This meta-analysis found vasopressin receptor antagonists are effective at raising serum sodium levels in patients with euvolemic and hypervolemic hyponatremia. Normalization of serum sodium occurred significantly earlier with these agents than without, and were more effective in euvolemic than hypervolemic patients. There was also no increase risk of adverse events or hypernatremia, and no reported demyelination syndromes. Although these agents seem to be still finding their role in clinical medicine, they do appear to be safe and moderately effective based on this meta-analysis (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 […]