Renal & Urology News October 2012 Issue

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CONVENTIO N ISSUE

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VOLUME 11, ISSUE NUMBER 10

MHD Patient Death Rate Lower in China

www.renalandurologynews.com

Hemodialysis Mortality Rates in China vs. the U.S. Regardless of race, mortality rates among maintenance hemodialysis patients are higher in the United States than in China, according to a Chinese study. Shown here are the raw mortality rates per 1,000 patients at risk each year. Whites African-Americans 236.3%

Racial and practice pattern differences suspected

Asian-Americans

156.7%

BY JODY A. CHARNOW MORTALITY RATES among maintenance hemodialysis (MHD) patients in China are lower than those among MHD patients in the United States, and the reason may be differences in race or practice pattern, according to a new study. The study, by Li Zuo, MD, of Peking University First Hospital in Beijing, China, and colleagues, included 11,675 MHD patients from 104 dialysis centers in Beijing and 1,937,819 MHD patients in the U.S. Renal Data System (USRDS). The raw mortality for the

IN THIS ISSUE 5

Smoking hikes bladder cancer recurrence risk

13

Sex satisfaction often declines after prostate surgery

18

Preoperative hyponatremia increases death risk

20

Periodontitis linked to arterial stiffness in CKD patients

22

Q&A: Frequent dialysis and physical health concerns

Ultra-low CT dose for renal stone imaging PAGE 14

Beijing cohort (per 1,000 patient-years) increased from 47.8 in 2007 to 76.8 in 2010, the study showed. In the USRDS cohort, the raw mortality rate (per 1,000 patient-years) for white patients decreased from 250.7 in 2007 to 236.3 in 2009. For African Americans, the rate decreased from 167.8 in 2007 to 156.7 in 2009. For Asian Americans, the rate was 157.6 and 147.9 for those years, respectively. In adjusted analyses, the Beijing cohort had a survival benefit compared with each of the U.S. race groups. The annual mortality rates for the Beijing patients

PCa Diagnosis Alone Raises Risk of ED BY JODY A. CHARNOW CHICAGO—A prostate cancer (PCa) diagnosis, by itself, has a negative psychological impact on men that may result in erectile dysfunction, according to a study. Most clinicians evaluate a man’s erectile function following a prostate biopsy, but study findings suggest that erectile function should be evaluated prior to biopsy because a positive diagnosis may influence the results of the evaluation, said investigator Brian T. Helfand, MD, PhD, of NorthShore University Healthsystem in Evanston, Ill. He presented study findings at the World Meeting on Sexual continued on page 12

147.9%

76.8%

China (2010 data)

United States (2009 USRDS data)

Source: Cheng X, Nayyar S, Wang M, et al. Mortality rates among prevalence hemodialysis patients in Beijing: a comparison with USRDS data. Nephrol Dial Transplant 2012; published online ahead of print.

were 99.4, 80.6, and 94.3 when adjusted to whites, African Americans, and Asian Americans, respectively, in 2009. In an online report in Nephrology Dialysis Transplantation, Dr. Zuo’s group noted that the Beijing cohort was relatively younger than the USRDS

© PHOTO RESEARCHERS, INC. / AJPHOTO / HÔSPITAL AMÉRICAIN

OCTOBER 2012

cohort and had a lower prevalence of diabetic end-stage renal disease (ESRD). Regardless of age group, U.S. patients suffered from relatively higher mortality compared with their Beijing counterparts. The survival advantage continued on page 12

Kidney Stones Increase CKD Risk KIDNEY STONES increase the risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD), according to findings published online in the British Medical Journal. Marcello Tonelli, MD, of the University of Alberta in Edmonton, and colleagues studied more than 1.9 million adults without ESRD at baseline or a history of pyelonephritis and who had outpatient serum creatinine measurements. A total of 23,706 individuals had at least one kidney stone. Over a median follow-up of 11 years, ESRD developed in 5,333 (0.2%) individuals, late stage chronic kidney disease (CKD) developed in 68,525 (4%),

CME FEATURE

sustained doubling of serum creatinine occurred in 6,581 (0.3%). In adjusted analyses, one or more stone episodes during follow-up was associated with a significant twofold increased risk of ESRD, a 1.7 times increased risk of late stage CKD, and a 1.9 times increased risk of a doubling of serum creatinine compared with individuals who did not have kidney stones. However, the investigators pointed out that the increases were small in absolute terms. The magnitude of the association between kidney stones and adverse renal outcomes was larger for women continued on page 12

Earn 1 CME credit in this issue

The Evaluation and Treatment of Resistant Hypertension PAGE 42


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Renal & Urology News October 2012 Issue by Haymarket Media - Issuu