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Myeloperoxidase and the Risk of CKD Progression, Cardiovascular Disease, and Death in the Chronic Renal Insufficiency Cohort (CRIC) Study
ConclusionsHigher MPO level was associated with increased risk for CKD progression, but not with CVD and death in patients with CKD from CRIC. Whether therapies aimed at reducing MPO activity can result in improved clinical outcomes is yet to be determined.
Source: American Journal of Kidney Diseases - December 20, 2019 Category: Urology & Nephrology Source Type: research

Lipids, Apolipoproteins, and Risk of Atherosclerotic Cardiovascular Disease in Persons With CKD
ConclusionsHigher VLDL-C and Apo-B levels, as well as lower HDL-C and Apo-AI levels, are associated with increased risk for ASCVD. These findings support future investigations into pharmacologic targeting of lipoproteins beyond LDL-C, such as triglyceride-rich lipoproteins, to reduce residual risk for ASCVD among individuals with CKD.
Source: American Journal of Kidney Diseases - January 25, 2019 Category: Urology & Nephrology Source Type: research

Treatment of Anemia With Darbepoetin Prior to Dialysis Initiation and Clinical Outcomes: Analyses From the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)
ConclusionsDespite initiating dialysis therapy with a higher hemoglobin level, prior treatment with darbepoetin was not associated with a reduction in mortality, myocardial infarction, or heart failure in the first 180 days, but a higher frequency of stroke was observed. In the absence of more definitive data, this may inform decisions regarding the use of erythropoiesis-stimulating agents to treat mild to moderate anemia in patients with type 2 diabetes and chronic kidney disease nearing dialysis therapy initiation.
Source: American Journal of Kidney Diseases - December 19, 2018 Category: Urology & Nephrology Source Type: research

Prognostic Value of High-Sensitivity Versus Conventional Cardiac Troponin T Assays Among Patients With Type 2 Diabetes Mellitus Undergoing Maintenance Hemodialysis
ConclusionsIn patients with type 2 diabetes mellitus receiving hemodialysis, cardiac TnT is associated with long-term mortality and cardiovascular outcomes. Concentrations of TnT not measurable with acceptable precision using a conventional TnT assay were associated with a poor prognosis when measured using a high-sensitivity assay.
Source: American Journal of Kidney Diseases - July 11, 2018 Category: Urology & Nephrology Source Type: research

ESRD After Heart Failure, Myocardial Infarction, or Stroke in Type  2 Diabetic Patients With CKD
Conclusions Most ESRD cases occurred in individuals without intercurrent CV events who had lower eGFRs than individuals with intercurrent CV events, but similar post-ESRD mortality. Nevertheless, intercurrent CV events, particularly heart failure, are strongly associated with risk for ESRD. These findings underscore the need for kidney-specific therapies in addition to treatment of CV risk factors to lower ESRD incidence in diabetes.
Source: American Journal of Kidney Diseases - June 7, 2017 Category: Urology & Nephrology Source Type: research

Frequency of Early Predialysis Nephrology Care and  Postdialysis Cardiovascular Events
Conclusions Early frequent nephrology care for 6 or more months before the initiation of long-term dialysis therapy may improve 1-year postdialysis major cardiovascular outcomes.
Source: American Journal of Kidney Diseases - March 3, 2017 Category: Urology & Nephrology Source Type: research

Warfarin Initiation, Atrial Fibrillation, and Kidney Function:  Comparative Effectiveness and Safety of Warfarin in Older Adults With Newly Diagnosed Atrial Fibrillation
Conclusions Among older adults with AF, warfarin therapy initiation was associated with a significantly lower 1-year risk for the composite outcome across all strata of kidney function. The risk for major bleeding associated with warfarin use was increased only among those with eGFRs of 60 to 89mL/min/1.73m2.
Source: American Journal of Kidney Diseases - December 18, 2016 Category: Urology & Nephrology Source Type: research

Phosphate-Binding Agents in Adults With CKD: A Network Meta-analysis of Randomized Trials
Conclusions There is currently no evidence that phosphate-binder treatment reduces mortality compared to placebo in adults with CKD. It is not clear whether the higher mortality with calcium versus sevelamer reflects whether there is net harm associated with calcium, net benefit with sevelamer, both, or neither. Iron-based binders show evidence of greater phosphate lowering that warrants further examination in randomized trials.
Source: American Journal of Kidney Diseases - July 22, 2016 Category: Urology & Nephrology Source Type: research

Race/Ethnicity and Cardiovascular Outcomes in Adults With CKD: Findings From the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic CRIC Studies
Conclusions There were no significant racial/ethnic differences in adjusted risk for atherosclerotic or heart failure outcomes. Future research is needed to better explain the reduced risk for atherosclerotic events or death in non-Hispanic blacks compared with non-Hispanic whites.
Source: American Journal of Kidney Diseases - May 19, 2016 Category: Urology & Nephrology Source Type: research

The Brain in Kidney Disease (BRINK) Cohort Study: Design and Baseline Cognitive Function
Conclusions Cognitive function was significantly worse in participants with eGFRs<30mL/min/1.73m2. Future BRINK analyses will measure risk factors for cognitive decline using the longitudinal data.
Source: American Journal of Kidney Diseases - January 11, 2016 Category: Urology & Nephrology Source Type: research

Timing of Dialysis Initiation, Duration and Frequency of Hemodialysis Sessions, and Membrane Flux: A Systematic Review for a KDOQI Clinical Practice Guideline
Conclusions Limited data indicate that earlier dialysis therapy initiation and more frequent and longer hemodialysis did not improve clinical outcomes compared to conventional hemodialysis.
Source: American Journal of Kidney Diseases - October 21, 2015 Category: Urology & Nephrology Source Type: research

Dose-Finding Study of Rivaroxaban in Hemodialysis Patients
Conclusions A 10-mg dose of rivaroxaban in hemodialysis patients without residual kidney function results in drug exposure similar as published for 20mg in healthy volunteers. Rivaroxaban is not eliminated by dialysis. There is no accumulation after multiple daily dosing. The efficacy and safety of rivaroxaban in hemodialysis patients should be the subject of a large randomized trial.
Source: American Journal of Kidney Diseases - June 22, 2015 Category: Urology & Nephrology Source Type: research

Longer-term Outcomes of Darbepoetin Alfa Versus Epoetin Alfa in Patients With ESRD Initiating Hemodialysis: A Quasi-experimental Cohort Study
Conclusions In incident hemodialysis patients, mortality and cardiovascular event rates did not differ between patients treated at facilities predominantly using DPO versus EPO.
Source: American Journal of Kidney Diseases - May 2, 2015 Category: Urology & Nephrology Source Type: research

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