Category Archives: Risk Factors
Study: NSAIDS Use Still High Among Patients At Risk for Kidney Disease
Hemodialysis.com Interview with: Aafke Koffeman MD
Department of General Practice, Erasmus MC
University Medical Centre Rotterdam,
Rotterdam, the Netherlands
Hemodialysis.com: What are the main findings of the study?
Dr. Koffeman: In many countries, non-steroidal anti-inflammatory drugs (NSAIDs) are available over-the-counter. The use of NSAIDs is known to be associated with the occurrence of serious adverse drug events (ADEs) and these drugs should therefore be used with caution, especially in elderly patients and in those with relevant comorbidity or comedication. Our cross-sectional population-based study shows that one in eight patients at a high risk of developing a gastrointestinal, cardiovascular or renal NSAID-related ADE has used an over-the-counter NSAID in the past four weeks. In the general population, we found that almost one third of adults has used an over-the-counter NSAID, and use in a dosage exceeding the recommended daily maximum occurs in almost one in ten users.
Marie Benz, MD on Google+Progression of CKD and Nocturnal Hypoxemia
Hemodialysis.com Interview with:
Hemodialysis.com: What are the main findings of the study?
Dr. Sakaguchi: Nocturnal intermittent hypoxemia (NH) is highly prevalent among patients with chronic kidney disease (CKD), but little is known whether it affects progression of CKD. In this retrospective cohort study, we included 161 stage 3-4 CKD patients whose body mass index less than 25.0 kg/m2 to assess an association between severity of NH and a decline of estimated glomerular filtration rate (eGFR) in 1 year. In a multivariate analysis, those with moderate to severe NH had a significantly faster eGFR decline than those with non- and mild NH.
Lipoprotein Kinetics in Male Hemodialysis Patients Treated with Atorvastatin.
Hemodialysis.com eInterview with Prof. Hans Dieplinger PhD
Division of Genetic Epidemiology
Department of Medical Genetics, Clinical and Molecular Pharmacology
Innsbruck Medical University
Schöpfstrasse 41
A-6020 Innsbruck Austria
email hans.dieplinger@i-med.ac.at
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Dr. Dieplinger: Our study was based on previous investigations from our group on the kinetics of atherogenic lipoproteins in hemodialysis patients. These former studies revealed a metabolic disorder of diminished synthesis AND degradation of apoB-containing lipoproteins resulting in prolonged residence times in circulation of these lipoproteins despite of their concentrations in normal ranges. The aim of our recent study was therefore to test whether HMG-CoA-reductase inhibitors (statins) which are known to normalize impaired degradation of apoB-containing lipoproteins in hypercholesterolemic patients exert similar beneficial effects also in CKD patients treated with hemodialysis. The main findings in a small group of male hemodialysis patients were significant reductions of total and LDL cholesterol as well as improved kinetics (including residence times) of atherogenic lipoproteins.
Air Quality Index and All-Cause Mortality in Maintenance Dialysis Patients
Hemodialysis.com eInterview with: Elani Streja
Doctoral StudentHarold Simmons Center for Chronic Disease Research & Epidemiology
University of California Irvine Medical Center, Irvine, CA, USA
Hemodialysis.com: What is the Rationale for the study?
Answer: Air quality is considered an important modifier of health in the general population, as poor air quality have been associated with increased risk of heart disease, lung cancer, and respiratory infection. We explored how residential air quality correlates with mortality outcomes in maintenance hemodialysis (MHD) patients, for whom pulmonary infections and cardiovascular mortality occur far more frequently as compared to the general population. The “Air Quality Index,” a scale developed by Environmental Protection Agency (EPA) to assess ambient air quality, measures levels of five major air pollutants: ground-level ozone, particulate matter, carbon monoxide, nitrogen dioxide, and sulfur dioxide. In high amounts, these pollutants are associated with several adverse health effects in the general population, including increased risk of heart disease, lung cancer, and respiratory infections.
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.
Survival Advantage in Black Versus White Men With CKD: Effect of Estimated GFR and Case Mix
Hemodialysis.com Author Interview: Csaba P. Kovesdy MD FASN.
The Fred Hatch Professor of Medicine
Director, Clinical Outcomes and Clinical Trials Program in Nephrology
University of Tennessee Health Science Center
Chief of Nephrology
Division of Nephrology, Memphis VA Medical Center
Hemodialysis.com Editor Marie Benz: What are the main findings of the study?
Dr. Kovesdy: In this very large cohort of male US veterans, African Americans with all stages of non-dialysis dependent CKD had significantly lower mortality compared to Caucasian patients.
The more advanced the CKD stage was, the more accentuated this difference became.
