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Management of Hyperphosphatemia in Patients with ESRD: A New Direction for Treatment in 2008
Flash slide/audio
(CME Symposium (MER), January, 2008)
Qunibi: How do sevelamer and calcium acetate compare in terms of phosphate control? In terms of grams of binder needed to achieve equivalent phosphate control? The explanation for reduced
progression rate of vascular calcification in the RIND and DCOR studies has been lack of calcium-loading with sevelamer. To what extent is an alternative hypothesis, that of lowering of LDL-
cholesterol, consistent with the data? What are data in animal models regarding vascular calcification in CKD and the effect of calcium-based phosphate binders? In the CARE-2 study (now available
on-line at the AJKD website) progression of calcification was compared between calcium acetate plus atorvastatin and sevelamer plus atorvastatin (as needed to achieve equivalent LDL levels).
What were the principal findings of CARE-2? Nolan: What did Treat-to-Goal, DCOR, RIND, DCOR Revisited, and CARE-2 show with respect to both calcification and mortality? How were the mortality
results different from the calcification results? What are the DOPPS data with regard to phosphate binder use and mortality? What percentage of patients do the KDOQI guidelines recommend for
non-calcium containing phosphate binders? What are the relative costs of sevelamer, calcium acetate, and calcium carbonate?
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Aldosterone: New Insights in Kidney Health and Disease
Flash slide/audio
(ASN Clinical Nephrology Conference, November, 2007)
Calhoun: In normotensive individuals, how do aldo levels affect the risk of incident hypertension? What is the prevalence of aldosteronism in mild, moderate, and severe or resistant
hypotension? What percent of this is due to adenoma? How effective is spironolactone as an anti-hypertensive drug? By how much does it lower blood pressure? Is spironolactone more effective in
those patients with primary hyperaldosteronism? What is the risk of hyperkalemia with spironolactone, and how can this be mitigated? Rosenberg: What does the animal data show about use of
aldosterone blockers in various animal models of CKD and/or renal injury? What do the clinical studies of spironolactone in CKD show? At what level of GFR do we need to start monitoring most closely
for hyperkalemia? In 2008, can the use of aldosterone antagonists for CKD progression prevention be recommended?
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RPA Annual Meeting. March, 2008. Part One.
Flash slide/audio -- Free to RPA members
RPA: Year in Review
Alan Kliger, MD
RPA's Advocacy Agenda
Robert Blaser, MD
Brian Ling Lecture: Pay for Performance is Here! Lessons of success from Medicare Physician Payment Demonstration Project
Karl Ulrich, MD
ESA Payment Update: Where Knowledge Meets Politics
Alan Nissenson, MD
Value and Courage in Politics: Nephrology Reaches Farther
Rebecca Schmidt, MD
Value and Courage in Politics: Nephrology Reaches Farther
Larry Lehrner, MD
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RRI Tenth International Conference on Dialysis, January, 2008. Part Three
Flash slide/audio
(Renal Research Institute, January, 2008)
Angiotensin II, interstitial inflammation and the pathogenesis of salt sensitive hypertension
Martha Franco, MD, PhD
How common is malnutrition in ESRD? An approach to diagnosis and management
Martin Kuhlmann, MD
Blind Pugh sends a black spot: The current hemoglobin controversy
Paul E. Stevens, MB, FRCP
KEYNOTE ADDRESS: The metabolic syndrome and kidney disease
Eberhard Ritz, MD
Transplant and CKD patients at the same stage of renal insufficiency: how are they the same or different?
Warren Kupin, MD, FACP
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ASN Renal Week 2007 now in MP3
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AUDIOFILE
LIST (Renal Week 2007)
2007 Renal Week PGE Course:
INTERVENTIONAL NEPHROLOGY: WHAT NEPHROLOGISTS SHOULD KNOW (Part 2 of 2)
Complications of Tunneled HD Catheters
Antoine L. Samaha, MD
Management of Catheter Infection
Bharat S. Sachdeva, MD
Peritoneal Dialysis Catheters: Peritoneoscopic Method
Stephen R. Ash, MD
Peritoneal Dialysis Catheters: Fluoroscopic Method
Ivan D. Maya, MD
Percutaneous Balloon Angioplasty Procedure
Alexander S. Yevzlin, MD
Management of Central Venous Stenosis
Florin N. Gadalean, MD
Hand Ischemia
Steven Wu, MD
Preservation of Veins?
Edgar V. Lerma, MD, FASN
Evaluation Stents: Do They Work?
Kenneth D. Abreo, MD
Vascular Access Center: What Does It Mean for You and What Does It Do for the Patient?
Donald Schon, MD
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Hypertension, Cardiovascular:
Salt loading and urinary linoleic acids; Muscle sympathetic nerve activity up in obesity; Thiazide diabetes related to K depletion; Hypertension and low 25D; Masked HTN in AASK patients on follow-up.
Dialysis, ESRD:
Inflammatory gene expression to study dialyzer membrane biocompatibility; IDH reduced by automated UF control; GDP toxicity in PD fluids; bicarbonate PD and aquaporins; Icodextrin and LVH; ACEI/ARB do
not increase survival in ESRD; RAS blockade in PD meta; Ambulatory BP in stage -5 CKD; Renal failure from RAAS blockade; slight decreases in eGFR predicts LV abnormalities; LBM by BIA; High platelet
counts the reason for death risk with high Hb and high EPO? Why ESA guidelines are impossible to meet; Cinacalcet and calciuria in transplant; Sevelamer lowers pentosidine; Fructosamine better than
A1C as outcome predictor in nondiabetic dialysis patients; Pulmonary hypertension predicts mortality; ACEI and CV outcomes meta; Indoxyl sulfate promotes vascular calcification; Platelet-derived
microparticles predict CV risk; Atorvastatin and heart valve calcification; Statins do not increase stroke risk in ESRD in CHOICE; L-carnitine of no CV benefit; Implantable cardioverter defibrillators
have high failure rate in CKD.
Clinical Nephrology:
GFR based on creatinine no good in transplant patients; Cystatin is better; Low-dose calcineurin inhibitors and MMF improve renal function in kids with transplanted hearts; Cardiac evaluation may
delay kidney transplant in low-risk patients.
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Nephrogenic systemic fibrosis: early recognition and treatment
Knopp and Cowper review the very early signs of this disorder, and discuss criteria for diagnosis as well as etiology.
from the April issue of Seminars in Dialysis.
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Glucose in the dialysate: Historical perspective and possible implications?
Sharma and Rosner discuss this. Should we add glucose at all? If so, how much is too much, and how much is enough?
from the April issue of Hemodialysis International.
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Atherosclerotic renal artery stenosis: overtreated but underrated?
Textor reviews the latest in terms of diagnosis and treatment; this test;
from the April issue of
the J Am Soc Nephrol (JASN)
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Trends in organ donation and transplantation in the United States, 1997-2006
Port and his colleagues document the trends in organ transplantation and transplantation up through 2006;
in the April 2008 issue of the
Am J Transplant.
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Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients.
Santos and Peixoto review the current recommendations for optimizing dialysate sodium level in dialysis patients;
from the March issue of the Clinical J Am Soc Nephrol (CJASN)
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The utility of the transtubular potassium gradient in the evaluation of hyperkalemia
Choi and Ziyadeh review how the TTKG can be used to distinguish etiology of hyperkalemia, and discuss the pitfalls and shortcomings of this test;
from the March issue of
the J Am Soc Nephrol (JASN)
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Beta-blockade in chronic dialysis patients
Furgeson and Chonchol review the data of benefit, and also point out the potential risks of using them in CKD;
in the Jan/Feb issue of Seminars in Dialysis.
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Transplant glomerulopathy
Cosio et al present evidence that transplant glomerulopathy (TG) may be a distinct entity. Onset may be early, progression insidious. It is associated with HLA Class II antibodies.
Therapy for this progressive condition is not yet well worked out;
in the March 2008 issue of the
Am J Transplant.
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Poor correlation between coronary artery calcification and obstructive coronary artery disease in an end-stage renal disease patient.
Ton, Mehrotra, and their colleagues look at calcification and atherosclerosis and find one patient where lots of calcium did not mean obstructive coronary disease.
from the January issue of Hemodialysis International.
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Cerebral salt wasting vs. SIADH
Sterns and Silver argue that maybe we can't tell them apart and maybe we don't even need to be able to do this;
from the February issue of
the J Am Soc Nephrol (JASN)
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Mechanisms of vascular calcification in chronic kidney disease
Moe and Chen discuss the complexities of VSMCs thinking that they are osteoblasts;
from the February issue of
the J Am Soc Nephrol (JASN)
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Battleground: chronic kidney disorders mineral and bone disease - calcium obsession, vitamin F, and binder confusion
Kovesdy, Mehrotra, and Kalantar-Zadeh present a skeptical view of many truisms in the mineral bone disorder of CKD, and discuss where answers may be counter-intuitive; from the January issue of
the Clinical J Am Soc Nephrol (CJASN)
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