KIDNEY / NEPHROLOGY NEWS

Robotic Partial Nephrectomy Mostly Superior to Other Surgeries

Robotic PN was associated with significantly lower rates of complications, cancer recurrence, and mortality compared with open and laparoscopic PN.

AV Access at Hemodialysis Initiation Less Likely Among Women

Study reveals 15% lower odds of arteriovenous access use at hemodialysis initiation among women vs men.

DIRECT ORAL ANTICOAGULANTS LINKED WITH HIGHER BLEEDING RISK IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Compared with warfarin use, direct oral anticoagulant use was linked with a 23% higher risk of bleeding in patients with chronic kidney disease. There was no difference between direct oral anticoagulant and warfarin users in benefits from prevention of ischemic stroke.

Kidney podocytes, all grown up

Unlike other human stem cells, Induced pluripotent stem cells (iPS cells) can be produced directly from adult cells. Now, researchers have shown that human kidney podocytes produced from iPS cells via a highly efficient, previously described protocol exhibit transcriptomic and protein expression profiles that match those of mature podocytes -- a feat that no other method has so far been able to achieve. This confirmation gives kidney researchers a tool for investigating human kidney development, function, and disease.

Gene therapy shown to cure type 2 diabetes and obesity in mice, researchers report

A single administration of a therapeutic vector in mouse models cures type 2 diabetes and obesity in the absence of long-term side effects, researchers report. In healthy mice, the therapy prevents age-associated weight gain and insulin resistance and promotes healthy aging.

the healing edge: Dying Organs Restored to Life in Novel Experiments

An unusual transplant may revive tissues thought to be hopelessly damaged, including the heart and brain.

Sodium Bicarbonate for Severe Acidemia Beneficial in AKI

Sodium bicarbonate infusions decreased the risk of death or organ failure among ICU patients with acute kidney injury and severe metabolic acidemia.

High Body Mass Index May Predict Survival Outcomes in RCC

The association between obesity, age, and renal cell carcinoma prognosis requires additional investigation.

Biomarker for salt sensitivity of blood pressure discovered

Researchers have identified a genetic marker (GNAI2) that is associated with the risk of salt sensitivity in blood pressure (BP) regardless of age or gender. It is hoped that with this discovery a simple test to identify salt sensitivity of BP during a clinical visit can be developed.

Obese HD Patients Need Less Erythropoietin to Treat Anemia

New study "adds to the evidence of obesity-associated advantages," researchers conclude.

TMVR Benefits Hold Firm in Post-Market Registry (CME/CE)

(MedPage Today) -- Do data point to a future 'transcatheter toolbox' for mitral disease?

Multivessel PCI Not Best in Cardiogenic Shock

(MedPage Today) -- Trial data show mortality disadvantage versus treating culprit lesions only

ASN 2017: The Future of Personalized Nephrology

(MedPage Today) -- Tissue engineering, drug discovery challenges among highlight topics

10 Questions to Challenge Your Medical News Savvy

(MedPage Today) -- Weekly News Quiz: October 20-26

Surgical Weight Loss; Low hs-cTNT Still Risky; VAD Before Pediatric Transplant

(MedPage Today) -- Cardiovascular Daily wraps up the top cardiology news of the week

EndoBreak: T1D and Vitamin D; VA's T2D Guideline; Oral Acromegaly Drug

(MedPage Today) -- News and commentary from the endocrinology world

For SAVR, Afternoon Tops Morning for Surgical Safety (CME/CE)

(MedPage Today) -- Circadian genes appear to interact with ischemia-reperfusion injury effects

Robotic-Assisted Surgery Adds Time, Costs Without Affecting Outcomes (CME/CE)

(MedPage Today) -- No improvements compared with laparoscopic procedures in kidney removal and rectal cancer

RAS Blockade After TAVI Tied to Better Outcomes (CME/CE)

(MedPage Today) -- Patients with severe aortic stenosis see reduced all-cause mortality

Borderline Pulmonary Hypertension Tied to Mortality Risk

(MedPage Today) -- Small increases in pressure might signal left heart failure, not early PAH

What happens when you get an adrenaline rush?

Certain situations will trigger an adrenaline rush, which is the release of adrenaline from the adrenal gland. This defense mechanism causes an increased heart rate, sweating, and pupil dilation. People can control an adrenaline rush with slow breathing and calming techniques. Learn more about an adrenaline rush here.

What to know about end-stage kidney disease

End-stage kidney disease is the last stage of chronic kidney disease when the kidneys stop functioning properly. Without sufficient kidney function, waste products begin to build up in a person's blood, causing a variety of symptoms. In this article, learn about the causes and treatment of end-stage kidney disease.

Causes and treatment of chronic prostatitis

Prostatitis is an inflammation of the prostate that can cause pain, sexual dysfunction, and urination issues. Chronic prostatitis might last for more than 3 months. Possible causes include bacterial infections and damage to the nerves or muscles in the pelvic area. Treatment often involves antibiotics. Learn more here.

What are the treatment options for BPH?

Benign prostatic hyperplasia, or BPH, is the medical term for an enlarged prostate. BPH can cause difficulties with urination. Treatment options for BPH include watchful waiting, medication, minimally invasive procedures, and surgery. Lifestyle changes can also help improve a person’s symptoms. Learn more here.

Seven ways to treat a UTI without antibiotics

Antibiotics are a common and effective treatment for urinary tract infections (UTIs), but they come with risks. Some UTIs can go away on their own, and several home remedies can speed up this process. In this article, we discuss the benefits and risks of antibiotics and provide seven home remedies to treat UTIs.

What is the normal range for a creatinine blood test?

A creatinine blood test measures how much creatinine is in the blood. It is used to check kidney function, and high levels may indicate the kidney is damaged. The procedure involves drawing a small amount of blood for testing, and there is no special preparation necessary. Learn more about the test here.

Lithotripsy for stones: What to expect

Lithotripsy is a procedure that uses shock waves or lasers to break down stones in the kidneys, bladder, or ureter. In this article, learn about how the procedure works, the success rate, how to prepare, and what to expect during recovery. We also cover the possible risks and side effects.

Is having vaginal pressure during pregnancy normal?

It is normal to feel a heaviness or pressure on the vagina or pelvis during pregnancy. The common causes of vaginal or pelvic pressure are different in the early and late trimesters but are not usually cause for concern. In this article, we look at common causes, when to see a doctor, and how to relieve symptoms.

How can you stop a chronic UTI?

A urinary tract infection is a painful condition that has a variety of symptoms, including frequent urination accompanied by a burning feeling. There is a range of treatment options available for recurring urinary tract infections, including home remedies. Learn ways to prevent them, such as drinking plenty of water.

What is penicillamine?

Penicillamine is a drug that is used to treat Wilson’s disease, rheumatoid arthritis, and kidney and bladder stones. It can have serious side effects, so it is important to follow the doctor’s instructions and to attend all follow-up appointments to monitor for any changes while taking this drug. Find out more.

HYPERTENSION NEWS

E-counseling can lower blood pressure, heart disease risk

New research shows that virtual counseling, when added to medical therapy, lowers high blood pressure and heart disease risk in people with hypertension.

Is it true that 'healthy obesity' boosts death risk?

New research questions whether metabolically healthy obesity — obesity without diabetes, hypertension, or high cholesterol — actually increases mortality.

Can high blood pressure lead to headaches?

High blood pressure, also called hypertension, has many potential symptoms. These may include back pain, difficulty sleeping, and shortness of breath. Some research also suggests that very high blood pressure can cause headaches. Treatment depends on the causes. Learn more about high blood pressure and headaches here.

High blood pressure may increase dementia risk

A new study looking at links between hypertension in later life and brain health finds an increased risk of Alzheimer's hallmarks and brain lesions.

Fifteen good foods for high blood pressure

The diet has a strong influence on blood pressure. Certain foods are scientifically shown to reduce high blood pressure, including berries, bananas, and oats. In some cases, dietary changes alone can lower blood pressure to normal levels. Learn more about good foods for high blood pressure, or hypertension, here.

Even minor sleep problems raise women's blood pressure

A new study concludes that even minor sleep disturbances, such as finding it difficult to nod off, can increase the risk of hypertension in women.

16:8 fasting diet actually works, study finds

A first-of-its-kind study analyzes the effect of the so-called 16:8 fasting diet in people with obesity. The study found unexpected health benefits.

Metabolic risk tied to both too much and too little sleep

Lack of sleep can impact our health, but can too much sleep also be harmful? New research links both extremes to an increased risk of metabolic problems.

Even slightly elevated blood pressure increases dementia risk

Hypertension in middle age is known to increase the risk of dementia, but so far the specifics are unclear. A new study sheds fresh light on this matter.

High-salt diet may kill off 'good' gut bacteria

Eating too much salt is known to increase blood pressure. Researchers recently discovered that this might be due to salt’s impact on gut bacteria.

GENERAL MEDICAL NEWS

Pharmacologic approach to weight loss that prevents food absorption.

UPI (Allen Cone): "We envision a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery," co-senior author Dr. Jeff Karp, a bioengineer and principal investigator at BWH, said. "Over the last several years, we've been working with our surgical colleagues on this idea and have developed a material that meets an important clinical need." Researchers are now testing LuCl in diabetic and obese rodents, measuring it's short- and long-term effects as an alternative to gastric bypass.

NKF 2018 Spring Clinical Meeting abstracts (.pdf)

NKF Spring Clinical Meeting 2018 abstracts

ERA-EDTA Copenhagen meeting newsletters

ERA-EDTA: Links can be found here to the initial 3 post-congress newsletters, as well as to the accepted abstracts.

CDC issues alert re warfarin coagulopathy and synthetic cannabinoids

CDC: What Do Health Care Providers Need To Do? ............ Healthcare providers should maintain a high index of suspicion for vitamin K-dependent antagonist coagulopathy in patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use:.................Presenting with clinical signs of coagulopathy, bleeding unrelated to an injury, or bleeding without another explanation; some patients may not divulge use of synthetic cannabinoids...................Presenting with complaints unrelated to bleeding (e.g., appendicitis).

Renal Disease and Electrolyte Course, Aspen, CO; July 23-27, 2018

University of Colorado: Registration: To register visit http://medschool.ucdenver.edu/cme or contact Pam Welker at (303)724-3551 or at pam.welker@ucdenver.edu

USRDS Annual Report 2017

USRDS: US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States

In ICU, Ringer's lactate also better than saline.

NEJM: Conclusions: Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal dysfunction than the use of saline.

Ringer's lactate causes less kidney injury than saline.

NEJM: Balanced crystalloids resulted in a lower incidence of major adverse kidney events within 30 days than saline (4.7% vs. 5.6%; adjusted odds ratio, 0.82; 95% CI, 0.70 to 0.95; P=0.01).

Lp(a) in the news in the New York Times

NY Times (Anahad O'Connor): “Only a small percentage of physicians know about this,” she said. “The biggest challenge for patients is finding knowledgeable physicians who know about this and can help them.”

Inhibitors of NMMT reduce obesity by increasing fat cell metabolism.

Biochem Pharmacol (Neelakantan et al): Research scientists at the University of Texas Medical Branch (UTMB) at Galveston say they developed a promising new drug that curbs obesity without dieting and, based upon preliminary study findings, they may be on their way to unleashing a breakthrough for the millions who struggle with their weight. "Treatment of diet-induced obese mice systemically with a potent NNMT inhibitor significantly reduced body weight and white adipose mass, decreased adipocyte size, and lowered plasma total cholesterol levels. Notably, administration of NNMT inhibitors did not impact total food intake nor produce any observable adverse effects."

Snake venom treatment investigated as antibiotic alternative for eye infections

(University of Liverpool) An innovative University of Liverpool research project that will investigate whether compounds used to treat snake venom and bee stings could provide an alternative to antibiotics in treating eye infection has been awarded £170,000 by the charity Fight for Sight.

TGen-led study shows DNA methylation related to liver disease among obese patients

(The Translational Genomics Research Institute) A TGen-led team has identified how DNA methylation is associated with a condition known as non-alcoholic fatty liver disease (NAFLD), which can lead to liver cirrhosis and death, and is one of the leading indicators for liver transplants. In one of the most exacting studies of its kind, TGen scientists found evidence that DNA methylation has a role in the initiation of NAFLD-related fibrosis, according to a study published in the journal Clinical Epigenetics.

Physicians who visit patients post-hospitalization give more comprehensive discharge plans

(Boston University School of Medicine) (Boston)-- When resident physicians visit the homes of their former hospital patients they are better able to assess patient needs and understand the important role that community services and agencies play in keeping them at home and out of the hospital, according to a new study by Boston University School of Medicine (BUSM).

Researchers identify characteristics of over the counter skin lightening users

(Boston University School of Medicine) (Boston) -- The desire for unblemished, clear skin permeates all cultures and societies, making the practice of skin lightening to minimize spots and even a skin tone quite common worldwide. Internationally, the use of creams to lighten skin is widespread and widely studied. In the U.S. however, information about use of these creams is sparse.

UCI-led study finds therapy dogs effective in reducing symptoms of ADHD

(University of California - Irvine) In a first of its kind randomized trial, researchers from the UCI School of Medicine found therapy dogs to be effective in reducing the symptoms of attention deficit/hyperactivity disorder (ADHD) in children. The study's main outcomes were recently published by the American Psychological Association in the Society of Counseling Psychology's Human-Animal Interaction Bulletin (HAIB). Additional new findings were presented at the International Society for Anthrozoology 2018 Conference held July 2-5 in Sydney, Australia.

Prolonged opioid use before knee or hip replacement surgery increases risk of poor outcomes

(Wolters Kluwer Health) Patients who take prescription opioids for more than 60 days before total knee or hip replacement surgery are at significantly higher risk of being readmitted to the hospital and of undergoing repeat joint-replacement surgery, compared to patients with no preoperative opioid use, reports a study in the July 18 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

In rats, perinatal exposure to phthalates impairs brain structure and function

(University of Illinois at Urbana-Champaign) Rats exposed in the womb and during lactation to plasticizing chemicals known as phthalates had fewer neurons and synapses than those that were not exposed, researchers report in a new study. The phthalate-exposed rats had reductions in the size of their medial prefrontal cortex, a brain region that regulates behavior, and showed deficits in cognitive flexibility. The variety of phthalates and quantities used in the study were environmentally relevant to human exposures, researchers said.

UM professor studies complexities of biodiversity, disease transmission

(The University of Montana) Biodiversity is disappearing at an alarming rate as infectious diseases increasingly spill over from wildlife to humans. Disease ecologists fervently debate whether biodiversity loss leads to an increased disease risk. Now, a University of Montana researcher has published a new study with some answers.

UA clinical trial to repurpose ketamine for Parkinson's patients

(University of Arizona Health Sciences) A decades-old drug known as ketamine is being repurposed to potentially help Parkinson's patients in a new clinical trial at the UA College of Medicine -- Tucson.

Identified RNA molecules that regulate action of male hormone in prostate cancer

(Fundação de Amparo à Pesquisa do Estado de São Paulo) A study detected in tumoral tissue hundreds of RNAs that do not encode proteins but appear to regulate effects of androgens and androgen receptors on gene expression in tumors. By investigating the connection between the presençe of these molecules and tumor aggressiveness, the research paves the way for new scientific approaches focusing on the transcription process of noncoding RNA.