KIDNEY NEWS NOW
We post the most recent news about Kidney Disease, Dialysis and Treatment.
- Procalcitonin to Predict Severity of Acute Cholangitis and Need for Urgent Biliary DecompressionDr. Ally Clinical question: What impact does procalcitonin have on the management of acute cholangitis? Background: Procalcitonin has been used to predict disease severity that may lead to septic shock, though this remains a debatable topic. Acute cholangitis portended high morbidity and mortality prior to biliary decompression and enhanced critical care. Severe acute cholangitis is defined by one of these characteristics: cardiovascular dysfunction (such as hypotension requiring dopamine or norepinephrine infusion); neurologic dysfunction… ... read more
- Aggressive or Moderate Fluid Resuscitation in Acute PancreatitisDr. Hammond Clinical question: Is early, aggressive, fluid resuscitation in acute pancreatitis or moderate fluid resuscitation the best and safest way to prevent progression to moderately severe or severe pancreatitis? Background: Early, aggressive, fluid resuscitation is widely recommended and used in the management of acute pancreatitis. However, subsequent studies have shown this strategy may result in increased adverse events without significantly improving morbidity and mortality. Study design: Investigator-initiated, multicenter, open-label, randomized, clinical trial… ... read more
- SIG Spotlight: Global Hospital MedicineAll of SHM’s Special Interest Groups (SIG) look to solve issues, but some are more challenging in scope than others. Those focused on the spread of interdisciplinary rounding, or the improvement of health information technology, for example, can produce tactile examples of success. But the Global Hospital Medicine SIG? Defining hard-fought victories can be more ephemeral—if no less profound. Dr. Ajala “We really want to normalize the idea of partnership across the… ... read more
- Oral Tebipenem Pivoxil Hydrobromide is Noninferior to IV Ertapenem in Complicated UTIDr. Modha Clinical question: Is oral carbapenem tebipenem effective in treating complicated urinary tract infections (UTIs)? Background: Antimicrobial resistance among pathogens, especially gram-negative organisms, is increasing worldwide. Extended-spectrum beta-lactamase-producing and fluoroquinolone-resistant Enterobacteriaceae have become limited to no oral antibiotic options, posing a clinical and financial concern due to the need for inpatient treatment with intravenous agents. Study design: Phase 3, randomized, double-blind, double-dummy, noninferiority trial Setting: 95 centers in Central and Eastern Europe,… ... read more
- Association of Chronic Medication Adherence with ED Visits and HospitalizationsDr. Gibson Clinical question: Is there an association between chronic medication adherence and emergency department (ED) visits and hospitalizations? Background: Medication adherence for hypertension and diabetes has been shown to be associated with decreased health care visits and decreased health care costs, however it is usually examined for one medication or medication group. Adherence can vary between different medications and patients may take more than one medication. This study examines the association between… ... read more
- Acetaminophen Rises Systolic Blood Pressure in Those with HypertensionClinical question: Does regular intake of acetaminophen cause an increase in blood pressure? Background: Acetaminophen is one of the most commonly used analgesics in the world. Because of its widespread use and limited demonstrated efficacy, there have been growing reservations regarding its long-term safety, particularly its influence on blood pressure (BP). Study design: Single-center, randomized, double-blinded, placebo-controlled crossover trial Setting: United Kingdom Synopsis: 110 patients were randomized to receive 1 g of acetaminophen four times… ... read more
- Early Initiation of Dialysis Improves Survival: To Start or Not to StartClinical question: What is the ideal estimated glomerular filtration rate (eGFR) at which to start dialysis in patients with advanced chronic kidney disease? Background: Uncertainty exists over the optimum time to start dialysis in order to lower mortality and cardiovascular events. The Initiating Dialysis Early and Late (IDEAL) trial, published in 2010, demonstrated that initiating dialysis at an eGFR of 10 to 14 mL/min/1.73 m2 was not associated with an improvement in survival or clinical… ... read more