Increased Risk of Adverse Pregnancy Outcomes after Recovery from Acute Kidney Injury

By Martina McGrath, MD
September 26, 2017

Women with advanced chronic kidney disease (CKD) have long been known to be at increased risk of complications in pregnancy including preeclampsia, pre-term birth, small-for-dates offspring, and progression of underlying CKD following pregnancy.1 However, several recent studies have highlighted a less obvious connection between earlier stages of renal disease and adverse pregnancy outcomes.2,3 Continue reading “Increased Risk of Adverse Pregnancy Outcomes after Recovery from Acute Kidney Injury”

Hep C Positive Kidneys into Hep C Negative Patients: Pushing the Boundaries of Transplantation

[Photo by Bill Branson, NIH Medical Arts, National Institutes of Health. Pictured are Robert Colbert, M.D., Ph.D., Amy Petrik, Ph.D., and Grace Kwon, Ph.D. ]

By Martina M. McGrath, MD
May 4, 2017

Currently, over 97,000 patients are awaiting kidney transplant.1 Hepatitis C (HCV) infection is prevalent in the community, and it has been reported that >3000 kidneys from HCV+ donors were offered between 2005 and 2014.2 Prior to the current era of direct-acting antiviral agents (DAAV), patients with HCV who underwent renal transplantation had poorer outcomes, and antiviral treatment with interferon was associated with increased risk of rejection. Likely related to these risks, it has been reported that over 500 kidneys from HCV+ donors are discarded annually.2 However, DAAVs have transformed the management of HCV infection. Greater than 90 percent cure rates have been reported with many of these medications, which are generally well-tolerated. With the availability of safe and effective antiviral therapy for HCV, the question has arisen, could these kidneys now be safely used in HCV-negative recipients? Continue reading “Hep C Positive Kidneys into Hep C Negative Patients: Pushing the Boundaries of Transplantation”

The Link Between Proton Pump Inhibitors and Kidney Disease

By Lea Borgi, MD
April 27, 2017

Proton pump inhibitors (PPI) are among the most prescribed medication in the United States1, with an increasing proportion of US adults reporting using prescription PPI (3.9% in 1999 to 7.8% in 2012) according to the National Health and Nutrition Examination Survey (NHANES).2 However, overall PPI use is most likely underestimated, given their widespread over-the-counter availability. Continue reading “The Link Between Proton Pump Inhibitors and Kidney Disease”

Kidney Transplants from Deceased Donors: How Old is Too Old?

Are older deceased donors an underused resource?

By Martina M. McGrath, MD
December, 29, 2016

Since publication of Robert Wolfe’s landmark paper in 19991 demonstrating a doubling of life expectancy post-renal transplantation compared with remaining on dialysis, demand for renal transplants has continuously grown. Over 99,000 individuals are currently awaiting renal transplantation in the US.2 Kidneys from deceased donors previously termed ‘extended criteria donors’ (ECD), provide good outcomes with acceptable duration of function for selected, older recipients or those not expected to survive on long-term dialysis. ECD kidneys come from donors over 60 years old or from those aged 50-59 years old with coexisting medical conditions such as hypertension, cerebrovascular disease, or creatinine >1.5mg/dL. Despite good short-term outcomes, the rates of discard for these kidneys remain high. For those in the transplant community, these kidneys may be a precious resource that is being wasted. So the question remains—when it comes to deceased donation, how old is too old? Continue reading “Kidney Transplants from Deceased Donors: How Old is Too Old?”

Two Promising New Diabetes Drugs

Reducing cardiovascular complications in patients with diabetes: exciting new drug therapy on the horizon.

By Ajay K. Singh, MBBS, FRCP, MBA
December 7, 2016

Diabetes mellitus is in epidemic proportions in many parts of the world. Its most consequential and debilitating complications are cardiovascular disease, retinopathy, and nephropathy. Newer agents are now emerging and have the potential to transform the management of diabetes. Continue reading “Two Promising New Diabetes Drugs”

Pushing the envelope across HLA boundaries: HLA-incompatible renal transplants

By Martina M. McGrath, MD
July 6, 2016

The deceased-donor renal transplant waiting list continues to expand inexorably, and currently, up to 15% of wait-listed patients are awaiting their second or subsequent kidneys. With this changing demographic, the challenge of transplanting patients with increasing levels of HLA sensitization becomes ever more prevalent. Continue reading “Pushing the envelope across HLA boundaries: HLA-incompatible renal transplants”