Study suggests donation views held by the family, or the deceased in life, do not guarantee organ donation.

The most frequently-recurring theme, reported in 15 out of 26 interviews conducted in the United Kingdom, related to keeping the body whole and intact. In its conclusion, the study suggests that there is a tension between the notions of ‘gift of life’ from the point of view of the transplant organization and ‘sacrifice’ of the body" from the point of view of the family.

A research letter published in the Canadian Medical Association Journal reports on accidental finding that excessive drinking of water may cause proteinuria. Full text is available on the journal's website.

This study tried to clarify whether the expression of the down-regulation of core I β3-Gal-T-specific molecular chaperone (Cosmc) mRNA in IgAN patients is a result of genetic disorders or external suppressions. The study concluded that it might not be genetic disorders but external suppression that causes the low Cosmc mRNA expression in IgAN.

Full text available at source.

Full published text available at source.

Full text available at source.

Full text available at source.

Full text available at source.

Nephrotic syndrome (NS) remains a therapeutic challenge to nephrologists, despite trials of different ranges of therapeutic regimens. This systematic review and analysis of published articles has been used in refractory NS secondary to idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis and minimal change glomerulonephritis with mostly favourable outcome and no serious adverse events. However, because the follow-up period in all cases was relatively short, the authors suggest that the benefit of long-term use and follow-up of rituximab in nephrotic syndrome and glomerulonephritis need further evaluation and prospective randomized controlled trials. IgA nephropathy was not mentioned in this study, although a subset of IgAN patients may present with nephrotic syndrome.

Researchers have brought the heart of a euthanized lab animals back to life in the lab by repopulating it with healthy cells, a feat they believe may someday allow them to grow new organs for people who need an organ transplant. Researcher says the process could be used to generate other organs – from the liver and lungs to the pancreas and kidneys. Any benefit of this to humans is still in the future. Experts caution that the heart is an easier organ to revitalize because its functions are simpler. For example, the kidneys contain various cellular structures to filter waste from the body which would make it more difficult to accomplish.

The proposals would mean consent for organ donation after death would be automatically presumed, unless individuals had opted out of the national register or family members objected.

This study analysed 395 membranous (MGN), 370 focal and segmental glomerulosclerosis (FSGS) and 542 IgA nephropathy patients to determine the impact of the patients’ sex on outcome. It concluded that women have a better outcome than men in MGN and FSGS but not in IgA nephropathy.

Major study shows low vitamin D levels increase risk of cardiovascular problems, and particularly so in those who also have high blood pressure.

Feed editor's note:

This study was not conducted in the context of kidney disease, but vitamin D often needs to be supplemented either with regular vitamin D or prescription active vitamin D (such as calcitriol) in advanced chronic renal insufficiency and end-stage renal failure, and also sometimes in kidney transplant patients. This is also a population where high blood pressure is a problem. This news comes at a time when the whole subject of vitamin D supplementation is being questioned in nephrology, and recent studies and commentary suggest limiting vitamin D supplementation compared to what has been done in the past. We suggest discussing this with your nephrologist at the next follow-up. Never take vitamin supplements without checking with your doctor if you have chronic kidney disease with some level of renal insufficiency. Some could be harmful to your health.

Immunoglobulin A nephropathy (IgAN) is characterized by an aberrant structure of O-glycans in the IgA1 hinge region. Recently, under-galactosylated IgA1 has been found to be increased in Caucasian IgAN patients. This study examined this in Japanese IgAN patients. It concluded that HAA–IgA binding is significantly increased in Japanese IgAN patients.

This prospective diary-based study shows that taking medications late is the most common non-adherence to the prescribed immunosuppresion regime. It suggests interventions should be designed to better assist kidney recipients with taking medications on time, especially when they are away from home.

This single-center, retrospective study of 325 kidney transplant recipients demonstrated compelling effects of statins against all adverse outcomes among patients treated with sirolimus-based, cyclosporine-containing regimens.

Editorial which brings up point that we know too little about the long-term safety of drugs which inhibit the renin-angiotensin system in chronic kidney disease patients, especially with combination therapy of ACE inhibitors plus ARBs in stage 3 or 4 chronic kidney disease.

This meta-analysis finds that angiotensin II receptor blockers (ARBs) reduce proteinuria, independent of the degree of proteinuria and of the underlying kidney disease. Reduction in proteinuria from ARBs and ACE inhibitors is similar, but their combination is more effective than either drug alone. The stated limitations of the meta-analysis were that most studies were small, varied in quality, and did not provide reliable data on adverse drug reactions. It adds that proteinuria reduction is only a surrogate for important progression of renal failure.

Study finds no clinically meaningful evidence for an increased risk of ESRD associated with use of phenacetin-free analgesics in single or combined formulation.

A prospective, open, randomized, controlled study which looked at whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance < 30 ml/min). Although atorvastatin reduced total and LDL cholesterol effectively it was not beneficial regarding the long-term outcomes of cardiovascular endpoints or survival. In contrast to other patient groups, the study concludes that patients with severe chronic kidney disease, especially those on dialysis, seem to derive limited benefit from this lower dose of atorvastatin.

ACE inhibitors and angiotensin II receptor blockers can decrease hemoglobin and cause anemia. It is not clear whether this decrease has any adverse effects in progression of the kidney disease. This study looked at the relationship between a decline in hemoglobin (anemia) caused by drugs like losartan and outcome in 1513 patients with type 2 diabetes and kidney disease. It concludes that the renal protective properties of losartan are maintained despite a significant lowering of hemoglobin concentration.

Geriatric dialysis rehabilitation program created by the University Health Network and Toronto Rehabilitation provides shorter, less tiring daily dialysis treatments combined with integrated multi-disciplinary care by experts in rehabilitation.

Dale Ester, dialysis_support listserv founder, passes away.

According to this study, the value of vitamin D treatment for people with chronic kidney disease remains uncertain.

Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens.

In a groundbreaking experiment scientists from International Stem Cell (ISC) Corp. derived four unique embryonic stem cell lines that open the door for the creation of therapeutic cells that will not provoke an immune reaction in large segments of the population.

The Foundation for IgA Nephropathy has included a warning about cyberchondria on its website for a few years already. Read about cyberchondria in the news.

Very obese people who need a kidney transplant are far less likely to get one than people of normal weight, a new U.S. study finds. And when they do, they wait on average a year to 18 months longer.

A new report written for the Public Health Agency of Canada says there is no evidence surgical masks can protect against flu virus particles small enough to be inhaled into the lower respiratory tract or the lungs.

Study concludes it is likely that serum high-sensitivity C-reactive protein does not closely reflect inflammatory pathogenesis in patients with IgA nephropathy , membranous nephropathy and minimal change disease.

Study concludes high prevalence of sleep disorders at time of diagnosis with chronic kidney disease affects difficulty in coping with the disease. CKD-related sleep disorders are usually not cured by renal transplantation.

Study shows a brisk 30-minute walk 6 days a week is enough to trim waistlines and cut the risk of metabolic syndrome -- an increasingly common condition that is linked to obesity and a sedentary lifestyle.

New research, published in the December issue of the American Journal of Kidney Diseases, suggests switching dosing of blood pressure medications to bedtime may normalize patterns of blood pressure in patients at extra risk from both heart and kidney disease. THIS IS A NEWS ITEM ABOUT ONGOING STUDIES. DO NOT SWITCH ON YOUR OWN.

An observational study based on outpatient renal-transplant follow-up clinic in Ireland suggests that dietary and total calcium and vitamin D intakes in adult renal-transplant patients are in many cases inadequate.

Physicochemical alterations of the IgA molecule are supposed to play a pathogenetic role in IgA nephropathy (IgAN). This study concludes that abnormalities of hinge region O-linked glycans were confirmed using advanced spectrometry technology. The pathogenetic implications for aggregation and defective removal of IgA1 are discussed.

It is standard practice to put kidney patients on the same standard maintenance dose of Cellcept MMF post-transplant without regard to actual body weight of the patient. This dosage must often be lowered in order to deal with significant side effects such as gastrointestinal side-effects, and more importantly, severe neutrophilia. This study proposes that MMF should be dosed based on TBW rather than a fixed dose regimen in RTX.

Membranous glomerulopathy accounts for 28% of the biopsy-proven systemic lupus erythematosus nephritis in paediatric patients at the time of first biopsy. Initial creatinine in patients with classes Va and Vb lupus nephritis predicted follow-up renal function. The following parameters failed to predict GFR at last follow-up visit: blood pressure, C3, C4 and UPr/UCr. No correlation was found with outcome based on therapy with cyclophosphamide and/or mycophenolate mofetil.

This subanalysis of the Treating to New Targets study investigated how intensive lipid lowering with 80 mg of atorvastatin affects renal function when compared with 10 mg in patients with coronary heart disease. The expected 5-yr decline in renal function was not observed. Estimated GFR improved in both treatment groups but was significantly greater with 80 mg than with 10 mg, suggesting this benefit may be dosage related.

EPO, short for erythropoietin, may actually contribute to improving mood. Many IgAN patients with advanced chronic renal insufficiency or in end-stage renal failure require regular injections of EPO to combat anemia.

This wearable haemodialysis device shows promise in terms of safety and efficacy, although further studies will be necessary to confirm these results.

Henoch-Schönlein Purpura (HSP) is a systemic disease which is closely-related to IgA nephropathy. Many pediatric cases of IgAN may associated with HSP. This review concludes that corticosteroids, given early in the course of illness, seem to produce consistent benefits for several major clinically relevant Henoch-Schönlein purpura outcomes.

Proteinuria is one of the main symptoms of IgA nephropathy. The value of lowering proteinuria has never been clearly established. This study concludes that lowering proteinuria has a positive effect on slowing the rate of decline.

BioMarin Pharmaceutical Inc. and IGAN Biosciences announced today that they have initiated a program to develop an IgA protease for treating IgA nephropathy. IgA proteases have been shown to cleave IgA complexes, the deposition of which causes IgA nephropathy, an kidney disorder with few treatment alternatives. There is currently no specific treatment for IgAN nephropathy.