key Try Dr. Mendelssohn's poll: INITIAL CHOICE OF ESRD THERAPY. This poll, which has no right or wrong answers, is meant to query renal health providers about their approach to patients approaching dialysis, especially in terms of which potential options for therapy are presented to such patients.
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Muntner  

Fried  

  Renal Disease and the Metabolic Syndrome Flash slide/audio
 (ASN Clinical Nephrology Conference, November, 2007)
Muntner: How is metabolic syndrome defined and how do definitions vary among various organizations? What is its prevalence? How do individual components of metabolic syndrome associate with progression of CKD? What are the treatment options?
Fried: What is the evidence that statins reduce cardiovascular disease endpoints in CKD? What did the 4D study show and how cane these negative results in stage 5D patients be explained? Is there an increased risk of stroke with statins in stage 5D patients? In other patients? What is the effect of statins on progression of CKD? What are the possible mechanisms? Which types of CKD patients might be expected to get the most benefit from statins? Is there an increased risk of tubular proteinuria?
(more...)


Foley  

Sica  

Pathogenesis and Management of Cardiovascular Disease (CVD) in Chronic Kidney Disease
Robert N. Foley, MD, and Domenic A. Sica, MD. (ASN Renal Week, 2006). Foley: How are classic and novel risk factors related to outcome in CKD patients as well as in dialysis patients? What can we learn from Framingham data? From NHANES? Which of the classical risk factors works in the opposite direction when GFR is low? To what extent have patients with mild-moderate CKD been excluded from the major cardiovascular trials? What can we learn from analysis of these subsets? How do the observational data differ from randomized, controlled trials?
Sica: How are the pathogenses of CKD and CVD (cardiovascular disease) related? Where do both impact the RAS (renin-angiotensin system)? How does ACE inhibition affect different parts of the cardiovascular system? What conclusions can we draw from AASK? How can we rationally choose drugs from different classes to treat hypertension? How should different calcium-blockers and ACE inhibitors be used in CKD? How do ACE inhibitors and ARBs compare? (ASN Renal Week Official Symposium, 2006).
(more...)



Haley

Implementation of the RPA CKD Toolkit and its Potential Impact on P4R and P4P
(RPA 2006, General Session 1)
What lessons did we learn from the Advanced CKD Guideline Implementation Project? Unlike ESRD, resources for CKD are not optimally distributed. Substantial numbers of pre-ESRD patients are managed by PCPs, and management does not conform to guidelines. (more...)

Updated: November 26, 2008 (N26)
N26 Vitamin K deficiency linked to insulin resistance in older men
N21 Do your CKD patients still smoke? Who is still smoking in the US by state.
N19 New GFR estimating equation first presented at Renal Week in the news.
N18 NY Times article highlights growing burden of CKD.
N17 Canadians issue new guidelines for CKD management
N07 MDRD equation to estimate GFR is out, new CKD-EPI equation is in and is more accurate.
O27 Costs of treating diabetes has nearly doubled in past 7 years.
O27 Pentoxifylline lowers proteinuria alone or in addition to an ACE inhibitor.
O17 EPA toughens standard on lead emissions by 90%.
O08 USRDS Annual Data report breaks out a separate section dealing with earlier stage CKD.
O06 One-dollar-a-month polypill containing ASA, thiazide, ACEI, and statin to undergo clinical testing.
S25 Tea found to contain relatively high fluoride levels (fluoride of potential concern in CKD patients)
S18 JASN paper in press identifies uric acid as a risk factor for CKD.
A21 NKF launches education toolkit targeting treatment of patients with HIV and CKD.
A19 Low-level arsenic exposure linked to increased type 2 diabetes risk.
Industry Advances Emphasis
archive
Secondary Hypertension, including Chronic Kidney Disease ASN Board Review 2006
Pathogenesis and Management of Cardiovascular Disease (CVD) in Chronic Kidney Disease ASN Renal Week 2006
Emerging New Agents in Diabetic Kidney Disease (Lewis) ASN 2005 Renal Week
CKD Management: What Can We Learn from South African and Australasian Efforts? (Katz) RRI 2006, Part 3 (handouts)
Implementation of the RPA CKD Toolkit and its Potential Impact on P4R and P4P (Haley) RPA 2006, General Session 1
CKD Outcomes (Somermeyer) RPA 2006, General Session 4
Anemia Management in CKD: Improving Iron Management (Reed, Copeland) ANNA 2006
Medical Crossfire: An Expert Panel Debates Key Clinical Issues in Mineral Metabolism and Mortality in CKD (Coyne, Moe, Martin) ASN Renal Week 2005
The Pathophysiology of Progressive Renal Disease and Hypertension: Importance of Gender and Ethnicity (August, Maric, Thomas, Lewis) ASN Renal Week 2005 (audiofiles)
Evidence for a New Treatment Paradigm in the Management of Secondary Hyperparathyroidism in CKD Stages 3 and 4 (Andress, Coyne) ASN Renal Week 2005 (audiofiles)
Redefining Outcomes in CKD (London, Block) ASN Renal Week 2005 (audiofiles)
Developing Therapeutics for Progressive Renal Disease (Martin, Mauer, Klein, Throckmorton, Hostetter, Kopp) ASN Renal Week 2005 (audiofiles)
RPA’s Advanced CKD Patient Management Tool Kit: How to improve care (Goldman) RPA 2005
Information Systems to Monitor CKD Patient Management (Fadem) RPA 2005
Complications of Anemia and the CKD Patient (Petroff) ANNA 2005
Caring Through the End: Palliative Care Along the Continuum of CKD. (Various) MARC 2004

Balkan Nephropathy: Evolution of Our Knowledge (Bamias and Boletis) Am J Kidney Dis (Sep 2008)
Routine reporting of estimated glomerular filtration rate: not ready for prime time (Glassock and Winearls) Nature Clin Pract Nephrol (Aug 2008)
Formula-Based Estimates of the GFR: Equations Variable and Uncertain (Delanaye and Cohen) Nephron-Clin-Practice (Jul 2008)
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Dyslipidemia in CKD: An approach to pathogenesis and treatment. (Tsimihodimos) (Am J Nephrol Jul 2008)
Treating elderly people with diabetes and stages 3 and 4 chronic kidney disease CJASN (Jul 2008)
Role of remission clinics in the longitudinal treatment of CKD J Am Soc Nephrol (Jun 2008)
Adynamic bone in patients with chronic kidney disease Kidney Int (Jun 2008)
Lipid abnormalities and cardiovascular risk in renal disease J Am Soc Nephrol (Jun 2008)
Urinalysis: core curriculum 2008 Am J Kidney Dis (Jun 2008)
Should patients with venous thromboembolism be screened for thrombophilia? Am J Med (Jun 2008)
Staging of chronic kidney disease: time for a course correction J Am Soc Nephrol (May 2008)
Efficacy and safety of fondaparinux and enoxaparin for acute coronary syndromes in CKD Am J Kidney Dis (May 2008)
Atherosclerotic renal artery stenosis: overtreated but underrated? J Am Soc Nephrol (Apr 2008)
Targeting proteinuria as a valid surrogate for individualized kidney protective therapy Am J Kidney Dis (May 2008)
Nephrogenic systemic fibrosis: early recognition and treatment Semin Dial (Apr 2008)
The utility of the transtubular potassium gradient in the evaluation of hyperkalemia J Am Soc Nephrol (Mar 2008)
The Janus faces of allopurinol -- allopurinol hypersensitivity syndrome Am J Med (Mar 2008)
Systematic Review: Randomized, controlled trials of nonsurgical treatments for urinary incontinence in women Ann Intern Med (Mar 2008)
Supratherapeutic doses of angiotensin receptor blockers to decrease proteinuria in patients with chronic kidney disease Am J Nephrol (Mar 2008)
National Institutes of Health State-of-the-Science Conference Statement: Prevention of fecal and urinary incontinence in adults Ann Intern Med (Mar 2008)
Protein restriction and body composition in renal disease J Ren Nutr (Mar 2008)
Rationale for combination angiotensin receptor blocker and angiotensin-converting enzyme inhibitor treatment and end-organ protection in patients with chronic kidney disease Am J Nephrol (Mar 2008)
Association between obesity and kidney disease: A systematic review and meta-analysis Kidney Int (Jan 2008)
Dermatological disease in patients with CKD Am J Kidney Dis (Feb 2008)
Renal and cardiac effects of antihypertensive treatment with ramipril vs metoprolol in autosomal dominant polycystic kidney disease Nephrol Dial Transplant (Feb 2008)
The impact of population-based identification of chronic kidney disease using estimated glomerular filtration rate (eGFR) reporting Nephrol Dial Transplant (Feb 2008)
Mechanisms of vascular calcification in chronic kidney disease J Am Soc Nephrol (Feb 2008)
Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study Brit Med J (Feb 2008)
Low birth weight is associated with chronic kidney disease only in men Kidney Int (Feb 2008)
Primary care-based disease management of chronic kidney disease (CKD), based on estimated glomerular filtration rate (eGFR) reporting, improves patient outcomes Nephrol Dial Transplant (Feb 2008)
Beta-blockade in chronic dialysis patients Semin Dial (Feb 2008)
Poor correlation between coronary artery calcification and obstructive coronary artery disease in an end-stage renal disease patient Hemodial Int (Jan 2008)
Meta-analysis: Effect of monotherapy and combination therapy with inhibitors of the renin-angiotensin system on proteinuria in renal disease Ann Intern Med (Jan 2008)
Outcomes in patients with chronic kidney disease referred late to nephrologists: a meta-analysis (Chan et al) Am J Med (Dec 2007)
Treatment of microalbuminuria in hypertensive subjects with elevated cardiovascular risk: Results of the IMPROVE trial (Bakris et al) Kidney Int (Oct 2007)
Twenty years of PSA: From prostate antigen to tumor marker (De Angelis et al) Rev Urol (Sep 2007)
Association of antihypertensive therapy and diastolic hypotension in chronic kidney disease (Peralta et al) Hypertens (Sep 2007)
Antibiotic treatment for pyelonephritis in children: multicentre randomised controlled non-inferiority trial (Montini et al) Brit Med J (Aug 2007)
The role of magnesium binders in chronic kidney disease (Spiegel) Semin Dial (Aug 2007)
Methodology of screening for albuminuria (Gansevoort et al) Nephrol Dial Transplant (Aug 2007)
Gadolinium-induced nephrogenic systemic fibrosis in patients with kidney disease (Perazella et al) Am J Med (Jul 2007)
Early Start Peritoneal Dialysis Adv Chronic Kidney Dis (Jul 07)
Intensive versus moderate blood-pressure control in normotensive patients with type 2 diabetes (Briggs J) NCPN Jun 07
Kidney disease, Framingham risk scores, and cardiac and mortality outcomes (Weiner et al) Am J Med (Jun 2007)
Gadolinium use in patients with kidney disease: A cause for concern (Perazella et al) Semin Dial (Jun 2007)
Proteinuria as a therapeutic target in patients with chronic kidney disease (Palmer) Am J Nephrol (May 2007)
Autosomal dominant polycystic kidney disease: time for a change? (Chapman) J Am Soc Nephrol (May 2007)
The ESRD uninsured matter (Williams) Adv CKD (02-2007)
KDOQI Clinical Practice Guidelines and CPRs (2006 update) for Treatment of Diabetes and CKD AJKD (Feb 07)
Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: Results of the study to evaluate early kidney disease. (A. Levin et al) Kidney Int 01-07
Core Curriculum: Chronic Kidney Disease (Lederer, Ouseph) Am-J-Kidney-Dis 01-2007
Aldosterone and Cardiovascular Disease. Smoke and Fire (Calhoun). Circulation 12-06
Obesity: Growing Impact on CKD (McGill, Furth, Kaskel) Adv Chronic Kidney Dis 10-06
Management of dyslipidemias in patients with diabetes and chronic kidney disease (Molitch). CJASN 09-06
K/DOQI CKD GUIDELINES
When to initiate dialysis (1-2) CKD-Diabetes, 2006
GFR CALCULATORS
MDRD GFR per 1.73 M2
HDCN Topic Pages (KEY)
Pre-ESRD care
Dialysis outcomes
Quality Assurance
Progression of CKD
Etiology of CKD
OTHER GUIDELINES
Healthy People 2010 CKD
VA Guidelines
Canadian: Elevated Scr
NIDDK CKD Info
STILL MORE LINKS
U.S. NKF

David Mendelssohn, M.D.
Head, Division of Nephrology; Medical Director of Dialysis, Humber River Regional Hospital; Associate Professor of Medicine University of Toronto, CANADA.