In this large trial of patients with end stage kidney disease, patients were randomized to initiation of dialysis at a GFR of 10-14 or GFR of 5-7. Mean time to dialysis initiation was 1.8 months versus 7.4 months, but there was no difference between the groups (after a median of 3.6 years) in death or adverse events (including complications of dialysis). Dialysis initiation can be delayed until the development of symptoms (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 […]