• High parathyroid hormone levels and subsequent bone loss are major risk factors for worsening of coronary artery calcification in patients on dialysis.
• For older patients in need of a kidney transplant, rapid transplantation from an older deceased donor is superior to delayed transplantation from a younger donor.
• Kidneys from older donors do not have sufficient longevity to provide younger patients with a lifetime of kidney function, but they do have sufficient longevity to provide older patients who have a shorter life expectancy with a lifetime of kidney function.
• Compared with uninfected (HIV-/HCV-) kidney transplant recipients, mono-infected HIV+ (HIV+/HCV-) recipients had similar 5-year and 10-year kidney survival rates, while HIV+ recipients co-infected with HCV (HIV+/HCV+) had worse kidney survival rates.
• Patient survival among mono-infected HIV+ recipients was similar to uninfected recipients but was significantly lower for co-infected recipients.
Kidney recipients infected only with HIV do as well as uninfected recipients, but HIV-infected recipients co-infected with hepatitis C virus have poorer outcomes.
Cardiovascular researchers at The Ohio State University Wexner Medical Center have shown that a protein known as MG53 is not only present in kidney cells, but necessary for the organ to repair itself after acute injury.
Highlights
• Among pregnant women, the risk for adverse pregnancy outcomes—such as preterm delivery or the need for neonatal intensive care—increased across stages of chronic kidney disease.
• The risks of intrauterine death or fetal malformations were not higher in women with chronic kidney disease.
• In kidney disease patients on hemodialysis or peritoneal dialysis, enzyme activities involved in HDL metabolism and HDL maturation were significantly altered.
• The normal function of HDL was also compromised in patients on hemodialysis or peritoneal dialysis.
The prevalence of chronic kidney disease (CKD) will rise in the United States, according to a new report led by RTI International and published in the American Journal of Kidney Diseases during March's National Kidney Month
An estimated 26 million people in the United States have chronic kidney disease, which can lead to complete kidney failure. Once the kidneys fail, patients either need to undergo dialysis treatments three times a week or have a kidney transplant to remain alive.
• In VA medical centers, patients started dialysis progressively earlier in the course of their kidney disease in more recent years.
• There were no measurable differences in how sick patients were at the time of initiation or in the reasons for dialysis initiation to explain this trend.
• In a study of patients with pre-dialysis chronic kidney disease, most patients reported chronic pain.
• More severe pain was linked with both proper and improper use of pain medications.
• Among patients with chronic kidney disease, patients who consumed high acid diets were 3-times more likely to develop kidney failure than patients who consumed low acid diets.
• Low acid load diets are rich in fruits and vegetables, while high acid diets contain more meats.
• An enzyme called heme oxygenase-1 (HO-1) affects immune cells as they travel through the body in response to kidney injury.
• In mice, the absence of HO-1 leads to poor recovery after acute kidney injury.
• A simple test performed with the FDA-approved medication furosemide, along with a measurement of urine output, can predict which patients with acute kidney injury will later require dialysis.
• The test could help clinicians safeguard patients’ kidney health.
• Salt intake accelerated kidney scarring in rats with chronic kidney disease by activating a brain-kidney connection called the renin-angiotensin axis that interlinks the damaged kidney and brain by afferent and efferent sympathetic nerves.
• Targeting these nerves reduced salt-induced kidney scarring.
• Both low and high blood calcium levels, as well as high phosphorus levels, were linked with an increased risk of dying prematurely in dialysis patients, regardless of the type of dialysis.
• The findings address a pending Medicare quality measure related to dialysis patients’ blood calcium levels.
• A new algorithm is a useful tool for measuring chronic kidney disease patients’ readiness for making decisions about initiating dialysis.
• Patients who have knowledge about their options and have fewer lifestyle barriers to home dialysis are more likely to be ready to make decisions. Doctors who explain all of the treatment options that are available can increase patients’ readiness for decision-making.
• Among patients with a kidney disease called focal segmental glomerulosclerosis (FSGS), those who had certain genetic variants tended to have more advanced disease when they were diagnosed.
• Patients with the variants responded to immunosuppressant treatments just as well as other patients but tended to progress more rapidly to kidney failure.
Fewer new cases of end-stage renal disease are being reported in the United States and mortality rates are declining, indicating that patients on dialysis or with a kidney transplant are living longer.
Kidney donors with hypertension had slightly fewer nephrons (the kidney’s filtering units) at the time of donation than similarly aged donors with normal blood pressure; however, 6 months following their surgery, hypertensive and non-hypertensive donors both maintained excellent blood pressure control and had similarly robust compensatory kidney responses.
Frequent kidney dialysis can cause systemic inflammation, leading to complications such as cardiovascular disease and anemia by triggering the complement cascade, part of the innate immune system. Complement is inadvertently activated by modern polymer-based dialysis blood filters. New work has found an effective way to avoid these problems by temporarily suppressing complement during dialysis.
• Decreased blood levels of a protein called Klotho increases the risk of heart disease in mice with chronic kidney disease.
• If confirmed in humans, increasing Klotho levels may help protect the hearts of patients with chronic kidney disease.
• A simple model using 5 commonly available variables from electronic health records adequately discriminates between socially disadvantaged individuals with chronic kidney disease who will and will not progress to kidney failure.
Chronic kidney disease affects at least one in four Americans who are older than 60 and can significantly shorten lifespan. Yet the few available drugs for CKD can only modestly delay the disease’s progress towards kidney failure. Now, a team has found an aspect of CKD’s development that points to a promising new therapeutic strategy.
Researchers presented two preliminary studies at ASN Kidney Week 2014 in Philadelphia, PA, that demonstrate the potential of a small-molecule inhibitor of NHE3 to help reduce phosphorus absorption in patients with kidney disease. Patients with reduced kidney function are unable to maintain normal levels of phosphorus, which can lead to hyperphosphatemia.
Chronic kidney disease (CKD) affects at least one in four Americans who are older than 60 and can significantly shorten lifespan. Yet the few available drugs for CKD can only modestly delay the disease’s progress towards kidney failure. Now, a team has found an aspect of CKD’s development that points to a promising new therapeutic strategy.
Researchers have identified genetic markers that may help to identify individuals at risk for acute kidney injury (AKI) in the hospital setting. Presented at ASN Kidney Week 2014 in Philadelphia, PA, the study offers new clues about the development of AKI and could lead to potential therapeutic interventions.
Research published today found that the investigational drug patiromer decreased high potassium levels and maintained normal potassium levels in patients with chronic kidney disease. The results of a multicenter trial appear in the New England Journal of Medicine.
• A 12-week course of aerobic exercise improved physical function and quality of life in patients with advanced chronic kidney disease.
• The exercise program also decreased patients’ pain.
• Living organ donors who later need kidney transplants have much shorter waiting times, and they receive higher quality kidneys compared with similar people on the waiting list who were not organ donors.
Rates of diabetic kidney disease could be higher than currently assumed according to a new study presented at ASN Kidney Week 2014 in Philadelphia. In an autopsy study of 150 individuals with type both type 1 and type 2 diabetes, researchers found 49.3% of individuals had diabetic nephropathy
An international team of researchers from France, Germany, and the US have identified a protein that turns a person’s immune system against itself in a form of kidney disease called membranous nephropathy (MN). The new research was presented at ASN Kidney Week 2014 in Philadelphia and published online in the New England Journal of Medicine.
Home dialysis therapies may help prolong the lives of patients with kidney failure compared with hemodialysis treatments administered in medical centers.
The results of numerous high-impact clinical trials that could affect kidney-related medical care will be presented at ASN Kidney Week 2014, November 11¬–16 at the Pennsylvania Convention Center in Philadelphia, PA.
Among kidney transplant recipients, a 3-month course of the antibiotic levofloxacin following transplantation did not prevent the major complication known as BK virus from appearing in the urine. The intervention was associated with an increased risk of adverse events such as bacterial resistance, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the American Society of Nephrology’s annual Kidney Week meeting.
In a study of blacks with normal kidney function, those with severe periodontal disease developed chronic kidney disease at 4 times the rate of those without severe periodontal disease.
Many young patients with chronic conditions don’t take their medications correctly, but 2 new studies point to ways to address such medication non-adherence.
• A comparison of two different cholesterol management guidelines indicates that the vast majority of patients with chronic kidney disease are recommended to receive statins.
• 50% of people with chronic kidney disease who are recommended to receive statins are not taking them.