Severe LUTS, Big Waists Linked by ProQuest


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      10 Renal & Urology News                                                          NOVEMBER 2009                                                                                                      

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     News in Brief
       Severe LUTS, Big                                                                         CAC in Stage 3                                                      Warfarin May Raise Stroke
       Waists Linked                                                                            CKD Patients                                                        Risk in ESRD Patients
            study of 602 Korean men with
       A    lower urinary tract symptoms
       (LUTS) secondary to benign prosta-                                                       C     oronary artery calcification (CAC)
                                                                                                      is common among patients with                                 W      arfarin use in patients with both end-stage renal disease (ESRD) and
                                                                                                                                                                           atrial fibrillation are at increased risk for stroke, data suggest. It is not asso-
       tic hyperplasia found that those with                                                    stage 3 CKD, data show. Bryan R.                                    ciated with increased all-cause mortality or hospitalization.
       a waist circumference greater than                                                       Kestenbaum, MD, of the University of                                  Researchers followed 1,671 new ESRD patients with preexisting atrial fibril-
       90 cm (central obesity) had a 36%                                                        Washington in Seattle, and colleagues                               lation for an average of 1.6 years from the time they started dialysis. Compared
       increased risk of severe LUTS com-                                                       studied 562 adult patients with CKD                                 with nonuse, warfarin use was associated with a nearly twofold increased risk
       pared with men who had smaller                                                           (estimated glomerular filtration rate                               for a new stroke, investigators reported in the Journal of the American Society
       waists. In addition, in men with cen-                                                    [eGFR] of less than 60 mL/min/                                      of Nephrology (2009;20:2223-2233). Clopidogrel or aspirin use was not associ-
       tral obesity, prostate volume corre-                                                     1.73 m2) and without clinical car-                                  ated with the risk of a new stroke.
       lated positively with urgency and                                                        diovascular disease. The patients were                                The investigators concluded that “physicians should be cognizant of the pos-
       nocturia. Findings appear in the                                                         participants in the Multi-Ethnic Study                              sible risks associated with warfarin use for atrial fibrillation in patients with
       Asian Journal of Andrology (2009;                                                        of Atherosclerosis. Of the 562 subjects,                            ESRD, with careful evaluation of the risks and benefits of intervention at the
       published online ahead of print). n                                                      98% had stage 3 CKD at baseline                                     individual patient level.” n
                                                                                                (median eGFR of 55.4). The study
                                                                                                measured CAC at baseline and again
       Megestrol May                                                                            approximately 1.6 or 3.2 years later.
                                                                                                  At baseline, 370 subjects (66%) had
                                                                                                                                                                    Emergency Departments Found
       Improve Weight                                                                           CAC and 192 (34%) did not, accord-                                  To Underuse MET for Stones
                                                                                                ing to a report in Kidney International
             pilot study showed that mega-                                                      (2009;76:991-998). The prevalence                                         edical expulsive therapy (MET) for urinary stones in American emer-
       A     strol may help improve weight
       and the ability to exercise in dialy-
                                                                                                was 24% lower in African Americans
                                                                                                than in Caucasians after adjusting for
                                                                                                                                                                    M     gency departments (ED) is underused despite evidence of its safety
                                                                                                                                                                    and efficacy, investigators have concluded.
       sis patients, according to a report in                                                   numerous potential confounders. CAC                                   John M. Hollingsworth, MD, and colleagues at the University of Michigan in
       the Journal of Renal Nutrition (2009;                                                    developed in 39 (20%) who did not                                   Ann Arbor analyzed 2000-2006 data from the National Hospital Ambulatory
       published online ahead of print).                                                        have it at baseline, for an estimated                               Medical Care Survey. They determined MET use by the prescription for a cal-
         Investigators randomized nine el-                                                      incidence of 8.5% per year. The inci-              
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