Editorial issue 227

Frequent in-center hemodialysis does not increase serum albumin levels


In the 227th issue of NDT-E you will find six interesting full papers to read. The first paper (published in J Clin Invest by Yuan Zhang et al.) shows that therapeutic strategies that bypass the liver or limit the activation of hepatic liver X receptors (LXR) could be beneficial for the treatment of cardiovascular disease. In the 2nd full paper published in Kidney Int Johanna Temme et al. analyzed the outcome of 234 Alport carriers including 29 with autosomal recessive mutations and concluded that a yearly follow-up by a nephrologist is advised for X-linked Alport carriers and patients with thin basement membrane nephropathy, microalbuminuria, proteinuria, or hypertension. In another recent Kidney Int paper Hans-Joachim Paust et al. show that chemokines play a critical role in the cross-regulation of Th1 and Th17 immune responses in murine crescentic glomerulonephritis. In the 3rd Kidney Int paper George A Kaysen et al. investigated the effects of frequency of HD on nutritional status by analyzing the data in the Frequent Hemodialysis Network Trial. This study demonstrates that although frequent in-center HD reduced extracellular water it did not increase serum albumin or body cell mass. Frequent nocturnal HD yielded no net effect on parameters of nutritional status or body composition. In this issue of NDT-E you will also find two full papers published in Nephrol Dial Transpl. In the first paper, Trijntje Cnossen et al, evaluated 23 patients with type-2 cardiorenal syndrome in a prospective study and showed that although functional NYHA class improved and quality of life tended to improve, there was no evidence for a change in cardiac function after starting dialysis.  In the 2nd NDT paper Altair Oliveira de Lima et al. evaluated 38 721 inhabitants in the state ofSao Paulo (Brazil) with a dipstick test. They report that as proteinuria was detected in 7.3% of these inhabitants the prevalence is similar to that previously described in developed countries.


In this issue of NDT-E you will also find four oral presentations from the ERA-EDTA meeting in Prague 2011. Inthe first talk Angel Argiles, Sète, France discusses “REMOVAL OF PEPTIDES BY DIALYSIS”. In the 2nd talk, the current President of ERA-EDTA Raymond Vanholder, Ghent, Belgium discusses the “CLINICAL IMPACT OF PEPTIDES IN UREMIA” and concludes by stating that middle molecules have been associated directly and indirectly with several uremic effects, especially cardiovascular. Their removal may be enhanced by increasing dialyzer pore size, applying convection and prolong dialysis. In the 3rd presentation Danilo Fliser, Homburg, Germany present data on “HIGH DENSITY LIPOPROTEIN AND VASCULAR FUNCTION”. Finally, Harald Mischak, fromHannover,Germany, lectures about “PEPTIDES AND VASCULAR DISEASE”. Dr Mischak concludes his interesting talk by stating that as specific peptides have a pathophysiological relevance in extracellular matrix accumulation, inflammation and apoptosis they have a potential as biomarkers in patient stratification and therapy monitoring.


Do not forget to do the survey on home-hemodialysis and study the novel case report by Dr. Ourania S. Drakoulogkona about Fabry disease presented in this issue of NDT-E.



Enjoy your NDT-E!



Peter Stenvinkel, Editor in Chief NDT-Educational