August 2016 Issue of Renal And Urology News

August 2016 Issue of Renal And Urology News

Renal & Urology News - August 2016 issue

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Nephrology Cover Articles

Muscle Density Predicts Death Risk in Patients Waiting for a Kidney

Each Hounsfield unit increase on CT is associated with a 7% decreased risk of death among waitlisted kidney transplant candidates.

Higher Red Meat Intake Raises Kidney Failure Risk

Highest vs lowest quartile of intake is associated with a 40% increased risk.

Urology Cover Articles

Dutasteride Cuts Risk of Prostate Biopsy-Related UTIs

In a study, use of the medication was associated with a significant 61% decreased risk.

Metformin May Have a Protective Effect in Bladder Cancer Patients

Diabetics taking the drug had a significant 68% decreased risk of grade progression compared with diabetics not on the drug.

PD-1 Blockade Shows Promise for mCRPC

In a small study, some men whose cancer progressed while on enzalutamide had a profound PSA response to pembrolizumab.

Commentary

Later HD, Less HD, No HD: A New Paradigm?

Recent studies have cast doubt on the universal superiority of the conventional approach to dialysis.

News in Brief

Morbid Obesity Ups Viral Infection Risk After a Kidney Transplant

In a study, viral infections occurred in 52.4% of patients with a BMI of 35 kg/m2 or higher compared with 37.1% of those with a ...

New Drug Cleared to Treat SHPT in Chronic Kidney Disease Patients

Calcifediol formulation is indicated for CKD stage 3 or 4 patients with secondary hyperparathyroidism associated with vitamin D insufficiency.

New Study Supports Use of Trimodal Therapy for MIBC

Researchers find no difference in 5-year disease-specific survival between multi-disciplinary bladder-sparing approach and radical cystectomy.

Venous Thromboembolism Linked to High Uric Acid

Highest vs lowest uric acid levels associated with a 2-fold increased risk of VTE.

Shockwave Therapy May Ease Peyronie's Disease

ESWT is associated with significantly increased odds of reduced plaques and pain relief.

Intestinal Autoimmunity Possibly Linked to ADT

ADT for prostate cancer may be associated with a reduced risk of inflammatory bowel disease.

Practice Management

Transition to ICD-10 Going Smoothly? Not So Fast

Providers are becoming more comfortable with the new system, so Medicare and other payers may scrutinize claims more closely.

General News

Water Vapor Ablation Eases BPH/LUTS, Preserves Sexual Function

Significant improvements in lower urinary tract symptoms are durable to 24 months, data show.

Novel Oral Testosterone Shows Long-Term Safety, Tolerability

In particular, no hepatic toxicities emerged during a 52-week phase 3 trial.

Baseline PSA at Age 55-60 Predicts Prostate Cancer Risk

The higher the baseline PSA levels, the greater the risk of being diagnosed with any or significant prostate cancer.

No Survival Advantage With Early Renal-Replacement Therapy in AKI

Mortality no different for early versus delayed strategy for patients with severe acute kidney injury.

Long-Term Kidney Transplant Outcomes Linked to 30% eGFR Decline

An eGFR decline of at least 30% during the 6 to 24 months after kidney transplantation predicts a higher risk of graft loss.

Patient Non-Adherence Predicts Worse Kidney Transplant Outcomes

Rates of non-adherence to follow-up care and medication regimens also found to differ by race.

Bariatric Surgery May Increase Risk of Renal Allograft Loss

Possible reasons include malabsorption of immunosuppressive drugs and deposition of oxalate crystals in transplanted kidneys.

Slower Kidney Disease Progression Observed With Empagliflozin Use

Incident or worsening nephropathy was observed in 12.7% of patients receiving empagliflozin compared with 18.8% of those receiving placebo.

Midlife PSA Levels Predict Lethal Prostate Cancer

The odds of developing lethal prostate cancer were increased by 6.9 to 12.6 times for men aged 40 to 59 years with higher PSA values.

Novel Hyperkalemia Drugs May Help Optimize Use of RAAS Inhibitors

High potassium levels associated with the use of renin-angiotensin-aldosterone system inhibitors limit their use in CKD patients.

Parathyroidectomy Rates Stable Despite Changes in Medical Therapy

The debate continues on how best to use parathyroidectomy to treat severe SHPT.

Visceral Fat Predicts Prostate Cancer Treatment Outcomes

Greater visceral adipose tissue volume and density are associated with a lower the risk of biochemical recurrence.

Testosterone Replacement Safe for Men With Prostate Cancer

Findings emerge from a study of hypogonadal men who underwent radiation therapy, surgery, or active surveillance for prostate cancer.

Smokers Face Delayed Continence Recovery After Prostate Surgery

Large prostates and bladder neck sparing also predict longer time to return of continence.

Antihypertensive Drug Use in Dialysis Transition May Need Improvement

Only 40% of older patients transitioning to maintenance dialysis were on renin-angiotensin system blockade.

Deceased-Donor Age Affects Kidney Transplant Outcomes

Recipients of kidneys from individuals who donated the organs after cardiac death are more likely to experience graft loss and delayed graft function.

Invasive Penile Cancer Linked to Low Education, Income

Being divorced or having never married also identified as risk factors.

Inherited Mutations Common Among Men With Metastatic Prostate Cancer

Genetic testing results could help guide therapy for advanced prostate cancer.

Rituximab May Have Membranous Nephropathy Treatment Role

Positive effect on remission observed after 6 months in patients with severe membranous nephropathy.

Expectant Management for PCa More Likely at Academic Centers

Odds of using this strategy are 2.7-fold greater vs community facilities.

Erectile Dysfunction Predicts Higher Risk of Osteoporosis

Low testosterone levels may be a contributing factor.

Low Sodium Increases Death Risk in Peritoneal Dialysis

Sodium levels below 140 mEq/L associated with a higher death risk vs levels of 140 to less than 142 mEq/L.

Proton Pump Inhibitor Use Linked to Low Magnesium in Dialysis Patients

Hypomagnesemia in the presence of inflammation is associated with increased 1-year death risk.

Risk Factors for Abscess Formation in Acute Prostatitis Identified

Imaging studies should be considered for men who have long symptom duration and voiding disturbances associated with acute prostatitis, researchers say.

Familial Risk of Aggressive Prostate Cancer Quantified

Swedish researchers say their findings are more useful for counseling men with a family history of prostate cancer.

Restricting Fat May Cut Chronic Kidney Disease Risk

Study implicates higher consumption of advanced glycation end products through dietary fat.

Skeletal-Related Events Predict Higher Mortality in mCRPC

Skeletal-related events occurred in 38% of patients with metastatic castration-resistant prostate cancer.

Fracture Risk Factors in Transplant Patients ID'd

Major fractures included the proximal humerus, forearm, hip, and clinical vertebral fractures.

Sleep Apnea May Increase Risk of Urinary Incontinence

Incidence of UI among men with OSA was 2.3%.

Urinary Incontinence Care Varies by Specialty

The number of urinary incontinence visits has increased from 10.7 million to 13.6 million since 1999.

Selenium May Cut Aggressive Prostate Cancer Risk

An analysis of individual participant data from 15 prospective studies suggests a protective effect.

Serum Creatinine Doubling Ups Cardiovascular Risks in Diabetes Patients

Doubling of serum creatinine occured in 1,262 patients studied.

Hyperkalemia Drug Lowers Aldosterone

Study demonstrates a novel effect of patiromer treatment in hyperkalemic CKD patients

Vesicoureteral Reflux Scans Not Good Alternatives

The presence of VUR is linked to an increased risk of UTI and renal scarring.

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