Atrial natriuretic peptide for preventing and treating acute kidney injury.

Background: Acute kidney injury (AKI) is common in hospitalised patients and is associated with significant morbidity and mortality. Despite recent advances, outcomes have not substantially changed in the last four decades. Atrial natriuretic peptide (ANP) has shown promise in animal studies, however randomised controlled trials (RCTs) have shown inconsistent clinical benefits.

Weight loss interventions in chronic kidney disease: a systematic review and meta-analysis.

Background And Objectives: Obesity is an independent risk factor for development and progression of chronic kidney disease (CKD). We conducted a systematic review to assess the benefits of intentional weight loss in patients with non-dialysis-dependent CKD and glomerular hyperfiltration.

Design, Setting, Participants, & Measurements: We searched MEDLINE, SCOPUS, and conference proceedings for randomized, controlled trials and observational studies that examined various surgical and nonsurgical interventions (diet, exercise, and/or antiobesity agents) in adult patients with CKD.

Benefits and harms of phosphate binders in CKD: a systematic review of randomized controlled trials.

Background: Phosphate binders are widely used to control serum phosphorus levels in patients with chronic kidney disease (CKD). We analyzed the effects of phosphate binders on biochemical and patient-level end points in patients with CKD.

Study Design: Systematic review and meta-analysis by searching MEDLINE (1966 to April 2009), EMBASE (1980 to April 2009), and the Cochrane Renal Group Specialised Register and the Cochrane Central Register of Controlled Trials (CENTRAL).

Aldosterone antagonists for preventing the progression of chronic kidney disease.

Background: Treatment with angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) is increasingly used to reduce proteinuria and retard the progression of chronic kidney disease (CKD). But some patients do not attain complete resolution of proteinuria and might have higher aldosterone levels within few months of treatment. The addition of aldosterone antagonists may be beneficial to these patients for reduction of progression of renal damage.

HMG CoA reductase inhibitors (statins) for dialysis patients.

Background: Cardiovascular disease accounts for more than half the number of deaths among dialysis patients. The role of HMG CoA reductase inhibitors (statins) in the treatment of dyslipidaemia in dialysis patients is unclear and their safety has not been established.

Objectives: To assess the benefits and harms of statins in peritoneal dialysis (PD) and haemodialysis patients (HD).

HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis.

Background: Dyslipidaemia occurs frequently in chronic kidney disease (CKD) patients and contributes both to cardiovascular disease and worsening renal function. Statins are widely used in non-dialysis dependent CKD patients (pre-dialysis) even though evidence favouring their use is lacking.

Objectives: To evaluate the benefits and harms of statins in CKD patients who were not receiving renal replacement therapy.

HMG CoA reductase inhibitors (statins) for kidney transplant recipients.

Background: Cardiovascular deaths account for the majority of deaths in kidney transplant recipients and dyslipidaemia contributes significantly to their cardiovascular disease. Statins are widely used in kidney transplant patients given their established benefits in the general population, however evidence favouring their use is lacking.

Objectives: To assess the benefits and harms of statin therapy on mortality and renal outcomes in kidney transplant recipients.

HMG CoA reductase inhibitors (statins) for dialysis patients.

Background: Cardiovascular disease accounts for more than half the number of deaths among dialysis patients. The role of HMG CoA reductase inhibitors (statins) in the treatment of dyslipidaemia in dialysis patients is unclear and their safety has not been established.

Objectives: To assess the benefits and harms of statins in peritoneal dialysis (PD) and haemodialysis patients (HD).

Bariatric surgery and progression of chronic kidney disease.

Background: Obesity is an independent predictor for the development and progression of chronic kidney disease (CKD). The effect of weight reduction on the progression of kidney disease in patients with pre-existing CKD is unclear.

Methods: We conducted a retrospective study at a U.

Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis.

Background And Objectives: Addition of aldosterone antagonists (AA) might provide renal benefits to proteinuric chronic kidney disease (CKD) patients over and above the inhibition of renin-angiotensin system blockers (RAS). We evaluated the benefits and harms of adding selective and nonselective AA in CKD patients already on RAS.

Design, Setting, Participants, & Measurements: MEDLINE, EMBASE, and Renal Health Library were searched for relevant randomized clinical trials in adult CKD patients.

Anti-neutrophil cytoplasmic antibody associated crescentic IgA nephropathy in hematopoietic stem cell transplantation.

Membranous glomerulonephritis and minimal change disease are the most common forms of glomerular diseases noted in patients with graft versus host disease after hematopoietic stem cell transplantation. Herein, we report a patient who developed anti-neutrophil cytoplasmic antibody associated crescentic IgA nephropathy within 3 months after autologous hematopoietic stem cell transplantation. He was treated with intravenous pulse steroids and monthly intravenous cyclophosphamide for 6 months followed by cyclophosphamide every 3 months and tapering dose of steroids.

Baroreflex stimulation: A novel treatment option for resistant hypertension.

Hypertension is a major public health problem in both developing and developed countries. Despite the increasing awareness of hypertension and its implications among patients and the treating physicians, the prevalence of resistant hypertension remains high and is expected to increase. Many patients fail to reach their target blood pressure (BP) despite the wide availability of several antihypertensive agents and the continued recommendation of dietary and lifestyle modifications.

Atrial natriuretic peptide for management of acute kidney injury: a systematic review and meta-analysis.

Background And Objectives: Randomized controlled trials (RCTs) with atrial natriuretic peptide (ANP) have shown inconsistent effects for renal end-points. The authors aimed to systematically review these trials to ascertain the benefit of ANP in prevention and treatment of acute kidney injury (AKI).

Design, Setting, Participants, & Measurements: The authors searched MEDLINE, EMBASE, and Cochrane Renal Health Library that investigated ANP in adult patients considered with or at risk for AKI.

Associations of serum uric acid with cardiovascular events and mortality in moderate chronic kidney disease.

Background: It is unclear whether the presence of kidney disease modifies the associations of uric acid with cardiovascular events and death.

Methods: In the limited access, public use Atherosclerosis Risk In Communities (ARIC) database, associations of serum uric acid levels with cardiovascular events and death were analysed using a parametric proportional hazards model and the modification of these associations by the presence of CKD was assessed using a likelihood ratio test.

Results: Of the 15 366 ARIC participants included in this analysis, 461 had CKD (eGFR <60 ml/min/1.

Sodium bicarbonate therapy for prevention of contrast-induced nephropathy: a systematic review and meta-analysis.

Background: Optimal hydration measures to prevent contrast-induced nephropathy are controversial.

Study Design: We conducted a systematic review and meta-analysis using the MEDLINE database (1966 to January 2008), EMBASE (January 2008), and abstracts from conference proceedings.

Setting & Population: Adult patients undergoing contrast procedures.

Treatment options for proliferative lupus nephritis: an update of clinical trial evidence.

Systemic lupus erythematosus involves the kidney in up to 60% of patients, and if untreated, may result in complete loss of kidney function. In this article, we review meta-analyses and clinical trial data on the therapeutic options for proliferative lupus nephritis, and complete a meta-analysis of the use of mycophenolate mofetil (MMF) compared with cyclophosphamide-based regimens. Clinical trials have found that cyclophosphamide-based regimens result in a decreased risk of end-stage renal disease, but are associated with significant toxicity in lupus nephritis.

Rituximab treatment of fibrillary glomerulonephritis.

Fibrillary glomerulonephritis belongs to a group of disorders characterized by pathogenic deposition of fibrils in glomeruli. This glomerulopathy tends to progress to end-stage kidney disease, and there currently are no treatments of proven benefit, including corticosteroids and cytotoxic agents. Because the glomerular deposits contain an immunoglobulin component, it was postulated that anti-B-cell therapy with rituximab, an anti-CD20 monoclonal antibody, may be effective in the treatment of patients with fibrillary glomerulonephritis.

Metaanalysis on effects of cardiac resynchronization therapy in heart failure patients with narrow QRS complex.

Background: To systematically review the benefits of cardiac resynchronization therapy (CRT) in heart failure patients with narrow QRS (< 120 ms) who have baseline mechanical asynchrony.

Methods: We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and reference lists of retrieved articles for relevant trials through October 2007. Studies were included if they were clinical trials in heart failure patients with narrow QRS complex, had at least 3 months of duration and measured baseline mechanical dyssynchrony.

Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials.

Objective: To analyse the benefits and harms of statins in patients with chronic kidney disease (pre-dialysis, dialysis, and transplant populations).

Design: Meta-analysis.

Data Sources: Cochrane Central Register of Controlled Trials, Medline, Embase, and Renal Health Library (July 2006).

A systematic review of patient and health system characteristics associated with late referral in chronic kidney disease.

Background: To identify patient and health system characteristics associated with late referral of patients with chronic kidney disease to nephrologists.

Methods: MEDLINE, CENTRAL, and CINAHL were searched using the appropriate MESH terms in March 2007. Two reviewers individually and in duplicate reviewed the abstracts of 256 articles and selected 18 observational studies for inclusion.