March 2011 Briefing - Nephrology

Here are what the editors at HealthDay consider to be the most important developments in Nephrology for March 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Changes Seen in Incidence of ESRD From Lupus Nephritis

WEDNESDAY, March 30 (HealthDay News) -- For children with lupus nephritis (LN)-associated end-stage renal disease (ESRD), disparities in treatment and mortality exist by several demographic characteristics; also, incidence rates have increased in younger patients and in African-Americans since 1995, according to two articles published online March 28 in Arthritis & Rheumatism.

Abstract - Hiraki
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Online Health Records Less Used by Minorities, Poor

WEDNESDAY, March 30 (HealthDay News) -- Online personal health records (PHRs) are less frequently used by racial or ethnic minorities and patients with low annual income, according to a study published in the March 28 issue of the Archives of Internal Medicine.

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High Number of 'Medalists' Free From Diabetes Complications

WEDNESDAY, March 30 (HealthDay News) -- The relatively high proportion of patients with type 1 diabetes for 50 years or more without complications indicates the presence of protective factors, according to a study published in the April issue of Diabetes Care.

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Insulin Delivery System Recalled by Roche

TUESDAY, March 29 (HealthDay News) -- ACCU-CHEK FlexLink Plus infusion sets are being recalled by their manufacturer, Roche, because the tube used for inserting the set may become kinked or bent, which could result in the under-delivery or no delivery of insulin, the U.S. Food and Drug Administration has announced.

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Decline Seen in Global Youth Mortality Over Last 50 Years

TUESDAY, March 29 (HealthDay News) -- Overall mortality declined substantially between 1955 and 2004 in children aged 14 years or younger and in females aged 15 to 24, but a smaller decline was evident for males aged 15 to 24 years, according to a study published online March 29 in The Lancet.

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Reduced Hours for Trainees Has Had Little Effect in U.S.

THURSDAY, March 24 (HealthDay News) -- Reducing work hours for doctors in training to less than 80 per week has had little impact on patient outcomes or postgraduate training in the United States, according to a literature review published online March 22 in BMJ.

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Combination Therapy Given to Elderly Without Indications

MONDAY, March 21 (HealthDay News) -- Combination therapy of angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers is often prescribed without established indications, and is associated with an elevated risk of adverse renal outcomes compared to monotherapy, according to a study published online March 21 in CMAJ, the journal of the Canadian Medical Association.

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Daily Hemodialysis Helps Restless Legs Syndrome

FRIDAY, March 18 (HealthDay News) -- The prevalence and severity of restless legs syndrome (RLS) and sleep disturbances decline with the initiation of short daily hemodialysis (SDHD) at home, according to a study published online March 17 in the Clinical Journal of the American Society of Nephrology.

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CDC: HIV Transmitted Through Living Kidney Donation

THURSDAY, March 17 (HealthDay News) -- Despite HIV screening of the donor, using serologic testing, HIV was transmitted from a living kidney donor to the transplant recipient recently in New York City, according to a report in the March 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Professional Values of U.S. and U.K. Doctors Examined

THURSDAY, March 17 (HealthDay News) -- A core of professional values exists among doctors in the United States and the United Kingdom, though significant differences exist in how these values are expressed and prioritized, according to a study published online March 7 in BMJ Quality & Safety.

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Short Nurse Staffing Linked to Higher Patient Mortality

WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.

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U.S. Death Rate Reaches All-Time Low

WEDNESDAY, March 16 (HealthDay News) -- The age-adjusted death rate for the United States has fallen for 10 straight years and has reached an all-time low of 741 per 100,000, or 2,436,682 deaths, in 2009, down 2.3 percent from 2008, according to a new report issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Regional Variation in Chronic Disease Case Fatality Rates

TUESDAY, March 15 (HealthDay News) -- There is an inverse relationship between the regional frequency of diagnoses for chronic conditions and the case-fatality rate among fee-for-service Medicare beneficiaries, according to a study published in the March 16 issue of the Journal of the American Medical Association.

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High Phosphorus Level Tied to Kidney Disease Mortality

TUESDAY, March 15 (HealthDay News) -- In patients with chronic kidney disease, evidence suggests that there is an association between higher serum levels of phosphorus and mortality, but there is a lack of strong and consistent evidence associating serum calcium and parathyroid hormone levels with risk of death or cardiovascular events, according to a meta-analysis published in the March 16 issue of the Journal of the American Medical Association.

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U.S. Has Higher Rates of Chronic Disease Than England

MONDAY, March 14 (HealthDay News) -- Americans experience higher rates of chronic disease and markers of disease than their English counterparts at all ages, according to a study published online March 9 in the American Journal of Epidemiology.

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Depression Linked to Adverse Renal Disease Outcomes

FRIDAY, March 11 (HealthDay News) -- Symptoms of depression are associated with subsequent adverse outcomes in patients with renal disease, according to a study published online March 10 in the Clinical Journal of the American Society of Nephrology.

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Non-Infectious Problems Lower Dialysis Catheter Survival

THURSDAY, March 10 (HealthDay News) -- The failure of peritoneal dialysis (PD) catheters is associated with catheter-related non-infectious problems, and other risk factors need not hinder the selection of patients for PD catheter initiation, according to a study published in the October-December 2010 issue of The Journal of Vascular Access.

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Number of Cancer Survivors in U.S. Reaches 11.7 Million

THURSDAY, March 10 (HealthDay News) -- The number of cancer survivors in the United States had increased to nearly 12 million by 2007, according to a report in the March 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Laparoscopic Hernia Repair Safe in Transplant Patients

THURSDAY, March 10 (HealthDay News) -- Laparoscopic incisional hernia repair (LIHR) appears to be a reasonable alternative to open surgery in kidney and/or pancreas transplant patients, as it is in nontransplant patients, according to research published in the February issue of the American Journal of Transplantation.

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HealthGrades Finds Rates of Patient Safety Events Vary

WEDNESDAY, March 9 (HealthDay News) -- Patients treated at hospitals rated with a HealthGrades Patient Safety Excellence Award have, on average, a 46 percent lower risk of experiencing a patient safety incident compared to those treated at the lowest-ranked hospitals, according to the eighth annual HealthGrades Patient Safety in American Hospitals Study published online March 9.

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Ethnic Differences Seen in Academic Measures for U.K. Docs

WEDNESDAY, March 9 (HealthDay News) -- United Kingdom-trained physicians and medical students with ethnic minority backgrounds tend to underperform academically compared to their white peers, according to a meta-analysis published online March 8 in BMJ.

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Cyclophosphamide Treatment Tied to Urinary Tract Cancer

WEDNESDAY, March 9 (HealthDay News) -- Patients with systemic necrotizing vasculitides (SNV) treated with cyclophosphamide (CYC) have a five-fold higher risk of developing urinary tract cancer (UTC), according to a study published online Feb. 17 in Arthritis & Rheumatism.

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Pharmacological Meta-Analyses Rarely Report Disclosures

TUESDAY, March 8 (HealthDay News) -- Meta-analyses of pharmacological treatments rarely include information addressing primary study funding and conflicts of interest (COIs) of the authors for the included randomized control trials (RCTs), according to a study published in the March 9 issue of the Journal of the American Medical Association.

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Diabetes Belt Identified in Southern United States

TUESDAY, March 8 (HealthDay News) -- A geographically congruent "diabetes belt" with high prevalence of diabetes exists in the United States, according to a study published online March 8 in the American Journal of Preventive Medicine.

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FDA: Adverse Events Tied to Kaletra in Preterm Infants

TUESDAY, March 8 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care providers of a revision to the label of lopinavir/ritonavir (Kaletra) oral solution to include a new warning, as administration of the oral solution may result in serious health problems among premature babies.

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Enough Transplant Surgeons Likely Being Trained

FRIDAY, March 4 (HealthDay News) -- Sufficient numbers of fellows, some say more than enough, are being trained to meet the foreseeable demand for abdominal organ transplant surgeons, according to research published in the February issue of the American Journal of Transplantation.

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Physical Activity Tied to Mortality in Kidney Recipients

FRIDAY, March 4 (HealthDay News) -- Low physical activity (PA) in renal transplant recipients (RTRs) is independently associated with increased risk for cardiovascular and all-cause mortality, according to a study published online March 3 in the Clinical Journal of the American Society of Nephrology.

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Racial Disparity in Deceased Donor Kidney Transplant Rate

FRIDAY, March 4 (HealthDay News) -- There are discrepancies in the waiting times and rates of deceased donor kidney transplantation for whites and ethnic racial minorities in the United States, according to a study published online March 3 in the Journal of the American Society of Nephrology.

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Type of Health Care-Associated Infections Is Falling

TUESDAY, March 1 (HealthDay News) -- The incidence of central line-associated blood stream infections (CLABSIs) in intensive care units (ICUs) has decreased by more than half since 2001, but the infections continue to occur in substantial numbers in inpatient wards and outpatient hemodialysis centers, according to research published in the March 1 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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