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oc tober 2013 n n n Vo l ume 12, is sue Numbe r 10 Kidney Donors Show Signs of Mild CKD Measured GFR declined by 28% at six months BY JODY A. CHARNOW Kidney donors have some of the abnormalities typically associated with mild chronic kidney disease (CKD) six months after donation, researchers concluded. These abnormalities include a decline in kidney function, increased parathyroid hormone (PTH) and uric acid levels, and lower hemoglobin ­levels, they stated. The prospective study compared 203 kidney donors with 201 controls, who were healthy individuals with two kidneys and who theoreti- in this issue 9 Mortality after MI is declining in CKD patients 10 AKI outcomes linked to nephrology referrals 12 Painless MI increases CKD patient death risk 15 Ascorbic acid does not cut risk of contrast nephropathy 18 Novel iron drug safe, effective in hemodialysis patients A surgical complication results in a lawsuit PAGE 16 cally would have been suitable to donate a kidney. Donors and controls were comparable with respect to all parameters measured. A team led by Bertram L. Kasiske, MD, of the Hennepin County Medical Center in Minneapolis, measured glomerular filtration rate (GFR), blood pressure, and other variables at baseline (predonation) and at six months. Compared with controls, donors had a significant 28% decrease from baseline in measured GFR at six months (94.6 vs. 67.6 mL/min/1.73 m2), a significant 23% increase in PTH level RRT Risk Higher in HIV Patients HIV patients, who are known to be at increased risk of impaired renal function, are much more likely to be placed on renal replacement therapy (RRT) than the general population, a Danish study found. In a nationwide, population-based cohort study that included 5,300 HIV patients and 53,000 population controls, Magnus G. Rasch, MD, of the University of Copenhagen, and colleagues found that HIV patients had a fourfold increased risk of any RRT (aRRT) and a threefold increased risk of chronic RRT (cRRT) compared with age- and gender-matched controls, continued on page 10 n n n Kidney Donor Abnormalities At Six Months Six months after donating a kidney, donors had significant changes (compared with controls) that are typically associated with chronic kidney disease: Measured GFR 28% decrease PTH level 23% increase Uric acid level 8.2% increase Hemoglobin level 3.7% decrease 0 5 10 15 20 25 30 Source: Kasiske BL et al. A prospective controlled study of kidney donors: Baseline and 6-month follow-up. Am J Kidney Dis (2013;62:577-586). (42.8 vs. 52.7 pg/mL), a significant 8.2% increase in uric acid level (4.9 vs. 5.3 mg/dL), and a significant 3.7% decrease in hemoglobin level (13.6 vs. 13.1 g/dL). The study found no significant difference between donors and controls in blood pressure, urine total protein, urine albumin, body weight, or body mass index. “The increase in PTH levels is in keeping with the correlation continued on page 10 Drug Works For Resistant CMV BY JOHN SCHIESZER DENVER—Cidofovir with or without adjunctive therapy may be an appropriate treatment option for ganciclovirresistant cytomegalovirus (CMV) infections in solid organ transplant (SOT) recipients, according to study findings reported at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy. “There is no standard of care and there has been little evidence on which agent to use in solid organ transplantation,” said study investigator Katherine Perez, PharmD, an infectious diseases clinical specialist at Houston Methodist Hospital in Texas. cme feature The study is the first to show the possible usefulness of cidofovir in treating ganciclovir-resistant infections among transplant recipients, and the findings could give clinicians some guidance on what to use, Dr. Perez said. Dr. Perez and her colleagues conducted a single-center analysis of all SOT recipients from 2009 through 2012. Valganciclovir universal prophylaxis was standard for the center and 1,549 patients were included in the analysis. The researchers identified CMV infection in 284 of the 1,549 patients continued on page 10 Earn 1 CME credit in this issue Dietary Interventions for Treating Progressive CKD Page 20 RUN1013_Cover_Neph.indd 1 9/24/13 10:22 AM

Renal & Urology News October 2013 Issue

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