For patients with chronic kidney disease, statin treatment: • Lowered LDL cholesterol, • Lowered the risk of heart disease and stroke, • Had no impact on the development of kidney failure, • Was safe and well tolerated.
On May 1, 2014, the American Society of Nephrology (ASN) will join 14 other leading kidney organizations in Washington, DC, to push for essential change in kidney care. Participants in Kidney Community Advocacy Day, representing the nation’s kidney patients and health professionals, will meet with government leaders to discuss two issues that will improve the treatment and quality of life for millions of Americans: increasing federal investment in kidney research, and extending lifetime immunosuppressive drug coverage for kidney transplant recipients.
• In Australia, kidney failure patients from the most advantaged areas were less likely to use home dialysis and more likely to use in-center hemodialysis than patients from the most disadvantaged areas. • Patients from the most advantaged areas were more likely to use private hospitals than those from the most disadvantaged areas.
• Dialysis patients with higher BMI, waist circumference, and abdominal fat measures had poorer scores on a 6-minute walking test. • Patients with more muscle mass had better scores on the walking test as well as better scores on physical and mental health questionnaires
Certain prenatal risk factors are associated with the development of chronic kidney disease in children, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Future studies should investigate whether modifying these factors could help protect children’s kidney health.
• Kidneys from most patients with chronic kidney disease were positive for active cytomegalovirus infection. • Patients with higher levels of anti-cytomegalovirus antibodies in their blood had lower number of red blood cells. • Cytomegalovirus blocks a protein needed to make a hormone that in turn stimulates red blood cell production.
• Low doses of atrasentan, an endothelin receptor A inhibitor, lowered urinary protein excretion by 36% in patients with diabetes and kidney disease. • Atrasentan also lowered blood pressure and cholesterol levels without causing major side effects.
The President of the American Society of Nephrology (ASN) testified before the House Science, Space, and Technology Committee that a prize competition could help spur innovation in kidney disease research.
In African American patients with chronic kidney disease, poor quality of life was linked with increased risks of disease progression and heart problems
• In kidney disease patients, 30 minutes of walking improved the responsiveness of certain immune cells to a bacterial challenge and induced a systemic anti-inflammatory environment in the body. • Six months of regular walking reduced immune cell activation and markers of systemic inflammation.
• A receptor called B7-1 is expressed by kidney cells during the progression of kidney disease in diabetic mice and humans. • Targeting this receptor with an available drug called CTLA4-Ig, or abatacept, helps to maintain kidney function in mice.
• Diabetics with major depressive symptoms had an 85% higher risk of developing kidney failure. • Minor depressive symptoms were not significantly linked with the development of kidney failure among diabetics.
• States with broader Medicaid coverage among low-income nonelderly adults had lower incidences of kidney failure from 2001 through 2008. • Low-income nonelderly kidney failure patients with Medicaid had better access to care in states with broader Medicaid coverage.
• Medical research funding in the United States is at an all-time low. • Diminished funding has affected kidney disease research more than other disease-defined research areas.
• In rats with kidney disease, functioning of the kidney improved when the organ was fused with the omentum, a fatty fold of tissue that lies close to the kidney and is a rich source of stem cells. • Stem cells from a chronic kidney disease patient’s own omentum may help heal diseased kidneys without the need for an outside source of cells.
Highlights • Older adults are the fastest growing population with end-stage renal disease in the U.S. • The American Society of Nephrology (ASN) has released an educational video for medical professionals and key information for older patients.
• A new urine test can distinguish among different causes of kidney dysfunction in kidney transplant recipients. • If validated in larger multicenter study, the test may allow patients to avoid invasive kidney biopsies.
• In a study of 267 patients with chronic kidney disease, 69% of participants experienced at least one hazardous event related to their outpatient care. • Hypoglycemia (in patients with diabetes) and falling or severe dizziness (in patients without diabetes) were most frequently paired with other complications of medical care.
• Biopsy-detected injury in donated kidneys was modestly associated with a delay in organ function in the first week after transplantation, but only for donor kidneys already known to be at high risk. Donor kidney biopsies frequently underreported kidney injury with substantial variability. • There was a large degree of overlap between the results of biopsies from kidneys that were deemed unsuitable for transplantation and kidneys that were approved for transplantation. The quality of biopsies used in acceptance decisions was low.
• For pregnant women with kidney failure who underwent dialysis for more than 36 hours per week, the live birth rate was 85%, while it was only 48% in women dialyzed for 20 hours or less per week. • Infants were a healthier weight at birth when women were dialyzed for more than 20 hours per week than when women were dialyzed for 20 hours or less per week. • Pregnancy complications were few and manageable in patients receiving intensive dialysis.
• Hospitalized patients who recovered from acute kidney injury had a 67% increased risk of experiencing coronary events or dying during a recent study. • Acute kidney injury’s harmful effects on heart health were comparable to those attributed to diabetes.
• Domoic acid accumulates in seafood and is toxic to the brain • The toxin damages kidneys at concentrations that are 100 times lower than what causes neurological effects.
Drug could help patients forgo toxic standard treatments that are often ineffective
• African-American dialysis patients with sickle cell trait received about 13% more of the medications used to treat anemia than other African-American patients to reach the same level of hemoglobin. • Sickle cell trait was slightly more common in African-American patients on dialysis (10%) than in the general African-American population (6.5% to 8.7%).
• There is substantial geographic variation in deceased donor kidney waiting times for children across the United States, with median waiting time ranging from as little as two weeks to as long as three years. • Local supply and demand of high quality organs had a significant impact on waiting times for children in need of kidneys.
• A single low dose of lithium given to mice following acute kidney injury promotes kidney repair and accelerates the recovery of kidney function.
• Putative kidney progenitor cells contribute to kidney function decline by causing kidney scarring. Targeting these cells may therefore help prevent or treat kidney failure. • Researchers have identified an additional but limited reserve of kidney filtering cells that are present at birth and become mature and functional filter cells by adulthood.
• Among women on chronic dialysis, sexual inactivity is common, with the most frequently described reasons being lack of interest in sex and lack of a partner. Rarely is sexual difficulty reported as a reason for lack of interest • Most women on chronic dialysis—including those lacking interest in sex—are satisfied with their sex lives.
• Investigators have discovered a cocktail of chemicals which, when added to stem cells in a precise order, turns on genes found in kidney cells in the same order that they turn on during embryonic kidney development. • The kidney cells continued to behave like kidney cells when transplanted into adult or embryonic mouse kidneys.
• In individuals with moderate-to-severe kidney disease, those performing more than 150 minutes of physical activity per week had the lowest rate of kidney function decline. • Each 60-minute increment in weekly physical activity was linked with a 0.5% slower decline per year in kidney function.
• Even small amounts of physical activity can lead to up to a 31% decreased risk of developing kidney stones. • Eating more than 2200 calories per day may increase one’s risk of developing kidney stones by up to 42%.
• HIV infection occurred in 68% of the HIV-positive transplant recipients’ new kidneys even in the absence of any detectable HIV in their blood. • A new urine test can detect these infections and lead to better diagnosis and treatment
• Among a group of veterans discharged from the hospital after acute kidney injury or heart attacks, death occurred most often in patients who experienced both conditions and least often in patients experiencing heart attacks alone. • Patients with acute kidney injury later experienced more major heart and kidney problems than those who had heart attacks.
• Most older adults initiate chronic dialysis in the hospital. • Those who have a prolonged hospital stay and receive other forms of life support around the time of dialysis initiation have limited survival and eventually need to undergo more intensive procedures.
• Compared with women with advanced kidney disease who conceived after starting dialysis, women who conceived and then started dialysis during the pregnancy had a much better live birth rate (91% vs 63%), but their infants were of similar birth weight and gestational age. • In both groups of women with kidney disease, babies were likely to be premature and of low birth-weight, which reflects the high-risk nature of these pregnancies.
The HOPE Act could allow individuals with HIV to receive organ transplants from donors with HIV, and may help reduce the country’s current organ shortage. The American Society of Nephrology worked hard to ensure passage of this no-cost legislation that may help reduce kidney transplant waiting times.
Dr. Moe's priorities include reducing health disparities, strengthening the workforce, protecting research, and improving quality of care.
• Preeclampsia was associated with an increased likelihood of developing kidney failure; however, after adjusting for diabetes and hypertension, the association was attenuated and no longer significant. • Additional studies are needed to confirm the association of preeclampsia and kidney failure.
• In patients with hypertensive nephropathy, kidney health was preserved in those consuming extra fruits and vegetables, which are highly alkaline. • In patients with chronic kidney disease, those with high dietary acid levels experienced accelerated kidney function decline. • In chronic kidney disease patients with low socioeconomic status, the detrimental effect of high dietary acid levels on progression to kidney failure was greater for blacks than for whites
Highlight • Among first responders at Ground Zero following the 9/11 tragedy, those exposed to high levels of particulate matter experienced significant kidney damage.
Highlights • Consuming at least two soft drinks per day is linked with increased excretion of protein in the urine. • Moderate fructose intake increases salt reabsorption by the kidneys.
View research, multimedia, and additional meeting resources in the ASN Kidney Week 2013 virtual newsroom on Newswise
• In a new study, kidney failure patients who said they had more experiences of discrimination in health care, greater medical mistrust, and lower trust in one's physician also had poorer quality of life.
• Combining blood pressure–lowering drugs can cause serious side effects in patients with type 2 diabetes and moderately decreased kidney function. • Among dialysis patients with hypertension and thickened heart muscles, certain antihypertensive medications are better than others for preventing cardiovascular disease and hospitalizations. • Variants in the APOL1 gene are linked with an increased risk of kidney disease progression in African Americans, regardless of diabetes or blood pressure status. • An intervention that reduces the risk of acute kidney injury may not necessarily improve surgery patients’ long-term kidney function.
• An investigational drug called ZS-9 demonstrated promising phase 2 clinical trial results for treating abnormally high potassium levels in patients with chronic kidney disease. • The immune drug abatacept did not provide benefits above standard treatment for patients with kidney inflammation caused by lupus.
Highlights • Vitamin D levels had an almost linear relationship with annual kidney function decline among kidney transplant recipients • Vitamin D inadequacy and deficiency showed significant dose-dependent associations with higher risks of organ rejection and death.
• In patients with chronic kidney disease who lowered their salt intake for two weeks, excess extracellular fluid volume, blood pressure, and protein excretion in the urine all dropped considerably. • If maintained long-term, the effects could reduce a patient’s risk of progressing to kidney failure by 30%.
• In 74 obese kidney disease patients undergoing weight loss surgery, there were 16 adverse events, including two deaths related to surgical complications.
• Worldwide, there has been a 165% increase in dialysis treatments for ESRD over the past two decades.
• Acute kidney injury is the most common in-hospital diagnosis seen by US nephrologists. • Patients with AKI are often critically ill, but survivors of in-hospital AKI are often not seen by kidney specialists after being discharged.
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