Nephron NEWS
Nephron NEWS
Nephron NEWS
Issue 1,2010 [January 12, 2010]
Nephron Digest wishes all its readers a Happy New Year
Professor Meguid El Nahas, PhD, FRCP
Editor, Nephron Clinical Practice
nephron@sheffield.ac.uk
m.el-nahas@sheffield.ac.uk
Digest of issue 114/2/2010
Ureteral Endometriosis: Rare and Underdiagnosed Cause of Kidney Dysfunction. Claudio Ponticelli and colleagues, Italy (Nephron Clin Pract 2010;114:c89-c94) draw attention to an unusual cause of ureteral obstruction and hydronephrosis in premenopausal women, namely ureteral endometriosis. They provide the reader with clues to diagnosis and recommend a high index of suspicion in those at risk. Moreover, they also supply recommendations for comprehensive monitoring, diagnosis and management. This minireview points to an uncommon and probably underdiagnosed cause of ureteral obstruction in young women.
Serum Cystatin C-Based Formulas for Prediction of Glomerular Filtration Rate. Radovan Hojs and colleagues, Slovenia (Nephron Clin Pract 2010;114:c118-c126) argue that most serum cystatin C-based GFR equations are reliable markers of GFR in patients with CKD; according to the authors, the simplest formula (100/cystatin C) could be accurate enough for GFR estimation in daily clinical practice. This observation is at variance with a publication that concluded that all eight cystatin C-based GFR estimating equations underestimated or overestimated GFR in a Chinese population (Sun, Y. et al., Nephrol Dial Transplant. 2009 Dec 27). Moreover, a Scandinavian study showed that intra-individual variance was greater for cystatin C than for creatinine in healthy subjects and CKD, thus recommending serum creatinine as the pref erred marker for serial monitoring of renal function in individuals with stable muscle mass (Reinhard, M. et al., Scand J Clin Lab Invest. 2009;69:831-836). These publications highlight the fact that knowledge of the merit and pitfalls of the various tools available to estimate GFR is essential for data interpretation (reviewed by White et al, Transplant Rev 2010;24:18-27).
Medication Compliance among Dialysis Patients. Ze'ev Katzir and colleagues, Israel (Nephron Clin Pract 2010;114:c151-c157) show that dialysis patients appear to benefit from comprehensive guidance about medication in terms of compliance. Nonadherence to oral medication in haemodialysis patients is still an underestimated but life-threatening behaviour (Schmid, H. et al., Eur J Med Res. 2009;14:185-190). A recent publication highlighted depression as a major contributor to non-adherence to medication in the dialysis population (Cukor, D. et al., Kidney Int. 2009;75:1223-1229). It is therefore important to take poor compliance very seriously and address a number of clinical, psychological, biochemical/haematological as well as pharmacological variables to optimise adherence to medication amongst patients on renal rep lacement therapy. These could be complemented by careful instructions, guidance and reinforcement at regular intervals.
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