Research Highlight |
Featured
-
-
-
News & Views |
Meta-analyses can misdirect decisions on treatment
A recent meta-analysis concluded that the risk-to-benefit ratio of dual (versus single-drug) renin–angiotensin system blockade argues against the use of dual therapy. This conclusion, however, seems inconsistent with the actual data and may convey to physicians a misleading message that could misdirect important decisions on treatment.
- Piero Ruggenenti
- & Giuseppe Remuzzi
-
Review Article |
The effect of vitamin D status on risk factors for cardiovascular disease
Vitamin D deficiency has been linked to a variety of disorders, including hypertension, type 2 diabetes and chronic kidney disease. A potential role for vitamin D deficiency in cardiovascular morbidity and mortality has also emerged. In this Review, the authors describe the evidence for an association between risk factors for cardiovascular disease and vitamin D status, and discuss the limitations of available data on vitamin D therapy in patients at increased risk of cardiovascular events.
- Sujana S. Gunta
- , Ravi I. Thadhani
- & Robert H. Mak
-
News & Views |
Cystatin-C-based eGFR: what is it telling us?
Cystatin C was introduced as a potential alternative or supplement to the estimation of glomerular filtration rate (GFR) using creatinine. Although cystatin C is well supported as a better predictor of outcomes than creatinine, its reflection of actual renal function compared with creatinine is widely debated. A new study by Rule et al. asserts that cystatin-C-based estimated GFR is biased by non-GFR-associated risk factors for chronic kidney disease.
- Kristen L. Jablonski
- & Michel Chonchol
-
-
Research Highlight |
Patients with ESRD are at increased risk of complications and death after major elective vascular surgery
- Rebecca Kelsey
-
-
-
Research Highlight |
Serious safety concerns regarding use of hydroxyethyl starch for acute fluid resuscitation
- Rebecca Kelsey
-
Review Article |
Anaemia management and mortality risk in chronic kidney disease
Anaemia is common in patients with chronic kidney disease (CKD) and is associated with increased mortality and morbidity. This Review describes findings from randomized controlled trials and observational studies investigating how target haemoglobin level and erythropoiesis-stimulating agent (ESA) dose affect outcomes in patients with CKD and discusses whether high haemoglobin targets, high ESA dosage or ESA resistance are risk factors for adverse outcomes.
- Walter H. Hörl
-
-
-
-
-
Review Article |
Assessing risk in chronic kidney disease: a methodological review
Chronic kidney disease (CKD) is an important public health issue that is strongly associated with adverse outcomes. Evaluation of existing therapies, development of new interventions, and timely patient counselling requires accurate prediction models that estimate individual-level risk. Here, Grams and Coresh outline the fundamentals of risk prediction, including considerations pertinent to CKD, common methodological shortcomings in risk prediction studies, and metrics often used to assess the performance of risk prediction models.
- Morgan E. Grams
- & Josef Coresh
-
Review Article |
Resistant hypertension—its identification and epidemiology
Resistant hypertension is defined as failure to reach goal blood pressure in patients who are compliant with maximal doses of three antihypertensive drugs, one of which is a diuretic. Despite improvements in controlling blood pressure in the past decade, studies show the prevalence of resistant hypertension is increasing. In this Review, the authors define resistant hypertension and discuss current data on its prevalence, associated comorbidities and prognostic implications.
- Pantelis A. Sarafidis
- , Panagiotis Georgianos
- & George L. Bakris
-
-
-
News & Views |
Paediatric CRRT and ECMO: fluid overload is not the only issue
Current dogma suggests that fluid overload—when associated with acute kidney injury (AKI)—is an independent risk factor for death. Although the volume status of the patient is important, there are other predictors of morbidity, mortality and the need for renal replacement therapy in patients with AKI.
- Timothy E. Bunchman
-
Research Highlight |
Chronic kidney disease: a risk factor for stroke and bleeding in patients with atrial fibrillation
- Rebecca Kelsey
-
-
-
-
News & Views |
Hypokalaemia and cardiac risk in peritoneal dialysis patients
Dialysis, particularly haemodialysis, is associated with an increased risk of cardiovascular disease. A new study confirms that hypokalaemia confers an excess cardiovascular risk and contributes disproportionately to the high risk of death in patients on peritoneal dialysis, which may partially account for the fact that observed cardiac risk is similar for patients on peritoneal dialysis and haemodialysis.
- Bonnie Ching-Ha Kwan
- & Cheuk-Chun Szeto
-
-
Research Highlight |
Should CKD be considered as a coronary heart disease risk equivalent?
- Rebecca Kelsey
-
News & Views |
Should statin therapy be expanded in patients with CKD?
The use of statins as a line of primary prevention in individuals at low risk of cardiovascular events is an area of debate. The most recent meta-analysis from the Cholesterol Treatment Trialists' (CTT) Collaboration suggests that present guidelines for prescribing statin therapy may need to be reconsidered.
- Kristen L. Jablonski
- & Michel Chonchol
-
Review Article |
Influence of race, ethnicity and socioeconomic status on kidney disease
Socioeconomic status, race and ethnicity contribute to the variability in incidence and progression of kidney disease, access to treatment and health outcomes. In this Review, Patzer and McClellan discuss the multifactorial associations between poverty, race and kidney disease at the individual and community level that are fundamental to the occurrence and outcomes of disease.
- Rachel E. Patzer
- & William M. McClellan
-
-
Research Highlight |
Obesity is associated with AKI after surgery via oxidative stress
- Helene Myrvang
-
News & Views |
Modifiable risk factors for sudden death in dialysis patients
Sudden death is very common in patients on dialysis, and identifying factors that may lower the risk of sudden death could improve survival of these patients. A recent international comparison of sudden death rates by Jadoul and colleagues gives us insight into how our clinical practice might affect rates of sudden death in dialysis patients.
- Anthony J. Bleyer
- & Amret Hawfield
-
-
-
-
Research Highlight |
High systolic blood pressure is a major contributor to ESRD risk
- Susan J. Allison
-
Year in Review |
Can cardiovascular risk in dialysis patients be decreased?
More than 1.4 million patients are on renal replacement therapy worldwide. Mortality in patients with end-stage renal disease (ESRD) is as high as that seen in some types of metastatic cancer, and premature cardiovascular disease is the major killer in ESRD. Several publications in 2011 addressed how interventions can modify cardiovascular risk factors and improve outcomes.
- Peter Stenvinkel
- & Peter Bárány
-
-
News & Views |
Health burden of kidney disease recognized by UN
Non-communicable diseases (NCDs) are taking center stage in global health policy. Intensive lobbying by the International Society of Nephrology has gained recognition for chronic kidney disease (CKD) as a major NCD. Continuing advocacy is needed for the health risk of CKD to be understood and opportunities for prevention and treatment grasped.
- John Feehally
-
In Brief |
Use of skin autofluorescence to assess risk
-
News & Views |
Race, renal disease and albuminuria
A new report suggests that differences in albuminuria might contribute to disparities in susceptibility to nephropathy in African American and white individuals. Interpretation of this finding requires consideration of renal histology, clinical trials and genetic studies. These factors indicate that a far more complex scenario is likely to exist than previously thought.
- Barry I. Freedman
- & Donald W. Bowden
-
-
Research Highlight |
Glomerular hyperfiltration may be a risk factor for progression of ADPKD
- Helene Myrvang
-
Research Highlight |
Acetylcysteine does not prevent contrast-induced acute kidney injury
- Helene Myrvang
-
Review Article |
Cardiovascular complications in children with chronic kidney disease
Cardiovascular disease is the main cause of death in children with chronic kidney disease, as these patients have a high prevalence of traditional and uremia-related risk factors for cardiovascular disease. This Review discusses the vascular and cardiac adaptations that occur in these patients, the pathological factors that stimulate these alterations and the consequences for cardiorespiratory fitness and physical functioning.
- Rukshana Shroff
- , Donald J. Weaver Jr
- & Mark M. Mitsnefes
-
-
-
Review Article |
Noninvasive imaging for assessment of calcification in chronic kidney disease
Calcification is highly prevalent and a leading cause of death in patients with chronic kidney disease. Noninvasive imaging techniques can be used to identify patients with calcification who are at high risk of clinical events, and monitor progression and treatment-related changes in calcification burden. The authors of this Review discuss noninvasive imaging techniques that are commonly used to assess vascular and valvular calcification and evaluate their advantages and limitations.
- Cristina Karohl
- , Luis D'Marco Gascón
- & Paolo Raggi
-
-
Research Highlight |
Lowering homocysteine levels may have no 'FAVORITable' effect on cardiovascular outcomes
- Helene Myrvang