Oral Anticoagulant Initiation in Patients With Kidney Failure on Hemodialysis Newly Diagnosed With Atrial Fibrillation (2007-2020): An Observational Study of Trends and Disparities.

Rationale & Objective: Atrial fibrillation (AF) is common in patients with kidney failure on hemodialysis (HD), but few patients receive oral anticoagulant (OAC) treatment. Availability of direct-target OACs starting in 2010 may have induced greater OAC initiation, but this has not been systematically studied.

Study Design: Retrospective cohort study.

Glomerular Disease in Liver Disease.

Glomerular diseases are an important cause of kidney disease in patients with liver disease. Although kidney involvement due to tubular or vascular disease is more common, glomerular diseases became more prevalent as hepatitis infections increased and then subsequently decreased with the widespread availability of hepatitis A and B vaccines and the development of effective antiviral treatments for hepatitis B and C. In this review, we discuss the common glomerular pathologies that are seen in patients with liver disease and the current treatment options available to them.

The Association of Pre-Kidney Transplant Dialysis Modality with de novo Posttransplant Heart Failure.

Background: Heart failure (HF) after kidney transplantation is a significant but understudied problem. Pretransplant dialysis modality could influence incident HF risk through differing cardiac stressors. However, whether pretransplant dialysis modality is associated with the development of posttransplant HF is unknown.

The impact of COVID-19 on kidney transplantation and the kidney transplant recipient - One year into the pandemic.

The COVID-19 pandemic has significantly changed the landscape of kidney transplantation in the United States and worldwide. In addition to adversely impacting allograft and patient survival in postkidney transplant recipients, the current pandemic has affected all aspects of transplant care, including transplant referrals and listing, organ donation rates, organ procurement and shipping, and waitlist mortality. Critical decisions were made during this period by transplant centers and individual transplant physicians taking into consideration patient safety and resource utilization.

Association Between Type of Vascular Access Used in Hemodialysis Patients and Subsequent Kidney Transplant Outcomes.

Rationale & Objective: Vascular access type (arteriovenous fistula [AVF] vs arteriovenous graft [AVG] vs central venous catheter [CVC]) associates with clinical outcomes in patients with end-stage kidney disease undergoing hemodialysis. Whether a similar association exists with outcomes after kidney transplantation is unknown. We hypothesized that AVGs would associate with worse outcomes, perhaps owing to persistent subclinical inflammation.

Blood Pressure and Incident Atrial Fibrillation in Older Patients Initiating Hemodialysis.

Background And Objectives: We examined the association of predialysis systolic and diastolic BP and intradialytic hypotension with incident atrial fibrillation in older patients initiating hemodialysis.

Design, Setting, Participants, & Measurements: We used the US Renal Data System linked to the records of a large dialysis provider to identify patients aged ≥67 years initiating hemodialysis between January 2006 and October 2011. We examined quarterly average predialysis systolic BP, diastolic BP, and proportion of sessions with intradialytic hypotension (, nadir systolic BP <90 mm Hg).

Predialysis Nephrology Care and Incident Atrial Fibrillation in Older Patients With ESKD Initiating Dialysis.

Background: Atrial fibrillation (AF) is common in patients with end-stage kidney disease (ESKD) on dialysis. Whether pre-ESKD nephrology care associates with AF is uncertain.

Methods: We conducted a retrospective cohort study of older US patients (≥67 years) with Medicare A&B who initiated dialysis (1996-2013) without a prior diagnosis of AF.

Lupus nephritis: A historical appraisal of how a skin lesion became a kidney disease .

"Lupus nephritis", a serious complication of systemic lupus erythematosus (SLE), is an entity of recent vintage. The term "lupus", derived from Latin for wolf, was introduced in the Middle Ages to denote nondescript erosive skin lesions which resembled wolf bites that were known theretofore by their Greek name of "", used in the Hippocratic Corpus for the spread of the lesions like a crawling snake. The specific dermatologic features of lupus were characterized as an "erythematous" butterfly rash in 1828 and dubbed "lupus erythematosus" in 1850.

Dialysis Modality and Incident Atrial Fibrillation in Older Patients With ESRD.

Rationale & Objective: Atrial fibrillation (AF) is common in patients with kidney failure treated by maintenance dialysis. Whether the incidence of AF differs between patients receiving hemodialysis and peritoneal dialysis is uncertain.

Study Design: Retrospective cohort study.

Cause-Specific Mortality in Patients with Chronic Kidney Disease and Atrial Fibrillation.

Background: Atrial fibrillation (AF) is associated with death in patients with chronic kidney disease (CKD). We examined the associations between AF and cause-specific mortality in a large CKD population.

Methods: We included 62,459 patients with estimated glomerular filtration rate 15-59 mL/min/1.

Risk profiles for acute health events after incident atrial fibrillation in patients with end-stage renal disease on hemodialysis.

Background: Little is known about the cardiovascular risks of incident atrial fibrillation/flutter (AF) in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD).

Methods: We studied older US patients who newly initiated HD for ESRD (2006-11) and who had not previously been diagnosed with AF, stroke, myocardial infarction (MI) or hip fracture. We used Cox regression with AF as a time-varying covariate, adjusted for socio-demographic characteristics and comorbidities to estimate hazard ratios [HRs (95% confidence intervals)] for the events of ischemic stroke, MI and death.

Safety of Intravenous Iron in Hemodialysis: Longer-term Comparisons of Iron Sucrose Versus Sodium Ferric Gluconate Complex.

Background: Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy in facilities that predominantly (in ≥90% of their patients) used iron sucrose versus sodium ferric gluconate complex.

Study Design: Retrospective cohort study of incident HD patients.

The kidney in sickle hemoglobinopathies .

With improvements in the care of patients with sickle hemoglobinopathies, sickle cell disease (SCD) has evolved from a disease that was fatal in childhood into one in which most survive past their 5th decade and some into old age. As a result, the renal complications of sickle hemoglobinopathies, which are age dependent, have emerged as a common and serious complication of SCD. Approximately 14 - 18% of mortality in SCD is attributed to chronic kidney disease (CKD), which develops in 1/3 of individuals with SCD and progresses to end-stage renal disease in 4 - 18% of them.

Associations of dysnatremias with mortality in chronic kidney disease.

Background: Hyponatremia and hypernatremia are associated with death in the general population and those with chronic kidney disease (CKD). We studied the associations between dysnatremias, all-cause mortality and causes of death in a large cohort of Stage 3 and 4 CKD patients.

Methods: We included 45 333 patients with Stage 3 and 4 CKDs followed in a large healthcare system.

Comparative outcomes of predominant facility-level use of ferumoxytol versus other intravenous iron formulations in incident hemodialysis patients.

Background: Ferumoxytol was first approved for clinical use in 2009 solely based on data from trial comparisons with oral iron on biochemical anemia efficacy end points. To compare the rates of important patient outcomes (infection, cardiovascular events and death) between facilities predominantly using ferumoxytol versus iron sucrose (IS) or ferric gluconate (FG) in patients with end-stage renal disease (ESRD)-initiating hemodialysis (HD).

Methods: Using the United States Renal Data System, we identified all HD facilities that switched (almost) all patients from IS/FG to ferumoxytol (July 2009-December 2011).

Tubulointerstitial nephritis and cancer chemotherapy: update on a neglected clinical entity.

Background: Cancer patients are particularly vulnerable to drug-induced kidney injury during their chemotherapy. Whereas the direct nephrotoxic effects of these drugs are well recognized, that of tubulointerstitial nephritis (TIN) is less well known, underdiagnosed and often reported only as a functional tubular disorder. The diagnosis of acute TIN is important because of its insidious onset with tubular dysfunction, its potential reversibility if detected early and the possibility of its response to steroid treatment.

Significant decrease in glomerular filtration rate at 5 years posttransplantation in the recipients of live donor kidneys 50 years of age or older.

Introduction: Age is an established predictor of renal failure among recipients of cadaveric transplants; however, the impact of donor age on recipient glomerular filtration rate (GFR) among living donor kidney (LDK) transplantations is not well established.

Methods: We retrospectively analyzed recipient posttransplantation GFR at 12, 36, and 60 months among 315 LDK allograft recipients. The impact of donor age was assessed on the recipient estimated GFR (eGFR) using multivariate linear regression stratified according to donor age <50 years (n = 246) and >or=50 years (n = 69).

Effects of chest physical therapy on lung function in children recovering from acute severe asthma.

The effects of chest physical therapy in acute severe asthma in children have been studied in 38 children aged 6 to 13 years in a randomized placebo controlled trial. The study began between 6 and 24 hours after admission to hospital; 19 children received chest physical therapy (PT) and 19 children received placebo visits. Each child had 4 treatments over 2 days which were preceded by nebulized salbutamol.