American Society of Nephrology, Nov. 8-13, 2011

The Annual Meeting of the American Society of Nephrology, Kidney Week 2011

The annual meeting of the American Society of Nephrology was held from Nov. 8 to 13 in Philadelphia, and attracted approximately 13,000 participants from around the world, including nephrology specialists, researchers, scientists, and other health care professionals. The conference featured presentations focusing on the latest advances in the management of patients with kidney diseases and related disorders.

Vanessa Grubbs, M.D., of the University of California in San Francisco, and colleagues found that many adults were taking supplements that were likely harmful to their kidneys.

"We evaluated 10 years of data from over 20,000 nationally-representative adults who participated in the National Health and Nutrition Examination Survey to assess the consumption of dietary supplements that may be harmful to kidney function. Adults provided information on what dietary supplements they were taking. We defined supplements as potentially harmful if they contained any of 39 herbs listed as potentially harmful to kidneys on the National Kidney Foundation's patient education Web page," Grubbs said. "Overall, we found that nearly one in 10 adults was taking supplements that were potentially harmful to their kidneys."

The investigators found that estimates were slightly lower among adults with kidney disease, but after accounting for factors including age, gender, and education, those with kidney disease were about as likely to be taking a supplement potentially harmful to their kidneys as those without kidney disease.

"Many individuals with significant kidney disease are not even aware that they have severe kidney disease and certainly not aware that many supplements can have harmful effects," Grubbs added. "It is very important that health care providers educate themselves about potential risks associated with supplements and be vigilant about finding out everything patients are taking, as patients often don't disclose dietary supplements to their health care providers."

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In another study, Vesna Garovic, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues evaluated whether preeclampsia was a risk factor for future cardiovascular and renal disease.

"We specifically looked at a cohort of women in a population-based study, which took out a possible selection bias, and found that a history of preeclampsia was associated with an elevated risk of renal and cardiovascular disease," Garovic said. "Clinicians should follow women with a history of preeclampsia closely to identify and treat timely modifiable risk factors, such as persistent hypertension, in an attempt to prevent renal or cardiovascular disease."

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Sylvia Paz Ramirez, M.D., M.P.H., of the Arbor Research Collaborative for Health in Ann Arbor, Mich., and colleagues evaluated the relationship between blood sugar control, based on mean hemoglobin A1c (HbA1c) levels, and mortality in an international study known as the Dialysis Outcomes and Practice Patterns Study.

"There is a 'U-shaped' relationship between HbA1c levels and mortality risk, with increased risk of mortality at HbA1c levels below 6 and 9 percent," Ramirez said. "We also found that the use of diabetes medications was common among patients with HbA1c <6 percent; avoiding excessively low blood glucose levels by tapering these medications may be a readily modifiable practice to improve outcomes."

The investigators also evaluated whether dialysis patients who had diabetes mellitus and had evidence of poor nutrition were particularly at risk for low blood sugar.

"Our findings did not show a statistically significant difference between these patients and those without evidence of poor nutrition; however, an increased risk for mortality for low HbA1c was more notable among those with evidence of poor nutrition," Ramirez said. "The key conclusion from this study was that target HbA1c levels may be higher among patients with diabetes mellitus on dialysis as compared to those with diabetes but not on dialysis, since mortality risk appears to be lowest at A1c levels of 6 to 9 percent (rather than below 7 percent)."

One author disclosed financial relationships with Amgen and Abbott.

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ASN: Intensive Diabetes Therapy Lowers Risk of Impaired GFR

MONDAY, Nov. 14 (HealthDay News) -- Long-term intensive diabetes therapy reduces the risk of impaired glomerular filtration rate (GFR), according to a study published online Nov. 12 in the New England Journal of Medicine to coincide with presentation at the American Society of Nephrology's annual meeting, Kidney Week 2011, held from Nov. 8 to 13 in Philadelphia.

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