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Hemodialysis care for undocumented immigrants with end-stage renal disease in the United States
Purpose of review Across the United States, significant variation exists in the provision of care of undocumented immigrants with end-stage renal disease (ESRD), with some states providing standard dialysis, and other states providing emergency-only hemodialysis (EoHD). Recent findings EoHD is associated with higher morbidity and mortality compared with standard hemodialysis. EoHD is also associated with higher healthcare utilization, resulting in more emergency department visits, more days spent in the hospital, and higher healthcare costs. Undocumented immigrants with ESRD who rely on EoHD also experience crippling ...
Source: Current Opinion in Nephrology and Hypertension - October 8, 2019 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker Source Type: research

Influenza in dialysis patients: an opportunity to decrease mortality?
Purpose of review Influenza is a major cause of morbidity in dialysis patients. Recent findings A recent meta-analysis finds reduced influenza infections, hospitalizations and deaths with use of high dose as compared with standard-dose vaccine in the elderly. There remain no randomized clinical trials of vaccine efficacy in dialysis patients. One observational study finds reduced all-cause hospitalization with high-dose as compared with standard-dose vaccine but another study finds no difference in influenza related events. A simulation study, in which the timing of vaccination and antibody waning rates are varied, fi...
Source: Current Opinion in Nephrology and Hypertension - October 8, 2019 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker Source Type: research

Prolyl-hydroxylase inhibitors for the treatment of anemia in chronic kidney disease
Purpose of review Prolyl-hydroxylase inhibitors are a novel class of orally administered drugs that are under development for the treatment of anemia in patients with chronic kidney disease. This review discusses the biology of these drugs and their target – hypoxia-inducible factor and potential advantages and disadvantages of these therapies. Finally, we will discuss current trials in patients with both chronic kidney disease and end-stage renal disease. Recent findings Recent smaller studies have found that prolyl-hydroxylase are as effective as erythropoietin in treating anemia of chronic kidney disease. We do n...
Source: Current Opinion in Nephrology and Hypertension - October 8, 2019 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker Source Type: research

When are you too old to get a kidney transplants?
Purpose of review With the increasing incidence and prevalence of ESRD in the elderly, we are now transplanting more elderly patients. Although we know from previous reports that transplantation provides increased survival advantage and/or quality of life when compared to being on dialysis, we also know that transplantation is not the best option for all patients. In this review, we try to identify the upper age limit (if any) for deceased donor renal transplantation, predictive factors that can identify the risks for transplant outcomes, frailty, and immunosenescence. Recent findings Review of data over the last 5 ye...
Source: Current Opinion in Nephrology and Hypertension - October 8, 2019 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker Source Type: research

New treatments for cytomegalovirus in transplant patients
Purpose of review The purpose of this review is to highlight novel advances in prophylaxis against and treatment of CMV in kidney transplant recipients. Current options include intravenous ganciclovir and oral valganciclovir, but use of these agents is limited by side effects, such as myelosuppression as well as evolving resistance in CMV strains. Recent findings Advances in the field include novel drugs that have shown promise in preliminary studies and are now being tested in large-scale clinical trials. Moreover, there is a developing focus in enhancing host immune responses to better protect against viral infectio...
Source: Current Opinion in Nephrology and Hypertension - October 8, 2019 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker Source Type: research