O C T O B E R 2 014
■ ■ ■
VO L UME 13, IS SUE NUMBE R 10
■ ■ ■
www.renalandurologynews.com
Gout Risk Linked to Body Mass Index Each 5-unit increment in BMI is associated with a 55% increased relative risk, meta-analysis shows
The Effect of BMI on Gout Risk A new meta-analysis shows that the relative risk of gout increases with increasing body mass index (BMI). Shown here are the numbers of times by which the relative risk of gout increases with each 5-unit increment in BMI compared with a BMI of 20 kg/m2. Source: Aune D et al. Body mass index and the risk of gout: a systematic review and dose– response meta-analysis of prospective studies. Eur J Nutr (published online ahead of print).
Risk Increased by 1.8 × BMI
25
2.7 × 30
3.6 × 35
4.6 × 40
Body mass index (kg/m2)
Calciphylaxis Incidence Rising CALCIPHYLAXIS, a rare and potentially fatal disorder seen predominantly among patients with end-stage renal disease, has been increasing significantly in incidence, according to researchers who developed a novel algorithm to characterize the disorder’s epidemiology. The study, published online in the Journal of General Internal Medicine
Living kidney donor transplantation has been declining since 2004.
(JGIM), also showed that chronic hemodialysis (HD) patients with calciphylaxis have mortality rates 2.5 to 3.0 times higher than their counterparts without calciphylaxis. “To the best of our knowledge, ours is the first study to systematically investigate the incidence and mortality of continued on page 7
THE LIVING KIDNEY DONOR DILEMMA
Many people who want to donate a kidney cannot because of various barriers. SEE STORY PAGE 12
BY JODY A. CHARNOW AS AN INDIVIDUAL’S body mass index increases, so does his or her risk of gout, according to a new study. In a systematic review and metaanalysis of 10 prospective studies involving a total of 27,944 cases among 215,739 participants, researchers found that each 5-unit increment in BMI was associated with a 55% increased relative risk of gout, with a non-significant difference in relative risk between men and women (62% vs. 49%, respectively). In addition, compared with individuals who had a BMI of 20 kg/m2, those with a BMI of 25, 30, 35, and 40 kg/m2 had a 1.8, 2.7, 3.6, and 4.6 times increased relative risk of gout, Dagfinn Aune, a PhD student in nutrition at the Norwegian
CKD Predicts AKI Following Nephrectomy PREOPERATIVE chronic kidney disease (CKD) stage 2 and 3, a history of neurovascular disease, and obesity are among the factors that independently predict development of acute kidney injury (AKI) within 30 days of undergoing radical (RN) or partial (PN) nephrectomy, according to researchers. Marianne Schmid, MD, of Brigham and Women’s Hospital, Harvard Medical School in Boston, and University Medical Center HamburgEppendorf, Hamburg, Germany, and colleagues studied 3,320 patients who underwent surgery for renal cell carcinoma (RCC), including 1,944 patients (58.6%) and 1,376 (41.4%) patients who underwent RN or PN, respectively. Patients with an estimated glomerular filtration rate less than 30 mL/ min/1.73 m2 were excluded from the analyses. AKI—defi ned as a greater than 2 mg/dL rise in serum creatinine above baseline or the need for dialysis within
University of Science and Technology in Trondheim, Norway, and colleagues reported online ahead of print in the European Journal of Nutrition. Of the 10 studies, 2 reported on BMI in younger adulthood (aged 21–25 years), waist-to-hip ratio (WHR), and weight gain in relation to gout. The study totaled 836 cases among 53,413 participants. In early adulthood (age 21–25 years), each 5-unit increment in BMI was associated with a 57% increased relative risk of gout. Each 0.1-unit increment in WHR was associated with an 82% increased relative risk of gout. Each 5-kg of weight gain from age 21–25 to baseline was associated with a 28% increased risk of gout. continued on page 7
IN THIS ISSUE 5
RARP outcomes similar in obese and non-obese patients
10
Most cases of erectile dysfunction go untreated
12
Feature: Why living donor kidney transplantation is in decline
18
LUTS found to progress in a high proportion of men
18
FDA approves a lab test for predicting acute kidney injury
19
Sitting may ease urination problems in male LUTS sufferers
25
Microscopic hematuria shown to increase bladder cancer risk Experts offer advice on how to negotiate payer contracts. PAGE 24
continued on page 7
Cover_Neph_RUN1014.indd 1
9/25/14 4:45 PM