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Nephrology

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

 

KDOQI US commentary on the 2021 KDIGO clinical practice guideline for the management of glomerular diseases

28 Jun, 2023 | 13:07h | UTC

KDOQI US Commentary on the 2021 KDIGO Clinical Practice Guideline for the Management of Glomerular Diseases – American Journal of Kidney Diseases

Original Guideline: KDIGO 2021 clinical practice guideline for the management of glomerular diseases – Kidney Disease: Improving Global Outcomes

 

Review | Renal thrombotic microangiopathy

27 Jun, 2023 | 13:34h | UTC

Renal Thrombotic Microangiopathy: A Review – American Journal of Kidney Diseases

 

Commentary on Twitter

 

Scientific Advisory | Expedited CT scanning with iodinated contrast when necessary favored over renal concerns in emergencies

22 Jun, 2023 | 15:19h | UTC

Joint Advisory Statement between Royal College of Radiologists & Royal College Emergency Medicine regarding Emergency Computed Tomography scans and the use of Intravenous Iodinated Contrast Agents

Related:

Radiographic Contrast Media and the Kidney – Clinical Journal of the American Society of Nephrology 

Contrast-Associated Acute Kidney Injury – Journal of Clinical Medicine

Canadian Association of Radiologists Guidance on Contrast Associated Acute Kidney Injury – Canadian Association of Radiologists Journal

Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation – Radiology

SIRM-SIN-AIOM: appropriateness criteria for evaluation and prevention of renal damage in the patient undergoing contrast medium examinations—consensus statements from Italian College of Radiology (SIRM), Italian College of Nephrology (SIN) and Italian Association of Medical Oncology (AIOM) – La radiologia medica

Association of Intravenous Radiocontrast With Kidney Function: A Regression Discontinuity Analysis – JAMA Internal Medicine

 

M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients

22 Jun, 2023 | 14:54h | UTC

Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials – Critical Care

 

Review | Glomerular hematuria and the utility of urine microscopy

21 Jun, 2023 | 13:14h | UTC

Glomerular Hematuria and the Utility of Urine Microscopy: A Review – American Journal of Kidney Diseases

 

Commentary on Twitter

 

RCT | High-dose hemodiafiltration reduces mortality risk in kidney failure patients compared to conventional high-flux hemodialysis

19 Jun, 2023 | 14:17h | UTC

Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Wider use of high-dose hemodiafiltration may have benefits for kidney failure patients – News Medical/University College London

 

Commentary on Twitter

 

RCT | Adding bio-impedance to fluid management fails to enhance kidney function preservation in new hemodialysis patients

19 Jun, 2023 | 14:01h | UTC

Bio-impedance spectroscopy added to a fluid management protocol does not improve preservation of residual kidney function in incident hemodialysis patients in a randomized controlled trial – Kidney International

 

M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients

19 Jun, 2023 | 13:51h | UTC

Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials – Critical Care

 

RCT | Multiple electrolytes solution reduces acute kidney injury in pediatric septic shock compared to saline

16 Jun, 2023 | 14:10h | UTC

Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial – Critical Care Medicine (link to abstract – $ for full-text)

 

Cohort Study | Identification of an optimal threshold to define oliguria in critically ill patients

15 Jun, 2023 | 15:05h | UTC

Identification of an optimal threshold to define oliguria in critically ill patients: an observational study – Critical Care

 

Commentary on Twitter

 

RCT | No significant kidney outcome differences observed across glucose-lowering medications in T2D patients

15 Jun, 2023 | 15:02h | UTC

Comparative Effects of Glucose-Lowering Medications on Kidney Outcomes in Type 2 Diabetes: The GRADE Randomized Clinical Trial – JAMA Internal Medicine (link to abstract – $ for full-text)

See also: Visual Abstract

Commentaries:

No differences found in effects of secondary diabetes drugs on kidney outcomes – ACP Diabetes

Do glucose-lowering medications have different effects on kidney outcomes? – News Medical

 

RCT | No change in delayed graft function with normothermic perfusion vs. cold storage in kidney transplants

13 Jun, 2023 | 14:00h | UTC

Normothermic machine perfusion versus static cold storage in donation after circulatory death kidney transplantation: a randomized controlled trial – Nature Medicine

 

Commentary on Twitter

 

Review | Volume management with kidney replacement therapy in the critically ill patient

12 Jun, 2023 | 13:43h | UTC

Volume Management with Kidney Replacement Therapy in the Critically Ill Patient – Clinical Journal of the American Society of Nephrology

 

RCT | Letermovir demonstrates noninferiority to valganciclovir for CMV prophylaxis in kidney transplantation

12 Jun, 2023 | 13:38h | UTC

Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: A New Antiviral Option for Cytomegalovirus Prevention After Kidney Transplant – JAMA (free for a limited period)

See also: Visual Abstract

Commentary: Newly approved antiviral is promising alternative against cytomegalovirus illness in kidney transplants – CIDRAP

 

Review | Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges

12 Jun, 2023 | 13:30h | UTC

Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges – Nature Reviews Nephrology (if the link is paywalled, try this one)

 

Magnetic resonance imaging to evaluate kidney structure, function, and pathology: moving towards clinical application

7 Jun, 2023 | 13:57h | UTC

Magnetic Resonance Imaging to Evaluate Kidney Structure, Function, and Pathology: Moving Towards Clinical Application – American Journal of Kidney Diseases

 

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