In this large cohort of patients with acute kidney injury, proteinuria predicted the risk of injury as well as did GFR. Risk increased with increasing levels of proteinuria, and the highest risk were patients with both proteinuria and low GFR. Currently GFR is used to predict risk of acute kidney injury (and therefore to avoid nephrotoxins such as NSAIDs or IV contrast), but this suggests that proteinuria may need to be evaluated as well (abstract)
Synthetic marijuana, or “spice” has been linked to at least 16 cases of acute renal failure, according to the CDC. Unexplained renal failure in young otherwise healthy patients should prompt questioning about synthetic marijuana use (CDC site).
In this case-control study, patients on ACE/ARBs were significantly more likely than those not on ACE/ARBs to experience contrast-induced acute kidney injury (odds ratio 1.4, CI 1.1 to 1.8). However, this does not prove causality, and it is not clear that discontinuing ACE/ARBs before a contrast load would prevent the kidney injury (abstract).
In this large administrative database analysis of patients with non-valvular afib, patients with ESRD were significantly more likely to suffer stroke, system thromboembolism, and bleeding than those without ESRD; the risk of stroke/embolism was significantly lower for those on warfarin but not those on ASA, while the risk of bleeding was higher with both ASA […]