Marcello Tonelli

..The impact on healthcare systems in countries where these indigenous populations reside will be substantial unless significant efforts are made to improve diabetic renal disease outcomes in the near future...

..The major metabolic complications of obesity and type 2 diabetes may be prevented and managed with dietary modification. The use of sweeteners that provide little or no calories may help to achieve this objective...

..We conducted a systematic review to summarize existing literature on trace element status in hemodialysis patients...

..Higher levels of serum alkaline phosphatase (AlkP) are associated with excess mortality in dialysis patients, but whether AlkP is associated with adverse outcomes among people without kidney failure is unknown...

..We did a systematic review of randomized trials to assess the efficacy and harms of statins in these individuals...

..US residents with end-stage renal disease (ESRD) may live far away from the closest transplant center, which could compromise their access to kidney transplantation...

..However, their safety and effectiveness is controversial. We did a systematic review of the clinical efficacy and harms of these agents in adults with anemia related to cancer or chemotherapy...

..We investigated whether patients receiving hemodialysis who live farther from their attending nephrologist are more likely to die than those who live closer...

..We do not know, however, whether the finding at higher eGFR could be due to inadequacies of the eGFR formula at low serum creatinine levels...

..Most studies of chronic kidney disease (CKD) and outcomes focus on mortality and ESRD, with limited data on other adverse outcomes. This study examined the associations among proteinuria, eGFR, and adverse cardiovascular (CV) events...

..Although proteinuria is also associated with adverse outcomes, it is not used to refine risk estimates of adverse events in this current system...

..We performed this analysis to determine whether pravastatin reduced the rate of kidney function loss over approximately 5 years in people with or at high risk for coronary disease...

..Acute kidney injury (AKI) is associated with early mortality after percutaneous coronary revascularization procedures, but its prognostic relevance to long-term clinical outcomes remains controversial...

..We aimed to investigate how eGFR and proteinuria jointly modified the risks of acute kidney injury and subsequent adverse clinical outcomes...

..Whether a lower HbA(1c) level improves outcomes in people with DM and chronic kidney disease (CKD) is unknown...

..9 g/dL), intermediate (11-12 g/dL), or high (> 12 g/dL) hemoglobin level target compared with a strategy of managing anemia without ESAs...

..Future studies should address barriers to the initiation and maintenance of PD in the Aboriginal population, especially those who reside in rural locations...

..Patients with renal insufficiency are less likely to be prescribed efficacious therapies, but have better outcomes if they receive these medications...

..Due to the high prevalence of both CKD and NSAID use in older adults, we sought to determine the association between NSAID use and the progression of CKD in an elderly community-based cohort...

..We investigated barriers to kidney transplantation for Aboriginal patients treated with hemodialysis for ESRD in Canada...

..Racial differences in health outcomes in general are well documented; however, few studies examined the impact of East Asian and Indo Asian race on choice of dialytic modality and survival among patients with end-stage renal disease (ESRD)...

..The effects of NHD on PTH are variable. The impact of these changes on long-term cardiovascular and bone-related outcomes requires further investigation...

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..Additional studies are needed to determine whether these benefits apply to patients with more severe CKD, and recruitment to such studies should be given high priority...

..More frequent dialysis may improve nutrition and remove dietary restrictions in hemodialysis (HD) patients. We present results from a trial comparing nutritional parameters between nocturnal hemodialysis (NHD) and conventional HD patients...

..We sought to determine agreement between various blood pressure measurement methods, as well as identify which method was the strongest correlate of LV hypertrophy among patients on hemodialysis...

..Laboratory reporting of estimated glomerular filtration rate (GFR) has been widely implemented, with limited evaluation...

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..The staging system for chronic kidney disease relies almost exclusively on estimated glomerular filtration rate (eGFR), although proteinuria is also associated with adverse outcomes...

..Within each region we also determined whether distance from the closest transplant centre was associated with the likelihood of transplantation...

..The objective of this study is to determine the associations between estimated glomerular filtration rate (eGFR) and hospitalization or death with pneumonia...

..Concerns about toxicity have led to more restrictive recommendations for ESA use; however, the incremental costs and benefits of such a strategy are unknown...

..This meta-analysis was performed to determine whether angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) reduce fatal and nonfatal CV events and left ventricular (LV) mass in patients receiving HD...

..Given the biological importance of phosphorus, it is plausible that higher levels of serum phosphate within the normal range may also be associated with adverse outcomes...

..Comparing outcomes of arteriovenous grafts and fistulas is challenging because the pathophysiology of access dysfunction and failure rate profiles differ by access type. Studying how risks vary over time may be important...

..Although obstructive sleep apnea (OSA) is more common in patients with kidney disease, whether nocturnal hypoxia affects kidney function is unknown...

..The objective of this analysis was to determine whether pravastatin reduced the incidence of cardiovascular events in people with or at high risk for coronary disease and with concomitant moderate CKD...

..Morbidity and mortality rates in hemodialysis patients remain excessive. Alterations in the delivery of dialysis may lead to improved patient outcomes...

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..8 ml/min following moderate to severe acute kidney injury. Thus, acute kidney injury following coronary angiography is associated with a sustained loss and a larger rate of future decline in kidney function...

..CONCLUSIONS: The presence or absence of proteinuria on dipstick urinalysis may be used to refine estimates of risk based on kidney function alone...

..The Alberta Kidney Disease Network is a collaborative nephrology research organization based on a central repository of laboratory and administrative data from the Canadian province of Alberta...

..Such factors could be used in conjunction with Qa to improve the diagnostic performance of screening. We examined the relationship between Qa and certain clinical characteristics in a large group of patients with AVF...

..To account for uncertainty, we considered four separate modelling strategies, obtaining data on the relative effectiveness of sevelamer from the recent Dialysis Clinical Outcomes Revisited study...

..The objective of this study is to determine the validity of outpatient physician billing derived algorithms for defining chronic dialysis compared to a reference standard ESRD registry...

..Whether patients with chronic kidney disease who are not receiving dialysis are also at increased risk of bloodstream infection is less clear...

..Whether modifying dialysis prescription to intensify small-solute clearance also leads to better phosphate clearance is unknown...

..To determine the cost effectiveness of one-off population based screening for chronic kidney disease based on estimated glomerular filtration rate...

..We evaluated differences in survival and rate of renal transplantation among Aboriginal and white patients after initiation of dialysis...

..We examined the association between pravastatin use, levels of C-reactive protein (CRP), soluble tumor necrosis factor receptor II (sTNFrii), and the rate of kidney function loss...

..These findings require confirmation by a large randomized trial conducted specifically in people with chronic renal insufficiency...

..This study was designed to determine the safety of combination therapy with these two drugs in clinical practice...

..Because this differs from the experience reported from the United States, further direct comparisons between the two populations is warranted...

..The benefits of MDC and an assessment of their economic impact should be tested in a randomized, controlled trial...

..Longer waiting times may limit the survival benefit of kidney transplantation in older patients or those with a high burden of comorbid disease...

..Ascorbic acid is believed to improve anemia in patients with end-stage renal disease, but its overall effectiveness is unclear...

..0-12.0 g/dL) and high hemoglobin target levels (>12.0 g/dL) and performed a meta-analysis of all available 36-item short-form (SF-36) RCT data...

..We conducted this study to determine whether gemfibrozil reduced rates of renal function loss in people with moderate CRI...

..We sought to determine the association between enrolment in primary care networks and the care and outcomes of patients with diabetes...

..This paper outlines evidence for the putative renal benefits of statins in people with vascular disease...

..Controversy exists regarding the optimal method of providing dialysis in critically ill patients with acute renal failure. We sought to determine the cost-effectiveness of treatment strategies...

..Novel clinical methods to better identify patients at risk of progression to later stages of chronic kidney disease, including kidney failure, are needed to target management to high-risk subgroups...

..Few data guide the prescription of dialysate potassium (dK) in hemodialysis, which is usually prescribed empirically on the basis of predialysis serum potassium levels...

..Whether increasing dialysis adequacy in large patients not achieving KDOQI targets improves HRQL is unknown...

..The impact of NHD on LV mass represents a clinically important outcome which will further elucidate the potential benefits of NHD and guide future clinical endpoint studies...

..There has been little exploration of how the use of other devices might affect the feasibility or performance of screening in AV accesses...

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..Before significant resources are invested in initiating nocturnal hemodialysis programs, further data on mortality and cardiovascular morbidity, preferably from randomized clinical trials, are required...

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..Observational studies indicate that routine measurements of access blood flow and use of Doppler ultrasound improve vascular access outcomes in hemodialysis patients, but randomized trials reached conflicting conclusions...

..It is recommended that clinicians arrange angiography when Qa is <500 ml/min in AVF...

..This study demonstrates that in a Canadian kidney transplant population that there is a significant risk of PTDM following kidney transplantation, and it is therefore advisable to minimize this risk...

..Patients were followed from the date of Qa measurement until death; follow-up was discontinued at loss to follow-up, kidney transplantation, or end of study...

..01). Vascular access care is responsible for a significant proportion of health care costs in the first year of hemodialysis. These results support clinical practice guidelines that recommend preferential placement of a native fistula...

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..Since statins may be underused in this setting, physicians should consider prescribing them for patients with chronic renal insufficiency and known coronary disease...

..Although the use of these strategies may be increasing, there remains room for improvement. Physicians should remain aware of the need to use these proven strategies in patients with CRI...

..This study focuses on delineating potentially reversible determinants of adverse outcomes that occur in patients receiving dialysis for end-stage renal disease (ESRD)...

..Increasing the maximum number of uses to 20 may permit cost savings compared with current practice without additional risk...

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..Although observational studies show a significant benefit of such strategies, data from randomized trials are limited. This review describes recently published information that has helped to advance this field during the past year...

..This suggests that QB in CVC should be set as high as circuit pressure limits will allow, regardless of the potential for AR, and that reversal of line position confers no benefit with respect to solute clearance...

..Recent clinical trials of prophylactic strategies have reported contradictory results. This review presents recent insights into the pathophysiology of contrast nephropathy and reviews trial results in this context...

..17 to 0.98). Statin therapy seems to reduce proteinuria modestly and results in a small reduction in the rate of kidney function loss, especially in populations with cardiovascular disease...

..The prevalence, prognostic import, and impact of renal insufficiency on the benefits of ACE inhibitors and beta-blockers in community-dwelling patients with heart failure are uncertain...

..Contrast-induced nephropathy is associated with significant economic and clinical consequences, including prolonged hospitalization, the requirement for dialysis, and an increased risk of death...

..We studied persons with both of these risk factors to determine the prevalence of vitamin D insufficiency and whether serum 25-hydroxyvitamin D (25(OH)D) levels were affected by oral vitamin D3 supplementation...

..Because of the high cost of ongoing dialysis, CRRT may still be an economically efficient treatment if it improves renal recovery among survivors; further study in this area is required...

..Before NAC becomes the standard of care for all patients receiving intravenous contrast, new randomized trials evaluating its effect on clinically relevant outcomes are required...

..In this study we determined the effect of maintenance immunosuppression medications on the rate of kidney allograft function loss defined by the annualized change in glomerular filtration rate (GFR)...

..Strategies to improve long-term kidney allograft survival that increase baseline allograft function may be more effective than strategies to slow the decline in GFR...

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..Continued screening after correction of first stenoses appears reasonable, because of both the frequency of recurrent stenosis and the success of repeat intervention...

..Little is known about the characteristics of patients with Fabry disease that initiate dialysis in the United States, although data from Europe suggests these individuals have a poor survival...

..The fish oil inhibition of stenosis in hemodialysis grafts (FISH) study evaluates the efficacy of fish oil in improving HD graft patency...

..0 in 71% of cohorts. This review supports current guidelines that identify individuals with CKD as being at high risk for cardiovascular mortality. Determining which interventions best offset this risk remains a health priority...

..We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease...

..Concern about primary fistula failure may contribute to the underuse of arteriovenous fistula. The objective of this study was to investigate the baseline clinical parameters associated with primary fistula success...