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In the AASK (African-American Study of Kidney Disease and Hypertension) trial, 1094 non-diabetic, black patients, with hypertension-related nephropathy, have been examined, randomizing them to a standard or intensive anti-hypertension treatment. In spite of the average pressure value obtained through intensive treatment (130/78 vs. 141/86 mmHg), the obtained composed outcome– a reduction of 50% in glomerular filtration, terminal-stage renal disease, death – has been reached with a similar frequency in the two groups.
MedNews (Nefrologia) - Lun, 21 Novembre 2011
http://mn.medsurfnews.com/
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African-Americans with two copies of the APOL1 gene have about a 4 percent lifetime risk of developing a form of kidney disease, according to scientists at the National Institutes of Health. The finding brings scientists closer to understanding why African-Americans are four times more likely to develop kidney failure than whites, as they reported in the Oct. 13 online edition of the Journal of the American Society of Nephrology.
National Institutes of Health (Nefrologia) - Mar, 25 Ottobre 2011
http://www.nih.gov
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Besides being non-invasive, urine sTREM-1 testing is more sensitive than testing WBC, serum CRP, and serum PCT for the early diagnosis of sepsis, as well as for dynamic assessments of severity and prognosis. It can also provide an early warning of possible secondary AKI in sepsis patients.
Critical Care (Nefrologia) - Mar, 25 Ottobre 2011
http://ccforum.com
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We have recently seen a certain tendency to anticipate as much as possible the beginning of dialysis in patients with severe renal diseases, but is there an evidence justifying this tendency? In Australia and New Zealand a randomized trial has been performed, where 828 adults with chronic nephropathy have been assigned to dialysis according to the value of glomerular filtration, if it had decreased to 10-14 ml/min/m2 or 5-7 ml/min/m2. If the subjects randomized to the second group (late beginning) had presented symptoms justifying it, they would have been immediately sent to dialysis.
MedNews (Nefrologia) - Lun, 26 Settembre 2011
http://mn.medsurfnews.com/
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NICE has launched its new quality standard for chronic kidney disease (CKD) in adults. The launch coincides with World Kidney Day(10 March). The quality standard on CKD defines high quality patient care, and includes such statements as: people with CKD are assessed for disease progression; people with CKD are assessed for cardiovascular risk; people with established renal failure have access to psychosocial support (which may include support with personal, family, financial, employment and/or social needs) appropriate to their circumstances; and, people with CKD are supported to receive a pre-emptive kidney transplant before they need dialysis, if they are medically suitable.
National Institute for Health and Clinical Excellence (Nefrologia) - Lun, 14 Marzo 2011
http://www.nice.org.uk
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As the immunosuppressive potency of 15-deoxyspergualin (DSG) has been shown in the therapy of renal transplant rejection and Wegener's granulomatosis, a study evaluates the safety of DSG in the therapy of lupus nephritis (LN). Patients with histologically proven active LN after prior treatment with at least one immunosuppressant were treated with 0.5 mg/kg normal body weight/day DSG, injected subcutaneously for 14 days, followed by a break of one week. These cycles were repeated to a maximum of 9 times. Doses of oral corticosteroids were gradually reduced to 7.5 mg/day or lower by cycle 4. Response was measured according to a predefined decision pattern. The dose of DSG was adjusted depending on the efficacy and side effects. Although the number of patients was small, results demonstrate that DSG appears to provide a tolerably safe treatment for LN. The improvement in proteinuria encourages larger controlled trials.
Arthritis Research & Therapy (Nefrologia) - Mar, 1 Marzo 2011
http://arthritis-research.com/
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A large number of dialysis patients are at increased risk of cancer due to high radiation doses, and doctors should think about reducing these patients' levels of radiation exposure, a new study suggests. The researchers noted that many kidney disease patients who are receiving dialysis also have other health conditions that require them to undergo radiation procedures for diagnosis and treatment, resulting in high doses of radiation over an extended period of time. The study, from researchers at University Hospital "Maggiore della Carita," in Novara, Italy, included 106 dialysis patients whose exposure to radiation from medical procedures was assessed for an average of three years. Overall, 22 patients received low doses of radiation each year, 51 received moderate doses, 22 received high doses and 11 received very high doses. In addition, the investigators found that exposure to radiation at levels that have been associated with a substantial increase in the risk of cancer-related death were noted among 17 of the patients.
Medline Plus (Nefrologia) - Mar, 1 Marzo 2011
http://www.nlm.nih.gov/medlineplus
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Despite major advances in kidney care over the last two decades, type 1 diabetes patients with kidney dysfunction still have high rates of kidney failure and heart-related death. A new study included 423 white patients with type 1 diabetes who developed macroalbuminuria and were enrolled in the study between 1991 and 2004. Most of the patients (98 percent) were followed through 2008. During the follow-up, 172 patients developed end-stage renal disease, and 70 of these patients died. Another 29 study participants died before developing end-stage renal disease. "Our findings - investigators said - clearly indicate that the accomplishments in treatment of patients with type 1 diabetes and macroalbuminuria over the last 20 years are not effective enough, and more effective therapies to retard progression to end-stage renal disease are desperately needed. New therapies need to be developed including more aggressive or experimental protocols to stop or retard declining renal function, which leads to end-stage renal disease".
Medline Plus (Nefrologia) - Mar, 1 Marzo 2011
http://www.nlm.nih.gov/medlineplus
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New evidence has prompted NICE to update its clinical guideline on the levels of haemoglobin that help doctors determine when their patients with chronic kidney disease should receive treatment for anaemia, as well as the safe haemoglobin limits that they should aspire to keep their patients within.
National Institute for Health and Clinical Excellence (Nefrologia) - Mar, 15 Febbraio 2011
http://www.nice.org.uk
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Recent studies suggest that renin-angiotensin blockade can slow the progression of--and possibly prevent--diabetic retinopathy, providing hope for this greatly feared complication of diabetes.
Medscape (Nefrologia) - Mar, 15 Febbraio 2011
http://www.medscape.com