Risks and benefits of preemptive second kidney transplantation.

Background: Information to guide the timing of a second kidney transplantation is limited.

Methods: We compared outcomes of 3509 preemptive and 14,075 nonpreemptive second kidney transplant recipients in the U.S.

FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups.

Objective: To determine whether menstrual cups are a viable alternative to tampons.

Design: Randomized controlled trial.

Setting: Prince George, Victoria, and Vancouver, BC.

Utilization and outcome of 'out-of-center hemodialysis' in the United States: a contemporary analysis.

Background: There is increasing interest in the delivery of out-of-center hemodialysis (HD), particularly in the home setting, but little systematic information about its use and outcome in contemporary incident patients is available.

Patients And Methods: Out-of-center HD was defined as HD delivered in a residential setting, mainly at home or in a long-term care facility (such as a nursing home) irrespective of the length and frequency of therapy. All-cause mortality was determined in an observational cohort study of 458,329 adult patients initiating dialysis in the United States with Medicare as a primary payer.

Survival among nocturnal home haemodialysis patients compared to kidney transplant recipients.

Background: Kidney transplantation is the gold standard renal replacement therapy. Nocturnal haemodialysis (NHD) is an intensive dialysis modality (6-8 h/session, 3-7 sessions/week) associated with a significant improvement of clinical and biochemical parameters compared to conventional dialysis. To date, no studies have compared survival in patients treated with NHD and kidney transplantation.

Focal segmental glomerulosclerosis in mild IgA nephropathy: a clinical-pathologic study.

Background: The significance of focal segmental glomerulosclerosis (FSGS) in mild IgA nephropathy is uncertain.

Methods: All consecutive renal biopsies performed between 1996 and 2005 in adults with a diagnosis of mild IgA nephropathy (Lee Grade 1 or 2) at St Paul's Hospital, Vancouver, Canada, were reviewed.

Results: Seventy-five patients were included, 26 (35%) with IgA nephropathy and FSGS (FSGS+ group) and 49 (65%) with IgA nephropathy without FSGS (FSGS- group).

Sirolimus is associated with new-onset diabetes in kidney transplant recipients.

New-onset diabetes (NOD) is associated with transplant failure. A few single-center studies have suggested that sirolimus is associated with NOD, but this is not well established. With the use of data from the United States Renal Data System, this study evaluated the association between sirolimus use at the time of transplantation and NOD among 20,124 adult recipients of a first kidney transplant without diabetes.

Impact of acute rejection and new-onset diabetes on long-term transplant graft and patient survival.

Background And Objectives: Development of new therapeutic strategies to improve long-term transplant outcomes requires improved understanding of the mechanisms by which these complications limit long-term transplant survival.

Design, Setting, Participants, & Measurements: The association of acute rejection and new-onset diabetes was determined in the first posttransplantation year with the outcomes of transplant failure from any cause, death-censored graft loss, and death with a functioning graft in 27,707 adult recipients of first kidney-only transplants, with graft survival of at least 1 yr, performed between 1995 and 2002 in the United States.

Results: In multivariate analyses, patients who developed acute rejection or new-onset diabetes had a similar risk for transplant failure from any cause, but the mechanisms of transplant failure were different: Acute rejection was associated with death-censored graft loss but only weakly associated with death with a functioning graft.

Outcomes of acute coronary syndrome in a large Canadian cohort: impact of chronic renal insufficiency, cardiac interventions, and anemia.

Background: Chronic renal insufficiency (CRI) has been identified as an important risk factor for cardiac events. Studies in the United States reported decreased survival and decreased use of surgical and medical interventions after myocardial infarction in patients with CRI.

Methods: We studied the impact of renal function on health outcomes in a Canadian cohort of consecutive patients admitted with acute coronary syndrome (ACS) between October 1997 and October 1999.