collection
https://read.qxmd.com/read/101001374/acute-kidney-injury-more-prevalent-amongst-extremely-premature-neonates
#1
SUMMARY
Donika Yakoub, Alex Chan
1. A secondary  analysis of a randomized clinical trial found that when correcting for fluid balance, AKI was more commonly diagnosed in extremely premature neonates.  2. A diagnosis of fluid-corrected AKI resulted in a significantly higher risk of requiring mechanical ventilation, longer hospital stay, and bronchopulmonary dysplasia (BPD). Evidence Rating Level: 1 (Excellent) Acute kidney injury (AKI) is a common condition in premature neonates, particularly those of extremely low gestational age. The potential complications of AKI do not exist solely in the short term; AKI in neonates also increases the risk of future chronic kidney disease...
August 14, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001348/risk-of-adverse-kidney-related-events-for-patients-on-lithium-is-low-but-increases-with-greater-exposure
#2
SUMMARY
Davy Lau, Alex Chan
1. For patients newly initiated on lithium or valproate, the absolute risks of chronic kidney disease (CKD) progression or acute kidney injury (AKI) were low and similar. 2. Higher cumulative exposure to lithium was associated with greater risk of CKD progression compared to valproate. 3. Higher median lithium levels were associated with increased risk of AKI in a dose-response relationship. EvidEnce Rating Level: 2 (Good) Study Rundown:  Lithium is used in the treatment of bipolar disorder, but has always been associated with concerns of nephrotoxicity, although the pathophysiology is not well understood...
August 1, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001337/there-is-a-low-risk-of-chronic-kidney-disease-progression-following-acute-kidney-injury
#3
SUMMARY
David Xiang, Kiera Liblik
1. In this prospective cohort study, there was a limited association between acute kidney injury (AKI) and worsening kidney function in patients with chronic kidney disease (CKD). 2. There was no significant decrease in estimated glomerular filtration rate (eGFR) after a mild to moderate AKI in patients with CKD.  Evidence Rating Level: 1 (Excellent) Study Rundown: AKI is typically considered a significant risk factor for the progression of loss of kidney function. However, in prior studies that examined this association, there were many methodological limitations...
July 25, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001242/comparison-between-hydroxychloroquine-and-systemic-corticosteroids-in-iga-nephropathy
#4
SUMMARY
Soroush Nedaie, Alex Chan
1. For patients with IgA nephropathy (IgAN), long-term use of hydroxychloroquine demonstrated antiproteinuric effects compared to corticosteroids at 24 months.  Evidence Rating Level : 3 (Average) IgAN is the most common form of primary glomerulonephritis, occurring in 1 in 100 people worldwide, and can lead to end-stage renal disease. No specific treatment currently exists for IgAN, but corticosteroids (CS) are widely used as supportive treatment to maintain renal function in patients, despite their significant side effects...
June 22, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001168/sparsentan-superior-to-irbesartan-for-reduction-of-proteinuria-in-patients-with-iga-nephropathy
#5
SUMMARY
Neel Mistry, Teddy Guo
1. Patients in sparsentan group reported a 50% reduction in proteinuria compared to 15% in the irbesartan group at week 36. 2. Complete remission of proteinuria was significantly higher in the sparsentan group. Evidence Rating Level: 1 (Excellent) Study Rundown: IgA nephropathy is the most common cause of primary glomerulonephritis worldwide. Although renin-angiotensin blockers (ARBs), such as irbesartan, have been primarily used for treatment, some patients continue to have persistent proteinuria. Sparsentan, a novel single-molecule, angiotensin II receptor antagonist, may have improved efficacy in patients with refractory proteinuria although existing trials suggest mixed results...
May 23, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001102/intradialytic-exercise-may-improve-patient-survival-rates-in-patients-receiving-hemodialysis
#6
SUMMARY
Soroush Nedaie, Alex Chan
1. Intradialytic exercise for a minimum of 60 minutes during thrice weekly dialysis sessions improved survival rates in adult patients who are receiving hemodialysis (HD). Evidence Rating Level :1 (Excellent) Chronic kidney disease is becoming increasingly prevalent worldwide, leading to an exponential increase in the number of individuals experiencing kidney failure requiring kidney-replacement therapy (KRT), which is primarily achieved through hemodialysis. Patients undergoing HD experience high rates of morbidity, and a mortality rate 10-30 times higher than those with normal kidney function...
April 26, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001085/parathyroidectomy-does-not-impact-renal-function-in-adults-with-primary-hyperparathyroidism
#7
SUMMARY
David Xiang, Kiera Liblik
1. In this target emulation trial, parathyroidectomy did not affect long-term renal function in adults with primary hyperparathyroidism (PHPT). 2. Patients with parathyroidectomy had no difference in the estimated glomerular filtration rate (eGFR) decline compared to those without parathyroidectomy. Evidence Rating Level: 1 (Excellent) Study Rundown: The definitive treatment for PHPT is parathyroidectomy to remove one or more abnormal parathyroid glands. However, observation for disease progression is an alternative that can be considered in patients without apparent end-organ damage related to PHPT...
April 19, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001032/risk-factors-for-blood-vessel-rupture-during-vascular-access-intervention-therapy-for-hemodialysis-patients
#8
SUMMARY
Davy Lau, Alex Chan
1. In vascular access intervention therapy (VAIVT) for hemodialysis patients, patient factors for vessel rupture include lower BMI, fewer prior VAIVT procedures, and shorter access vintage. 2. Hemodynamic risk factors for vessel rupture found on ultrasound imaging include lower blood flow quantity, higher resistance index, and lower brachial artery flow volume. Evidence Rating Level: 2 (Good) Vascular access for hemodialysis patients, including arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs), can have high failure rates due to thrombosis or stenosis, with 1-year patency rates of 86% and 51% for AVF and AVG respectively...
April 4, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001028/inaxaplin-reduces-proteinuria-in-focal-segmental-glomerulosclerosis-with-two-apol1-variants
#9
SUMMARY
Bryant Lim, Kiera Liblik
1. In preclinical studies, inaxaplin selectively inhibited apolipoprotein L1 (APOL1) in vitro and reduced proteinuria in a APOL1 G2-homologous transgenic mouse model of proteinuric kidney disease. 2. In a following phase 2a clinical study, 13 participants treated with inaxaplin had a significant reduction in urinary protein-to-creatinine ratio at week 13. Evidence Rating Level: 3 (Average) Study Rundown: The presence of two APOL1 variants confers a higher risk for proteinuric chronic kidney disease. These toxic gain-of-function variants may enhance APOL1 channel function leading to podocyte damage...
April 3, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001006/febuxostat-may-be-effective-in-preventing-contrast-induced-acute-kidney-injury
#10
SUMMARY
Alex Chan
1. This randomized control trial found that febuxostat has a reno-protective effect that can reduce the incidence of contrast-induced acute kidney injury in chronic kidney disease stage 3 patients undergoing percutaneous coronary intervention   Evidence Rating Level: 1 (Excellent) Contrast-induced acute kidney injury (CI-AKI) is considered the third most common cause of AKI in hospitalized patients. Percutaneous coronary intervention (PCI) increases the incidence of CI-AKI, which is already gradually increasing...
March 27, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000996/hydrochlorothiazide-does-not-impact-risk-of-kidney-stone-recurrence
#11
SUMMARY
Nhat Hung Benjamin Lam, Kiera Liblik
1. In this randomized controlled trial, among patients with recurrent kidney stones, hydrochlorothiazide did not alter the risk of symptomatic or radiographic stone recurrence. 2. Hydrochlorothiazide was associated with an increased risk of adverse events as compared to placebo. Evidence Rating Level: 1 (Excellent) Study Rundown: Kidney stones are a common medical condition. In many patients, these stones can be recurrent, resulting in significant distress, impaired quality of life, and healthcare burden. Calcium oxalate and calcium phosphate comprise the most common forms of kidney stones, and hypercalciuria is the most common metabolic disturbance predisposing patients to kidney stones...
March 22, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000990/nivolumab-plus-ipilimumab-does-not-improve-survival-in-post-nephrectomy-patients-with-renal-cell-carcinoma
#12
SUMMARY
Neel Mistry, Teddy Guo
1. Disease-free survival in the placebo group was 50.7 months and was never reached in the intervention group; however, there were no significant differences. 2. 38% of patients in the intervention group reported grade 3-5 adverse events versus 10% in the placebo group which led to a greater proportion of treatment discontinuations in the former. Evidence Rating Level: 1 (Excellent) Study Rundown: Nephrectomy is currently the standard of care for patients with localized renal cell carcinoma (RCC). However, despite resection of the tumor, up to 40% of patients are known to relapse...
March 21, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000973/sodium-bicarbonate-does-not-prevent-declining-kidney-function-in-kidney-transplant-recipients
#13
SUMMARY
Neel Mistry, Teddy Guo
1. The mean eGFR slope was comparable among patients allocated to sodium bicarbonate and placebo over 24 months. 2. Sodium bicarbonate was effective in correcting metabolic acidosis, although the effect on renal function remains insignificant. Evidence Rating Level: 1 (Excellent) Study Rundown: Metabolic acidosis is a common complication among patients with chronic kidney disease. Although sodium bicarbonate is used to correct this complication, its effect on declining renal function remains unclear. This randomized controlled trial aimed to assess the safety and efficacy of sodium bicarbonate in the prevention of declining estimated glomerular filtration rate (eGFR) among adult kidney transplant patients with metabolic acidosis...
March 15, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000885/machine-renal-perfusion-reduces-delayed-graft-function-after-transplantation
#14
SUMMARY
Bryant Lim, Kiera Liblik
1. In this randomized controlled trial, machine perfusion of the kidney reduced delayed graft function compared to therapeutic hypothermia.  2. There were no significant differences in one-year graft survival frequency between groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Therapeutic hypothermia and machine organ perfusion reduce the risk of delayed graft function in kidney transplant recipients. However, machine perfusion is complex and involves high costs for transplant centers. There is a paucity of evidence comparing transplant outcomes between organ preservation methods...
February 8, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000866/cystatin-c-based-equation-without-race-or-sex-improves-accuracy-of-gfr-estimation
#15
SUMMARY
Andrew Lee, Kiera Liblik
1. In this cross-sectional study, serum cystatin C levels were similar in both Black and White patients at the same measured glomerular filtration rate (GFR).  2. A cystatin C-based equation had better accuracy in estimating GFR when compared to serum creatinine equations. Evidence Rating Level: 1 (Excellent) Study Rundown: GFR is used as a marker of renal function as well as a parameter to determine disease severity in conditions like chronic kidney disease. Historically, estimated GFR is determined with equations based on measurements of serum creatinine, taking into account sociodemographic variables such as race...
February 3, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000836/empagliflozin-use-is-associated-with-slower-progression-of-chronic-kidney-disease
#16
SUMMARY
David Xiang, Kiera Liblik
1. Empagliflozin led to a lower risk of kidney disease progression in patients with chronic kidney disease (CKD) as compared to placebo control. 2. Compared to placebo, empagliflozin was associated with a lower risk of death from cardiovascular causes in patients with CKD. Evidence Rating Level: 1 (Excellent) Study Rundown: Chronic kidney disease (CKD) is a progressive disease. Slowing the disease process while avoiding the need for dialysis or kidney transplant is one of the primary goals of care. Notably, dialysis and kidney transplantation have significant impacts on the quality of life and cardiovascular morbidity and mortality...
January 26, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000789/dart-improves-treatment-decision-making-for-patients-with-chronic-kidney-disease
#17
SUMMARY
Andrew Lee, Kiera Liblik
1. Patients with chronic kidney disease (CKD) who used Decision-Aid for Renal Therapy (DART) demonstrated improved decision quality compared to those receiving care as usual. 2. Patients who used DART had increased knowledge regarding treatment options compared to those who received care as usual.  Evidence Rating Level: 1 (Excellent) Study Rundown: Individuals with advanced CKD face decisions regarding kidney replacement therapy, which are often life-long interventions. Patients require knowledge about their prognosis and treatment options to make informed decisions that are aligned with their personal values...
January 9, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101000755/dapagliflozin-reduces-the-risk-of-hospitalization-in-patients-with-chronic-kidney-disease
#18
SUMMARY
David Xiang, Kiera Liblik
1. Dapagliflozin reduced the risk of hospitalization in patients with chronic kidney disease (CKD) with and without type 2 diabetes (T2DM). 2. Dapagliflozin also reduced the risk of mortality in patients with CKD.  Evidence Rating Level: 1 (Excellent) Study Rundown: Patients with CKD are at high risk for repeated hospitalizations. These hospitalizations are associated with worse long-term prognosis, diminished quality of life, and increased CKD-related burden on the healthcare system. Prior randomized control trials have demonstrated that sodium-glucose co-transporter-2 (SGLT2) inhibitors reduced the risk for adverse cardiovascular outcomes and attenuate the progression of kidney disease in patients with T2DM...
December 26, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000727/aprocitentan-is-an-effective-and-safe-option-for-the-treatment-of-resistant-hypertension
#19
SUMMARY
Jessie Willis, Teddy Guo
1. Compared to placebo, participants on aprocitentan had a greater reduction in office systolic blood pressure at four weeks and this was sustained for a total of 40 weeks. 2. The most common adverse effect of aprocitentan was fluid retention and edema. Evidence Rating Level: 1 (Excellent) Study Rundown: Hypertension is a common medical condition that increases the risk of cardiovascular disease. While there exist numerous classes of antihypertensive drugs, there are cases of resistant hypertension in which blood pressure remains suboptimally controlled on three or more antihypertensives...
December 14, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000702/discontinuing-ras-inhibitors-in-advanced-chronic-kidney-disease-does-not-impact-long-term-outcomes
#20
SUMMARY
Grace Yin, Kiera Liblik
1. In advanced-stage chronic kidney disease (CKD), there was no significant difference in long-term glomerular filtration rate (eGFR) between those who used and who discontinued renin-angiotensin system (RAS) inhibitors. 2. There was no significant difference in long-term clinical endpoints, such as hospitalization rate and quality of life, between the discontinuation and continuation groups. Evidence Rating Level: 1 (Excellent) Study Rundown: RAS inhibitors have been a cornerstone in managing CKD both due to their benefits in controlling blood pressure and reducing the rate of decline of eGFR...
December 7, 2022: 2 Minute Medicine
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