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Nephrology

News, opinions and meeting coverage in nephrology.

In AKI, Dialysis Works Better With Higher Creatinine

For patients with acute kidney injury, dialysis is associated with better survival among those with higher creatinine levels, but higher mortality for those with lower levels, researchers found.

Early Preeclampsia Often Overlooked

Clinicians wait too long before diagnosing and treating preeclampsia, a hesitance that can be costly, according to an anesthesiologist who serves on a California preeclampsia task force.

CT Appears Safe in Patients With Pacemakers, ICDs

Patients with cardiac rhythm management devices showed no clinically significant major or minor events related to computed tomography imaging over a 10-year period at two large-volume care centers, researchers reported.

ER Briefs: DIY Laptop to AED Kit -- Good Idea?

Inventors aim to resurrect laptops and tablets as AEDs. We asked Clifton Callaway, MD, PhD, an emergency medicine doctor who heads up EM research at the University of Pittsburgh, to weigh in.

Ob/Gyns Uneasy With AHA's Take on Stroke in Pregnancy

NEW ORLEANS -- Recent guidelines from the American Heart Association on the management of stroke risk in pregnant women differ significantly from those issued by the American Congress of Obstetricians and Gynecologists, maternal-fetal medicine specialists said here.

New Guideline Lowers eGFR for Dialysis Start

New Canadian guidelines suggest that nephrologists can wait to start dialysis in some chronic kidney disease patients until their estimated glomerular filtration rate drops below the 10 to 12 mL/min now commonly used.

11 Endocrinology Apps for Docs' Toolboxes

Even if endocrinologists aren't already suggesting smartphone apps to their patients, they've likely been asked to offer up recommendations. Here's a list of 11 apps you should know about.

Diabetes: TAVI Trumps Heart Surgery

Patients with diabetes who had aortic stenosis fared better in terms of mortality and kidney function during the first year if they underwent transcatheter aortic valve implantation (TAVI) rather than surgery, a post-hoc analysis found.

FDA Flags Risk of Nuclear Stress Test Drugs

SILVER SPRING, Md. -- Two agents used in cardiac nuclear stress tests may carry a greater risk of heart attack and death than previously believed, the FDA said Wednesday.

ACE Inhibitors Linked to Severe Allergic Reactions

BALTIMORE -- Antihypertensive treatment with ACE inhibitors may prime oral allergy syndrome patients for severe reactions, a case-report suggested.

Combo Angiotensin Tx Ups Kidney Risks

ATLANTA -- In yet another trial, dual blockade of the renin-angiotensin system (RAAS) didn't slow progression of kidney disease in diabetic patients and carried a higher risk of serious adverse events compared with monotherapy, researchers reported here.

Daytime Snoozing May Tell Risk of Hypoglycemia

Older patients with diabetes who are overly tired during the day may be at a higher risk for hypoglycemia, researchers reported.

In Some Patients Metformin Impairs Thinking

The widely acclaimed diabetes drug metformin was linked with impaired brain function in patients who took the drug, although supplementation with vitamin B12 may alleviate metformin-induced deficiencies, according to new research.

Low BP May Be Fatal in CKD

Chronic kidney disease patients, including those with diabetes, who were not on dialysis were more likely to die when blood pressure was too low, even if only on the diastolic measure, a veterans cohort showed.

FDA Panel Vetoes New Tolvaptan Indication

SILVER SPRING, Md. -- An FDA advisory committee has declined to endorse an expanded indication for tolvaptan (Samsca) to treat autosomal dominant polycystic kidney disease.

Wyeth Settles Rapamune Marketing Charge

WASHINGTON, D.C. -- Pfizer's Wyeth Pharmaceuticals unit will pay $490.9 million to resolve state and federal allegations that it marketed rapamycin (sirolimus, Rapamune) for unapproved indications.

Nephritis May Raise Death Risk in Lupus

The presence of renal involvement in patients with lupus was associated with a significantly increased mortality risk, a longitudinal Chinese study found.

FDA Adds GI Warning to Benicar Label

WASHINGTON -- The FDA ordered the maker of the blood pressure drug olmesartan (Benicar) to add a warning about risk of the intestinal condition known as sprue-like enteropathy to the drug's label.

Xarelto Gets a No for Stent Thrombosis

SILVER SPRING, Md. -- The FDA has rejected an application for a new indication allowing rivaroxaban (Xarelto) to be used to reduce the risk of stent thrombosis in patients with acute coronary syndrome.

Honey, Cola May Disrupt Heart

A detailed history of patients with arrhythmia or syncope might need to include their cola intake or the origin of the honey they consume, two case studies suggest.

Society Seconds Call for Incretin Data

SAN FRANCISCO -- The Endocrine Society has joined its voice to the recent call for incretin drugmakers to release all patient-level data on their products, the group announced at its annual meeting.

Diabetes Experts Divided About 'Lone Wolf' Butler

Top experts in diabetes and endocrinology have offered mixed reactions to a profile of Peter Butler, MD, chair of endocrinology at the University of California Los Angeles, in the New York Times.

Hypothyroidism Hikes Death Risk in Blacks

African Americans with hypothyroidism face an increased risk of death, and in patients with congestive heart failure, even mild underactive thyroid disease raises mortality risk, a retrospective cohort study found.

High-Salt Diet May Boost Cortisol

Eating a diet high in sodium increased levels of cortisol and other metabolites, potentially giving rise to metabolic syndrome, researchers found.

Is Protein the Key to Fountain of Youth?

The cardiac clocks of aging mice were turned back to a more youthful time when they received a protein taken from the blood of younger mice, researchers found.

Finger Stick Has Promise as Prediabetes Test

PHOENIX -- Measuring capillary blood via finger stick assay was as accurate as venous blood sample assays in predicting 5-year likelihood of diabetes, researchers reported here.

How Much Exercise to Burn Off a Burger?

Menus displaying the amount of exercise required to burn off calories in a meal had some impact on food choice, researchers found.

Migraine Drug May Set Stage for Kidney Stones

ORLANDO - Patients who take topiramate (Topamax) therapy for treatment of migraine appear to deplete citrate in the urine, creating an environment for kidney stones, researchers reported here.

C. Diff Dangerous in ESRD

ORLANDO -- Kidney dialysis patients who are infected with Clostridium difficile have a greater risk of infection relapse and also have a higher all-cause mortality that patients who do not have kidney disease, researchers said here.

ACC: Is Chelation Plus Vitamins a Winning Combo?

SAN FRANCISCO -- Vitamins alone won't improve outcomes for patients who've had a heart attack, but they do appear to have additive benefits when given in conjunction with controversial chelation therapy, researchers reported here.

Fatal Reactions Prompt Omontys Recall

All lots of the new anemia drug peginesatide (Omontys) have been recalled because of severe hypersensitivity reactions -- some fatal -- observed after the drug was approved last March.

ACE Inhibitors Linked to Hallucinations in Elderly

Elderly patients with memory problems who suddenly have visual hallucinations may need to stop taking ACE inhibitors, researchers suggested.

Judge OKs $762 Million Deal in Aranesp Case

A federal judge approved a $762 million settlement Wednesday in a case involving Amgen's off-label promotion of darbepoetin alfa (Aranesp), an anemia drug.

Amgen Agrees to Pay $762 Million in Aranesp Case

The biotech drug giant Amgen pled guilty Monday to promoting its blockbuster anemia drug darbepoetin alfa (Aranesp) for off-label dosing regimens, agreeing to pay $762 million in fines.

Novel Drug Stars in Phase III PAH Trial

ATLANTA -- Macitentan, a next-generation endothelin receptor antagonist for pulmonary arterial hypertension, met its efficacy endpoint and was said to be well tolerated in a large clinical trial.

BP Drug Linked to Severe Diarrheal Illness

LAS VEGAS -- A patient's insightful question led to the identification of almost two dozen cases of severe enteropathy associated with use of blood pressure medication, investigators reported here.

Cardio Notes: Sex Improves with Stenting

Opening the arteries of those with stable coronary disease also opens the door to an improved sex life. Also this week, bariatric surgery helps remodel the heart.

Watchdog Group Wants Black Box on BP Meds

WASHINGTON -- The consumer watchdog group Public Citizen petitioned the FDA to add a black box warning to three classes of hypertension drugs, cautioning against their combined use.

Cranberry Juice May Help Lower BP a Bit

Cranberry juice modestly lowers blood pressure in healthy adults when consumed daily, a carefully controlled trial showed.

Anemia a Risk with Low-Dose IVIG, Too

Even small doses of intravenous immune globulin (IVIG) can cause acute, severe anemia, researchers warned.

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