What happens to the heart in chronic kidney disease

Cardiovascular disease is common in patients with chronic kidney disease. The increased risk of cardiovascular disease seen in this population is attributable to both traditional and novel vascular risk factors. Risk of sudden cardiac or arrhythmogenic death is greatly exaggerated in chronic kidney disease, particularly in patients with end stage renal disease where the risk is roughly 20 times that of the general population.

Palliative care for patients with advanced chronic kidney disease

Over the past three decades there has been a dramatic rise in the number of patients with advanced chronic kidney disease. The fastest expanding group receiving dialysis has been the elderly. However, for those patients who are very elderly with co-morbidity, dialysis may not offer a survival advantage. Therefore, active conservative management is a growing service offered by many renal units in the UK and focuses on non-dialytic correction of fluid and electrolyes, management of renal anaemia, and assessment and management of symptoms.

Current practices in the management of diabetic nephropathy

The social and economic burden of treating patients with diabetes mellitus (DM) is rapidly rising. Current projections estimate the global prevalence of individuals with DM to rise from 6.4% (285 million) in 2010 to 7.7% (439 million) in 2030.1 The main problem with this disease entity is its propensity to incur macro- and micro-vascular complications over time, including diabetic nephropathy (DN).

Bisphosphonate prescribing in chronic kidney disease

Osteoporosis and chronic kidney disease (CKD) are both increasingly prevalent with advancing age. Bisphosphonates are licensed for use in osteoporosis, but the appropriateness and safety of this class of drug in CKD is uncertain. This study assessed the use of bisphosphonates for persons with CKD in clinical practice. The prescribing pattern of bisphosphonates in all 595 persons attending renal services in one UK hospital was analysed.