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Two recent studies have investigated the prevalence of anti-hLAMP-2 antibodies in patients with antineutrophil cytoplasmic antibody-associated vasculitides. Results from these studies suggest that more work is needed to standardize the assays used to detect anti-hLAMP-2 antibodies in patient sera before we can estimate their true prevalence in different patient populations and assess their potential clinical utility.
A recent report suggests that the incidence of acute kidney injury (AKI) in patients with acute myocardial infarction declined between 2000 and 2008 and was associated with decreased mortality despite concurrent increases in comorbidities. Although encouraging, changing patterns of care and an understanding of factors contributing to AKI in this setting must be considered.
A consistent association between hyponatremia and increased mortality has been shown in hospitalized patients. A new study investigating dysnatremia in non-dialysis-dependent patients with chronic kidney disease found that both hyponatremia and hypernatremia are associated with increased mortality, independently of other diseases known to cause hyponatremia.
Aliskiren combined with other inhibitors of the renin–angiotensin system increases the risk of hyperkalemia. This risk does not translate into an increased incidence of acute kidney injury, suggest the results of a meta-analysis. However, further research is needed to fully evaluate the safety of combination therapy with aliskiren.
Measurement of glomerular and peritubular capillaritis in kidney transplant biopsy samples identifies allograft dysfunction associated with alloantibodies. Sis et al. show that this technique has a higher sensitivity but lower specificity than the current diagnostic criteria using peritubular capillary C4d deposition, and that capillaritis is an independent predictor of progression to graft failure.
The association between obesity and mortality has been observed to be paradoxical in persons on dialysis. Hoogeveen et al. examined whether the association between obesity and mortality on dialysis differed by age in participants in the NECOSAD2 study.
Comparisons of sodium chloride and sodium bicarbonate for the prevention of contrast-induced acute kidney injury have produced inconclusive results. A new study by Klima et al. shows that sodium chloride provides greater renal protection than does sodium bicarbonate following exposure to contrast medium. However, this finding should be interpreted with caution.
Acute kidney injury (AKI) is a common complication associated with increased patient mortality and progression to advanced chronic kidney disease. Mehrotra et al. recently investigated the incidence and long-term sequelae of AKI in a large cohort of kidney transplant recipients.
In an era of increased concern about the safety of using erythropoiesis-stimulating agents (ESAs) in patients with chronic kidney disease, findings from the CAPRIT trial have suggested that ESA administration to correct anemia may slow the progression of kidney allograft dysfunction.
Recent analyses from the FIELD randomized trial of fenofibrate in type 2 diabetes mellitus suggests that fibrates have beneficial effects and are safe in patients with moderate renal impairment. However, too few participants with chronic kidney disease were included in the study to provide reliable information.
The combined effect of intensive glycemic and blood-pressure control on microvascular complications has been examined in an analysis of the ACCORD study. The investigators hypothesized that simultaneous intensive management would have an additive effect on outcomes; however, the results provide no evidence to support the combined intensive control of glycemia and blood pressure.
A recently published study on therapy for antineutrophil cytoplasmic autoantibody-associated small vessel vasculitis has provided answers but not clarity towards defining how best to treat patients with vasculitis. How do we use recent advances in knowledge to optimally influence our patients' outcomes without causing harm in the process?
Poor glycemic control is considered harmful in people with diabetes and chronic kidney disease; however, the ideal hemoglobin A1c target continues to be elusive. What can we learn from new observational evidence published by Shurraw et al. in the Archives of Internal Medicine?
World Kidney Day on March 8, 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage renal disease that surpasses dialysis treatments in terms of cost-effectiveness and improving quality and length of life.
Maintenance immunosuppressive drug therapy is necessary to counter the propensity of lupus nephritis to relapse. Claims that mycophenolate mofetil might be the magic bullet for both induction and maintenance therapies merit critical reappraisal due to inconsistent evidence of the superiority of mycophenolate mofetil over azathioprine, as well as its inordinately greater cost.
A report has suggested a J-shaped association between estimated sodium excretion and cardiovascular risk. However, because spot urinary sodium does not reflect daily salt intake, the results from this study do not change the strong evidence showing that a modest reduction in salt intake has major beneficial effects on health.
