Kidney disease drug recommended by Nice 'may do more harm than good'

Exclusive: Little evidence that phosphate binders improve patient wellbeing, warn experts, while one type may contribute to increased risk of cardiovascular diseaseThe UK ’s drug guidelines body is recommending a type of medication to treat chronic kidney disease despite no firm evidence that it benefits patients – and some signs that the drugs may do more harm than good, experts have warned.Phosphate binders are commonly prescribed to lower blood phosphate levels in patients with advanced kidney disease, including those on dialysis. High phosphate has been linked to worse patient outcomes, including bone and muscle problems, a build-up of calcium in the blood vessels causing them to stiffen, and an increased death rate.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Drugs The National Institute for Health and Care Excellence (Nice) NHS Society Science Source Type: news

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Authors: Kim HJ, Oh YN, Ju MH, Kim JB, Jung SH, Chung CH, Lee JW, Choo SJ Abstract Background: We reviewed our experience with on-pump beating (OPB) heart coronary artery bypass grafting (CABG) to evaluate the impacts of obviating aortic cross-clamping and cardioplegic arrest on clinical outcomes compared with conventional CABG (C-CABG). Methods: Between 2006 and 2012, elective isolated cardiopulmonary bypass (CPB)-assisted CABG was consecutively performed in 645 patients (mean patient age 63.3±9.1 years, 471 women) with 254 (39.4%) undergoing OPB-CABG and 391 (60.6%) undergoing C-CABG. The early and lon...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
"Why I Chose Hemodialysis Over Peritoneal Dialysis": An Opinion Survey Among In-Center Hemodialysis Patients. Perit Dial Int. 2018 Jul-Aug;38(4):305-308 Authors: Valson AT, Asad RA, Radhakrishnan RC, Sinha S, Jacob S, Varughese S, Tamilarasi V Abstract Peritoneal dialysis (PD) penetration in India remains low despite the huge chronic kidney disease burden and unmet need for renal replacement therapy (RRT). In order to understand the socioeconomic reasons that govern patients' preference for hemodialysis (HD), we carried out an opinion survey among prevalent in-center HD patients at our instit...
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
CONCLUSIONS: No difference in rates of acute kidney injury was detected before and after implementation of a colorectal enhanced recovery protocol. Independent predictors of acute kidney injury were identified and could be used to alter the protocol in high-risk patients. Future study is needed to determine whether protocol modifications will further decrease rates of acute kidney injury in this population. See Video Abstract at
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Socioeconomic Source Type: research
Conclusions: CD146 is associated with kidney injury and could be a good marker to predict renal outcomes in patients with early stages of DN.Cell Physiol Biochem 2018;48:63 –74
Source: Cellular Physiology and Biochemistry - Category: Cytology Source Type: research
Some studies have shown abnormalities of nutritional status in patients with chronic kidney disease (CKD) [1,2]. Protein energy wasting (PEW) is highly prevalent in haemodialysis (HD) patients [3,4]. The underlying mechanisms of PEW are complex, but metabolic derangements related both to exaggerated protein degradation and decreased protein synthesis are of utmost importance [5,6,7,8]. Homeostasis between protein synthesis and degradation depends on protein intake and utilization. Accelerated protein degradation, without a sufficient protein supply, may lead to skeletal muscle wasting (9).
Source: Nutrition - Category: Nutrition Authors: Source Type: research
ConclusionsEculizumab appears to be a potential treatment for patients with crescentic rapidly progressive C3 glomerulopathy. Its benefit in patients with non–rapidly progressing forms seems to be limited.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
ConclusionsPulmonary hypertension is associated with a substantially increased risk for death and cardiovascular events in patients with CKD and ESRD. Risk is higher in patients with ESRD receiving dialysis compared with patients with CKD stages 1 to 5. Understanding the effect of interventions to lower pulmonary artery pressure on the survival of these patents awaits their evaluation in randomized controlled trials.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Publication date: Available online 6 June 2018Source: American Journal of Kidney DiseasesAuthor(s): Nisha Bansal, Leila R. Zelnick, Jonathan Himmelfarb, Glenn M. ChertowRationale &ObjectiveBioelectrical impedance analysis (BIA) provides a noninvasive assessment of body composition. BIA measures of cell integrity (phase angle) and hydration (vector length) have been associated with mortality among patients receiving dialysis. Whether these measures are associated with clinical outcomes in patients with chronic kidney disease (CKD) is unknown.Study DesignObservational study.Settings &ParticipantsWe studied 3,751 part...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
This article reviews policies that affect the delivery of palliative care for this population, discusses reforms that could address disincentives to palliative care, identifies quality measurement issues for palliative care for individuals with advanced CKD and ESRD, and considers potential pitfalls in the implementation of new models of integrated palliative care. Reforming health care delivery in ways that remove policy disincentives to palliative care for patients with advanced CKD and ESRD will fill a critical gap in care.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
We examined changes in echocardiographic measures during the transition from CKD to ESRD and their associations with post-ESRD mortality.Study DesignProspective study.Setting &ParticipantsWe studied 417 participants with CKD in the Chronic Renal Insufficiency Cohort (CRIC) who had research echocardiograms during CKD and ESRD.PredictorWe measured change in left ventricular mass index, left ventricular ejection fraction (LVEF), diastolic relaxation (normal, mildly abnormal, and moderately/severely abnormal), left ventricular end-systolic (LVESV), end-diastolic (LVEDV) volume, and left atrial volume from CKD to ESRD.Outco...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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