Kari Oakes, PA-C

Recent updates by the 8th Joint National Committee (JNC 8), the American and International Societies of Hypertension (ASH-ISH), and KDIGO recommend target blood pressure of less than 140/90 mm Hg for most individuals, including those with CKD.

Two major sets of hypertension guidelines released in 2014 contain more common threads than differences, and are intended to serve different purposes. Clinicians seeking guidance for managing hypertension in chronic kidney disease (CKD) can look for this common ground to avoid "guideline overload."

Guidelines for hypertension have converged on a blood pressure target of less than 140/90 mm Hg for most individuals with chronic kidney disease (CKD). However, studies still need to clarify optimal BPs for advanced disease and optimal cardiovascular prevention.

Though warfarin has long been the mainstay of anticoagulation in atrial fibrillation (AF), dosing is complicated by a host of factors, and the drug has a famously narrow therapeutic range. One way to fine-tune warfarin therapy is to account for genetic variation.

Anticoagulation is recommended for members of the general population with atrial fibrillation, but its significant risks must be weighed carefully in the medically fragile chronic kidney disease population.

Treatment of atrial fibrillation (AF) in patients with CKD may help prevent disease progression. Ablation has been shown produce marked improvement in kidney function as measured by eGFR. A prospective study of individuals undergoing catheter ablation for AF showed that most patients remained AF-free, and that eGFR improved significantly for those with persistent or longstanding persistent AF.

Secondary hyperparathyroidism can occur in CKD when the kidney loses its ability to produce active metabolites of vitamin D, and reduces phosphorus excretion. Cinacalcet seeks to interrupt the progression to severe unremitting hyperparathyroidism by mimicking calcium to the calcium-sensing receptors that control parathyroid hormone levels.

Physicians caring for individuals with chronic kidney disease (CKD) must strike a balance between ensuring optimal lipid control for protection from vascular events, while avoiding undue risk.

Despite achieving optimal goals for "bad" cholesterol levels, individuals with diabetes and chronic kidney disease still have an elevated risk of vascular complications.

A liver damaged by hepatitis C virus (HCV) can be replaced by transplantation, but HCV recurs universally and, unchecked, will damage the new liver as well. Study results show a new combination of direct-acting antivirals combined with ribavirin eradicated HCV for most transplant patients with recurrent HCV genotype 1 infection and liver damage.

Three strategies for achieving one-time screening for hepatitis C virus (HCV) show variable success, but all detected more cases of HCV than current practice.

A screening tool that uses a common marker for liver malignancy or inflammation in combination with other values holds promise for improved screening accuracy in hepatocellular carcinoma.

New combinations of direct-acting antivirals (DAAs) may point the way to hepatitis C virus (HCV) cures without ribavirin (RBV) for some patients.

As the rapidly evolving field of hepatitis C virus (HCV) treatment progresses, clinicians can look to an expanding array of clinical trials to guide and individualize treatment decisions.

Autoimmune hepatitis (AIH) represents a complex and heterogenous disease entity, with an increasing incidence for both genders and worldwide.

Outcomes for liver transplant recipients have never been better, and long-term survival will depend on a holistic approach that includes evidence-based health surveillance by hepatologists and others to optimize screening and primary prevention in this population.

Hepatorenal syndrome, a potentially deadly complication of ascites in liver disease that represents a devastating metabolic cascade of organ failure, should be recognized early and managed vigorously.

A small but rigorous 6-month randomized, controlled parallel arm trial comparing alternate day fasting and daily calorie restriction showed that each approach can result in significant weight loss for individuals who are overweight or have obesity, with similar adherence between the two methods of dieting.

Alternate day fasting can be an effective weight loss strategy, but optimal meal timing on fast days has not been thoroughly examined.

For individuals with type 2 diabetes mellitus, a low carbohydrate, low saturated fat diet in combination with exercise resulted in superior glycemic control with less medication use than did a higher carbohydrate diet

Acceptance-based therapy encourages a mindful but nonjudgmental approach to give participants the tools to note, but not act on, urges to overeat or to make unhealthy food choices.

Use positive language, start with the basics, and keep it fun. These are the fundamentals in designing a family-based program to combat childhood obesity.

Mindfulness-based treatment for obesity and binge eating disorder can promote self-regulation and yield significant results. A dose-response effect may yield better results for those who practice the approach more intensively.

Pediatric obesity is increasing in prevalence, with severe childhood obesity being seen more and more frequently.

There is currently no algorithm to guide clinicians in deciding which medication to choose to help promote weight loss in individuals with obesity. Rather, clinicians must take stock of a variety of factors when making treatment decisions for a particular patient.

The range of medication choices to treat obesity is expanding, and a rational prescribing plan requires a solid grasp of medication side effects.

Physicians treating individuals affected by obesity who are contemplating laparascopic sleeve gastrectomy (LSG) have a new risk assessment tool available. The user-friendly online risk calculator uses a robust statistical model and can offer an accurate preoperative risk assessment, based on updated outcome data.

Using a variety of cognitive strategies may help dampen food cravings and boost inhibitory control in individuals with obesity, according to a small neuroimaging study that draws methods from addiction research.

An intragastric dual-balloon device was well tolerated and proved effective for patients with moderate levels of obesity, owing in part to its ability to conform to stomach anatomy, according to Jaime Ponce, MD, Medical Director for the Bariatric Surgery program at Hamilton Medical Center, in Dalton, Georgia.

Assessment of long-term data on treatment utility demonstrates the effectiveness and cost-effectiveness of interferon-beta and glatiramer acetate for multiple sclerosis.