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Review | Cardiorenal syndrome in the hospital

7 Aug, 2023 | 14:36h | UTC

Cardiorenal Syndrome in the Hospital – Clinical Journal of the American Society of Nephrology


Commentary on Twitter



Review | Primary aldosteronism: a pragmatic approach to diagnosis and management

4 Aug, 2023 | 12:06h | UTC

Primary Aldosteronism: A Pragmatic Approach to Diagnosis and Management – Mayo Clinic Proceedings


KDIGO Conference | Managing the symptom burden associated with maintenance dialysis

4 Aug, 2023 | 12:02h | UTC

Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference – Kidney International

News Release: KDIGO Announces Publication of “Managing the Symptom Burden Associated with Maintenance Dialysis”


Commentary on Twitter


M-A | Uncertain benefits of blood purification techniques in severe infection or sepsis

4 Aug, 2023 | 11:41h | UTC

Blood Purification for Adult Patients With Severe Infection or Sepsis/Septic Shock: A Network Meta-Analysis of Randomized Controlled Trials – Critical Care Medicine


International Study | Postoperative acute kidney injury affects one in five patients after major surgery

1 Aug, 2023 | 14:23h | UTC

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study – Intensive Care Medicine


Commentary on Twitter


Novel therapeutics for management of lupus nephritis: what is next?

1 Aug, 2023 | 14:22h | UTC

Novel Therapeutics for Management of Lupus Nephritis: What Is Next? – Kidney Medicine

Related: Consensus document of the Spanish Group for the Study of the Glomerular Diseases (GLOSEN) for the diagnosis and treatment of lupus nephritis – Nefrología


Review | Revisiting resistant hypertension

1 Aug, 2023 | 14:16h | UTC

Revisiting resistant hypertension: a comprehensive review – Internal Medicine Journal

Related: Resistant hypertension: A stepwise approach – Cleveland Clinic Journal of Medicine

Podcast: #390 Resistant Hypertension – The Curbsiders


Review | Updates on infectious and other complications in peritoneal dialysis

26 Jul, 2023 | 13:23h | UTC

Updates on Infectious and Other Complications in Peritoneal Dialysis: Core Curriculum 2023 – American Journal of Kidney Diseases (free for a limited period)

Related: ISPD Catheter-related Infection Recommendations: 2023 Update – Peritoneal Dialysis International


Commentary on Twitter


Cohort Study | Proton pump inhibitor use linked to increased fatigue in kidney transplant recipients

26 Jul, 2023 | 13:21h | UTC

Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study – American Journal of Kidney Diseases


Commentary on Twitter


M-A | P2Y12 monotherapy after 1-3 months DAPT safely reduces bleeding in PCI patients with CAD and CKD

26 Jul, 2023 | 13:18h | UTC

P2y12 inhibitor monotherapy after 1–3 months dual antiplatelet therapy in patients with coronary artery disease and chronic kidney disease undergoing percutaneous coronary intervention: a meta-analysis of randomized controlled trials – Frontiers in Cardiovascular Medicine


De-escalation or abbreviation of dual antiplatelet therapy in acute coronary syndromes and percutaneous coronary intervention: a Consensus Statement from an international expert panel on coronary thrombosis – Nature Reviews Cardiology (if the link is paywalled, try this one)

RCT | 3-6 month DAPT noninferior to 12 month DAPT in patients undergoing PCI with third-generation DES

Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes – JACC: Cardiovascular Interventions

Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention: 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial – JAMA Cardiology (link to abstract – $ for full-text)

Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial – JAMA

Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial – JAMA

Comparison of Clopidogrel Monotherapy After 1 to 2 Months of Dual Antiplatelet Therapy With 12 Months of Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome: The STOPDAPT-2 ACS Randomized Clinical Trial – JAMA Cardiology

Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial – The BMJ

6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial – The Lancet

Dual Antiplatelet Therapy Duration Based on Ischemic and Bleeding Risks After Coronary Stenting – Journal of the American College of Cardiology


M-A | Early initiation of renal replacement therapy fails to improve survival rates in AKI patients

25 Jul, 2023 | 13:46h | UTC

Early strategy vs. late initiation of renal replacement therapy in adult patients with acute kidney injury: an updated systematic review and meta-analysis of randomized controlled trials – European Review for Medical and Pharmacological Sciences


Systematic Review | Insufficient evidence for ACEi/ARB’s impact on early non-diabetic CKD

24 Jul, 2023 | 12:56h | UTC

Angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non‐diabetic chronic kidney disease – Cochrane Library

Summary: Blood pressure lowering medication for adults with early stages of chronic kidney disease (without diabetes) – Cochrane Library


Podcast | Hematuria pearls

19 Jul, 2023 | 14:19h | UTC

#404 Hematuria with Dr. Derek Fine – The Curbsiders


RCT | Midodrine show promise as an alternative to albumin for the prevention of circulatory disturbance in paracentesis between 3 and 5 L

18 Jul, 2023 | 13:47h | UTC

Midodrine versus Albumin to Prevent Paracentesis Induced Circulatory Dysfunction in Acute on Chronic Liver Failure Patients in the Outpatient Clinic–a Randomized Controlled Trial – Journal of Clinical and Experimental Hepatology


M-A | First-line thiazide diuretics show reduced cardiovascular events, comparable mortality vs. other antihypertensive drugs

14 Jul, 2023 | 12:55h | UTC

First‐line diuretics versus other classes of antihypertensive drugs for hypertension – Cochrane Library

Summary: What are the benefits and harms of diuretics given as a first treatment compared to other drug classes for hypertension (high blood pressure)? – Cochrane Library


AHA Statement | Indications, evaluation, and outcomes for dual heart-kidney and heart-liver transplantation

14 Jul, 2023 | 12:51h | UTC

Dual-Organ Transplantation: Indications, Evaluation, and Outcomes for Heart-Kidney and Heart-Liver Transplantation: A Scientific Statement From the American Heart Association – Circulation


Cohort Study | No significant difference in kidney risks between lithium and valproate therapies, but high lithium levels remain a concern

14 Jul, 2023 | 12:46h | UTC

Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden – JAMA Network Open


RCT| Exercise during hemodialysis improves physical function in chronic kidney failure patients

13 Jul, 2023 | 13:01h | UTC

Exercise during Hemodialysis in Patients with Chronic Kidney Failure – NEJM Evidence


Retrospective Analysis | 18% of ICU patients develop sepsis-associated AKI, mostly stage 1, diagnosed by low urine output

12 Jul, 2023 | 13:39h | UTC

Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study – Intensive Care Medicine


Commentary on Twitter


Podcast | Untangling catheter associated UTIs

10 Jul, 2023 | 13:21h | UTC

#402 Don’t Get Caught with a CAUTI – The Curbsiders


Review | Cardiovascular outcomes in patients with diabetes and kidney disease

7 Jul, 2023 | 16:13h | UTC

Cardiovascular Outcomes in Patients With Diabetes and Kidney Disease: JACC Review Topic of the Week – Journal of the American College of Cardiology


2023 ESH Guidelines for the management of arterial hypertension

3 Jul, 2023 | 14:34h | UTC

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH) – Journal of Hypertension


RCT | Substituting saline with balanced crystalloid solution reduces delayed graft function in kidney transplantation

30 Jun, 2023 | 14:56h | UTC

Summary: The BEST-Fluids study was a pragmatic, multicentre, double-blind, randomized controlled trial carried out across 16 hospitals in Australia and New Zealand, aimed at comparing the use of balanced crystalloid solution (Plasma-Lyte 148) and saline in deceased donor kidney transplantation. The sample size comprised of 808 participants, who were either adults or children of any age, with the primary outcome defined as delayed graft function (DGF) occurring within 7 days post-transplantation.

Findings from the trial revealed that the balanced crystalloid group experienced less DGF than the saline group, with 121 out of 404 participants (30%) and 160 out of 403 participants (40%), respectively. This result yields an adjusted relative risk of 0.74 and an adjusted risk difference of 10.1%.

The study suggests that balanced crystalloid solution significantly reduces the incidence of DGF compared to saline. As no significant safety concerns were raised during the trial, the researchers recommend the use of balanced crystalloid solution as the standard-of-care intravenous fluid in deceased donor kidney transplantation. However, the study doesn’t indicate any significant differences in graft failure or mortality rates, which calls for further research.

Article: Balanced crystalloid solution versus saline in deceased donor kidney transplantation (BEST-Fluids): a pragmatic, double-blind, randomised, controlled trial – The Lancet (free registration required)


Clinical Trial Update | Equal long-term health and survival from restrictive vs. standard IV fluid therapy in septic shock patients

29 Jun, 2023 | 14:01h | UTC

Long-term effects of restriction of intravenous fluid in adult ICU patients with septic shock – Intensive Care Medicine

Original Study: RCT: A restrictive intravenous fluid strategy does not improve outcomes in ICU patients with septic shock.


Cohort Study | Younger adults with modest kidney function reductions show increased risk of adverse outcomes

28 Jun, 2023 | 13:14h | UTC

Summary: This study was a retrospective, population-based cohort study exploring the implications of modest reductions in estimated glomerular filtration rate (eGFR) in young adults. The study was conducted on 8.7 million adult residents aged 18-65 years in Ontario, Canada, with no history of kidney disease. Data was collected from January 2008 to March 2021.

The research revealed that 18.0% of those aged 18-39, 18.8% of those aged 40-49, and 17.0% of those aged 50-65 had modestly reduced eGFR measurements specific to their age group. Adverse outcomes, including all-cause mortality, cardiovascular events, and kidney failure, were consistently higher by hazard ratio and incidence for ages 18-39 across all eGFR categories, compared to older groups. The hazard ratio for modest reductions (eGFR 70-80 mL/min/1.73m2) was found to be 1.42 for ages 18-39 years.

The findings suggest that even modest reductions in kidney function can significantly impact younger adults, necessitating frequent monitoring of kidney function in this demographic to prevent chronic kidney disease and its complications. It is noteworthy, however, that potential limitations of this study include possible misclassification of comorbidities, unmeasured confounding, and a lack of insight into the mechanism of these modest eGFR reductions.

Article: Associations between modest reductions in kidney function and adverse outcomes in young adults: retrospective, population based cohort study – The BMJ

News Release: Even a modest reduction in kidney function increases health risks in young adults – University of Ottawa


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