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July 2008 Briefing - Nephrology

Here are what the editors at HealthDay consider to be the most important developments in Nephrology for July 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Glomerular Filtration Screening Should Not Be Universal

THURSDAY, July 31 (HealthDay News) -- Estimated glomerular filtration rate (eGFR) should not be used to universally screen for chronic kidney disease and should be restricted to high-risk groups due to the potential to falsely diagnose women and particularly the elderly, according to two articles published online July 30 in the Clinical Journal of the American Society of Nephrology.

Abstract - Glassock
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Abstract - Melamed
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Editorial

Bone Marker Linked to Death in Dialysis Patients

THURSDAY, July 31 (HealthDay News) -- High or rising levels of alkaline phosphatase, a marker of bone turnover, are associated with a higher risk of death in patients undergoing dialysis, according to the results of a study published online July 30 in the Journal of the American Society of Nephrology.

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Use of Antibiotic Prophylaxis for Endocarditis Discouraged

TUESDAY, July 29 (HealthDay News) -- Antibiotic prophylaxis should no longer routinely be given to prevent infective endocarditis in patients undergoing dental and other medical procedures, according to updated guidelines published online July 28 in the Journal of the American College of Cardiology. The guidelines were jointly developed by the American College of Cardiology and the American Heart Association.

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Statin Use May Benefit Kidney Transplant Patients

THURSDAY, July 24 (HealthDay News) -- In kidney transplant patients, statin use may be associated with prolonged survival, according to research published online July 23 in the Journal of the American Society of Nephrology.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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New Standard of Care Proposed for Metastatic Kidney Cancer

WEDNESDAY, July 23 (HealthDay News) -- Everolimus improves progression-free survival compared to placebo in patients with progressive, metastatic renal cell carcinoma that failed other targeted therapies, according to research published online July 23 in The Lancet.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medication Use After Heart Attack Varies By Kidney Status

THURSDAY, July 17 (HealthDay News) -- In older heart attack survivors, the use and adherence to recommended cardiovascular medications varies by kidney status but is unlikely to explain differences in long-term outcomes, according to research published online July 9 in the Clinical Journal of the American Society of Nephrology.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

Abstract - Dienstag
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Abstract - Jauhar
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Therapy May Increase Kidney Transplant Rates

WEDNESDAY, July 16 (HealthDay News) -- Intravenous immune globulin plus rituximab is a promising desensitization combination regimen for patients awaiting kidney transplant, according to an article published in the July 17 issue of the New England Journal of Medicine.

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Editorial

AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Frequent Dialysis Increases Costs But Is Cost-Effective

THURSDAY, July 10 (HealthDay News) -- More frequent hemodialysis is more expensive but cost-effective for patients with end-stage renal disease, and the increased costs could be neutralized by changing the economic model underlying dialysis delivery, according to research published online July 9 in the Journal of the American Society of Nephrology.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

Abstract - Cookson
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Abstract - Popay
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H-Y Effect Occurs in Kidney Transplantation

MONDAY, July 7 (HealthDay News) -- Outcomes are poorer in women who receive transplanted kidneys from male donors, suggesting that an immunological H-Y effect occurs in kidney transplantation, but outcomes are the same in patients who receive either vitespen -- an adjuvant autologous therapeutic vaccine -- or observation after nephrectomy for renal cell carcinoma, according to two studies published online July 4 in The Lancet.

Abstract - Gratwohl
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Abstract - Wood
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Bone Marker Control Benefits Hemodialysis Patients

THURSDAY, July 3 (HealthDay News) -- In hemodialysis patients, consistent control of three markers for mineral and bone disorders -- parathyroid hormone, calcium and phosphorus -- within guidelines established by the National Kidney Foundation is a strong predictor of survival, according to a report published online July 2 in the Clinical Journal of the American Society of Nephrology.

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New Regimen More Effective for Lupus Nephritis

THURSDAY, July 3 (HealthDay News) -- A combination of mycophenolate mofetil, tacrolimus and steroids is more effective than intravenous cyclophosphamide for inducing complete remission of lupus nephritis, according to an article published online July 2 in the Journal of the American Society of Nephrology.

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Physician's Briefing