Safety of cinacalcet in children and adolescents with chronic kidney disease-mineral bone disorder: systematic review and proportional meta-analysis of case series.

Background: Mineral and bone disease in children with chronic kidney disease can cause abnormalities in calcium, phosphorus, parathyroid hormone, and vitamin D and when left untreated can result in impaired growth, bone deformities, fractures, and vascular calcification. Cinacalcet is a calcimimetic widely used as a therapy to reduce parathyroid hormone levels in the adult population, with hypocalcemia among its side effects. The analysis of safety in the pediatric population is questioned due to the scarcity of randomized clinical trials in this group.

Serum myostatin levels are associated with physical function and hospitalization in peritoneal dialysis patients.

Background: Myostatin functions as a negative regulator of skeletal muscle growth. The association of myostatin with muscle parameters in dialysis patients is inconsistent, and there are no studies associating myostatin with physical function and outcomes in peritoneal dialysis (PD) patients. Therefore, we assessed the association of serum myostatin with lean mass, physical function, and hospitalization in a prospective cohort of PD patients.

Association between urinary sodium excretion and hard outcomes in non-dialysis chronic kidney disease patients.

Background: Restriction of sodium intake is routinely recommended for patients with chronic kidney disease (CKD). Whether or not sodium intake is associated with the progression of CKD and mortality remains uncertain. We evaluated the association between urinary sodium excretion (as a surrogate for sodium intake) with the occurrence of renal failure and mortality in patients with non-dialytic CKD.

Handgrip Strength Thresholds are Associated With Malnutrition Inflammation Score (MIS) in Maintenance Hemodialysis Patients.

Objective: The aim is to verify the association between nutritional status and muscle strength, considering handgrip strength (HGS) cutoffs associated with sarcopenia and mortality.

Methods: Cross-sectional analysis, including hemodialysis patients. Malnutrition Inflammation Score (MIS) was used to assess nutritional status.

Association of Phase Angle, but Not Inflammation and Overhydration, With Physical Function in Peritoneal Dialysis Patients.

Muscle mass depletion, overhydration, and inflammatory state have been related to impaired physical function in chronic kidney disease patients. The relationship between bioelectrical impedance analysis (BIA) parameters, such as hydration status and phase angle (PhA), with physical function in peritoneal dialysis (PD), is still not well-established. Therefore, the objective was to evaluate the association of BIA parameters (overhydration index and PhA) and inflammatory markers with physical function in patients on PD.

Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients.

Background: Due to the poor outcomes associated with the impairment of physical function and muscle strength in patients on maintenance dialysis, it is important to understand the factors that may influence physical function and muscle strength. The aim of this study was to explore the factors associated with physical function in hemodialysis and peritoneal dialysis patients.

Methods: Patients with chronic kidney disease on dialysis for at least 3 months, aged 18 years old or above, were enrolled.

Vitamin D and skeletal muscle: A narrative review focusing on chronic kidney disease and dialysis.

Morphological, molecular, and physiological effects of vitamin D on skeletal muscle have been analyzed both in animals and humans. Vitamin D may be a potential therapeutic for increasing muscle mass and function. The presence of vitamin D receptors in skeletal muscle cells is already established.

Which Method Should Be Used to Assess Protein Intake in Peritoneal Dialysis Patients? Assessment of Agreement Between Protein Equivalent of Total Nitrogen Appearance and 24-Hour Dietary Recall.

Objectives: After dialysis initiation, a high protein diet is recommended due to significant nutrient losses through dialysate and increased risk of protein energy wasting. In peritoneal dialysis (PD) patients, protein intake can be assessed through different methods that have some advantages and limitations, which affect its use on routine care. The aim of this study is to evaluate the agreement between 2 different methods (24-hour dietary recall and PNA-protein equivalent of total nitrogen appearance) on estimating protein intake in PD patients.

Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-associated peritonitis in a single center using molecular methods.

Purpose: Peritonitis is a serious complication of peritoneal dialysis and coagulase-negative Staphylococcus (CNS) is the most frequent cause of peritoneal dialysis (PD)-infections in many centers. This study aimed to investigate the molecular epidemiology of CNS isolated from PD-peritonitis in a Brazilian single center, focusing on the genetic determinants conferring methicillin resistance.

Methods: Bacterial strains were isolated from peritoneal fluid of patients presenting PD-peritonitis, identified by phenotypic and molecular methods, and those identified as CNS were submitted to mecA detection, SCCmec, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).

Association between vitamin D levels and mortality in hemodialysis patients: a cohort study.

Low vitamin D levels are associated with mortality in hemodialysis (HD) patients; however, the serum vitamin D thresholds are unclear. This study aimed to identify the vitamin D level below which mortality increases in HD patients. A cohort of HD patients enrolled from January 2014 to January 2017 was evaluated.

Correction: Update of the European consensus on sarcopenia: what has changed in diagnosis and prevalence in peritoneal dialysis?

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Role of parathyroid hormone in anorexia on maintenance hemodialysis patients.

Background And Aim: Anorexia, which is a common condition in patients on hemodialysis (HD), is characterized by impaired appetite, a subjective condition that hinders anorexia diagnosis. Anorexia is frequently associated with protein energy wasting and inflammation, increasing morbidity and mortality risk. The aim of the study was to evaluate the association between appetite and nutritional, inflammatory, hormonal, and dietary intake parameters in patients on maintenance HD.

Aerobic Exercise Training and Nontraditional Cardiovascular Risk Factors in Hemodialysis Patients: Results from a Prospective Randomized Trial.

Introduction: Chronic kidney disease (CKD) patients have a high incidence of cardiovascular diseases (CVD) which increases their morbidity and mortality. A sedentary lifestyle in CKD is directly linked to the onset of CVD. Physical activity can bring beneficial effects to CKD patients.

Update of the European consensus on sarcopenia: what has changed in diagnosis and prevalence in peritoneal dialysis?

Patients on peritoneal dialysis (PD) may be affected by sarcopenia, which is a progressive and generalized skeletal muscle disorder characterized by muscle mass atrophy with decline of muscle strength and function. The aim was to evaluate differences in the diagnosis and prevalence of sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP). The screening for sarcopenia was performed in PD patients older than 18 years, with evaluation of appendicular skeletal muscle mass index (ASMMI), handgrip strength (HGS) and gait speed (GS).

Incorporating evidence-based principles in medical training. Sharing experience with McMaster.

This article was migrated. The article was marked as recommended. This workshop was the second activity of the collaboration between the McMaster University, Botucatu Medical School- São Paulo State University (UNESP) and Pontifical Catholic University of Minas Gerais - PUC Minas that took place in Botucatu, Brazil between March 27th to 28th 2017.

Influence of Intradialytic Aerobic Training in Cerebral Blood Flow and Cognitive Function in Patients with Chronic Kidney Disease: A Pilot Randomized Controlled Trial.

Background And Objectives: Changes in cerebral blood flow may play an important role in cognitive impairment among hemodialysis (HD) patients. Physical activity has a promising role in delaying cognitive impairment in general population, but there are only a few studies in HD to confirm this finding. We aimed to evaluate the effects of intradialytic aerobic training on cerebral blood flow and cognitive impairment in HD.

Advanced glycation end-products (AGEs) accumulation in skin: relations with chronic kidney disease-mineral and bone disorder.

Introduction: Chronic kidney disease (CKD) is associated with high morbidity and mortality rates, main causes related with cardiovascular disease (CVD) and bone mineral disorder (CKD-BMD). Uremic toxins, as advanced glycation end products (AGEs), are non-traditional cardiovascular risk factor and play a role on development of CKD-BMD in CKD. The measurement of skin autofluorescence (sAF) is a noninvasive method to assess the level of AGEs in tissue, validated in CKD patients.

Malnutrition Inflammation Score cut-off predicting mortality in maintenance hemodialysis patients.

Background: Malnutrition is a strong predictor of mortality on hemodialysis patients, especially when it is associated with inflammation. Malnutrition Inflammation Score (MIS) is a simple and low cost tool which assesses the presence of malnutrition associated with inflammation. Therefore, the aim is to evaluate if MIS is associated with mortality in patients on maintenance hemodialysis and establish a cut-off to predict mortality at different follow-up periods.

Aldosterone is associated with left ventricular hypertrophy in hemodialysis patients.

Objectives: Patients with chronic kidney disease present a higher degree of left ventricular hypertrophy than expected for hypertension levels. In chronic kidney disease the plot between the quotient extracellular water/total body water and aldosterone is shifted up and to the right. There are few studies that verified the role of aldosterone in cardiac remodeling in this set of patients.

Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients.

Background & Aims: Muscle wasting is associated with mortality in dialysis patients. The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD).

Are Nutritional Composed Scoring Systems and Protein-Energy Wasting Score Associated With Mortality in Maintenance Hemodialysis Patients?

Objective: The diagnostic of protein-energy wasting should be done using a tool that can predict clinically important outcomes, besides identifying malnutrition. This study investigated which nutritional composed scoring systems best predicts all-cause mortality in maintenance hemodialysis patients.

Design And Methods: Cohort study that included prevalent patients undergoing hemodialysis for at least 1 month.