TUESDAY, Nov. 3, 2020 (HealthDay News) — The annual meeting of the American Society of Nephrology was held virtually this year from Oct. 22 to 25 and attracted participants from around the world, including nephrology specialists, researchers, scientists, and other health care professionals. The conference featured presentations focusing on the latest advances in the management of patients with kidney diseases and related disorders.
In one study, Lili Chan, M.D., of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues found that a machine learning model using admission features has good performance for prediction of the need for dialysis in hospitalized patients with COVID-19.
The researchers trained a machine learning model using data from more than 3,000 hospitalized patients with COVID-19 to predict acute kidney injury (AKI) requiring dialysis. Data collected within the first 48 hours of admission were included, so predictions could be made when the patient was admitted. The classifier achieved good performance. Features that were important for prediction included serum creatinine and potassium levels, age, and vital signs of heart rate and oxygen saturation.
“Models like this are potentially useful for resource allocation and planning during future COVID-19 surges,” Chan said. “We are in the process of deploying this model into our health care system to help clinicians better care for their patients as well as for resource allocation.”
In a retrospective population-level cohort study, Heather Gunning, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues found that patients with glomerular disease are at higher risk for cardiovascular disease, which is not fully explained by progression to end-stage kidney disease or by traditional cardiovascular risk factors.
The authors retrospectively evaluated all patients ages 18 years and older in British Columbia with glomerular disease diagnosed on native kidney biopsy between Jan. 1, 2000, and Dec. 31, 2012. Linkage to various administrative databases was used to ascertain lab values, medication use, comorbidities, outcome, dialysis, transplantation, and death events. The researchers found that patients with glomerular disease were at a 2.5-fold higher risk for cardiovascular disease than the general population.
“Consideration of glomerular disease-specific factors can help improve cardiovascular risk prediction,” Gunning said. “Failure to take these novel factors into account will lead to underestimation of cardiovascular risk and underutilization of cardiovascular primary prevention strategies.”
In another study, Kabir Olaniran, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues observed an increased risk for AKI among Black individuals with sickle cell trait or sickle cell disease.
The authors performed a chart review of electronic medical records between 2005 and 2018 at a large multihospital system in Boston. The investigators found that the presence of the sickle cell gene appeared to increase the risk for AKI, especially among those with sickle cell disease, and may contribute to a faster loss of kidney function over time.
“The results of this study may help raise awareness among both patients and health care providers of the increased risk for kidney injury and chronic kidney disease among persons carrying the sickle cell gene,” Olaniran said. “Further research is needed to clarify how the presence of the sickle cell gene mediates acute kidney injury, determine the most accurate criteria for identifying people carrying the sickle cell gene who are most at risk for acute kidney injury, and develop protective therapies and best practices to reduce the risk for acute kidney injury among persons carrying sickle cell gene.”
In a large, national population study, Guofen Yan, Ph.D., of the University of Virginia in Charlottesville, and colleagues found that Black and Hispanic individuals are more likely than White individuals to develop kidney failure after chronic kidney disease (CKD) onset.
The authors extracted data from the U.S. Veterans Health Administration, analyzing information for nearly 850,000 veterans who developed CKD (estimated glomerular filtration rate, <60 mL/min/1.73 m2) between 2002 and 2015, with the outcome events followed through 2016. The researchers found that Black and Hispanic patients were twice as likely as White patients to develop kidney failure following disease onset.
“This was truly driven by a greater risk of kidney failure due to faster decline in kidney function after CKD incidence, rather than because of a lower risk of death prior to kidney failure,” Yan said. “The next focus is how we can slow the faster progression in Blacks and Hispanics with CKD — this should be a major focus in research, practice, and health care policy to improve clinical outcomes in Blacks and Hispanics with CKD.”
ASN: Finerenone May Slow Progression in CKD With T2DM
MONDAY, Oct. 26, 2020 (HealthDay News) — Finerenone results in a lower risk for chronic kidney disease (CKD) progression in patients with CKD and type 2 diabetes, according to a study published online Oct. 23 in the New England Journal of Medicine to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held virtually from Oct. 22 to 25.