A Levin

..In light of recent observational studies showing an association of vitamin D therapy and survival benefit in hemodialysis patients, the effects of vitamin D on cardiovascular system have become a heavily debated issue...

..Patients with these conditions contribute excessively to health care costs. Opportunities for system redesign require metrics by which to evaluate the impact...

..We studied the responsiveness of FGF-23 and mineral metabolism to altered dietary phosphate intake in chronic kidney disease (CKD) and healthy control patients...

....

....

....

..We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI...

..We identify the importance of well-conducted studies of patient groups with and without CVD, with and without CKD, in order to better understand the complex physiology so that treatment strategies can be appropriately applied...

..Study design and sample size calculations were based on previously published Canadian data...

....

..The objectives of this analysis are to describe the predictors of rapid progression of kidney disease and death in patients followed up by nephrologists...

..This overview describes the current state of knowledge and emphasizes the interplay between CVD and CKD as two aspects of a set of pathophysiological processes, which impact on patient outcomes...

..The systematic evaluation of all patients and incorporation of simplified definitions and classification systems should enhance the ability to improve the outcomes of patients with kidney disease irrespective of time of identification...

..We suggest further studies and surveillance for this high-risk group of infants in order to gain additional insights into the impact of perinatal factors such as LBW...

....

..Substantial variation in Hgb values exists at all GFR levels. These findings underscore the importance of evaluating Hgb at all GFR levels, and the need to study the impact of modification of Hgb at different GFR levels on survival...

..It is important for clinical care to identify appropriate treatments and targets for hemoglobin. This review describes current understandings of the treatment of anemia using the most recent published articles...

..As bone, cardiovascular disease, and mineral metabolite are correlated; further studies are necessary to determine the importance of these findings relative to outcomes...

..Further large-scale, observational studies as well as interventional studies are needed to more clearly understand the complex biology of cardiovascular and kidney disease progression...

..Rigorous evaluation of current implementation techniques and resultant impacts should be undertaken...

....

..Finally, physicians should be careful to avoid therapeutic nihilism in patients with kidney disease; those at highest risk of CVD are likely to receive the greatest benefit from cardiovascular therapies...

..Long-term interventional studies are needed to determine costs, benefits, and risks of such strategies...

..We defined the important modifiable risk factors. There remains a critical need to establish optimal therapeutic strategies and targets to improve clinical outcomes...

..This survey serves as an important baseline for future comparisons after the implementation of educational strategies for referring physicians and nephrologists...

..This study was designed to estimate the prevalence of patients who have significantly reduced GFR as calculated by the Cockcroft-Gault (C-G) formula, but normal-range SCR:..

..Well designed prospective studies with both CVD events and mortality as outcomes, and with enrollment beginning before the start of dialysis, are essential if we are to determine the optimal therapeutic strategies...

..Further research is needed to determine which specific components of care both prior to dialysis and after its commencement are most important with respect to outcomes...

..Central arterial stiffness can be measured using noninvasive technologies, including augmentation index (AIx), a composite measure of arterial stiffness...

..Hence, it appears that South Asians and Oriental Asians have more laboratory abnormalities compared with Caucasians at most levels of eGFR...

..The value of a new perspective on haemoglobin and gender in kidney disease is important from both a physiological and an economical perspective...

..CONCLUSION: Family physicians play an important role in recognizing patients with potential for renal failure, in demonstrating progressive chronic renal failure, and in initiating therapy early to improve outcomes...

....

..Recognizing modifiable risk factors and addressing them early in the course of renal disease will facilitate the improvement of patient outcomes...

..Future studies will explore specific mechanisms to explain this phenomenon...

..Current data support the use of multidisciplinary clinics in improving outcomes of referred patients. Future research will help to refine and define appropriate care models for this growing chronic kidney disease population...

..The aim of this study was to investigate the ability of 4 observers to acquire reproducible PWV and pulse wave analysis (PWA) measurements after a 6-week training period...

..The present study sought to describe renal perfusion using non-captopril (baseline) nuclear renograms in patients with iARAS, and to determine characteristics associated with a positive captopril renogram...

..Insufficient time was the key obstacle to completing research. Residents with previous research experience, senior residents, and men were more likely to publish...

..CONCLUSION: Patients with CKD undergoing PCI in the stenting era show improved outcomes. Additional studies are needed to determine optimal revascularization strategies in patients with CKD...

..We hypothesized that MMP-2 and -9 were up-regulated in the arterial vasculature from CKD patients with diabetes, compared with those without diabetes...

....

..This will allow for the assessment of numerous outcomes on a global scale for this state-of-the art dialysis modality in the form of a multidimensional programmatic evaluation...

..001). In conclusion, the success rate of early AVF creation is reasonable and complications when identified can be remedied without the need for a catheter, thus ultimately maximizing the use of AVF in dialysis patients...

..The objective of this study was to evaluate, in a blinded, randomized, placebo-controlled fashion, whether intravenous NAC reduced CIN in the setting of cardiac catheterization in patients with preexisting renal insufficiency...

..The MDRD formula has been shown to be more accurate in non-cancer patients with chronic renal disease. We compared the accuracy of these formulae for dosing carboplatin in patients with gynecological cancers...

..However, the effects of therapy will be most impressive when accompanied by the optimal care of all hemodynamic and metabolic abnormalities that are associated with CKD...

..The American Society of Clinical Oncology recommends infusion of pamidronate over 2 hours to avoid renal deterioration, although there are data to suggest that 1-hour infusions may be safe...

..We support ongoing efforts to develop or refine equations for specific unique and easily identifiable populations...

..This study systematically reviews the current literature, to assess whether IDPN improves survival, quality of life, or nutritional status in those receiving maintenance HD...

....

..282, p = 0.01). In conclusion, we have uniquely demonstrated differential microvasculature dysfunction between nondialyzed and dialyzed CKD patients...

....

..Initial cardiac investigations have limited value in guiding the timing of patient reevaluation after wait-listing. Periodic surveillance cardiac investigation after wait-listing may be unnecessary and requires further study...

..Thus further studies should attempt to determine the true incidence of this problem and ultimately address the optimal treatment strategies...

..The mechanisms of vascular damage are not fully understood. The objective of this study was to prospectively investigate the importance of novel mediators of vascular damage, in conjunction with vascular calcification (VC), on survival...

..Some recommendations for pragmatic approaches and study design are suggested...

..Future research in this arena must focus on the optimal dose of erythropoietin administered to hemoglobin level achieved that will result in improved cardiovascular outcomes for patients with heart failure and kidney disease...

....

....

..Glomerular filtration rate (GFR) estimation equations have never been validated in the HIV population. This pilot study aimed to compare all currently available methods of kidney function assessment with nuclear GFR in HIV-infected adults...

..The purpose of this Commentary is to briefly summarize the current knowledge of nephrogenic systemic fibrosis in order to promote better understanding of the complexity of chronic kidney disease and its associated conditions...

..It is the first report suggesting that MMP-2 in the arterial vasculature could be the possible mediator crucial in linking the progression of kidney function to cardiovascular disease...

..A cross-sectional study of long-term care facility patients was conducted to demonstrate the impact of the use of different formulae in the elderly for the purposes of medication dosing...

....

..Although evidence supporting the advantages of multidisciplinary team-based chronic kidney disease (CKD) care is not well developed, many groups are advocating increased availability of this model...

..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...

..The purpose of this study was to determine if TPA dwell time affects short- or long-term catheter patency rates...

..We report 3 HIV-negative patients (2 men, 1 woman) who developed nephrotic syndrome secondary to MGN complicated by CG, with relatively rapid disease progression despite aggressive therapy...

..Single CRP values must be interpreted with caution, and multiple measurements, or use of other biomarkers, should be considered...

..The current diagnostic and revascularization strategy for CAD in CKD patients is discussed, highlighting current controversies that warrant further investigation...

..Hepatitis B virus (HBV) immunization protocols are routinely followed in dialysis units. Recommendations for retesting and booster dose administration are variable and less well known...

..For this reason potentially life-saving procedures such as angiography are sometimes withheld or delayed...

....

....

..HHD programmes have reported successful outcomes with respect to patients' well-being, haemodynamic stability and improvement of clinical and biochemical parameters in small selected groups of patients...

..However, further evidence-based demonstrations of success are required, showing benefit to both patients and health care systems...

..Again, if no benefits are seen, the treatment should be stopped. Attention to factors known to delay the progression of renal decline and close follow-up should be part of the treatment plan (grades B and C)...

..This information will assist decision-makers in determining whether to make HNHD more widely available...

..Rate of decline in kidney function is a strong predictor of increased mortality in this population, independent of worsening heart failure and baseline kidney function...

....

..16.7%, p > 0.05). The strategy of treating positive surveillance cultures is not beneficial. Positive Ssc do not predict the occurrence of catheter-related infection, and treatment of these cultures may lead to increased infection rates...

..Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis...

..It appears that there may be problems associated with discontinuation of immunosuppressive therapy in the presence of sustained erythropoiesis-stimulating agent therapy in those in whom the condition has occurred previously...

..This study sought to determine the prevalence of Fabry disease in a multiethnic male chronic kidney disease population, involving dialysis-dependent, non-dialysis-dependent, and transplant patients...

..We describe urinary neutrophil gelatinase-associated lipocalin (uNGAL) values in association with clinical characteristics and urinary parameters in adults undergoing coronary angiography...

..This study attempts to look at the impact of a new home haemodialysis programme on an existing peritoneal dialysis programme in the province of British Columbia...

..Because of the high prevalence of early stages of chronic kidney disease in the general population (approximately 11% of adults), this information is particularly important for general internists and specialists...

....

..The Irbesartan in Reduction of Microalbuminuria trial and the Irbesartan in Diabetic Nephropathy Trial found that irbesartan is renoprotective in patients having hypertension with type 2 diabetes...

..03 to 1.31) of rapid decrease (p for interaction <0.001). In conclusion, anemia is associated with a rapid decrease in kidney function in patients with heart failure, particularly in those with underlying CKD...

..Kidney failure is known to cause anemia, which is associated with a higher risk of cardiac failure and mortality. The impact of milder decreases in kidney function on hemoglobin levels and anemia in the US population, however, is unknown...