Dialysis world news


JASN early release: Rituximab shows good results in membranous nephropathy.
JASN: All 24 patients who had at least 4 years of follow-up achieved complete or partial remission. Rates of remission were similar between patients with or without previous immunosuppressive treatment. Four patients died and four progressed to ESRD. Measured GFR increased by a mean 13.2 (SD 19.6) ml/min per 1.73 m2 among those who achieved complete remission. Serum albumin significantly increased and albumin fractional clearance decreased among those achieving complete or partial remission. Proteinuria at baseline and the follow-up duration each independently predicted the decline of proteinuria. Furthermore, the magnitude of proteinuria reduction significantly correlated with slower GFR decline (P=0.0001). No treatment-related serious adverse events occurred. In summary, rituximab achieved disease remission and stabilized or improved renal function in a large cohort of high-risk patients with IMN.

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JASN RCT finds no benefits of 3 phosphorus binding drugs on vascular calcification in predialysis CKD..
JASN: Active therapy did, however, significantly increase calcification of the coronary arteries and abdominal aorta (coronary: median increases of 18.1% versus 0.6%, P=0.05; abdominal aorta: median increases of 15.4% versus 3.4%, P=0.03). In conclusion, phosphate binders significantly lower serum and urinary phosphorus and attenuate progression of secondary hyperparathyroidism among patients with CKD who have normal or near-normal levels of serum phosphorus; however, they also promote the progression of vascular calcification. The safety and efficacy of phosphate binders in CKD remain uncertain.

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FDA: Seizure risk from cefepime in patients with renal impairment.
FDA: The U.S. Food and Drug Administration (FDA) is reminding health care professionals about the need to adjust the dosage of the antibacterial drug cefepime in patients with renal (kidney) impairment. There have been cases of a specific type of seizure called nonconvulsive status epilepticus associated with the use of cefepime, primarily in patients with renal impairment who did not receive appropriate dosage adjustments of cefepime. The Warnings and Precautions and Adverse Reactions sections of the cefepime label are being revised to highlight this risk.

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FDA approves new phosphate-free colon cleansing prep.
FDA: On July 16, the U.S. Food and Drug Administration approved Prepopik (sodium picosulfate, magnesium oxide and citric acid) to help cleanse the colon in adults preparing for colonoscopy. One dose of Prepopik consists of two packets of powder, each dissolved in cold water and taken at separate times. Patients should take Prepopik the night before colonoscopy and the morning of colonoscopy (Split-Dose regimen). If this is not possible, patients may take Prepopik in the afternoon and evening before the colonoscopy (Day-Before regimen).

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Trial of EPO pump underway.
Business Wire: Medgenics, Inc. (NYSE MKT: MDGN and AIM: MEDU, MEDG), the developer of Biopump(TM), a novel technology for the sustained production and delivery of therapeutic proteins in patients using their own tissue, announces the launch of its Phase IIa clinical trial in Israel of EPODUR(TM) Biopumps to treat anemia in patients with end-stage renal disease (“ESRD” or “kidney failure”) on dialysis, through the sustained delivery of erythropoietin (“EPO”). Following the Israeli Ministry of Health’s recent approval of the trial, Medgenics has enrolled and begun to treat the first two dialysis patients ever to receive EPODURE Biopumps.

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