Category Archives: JASN
Central Body Fat Distribution Associates with Unfavorable Renal Hemodynamics Independent of Body Mass Index
Hemodialysis.com eInterview: Dr. Arjan J. Kwakernaak
Department of Medicine, Division of Nephrology
University Medical Center Groningen
PO Box 30001, NL-9700 RB
Groningen, The Netherlands
Hemodialysis.com: What was the rationale for the study?
Dr. Kwakernaak: Body fat distribution is a well-established risk factor for long-term kidney damage. The mechanisms underlying this increased renal risk in association with a central body fat distribution is often attributed to associated conditions, such as overall weight excess, hypertension, and diabetes. We suspected that body fat distribution might also exert an adverse effect on renal hemodynamics, independent from these factors. We therefore investigated whether a central body fat distribution was associated with an altered renal hemodynamic profile, independent of overall weight excess.
Marie Benz, MD on Google+Association between Younger Age When First Overweight and Increased Risk for CKD
Dr. Richard Silverwood BSc MSc PhD
Department of Medical Statistics.
The London School of Hygiene & Tropical Medicine
Hemodialysis.com: What are the main findings of the study?
Dr. Silverwood: In a prospective cohort representative of the general United Kingdom population we found overweight beginning early in adulthood (by age 26 or 36 years) to be strongly associated with reduced kidney function at age 60-64. Diabetes and hypertension were both moderate mediators of the age at overweight-kidney function association.
Pulmonary Congestion Predicts Cardiac Events and Mortality in ESRD
Hemodialysis.com Author Interview: Dr. Carmine Zoccali CNR-IBIM
Nephrology, Dialysis and Transplantation Unit, and CNR-IBIM,
Clinical Epidemiology and Pathophysiology
of Renal Diseases and Hypertension
Reggio Calabria, Italy
Hemodialysis.com: Explain why you believe this research is especially important.
Dr. Zoccali: In this study we measured the degree of lung congestion in dialysis patients by a novel, very simple, inexpensive technique, i.e. lung ultrasound (US).
We found that asymptomatic dialysis patients frequently have substantial accumulation of water in the lungs (subclinical pulmonary edema). Importantly, lung water by US was a better predictor of the risk of death and cardiac events than symptoms of heart failure as assessed by the NYHA score. The prognostic value of subclinical lung edema was independent of classical risk factors and risk factors associated with CKD like low serum albumin, hyperphosphatemia and high CRP. Thus, detection of subclinical pulmonary edema is useful for prognosis in dialysis patients. More importantly, our findings generate the hypothesis that targeting subclinical pulmonary edema may improve cardiovascular disease and reduce death risk in the dialysis population, a population at an extremely high death risk.
High-Efficiency Postdilution On-Line Hemodiafiltration Reduces All-Cause Mortality in Hemodialysis Patients
Hemodialysis.com Author Interview:
Dr. Francisco Maduell
Department of Nephrology and Renal Transplantation
Hospital Clinic, University of Barcelona
Villarroel, 170 – 08036 Barcelona, Spain.
Hemodialysis.com: What are the main findings of the study?
Dr. Maduell: The results of the ESHOL trial indicate that high efficiency postdilution OL-HDF reduces all-cause mortality versus conventional hemodialysis in prevalent patients.
Furthermore, the main causes of mortality, cardiovascular and infectious diseases, were significantly reduced by OL-HDF. The incidence rate of dialysis sessions complicated with hypotension episodes and all-cause hospitalization were lower in patients randomized to OL-HDF
Associations between Hemodialysis Access Type and Clinical Outcomes: A Systematic Review
Hemodialysis.com Author Interview: Dr. Pietro Ravani,
University of Calgary, Faculty of Medicine,
Foothills Medical Centre, 1403 29th Street NW, Calgary
Alberta, Canada T2N 2T9
Hemodialysis.com: What are the main findings of the study?
Dr. Ravani: Most available data compare outcomes by access achieved/used rather than access intended/planned.
