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Concept: Artificial kidney


Risk of end-stage renal disease (ESRD) in kidney donors has been compared with risk faced by the general population, but the general population represents an unscreened, high-risk comparator. A comparison to similarly screened healthy nondonors would more properly estimate the sequelae of kidney donation.

Concepts: Renal failure, Chronic kidney disease, Kidney, Nephrology, Erythropoietin, Diabetic nephropathy, Kidney transplantation, Artificial kidney


An 80-year-old woman presented with left leg pain. She had end-stage renal disease caused by hypertensive nephrosclerosis and was undergoing maintenance hemodialysis.

Concepts: Renal failure, Chronic kidney disease, Kidney, Nephrology, Hypertension, Artificial kidney, Kidney diseases, Hypertensive nephropathy


Chronic kidney diseases are a major worldwide societal burden. In the United States, where the prevalence of chronic kidney disease is approximately 14%,(1) close to 1 million persons have end-stage renal disease (ESRD). Of those affected, 700,000 (70.8%) are treated with dialysis, and the remaining 300,000 (29.2%) with kidney transplantation (i.e., 56 cases per 1 million population).(2) Currently, just over 100,000 U.S. patients with ESRD are on the waiting list for a kidney transplant, but every year, only 15 to 16% will receive a kidney transplant, and of those kidneys, 32 to 34% are from live donors.(3) Annual U.S. expenditures . . .

Concepts: Renal failure, Chronic kidney disease, Kidney, Nephrology, Erythropoietin, Diabetic nephropathy, Kidney transplantation, Artificial kidney


There is a need to improve end-of-life care for people with end-stage kidney disease, particularly due to the increasingly elderly, frail and co-morbid end-stage kidney disease population. Timely, sensitive and individualised Advance Care Planning discussions are acceptable and beneficial for people with end-stage kidney disease and can help foster realistic hopes and goals.

Concepts: Psychology, Chronic kidney disease, Kidney, Medicine, Death, Sociology, Artificial kidney, End-of-life care


Erythropoiesis-stimulating agents (ESAs) increase hemoglobin levels, reduce transfusion requirements, and have been the standard of treatment for anemia in patients with chronic kidney disease (CKD) since 1989. Many safety concerns have emerged regarding the use of ESAs, including an increased occurrence of cardiovascular events and vascular access thrombosis. Hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzyme inhibitors are a new class of agents for the treatment of anemia in CKD. These agents work by stabilizing the HIF complex and stimulating endogenous erythropoietin production even in patients with end-stage kidney disease. HIF-PH inhibitors improve iron mobilization to the bone marrow. They are administered orally, which may be a more favorable route for patients not undergoing hemodialysis. By inducing considerably lower but more consistent blood erythropoietin levels than ESAs, HIF-PH inhibitors may be associated with fewer adverse cardiovascular effects at comparable hemoglobin levels, although this has yet to be proved in long-term clinical trials. One significant concern regarding the long-term use of these agents is their possible effect on tumor growth. There are 4 such agents undergoing phase 2 and 3 clinical trials in the United States; this report provides a focused review of HIF-PH inhibitors and their potential clinical utility in the management of anemia of CKD.

Concepts: Hemoglobin, Chronic kidney disease, Erythropoietin, Dialysis, Red blood cell, Bone marrow, Anemia, Artificial kidney


Hemodynamic instability related to renal replacement therapy (HIRRT) may increase the risk of death and limit renal recovery. Studies in end-stage renal disease populations on maintenance hemodialysis suggest that some renal replacement therapy (RRT)-related interventions (e.g., cool dialysate) may reduce the occurrence of HIRRT, but less is known about interventions to prevent HIRRT in critically ill patients receiving RRT for acute kidney injury (AKI). We sought to evaluate the effectiveness of RRT-related interventions for reducing HIRRT in such patients across RRT modalities.

Concepts: Renal failure, Chronic kidney disease, Kidney, Nephrology, Erythropoietin, Dialysis, Hemodialysis, Artificial kidney


The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD.

Concepts: Chronic kidney disease, Nephrology, Death, Life, Crossover study, Hemodialysis, Artificial kidney


Uremic pruritus (UP) is a common discomfort of dialysis-dependent end-stage renal disease. Some studies suggest a neuropathic cause of UP. Gabapentin, an anticonvulsant, has shown promising results as an emerging drug to treat this condition.

Concepts: Renal failure, Chronic kidney disease, Kidney, Nephrology, Erythropoietin, Hemodialysis, Kidney transplantation, Artificial kidney


There are no easily available markers of renal recovery to guide intermittent hemodialysis (IHD) weaning. The aim of this study was to identify markers for IHD weaning in critically ill patients with acute kidney injury (AKI).

Concepts: Chronic kidney disease, Kidney, Urine, Artificial kidney


Chronic musculoskeletal (MS) pain is common in patients with chronic kidney disease (CKD) undergoing haemodialysis. However, epidemiological data for chronic MS pain and factors associated with chronic MS pain in patients with early- or late-stage CKD who are not undergoing dialysis are limited.

Concepts: Renal failure, Chronic kidney disease, Nephrology, Erythropoietin, Dialysis, Epidemiology, Hemodialysis, Artificial kidney