Quality of care for people with chronic kidney disease: a systematic review and meta-analysis.

Objectives: Guideline-based strategies to prevent chronic kidney disease (CKD) progression and complications are available, yet their implementation in clinical practice is uncertain. We aimed to synthesise the available evidence on the concordance of CKD care with clinical guidelines to identify gaps and inform future CKD care.

Design: Systematic review and meta-analysis.

Safety and efficacy of steroidal mineralocorticoid receptor antagonists in patients with kidney failure requiring dialysis: a systematic review and meta-analysis of randomised controlled trials.

Background: Mineralocorticoid receptor antagonists can prevent cardiovascular events in patients with heart failure and non-severe chronic kidney disease, but their effects in patients with kidney failure requiring dialysis are uncertain. We aimed to assess the efficacy and safety of mineralocorticoid receptor antagonists in this patient population.

Methods: In this systematic review and meta-analysis, we updated our previous systematic review by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature for randomised controlled trials published between database inception and March 18, 2025.

Real-time field measurements of bioaerosols in the agricultural environment: Concentrations, components and environmental impacts.

In agricultural production, bioaerosols inevitably pose health hazards to animals and workers. Currently, there is a lack of research on real-time bioaerosol concentration monitoring at agricultural sites. We conducted a real-time airborne bioaerosol measurement study using the Multiparameter Bioaerosol Spectrometer (MBS) and applied a Uniform Manifold Approximation and Projection (UMAP) approach to classify bioaerosol emissions from the North Wyke Farm Platform between April and May.

Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international, parallel-group, randomised controlled trial.

Background: Patients undergoing maintenance dialysis for kidney failure are at substantial risk of cardiovascular morbidity and mortality. We aimed to establish if spironolactone reduces heart failure and cardiovascular deaths in these patients.

Methods: ACHIEVE was an international, parallel-group, randomised controlled trial done in 143 dialysis programmes in 12 countries.

Prophylactic Antibiotics Before Insertion of Tunneled Hemodialysis Catheters: A Nationwide Cohort Study.

Rationale & Objective: It is unknown whether administration of prophylactic systemic antibiotics immediately before tunneled catheter insertion can prevent early hemodialysis catheter-related bloodstream infections (HDCRBSI). We aimed to estimate the effect of systemic prophylactic antibiotics on early HDCRBSI.

Study Design: An observational secondary analysis using data from the nationwide REDUcing the burden of dialysis Catheter ComplicaTIOns: a National approach trial.

The epidemiology of haemodialysis catheter infections in Australia, 2016-20: a prospective cohort study.

Objectives: To investigate the epidemiology in Australia of catheter-related infections in a national cohort of adults with kidney failure with incident haemodialysis central venous catheters (CVCs).

Study Design: Cohort study nested within a cluster-randomised trial (REDUcing the burden of dialysis Catheter Complications, REDUCCTION); analysis of prospectively collected trial data, linked with Australian and New Zealand Dialysis and Transplant (ANZDATA) registry and state hospitalisations data.

Setting: Thirty-four health services in Australia (excluding Western Australia) that provide chronic haemodialysis and participated in the REDUCCTION trial.

Preoptic area influences sleep-related seizures in a genetic epilepsy mouse model.

In patients with refractory epilepsy, states of sleep and wakefulness affect the expression of seizures. However, the mechanism by which subcortical sleep circuitry affects seizures is unknown. Here, using Gabrg2Q390X knock-in (KI) genetic epileptic mouse model, we found that during sleep, subcortical preoptic area (POA) neurons were active in het Gabrg2Q390X KI mice and their activity preceded or/and coincided with epileptic (poly)spike-wave discharges.

Prevalence of SGLT2 inhibitor and GLP1 receptor agonist prescriptions in type 2 diabetes patients with and without chronic kidney disease: Analysis of an Australian primary care dataset.

Aims: Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) and glucagon-like peptide-1 receptor agonists (GLP1-RA) have cardio-kidney-metabolic benefit. This study aimed to understand the prevalence of prescription of SGLT2 inhibitors and GLP1-RA among patients with T2DM with and without chronic kidney disease (CKD) in Australian primary care.

Materials And Methods: We conducted a retrospective, cohort study of adults with T2DM who attended primary care practices participating in MedicineInsight.

Association between hyperkalemia and outcomes in hospitalized patients with acute kidney injury.

Introduction: To evaluate the association of hyperkalemia with outcomes of hospitalized patients with acute kidney injury (AKI) and explore the potential non-linear relationship between potassium and the outcomes in a publicly accessible dataset.

Methods: AKI patients with measured serum potassium were included. Hyperkalemia was defined as serum potassium level higher than 5.

The Aldosterone Blockade for Health Improvement Evaluation in End-Stage Renal Disease (ACHIEVE) Trial: Rationale and Clinical Research Protocol.

Background: The mineralocorticoid aldosterone may contribute to the risk of cardiovascular morbidity and mortality in patients receiving maintenance dialysis. Whether spironolactone, a mineralocorticoid receptor antagonist, improves outcomes for patients receiving maintenance dialysis is unclear.

Objective: To assess the efficacy and safety of spironolactone in patients receiving maintenance dialysis.

Data-Driven Detection of Nocturnal Pollen Fragmentation Triggered by High Humidity in an Urban Environment.

Biological particulate matter (BioPM) in the urban environment can affect human health and climate. Pollen, a key BioPM component, produces smaller particles when fragmented, significantly impacting public health. However, detecting pollen fragmentation and identifying the meteorological thresholds that trigger it remain largely hypothetical and uncertain.

Assessing patterns of chronic kidney disease care in Australian primary care: a retrospective cohort study of a national general practice dataset.

Background: Chronic kidney disease (CKD) monitoring and cardiovascular risk management are essential in reducing disease progression and cardiovascular events. This study aimed to understand CKD monitoring and management practices in Australian primary care.

Methods: We conducted a retrospective, population-based cohort study of adults who attended general practices participating in MedicineInsight between 1 January 2011 and 30 June 2020 and met diagnostic criteria for CKD.

Dialysis Dependence in Standard versus Accelerated Initiation of KRT in AKI: A Post Hoc Analysis.

Key Points: The Standard versus Accelerated Initiation of Renal Replacement Therapy in AKI trial found that starting dialysis earlier for AKI resulted in a 74% higher risk of still receiving dialysis at 90 days. Among patients who likely would have started dialysis under usual practice, the risks of dialysis dependence were similar. This suggests much of the risk observed may have been due to starting dialysis (versus never starting) rather than starting slightly earlier.

Safety and Effectiveness of Apixaban versus Warfarin by Kidney Function in Atrial Fibrillation: A Binational Population-Based Study.

Background: Evidence to guide use of apixaban in people with atrial fibrillation (AF) and chronic kidney disease (CKD) in routine clinical practice has been limited. We assessed comparative safety (major bleeding) and effectiveness (ischemic stroke and death) of apixaban versus warfarin in patients with AF across the spectrum of non-dialysis-dependent CKD using large, routinely collected data.

Methods: We combined findings from 5 retrospective cohorts (2013-2018) across Australia and Canada.

Transport of continental particulate over the Labrador Sea and entrainment are important pathways for glaciation of remote marine clouds.

Marine Arctic clouds greatly influence the radiative balance across the Arctic region and their effectiveness at scattering radiation changes considerably depending on cloud phase. Glaciation of these clouds relies on the presence of ice nucleating particles, which are often limited in number, so often clouds may be liquid even at temperatures well below 0 °C. As the Arctic region warms, cloud feedbacks may accelerate change or lessen absorbed solar radiation.

CKD Progression after Acute Kidney Injury: A Secondary Analysis of the Standard versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury Trial.

Key Points: Development or progression of CKD occurred in almost 40% of patients after an episode of severe AKI. Receipt of KRT, regardless of allocation to an accelerated or standard initiation strategy, was associated with development or progression of CKD. This study helps identify a subset of patients at risk of CKD after severe AKI who would benefit from dedicated kidney follow-up after discharge.

Primary Visual Pathway Changes in Individuals With Chronic Mild Traumatic Brain Injury.

Importance: Individuals with mild traumatic brain injury (TBI) often report vision problems despite having normal visual acuity and fundus examinations. Diagnostics are needed for these patients.

Objective: To determine if a battery of assessments or machine-learning approaches can aid in diagnosing visual dysfunction in patients with mild TBI.

Preoptic area controls sleep-related seizure onset in a genetic epilepsy mouse model.

In genetic and refractory epileptic patients, seizure activity exhibits sleep-related modulation/regulation and sleep and seizure are intermingled. In this study, by using one het KI mice as a genetic epilepsy model and optogenetic method , we found that subcortical POA neurons were active within epileptic network from the het KI mice and the POA activity preceded epileptic (poly)spike-wave discharges(SWD/PSDs) in the het KI mice. Meanwhile, as expected, the manipulating of the POA activity relatively altered NREM sleep and wake periods in both wt and the het KI mice.

Association of Age, Frailty, and Strategy for Initiation of Renal-Replacement Therapy: A Post Hoc analysis of the STARRT-Acute Kidney Injury Trial.

Introduction: This study was designed to assess the association of age and frailty with clinical outcomes in patients with severe acute kidney injury (AKI), according to accelerated and standard renal-replacement therapy (RRT) initiation strategies in the STARRT-AKI trial.

Methods: This was a secondary analysis of an international randomized trial. Older age was defined as ≥65 years.

Replacement Strategies for Tunneled Hemodialysis Catheters with Complications: A Nationwide Cohort Study.

Key Points: Replacement strategies for hemodialysis catheters with mechanical failure differed widely between services, which suggests clinical equipoise. For mechanical hemodialysis catheter failure, exchange did not result in more dysfunction or infection than removal and separate replacement. In Australia, infected catheters were almost universally removed and then replaced through a separate tunnel tract.