Saturday, November 23, 2013
Thursday, November 21, 2013
Time to stop ordering Urine Eos?
Urinary eosinophils don't add much information to either exclude or confirm a diagnosis of AIN:
http://cjasn.asnjournals.org/content/8/11/1857.abstract
http://cjasn.asnjournals.org/content/8/11/1857.abstract
Tuesday, November 19, 2013
Monday, November 18, 2013
Renal Fellow Network: Abatacept for Glomerular Diseases: A New Era of In...
Renal Fellow Network: Abatacept for Glomerular Diseases: A New Era of In...: At ASN Kidney Week there was some interest in abatacept as a targeted therapy for glomerular diseases. T-cell activation requires 2 signa...
Thursday, November 14, 2013
VA NEPHRON-D study
Another nail in the coffin for combination ACE/ARB in diabetic nephropathy!
http://www.nejm.org/doi/full/10.1056/NEJMoa1303154?query=TOC
Also see Kiran/Pradeep's posts on this article on Nov 10th.
Regarding Pradeep's question: might there still be a role for combined ACE/ARB in non-diabetics with CKD and proteinuria? Obviously this study was in diabetics and will not directly inform ACE+ARB use in non-diabetics. But its impressive that their findings generally confirm those in ONTARGET, suggesting adverse outcomes (renal failure, hyperkalemia) with combination therapy. ONTARGET included both diabetics and non-diabetics, and subgroup analysis suggested the adverse outcomes were not affected by the presence/absence of diabetes.
So I will continue to consider combined ACE/ARB only in very exceptional circumstances (perhaps multi-drug resistant hypertension and/or severe refractory proteinuria), and only with diligent laboratory monitoring.
http://www.nejm.org/doi/full/10.1056/NEJMoa1303154?query=TOC
Also see Kiran/Pradeep's posts on this article on Nov 10th.
Regarding Pradeep's question: might there still be a role for combined ACE/ARB in non-diabetics with CKD and proteinuria? Obviously this study was in diabetics and will not directly inform ACE+ARB use in non-diabetics. But its impressive that their findings generally confirm those in ONTARGET, suggesting adverse outcomes (renal failure, hyperkalemia) with combination therapy. ONTARGET included both diabetics and non-diabetics, and subgroup analysis suggested the adverse outcomes were not affected by the presence/absence of diabetes.
So I will continue to consider combined ACE/ARB only in very exceptional circumstances (perhaps multi-drug resistant hypertension and/or severe refractory proteinuria), and only with diligent laboratory monitoring.
Wednesday, November 13, 2013
Precious Bodily Fluids: So now that we know that ZS-9 lower potassium, how...
Precious Bodily Fluids: So now that we know that ZS-9 lower potassium, how...: One of the only positive trials at Kidney Week's Late Breaking Trials Session was ZS-9, a novel potassium binding crystal that hopes to ...
Sunday, November 10, 2013
Demystifying kidney disease for the average Joe!: Can certain herbal medications treat chronic kidne...
Demystifying kidney disease for the average Joe!: Can certain herbal medications treat chronic kidne...: I set off to try and answer this question after one of my patients whom I saw at my Bradenton clinic brought along an article that claimed ...
Nice one on "NETTLE". I had one recently who asked me about Nettle.
Nice one on "NETTLE". I had one recently who asked me about Nettle.
Precious Bodily Fluids: Tolvaptan, ADPKD, and lack of vision at the FDA
Precious Bodily Fluids: Tolvaptan, ADPKD, and lack of vision at the FDA: About a year ago the ASN Kidney Week hosted the most exciting Late Breaking Trial Session I have attended. The session included the first pu...
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