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March 2007 Issue of Renal And Urology News

World Literature Review

Anesthetic Spray May Work For Premature Ejaculation

An aerosol anesthetic spray may be a safe and effective treatment for premature ejaculation (PE), British researchers report.

Dyslipidemias, Obesity, and Smoking Raise CKD Risk

Like hypertension and diabetes, dyslipidemias, obesity, and current smoking are among the independent risk factors for CKD, according to Japanese investigators.

Laparoscopic Nephrectomies Safe Despite Comorbidities

Laparocopic nephrectomy can be performed safely and effectively in patients with three or more comorbidities, a Japanese study shows.

Renal Decline Is Unusual After Obstruction Relief

Progressive deterioration in renal function is unusual following relief of obstructive nephropathy in most patients over a three-year period, according to British researchers.

FDA News

New Doses Approved for Kidney Agent

New dosing recommendations have been approved for Wyeth Pharmaceuticals’ immunosuppressant Rapamune (sirolimus).

Fast Track for New Prostate Cancer Therapy

The FDA has assigned priority review status to the Biologics License Application for Provenge (sipuleucel-T), an investigational immunotherapy for asymptomatic, metastatic, androgen-independent (also known as ...

Agency Plans Changes in Drug Safety System

Citing the need to keep pace with the technological transformation of medicine, the FDA has outlined a set of new initiatives to strengthen its medical ...

Insulin Injection Rated Category B for Pregnancies

Novo Nordisk announced that the FDA has approved NovoLog (insulin aspart [rDNA origin] injection) for pregnancy Category B rating.

Legal Issues

Patient Is Noncompliant But Sues Urologist Anyway

Dr. E was a well-respected urologist whose pragmatic approach and wide experience gave him a reputation as the “go-to” man when things got tough. As ...

Malpractice News

Apologies for Errors May Dissuade Patient Lawsuits

The conventional wisdom used to be that apologizing to a patient was like talking to a cop: Anything you say can and will be used ...

Medical Malpractice Crisis A Myth, Report Says

America’s medical malpractice crisis is a myth, according to a new report by Public Citizen, Ralph Nader’s national watchdog group.

Oklahoma Legislature Mulls ‘Negative Outcome’ Insurance

If patients could buy “negative outcome” insurance, the number of malpractice suits would decline dramatically, and the high cost of medical services would come down.

Renal Nutrition Update

Meat May Increase Renal Stone Risk

THE ROLE OF meat consumption in the development of kidney stones remains controversial. Most of the recent research on this topic has focused on the ...

Your Money

A Back Door Entry into Hedge Funds

HEDGE FUNDS often score huge gains by taking big risks and investing in ways mutual funds are not allowed to. And unlike mutual funds, which ...

General News

Adjuvant Radiotherapy Benefits Some

Recent randomized trials have shown that following radical prostatectomy for prostate cancer, adjuvant radiotherapy improves progression-free survival (PFS). Nevertheless, it is possible that some patients ...

Advanced PCa Linked to High Zinc Intake

HIGH ZINC intake is associated with an elevated risk of advanced prostate cancer, according to an Italian study.

AVF Complication Rate Low, Study Shows

NEPHROLOGISTS should not let concerns about complications delay arteriovenous fistula (AVF) creation, according to a Canadian study.

Avoid Prostate Biopsies In Octogenarians?

PROSTATE BIOPSIES may be unwarranted in men aged 80 years and older and who have a PSA level of 30 ng/mL, according to investigators in ...

Freezing Away Prostate Cancer

CRYOABLATION AS a primary treatment for localized prostate cancer has come a long way since the 1980s and now should be considered part of the ...

Biomarkers May Boost Bladder Ca Care

ALTERED EXPRESSION of four apoptosis biomarkers may enable more accurate outcome predictions in patients with bladder cancer and identify those who could benefit from adjuvant ...

IV Iron Formulation Eases CKD Anemia

FERUMOXYTOL, a semi-synthetic iron oxide formulated with mannitol, may be a safe and effective IV iron treatment for anemia in CKD patients not on dialysis.

Percutaneous Cryo May Offer Benefits

PERCUTANEOUS renal cryoablation (PERC) for select tumors is comparable to laparoscopic renal cryoablation (LAP) with respect to short-term outcomes and complications, data suggest.

Better CIN Protection?

CHICAGO—N-acetylcysteine (NAC) may be superior to ascorbic acid in preventing contrast-induced nephropathy (CIN) in patients with renal insufficiency, Korean researchers reported here at the American ...

Colitis After Cystectomy

A study of patients who experienced Clostridium difficile colitis (CDC) following cystectomy found that the infection did not significantly affect patients’ hospital course.

Diagnostic Gleason Sums Often Wrong

DIAGNOSTIC GLEASON sums frequently differ from those determined by pathologic analysis of prostate biopsy specimens, a study shows. The discrepancies were due mostly to understaging. ...

Drug for Baldness Affects PSA Testing

AS LITTLE AS 1 mg/day of finasteride can seriously distort the results of a PSA screening for prostate cancer, a recent study has found.

Drugs Aid Metastatic RCC Outcomes

TWO RELATIVELY new oral agents can improve outcomes for patients with metastatic renal cell carcinoma (RCC), according to recent reports. The drugs, sunitinib and sorafenib, ...

Ergocalciferol Benefits CKD Patients

ERGOCALCIFEROL supplementation in CKD patients can safely raise levels of serum 25-hydroxyvitamin (OH) D levels and decrease serum intact parathyroid hormone (iPTH) levels, especially in ...

Growth Hormone May Help Dialysis Patients

GROWTH HORMONE therapy may safely improve lean body mass (LBM), cardiovascular risk factors, and quality of life in adult patients on maintenance hemodialysis, data suggest.

Histologic Improvements Documented

WASHINGTON, D.C.—The histologic changes that occur in patients with severe proliferative lupus nephritis following treatment with rituximab (Rituxan) plus cyclophosphamide may be seen, researchers say.

How Best to Manage BP in Diabetics

TWO NEW studies may help define how best to treat hypertensive patients with diabetes.

Hydronephrosis Is An Ominous Sign

HYDRONEPHROSIS at the diagnosis of bladder cancer is a significant prognostic marker for advanced malignancy, according to German researchers.

In a Woman, Not all Oocytes the Same

THE BINDING OF the sperm to the zona pellucida varies from egg to egg within the same woman, even when the sperm source is unchanged, ...

Kidney Stone Patients Often Have CKD

Researchers found that more than half of patients who presented to a nephrology clinic for a metabolic workup of nephrolithiasis had some level of CKD.

Lanthanum Not More Harmful

The phosphate binder lanthanum carbonate does not adversely affect cognitive function in hemodialysis patients compared with standard phosphate binders, according to a study published in ...

Laparoscopic LDN Side May Not Matter

RIGHT AND left laparoscopic living-donor nephrectomies (LDN) are equivalent in operative parameters and postoperative results.

Laparoscopic Cryo Okay For Selected Cases

TREATING RENAL masses with either laparoscopic cryoablation (LCA) or laparoscopic partial nephrectomy (LPN) achieves similar clinical outcomes, a study found.

Lower PSA Biopsy Threshold Advised

DIAGNOSTIC PSA levels in men younger than 50 years are significantly lower than guidelines suggest, according to researchers.

Lower Pulse Pressure Hikes Mortality

REDUCED MEAN arterial pressure (MAP) and pulse pressure (PP) are associated with increased mortality in hemodialysis patients, according to a study.

New Blood Test Can Diagnose Severe BPH

RESEARCHERS HAVE developed a new blood test that can distinguish severely symptomatic BPH from BPH that occurs with few if any symptoms, even if men ...

Partial Nephrectomy for RCC Has Excellent 15-Year Results

Partial nephrectomy for renal cell carcinoma provides excellent long-term disease-specific survival, researchers say.

Laparoscopic Nephrectomy Effective for Large Tumors

Large renal tumors can be removed safely and effectively with laparoscopic nephrectomy (LN), a study shows.

TCC Plus Variant Histology Reduces Treatment Response

Variant tumor histology in patients with transitional cell carcinoma (TCC) is an indication for neoadjuvant chemotherapy, according to researchers

Novel BP Agent Shows Clinical Promise

CHICAGO—Aliskiren, the first in a new class of direct renin inhibitors, is a useful adjunct to other antihypertensive agents for patients with mild to moderate ...

Obese Live Donors Incur Renal Risks

LIVE KIDNEY donors who are overweight or obese have increased filtration fraction (FF) in their remaining kidney. This could explain the previously found increased risk ...

Older Donors Are Suitable

SIMULTANEOUS pancreas-kidney (SPK) transplants using organs from older donors are associated with reasonable graft survival and improved patient survival compared with waiting for a transplant ...

Oldest Dialysis Population Exploding

RESEARCHERS REPORT a dramatic increase in the number of patients in their 80s and 90s starting dialysis.

OTC Drug Use Common in Renal Disease Patients

USE OF over-the-counter (OTC) medications and natural remedies is common among patients with moderate or severe chronic renal insufficiency (CRI), and some patients may be ...

Pediatric PD Outcomes Differ By Gender, Race

OUTCOMES AMONG pediatric peritoneal dialysis (PD) patients differ by gender and race, according to a study.

Pre-ESRD Care Cuts Early Mortality

PATIENTS WITH end-stage renal disease (ESRD) are at higher risk of death within the first 120 days of hemodialysis compared with 121-365 days after hemodialysis ...

PSA Velocity A Better Predictor

PREOPERATIVE PSA velocity is more useful than PSA doubling time for predicting outcomes after radical prostatectomy for prostate cancer, according to researchers.

Renal Disease Increases Risk of PAD

CKD PATIENTS are at increased risk for peripheral arterial disease (PAD), researchers conclude.

Renal Function at Biopsy Is Key

WASHINGTON, D.C.—The best predictor of outcome in patients with lupus nephritis is kidney function at the time of renal biopsy, supporting the need for early ...

Renal Link to Hip Fractures Found

MODERATE RENAL dysfunction in older women is associated with an increased risk of hip fractures, especially trochanteric fractures, a study found.

Screening Cuts Risk of Advanced PCa

BIENNIAL PSA screening decreases the likelihood of being diagnosed with metastatic prostate cancer, but nearly doubles the chance of being diagnosed with prostate cancer of ...

Shipping Live Donor Kidneys Is Possible

PROLONGED COLD ischemia time (CIT) in live donor kidneys does not worsen transplant outcomes, research shows. The finding could set the stage for more transplants ...

Study: tPA May Raise Bacteremia Risk

INTRA-DIALYTIC instillation of tissue plasminogen activator (tPA) may be associated with increased catheter-related bacteremia (CRB).

Study Zeroes In On Post-Transplant Anemia

ANEMIA THAT occurs after renal transplantation is due to more than just impaired allograft function. Gender, creatinine clearance, and age also contribute to development of ...

Tx Patients At Higher IPD Risk

SOLID ORGAN transplant recipients are at significantly greater risk for invasive pneumococcal disease (IPD) than the general population, according to Canadian researchers.

Uric Acid Stones May be Linked to Diabetes

DIABETES MELLITUS may increase the risk of urinary stones and predispose individuals to the development of uric acid stones, according to Mayo Clinic researchers.

Vacuum Device Stems Penile Shortening

EARLY INTERVENTION with a vacuum erection device (VED) after radical retropubic prostatectomy (RRP) may reduce the likelihood of penile shortening, a researcher concluded.

Advanced PCa is Rare in Statin Users

STATIN USE is associated with a reduced risk of advanced prostate cancer, according to a study.

BMI Not Linked to Death In Stage 3-4 CKD

Higher BMI is associated with worse survival in the general population, but appears to confer a survival advantage in patients on hemodialysis.

Feature

Howard Snyder III, MD: Changing Lives

PHILADELPHIA—Pediatric urologist Howard M. Snyder III has pioneered treatment for complex urinary tract and urogenital anomalies. He developed and taught one-step hypospadias repair to generations ...