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Nephrology Bracketology: Join the Madness! - Medscape

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Need for dialysis clinic in Barrington says group - Shelburne County Coastguard
Shelburne County Coastguard
“He had no choice but to try to get to the hospital as dialysis is not a treatment that can be casually left to another day,” said David Cleaver of the Barrington Dialysis Support Group. “It is a procedure with a timetable that must be strictly adhered

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Alternating Sunitinib, Everolimus Not Effective for Advanced Renal Cell Carcinoma - Cancer Therapy Advisor
February 25, 2015 Reduced Mortality Linked to Use of Statins in Patients With Colorectal Cancer
Alternating regimen of sunitinib and everolimus lacked clinical activity in the treatment of patients with advanced renal cell carcinoma.

According to a new study published in the journal Annals of Oncology, researchers in Australia have found that an alternating regimen of sunitinib and everolimus lacked clinical activity, despite being feasible and safe, in the treatment of patients with advanced renal cell carcinoma.

For the single-arm, two-stage, multicenter, phase 2 study, researchers enrolled 55 patients with favorable or intermediate risk advanced renal cell carcinoma and gave them 12-week cycles of sunitinib 50mg daily for 4 weeks on, 2 weeks off, alternating with everolimus 10mg daily for 5 weeks on, 1 week off, until disease progression or unacceptable toxicity.

Results showed a 6-month progression-free survival rate of 53% (95% CI: 40-66) and a tumor response rate of 13% (95% CI: 2-22).

RELATED: Prophylactic Effect of Urea-Based Cream on Sorafenib-Associated Hand-Foot Skin Reactions

All patients who experienced a response achieved a partial response. After a median follow-up of 20 months, the median progression-free survival was 8 months (95% CI: 5-10) and the median overall survival was 17 months (95% CI: 12 to undefined). In regard to safety, all adverse events were consistent with previous studies for each agent.

The findings suggest that the current approach of continuing anti-VEGF therapy until disease progression or unacceptable toxicity before changing treatment should be continued in clinical practice.

References

  1. Davis ID, et al. EVERSUN: a phase 2 trial of alternating sunitinib and everolimus as first line therapy for advanced renal cell carcinoma. Ann Oncol. February 20, 2015. [Epub ahead of print]. doi: 10.1093/annonc/mdv078

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Minorities, Uninsured Lack Care of ESRD in Lupus Nephritis - Renal and Urology News
February 25, 2015 Minorities-Uninsured-Lack-esrd-lupus-care
Minority race/ethnicity and lack of private insurance associated with inadequate care in U.S.

(HealthDay News) -- In the United States, minorities and those who lack private insurance are less likely to receive adequate care for end-stage renal disease (ESRD) due to lupus nephritis (LN), according to research published online Feb. 18 in Arthritis & Rheumatology.

Laura C. Plantinga, Sc.M., of Emory University in Atlanta, and colleagues analyzed data for 6,594 patients initiating treatment for LN-ESRD, from July 2005 through September 2011, to assess factors associated with quality of care.

The researchers found that, compared with white patients, black and Hispanic patients were less likely to receive pre-ESRD care (odds ratios [ORs], 0.73 and 0.72, respectively) and less likely to be placed on the waitlist for kidney transplant (hazard ratios [HRs], 0.78 and 0.82, respectively). 

Compared with patients with private insurance, patients with Medicaid (HR, 0.51) or without insurance (HR, 0.36) were less likely to be placed on the waitlist. Only 24% of patients had a permanent vascular access, and uninsured patients were even less likely to have placement of vascular access (OR, 0.62).

"LN-ESRD patients have suboptimal ESRD care, particularly with regard to vascular access placement," the authors write. "Minority race/ethnicity and lack of private insurance were associated with inadequate ESRD care."

Source

  1. Plantinga, LC, et al. Arthritis & Rheumatology; doi: 10.1002/art.38983.

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Car Smashes into Dialysis Center in Whittier - NBC Southern California

A wrecked white Toyota Avalon sat propped on a sidewalk in front of a dialysis center in Whittier where it was reported the driver crashed into the building and fled the scene.

The Whittier Kidney Dialysis Center at the 1600 block of Whittier Boulevard sustained major damage at about 4:50 a.m. when the crash occurred.

Officials from the Whittier Police Department said they were looking for the driver and no arrest had been made as of 7 a.m.

No injuries from persons inside the building were reported.


Published at 7:03 AM PST on Feb 25, 2015

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