6 Renal & Urology News MAY/JUNE 2021 www.renalandurologynews.com
News in Brief
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Short Takes Risk Factors for Urgent-Start Dialysis Identified
dying from PCa, Per-Olof Lundgren,
Investigators have identified factors
Karolinska University Hospital in
that put patients with chronic kidney
Stockholm, Sweden, and colleagues
disease (CKD) at increased risk for
reported in BJU International. A free-
urgent-start dialysis, according to a
to-total PSA ratio of 0.25 or higher
recent report in Nephrology Dialysis
extended the low-risk range to a PSA
Transplantation.
level less than 2.0 ng/mL (1.5% risk).
In the CKD-REIN prospective cohort study that included 3033 patients
MD, of the Karolinska Institutet and
PCa mortality risk increased by 4% for each 1 unit increase in baseline PSA.
seen in 40 French nephrology clinics, Paris-Saclay, and colleagues found
Graft Loss Tied to Pre-KT Unintentional Weight Loss
that low health literacy, living alone,
Unintentional weight loss prior to
heart failure, and polypharmacy were
kidney transplantation (KT) results
significantly associated with 2.2-, 2.1-,
in worse post-transplant outcomes,
2.6-, and 2.1-fold increased odds of
investigators reported in Nephrology
urgent-start dialysis.
Dialysis Transplantation.
Single PSA Test Can Predict PCa Death Risk
team led by Mara McAdams-DeMarco,
A low baseline level of PSA and a large
School of Medicine in Baltimore,
fraction of free PSA predict a low risk
Maryland, and colleagues found that
of dying from prostate cancer (PCa)
unintentional weight loss of 5% or
according to investigators.
greater was independently associated
Victor Fages, MD, of the Université
In a study of 919 KT recipients, a MD, of Johns Hopkins University
The finding is from a prospective
with an 80% and 91% increased risk
cohort study of 1782 men aged 55
for death-uncensored and death-cen-
to 70 years screened for PCa in 1988
sored graft loss, respectively, and a
and 1989. After 30 years of follow-
72% increased all-cause mortality risk
up, men with PSA levels less than 1.0
compared with stable pre-KT weight
ng/mL at baseline had a 1.2% risk of
(weight change of 5% or less).
Hypertension in Pediatric Diabetes Approximately one-quarter of pediatric patients aged 7 to 20 years with type 2 diabetes have hypertension, according to a recent meta-analysis. The prevalence varies by racial group, as shown below. 26.7%
26.5% 21.0%
19.0%
18.4% 15.1%
Pacific Islander
Indigenous
White
Black
Asian
Hispanic
Source: Cioana M, Deng J, Hou M, et al. Prevalence of hypertension and albuminuria in pediatric type 2 diabetes: a systematic review and meta-analysis. JAMA Netw Open.
Preemptive Therapy May Cut FSGS Recurrence Risk in KTRs P
reemptive therapeutic plasma exchange and rituximab treatment may lower the risk of recurrence of focal segmental glomerulosclerosis (FSGS) in kidney transplant recipients (KTRs), according to study findings presented at the virtual National Kidney Foundation 2021 Spring Clinical Meetings. Venkata Kishore Mukku, MD, of The University of Texas Medical Branch in Galveston, and colleagues studied 18 KTRs in whom FSGS was the primary cause of end-stage kidney disease. Of these, 8 underwent preemptive TPE/rituximab treatment (group 1) and 10 did not (group 2). The median follow-up duration was 2 years for group 1 and 3 years for group 2. Three patients in group 2 had FSGS recurrence, including a patient who experienced allograft loss, compared with none in group 1, the investigators reported in a poster presentation.
Occult Brain Metastases Found in Advanced RCC R
ecent study findings suggest a rationale for brain screening of patients with advanced renal cell carcinoma (RCC), investigators concluded in a paper published in the Journal of the National Comprehensive Cancer Network (2021;19:432-438). A retrospective study of 1689 patients with metastatic RCC screened for 68 clinical trials identified occult brain metastases in 72 (4.3%), Ritesh R. Kotecha, MD, of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues reported. Of these, 26%, 61%, and 13% had favorable-, intermediate-, and poorrisk disease, respectively, according to International Metastatic RCC Database Consortium criteria. The patients had a median overall survival (OS) time of 10.3 months and a 1-year OS probability of 48%. “Screening should be considered for patients with high metastatic burden or those who have experienced disease progression after first-line therapy,” the authors concluded.
Pregnancy Tied to Higher Risk of Symptomatic Kidney Stones P
regnancy is associated with an elevated risk for a first-time symptomatic kidney stone, according to the findings of a case-control study. The risk begins to increase in the second trimester and peaks just after delivery. Compared with nonpregnant women, women in the second and third trimester of pregnancy have significant 2.0- and 2.7-fold increased odds of forming their first kidney stone, a team led by Andrew D. Rule, MD, of Mayo Clinic in Rochester, Minnesota, reported the American Journal of Kidney Diseases. From 0 to 3 months after delivery, women had a 3.5-fold increased risk of kidney stone formation. Kidney stone risk returned to baseline by 1 year after delivery. The authors concluded that prenatal counseling of kidney stone risk with pregnancy may be warranted, particularly for women with other risk for kidney stones, such as obesity, diabetes, or family history of kidney stones. The study included 945 women aged 15 to 45 years who had a first-time symptomatic kidney stone and an age-matched control group of 1890 women.
