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Stories from the dialysis comunity across the globe.
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Warfarin Linked to Greater Renal Function Decline - Renal and Urology News |
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June 11, 2015
Greater decline in glomerular filtration rate for warfarin versus dabigatran etexilate among atrial fibrillation patients.
(HealthDay News) -- For patients with atrial fibrillation, decline in renal function is significantly greater with warfarin versus dabigatran etexilate (DE), according to a study published in the Journal of the American College of Cardiology.
Michael Böhm, M.D., from the Universitätsklinikum des Saarlandes in Homburg, Germany, and colleagues examined changes in glomerular filtration rate (GFR) during long-term treatment with warfarin or DE in 18,113 patients enrolled in the Randomized Evaluation of Long Term Anticoagulation Therapy trial. Participants were randomized to DE (110 mg or 150 mg twice daily) or warfarin and followed for up to 30 months.
The researchers observed a decrease in GFR in all treatment groups. The mean decline in GFR was significantly greater with warfarin (?3.68 ml/min) versus DE 110 mg (?2.57 ml/min; P = 0.0009versus warfarin) or DE 150 mg (?2.46 ml/min; P = 0.0002 versus warfarin), after an average of 30 months. In the observation period >18 months, the likelihood of a decrease in GFR >25% was lower with DE 110 mg (hazard ratio, 0.81; P = 0.017) or DE 150 mg (hazard ratio, 0.79; P = 0.0056) versus warfarin. The decline in GFR was more pronounced with previous warfarin use and presence of diabetes.
"Patients with atrial fibrillation receiving oral anticoagulation exhibited a decline in renal function that was greater in those taking warfarin versus DE, and it was amplified by diabetes and previous vitamin K antagonist use," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Sources
- Böhm, M, et al. J Am Coll Cardiol. 2015;65(23):2481-2493; doi:10.1016/j.jacc.2015.03.577.
- Richard W. Asinger, MD; Gautam R. Shroff, MBBS. J Am Coll Cardiol. 2015;65(23):2494-2495; doi:10.1016/j.jacc.2015.04.043.
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Should Kt/V be retired as a marker of dialysis adequacy? - NephrologyNews.com |
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A new review published online ahead of print in Kidney International concludes that Kt/Vurea is "too simple a concept for the complexities of uremia and of today’s dialysis."
Raymond Vanholder, MD et al, from the Department of Internal Medicine at the Ghent University Hospital in Ghent, Belgium, explain that the concept of using Kt/V to measure dialysis adequacy was developed in the 1980s "when dialysis was almost uniformly short and was applied thrice weekly with small pore cellulosic dialyzers." Since then dialysis has evolved to involve different methods, including include longer sessions, home dialysis, more frequent sessions, and large pore high-flux hemodialysis.
"Although still a useful baseline marker, Kt/Vurea no longer properly covers up for most of these modifications so that urea kinetics are hardly if at all representative for those of other solutes with a deleterious effect on morbidity and mortality of uremic patients. This is corroborated in several clinical studies showing a dissociation between removal of urea and that of other uremic toxins," the authors wrote in the abstract.
Read the full review (subscription required to read beyond the abstract).
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US News World Report again ranks Boston Children's Hospital number 1 ... - NephrologyNews.com |
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U.S. News & World Report has ranked Boston Children's Hospital number one among pediatric hospitals for nephrology. The magazine ranked the top pediatric hospitals for nephrology for 2015–2016 using data on survival following kidney transplant, biopsy complications and overall infection prevention.
"There is nothing more overwhelming for parents than finding care for a child with a rare or life-threatening condition," said Avery Comarow, U.S. News health rankings editor. "We hope the Best Children's Hospitals provides a good starting point for research and helps make a family's search for the best care for their child a little easier."
The rankings were based on clinical survey data from 184 pediatric centers and reputational survey information from pediatric specialists and subspecialists. RTI International, a North Carolina-based research and consulting firm, directed the surveys with the help of 115 medical directors, pediatric specialists and other experts, and analyzed the results.
Read also:
Vitamin D might help preserve kidney function in children with CKD
The Best Children's Hospitals methodology factors in clinical outcomes, efficiency and coordination of the process of care delivery, compliance with "best practices" and steps to control infection and care-related resources such as adequate nursing staff and availability of programs tailored to particular illnesses and conditions.
Boston Children's Hospital also ranked number one in last year's ranking, and Cincinnati Children's Hospital Medical Center was also ranked number two in both lists.
The top five hospitals for 2015–2016 include:
• Boston Children's Hospital
• Cincinnati Children's Hospital Medical Center
• Seattle Children's Hospital
• Texas Children's Hospital
• Children's Mercy Hospitals and Clinics (Kansas City, Mo.)
The top five hospitals ranked last year include:
• Boston Children's Hospital
• Cincinnati Children's Hospital Medical Center
• Children's Hospital of Philadelphia (now number 6)
• Texas Children's Hospital
• Seattle Children's Hospital
Find the entire ranking at U.S. News and World Report.
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ASPEN Compares Sunitinib, Everolimus in Metastatic Non-Clear Cell Renal Cell ... - Cancer Therapy Advisor |
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Clinicians now have a better picture of what may be the optimal first-line therapy for patients with metastatic non-clear cell renal cell carcinoma (NC-RCC), according to results from a randomized phase 2 international trial of everolimus compared with sunitinib.
Investigators reported at the 2015 American Society of Clinical Oncology Annual Meeting that sunitinib was superior overall compared with everolimus at delaying disease progression. However, it was also associated with a higher rate of severe toxicity.1
The researchers found that sunitinib was more effective for papillary-type kidney cancers and for better prognosis patients.
Patients with chromophobe and poor-risk tumors treated with everolimus had a longer median progression-free survival (PFS) than patients treated with sunitinib.
“We wanted to know which was better. We don't a have a standard of care,” said lead study author Andrew Armstrong, MD, who is the co-director of the Genitourinary Oncology Research Program at Duke Cancer Institute in Raleigh, NC.
Known as ASPEN (Afinitor [RAD001] vs. Sutent (Sunitinib) in Patients With Metastatic Non-Clear Cell Renal Cell Carcinoma), this trial included 108 patients (57 patients received everolimus and 51 received sunitinib).
None of the patients had prior systemic therapy and they were divided into three categories of non-clear cell kidney cancers: metastatic papillary, chromophobe, or unclassified histology.
All the patients were enrolled between September 2010 and October 2013 across 17 sites and three countries. The median age was 63 and 75% of the patients were male.
Among the 108 patients, 66% had papillary disease, 15% had chromophobe, and 19% were unclassified. The patients were randomly assigned to receive either everolimus or sunitinib until their tumors progressed.
RELATED: Study Suggests Renal Cell Carcinoma Reprograms its Metabolism to Evade Immune System
Dr. Armstrong said during the study period there were 87 progression-free survival (PFS) events, 53 deaths, and two patients remaining on study treatment. Sunitinib improved overall PFS, meeting the primary endpoint and sunitinib improved PFS in good/intermediate risk and papillary and unclassified patients.
However, that was not the case in patients with chromophobe and patients classified as poor risk. They did a little better on everolimus. The median PFS was 5.6 months in patients treated with everolimus compared to 8.3 months in the sunitinib group.
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Analysts forecast the global peritoneal dialysis market to grow at a CAGR of 4 ... - WhaTech |
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- Advertisement -
New report: Global Peritoneal Dialysis Market 2015-2019
Peritoneal dialysis is a needle-free treatment and can be performed either by a patient or with the help of a care partner. It is used to remove waste products and extra fluid from the body during the issue with kidney functions.
Peritoneal dialysis differs from hemodialysis as in this treatment the blood is not taken from the body to treat the patient. In peritoneal dialysis, a tube called PD catheter is placed in the belly of the patient, and the dialysis is carried out by sterile fluid flowing through the lining of the belly called the peritoneum.
This helps the blood flow into and out of the peritoneal space and the blood is cleansed inside the body.
The report's analysts forecast the global peritoneal dialysis market to grow at a CAGR of 4.40% over the period 2014-2019.
Access report: Global Peritoneal Dialysis Market 2015-2019
Covered in this report
The report considers the following segments of the market:
- Peritoneal dialysis products
- Peritoneal dialysis services
The global peritoneal dialysis market is categorized based on the type of application:
- Continuous ambulatory peritoneal dialysis (CAPD)
- Automated peritoneal dialysis (APD)
This report, the Global Peritoneal Dialysis Market 2015-2019, has been prepared based on an in-depth market analysis with inputs from industry experts. It covers the global peritoneal dialysis market landscape and its growth prospects in the coming years.
- Advertisement -
The report includes a discussion of the key vendors operating in this market.
Key regions
- Americas
- APAC
- EMEA
Key vendors
- B. Braun Melsungen
- Baxter International
- DaVita Healthcare Partners
- Fresenius Medical Care
Other prominent vendor
- Covidien
- Dialysis Clinic
- Diversified Specialty Institute Holdings
- Huaren Pharmaceutical
- Medical Components
- NephroPlus
- Nipro
- Northwest Kidney Centers
- NxStage Medical
- Renal Services
- Sandor
- Satellite Healthcare
- Sichuan Kelun Pharmaceutical
- U.S. Renal Care
Market driver
- Growing aging population
- For a full, detailed list, view our report
Market challenge
- Associated risks and after-effects of peritoneal dialysis treatment
- For a full, detailed list, view our report
Market trend
- Emerging markets
- For a full, detailed list, view our report
Key questions answered in this report
- What will the market size be in 2019 and what will the growth rate be?
- What are the key market trends?
- What is driving this market?
- What are the challenges to market growth?
- Who are the key vendors in this market space?
- What are the market opportunities and threats faced by the key vendors?
- What are the strengths and weaknesses of the key vendors?
New report: Global Peritoneal Dialysis Market 2015-2019
For more information: www.marketresearchint.com/medical-devices-market-research… Page views: 6 < Prev Next >
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