The American Society of Nephrology's Renal Week 2010 took place Nov. 16 to 21 in Denver and attracted over 13,000 participants from around the world. The conference highlighted recent advances in the areas of general nephrology, dialysis, transplantation, and hypertension, with presentations focusing on new approaches and clinical practice management of patients with kidney diseases and related disorders.
Pablo E. Pergola, M.D., of Renal Associates in San Antonio, and colleagues found that a novel antioxidant inflammation modulator, bardoxolone methyl, improved the estimated glomerular filtration rate (eGFR) and other measures of kidney function in patients with chronic kidney disease (CKD) and type 2 diabetes.
"We assessed the change in GFR at 24 weeks using three doses of bardoxolone methyl as compared to placebo. The study will continue through 52 weeks and includes a four week washout period," Pergola said. "The primary end point, the mean change in GFR at 24 weeks, showed that treatment with bardoxolone methyl increased the GFR, on average, a highly statistically significant 10.1 ml/min/1.73 m², compared with no change in the placebo group. In addition, the drug also improved other parameters of kidney function that correlated with the change in GFR, including a decrease in blood urea nitrogen and serum phosphorus and uric acid."
The investigators also evaluated the effect of treatment changes in CKD stage to understand the clinical importance of the increase in eGFR.
"A significant 59 percent of patients receiving bardoxolone methyl showed an improvement in stage as compared to 16 percent in the placebo group. Among those treated with bardoxolone methyl, 50 percent of those in stage 4 at baseline moved to earlier stages, with no change seen in the placebo group," Pergola added. "The drug was well tolerated, with only mild to moderate side effects, and serious adverse events were balanced across all groups, including placebo. Going forward, we will be analyzing the 52 week data in January 2011 and assessing other outcome measures, including the effects of bardoxolone methyl on proteinuria, blood pressure, and glycemic control."
Several authors disclosed financial relationships with Reata Pharmaceuticals; one author also disclosed financial relationships with other pharmaceutical companies.
In another study, Carmen A. Peralta, M.D., of the University of California in San Francisco, and colleagues found that blacks and some Hispanic groups experienced faster rates of kidney function decline prior to CKD compared to their white counterparts. The investigators evaluated race/ethnic differences in kidney function decline among white, black, Hispanic, and Chinese participants over a five-year follow up period, with two to three repeated measures of kidney function.
"One of the key results of our study was that self-reported black individuals lose kidney function much faster than their white counterparts. In addition, Hispanics also have a faster rate of kidney function decline but the rate of decline depends on country of origin. Dominicans and Puerto Ricans lose kidney function faster than whites, with the rate of decline among Mexicans not as great. Hispanics should not be considered one group and should be categorized by country of origin when looking at kidney function," Peralta said. "More research is required before these findings can be translated into clinical practice. Our results are the first to demonstrate race differences in kidney function decline before persons have established CKD. These findings now open the opportunity to research primary prevention strategies for CKD."
Nimrit Goraya, M.D., of the Texas A&M Health Science Center College of Medicine in Temple, and colleagues found that adding fruits and vegetables to the diets of individuals with macroalbuminuric hypertensive nephropathy and CKD stage 2 eGFR improved kidney injury. The investigators evaluated whether dietary addition of base-inducing fruits and vegetables reduced kidney injury in patients with hypertensive nephropathy with moderately reduced eGFR (CKD stage 2 = 60 to 90 ml/min/1.73 m²).
"The data show that adding fruits + vegetables to diets of subjects with macroalbuminuric hypetensive nephropathy and CKD stage 2 eGFR improves urine parameters of kidney injury and support exploring this dietary intervention as an adjunctive kidney protective strategy to blood pressure reduction and ACE inhibition," the authors write.
ASN: More Frequent Hemodialysis Improves Outcomes
MONDAY, Nov. 22 (HealthDay News) -- More frequent in-center hemodialysis (six days per week instead of three days per week) appears to improve left ventricular mass and improve patient-reported physical health, but may require more frequent interventions related to vascular access, according to a study published online Nov. 20 in the New England Journal of Medicine to coincide with a presentation at the American Society of Nephrology's Renal Week 2010, held from Nov. 16 to 21 in Denver.
ASN: Hyponatremia Associated With Fractures and Falls
MONDAY, Nov. 22 (HealthDay News) -- Older adults with mild hyponatremia appear to be at an increased risk of fractures and falls, though the condition is not associated with bone mineral density (BMD), according to a study presented at the American Society of Nephrology's Renal Week 2010, held from Nov. 16 to 21 in Denver.
ASN: Weekend Admissions May Raise ESRD Patients' Risk
FRIDAY, Nov. 19 (HealthDay News) -- Patients with end-stage renal disease (ESRD) appear to be at a higher risk of delayed dialysis and mortality when admitted to the hospital over the weekend as opposed to a weekday, according to a study presented at the American Society of Nephrology's Renal Week 2010, held from Nov. 16 to 21 in Denver.
ASN: Moderate Alcohol Intake Benefits Transplant Patients
THURSDAY, Nov. 18 (HealthDay News) -- Moderate alcohol intake among kidney transplant recipients appears to reduce the likelihood of developing diabetes and dying prematurely, according to a study presented at the American Society of Nephrology's Renal Week 2010, held from Nov. 16 to 21 in Denver. According to another study presented at the conference, obesity in younger dialysis patients increases the risk of dying within seven years.
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