Quick Take: Intravenous Iron in Patients Undergoing Maintenance Hemodialysis

Patients undergoing hemodialysis typically receive intravenous iron, despite a lack of established clinical efficacy. In this randomized controlled trial, investigators randomized 2141 patients undergoing hemodialysis to either high-dose iron sucrose, administrated proactively, or low-dose iron-sucrose, administered reactively to compare the safety and efficacy of these regimens in patients undergoing hemodialysis. The primary outcome examined was []

Angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use linked with decreased mortality after inpatient acute kidney injury.

1. In this retrospective cohort study looking at patients admitted to hospital with acute kidney injury, use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker within six months was associated with decreased mortality. 2. Angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use was also associated with increased risk of hospitalization for a renal cause (hyperkalemia, []

Intensive blood pressure lowering favored to not induce kidney disease, contrary to prior research

1. Patients managed with intensive blood pressure reduction were found to have significantly greater decreases in kidney damage biomarkers compared to standard blood pressure management. 2. Higher levels of kidney damage biomarkers at baseline were associated with greater odds of developing chronic kidney disease. Evidence Rating Level: 2 (Good) Study Rundown: Systolic blood pressure (SBP) []

Early and delayed renal-replacement therapy for septic shock associated acute kidney injury show similar mortality: the IDEAL-ICU trial

1. Among patients with septic shock and acute kidney injury (AKI), there was no significant difference in 90-day mortality between early (within 12 hours) and delayed (after 48 hours) initiation of renal-replacement therapy (RRT). 2. Patients in the delayed group had significantly more days free from RRT, with no significant differences compared to the early []

Lower patient satisfaction reported at for-profit dialysis centers

1. Patient reported experience has recently been incorporated into Quality Incentive Programs for dialysis centers across the United States. Lower patient experience scores were reported in for-profit, free-standing, and large dialysis organization centers. 2. Centers with higher proportion of black and Native American patients had lower patient reported experience scores. Evidence Rating Level: 3 (Average)       []

Nonsurgical treatment of small tumor renal cancer may be as effective as radical nephrectomy but with fewer complications

1. Rates of renal insufficiency were highest in patients receiving renal nephrectomy, compared to less invasive treatments. 2. Survival rates for renal nephrectomy and partial nephrectomy were very similar, suggesting little difference in efficacy between these treatments. Evidence Rating Level: 2 (Good) Study Rundown: Renal stage carcinoma (RCC) has relatively low mortality rates with respect []

Extreme preterm birth linked to hypertension at school age

1. Within a cohort of infants born extremely preterm (EPT), there were elevated rates of high systolic blood pressure (SBP≥90%ile) and hypertension (SBP≥95%ile) when these children reached school age. 2. School age children with high SBP who were born EPT, were significantly more likely to have been born to mothers with gestational diabetes, and as []

Using HCV-infected kidneys greatly reduces wait time for transplantation and improves survival for patients with HCV

1. Use of HCV-infected kidneys increased patients' quality-adjusted life expectancy. 2. Lower costs were associated with HCV-infected kidneys compared to transplanting HCV-uninfected kidneys to HCV-positive patients. Evidence Rating Level: 2 (Good) Study Rundown: Organ availability for transplantation is limited; therefore, for patients with end stage renal disease (ESRD), hemodialysis is often the final treatment compared []

Restricting perioperative fluid for abdominal surgery patients does not reduce complications: The RELIEF trial

1. Among patients at increased risk for complications undergoing abdominal surgery, those randomized to perioperative fluid restriction did not have increased disability-free survival at one year compared to patients who received liberal perioperative fluid management. 2. Patients managed with fluid restriction experienced higher rates of acute kidney injury. Evidence Rating Level: 1 (Excellent) Study Rundown: []

Improved calculations suggest major changes to statin, aspirin, and blood pressure medication prescribing

1. Updated risk calculations suggest that fewer people should be classified within the high-risk category for CVD. 2. Many Americans, especially those of African American descent, may require reduction and alteration to their statin, aspirin, and/or blood pressure medication. Evidence Rating Level: 2 (Good) Study Rundown: Cardiovascular disease (CVD) affects many people worldwide. Treatment for []

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