American journal of kidney diseases : the official journal of the National Kidney Foundation
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Nephrogenic systemic fibrosis is a disabling progressive condition that is being reported with increased frequency in patients with kidney disease. Treatment is extremely limited and largely supportive. We report a case of severe nephrogenic systemic fibrosis in a dialysis patient exposed to multiple doses of gadolinium who improved clinically and histologically with treatment with imatinib.
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The controversy surrounding hemoglobin and erythropoiesis-stimulating agents: what should we do now?
Treatment of the anemia of chronic kidney disease (CKD) with erythropoiesis-stimulating agents (ESAs) has been intensely debated during the past 2 years. Treatment with ESAs has transformed the lives of millions of patients with CKD, with fewer blood transfusions and improved quality of life. ⋯ The Centers for Medicare & Medicaid Services has decreased ESA dosing recommendations in the Medicare claims policy for ESAs. Managing the anemia of CKD in the era of the hemoglobin level and ESA controversy has required aiming for appropriate hemoglobin levels, using the lowest effective ESA dose, and better managing the problem of ESA hyporesponsiveness.
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Case Reports
Laparoscopic gastric banding surgery performed in obese dialysis patients prior to kidney transplantation.
Obese patients with end-stage renal disease who receive a kidney transplant experience greater rates of posttransplantation diabetes, delayed graft function, and local wound complications. Many centers exclude obese patients from transplantation programs. ⋯ We report 3 patients who underwent laparoscopically adjustable gastric banding, which enabled sufficient weight loss to gain eligibility for kidney transplantation. All these patients subsequently underwent successful uncomplicated kidney transplantations.