key Try Dr. Mendelssohn's poll: INITIAL CHOICE OF ESRD THERAPY. This poll, which has no right or wrong answers, is meant to query renal health providers about their approach to patients approaching dialysis, especially in terms of which potential options for therapy are presented to such patients.
Note: Use Internet Explorer only; feedback section does not work with some other browsers.


Foley  

Sica  

Pathogenesis and Management of Cardiovascular Disease (CVD) in Chronic Kidney Disease
Robert N. Foley, MD, and Domenic A. Sica, MD. (ASN Renal Week, 2006). Foley: How are classic and novel risk factors related to outcome in CKD patients as well as in dialysis patients? What can we learn from Framingham data? From NHANES? Which of the classical risk factors works in the opposite direction when GFR is low? To what extent have patients with mild-moderate CKD been excluded from the major cardiovascular trials? What can we learn from analysis of these subsets? How do the observational data differ from randomized, controlled trials?
Sica: How are the pathogenses of CKD and CVD (cardiovascular disease) related? Where do both impact the RAS (renin-angiotensin system)? How does ACE inhibition affect different parts of the cardiovascular system? What conclusions can we draw from AASK? How can we rationally choose drugs from different classes to treat hypertension? How should different calcium-blockers and ACE inhibitors be used in CKD? How do ACE inhibitors and ARBs compare? (ASN Renal Week Official Symposium, 2006).
(more...)



Haley

Implementation of the RPA CKD Toolkit and its Potential Impact on P4R and P4P
(RPA 2006, General Session 1)
What lessons did we learn from the Advanced CKD Guideline Implementation Project? Unlike ESRD, resources for CKD are not optimally distributed. Substantial numbers of pre-ESRD patients are managed by PCPs, and management does not conform to guidelines. (more...)

Updated: May 07, 2008 (M07)
M07 JASN: Calcitriol associated with a lower mortality in pre-ESRD patients.
M05 ASN Renal Week abstract archives 2003-2006 now available on-line in .pdf format.
A09 NEJM: ACEI = ARB, and ACEI + ARB no better than either ACEI or ARB, in high risk patients with diabetes or vascular disease.
M20 JASN Express: Remission clinic targetting proteinuria with multidrug therapy markedly slows rate of CKD progression.
M06 7th Annual Prevention in Renal Disease Conference, Toronto, Sept. 19-20, 2008.
M01 Screening test for CKD (SCORED) developed by Cornell and UNC Chapel Hill outperforms NKF KEEP approach.
F26 Diazyme introduces new assay for cystatin C.
F21 Study suggests that Medicare part D patients use more cardioprotective drugs after MI and live longer.
F13 University of Groningen study (PREVEND) emphasizes utility of treating hypertension in proteinuric patients.
J24 Researchers cast doubt on UK's universal screening program for CKD.
J18 Canadian study suggests drinking 4 liters of water per day can cause proteinuria; reversible when water ingestion reduced.
O12 FDA advisory meeting next Tuesday to study use of phosphate binders in pre-ESRD - Genzyme, Shire, Fresenius will all be present.
S12 JAMA paper shows no benefit of lowering homocysteine in CKD
J16 Kibow to test probiotic in stage III and IV CKD
M02 Editorial review of Brunori et al paper: (Late start dialysis in the elderly)
Industry Advances Emphasis
archive
Secondary Hypertension, including Chronic Kidney Disease ASN Board Review 2006
Pathogenesis and Management of Cardiovascular Disease (CVD) in Chronic Kidney Disease ASN Renal Week 2006
Emerging New Agents in Diabetic Kidney Disease (Lewis) ASN 2005 Renal Week
CKD Management: What Can We Learn from South African and Australasian Efforts? (Katz) RRI 2006, Part 3 (handouts)
Implementation of the RPA CKD Toolkit and its Potential Impact on P4R and P4P (Haley) RPA 2006, General Session 1
CKD Outcomes (Somermeyer) RPA 2006, General Session 4
Anemia Management in CKD: Improving Iron Management (Reed, Copeland) ANNA 2006
Medical Crossfire: An Expert Panel Debates Key Clinical Issues in Mineral Metabolism and Mortality in CKD (Coyne, Moe, Martin) ASN Renal Week 2005
The Pathophysiology of Progressive Renal Disease and Hypertension: Importance of Gender and Ethnicity (August, Maric, Thomas, Lewis) ASN Renal Week 2005 (audiofiles)
Evidence for a New Treatment Paradigm in the Management of Secondary Hyperparathyroidism in CKD Stages 3 and 4 (Andress, Coyne) ASN Renal Week 2005 (audiofiles)
Redefining Outcomes in CKD (London, Block) ASN Renal Week 2005 (audiofiles)
Developing Therapeutics for Progressive Renal Disease (Martin, Mauer, Klein, Throckmorton, Hostetter, Kopp) ASN Renal Week 2005 (audiofiles)
RPA’s Advanced CKD Patient Management Tool Kit: How to improve care (Goldman) RPA 2005
Information Systems to Monitor CKD Patient Management (Fadem) RPA 2005
Complications of Anemia and the CKD Patient (Petroff) ANNA 2005
Caring Through the End: Palliative Care Along the Continuum of CKD. (Various) MARC 2004

Early Start Peritoneal Dialysis Adv Chronic Kidney Dis (Jul 07)
Intensive versus moderate blood-pressure control in normotensive patients with type 2 diabetes (Briggs J) NCPN Jun 07
KDOQI Clinical Practice Guidelines and CPRs (2006 update) for Treatment of Diabetes and CKD AJKD (Feb 07)
Core Curriculum: Chronic Kidney Disease (Lederer, Ouseph) Am-J-Kidney-Dis 01-2007
Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: Results of the study to evaluate early kidney disease. (A. Levin et al) Kidney Int 01-07
Aldosterone and Cardiovascular Disease. Smoke and Fire (Calhoun). Circulation 12-06
Obesity: Growing Impact on CKD (McGill, Furth, Kaskel) Adv Chronic Kidney Dis 10-06
Management of dyslipidemias in patients with diabetes and chronic kidney disease (Molitch). CJASN 09-06
K/DOQI CKD GUIDELINES
When to initiate dialysis (1-2) CKD-Diabetes, 2006
GFR CALCULATORS
MDRD GFR per 1.73 M2
HDCN Topic Pages (KEY)
Pre-ESRD care
Dialysis outcomes
Quality Assurance
Progression of CKD
Etiology of CKD
OTHER GUIDELINES
Healthy People 2010 CKD
VA Guidelines
Canadian: Elevated Scr
NIDDK CKD Info
STILL MORE LINKS
U.S. NKF

David Mendelssohn, M.D.
Head, Division of Nephrology; Medical Director of Dialysis, Humber River Regional Hospital; Associate Professor of Medicine University of Toronto, CANADA.