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The challenge of replacing the terminology of renal osteodystrophy in CKD-BMD Although the new name of CKD/BMD is far more complete than the term "renal osteodystrophy" and covers in one concept all the mineral and bone disorders associated with CKD, there are also some limitations.See Cannata-Andia, pages 1811–1812
Treatment of hyponatraemia by urea limits brain damage in rats In this study, hyponatraemic rats received repeated doses of urea, and despite a large correction of the serum sodium, the mortality rate and neurological symptoms were lower in the urea-treated animals compared to control groups treated by water diuresis.
See Soupart et al., pages 1856–1863
N-acetylcysteine attenuates renal failure induced by a combination of NSAID administration and water deprivation in rats by restoring intrarenal prostaglandin synthesis. This attenuation was associated with renal vasodilatation, decreasing oxidative stress via inhibition of intrarenal reactive oxygen synthesis and restoration of intrarenal PGE2 release back to normal levels.
See Efrati et al., pages 1873–1881
Expression of filtrin in human glomerular diseases In this biopsy study in two sets of patients with proteinuria, a reduced glomerular expression of mRNA filtrin was observed in all studied groups. In particular patients with focal segmental glomerulosclerosis, the ratios of filtrin to nephrin and podocin were markedly decreased. This down-regulation of both the filtrin gene and protein expression implies a potential role for this molecule in the pathogenesis of proteinuric diseases.See Ihalmo et al., pages 1903–1909
Kidney dysfunction was found to be a risk factor for a first symptomatic stroke in a general Japanese population After adjustment for all possible variables, the relative hazard for stroke was associated with decreasing renal function (3.1 in Cr Cl <40 ml/min) and with the presence of macroalbuminuria.See Nakayama et al., pages 1910–1915
A meta-analysis of randomized controlled trials in severe lupus nephritis showed that mycophenolate mofetil (MMF) has a higher efficacy in inducing remission than pulsed intravenous therapy with cyclophosphamide and is also associated with fewer side effects.
MMF is also an alternative for maintenance therapy in these patients.See Zhu et al., pages 1933–1942
Are all patients older than 75 years with stage 5 CKD surviving longer with dialysis compared to those without dialysis? This paper shows that in patients with CKD stage 5 those who receive specialist nephrological care early, and who follow a planned management pathway, the survival advantage is substantially reduced by comorbidity, and ischaemic heart diseases in particular, compared to patients not admitted on dialysis. The authors advise that comorbidity should be a major consideration when advising elderly patients for or against dialysis.See Murtagh et al., pages 1955–1962
Intermittent haemodiafiltration was found to be beneficial in patients with refractory congestive heart failure It is an effective treatment when cytokines have to be cleared and diuretic responsiveness needs to be restored.
See Libetta et al., pages 2013–2019
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