In this small RCT of patients with impaired creatinine clearance (gfr<80) and renal artery stenosis (>50%), they were randomized to medical treatment, with or without renal artery stenting. Follow-up did not show a significant benefit to creatinine clearance (although limited by small sample size), but did demonstrate 4 serious complications in the stenting group (including 2 procedure-related deaths). This study failed to show a benefit of renal artery stenting in this patient population, and did show evidence of harm, indicating medical therapy should be the current standard of care for now (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 […]