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Selective cyclo-oxygenase 2 inhibitors (coxibs) were designed to provide effective analgesia without the gastrointestinal toxicity of classical, nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Concern has arisen, however, about the cardiovascular and renal safety of coxibs. In this Viewpoint, Matthias Hermann and Thomas F Lüscher examine the differences among these agents in their effects on sodium excretion, glomerular filtration rate and blood pressure, and provide their overall recommendation for use of these agents.
Although renal dysfunction can have a profound effect on the pathogenesis of cardiovascular disease, current guidelines for the management of hyperlipidemia in patients with chronic kidney disease (CKD) were formulated in the absence of data on cardiovascular and cerebrovascular outcomes in this population. Considering the individual stages of CKD, authors from the University of Würzburg, Germany, analyze data from the 4D trial and other studies, and attempt to answer the question of when hyperlipidemia should (or should not) be treated in patients with CKD.
Introduced in the late 1990s for non-Hodgkin's lymphoma, the anti-CD20 monoclonal antibody rituximab has had anecdotal success in several renal settings. Here, Salama and Pusey compile and evaluate the data supporting use of rituximab to manage post-transplantation lymphoproliferative disorder, graft rejection, and ABO- and HLA-incompatibility. The drug's potential utility in autoimmune conditions that affect the kidney, including focal segmental glomerulosclerosis and systemic lupus erythematosus, is also assessed.