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Lit review0609.qxp 6/1/09 11:20 AM Page 1 30 Renal & Urology News JUNE 2009 WORLD LITERATURE REVIEW Hip Fracture-Related Death Fernando E.C. Calais da Silva, MD, Linked to CKD in the Elderly of Centro Hospitalar de Lisboa Nephrol Dial Transplant. 2009;24:1539- Central in Lisbon, and colleagues 1544 recruited 766 men with locally or advanced prostate cancer who A mong older individuals, received an initial three-month in- an estimated glomerular duction treatment. During induc- filtration rate (eGFR) tion, all subjects received cypro- below 45 mL/min/1.73 m2 is as- terone acetate (CPA) 200 mg for sociated with a nearly twofold two weeks and then monthly depot increased risk of hip-fracture- injections of a luteinizing hormone- related mortality, according to releasing hormone (LHRH) analog British researchers. plus 200 mg of CPA daily. After Dorothea Nitsch, MD, MSc, of that their results are based only on patients after HD initiation. These three months, the 626 patients the London School of Hygiene & mortality and not on the incidence two subgroups had similar sur- who experienced a decline in PSA Tropical Medicine in the U.K., and of hip fracture. In addition, they did vival, which was significantly worse level to less than 4 ng/mL or to colleagues studied 13,167 patients not have a direct measure of true when compared with subjects 80% below the initial value were aged 75 years and older (5,111 men kidney function. without PHT. randomized to receive intermit- and 8,056 women) who had serum In multivariable analysis, devel- tent (314 patients) or continuous creatinine levels measured at base- Pulmonary Hypertension in HD opment of PHT before and after treatment (312 patients). The in- line. Eighty-four deaths related to Patients Increases Death Risk the start of HD was independently termittent arm ceased treatment hip fracture occurred over a medi- Kidney Int. 2009;75:969-975 associated with a 3.6 and 2.1 times whereas the continuous arm re- an follow-up of 7.25 years. Subjects increased risk of death, respective- ceived 200 mg CPA daily plus an I with an eGFR below 45 were at israeli researchers report that ly, compared with patients who did LHRH analog. 1.81 times higher risk of hip- pulmonary hypertension (PHT) not have PHT. In the intermittent arm, 127 men fracture-related death compared independently predicts high- progressed and 170 died; in the with those with a higher eGFR, er mortality in hemodialysis (HD) Intermittent Hormonal Therapy continuous arm, 107 progressed and
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