乌鸦传媒

AUSTIN, Texas -- Improving outcomes in chronic kidney disease was at the center of much of the new research presented at the here. Following are some brief highlights.

Even after one transplant center may refuse a donor kidney, a second center may accept it with subsequent good survival rates, researchers found. In an analysis of 291 transplantable kidney from 172 deceased donors, over 95% of donor kidney were initially refused by one transplant center, citing the refusal code 830 -- donor age or organ quality.

However, when the rejected kidneys were taken to a second transplant center, these kidneys had a median estimated post-transplant survival score of 59%.

"Rethink before you turn down an organ for quality using refusal codes," suggested lead author Vishy Chaudhary, MD, of the University of Texas Medical Branch at Galveston, in a written statement. "The importance of our findings is to educate the transplant community that organs discarded by another center, especially using the code 830, deserve a thorough evaluation as it may still be acceptable for transplantation to a suitable donor. There is a need to redefine codes."

These findings were accepted for publication by the American Journal of Kidney Diseases.

A multidisciplinary medication therapy management (MTM) program for dialysis patients after discharge cut 30-day hospital readmission rates by half: 14.3% versus 27.6% for patients receiving usual care (P<0.001).

The MTM program included involvement with a nurse, pharmacist review, and development of a medication plan with patient-specific recommendations by a physician.

"This is the first study to demonstrate that addressing medication-related problems post hospital discharge through a structured and multidisciplinary MTM process can reduce 30-day readmission rates," said lead author Harold J. Manley, PharmD, of the Dialysis Clinic in Nashville, in a statement.

Manley et al.'s study was accepted for publication by the American Journal of Kidney Diseases.

Use of a novel formulation of oral urea was effective for patients with low blood sodium. Among the 58 patients who received urea for hyponatremia -- most often caused by SIADH (syndrome of inappropriate antidiuretic hormone secretion) -- plasma sodium levels increased from 124 mEq/L to 130.5 mEq/L among the overall cohort. Many of those received other concomitant treatments, but similar numbers were reported among patients who only received urea.

Although urea treatment is seldom utilized in the U.S., the researchers suggest it's safe, effective, well-tolerated, and inexpensive.

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