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KDIGO Publishes Guideline For Managing Glomerulonephritis - Renal Business Today

NEW YORK—Evidence-based treatment guided by renal biopsy diagnosis can alleviate symptoms and avoid progression to kidney failure in patients with glomerulonephritis, according to the first clinical practice guideline for glomerulonephritis.

Published this month in Kidney International Supplements, the guideline was developed by an international group of experts, under the auspices of Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO is managed by the National Kidney Foundation (NKF).

Glomerulonephritis is a group of disorders characterized by damage to the kidney’s filtering units which result in the appearance of protein and/or blood in the urine. This guideline recommends that patients in whom these abnormalities are detected should be referred to a nephrologist for evaluation and that a kidney biopsy may need to be performed in order to make a definitive diagnosis.

According to the guideline, proteinuria is the most important parameter for predicting prognosis, relapse of disease and response to treatment, and persistent proteinuria is associated with a worse prognosis.

“Glomerulonephritis may not be curable in all cases, but with proper diagnosis and treatment, many patients can experience lasting remission and kidney function can be preserved,” said Dr. David Wheeler, KDIGO co-chair. “Effective treatments for glomerulonephritis include immunosuppressive agents which induce disease remission as well as medicines that reduce blood pressure and protein loss in the urine.”

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Police expect peaceful protest tonight - CBC.ca

Charlottetown police say they don't expect any trouble at Tuesday evening's rally at Province House.

People opposed to the closures of the Souris and Alberton dialysis centres have organized the rally, but a number of other groups opposed to recent government cuts and decisions are also expected.

Police have been in contact with the organizers and have informed them about rules for the gathering, Chief Gary McGuigan said.

He said police will be monitoring the situation.

Residents of Eastern Kings County will be bussed to Province House while MLAs are inside at an evening sitting of the legislature.

Organizers, hoping hundreds of Islanders will show up, have taken out ads in local papers and have mailed information directly to residents.

Souris Mayor David Macdonald is among the residents of rural P.E.I. who are making their way to Province House tonight.

He and dialysis patient Nathan Bushey are leading the effort to convince government not to close the dialysis unit at the local hospital.

"It's just a devastating decision to patients," Bushey told CBC News, "It's going to increase costs to health care and it just makes no sense at all."

The rally will begin at Peakes Quay and will march up Great George Street to Province House at 7 p.m., just in time for the evening session of the legislature.

But dialysis service is not the only issue that has people protesting.

Police expect people to gather at tonight's protest to take a stand on other issues such as the proposed highway in Bonshaw, the school in Souris, and the HST.

MacDonald said he is concerned some of those protesters might draw attention away from the dialysis issue.

Province struggling with rising health care costs

The number of dialysis patients on P.E.I. is expected to double over the next three years.

The province has updated dialysis units in Charlottetown and Summerside, and had announced its intentions to close units in rural hospitals.

But Health minister Doug Currie said he is taking a second look at that.

"We basically have already made a statement publicly that we have deferred the decision to take a more comprehensive look at our decision," Currie said.

"The challenge is with these types of decisions we're seeing intense growth, intense demand."

Charlottetown resident Wendy Budgeon told CBC News she thinks the province should leave dialysis treatment options alone.

"Now I think it's just a whole series of silly, silly things, this government is doing," she said, "They have issues with everything they lay their hands on and dialysis is only one of them."

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ESRD Patients With Diabetes May Benefit From Low-Glucose PD Regimen - Renal Business Today

PARIS—Baxter International Inc. announced results from two large, international multicenter trials demonstrating that a low glucose peritoneal dialysis (PD) regimen favorably impacted metabolic measures important for end-stage renal disease (ESRD) patients with diabetes, including blood glucose (sugar) control and selected lipids (fats and cholesterol).

The combined results were presented as a late-breaking presentation at the 49th Annual European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) congress in Paris.

Results from the combined IMPENDIA/EDEN trials showed that a low-glucose PD regimen led to clinically and statistically significant reductions in serum levels of HbA1c (the standard marker for assessing blood glucose control) in adult PD patients with diabetes. In the studies, significant reductions also were seen with certain lipid parameters including serum triglycerides (type of lipid or fat found in the blood), VLDL-cholesterol and apolipoprotein B (a protein that helps form LDL, or bad cholesterol, in blood) following a low-glucose PD regimen.

"A low-glucose prescription should be considered when managing diabetic patients on peritoneal dialysis," said Joanne Bargman, MD, University Health Network and professor of Medicine at the University of Toronto and presenting study investigator. "The data demonstrate low glucose PD regimens may be beneficial in aiding the management of glucose and lipid levels in diabetic PD patients."

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ESRD Patients With Diabetes May Benefit From Low-Glucose PD ... - Renal Business Today

PARIS—Baxter International Inc. announced results from two large, international multicenter trials demonstrating that a low glucose peritoneal dialysis (PD) regimen favorably impacted metabolic measures important for end-stage renal disease (ESRD) patients with diabetes, including blood glucose (sugar) control and selected lipids (fats and cholesterol).

The combined results were presented as a late-breaking presentation at the 49th Annual European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) congress in Paris.

Results from the combined IMPENDIA/EDEN trials showed that a low-glucose PD regimen led to clinically and statistically significant reductions in serum levels of HbA1c (the standard marker for assessing blood glucose control) in adult PD patients with diabetes. In the studies, significant reductions also were seen with certain lipid parameters including serum triglycerides (type of lipid or fat found in the blood), VLDL-cholesterol and apolipoprotein B (a protein that helps form LDL, or bad cholesterol, in blood) following a low-glucose PD regimen.

"A low-glucose prescription should be considered when managing diabetic patients on peritoneal dialysis," said Joanne Bargman, MD, University Health Network and professor of Medicine at the University of Toronto and presenting study investigator. "The data demonstrate low glucose PD regimens may be beneficial in aiding the management of glucose and lipid levels in diabetic PD patients."

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Obese patients face higher risks during heart surgery - CBS42
BIRMINGHAM, Ala. (WIAT)-

A new study shows that oxidative stress may put obese patients at an increased risk of developing kidney damage after heart surgery. Oxidative stress generates harmful unstable reactive oxygen molecules. The study is appearing in the upcoming issue of the Journal of the American Society of Nephrology(JASN).

More studies are needed to see if effective antioxidants can help reduce the risk. Acute kidney injury (AKI) affects 5% to 30% of heart surgery patients. AKI is an abrupt decline in kidney function and sometimes arises after heart surgery because the kidneys are deprived of normal blood flow during the procedure.

Frederic Billings IV, MD (Vanderbilt University School of Medicine) and members of his team evaluated information gathered from 445 heart surgery patients, 25% of whom developed AKI. The major findings of the study showed obese patients had an increased risk of developing AKI; and that oxidative stress plays a role in the link between obesity and AKI.

"The identification of oxidative stress during surgery as a possible mechanism for the development of kidney injury following surgery provides an opportunity to develop and test therapeutic treatments for surgical patients," Dr. Billings was quoted as saying.

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