Pragmatic diagnostic and therapeutic algorithms to optimize new potassium binder use in cardiorenal disease.

Background: Pivotal randomized trials demonstrating efficacy, safety and good tolerance, of two new potassium binders (patiromer and sodium zirconium cyclosilicate) led to their recent approval. A major hurdle to the implementation of these potassium-binders is understanding how to integrate them safely and effectively into the long-term management of cardiovascular and kidney disease patients using renin angiotensin aldosterone system inhibitors (RAASi), the latter being prone to induce hyperkalaemia.

Methods: A multidisciplinary academic panel including nephrologists and cardiologists was convened to develop consensus therapeutic algorithm(s) aimed at optimizing the use of the two novel potassium binders (patiromer and sodium zirconium cyclosilicate) in stable adults who require treatment with RAASi and experience(d) hyperkalaemia in a non-emergent setting.

Long-term glycemic variability and the risk of mortality in diabetic patients receiving peritoneal dialysis.

Background: The large amount of glucose in the dialysate used in peritoneal dialysis (PD) likely affects the glycemic control. The aim of this study was to investigate the association between HbA1c variability, as a measure of long-term glycemic variability, and the risk of all-cause mortality in diabetic patients with PD.

Methods: 325 patients with diabetes and ESRD were followed (2008-2018) in the Swedish Renal Registry.

The association of erythropoietin-stimulating agents and increased risk for AV-fistula dysfunction in hemodialysis patients. A retrospective analysis.

Background: Patients in maintenance hemodialysis (HD) need a patent vascular access for optimal treatment. The recommended first choice is a native arteriovenous fistula (AVF). Complications of AVF are frequent and include thrombosis, stenosis and infections leading to worsening of dialysis efficacy.

Risk factors for biopsy complications in initial versus subsequent biopsies in native and transplant kidneys.

Background: Few studies exist about risk factors for complications in subsequent biopsies.

Purpose: To explore risk factors for complications in initial versus subsequent biopsies in native and transplant kidneys, which may predict biopsy complications.

Material And Methods: In a multicenter study, 2830 native kidney biopsies (4.

Melanotan II: a possible cause of renal infarction: review of the literature and case report.

Renal infarction is an uncommon condition resulting from an acute disruption of renal blood flow and it is potentially life-threatening disease. The cause and outcome of renal infarction is not well established and is frequently misdiagnosed or diagnosed late. Melanotan II is a non-selective melanocortin-receptor agonist and its effect on humans is an increasing of skin pigmentation, producing of spontaneous penile erection and sexual stimulation.

High doses of erythropoietin stimulating agents may be a risk factor for AV-fistula stenosis.

Background: A native AV-fistula (AVF) for access in hemodialysis (HD) is preferable. Stenosis, a major hurdle, is associated with older age and diabetes mellitus.

Purpose: This case-control study aimed to clarify if any medical and/or laboratory factors, that can be altered, could be associated to AVF stenosis.

Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

Background: Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.

Methods: We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013.

Desmopressin (Octostim®) before a native kidney biopsy can reduce the risk for biopsy complications in patients with impaired renal function: A pilot study.

Aim: To evaluate whether the administration of desmopressin alters the risk for renal biopsy complications.

Methods: A multicenter registry containing 576 native kidney biopsies (NKb) with a serum creatinine above 150 μmol/L in 527 patients (372 men and 155 women, median age 61 years) was used. Most of the data were prospective.

High Resistive Index in Transplant Kidneys Is a Possible Predictor for Biopsy Complications.

Background: Transplant kidney biopsies are performed to determine a histological diagnosis for specific patient treatment. The aim of this study was to investigate if Resistive Index (RI) could be a predictor for biopsy complications.

Methods: In this study, 220 consecutive transplant kidney biopsies (136 men and 84 women; median age, 55.

Sixteen Gauge biopsy needles are better and safer than 18 Gauge in native and transplant kidney biopsies.

Background Kidney biopsies are essential for optimal diagnosis and treatment. Purpose To examine if quality and safety aspects differ between types and sizes of biopsy needles in native and transplant kidneys. Material and Methods A total of 1299 consecutive biopsies (1039 native and 260 transplant kidneys) were included.

Comparing changes in plasma and skin autofluorescence in low-flux versus high-flux hemodialysis.

Background: Tissue advanced glycation end products (AGE) are increased in hemodialysis (HD) patients, especially those with cardiovascular complications. Skin autofluorescence (skin-AF) can noninvasively estimate the accumulation of AGE in tissue. The aim was to clarify whether HD using a high-flux (HF) dialyzer favors plasma-or skin-AF removal compared to low-flux (LF) dialysis.

Increased risk of renal biopsy complications in patients with IgA-nephritis.

Background: The aim of this study was to investigate if specific clinical and histological findings can be related to biopsy complications to enable more closely monitoring patients at high risk.

Methods: Results from 1081 biopsies (994 patients, median age 54.5 years; 896 native and 185 transplant kidney biopsies) were included.

A study of clinical complications and risk factors in 1,001 native and transplant kidney biopsies in Sweden.

Background: In Sweden, native and transplant kidney biopsies are usually performed in major renal medical centers.

Purpose: To clarify risk factors in native and transplant kidney biopsies to improve patient safety.

Material And Methods: A total of 1001 biopsies (in 352 women and 565 men) were included.

A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure.

Background: The primary aim of this study was to assess whether a fixed protocol, using a specially trained team, for intermediate follow-up to fulfillment of guideline targets is non-inferior to conventional follow-up in the care of uraemic patients. A secondary aim was to investigate possible impact on patient outcome.

Methods: The cohort comprised 424 patients from seven centers.

Membranoproliferative glomerulonephritis and inflammatory pseudotumour of the spleen.

Inflammatory pseudotumour is a rare condition that can affect various organs. The clinical and histologic appearance of the pseudotumour may mimic haematological, lymphoproliferative, paraneoplastic or malignant processes. A previously healthy 39-year-old man presented with nephrotic syndrome.

Ongoing treatment with renin-angiotensin-aldosterone-blocking agents does not predict normoalbuminuric renal impairment in a general type 2 diabetes population.

Aim: To examine the prevalence and the clinical characteristics associated with normoalbuminuric renal impairment (RI) in a general type 2 diabetes (T2D) population.

Methods: We included 94 446 patients with T2D (56% men, age 68.3±11.

Risk factors for the development of albuminuria and renal impairment in type 2 diabetes--the Swedish National Diabetes Register (NDR).

Background: The aim of this study was to identify clinical risk factors associated with the development of albuminuria and renal impairment in patients with type 2 diabetes (T2D). In addition, we evaluated if different equations to estimate renal function had an impact on interpretation of data. This was done in a nationwide population-based study using data from the Swedish National Diabetes Register.

Echocardiographic findings in kidney transplant patients with autosomal dominant polycystic kidney disease.

Objective: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder with a tendency for aneurysm formation which may also affect the heart. ADPKD kidney transplant patients were studied by echocardiography.

Material And Methods: The case-control study consisted of 21 kidney transplant recipients and a group of 21 transplant patients with other diagnoses.

Biocompatibility and tolerability of a purely bicarbonate-buffered peritoneal dialysis solution.

Background: Novel peritoneal dialysis solutions are characterized by a minimal content of glucose degradation products and a neutral pH. Many studies have shown the biocompatibility of neutral lactate-buffered solutions; however, until now, the effect of purely bicarbonate-buffered solutions has not been intensively studied in vivo.

Methods: This study was an open label, prospective, crossover multicenter trial to investigate the biocompatibility of a purely bicarbonate-buffered solution (bicPDF) by measuring biocompatibility parameters such as cancer antigen 125 (CA125) in peritoneal effluent.

A new safety device for hemodialysis.

Accidental venous needle dislodgement during hemodialysis may cause serious bleeding including a sometimes fatal outcome. The venous pressure gauge of the dialysis monitor does not react when dislodgement occurs. A sensor patch put as an adhesive over the venous needle puncture site connected to an alarm unit by an optic fiber has been clinically tested in 5 dialysis departments.

Low-dose atorvastatin in severe chronic kidney disease patients: a randomized, controlled endpoint study.

Objective: There have been no endpoint studies with statins for patients with severe renal failure. The purpose of this prospective, open, randomized, controlled study was to investigate whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance < 30 ml/min).

Material And Methods: The study subjects comprised 143 patients who were randomized either to placebo (controls; n=73; mean age 69.

Steroid-free immunosuppression in kidney transplant recipients and prograf monotherapy: an interim analysis of a prospective multicenter trial.

This report described an interim analysis of a investigator-driven multicenter trial in renal transplant recipients: the Prospective Quality of life Renal Transplantation Switch Study; Tacrolimus-based immunosuppression ("PQRST study"). Patients included in the trial initially treated with cyclosporine-based immunosuppression after renal transplantation who experienced side effects, such as hypertension, hyperlipidemia, hypertrichosis, or other adverse reactions, were converted to a tacrolimus-based immunosuppressive regimen (n = 31). Steroids were subsequently discontinued between 3 and 6 months after the conversion.