Nonsurgical treatment of small tumor renal cancer may be as effective as radical nephrectomy but with fewer complications

1. Rates of renal insufficiency were highest in patients receiving renal nephrectomy, compared to less invasive treatments. 2. Survival rates for renal nephrectomy and partial nephrectomy were very similar, suggesting little difference in efficacy between these treatments. Evidence Rating Level: 2 (Good) Study Rundown: Renal stage carcinoma (RCC) has relatively low mortality rates with respect []

Extreme preterm birth linked to hypertension at school age

1. Within a cohort of infants born extremely preterm (EPT), there were elevated rates of high systolic blood pressure (SBP≥90%ile) and hypertension (SBP≥95%ile) when these children reached school age. 2. School age children with high SBP who were born EPT, were significantly more likely to have been born to mothers with gestational diabetes, and as []

Using HCV-infected kidneys greatly reduces wait time for transplantation and improves survival for patients with HCV

1. Use of HCV-infected kidneys increased patients' quality-adjusted life expectancy. 2. Lower costs were associated with HCV-infected kidneys compared to transplanting HCV-uninfected kidneys to HCV-positive patients. Evidence Rating Level: 2 (Good) Study Rundown: Organ availability for transplantation is limited; therefore, for patients with end stage renal disease (ESRD), hemodialysis is often the final treatment compared []

Restricting perioperative fluid for abdominal surgery patients does not reduce complications: The RELIEF trial

1. Among patients at increased risk for complications undergoing abdominal surgery, those randomized to perioperative fluid restriction did not have increased disability-free survival at one year compared to patients who received liberal perioperative fluid management. 2. Patients managed with fluid restriction experienced higher rates of acute kidney injury. Evidence Rating Level: 1 (Excellent) Study Rundown: []

Improved calculations suggest major changes to statin, aspirin, and blood pressure medication prescribing

1. Updated risk calculations suggest that fewer people should be classified within the high-risk category for CVD. 2. Many Americans, especially those of African American descent, may require reduction and alteration to their statin, aspirin, and/or blood pressure medication. Evidence Rating Level: 2 (Good) Study Rundown: Cardiovascular disease (CVD) affects many people worldwide. Treatment for []

Physicians report feeling moral distress over hospital policies that force inadequate care based on immigration status

1. Physicians working in settings that provide emergency only hemodialysis (EOHD) reported higher rates of professional burnout. 2. Physicians providing EOHD reported feeling moral distress regarding inadequate care based on immigration status and inspiration towards further patient advocacy. Evidence Rating Level: 2 (Good) Study Rundown: In the United States, the policy for undocumented immigrants with []

Coaching to improve water intake does not improve kidney function in adults with chronic kidney disease

1. In this randomized controlled trial, coaching to improve daily fluid intake did not improve kidney function in patients with Chronic Kidney Disease. 2. Increasing fluid intake via coaching was adequate to lower vasopressin secretion in patients. Evidence Rating Level: 1 (Excellent) Study Rundown: In both preclinical animal models and clinical human studies, increased water []

Hospice care may not decrease Medicare costs in patients on maintenance dialysis

1. In this cross-sectional study, of those patients on maintenance hemodialysis that were referred to hospice care, 41.5% received care for only 3 days or less. 2. While patients who were enrolled in hospice care were less likely to die in hospital or undergo intensive procedures prior to death, they were more likely to be []

Optimizing organ donations from overdose deaths may help address national organ shortage

1. U.S. transplants using organs from overdose-death donors (ODDs) has increased 24-fold from 2000 to 2016, and transplant outcomes from organs donated by ODDs have been noninferior to those donated by trauma-death donors (TDDs) and medical-death donors (MDDs). 2. Compared to TDD organs, ODD kidneys and livers were discarded at a greater rate. Evidence Rating []

Medicare pre-ESRD care results in more dialysis initiation but also increased two-year mortality

1. Veterans receiving pre-end stage renal disease (ESRD) nephrology care in under the Medicare system were more likely to undergo dialysis and had a higher two-year mortality rate than veterans that received pre-ESRD care through the Department of Veteran's Affairs (VA). 2. Differences in dialysis initiation between Medicare and VA were more pronounced in patients []

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