News & Views |
Featured
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News & Views |
Revising definitions of sepsis
The traditional definition of sepsis requires the presence of at least two systemic inflammatory response syndrome (SIRS) criteria in addition to a suspected or proven infection. A recent large retrospective study, however, suggests that the requirement for two SIRS criteria excludes one in eight patients with severe sepsis.
- Anne M. Drewry
- & Richard S. Hotchkiss
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News & Views |
Excess mortality in well-controlled T1DM without renal disease
The authors of a new study report that independent of renal disease, any level of glycaemia is associated with increased mortality risk in patients with type 1 diabetes mellitus. However, this view may be overly simplistic—a multifactorial approach is required to reduce excess mortality in this population.
- Janaka Karalliedde
- & Giancarlo Viberti
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Year in Review |
New insights into cardiovascular risk factors and outcomes
Chronic kidney disease (CKD) is an established independent risk factor for increased cardiovascular events and cardiovascular mortality. During 2014, several research efforts focused on clarifying the complex pathophysiology, assessing the prognostic associations and improving the treatment of cardiovascular disease in patients with CKD.
- Pantelis A. Sarafidis
- & George L. Bakris
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Research Highlight |
Sickle cell trait increases the risk of chronic kidney disease
- Jessica K. Edwards
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In Brief |
AKI after CABG increases risk of ESRD
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News & Views |
HDL-cholesterol levels and mortality in patients with ESRD
In the general population, risk of cardiovascular disease is inversely associated with HDL-cholesterol levels. However, a new post hoc analysis of data from the German Diabetes Dialysis study reports no correlation between HDL cholesterol and mortality among patients on dialysis—a phenomenon that the authors attribute to HDL dysfunction.
- Nosratola D. Vaziri
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News & Views |
Fluid overload and post-dialysis hypertension
Although intradialytic hypertension is associated with all-cause mortality, the mechanisms that underlie this phenomenon are not well understood. Now, Nongnuch et al. report that post-dialysis hypertension is associated with extracellular fluid overload, and suggest that patients with this condition might benefit from increased dialysis session length or frequency.
- Francesca Mallamaci
- & Giovanni Tripepi
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Review Article |
Donor-derived infection—the challenge for transplant safety
Each year, over 70,000 organs are transplanted worldwide. The degree of risk of transmission of infection from transplanted organs to the recipient is largely unknown and is difficult to assess for specific organs. Here, Jay A. Fishman and Paolo A. Grossi describe the major risk factors for organ donor-derived transmission of infection and discuss opportunities to reduce the incidence of such events.
- Jay A. Fishman
- & Paolo A. Grossi
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News & Views |
Prenatal risk factors for kidney and urinary tract anomalies
Childhood-onset chronic kidney disease is the result of congenital anomalies of the kidneys and urinary tract in approximately two-thirds of all patients. An area of intense research in recent years, however, is the potential impact of maternal obesity on renal ontogenesis or postnatal renal function in the offspring.
- Robert H. Mak
- & Franz Schaefer
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News & Views |
Molecular diagnosis of kidney transplant rejection
Acute or chronic antibody-mediated rejection (ABMR) of kidney allografts is currently diagnosed by the presence of donor-specific alloantibodies and distinct pathological findings in biopsy samples. A new study highlights the potential of molecular diagnostics incorporated into standard criteria for acute ABMR to help identify patients at risk of graft loss.
- Christian Morath
- & Martin Zeier
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Review Article |
Pathology of IgA nephropathy
In this Review, Ian Roberts provides a detailed description of the immunohistology and light microscopical features of IgA nephropathy, and highlights the importance of accurate recognition of the various histological lesions for reproducible classification of the disease. The different schemas used for classifying IgA nephropathy are compared, with particular focus on the Oxford classification.
- Ian S. D. Roberts
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In Brief |
Age modifies risk of coronary events
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Review Article |
Roles of phosphate and fibroblast growth factor 23 in cardiovascular disease
High serum levels of phosphate and fibroblast growth factor (FGF)-23 are associated with an increased risk of adverse cardiovascular events. In this Review, the authors discuss experimental and epidemiological data that supports high levels of phosphate or FGF-23 as risk factors for cardiovascular events in patients with or without chronic kidney disease.
- Julia J. Scialla
- & Myles Wolf
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News & Views |
Early hospital readmissions after kidney transplantation
A new study reports that 30.5% of kidney transplant recipients have an early hospital readmission (EHR; defined as within 30 days of discharge). As EHR is a strong independent risk factor for allograft loss and mortality, efforts should be made to implement and improve systems to minimize risk of EHR in these patients.
- Martha Pavlakis
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Review Article |
Noncardiovascular mortality in CKD: an epidemiological perspective
Patients with chronic kidney disease (CKD) are known to have increased all-cause and cardiovascular mortality. Of late, it has been recognized that these patients also have increased noncardiovascular mortality. Here, the authors discuss both cardiovascular and nonocardiovascular mortality in CKD, provide examples of traditional cardiovascular risk factors that also seem to be associated with noncardiovascular mortality, and summarize the potential pathophysiological mechanisms involved.
- Dinanda J. de Jager
- , Marc G. Vervloet
- & Friedo W. Dekker
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News & Views |
Increased ESRD and mortality risk for kidney donors?
For most patients with end-stage renal disease (ESRD), a kidney transplant is the best treatment option. Compared with dialysis, a successful kidney transplant is associated with increased life expectancy and improved quality of life; a living donor transplant is associated with better long-term results than a deceased donor transplant.
- Arthur J. Matas
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Review Article |
Orthostatic hypertension—a new haemodynamic cardiovascular risk factor
Orthostatic hypertension—a condition characterized by a hyper-reactive pressor response to orthostatic stress—is an emerging new risk factor for the development of hypertension, hypertensive target-organ damage and subsequent cardiovascular events. In this Review, Kazuomi Kario describes the diagnosis, epidemiology and pathophysiology of orthostatic hypertension and discusses its clinical implications.
- Kazuomi Kario
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Research Highlight |
Increased recipient BMI is associated with adverse outcomes after kidney transplantation
- Ellen F. Carney
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News & Views |
Predicting prognosis in patients with rhabdomyolysis
A recent study developed a formula predicting hard outcomes of rhabdomyolysis (dialysis and death). Based on a rigid analytical approach, an eight factor score was elaborated with acceptable prognostic value, but clinical usefulness at this time seems limited. Perhaps the most promising application is for triage.
- Raymond Vanholder
- & Mehmet Sever
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News & Views |
Fluid in chronic kidney disease—how much is too much?
A new study provides cogent evidence that fluid overload—measured using bioimpedance spectroscopy—promotes progression of chronic kidney disease (CKD). A prospective randomized trial is warranted to assess the effect of interventions to reduce fluid overload on disease progression in patients with CKD.
- Lee A. Hebert
- & Samir Parikh
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Correspondence |
Dual RAS blockade—unresolved controversy?
- Harikrishna Makani
- , Franz H. Messerli
- & Johannes F. E. Mann
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News & Views |
Proteinuria as a predictor of rapid eGFR decline
A new study by Turin et al. reports that proteinuria of increasing severity is associated with a faster rate of decline in estimated glomerular filtration rate (eGFR), regardless of eGFR at baseline. These findings support the use of proteinuria testing to identify individuals at risk of chronic kidney disease progression.
- Kunitoshi Iseki
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News & Views |
Does serum phosphate predict death and ESRD in CKD patients?
Mehrotra and colleagues report that serum phosphate does not predict subsequent death or development of end-stage renal disease in a community-based cohort of people with chronic kidney disease (CKD). This finding conflicts with previous research and questions the relevance of serum phosphate level to outcomes in the context of CKD.
- Richard Haynes
- & David C. Wheeler
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Research Highlight |
Is LDL-C level a good indicator of coronary risk in people with nondialysis-dependent CKD?
- Rebecca Kelsey
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Review Article |
Biomarkers for incident CKD: a new framework for interpreting the literature
A growing number of studies in nephrology are focusing on biomarkers for chronic kidney disease (CKD). Here, Michael Shlipak and Erica Day describe biomarkers that are used to predict risk of developing CKD and outline the statistical methods that can be used to assess the performance of candidate biomarkers. The authors also provide a conceptual framework for interpreting the results of studies evaluating biomarkers of declining kidney function and incident CKD.
- Michael G. Shlipak
- & Erica C. Day