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The Forgotten Antiproteinuric Properties of Diuretics
Trujillo H.a · Caravaca-Font?n F.b · Caro J.a,b · Morales E.a,b,c · Praga M.a,b,c
doi : 10.1159/000517020
Am J Nephrol 2021;52:435–449
Although diuretics are one of the most widely used drugs by nephrologists, their antiproteinuric properties are not generally taken into consideration.
Managing Anemia across the Stages of Kidney Disease in Those Hyporesponsive to Erythropoiesis-Stimulating Agents
Weir M.R.
doi : 10.1159/000516901
Am J Nephrol 2021;52:450–466
Patients with CKD frequently have anemia that results from iron-restricted erythropoiesis and inflammation. Anemia of CKD is currently managed with iron supplements and erythropoiesis-stimulating agents (ESAs) to promote erythropoiesis and with RBC transfusion in severe cases. Hyporesponse to ESAs, or the need for larger than usual doses to attain a given hemoglobin (Hb) level, is associated with increased morbidity and mortality and presents a pressing clinical challenge, particularly for patients on dialysis. This paper reviews ESA hyporesponse and potential new therapeutic options in the management of anemia of CKD.
Starvation Ketosis and the Kidney
Palmer B.F.a · Clegg D.J.b
doi : 10.1159/000517305
Am J Nephrol 2021;52:467–478
The remarkable ability of the body to adapt to long-term starvation has been critical for survival of primitive man. An appreciation of these processes can provide the clinician better insight into many clinical conditions characterized by ketoacidosis.
Efficacy and Safety of Plastic Cannulae Compared with Metal Needles in the Initial Use of an Arteriovenous Fistulae in Incident Hemodialysis Patients: A Randomized Controlled Study
Choi Y.S. · Lee H.S. · Joo N. · Park P. · Cho S.N. · Youn I.J. · Song Y.R. · Kim S.G. · Kim J.-K.
doi : 10.1159/000516212
Am J Nephrol 2021;52:479–486
Successful cannulation of an arteriovenous fistula (AVF) is important in patients starting hemodialysis (HD). Metal needles have been used for decades, but the usefulness of plastic cannulae has recently been demonstrated as a new technique.
Frequency and Severity of Moral Distress in Nephrology Fellows: A National Survey
Saeed F.a,b,e · Duberstein P.R.c · Epstein R.M.b,f,g,h,i · Lang V.J.a,d · Liebman S.E.a
doi : 10.1159/000516575
Am J Nephrol 2021;52:487–495
Moral distress is a negative affective response to a situation in which one is compelled to act in a way that conflicts with one’s values. Little is known about the workplace scenarios that elicit moral distress in nephrology fellows.
Therapeutic Effects of Add-On Tenapanor for Hemodialysis Patients with Refractory Hyperphosphatemia
Shigematsu T.a · Une Y.b · Ikejiri K.b · Kanda H.b · Fukagawa M.c · Akizawa T.d
doi : 10.1159/000516156
Am J Nephrol 2021;52:496–506
Phosphate binders are used to treat hyperphosphatemia. Some patients have inappropriately controlled serum phosphorus levels, which may occur for many reasons, including a high pill burden and adverse events (AEs). Tenapanor selectively inhibits the passive paracellular transfer of phosphate in the gastrointestinal tract, thereby reducing serum phosphorus levels. This novel mechanism of action may contribute to improved phosphate management. The efficacy and safety of tenapanor have not been evaluated in Japanese patients with high serum phosphorus levels despite treatment with phosphate binders. This study aimed to assess the efficacy and safety of add-on tenapanor therapy for reducing serum phosphorus levels in this population.
Volume of Crescents Affects Prognosis of IgA Nephropathy in Patients without Obvious Chronic Renal Pathology
Lin Z.a,b · Liu L.c · Zhang R.a,b · Lin X.a · Lu F.b · Bao K.b · Wang L.d · Lin Q.b · Mai J.e · Cao Y.e · Yang H.f · Liu X.a,b · Zou C.a,b
doi : 10.1159/000516187
Am J Nephrol 2021;52:507–518
A working group on the Oxford classification of IgA nephropathy (IgAN) recently reported that crescents detected in the kidney tissue predicted a worse renal outcome. However, the effect of C1 lesion (crescents in <1/4th of all glomeruli) and their volume on the prognosis of IgAN is still unclear. We explored the association of C1 lesion with the renal prognosis in IgAN patients without obvious chronic renal lesions (glomerulosclerosis <25%, T score <2).
