May 2013 Issue of Renal And Urology News

May 2013 Issue of Renal And Urology News

May 2013

Cover Articles

Focal Therapy for Prostate Cancer Advances

Modalities under investigation include laser ablation, hemiablative seed implantation, and results are promising.

Pre-Transplant Cancers Might Be Overlooked

In a study, 44% of neoplasias detected within a year of transplantation may have been present prior to surgery.

Predictor of Contrast-Induced Nephropathy Identified

Contrast volume:eGFR ratio may be useful in calculating the maximum amount of contrast to give.

Commentary

Hemoglobin Levels Fall, Transfusions On the Rise

Two studies presented at the recent NKF Spring Clinical Meetings provide more evidence of a trend toward decreasing use of ESAs and decreasing hemoglobin levels.

Expert Q&A

New Center for All-Around Prostate Cancer Treatment: Interview with Ashutosh Tewari, MB

Ringing in the new year was especially exciting this time around for Ashutosh K. Tewari, MB, BS, head of the new Center for Prostate Cancer ...

Men's Health Update

Prostate Cancer Mortality Higher Among Unmarried Men

Study finds a 40% increased death risk from the malignancy in unmarried versus married men.

Obesity Found to Increase BPH Risk

BPH has long been thought to be an inevitable function of genetic predisposition and age related changes in sex steroid hormones.

NFL's New Rule to Prevent Concussions

The NFL has taken a new interest in the safety of its players.

Video Game Urinals Help Boost Prostate Knowledge

New urinals were designed to bring attention to prostate health and prostate cancer.

Vitamin D Deficiency, Daytime Fatigue Linked

Men who doze off during the day may benefit from salmon, eggs, or a bit more time in the sun, all of which increase vitamin ...

High Fat Diet May Lower Sperm Count

Little is known regarding dietary habits and male reproduction.

Feature

Medical and Surgical Management of Bladder Outlet Obstruction

Treatment of LUTS secondary to BPH has evolved from surgical therapy to medical monotherapy, and now combination therapy.

Legal Issues

Nephrologist Serves as Expert Witness against Urologist

Over the past several years, Dr. N occasionally had been asked to serve as an expert in medical malpractice cases.

Malpractice News

Flaws in Patient Privacy, Data Security Must be Addressed

Medical identity theft and data security breaches are growing and that thousands of cases are reported per year.

N.Y. Statute of Limitations Archaic, Deprives Patients

The state's statute of limitations begins to run from the date of the malpractice, not the date of the discovery of the malpractice.

Medical Malpractice Mediation Bill Passes in Oregon

The legislation is expected to reduce lengthy, expensive lawsuits.

Renal Nutrition Update

Ghrelin Offers Good Outcome Measures in CKD

Ghrelin is metabolized by the kidney; thus serum levels are elevated in chronic kidney disease populations.

Practice Management

How to Combat Burnout

Doctors have to figure out how to work smarter, not harder.

General News

Beta-Blockers May Lower PCa Mortality in High-Risk Patients

Use of the medications was associated with a 21% decreased risk of death from prostate cancer.

Left Atrial Enlargement Linked to High Plasma Sodium in CKD

New study is the first to demonstrate this relationship.

Robotic Prostatectomy Suitable for Large Prostates

The procedure is safe and can result in good oncologic and function outcomes

Gout Discovered in 30% of Patients with Severe CKD

Gout prevalence is higher among patients with lower average estimated glomerular filtration rates or higher levels of albuminuria

Hematuria May Occur Years After Brachytherapy

Men with larger prostates are at higher risk for blood in urine.

Small Renal Cancers Can Recur Even 10 Years Post-Op

Microvascular invasion identified as risk factor for cancer-specific death.

Scoring System Rates Kidney Transplant Program Quality

A quality index that uses a simple formula allows comparisons of different transplant centers.

PSA Screening Lowers Prostate Cancer Death Risk

The survival benefit is limited to men aged 55-69 years at initial screening, large European study finds.

Risk Factors for Bladder Tumor Recurrence Identified

In patients with muscle-invasive bladder cancer, those with bladder neck or multiple tumors are more likely to experience recurrent intravesical tumors.

More Biopsy Cores Do Not Improve Prostate Cancer Detection

Increasing the number of prostate biopsy cores from 12 to 20 did not increase the likelihood or severity of complication.

Prostatic Arterial Embolization Safe, Effective for BPH

The procedure may be particularly useful in treatment men with prostates larger than 100 cc.

Kidney Stone Emergency Department Visits On the Rise

The trend is due mostly to an increasing incidence of visits by women.

Study Supports RP Use for High-Risk Prostate Cancer

Biochemical recurrence-free and metastasis-free survival can be achieved.

High BMI, Visceral Obesity May Benefit Kidney Cancer Patients

For patients with metastatic disease receiving systemic treatment, a high BMI was found to improve overall survival.

Hypertension Frequency Varies Widely Among Asian-American Subgroups

Filipinos had the highest rates, followed by Japanese, study found.

Metastases to the Kidney May Be Mistaken for Primary Tumors

Communication between the urologist and pathologist is key to arriving at the correct diagnosis, researcher says.

Hip Fracture Rates Have Increased Among the Elderly

Rates in 2009 were 25% higher than in 1996, study finds.

Racial Differences in Mineral Metabolism Identified

Researchers have confirmed findings showing that racial differences in markers of mineral metabolism in patients with CKD.

Pregnancy Outcomes Worse As CKD Progresses

Researchers observe an increased incidence of pre-term delivery and infants who are small for gestational age.

Intradialytic High Protein Meals May Correct Low Albumin

Combined with use of a binder, this approach raised serum albumin while maintaining target phosphorus levels.

Abnormal BP Raises Delayed Graft Function Risk

Study implicates low diastolic and high systolic pressure immediately after kidney transplantation.

Transfusions On the Rise in Dialysis Patients

The trend is most pronounced among Medicare recipients since the debut of bundling, ESA labeling changes.

Study Backs Shared Medical Appointments for Kidney Stone Patients

Appointment wait time decreased and number of patients seen per month increased.

Transfusions May Worsen Bladder Cancer Outcomes

Patients undergoing radical cystectomy for bladder cancer may be at increased risk for worse outcomes if they receive a PBT.

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