Medical management of hepatorenal syndrome.
Nephrol Dial Transplant. 2012 Jan;27(…

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The fallacy of the BUN:creatinine ratio in critically ill patients.
Nephrol Dial …

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Severe acute kidney injury not treated with renal replacement therapy: characteristics and outcome.
Nephrol Dial Transplant. 2011 Sep 8;
Authors: Schneider AG, Uchino S, Bellomo R
Abstract
BACKGROUND: Only a pr…

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Beta-blockers and cardiovascular outcomes in dialysis patients: a cohort study in Ontario, Canada.
Nephrol Dial Transplant. 2011 Aug 26;
Authors: Kitchlu A, Clemens K, Gomes T, Hackam DG, Juurlink DN, Mamdani M, Manno M, Olive…

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Elevated N-terminal pro-brain natriuretic peptide levels predict an enhanced anti-hypertensive and anti-proteinuric benefit of dietary sodium restriction and diuretics, but not angiotensin receptor blockade, in proteinuric renal patients.
…

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Osmotic diuresis due to urea as the cause of hypernatraemia in critically ill patients.
Nephrol Dial Transplant. 2011 Aug 2;
Authors: Lindner G, Schwarz C, Funk GC
BACKGROUND: Hypernatraemia is common in critically ill…

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Early nephrology consultation can have impact on outcome of acute kidney injury patients.
Nephrol Dial Transplant. 2011 Jul 15;
Authors: Ponce D, Zorzenon CD, Santos NY, Balbi AL
BACKGROUND: Patients who develop acute …

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Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients: presentation of two cases and a review of the literature.
Nephrol Dial Transplant. 2011 Jul 19;
Authors: Mom…

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A prospective evaluation of urine microscopy in septic and non-septic acute kidney injury.
Nephrol Dial Transplant. 2011 Jun 9;
Authors: Bagshaw SM, Haase M, Haase-Fielitz A, Bennett M, Devarajan P, Bellomo R
BACKGROUN…

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Acute kidney injury in patients admitted to a liver intensive therapy unit with paracetamol-induced hepatotoxicity.
Nephrol Dial Transplant. 2011 Jun 6;
Authors: O’ Riordan A, Brummell Z, Sizer E, Auzinger G, Heaton N, O’Grady…

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Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients.
Nephrol Dial Transplant. 2011 May 17;
Authors: Ei Amari EB, Hadaya K, Bühler L, Berney T, Rohner P, Martin PY, Mentha G, van Delden C
…

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Acute kidney injury in hospitalized HIV-infected patients: a cohort analysis.
Nephrol Dial Transplant. 2011 May 4;
Authors: Lopes JA, Melo MJ, Viegas A, Raimundo M, Câmara I, Antunes F, Gomes da Costa A
BACKGROUND: Ac…

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Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and combined therapy in patients with micro- and macroalbuminuria and other cardiovascular risk factors: a systematic review of randomized controlled trials.

Nephrol Dial Transplant. 2011 Mar 3;

Authors: Maione A, Navaneethan SD, Graziano G, Mitchell R, Johnson D, Mann JF, Gao P, Craig JC, Tognoni G, Perkovic V, Nicolucci A, De Cosmo S, Sasso A, Lamacchia O, Cignarelli M, Maria Manfreda V, Gentile G, Strippoli GF

BACKGROUND: A recent clinical trial showed harmful renal effects with the combined use of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) in people with diabetes or vascular disease. We examined the benefits and risks of these agents in people with albuminuria and one or more cardiovascular risk factors. METHODS: MEDLINE, EMBASE and Renal Health Library were searched for trials comparing ACEI, ARB or their combination with placebo or with one another in people with albuminuria and one or more cardiovascular risk factor. RESULTS: Eighty-five trials (21 708 patients) were included. There was no significant reduction in the risk of all-cause mortality or fatal cardiac-cerebrovascular outcomes with ACEI versus placebo, ARB versus placebo, ACEI versus ARB or with combined therapy with ACEI + ARB versus monotherapy. There was a significant reduction in the risk of nonfatal cardiovascular events with ACEI versus placebo but not with ARB versus placebo, ACEI versus ARB or with combined therapy with ACEI + ARB versus monotherapy. Development of end-stage kidney disease and progression of microalbuminuria to macroalbuminuria were reduced significantly with ACEI versus placebo and ARB versus placebo but not with combined therapy with ACEI + ARB versus monotherapy. CONCLUSIONS: ACEI and ARB exert independent renal and nonfatal cardiovascular benefits while their effects on mortality and fatal cardiovascular disease are uncertain. There is a lack of evidence to support the use of combination therapy. A comparative clinical trial with ACE, ARB and its combination in people with albuminuria and a cardiovascular risk factor is warranted.

PMID: 21372254 [PubMed - as supplied by publisher]

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Long-term outcomes of end-stage renal disease patients admitted to the ICU.

Nephrol Dial Transplant. 2011 Feb 15;

Authors: Sood MM, Miller L, Komenda P, Reslerova M, Bueti J, Santhianathan C, Roberts D, Mojica J, Rigatto C

BACKGROUND: End-stage renal disease (ESRD) patients admitted to the intensive care unit (ICU) have poor survival and high rates of readmission; however, little evidence exists on long-term outcomes. We set out to investigate the long-term (6 and 12 months) survival of ESRD patients admitted to the ICU and whether differential survival could be explained by dialysis modality and vascular access. METHODS: We compared the admission characteristics, outcomes and readmission rates of 619 ESRD [95 peritoneal dialysis (PD), 334 hemodialysis with a catheter (HD CVC), 190 hemodialysis with an AV fistula (HD AVF)] patients admitted to 11 ICU’s in Winnipeg, Manitoba, Canada. Parametric and nonparametric tests were used as appropriate to determine differences in baseline characteristics. Multivariable Cox and logistic regression was used to assess outcomes between the groups. RESULTS: The 6- and 12-month crude survival was 62 and 52%, respectively. In a univariate model, modality and vascular access were associated with an increased hazard ratio (HR) of death [PD HR 1.60 95% confidence interval (CI) 1.20-2.13, HD CVC HR 1.55 95% CI 1.25-1.93] compared to patients on HD with an AVF. In three different multivariate adjusted models, this association persisted with HRs for death of 1.63-1.75 for PD and 1.50-1.58 for HD CVC. CONCLUSIONS: Overall long-term survival of ESRD patients after admission to the ICU is poor. Being on PD or being dialyzed with a catheter was independently associated with an increased mortality.

PMID: 21324978 [PubMed - as supplied by publisher]

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Epidemiology, clinical features and outcomes of pneumonia in patients with chronic kidney disease.

Nephrol Dial Transplant. 2011 Jan 27;

Authors: Viasus D, Garcia-Vidal C, Cruzado JM, Adamuz J, Verdaguer R, Manresa F, Dorca J, Gudiol F, Carratalà J

BACKGROUND: Although infection remains among the most common causes of morbidity and mortality in patients with chronic kidney disease (CKD), data on epidemiology, clinical features and outcomes of pneumonia in this population are scarce. METHODS: Observational analysis of a prospective cohort of hospitalized adults with pneumonia, between 13 February 1995 and 30 April 2010, in a tertiary teaching hospital. CKD patients, defined as patients with a baseline glomerular filtration rate <60 mL/min/1.73m(2), were compared with non-CKD patients. RESULTS: During the study period, 3800 patients with pneumonia required hospitalization. Two-hundred and three (5.3%) patients had CKD, of whom 46 were on dialysis therapy. Patients with CKD were older (77 versus 70 years; P < 0.001), were more likely to have comorbidities (82.3 versus 63.3%; P < 0.001) and more commonly classified into high-risk pneumonia severity index classes (89.6 versus 57%; P < 0.001) than were the remaining patients. Streptococcus pneumoniae was the most frequent pathogen (28.1 versus 34.7%; P = 0.05). Mortality was higher in patients with CKD (15.8 versus 8.3%; P < 0.001). Among CKD patients, age [+1 year increase; adjusted odds ratio, 1.25; 95% confidence interval (CI) 1.07-1.46] and cardiac complications during hospitalization (adjusted odds ratio, 9.23; 95% CI 1.39-61.1) were found to be independent risk factors for mortality, whereas prior pneumococcal vaccination (adjusted odds ratio, 0.05; 95% CI 0.005-0.69) and leukocytosis at hospital admission (adjusted odds ratio, 0.10; 95% CI 0.01-0.64) were protective factors. CONCLUSIONS: Pneumonia is a serious complication in CKD patients. Independent factors for mortality are older age and cardiac complications, whereas prior pneumococcal vaccination and leucokytosis at hospital admission are protective factors. These findings should encourage physicians to increase pneumococcal vaccine coverage among CKD patients.

PMID: 21273232 [PubMed - as supplied by publisher]

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