Articles related to Nephrology

The Organ Transplant and Procurement Network (OTPN) is set to undergo modernization and improvement after being criticized for lack of transparency, long waits, mishandling of organs, and the number of people who die on the waitlist each year. The Health Resources and Services Administration (HRSA) has launched the OTPN modernization project, which will focus on accountability. The current system is outdated and has been responsible for 70 deaths between 2010 and 2020, according to a 2022 senate report. The HRSA plans to take steps, such as creating a new dashboard, to provide transparency and better serve patients and their families. Additional modernization will focus on overhauling the operations of the OTPN system to ensure higher compliance and a greater focus on patient safety. Organ transplants and the OTPN disproportionately affect the Black community in the US. About 30% of the ONTP waitlist is Black Americans, and about 90% are waiting for kidney transplants. The HRSA’s plan hopes to address the inequality by improving accountability, transparency, and systems of organ retrieval and matching. The changes will benefit patients, and physicians might be able to see more of their patients receive the life-saving transplants they need.

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.

This trial including more than 6,500 patients randomized to empagliflozin or placebo and followed for a median of 2 years. Progression of kidney disease or death from cardiovascular causes was monitored over the course of the trial. Those outcomes occurred in approximately 13% of patients in the empagliflozin group versus approximately 17% of patients in the placebo group.

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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.