Nephrology

Mineralocorticoid receptor antagonists (MRAs) are often used with a renin-angiotensin system (RAS) blocker to further reduce proteinuria in patients with CKD. However, eplerenone and spironolactone increase the risk of hyperkalemia in these patients. Finerenone (BAY94-8862) is a new nonsteroidal MRA that has better receptor selectivity than spironolactone, associating with lower …

Researchers study retinopathy as possible indicator of nephropathy… The number of diabetes mellitus cases is on the rise while the incidence of end-stage kidney disease from diabetes has decreased over the years. However, diabetes remains the main cause of end-stage kidney disease in the United States and other countries. There …

David Levy, MD, FRCP      Mononeuropathies and other focal syndromes Peripheral mononeuropathies Upper limb Carpal tunnel syndrome (median nerve) Carpal tunnel syndrome is very common (remember the association with primary hypothyroidism, especially in type 1 diabetes) and may present with atypical symptoms, as it is often superimposed on diabetic polyneuropathy. Consider it …

Dr. Paolo Fiorina talks about the process of stem cell therapy and how the researchers have found a way to use a patient’s own bone marrow stem cells. This also prevents an autoimmune response attacking the cells. Dr. Fiorina discusses how he would like to start fully testing this new …

Dr. Paolo Fiorina explains how, after 30 years of research into the potential of stem cell therapy and immunotherapy for curing type 1 diabetes, new developments in these fields are offering genuine hope for the first time. In a recent study with about 60 type 1 patients, significant progress was …

Trading 2 minutes/hour of sedentary activity with light-intensity activity was linked to 33% lower mortality in the general population and 41% lower mortality in those with chronic kidney disease (CKD)… Numerous studies have shown that sitting for extended periods of time each day leads to increased risk for early death, …

David Levy, MD, FRCP Management of diabetic nephropathy Investigations Mid-stream urine if leucocytes on routine urinalysis. Renal tract ultrasound scan: a. Normal renal length is about 11 cm, correlating weakly with height and BMI; it is about 10 cm in South Asian and oriental subjects. Kidneys are large in the poorly …

David Levy, MD, FRCP Overview of Diabetic Kidney Disease End-stage renal disease (ESRD) is a common and terrible outcome of diabetes. However, recent data in both type 1 and type 2 diabetes are encouraging. In type 1 diabetes, where not long ago diabetic nephropathy was almost inevitable after 20–30 years, fewer …

Mortality, cardiovascular disease risk remains same for patient with secondary hyperparathyroidism… After further review, adjusted findings from the EVOLVE Trial showed that cinacalcet may reduce the risk of fracture among patients on dialysis. In a pre-specified subgroup analysis, cinacalcet was associated with reduced fracture risk after taking baseline characteristics and …

The proportion of patients experiencing a rapid decline in estimated glomerular filtration rate (eGFR) can be decreased significantly with niacin, as can all-cause mortality… Elani Streja, PhD Chief investigator, University of California, Irvine Medical Center, commented on the study, stated, “Across all models of adjustment, patients who took niacin had …