disease and acute kidney injury. The healthcare sector contributes to climate crisis, producing 4.4% of the global carbon footprint. Nephrologists play a crucial role in addressing climate change.
The article highlights the importance of pediatric nephrologists' involvement in caring for children with cancer, from diagnosis to treatment and beyond. Key findings include the increasing need for onco-nephrology expertise due to rising childhood cancer rates and advances in therapy protocols.
Research highlights subtle racist undertones in kidney function reporting, which may perpetuate biological basis for race. Physicians and scientists have a moral obligation to address historical practices rooted in racist ideology.
The N-PATH project will train 40 young European nephrologists from 6 countries through a two-year educational path with hands-on training and online lessons. The course is funded by the European Commission and will provide innovative advanced training in interventional nephrology.
A recent analysis found that the diabetes medication canagliflozin slowed kidney function decline in patients with diabetes and advanced chronic kidney disease. The drug also reduced the risk of developing kidney failure and cardiovascular problems in these patients.
A study assessing US nephrology fellows' perceptions on home dialysis training found moderate preparedness for peritoneal dialysis and low confidence in home hemodialysis. The majority of trainees participated in continuity clinics and education, yet desired more focused teaching on PD and HHD.