Author Interviews, Blood Pressure - Hypertension, General Medicine, JAMA, Kidney Disease / 22.09.2014

Dr. Csaba P. Kovesdy, MD Professor of Medicine University of Tennessee Health Science Center Chief of Nephrology Memphis Veterans Affairs Medical CentMedicalResearch.com: Interview Invitation Dr. Csaba P. Kovesdy, MD Professor of Medicine University of Tennessee Health Science Center Chief of Nephrology Memphis Veterans Affairs Medical Center Medical Research: What are the main findings of the study? Dr. Kovesdy: We applied the structure of a clinical trial of hypertension management to our cohort of >600,000 patients with prevalent Chronic Kidney Disease (CKD). We first identified patients with baseline uncontrolled hypertension (using the definition applied by the SPRINT trial), then isolated the ones who had a decline in their baseline systolic blood pressure to two different levels (<120 and 120-139 mmHg) in response to a concomitant increase in prescribed antihypertensives, similar to what would happen in a trial examining two different systolic blood pressure targets. We then matched patients in the two groups to end up with identical baseline characteristics, similar to a randomized trial. When we examined the all-cause mortality of these two groups, we found that the group with follow-up systolic blood pressure of <120 had a 70% higher mortality. (more…)
Author Interviews, Diabetes, Kidney Disease, Neurology, Stroke / 21.08.2014

MedicalResearch.com Interview with: Prof. Chia-Huang Kao From the Graduate Institute of Clinical Medical Science Department of Radiation Oncology and Nuclear Medicine and PET Center Graduate Institute of Clinical Medical Science China Medical University Hospital, Taichung, Taiwan. Medical Research: What are the main findings of the study? Prof. Kao: Patients with chronic kidney disease (CKD) are at high risk for hypoglycemia; several factors are reported to contribute to hypoglycemia in these patients. However, most previous studies were limited by the relatively small number of patients with CKD included in the study by the exclusion of cases with CKD. In the present study, the incidence rate of hypoglycemia in patients with CKD was 4.5%, which is approximately twice the value noted in previous reports and multivariate analysis revealed a 2.53-fold increase in the risk of death for CKD patients with hypoglycemia after adjusting for related confounding factors including hypertension, hyperlipidemia, diabetes, and antidiabetic drugs. (more…)
Author Interviews, Brigham & Women's - Harvard, Compliance, Kidney Disease, Primary Care / 20.08.2014

Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115.MedicalResearch.com Interview with: Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115. Medical Research: What are the main findings of the study? Dr. Mendu: Our study found that implementation of a chronic kidney disease (CKD) checklist, a tool that succinctly and clearly outlines CKD management guidelines, in a primary care clinic improved adherence to a number of significant management guidelines. We conducted a prospective study during a one year period among 13 primary care providers, four of whom were assigned to use a CKD checklist incorporated into the electronic medical record during visits with patients with CKD. Patients whose providers utilized a CKD checklist had higher rates of adherence to annual albuminuria testing, parathyroid hormone testing, phosphate testing, achieving a hemoglobin A1c target<7, documentation of avoidance of nonsteroidal anti-inflammatory drugs, use of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker and vaccination for annual influenza and 5-year pneumococcus. (more…)
Blood Pressure - Hypertension, JACC, JAMA, Kidney Disease / 05.08.2014

Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles,MedicalResearch.com Interview with: Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles, Medical Research: What are the main findings of the study? Dr. Sim: Among a large diverse population of treated hypertensive people, those who achieved systolic blood pressures (SBP) in the ranges of 130-139mm Hg had the lowest risk for death and end stage renal disease (kidney failure).  Not surprisingly, those with SBP above 139 had incrementally greater risk, but somewhat surprising was that those with SBP under 130 also had a greater risk for death and kidney failure. (more…)
Author Interviews, Gender Differences, Kidney Disease, Mayo Clinic, Weight Research / 31.07.2014

Dr. John C. Lieske, MD Mayo Clinic, Rochester, MNMedicalResearch.com Interview with Dr. John C. Lieske, MD Mayo Clinic, Rochester, MN Medical Research: What are the main findings of the study? Dr. Lieske: We followed 11 women before, 6 and 12 months after Roux en Y gastric bypass surgery.  The patients successfully lost weight as mean BMI fell from 46 kg/m2 preoperatively to 28 kg/m2 postoperatively.   Mean serum creatinine did not significantly change from baseline (0.8 mg/dl) to 12 months (0.7 mg/dl).  Hence mean GFR estimated by the CKD-EPI equation (eGFR) did not significantly change from 84 ml/min/1.73 m2 (baseline) to 90 ml/min/1.73 m2 (12 months).  However, GFR measured by iothalamate clearance (mGFR) significantly decreased from 108 ml/min/1.73m2 (121 ml/min) to 85 ml/min/1.73 m2 (90 ml/min). (more…)
Author Interviews, Dartmouth, Kidney Disease / 31.07.2014

MedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NHMedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NH   Medical Research: What are the main findings of the study? Dr. Brown: Using simple team-based quality improvement methods we prevented kidney injury in 20% of patients having a procedure in the cardiac catheterization lab.  Among patients with pre-existing kidney disease, we prevent kidney injury in 30% of patients. We believed that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients.  Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury from the contrast dye exposure; these included:
  • Getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure),
  • Allow patient to drink fluids up to 2-hours before the procedure (whereas before they were "NPO" for up to 12 hours and came in dehydrated),
  • Training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money),
  • and creating stops in the system to delay a procedure if that patient had not received enough oral or IV fluids before the case (rather, they would delay the case until the patient received adequate fluids).Our success was really about hospital teams talking and innovating with one another instead of competing in the health care market, which resulted in simple, homegrown, easy to do solutions that improved patient safety.
(more…)
Author Interviews, Diabetes, Diabetes Care, Kidney Disease / 30.07.2014

MedicalResearch.com Interview with: Petter Bjornstad, M.D. Children's Hospital Colorado University of Colorado Denver Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Bjornstad: Type 2 diabetes is the most common cause of end-stage renal disease in the Western world. It is therefore of paramount importance to develop a better understanding of the determinants of diabetic nephropathy risk and progression, to improve outcome in adolescents with type 2 diabetes. We report high rates of microalbuminuria and renal hyperfiltration in adolescents with type 2 diabetes, which forecast early renal morbidity and mortality. In our observational study, insulin sensitivity measured by hyperinsulinemic-euglycemic clamp studies, rather than adiposity, blood pressure, lipid and glycemic control was associated with markers of renal health (albumin-to-creatinine ratio and estimated glomerular filtration rate). (more…)
Author Interviews, Kidney Disease, Lancet, Transplantation / 28.07.2014

MedicalResearch.com Interview with Dr. Richard Haynes Clinical Trial Service Unit and Epidemiological Studies Unit Roosevelt Drive, Headington Oxford OX3 Medical Research: What are the main findings of the study? Dr. Haynes: The main result from this analysis is that alemtuzumab-based induction therapy (ie, alemtuzumab followed by low-dose mycophenolate and tacrolimus with steroid avoidance) reduced biopsy-proven acute rejection by about half during the first 6 months after transplantation among a wide variety of different types of participant, compared to standard basiliximab-based induction therapy (basiliximab followed by standard dose mycophenolate, tacrolimus and steroids). This reduction was achieved despite the lower doses of tacrolimus used and there was no excess of infection observed. (more…)
Anemia, Author Interviews, Kidney Disease / 18.07.2014

MedicalResearch.com Interview with: Dennis J. Cotter President Medical Technology and Practice Patterns Institute, Inc. Bethesda, MD 20816 Medical Research: What are the main findings of the study? Answer: This is the first study to document anemia management practice patterns among predialysis CKD patients before and after publication of TREAT. Using a retrospective observational design based on a large US health plan database with over 1.2 million claims for predialysis CKD stage 3 and 4 patients, we report 4 main study findings. 1) For CKD stage 3 patients, the proportion prescribed ESA therapy declined from 17% pre-TREAT to 11% post-TREAT (a 38% decline) and for CKD stage 4 patients, from 34% to 27% (a 22% decline). 2) Prescribing of ESA therapy was declining even before TREAT, but the decline accelerated in the post-TREAT period. 3) ESA prescribing declined after TREAT regardless of anemia status; among patients with hemoglobin <10 g/dL, only 25% of stage 3 and 33% of stage 4 CKD were prescribed ESAs two years after TREAT, a notable 50% decline. 4) After adjusting for all covariates, the probability of prescribing ESAs was 35% less during a two year period after vs. before TREAT publication. (more…)
Author Interviews, Kidney Disease, Transplantation / 15.07.2014

Dr Hallvard Holdaas Consultant in Nephrology National Hospital of Oslo, NorwayMedicalResearch.com Interview with: Dr Hallvard Holdaas Consultant in Nephrology Department of Transplant Medicine Oslo University Hospital Rikshospitalet, Oslo Norway. Medical Research: What are the main findings of the study? Dr. Holdaas: Most studies examining long-term risk for living kidney donors have included  comparators from the background population with hypertension, diabetes mellitus, reduced renal function, cancer and other concomitant diseases; or for the few studies with more “healthy” comparators the follow-up time have been restricted. In our study we compared living donors to a healthy non-donor population which would have qualified as donors themselves, with median follow-up of 15.1 years for the donors. The relative risk for the living donors compared to a healthy control was 11.38 for endstage renal disease (ESRD), 1.4 for cardiovascular death and 1.3 for all-cause mortality (Mjoen et al., 2014). (more…)
Author Interviews, Kidney Disease, NEJM, Transplantation / 15.07.2014

Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington UniversityMedicalResearch.com Interview with: Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington University Medical Research:   What are the main findings of the review? Dr. Kimmel: AKI (Acute Kidney Injury) and CKD (Chronic Kidney Disease), two syndromes approached separately in medical school  curricula  as well as in the clinical arena are inextricably intertwined.  They should be taught as a combined entity, culminating in progressive loss of renal function necessitating renal replacement therapy (dialysis or transplantation). The two syndromes increase risk for cardiovascular disease and diminished quality of life as well.  Preventive and therapeutic strategies should be directed at the combined entity. (more…)
Author Interviews, Kidney Disease / 11.07.2014

MedicalResearch.com Interview with: Victoria A. Kumar, M.D. Internal Medicine/Nephrology Division of Nephrology Department of Internal Medicine Southern California Permanente Medical Group Los Angeles, California, USA Medical Research: What are the main findings of the study? Dr. Kumar: There was over a 2 fold increase in patient survival in incident peritoneal dialysis patients in the first year on dialysis compared to propensity matched incident hemodialysis patients.  We excluded any patients who utilized a central dialysis catheter at any point during the first 90 days on hemodialysis in an effort to reduce the mortality bias associated with hemodialysis patients who start with a catheter.  All hemodialysis patients had pre-dialysis care by a nephrologist prior to starting dialysis. The 2+ fold increase in survival among peritoneal dialysis patients resulted in a 2-3 year cumulative survival advantage for peritoneal dialysis patients, using both intent to treat and as-treated analyses. (more…)
Author Interviews, Kidney Disease, Transplantation / 01.07.2014

Daniela P Ladner, MD, MPH, FACS Assistant Professor Transplant Surgery Department of Surgery, Division of Organ Transplantation Director Northwestern University Transplant Outcomes Research Collaborative (NUTORC) Comprehensive Transplant Center Feinberg School of Medicine, Northwestern UniversityMedicalResearch.com Interview with Daniela P Ladner, MD, MPH, FACS Assistant Professor Transplant Surgery Department of Surgery, Division of Organ Transplantation Director Northwestern University Transplant Outcomes Research Collaborative (NUTORC) Comprehensive Transplant Center Feinberg School of Medicine, Northwestern University MedicalResearch: What are the main findings of the study? Dr. Ladner: With the current kidney organ allocation system, there exists significant geographic disparity between the 58 Donor Services Areas (DSAs) in the US, which are distributed among 11 regions. This means that depending on where a patient lives it might take shorter or longer to receive a kidney organ for transplantation. Despite efforts, this has not improved over the course of 20 years and in most regions this has worsened. In 1991 and 1992 respectively, two states changed their kidney allocation system, such that kidneys would first be allocated with the DSA of procurement, then statewide, then regionally (which may include several states) and then nationally. Usually kidneys don’t get allocated statewide before regionally. The main finding of this study is that in those two states (FL, TN), where a minor change to the kidney allocation was put into place, there was significant reduction in the geographic disparity between their Donor Services Areas. In other comparable states (equal numbers of DSAs within the state) the geographic disparity did not improve and in many the geographic disparity worsened. (more…)
Anemia, Author Interviews, Kidney Disease, Transfusions / 28.05.2014

MedicalResearch.com Interview with: David T. Gilbertson, Ph.D. Chronic Disease Research Group Center for Observational Research, Amgen, Inc, Thousand Oaks, CA MedicalResearch: What were the main findings of the study? Dr. Gilbertson: Since transfusion avoidance is important in patients receiving maintenance hemodialysis, development of a measure of red blood cell transfusion use to assess dialysis facility anemia management is reasonable. Because dialysis facility size varies widely, calculation of a standardized transfusion ratio (STfR) using standard methods is possible, but these methods result in significant instability in estimates for small dialysis facilities. Use of more advanced statistical methods results in standardized transfusion ratio estimates that are considerably more stable and more consistently precise across dialysis facilities of all sizes. (more…)
Author Interviews, Kidney Disease, Mayo Clinic, Rheumatology / 11.04.2014

Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com Interview with: Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com: What are the main findings of the study? Dr. Matteson: “The main points are that kidney disease is more common in patients with rheumatoid arthritis than in the general population and that moderate reduction in kidney function was more likely to be associated with cardiovascular disease in these patients as well. Patients with more active disease week are also at higher risk for kidney disease. “ (more…)
Author Interviews, Heart Disease, Kidney Disease / 06.04.2014

Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The NetherlandsMedicalResearch.com Interview with: Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The Netherlands   MedicalResearch.com: What are the main findings of the study? Dr. Kooiman: The main finding of our study is that trans radial PCI (TRI) is associated with a significantly lower risk of AKI compared with trans femoral PCI (TFI), after adjustment for confounding factors. (more…)
Author Interviews, Diabetes, Kidney Disease / 30.03.2014

Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical School and Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston. Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston.   MedicalResearch.com: What are the main findings of the study? Dr. Fiorina: It is common knowledge that type 2 diabetes is a worldwide epidemic and that diabetic nephropathy has become the leading cause of renal failure in the western world. One of the main drivers and worsening factors for the diabetic kidney disease is proteinuria associated with various degrees of tubular damage, and unfortunately, therapies to halt or prevent this complication are not available so far. Our findings show that B7-1 when expressed on podocytes (a specific subset of renal cells) determines alterations in podocytes function and morphology, predisposing individuals with T2D to the loss of proteins into the urine. We also demonstrate that Abatacept, an immunomodulatory drug currently employed for the treatment of a variety of autoimmune diseases, is able to specifically target this malignant pathway, preventing podocytes cellular alterations in vitro and proteinuria development in two murine models of diabetic nephropathy in vivo. (more…)
Author Interviews, Heart Disease, Kidney Disease, McGill / 27.03.2014

Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill UniversityMedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22). (more…)
Author Interviews, Biomarkers, Diabetes, Diabetologia, Kidney Disease / 14.03.2014

Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, FranceMedicalResearch.com Interview with: Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, France MedicalResearch.com: What are the main findings of the study? Prof: Hadjadj: The study helps to establish sTNFR1 as a valid biomarker not only for renal outcomes in type 2 diabetes but also for all cause death. Interestingly the addition of sTNFR1 concentration to the UKPDS model outcome equation showed to add some clinical prognostic value to this model for all-cause death. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute, Kidney Disease / 04.03.2014

Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.MedicalResearch.com Interview with: Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.   MedicalResearch.com: Why did you choose to study this particular question? Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Kidney Disease / 25.02.2014

Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical CenterMedicalResearch.com Interview with: Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Kovesdy: We describe significantly lower all-cause mortality rates in 141,413 non-dialysis dependent CKD (chronic kidney disease) patients who were de-novo users of ACEI/ARB. (more…)
Author Interviews, Diabetes, Diabetes Care, General Medicine, Kidney Disease / 25.02.2014

MedicalResearch.com Interview with: Eiji Ishimura, MD, PhD, FASN, FACP Osaka City University Hospital Professor,Department of Nephrology Osaka, JAPAN MedicalResearch.com: What are the main findings of the study? Dr. Ishimura: Poor glycemic control is a major factor in the overestimation of glomerular filtration rate (GFR) in diabetic patients. We found this simple conclusion by directly measuring GFR by use of inulin clearance. We have created new formulae to accurately assess the GFR in diabetic patients, with the correction of hemoglobin A1C (HbA1C) or glycated albumin (GA) as followings; 1)      eGFRcr corrected by HbA1c=eGFRcr / (0.428 + 0.085 × HbA1c) 2)      eGFRcr corrected by GA=eGFRcr / (0.525 + 0.028 × GA) (more…)
Author Interviews, Heart Disease, Kidney Disease / 31.12.2013

Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com Interview with: Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com: What are the main findings of the study? This was the first long-term study in individuals with atrial fibrillation to consider the impact of renal function, as measured by eGFR, on stroke/thromboembolism, mortality and bleeding in the same population concurrently. Answer: There were three main findings of our study.
  • First, patients with worsening renal function had more severe risk factor profiles and had higher rates of stroke/thromboembolism, mortality and bleeding.
  • Second, individuals receiving oral anticoagulation had lower rates of stroke/thromboembolism and mortality than those not receiving anticoagulation at all levels of renal function measured by eGFR, suggesting that anticoagulation has benefit in even patients with low eGFR.
  • Third, renal function was not an independent predictor of stroke/thromboembolism at 1 year after adjustment for baseline characteristics. (more…)
Author Interviews, Blood Clots, Kidney Disease / 24.11.2013

Frits R. Rosendaal PhD Department of Clinical Epidemiology Leiden University Medical Center, Leiden, The NetherlandsMedicalResearch.com Interview with: Frits R. Rosendaal PhD Department of Clinical Epidemiology Leiden University Medical Center, Leiden, The Netherlands MedicalResearch.com: What are the main findings of the study? Answer: In our study, we  found that moderately to severely decreased kidney function was associated with a 2.6-fold (95%CI 2.0-3.5) increased risk of venous thrombosis as compared with normal kidney function. Several hemostatic factors showed a procoagulant shift with decreasing kidney function, most notably factor VIII and von Willebrand factor. We showed that the increased risk of venous thrombosis in chronic kidney disease could not be explained by confounding factors such as body mass index, diabetes, hospitalization, or corticosteroid use. However, we found that factor VIII and von Willebrand factor fully explained the increased risk of venous thrombosis associated with impaired kidney function. (more…)
Author Interviews, Kidney Disease / 25.09.2013

Renée L. Mulder, PhD Department of Pediatric Oncology Emma Children's Hospital / Academic Medical Center 1100 DD Amsterdam The NetherlandsMedicalResearch.com Interview with: Renée L. Mulder, PhD Department of Pediatric Oncology Emma Children's Hospital / Academic Medical Center 1100 DD Amsterdam The Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Mulder: The glomerular function of childhood cancer survivors treated with nephrotoxic therapy declines very soon after treatment and does not recover. The glomerular function declines over time. This decline is comparable to survivors treated without nephrotoxic therapy. (more…)
Author Interviews, HIV, Kidney Disease / 11.09.2013

MedicalResearch.com Interview with: Magnus G. Rasch MD Faculty of Health Sciences, University of Copenhagen 1455 København K, Denmark Department of Infectious Diseases Copenhagen University Hospital, Rigshospitalet, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population. The risk of aRRT was highest the first year after HIV diagnosis. Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate. (more…)
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Medical Research Centers / 05.09.2013

MedicalResearch.com Interview with: Gearoid M. McMahon, MB, BCh Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Framingham Heart Study, National Heart, Lung, and Blood Institute, and Center for Population Studies, Framingham, Massachusetts MedicalResearch.com: What are the main findings of the study? Answer: This study examined the incidence, causes and outcomes of rhabdomyolysis in two large University Teaching hospitals. Rhabdomyolysis is a characterized by an increase in serum creatine phosphokinase (CPK) and results from muscle damage from a variety of causes. The most important complication of rhabdomyolysis is acute kidney injury which can result in a need for dialysis. Using a series of laboratory and clinical variables that are readily available on admission, we constructed a risk score that can predict with some accuracy the likelihood that a patient with rhabdomyolysis might die or need dialysis during an admission. The final variables included in the model were age, gender, the cause of rhabdomyolysis and the admission CPK, creatinine, phosphate, bicarbonate and calcium. One of the advantages of this study was, because we had access to data from two institutions, we were able to derive the risk score in one hospital and confirm its accuracy in the second institution. (more…)
Author Interviews, Kidney Disease, University of Michigan / 03.09.2013

Afshinnia, Farsad, M.D., M.S. Research Fellow and Clinical Lecturer Department of Nephrology University of Michigan Health System MedicalResearch.com: What are the main findings of the study? Answer: Spontaneous Renal Artery Dissection (SRAD) is most commonly observed in middle aged individuals. Although SRAD can have no association with other comorbidities at the time of presentation, we have noticed association with a number of systemic disorders such as hypertension, cancer, congestive heart failure, and rheumatologic diseases. In particular clustering of Fibromascular dysplasia (FMD), Ehlers-Danlos syndrome, poly arteritis nodosa, Poland syndrome, and nail patella syndrome in our patients has been striking. The most commonly observed presenting symptom is sudden onset severe flank pain which may be spontaneous or following physical stress. Other presenting features may include uncontrolled hypertension, groin and/or testicular pain, headache, nausea, vomiting, fever, dysuria, hematuria and blurry vision. (more…)