Bone and Mineral Metabolism Disorders News

Following are reviews of select abstracts from the 2014 meeting of the Council of Renal Nutrition that took place April 23-26 as part of the National Kidney Foundation’s Spring Clinical Meeting in Las Vegas. The abstracts were selected by NN&I editorial advisory board members Jane H. Greene, RD, LDN, and Peggy Harum, RD, LD.

If you are a new renal dietitian, it didn’t take long to discover you are working with a patient population that has multiple, sometimes complex nutritional needs. Where do you turn for help in making sure your recommendations and interventions are appropriate and credible with other members of the health care team?

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Vifor Pharma's Phase III study on its hyperphosphatemia treatment in chronic kidney disease patients has been published in Kidney International. Velphoro (PA21) is a chewable, calcium-free, iron-based phosphate binder that was approved by the U.S. Food and Drug Administration to treat hyperphosphatemia in patients on dialysis in November 2013.

New York-based Keryx Biopharmaceuticals Inc. said that it has submitted a Marketing Authorization Application to the European Medicines Agency (EMA), seeking the approval of Zerenex (ferric citrate coordination complex) to treat hyperphosphatemia in patients with chronic kidney disease, including dialysis- and non-dialysis dependent.

Kidney Disease: Improving Global Outcomes said in a news release that its Clinical Guidelines for Kidney Disease iPad app has been downloaded more than 2,000 times, primarily in the United States, the Philippines, and Mexico. The application is supported by an educational grant from Shire International GmbH, and is available to iPad users free-of-charge through the Apple App Store.

Accurate assessment of iron status is critical to prescribing treatments for anemia in chronic kidney disease and assessing the effectiveness of those treatments. Iron status can be assessed by a wide range of tests, blood tests and more invasive procedures. But which of these tests are most useful?  Both the presence of storage iron and the availability of iron to support ongoing erythropoiesis must be determined. Further, once the results of the tests are received, what level constitutes iron deficiency in patients with end-stage renal disease and indicates a need for an adjustment in treatment?

Readers can earn continuing education contact hours for reading this article and completing this downloadable evaluation form. Contact Hours for Continuing education are provided by Nephrology Clinical Solutions. Provider approved by the California Board of Registered Nursing, Provider # 14961, for 1.2 Contact Hour.

The end-stage renal disease program has often been the vanguard of proposed changes in Medicare payment systems. Most visible amongst these in recent years is the creation of an ESRD value-based purchasing program called the Quality Incentive Program that included for the first time payment for performance. In this program, CMS withholds 2% of each dialysis session’s payment at the facility level and pays back up to this 2% if certain quality measures are met. These measures are usually created by the Centers for Medicare & Medicaid Services, which administers the QIP, through a technical expert panel. The measures are endorsed by the National Quality Forum, subject to public comment, and finally administered via existing CMS information systems.

Several late-stage renal treatments and market events are set to occur over the next few years, including the potential launch of a new class of renal anemia products, iron-based phosphate binders, and new products for secondary hyperparathyroidism, among others. This should make nephrology an exciting area to study on how nephrologists’ perceptions change over time as new clinical data is released.