Wednesday, November 14, 2012

IN THE NEWS: Nephrology NEJM showcase

Latest offerings in NEJM highlight nephrology articles:

One of them is comparing ultrafiltration to diuretic use in cardio renal syndrome(CARRESS-HF).
Interestingly, ultrafiltration performed inferiorly compared to a catered diuretic regimen in a randomized controlled trial. Does it end the role of UF? Or is SCUF still a consideration. An editorial attached still says slow and steady might be preferred.

ADPKD and treatment with aquretic treatment is the next major article. The TEMPO trial showed this using tolvaptan. Can this drug show promise in protecting renal function in ADPKD.

EVOLVE trial looked at cinacalcet in ESRD patients in a randomized trial and evaluated cardiac endpoints and found shockingly negative results.

ALTITUDE trial evaluated adding aliskiren to other renin angi inhibitors in DMII for cardio renal end points and found harm and no significant benefit.

3 negative trials
1 positive trial

Evidence based medicine keeps knocking off physiology based medicine in Nephrology.

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