Editorial issue 226

High frequency of aspirin resistance in patients with nephrotic syndrome 


In the 226th issue of NDT-E you will find four interesting CME lectures presented at the ERA-EDTA meeting in Prague June 2011. In the first lecture Dr Rachel J. Johnson, Bristol, UK present an update on “ORGAN ALLOCATION – PRINCIPLES AND PRACTICE ”. The second talk is simply entitled ”LIVING DONATION” and is presented by Dr Jiri Fronek, London, UK. In his talk he discuss short term and long term risks of being a living donor. Whereas the risk of postoperative major complications (5%) and mortality 1/3000 are quite low the risk of new onset hypertension within 5 years for a living donor is 10%.  The 3rd talk is entitled ”WHAT IS STANDARD IMMUNOSUPPRESSION IN 2011?” and is presented by DrUwe Heemann, Munich, Germany. In the final talk Dr Josep M. Campistol, Barcelona, Spain discuss ”LATE COMPLICATIONS AND THEIR MANAGEMENT”. He conclude that the only way to improve and extend graft and patient survival is individualization of immunosuppressive therpy.


You will also find links to a number of novel and useful full papers recently published in Kidney International and Nephrology Dialysis Transplantation (NDT). The first full paper, by Iain C Macdougall et al is a minireview published in Kidney Int that focuses on the current knowledge regarding the etiology of antibody-mediated pure red cell aplasia and the current approach to therapy. In another Kidney Int reviewHirofumi Tomita et al review previous epidemiological and experimental studies, and discuss novel insights regarding the therapeutic implications of the importance of the kallikrein–kinin system in averting diabetic nephropathy. In the 3rd full paper, also published in Kidney Int,Chirag Parikh et al show that whereas urinary NGAL and IL-18 excretion is mildly and stably elevated in ADPKD, they do not correlate with changes in total kidney volume or kidney function.  Barry Johns et al present a paper in NDT showing that although CKD is more common among individuals with the metabolic syndrome, insulin resistance is not a common factor. In a 2nd NDT full paper Hadim Akoglu et al show in an interesting study based on 83 nephrotic patients using aspirin 100 mg/day that a significant number of them are resistant (defined as a normal collagen/epinephrine closure timeTammy Sirich et al show in a study based on nine patients on thrice-weekly nocturnal dialysis who underwent two experimental dialysis treatments one week apart that removal of bound solutes can be increased by raising the dialyzate flow and dialyzer size above the low levels sufficient to achieve target Kt/Vurea during extended treatment.


Please also take some of your time to answer the survey on home-hemodialysis.


Enjoy your NDT-E!


Peter Stenvinkel, Editor in Chief NDT-Educational