Gadolinium-Containing Magnetic Resonance Imaging Contrast and Nephrogenic Systemic Fibrosis: A Case-Control Study
, 26 March 2008
Alexander J. Kallen, Michael A. Jhung, Steven Cheng, Theresa Hess, George Turabelidze, Liana Abramova, Matthew Arduino, Jeannette Guarner, Brian Pollack, Georges Saab, Priti R. Patel
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 966-975) Abstract |
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C-Reactive Protein Levels and Clinical Symptoms Following Gadolinium Administration in Hemodialysis Patients
Gisela Schieren, Faruk Tokmak, Lutz Lefringhausen, Mark van Bracht, Christian Perings, Reinhardt Willers, Andreas Günsel, Fritz Kemper, Gerhard Andreas Wiesmüller, Lars Christian Rump
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 976-986) Abstract |
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A 1-Year Randomized Trial of Calcium Acetate Versus Sevelamer on Progression of Coronary Artery Calcification in Hemodialysis Patients With Comparable Lipid Control: The Calcium Acetate Renagel Evaluation-2 (CARE-2) Study
, 23 April 2008
Wajeh Qunibi, Moustafa Moustafa, Larry R. Muenz, David Y. He, Paul D. Kessler, Jose A. Diaz-Buxo, Mathew Budoff, CARE-2 Investigators
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 952-965) Abstract |
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Calcification in CKD: No Closer to the Cure
Bryan Kestenbaum
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 877-879) Full Text |
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CKD Following Kidney Transplantation in Children and Adolescents
, 06 May 2008
Colin Thomas White, Travis Schisler, Lee Er, Ognjenka Djurdjev, Mina Matsuda-Abedini
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 996-1004) Abstract |
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Kidney Transplantation in Children: The Preferred Option But Still No Cure
Jonathan C. Craig
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 880-881) Full Text |
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The History of Renal Transplantation in the Arab World: A View From Saudi Arabia
, 23 April 2008
Abdulla Ahmed Al Sayyari
American Journal of Kidney Diseases
June 2008 (Vol. 51, Issue 6, Pages 1033-1046) Abstract |
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Gadolinium-based MRI Contrast and Nephrogenic Systemic Fibrosis
See Kallen et al, pages 966-975 and Schieren et al, pages 976-986.
Nephrogenic Systemic Fibrosis (NSF), a rare but serious condition occurring in individuals with kidney failure, is believed to occur following gadolinium-based contrast exposure. In this issue, Kallen et al report the results of an investigation by the Centers for Disease Control and Prevention and the Missouri Department of Health and Senior Services into a large cluster of NSF identified in dialysis patients. Using a case-control design evaluating 19 dialysis patients affected with NSF matched to 57 dialysis patients without NSF at a single center, the authors conclude that gadolinium exposure (most notably gadodiamide) in the previous year was independently associated with development of NSF (OR, 8.97; 95% CI, 1.28 to 63.0); additionally, there was a dose-response effect such that higher doses of gadolinium were more likely to lead to NSF. In a related article, Schieren et al report an association between gadopentate administration and an acute rise in C-reactive protein in hemodialysis patients.
See Qunibi et al, pages 952-965 and Kestenbaum, pages 877-879.
Previous clinical trials indicate that progression of coronary artery calcification (CAC) may be slower in hemodialysis patients treated with sevelamer than in those treated with calcium-based phosphate binders. In this issue, Qunibi et al hypothesize that LDL cholesterol-lowering and pleiotropic properties of sevelamer play a major role in slowing progression of CAC and test this hypothesis in a randomized clinical trial of sevelamer versus calcium acetate in hemodialysis patients treated with atorvastatin to achieve a comparable LDL cholesterol goal. The Calcium Acetate Renagel Evaluation-2 (CARE-2) study evaluated 203 patients over 12 months to achieve serum phosphorus levels of 3.5 to 5.5 mg/dL. Results showed a similar progression in the two groups: mean LDL cholesterol levels decreased to 68.8 ± 23.0 mg/dL in the calcium acetate group and 62.4 ± 23.0 mg/dL in the sevelamer group (P = 0.3). The authors concluded that there was no difference between sevelamer and calcium acetate if serum LDL cholesterol is controlled. An editorial by Dr Kestenbaum reminds us that there is limited evidence supporting that LDL cholesterol plays an important role in CAC and there remains no effective treatment for vascular calcification.
CKD Following Kidney Transplantation in Children and Adolescents
See White et al, pages 996-1004 and Craig, pages 880-881.
There are few studies that compare comorbid conditions in children and adolescents with CKD after kidney transplantation versus CKD in native kidneys. In this issue, White et al compare comorbid conditions in 45 kidney transplant recipients and 102 age- and CKD-stage matched controls who had not undergone transplantation. They found that 68% of transplant recipients had 2 or more complications compared with 29% of native-kidney patients, with anemia (OR, 9.7; 95% CI, 3.9 to 24.6) and hypertension (OR, 12.9; 95% CI, 3.4 to 49.4) as the most prevalent comorbid conditions. The authors suggest that increased awareness and attention to these 2 modifiable risk factors for CKD and cardiovascular disease may improve outcomes after transplantation. In an accompanying editorial, Dr Craig points out that transplant recipients are not cured of CKD, and that care of CKD complications can be improved.
This month in the AJKD World Kidney Forum, Dr Al Sayyari examines the history of kidney transplantation in the Arab World. Dr Al Sayyari's account provides an in-depth history of the Saudi Center for Organ Transplantation (SCOT), a leading multi-organ procurement program in Saudi Arabia. He also discusses how Arabic culture, particularly the Muslim faith, has shaped the development of the procedure in Arab countries. The role of war is explored as Dr Al Sayyari underscores the impact that regional conflicts and strife have had on transplant programs. This fascinating installment of World Kidney Forum illuminates the unique barriers to kidney transplantation in this part of the globe.
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