For over four decades, Americans have enjoyed near universal access to treatment for ESRD irrespective of age, lack of qualifying disability, or their ability to pay. However, the health insurance benefits of the Medicare ESRD program do not extend to individuals in earlier stages of CKD, even to those for whom ESRD is imminent. Timely nephrology care before ESRD onset (predialysis nephrology c...

Chronic kidney disease related mineral and bone disease (CKD-MBD) is a worldwide challenge in hemodialysis patients. In china, the number of dialysis patients is growing but few data are available about their bone disorders. In the current study, we aimed to evaluate the effect of clinical factors on the serum phosphorus clearance in the 80 maintenance hemodialysis (MHD) patients. Six clinical ...

Abstract Introduction. Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stage disease. Patients with chronic kidney disease (CKD) face with uremic toxins and hyperkalemia. Also fluid overload in CKD patients is associated with rapid decline in kidney function. Lactulose is a hyper osmotic agent and as a prebiotic could reduce serum urea and p...

In the famous Pink Floyd song, education fails as it reduces every pupil in a totalitarian way to ‘another brick in the wall’. Recently, much attention has been paid to timely referral and multidisciplinary predialysis education (MPE) programmes (for review see [1]). In this issue of Nephrology Dialysis Transplantation (NDT), Wu et al. [2] report the results of a non-randomized observational tr...

BACKGROUND AND AIMS Homoarginine, a precursor of nitric oxide, is an inverse predictor of death in dialysis patients and in subjects with cardiovascular disease and normal kidney function but its relationship with clinical outcomes in chronic kidney disease (CKD) patients not yet on dialysis is unknown. DESIGN SETTING PARTICIPANTS AND MEASUREMENTS We enrolled 168 consecutive predialysis CKD p...

BACKGROUND Uremic toxins are emerging as important, non-traditional cardiovascular risk factors in chronic kidney disease (CKD). P-cresol has been defined as a prototype protein-bound uremic toxin. Conjugation of p-cresol creates p-cresylsulfate (PCS) as the main metabolite and p-cresylglucuronide (PCG), at a markedly lower concentration. The objective of the present study was to evaluate serum...

BACKGROUND/AIMS Predialysis care has been associated with improved first-year outcomes. We investigated types of predialysis care associated with improved patient outcomes in patients initiating dialysis with a fistula and at least 2 years of predialysis care. METHODS In this retrospective cohort of incident hemodialysis patients with ≥2 years of Medicare coverage before dialysis initiation, ...