Articles related to Nephrology

A young woman with progressive autosomal dominant PKD is seen for follow up. She had a recent infected kidney cyst. Except for a palpable right kidney, the exam is unremarkable. Labs show a decrease in eGFR from a year prior. She is on lisinopril. What is your approach to treatment now?

In this target trial emulation involving nearly 44,000 patients with primary hyperparathyroidism (PHPT), similar declines in kidney function at 5 and 10 years were seen in patients managed with parathyroidectomy and in those managed nonoperatively. Thus, in this study, parathyroidectomy had no effect on long-term kidney function in older adults with PHPT.

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A newly developed prolyl hydroxylase inhibitor (agents that increase endogenous erythropoietin production) holds the promise of improving outcomes for patients with anemia of chronic kidney disease. Randomized controlled trials have found these drugs to be at least as effective as erythropoiesis-stimulating agents.

The US Food and Drug Administration (FDA) has said “no” to Akebia Therapeutics’ drug application for vadadustat, a therapy to treat anemia due to chronic kidney disease. Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor designed to mimic the physiologic effect of altitude on oxygen availability. The FDA cited safety concerns as the main reason for it rejecting the application.

In contradistinction to recent reports that showed increased risk of death and no clinical benefit with escalation of allopurinol for progressive CKD, this 5-year population-based review found no increased mortality risk in escalating allopurinol dose and achieving target serum urate levels.