Editorial issue 230
New nutritional survey will be used as a starting point for a “Renal nutrition blog” at NDT-E
In the 230th issue of NDT-E you will find a couple of interesting full papers from Kidney International, Nephrology Dialysis and Transplantation and J Nephrology to read. Cardiovascular complications are the most common complications in patients on dialysis. Antibodies against β-glycoprotein I may play a role in antiphospholipid syndrome and stroke and are involved in atherosclerosis. In a paper published in Kidney IntAntonio Serrano et al. show that IgA antibodies to β-glycoprotein I are detrimental to the clinical outcome of hemodialysis patients. In another paper in Kidney Int Mark Perazella et al. examine the problems associated with the use of potentially nephrotoxic drugs in patients in the intensive care unit, a group exposed to numerous pharmaceutical agents, many of which have narrow therapeutic windows and toxic potential. The risk of death for hemodialysis patients is thought to be highest on the days following the longest interval without dialysis (usually Mondays and Tuesdays); however, existing results are inconclusive. To clarify this, Hui Zhang et al. analyzed Dialysis Outcomes and Practice Patterns Study (DOPPS) data of 22,163 hemodialysis patients from the United States, Europe, and Japan. Unexpectedly, Japanese patients on a Monday- Wednesday Friday schedule had a higher risk of non-cardiovascular mortality on Fridays, and European patients on a Tuesday – Thursday – Saturday schedule experienced an elevated cardiovascular mortality on Saturdays. In a paper published in Nephrol Dial TransplMarije van der Velde et al. show that elevated urinary albumin excretion has added value to the present metabolic syndrome defining variables in predicting new-onset type-2 diabetes mellitus, CVD and CKD, whereas hs-CRP adds to predicting new-onset CVD and CKD, it does not add in the prediction of new-onset type-2 diabetes mellitus. In a second NDT paper Se Won Oh et al. show that the risks of adverse outcomes are greater in the general population with mild renal impairment or mild proteinuria. Finally, Yong Liu et al. have published a paper in J Nephrology showing that hs-CRP >16 mg/L was a significant and independent predictor of contrast-induced nephropathy after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.
In this issue of NDT-E you will also find four of the remaining oral presentations from the ERA-EDTA meeting in Prague 2011. In the first talkPierre Ronco, Paris, France will discuss RENAL COMPLICATIONS OF MYELOMA AND RELATED DISORDERS: AN UPDATE”. The 2nd talk is also presented by a French nephrologist Jean-Paul Fermand, Paris, who will discuss TREATMENT AND MONITORING OF AL-AMYLOIDOSIS: THE EVOLVING STORY”. Dario Roccatello, Turin, Italy will present on RENAL INVOLVEMENT IN ESSENTIAL MIXED CRYOGLOBULINEMIA”. In the final presentation Colin Hutchison, Birmingham, UK will discuss “TREATMENT OF MYELOMA CAST NEPHROPATHY WITH HIGH CUT-OFF DIALYSIS”.
Do not forget to study the new case report on “Early renal allograft failure with widespread oxalate deposition in the graft” by Salwa Ibrahim.
Please take some of your time to read the interesting results of the home hemodialysis survey by Drs Jayanti and Mitra. I also suggest you do the new nutritional poll by Drs Carrero, Zlatkis and Avesani to test your knowledge about the dietary management in end-stage renal disease. I did the survey and can tell you that the questions are not very easy. Yoy will learn a lot from this survey that could benefit your patients. The information collected in this survey will be used as a starting point for a “renal nutrition blog” within the NDT-E platform where we will discuss together on the importance of dietary counseling and nutritional support in Nephrology clinical practice.
Enjoy your NDT-E!
Peter Stenvinkel, Editor in Chief NDT-Educational