Kidney international
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Renal artery stenosis is common especially in patients with generalized atherosclerosis. It is frequently associated with difficult-to-treat hypertension and with renal failure. ⋯ Advances in imaging and interventional devices offer new opportunities, however, clinicians still have to decide individually in every patient to treat or not to treat stenosis with revascularization. This review evaluates the current literature in order to help the physician to find the right decision in this challenging clinical issue.
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Kidney international · Nov 2006
CommentBisphosphonates prevent experimental vascular calcification: Treat the bone to cure the vessels?
Bisphosphonates are inhibitors of bone resorption that are widely used to treat osteoporosis. Price and colleagues demonstrate that ibandronate suppressed the development of uremia-related vascular calcification in rats. These findings extend the link between bone remodeling and vascular calcification to the context of chronic renal failure, opening perspectives toward novel therapeutic strategies.
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Kidney international · Oct 2006
Randomized Controlled Trial Comparative StudyAdding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure.
Acute renal failure (ARF) in critically ill patients is associated with high mortality. Optimal method and dose of continuous renal replacement therapy could improve survival in these patients. We studied the hypothesis that an increase in dialysis dose obtained by continuous veno-venous hemodiafiltration (CVVHDF) is associated with a better survival than continuous veno-venous hemofiltration (CVVH) among critically ill patients with ARF. ⋯ Apache II score, age, baseline blood urea nitrogen, and hemodiafiltration (hazard ratio 0.59, 95% confidence interval 0.40-0.87; P=0.008) were independent predictors of survival at 90 days. Renal recovery rate among survivors (71 versus 78% in the CVVH and CVVHDF groups respectively, P=0.62) was not affected by the type of renal replacement therapy. These results suggest that increasing the dialysis dose especially for low molecular weight solutes confers a better survival in severely ill patients with ARF.
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Kidney international · Sep 2006
Comparative StudyAssociation between residence location and likelihood of kidney transplantation in Aboriginal patients treated with dialysis in Canada.
For reasons that are not well understood, Aboriginal people with end-stage renal disease (ESRD) have lower rates of kidney transplantation. We hypothesized that distance between residence location and the closest transplant center was greater in Aboriginal dialysis patients and would partially explain the lower rate of transplantation in this population. We studied a random sample of 9905 patients initiating dialysis in Canada between 1990 and 2000. ⋯ For example, the relative likelihood of transplantation was hazard ratio (HR) 0.47, 95% confidence interval (CI) (0.31-0.72) in Aboriginal participants residing