Use of Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Peripherally inserted central catheters often used in CKD – HealthDay (free) AND Too Many CKD Patients Get Central Catheters Despite Warnings – Medscape (free registration required)


Related Commentary on Twitter

Long term tapering versus standard prednisolone treatment for first episode of childhood nephrotic syndrome: phase III randomised controlled trial and economic evaluation – The BMJ (free)


Related Commentary on Twitter


Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older – JAMA Internal Medicine (free for a limited period)


Related Commentary on Twitter


Fibrillary Glomerulonephritis: An Update

30 Apr, 2019 | 02:07h | UTC

Review: Acute Management of Hyperkalemia

28 Apr, 2019 | 13:33h | UTC

Review: Hepatorenal Syndrome

24 Apr, 2019 | 06:21h | UTC

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy – New England Journal of Medicine (free for a limited period)

Commentary: Canagliflozin may offer renal protection in people with type 2 diabetes and CKD – Medicine Matters (free)

“among 1000 patients treated for 2.5 years, 21.2 individuals would need to be treated to prevent the composite primary outcome.” (from Medicine Matters)


Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients With Hypertension – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Catheter-Based Renal Sympathetic Denervation Effectively Lowers BP – Cardiology Advisor (free) AND Renal Denervation Lowers BP in Sham-Controlled Studies: Meta-Analysis – TCTMD (free)

Compared with sham control, renal denervation lowered 24-h ambulatory systolic blood pressure by 3.65 mm Hg and diastolic blood pressure by 1.71 mm Hg.


Schedules for Self-monitoring Blood Pressure: A Systematic Review – American Journal of Hypertension (free)

Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold.”


Special Issue: Hyperkalemia

6 Mar, 2019 | 20:02h | UTC

Dialysis Is a Way of Life for Many Older Patients. Maybe It Shouldn’t Be – The New York Times (10 articles per month are free)

Related: Editorial: Prioritizing Patient and Caregiver Values in the Delivery of High-Quality Medical Management Without Dialysis (free)

“So-called conservative management can ease symptoms without dialysis in some people with kidney disease. But many of them are never given the option.”


Urine Sediment Examination in the Diagnosis and Management of Kidney Disease: Core Curriculum 2019 – American Journal of Kidney Diseases (free for a limited period)


Related Commentary on Twitter


Podcast: Hyperkalemia Master Class

6 Feb, 2019 | 00:52h | UTC

10 Myths About Frusemide

30 Jan, 2019 | 23:31h | UTC

10 myths about frusemide – Intensive Care Medicine (free)

Note: if the above link is paywalled, try this one


Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Prevention of Cognitive Impairment With Intensive Systolic Blood Pressure Control (free for a limited period)

Commentaries: Does intensive blood pressure control reduce dementia? – NIH News Releases (free) AND Intensive BP Control Helps Prevent Mild Cognitive Impairment – NEJM Journal Watch (free)


Related Commentary on Twitter


Care Practices for Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentaries: End Stage Kidney Disease: Decoding How Patients Decide to Forgo Dialysis – (free) AND Shared Decision-Making About Dialysis Initiation Needs to Improve – Renal & Urology News (free)

“There is need for more patient-centered models of care for advanced kidney disease capable of supporting those who do not wish to start dialysis.”


Sepsis associated acute kidney injury – The BMJ (free)


Related Commentary on Twitter


Review: Scleroderma Renal Crisis

4 Jan, 2019 | 19:33h | UTC

Review: Lithium and Nephrotoxicity

20 Nov, 2018 | 14:52h | UTC

Intravenous Iron in Patients Undergoing Maintenance Hemodialysis – New England Journal of Medicine (free)

“Proactive administration of high-dose iv iron did not adversely affect mortality or CV events, but enabled reduced erythropoiesis-stimulating agent dosing and transfusion rates.” (via @NatRevNeph see Tweet)


Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis – New England Journal of Medicine (link to abstract – $ for full-text)

Video Summary: Renal-Replacement Therapy for AKI (free)

Commentary: Is Kidney Dialysis Always Needed When Septic Shock Strikes? – HealthDay (free)

“Trial comparing early vs. delayed strategies of renal-replacement therapy in patients with early-stage septic shock who had severe acute kidney injury finds no significant between-group difference in overall mortality at 90 days.” (via @NEJM see Tweet)


Review: Arterial Hypertension

14 Sep, 2018 | 02:18h | UTC

Review: Cardiorenal Syndrome Revisited

2 Sep, 2018 | 02:26h | UTC

Optimal Blood Pressure Target in Diabetic and Nondiabetic Hypertensive Patients – Circulation Research (free)

See counterpoint suggesting lower BP targets: Sprinting Toward the Optimal Blood Pressure Target for Hypertensive Patients – Circulation Research (free)

“We have reviewed the randomized trial evidence in favor of a target blood pressure (BP) around 130/80 mm Hg in hypertensive patients with and without diabetes mellitus”


Guideline: Acute Kidney Injury

23 Aug, 2018 | 23:24h | UTC

Blood pressure targets for the treatment of people with hypertension and cardiovascular disease – Cochrane Library (free)

Summary: Blood pressure targets in people with cardiovascular disease – Cochrane Library (free)

“Insufficient evidence to justify lower than standard blood pressure targets in ppl w hypertension + CVD” (via @CochraneHTN see Tweet)


Guideline: Renal Transplantation

26 Jul, 2018 | 17:42h | UTC

Last Month in Nephrology – July 2018

20 Jul, 2018 | 01:49h | UTC

Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)

Commentary: BICAR-ICU – The Bottom Line (free)

“This study will reassure clinicians that already use sodium bicarbonate for correcting metabolic acidaemia, that this may delay and/or reduce the requirement for RRT. Equally, for those that opt to avoid sodium bicarbonate, there is no compelling evidence to change practice”


Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis – PLOS One (free)

“In addition to established traditional general population cardiovascular risk factors, left ventricular hypertrophy, serum albumin, phosphate, urate and hemoglobin were all found to be statistically significant in their association with future cardiovascular events”.


Review: Contrast-Induced Nephropathy

24 May, 2018 | 22:31h | UTC

Hypokalemia: A Clinical Update

23 Apr, 2018 | 21:16h | UTC

First-line drugs for hypertension – Cochrane Library (free)

Summary: Thiazides best first choice for hypertension – Cochrane Library (free)

“First-line low-dose thiazides reduced all morbidity and mortality outcomes in adult patients with moderate to severe primary hypertension. First-line ACE inhibitors and calcium channel blockers may be similarly effective, but the evidence was of lower quality”.


Acid‐suppressive drugs and risk of kidney disease: A systematic review and meta‐analysis – Journal of Gastroenterology and Hepatology (link to abstract – $ for full-text)

Source: Hospital Medicine Virtual Journal Club

Proton pump inhibitors were associated with higher risks of acute interstitial nephritis (HR, 2.78; 95% CI, 1.25‐6.17), acute kidney injury (HR, 1.85; 95% CI, 1.33‐2.59), chronic kidney disease (HR, 1.47; 95% CI, 1.03‐2.09), and end‐stage renal disease (HR, 1.61; 95% CI, 1.26‐2.04) than non‐PPI therapy. Similar risks were not identified for H2RA therapy.


Review: hyperchloraemia in sepsis

5 Apr, 2018 | 18:32h | UTC

Blood pressure-lowering treatment strategies based on cardiovascular risk versus blood pressure: A meta-analysis of individual participant data – PLOS Medicine (free)

Related study with similar conclusions: Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension – Journal of the American College of Cardiology (link to abstract – $ for full-text)

“An intelligent approach towards blood pressure management: by the individual’s risk instead of just their measurements” (via @EricTopol see Tweet)


Chronic kidney disease and arrhythmias

16 Mar, 2018 | 02:27h | UTC

Balanced Crystalloids versus Saline in Critically Ill Adults – New England Journal of Medicine (free)

Related article: Balanced Crystalloids versus Saline in Noncritically Ill Adults – New England Journal of Medicine (free)

Commentary: Balanced Crystalloids May Be Better Than Saline for Critically Ill Patients – NEJM Physician’s First Watch (free)

“Balanced crystalloids may be superior to saline in critically ill patients — but not in patients hospitalized outside an ICU” (from Physician’s First Watch)


Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial – The Lancet (free)

Commentaries: Hypertension: time for doctors to switch the driver’s seat? (free) AND Should home-based blood pressure monitoring be commonplace in NHS? – University of Oxford News & Events (free)

“Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings”.


Readmissions Following a Hospitalization for Cardiovascular Events in Dialysis Patients: A Retrospective Cohort Study – Journal of the American Heart Association (free for a limited period)

“Roughly 1 in 3 CVD hospitalizations resulted in 30‐day readmission; nearly 1 in 20 was followed by death within 30 days”.


Update on Diabetic Nephropathy

23 Feb, 2018 | 01:02h | UTC