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Kidney Konnection is a monthly independent publication from N ephrology On- Demand
Clues
1. The acronym for the condition that
occurs in up to 50% of stem cell
transplant recipients
2. This entity is indistinguishable from
hepatorenal syndrome and is a major
cause of renal failure in patients
undergoing myeloablative stem cell
transplantation
3. An antithrombotic and fibrinolytic
used in the management of
venoocclusive disease
4. The drug class of choice in the
treatment of thrombotic
microangiopathy
5. Chronic graft- versus- host disease is
associated with this nephrologic
syndrome
6. Severe forms of thrombotic
microangiopathy require this form of
therapy
7. The type of stem cell transplant
whereby the cells are from a donor
8. The type of stem cell transplant
whereby the cells are from a patient
LIT IN A M INUTE
Lit in a M inute is back and this month we celebrate by welcoming an old
friend back to the nephrology family. For years (perhaps even decades)
we've been taught that diabetic kidney disease patients with a serum
creatinine > 1.5 mg/ dl (1.4 if you're a women) should avoid metformin like
the plague. Largely an anecdotal warning, many believed that the risk of
lactic acidosis was unacceptably high if patients received metformin in the This is great news, because metformin remains a terrific drug
to treat diabetes. For years metformin has been banished
setting of moderate kidney disease.
from the nephrology world because of this fear. It's nice to
Thankfully, a new study in JAM A counters this fear with some evidence.
know that our kidney patients can, once again, avail
Investigators from Yale, UT Southwestern & Aston University (across the
themselves of this agent.
pond) looked at a large number of studies and did not find the rate of lactic
Welcome back to the family, metformin. N ot much has
acidosis to be any higher in renal failure patients taking metformin than
changed
while you were gone!
those w/ o kidney disease. Their new recommendation suggests that
Learn more @ JAM A. 2014;
metformin can be safely used in mild and moderate chronic kidney disease.
312(24): 2668