Proteinuria is a critical measure in the management of glomerular diseases. The urine protein creatinine ratio is most commonly used for the follow up of these patients, undoubtedly as doing a 24 hour collection is quite cumbersome and fraught with collection errors. But how does UPCR stand up against the 24 hr gold standard. Apparently not very well. In this paper in Kidney International investigators used the NEPTUNE data and identified only moderate correlation between UPCR and 24hr values (r=0.60). They used the data set to generate an equation from the random UPCR to predict the 24 hour proteinuria. This formula improved the correlation. (r=0.85).
Statins and CKD is back in the focus with a large meta-analysis published in Kidney International by the Cholesterol Treatment Trialists' (CTT) Collaboration using patient level data (n=183419) included in 28 RCTs. The results show that lowering LDL-C with statins improves cardiovascular outcomes in CKD but the benefit diminishes with advanced CKD and with no benefit observed in patients on dialysis.
Euglycemic DKA as a result of SGLT2 inhibitors should be recognized and prevented. In an excellent review the pathophysiology of this phenomenon is elegantly explained. Get it here from Diabetes Care
Transplantation International has an entire issue on Donation after Cardiac Death. Articles include reviews on the new classification, logistics, ethical concerns apart from organ specific essays on Kidneys, Lungs and Pancreas.
American Urological Association has come out with new guidelines for the management of kidney stones. Get these here.
Monoclonal Gammopathy of Renal Significance - A new review on this topic was published recently in CJASN.
In a series of PRO/CON and MODERATOR articles - NDT brings us a "Polar Views" discussion about the STOP-IgAN trial and the role of immunosuppression in the management of IgA nephropathy in general. Dont miss this!
-- Nikhil Shah (@dr_nikhilshah)