Category Archives: Kidney International
Major bleeding events and risk stratification of antithrombotic agents in hemodialysis: results from the DOPPS
Hemodialysis.com eInterview with Dr. Manish M. Sood
Department of Medicine, St. Boniface General Hospital
University of Manitoba, Winnipeg, Manitoba, Canada
Hemodialysis.com: What are the main findings of the study?
Dr. Sood: We examined over 48, 000 international hemodialysis patients from the DOPPS cohort for patterns of antithrombotic medication usage and there association with the outcomes of bleeding, stroke and mortality. We found large variations between and within countries with respect to antithrombotic medication usage. Furthermore, we examined whether clinical characteristics could predict major bleeding or strokes. The CHADS2 score was predictive of stroke risk whereas gastrointestinal bleeding within the past 12 months was highly predictive of bleeding events.
Marie Benz, MD on Google+Chronic kidney disease is associated with neovascularization and intraplaque hemorrhage in coronary atherosclerosis in elders: results from the Hisayama Study.
Hemodialysis.com eInterview with Toshiaki Nakano, MD, PhD
Department of Medicine and Clinical Science
Graduate School of Medical Sciences, Kyushu University
3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Dr. Nakano: In this population-based autopsy study, we examined the relationships of chronic kidney disease (CKD) with neovascularization and intraplaque hemorrhage in coronary atherosclerosis from 375 autopsy samples from 126 subjects. Lower eGFR was associated with increased numbers of newly formed blood vessels. The multivariate-adjusted odds ratio of the presence of intraplaque hemorrhages was 6.22 (95% CI, 1.10–35.04) in subjects with an eGFR of <30 mL/min/1.73 m2 compared with those with an eGFR of ≥60 mL/min/1.73 m2. We found that elderly patients with CKD have higher risks of intimal neoangiogenesis and intraplaque hemorrhages in coronary arteries.
Estimated GFR reporting is associated with decreased NSAID drug prescribing and increased renal function
Hemodialysis.com Author Interview: Dr Li Wei
Senior Lecturer Department of Practice and Policy
UCL School of Pharmacy Tavistock Square London WC1H 9JP
Hemodialysis.com: What are the main findings of the study?
Dr. Li: The study was a population-based longitudinal analysis using a record-linkage database in Tayside, Scotland, UK. The aim of the study was to determine NSAID prescribing before and after the implementation of estimated eGFR reporting and to evaluate renal function in patients who used NSAIDs but stopped these after the first eGFR report. The study found that prescriptions for NSAIDs significantly decreased after the implementation of eGFR reporting. eGFR reporting was associated with reduced NSAID prescriptions (adjusted OR, 0.78 95%CI 0.75-0.82). NSAID prescribing rates in the 6 months prior to April 2006 were 18.8%, 15.4% and 7.0% in patients with CKD stages 3, 4, and 5 and 15.5%, 10.7% and 6.3% respectively, after eGFR reporting commenced. In patients who stopped NSAID treatment, eGFR significantly increased from 45.9 to 46.9, 23.9 to 27.1, and 12.4 to 26.4 ml/min per 1.73m2 in 1340 stage 3 patients, 162 stage 4 patients, and 9 stage 5 patients, respectively.
The GFR and GFR decline cannot be accurately estimated in type 2 diabetics
Hemodialysis.com Authors’ Interview
- Piero Ruggenenti MDPiero Ruggenenti, Mario Negri Institute for Pharmacological Research, Centro Anna Maria Astori, Science and TechnologyPark Kilometro Rosso, Via Stezzano, 87, 24126 Bergamo, Italy
- Flavio Gaspari ChemDClinical ResearchCenter for Rare Diseases ‘Aldo & Cele Daccò’,
Mario Negri Institute for Pharmacological Research, Bergamo, Italy - Esteban PorriniNephrology Section and Research Unit, Hospital Universitario de Canarias,
University of La Laguna, Tenerife, Canary Islands, Spain - Giuseppe Remuzzi MDClinical ResearchCenter for Rare Diseases ‘Aldo & Cele Daccò’,
Mario Negri Institute for Pharmacological Research, Bergamo, Italy
Unit of Nephrology, Azienda Ospedaliera ‘Ospedali Riuniti di Bergamo’, Bergamo, Italy
Hemodialysis.com: What are the main findings of the study?
Response: The main finding of our study was that in hypertensive type 2 diabetes, subjects with normo- or micro-albuminuria, estimation formulas fail to detect glomerular hyperfiltration and to reliably describe GFR changes over time.
Baseline GFR was significantly underestimated by all formulas and a six-month GFR reduction was fully missed, in particular in hyperfiltering patients.
Long-term GFR decline was also underestimated by all formulas in the whole study group, as well as in hyper-, normo- and hypofiltering patients considered separately.
