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10 Renal & Urology News MAY 2010 www.renalandurologynews.com ■ National Kidney Foundation, Orlando, Fla. Reports from the 2010 National Kidney Foundation’s Spring Clinical Meetings. Pre-Dialysis Vitamin D May Decrease Preparation EPO Requirements May Improve ADMINISTRATION of ergocalciferol Dr. Larson reported. The absolute Survival (vitamin D2) to anemic hemodialysis (HD) patients receiving erythropoietin change was an average of 12.2 ng/mL. The total EPO dose decreased signiﬁ- PATIENTS WITH RENAL disease who (EPO) may decrease EPO require- cantly by an average of 95,063 units per are well prepared to start dialysis ments, data suggest. month. The average hemoglobin (Hb) Derek Larson, MD, and colleagues increased signiﬁcantly by 0.86 g/dL from are signiﬁcantly more likely to at Evanston Hospital, NorthShore baseline to month 9. The researchers survive their ﬁrst year of treatment, University HealthSystem in Evanston, also observed no signiﬁcant association a study found. Ill., studied 86 HD patients, of whom between the change in 25-D levels and As part of its Kidney Disease Out- 68 (78%) had 25-hydroxyvitamin D either Hb or total EPO dose. comes Quality Initiative, the National (25-D) levels below 30 ng/mL at base- Although the effect of ergocalciferol Kidney Foundation has issued guide- line. These patients received 50,000 treatment on EPO requirement was not Derek Larson, MD lines to help identify renal disease units of ergocalciferol weekly; pa - related directly to 25-D levels, further sooner in order to improve dialysis tients with higher 25-D levels received studies are needed to investigate the Center found that anemic HD patients care. These guidelines recommend 50,000 units monthly. Patients were impact of 25-D repletion on anemia in deﬁcient in 25-D who responded to that patients should have an arterio- followed with quarterly labs for patients with end-stage renal disease, ergocalciferol supplementation had no nine months. the researchers concluded. signiﬁcant decrease in EPO require- venous graft (AVG) or arteriovenous During the nine-month follow-up, In a separate study presented at the ments and no signiﬁcant improvement ﬁstula (AVF) in place prior to the start 25-D levels increased significantly conference, investigators at Kaiser in Hb levels compared with those who of dialysis and that they have ad- from an average of 23 to 36 ng/mL, Permanente Los Angeles Medical did not respond. ■ equate blood hemoglobin levels and albumin levels. Yelena Slinin, MD, MS, of the Min- neapolis VA Medical Center and the University of Minnesota in Minne- Phosphorus, Pulse Pressure Linked apolis, and her colleagues studied HIGHER SERUM phosphorus is pressure—is a reﬂection of vascular After adjusting for age, race, body mass 192,307 patients who began dialysis associated with lower pulse pres- stiffness and therefore may be related index, smoking, and other potential con- between June 1, 2005 and May 31, sure in women, but not men, with to vascular calcification associated founders, women in the highest phospho- nondialysis-dependent CKD, according with hyperphosphatemia. Previously, rus quartile (greater than 4.2 mg/dL) had 2007 to ascertain whether
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