A 22-year-old African-American woman who has been dialysis dependent for four months due to hypertensive kidney disease is referred for kidney transplantation evaluation.  Due to the recent occlusion of her left forearm arteriovenous graft, she is currently being dialyzed via a right internal jugular tunneled catheter.  Her medications include methyldopa 250 mg bid, Tums 1000 mg with each meal and erythropoietin with dialysis.  The patient is single without children, unemployed and lives with her 38 year old mother.  She does not smoke or drink.  Her review of systems is unremarkable.  On physical exam, her weight is 284 pounds, height is 5 feet 2 inches and her body mass index is 51.9 kg/m².  The blood pressure is 130/80 and the cardiac and pulmonary exams are unremarkable. The surgeon feels she is otherwise a good candidate for transplantation except she must lose weight before being listed.  What advice should she be given regarding weight loss?
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Raabe RD, Burr RB, Short R.  One-year cognitive outcomes associated with carotid artery stent placement.  J Vasc Interv Radiol 21:983-988;2010.

Purpose
To assess relatively long-term (ie, 1 year) neurocognitive outcomes of patients undergoing carotid artery stent (CAS) placement with cerebral protection.

Materials and Methods
Sixty-two patients (19 symptomatic; mean age, 73 years) with significant carotid stenosis (≥ 70% for symptomatic patients, ≥ 80% for asymptomatic patients) underwent CAS placement with embolic protection. Cognitive function was assessed prospectively with use of a battery of standardized tests administered at baseline (1-5 days before CAS endovascular therapy) and at 3, 6, and 12 months after CAS placement. Diffusion-weighted imaging (DWI) was performed before the procedure and within 24 hours after CAS placement.

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Oxidative Stress Mediates Protein Kinase C Activation and Advanced Glycation End Product Formation in a Mesangial Cell Model of Diabetes and High Protein Diet

Katherine R. Tuttle, Robert J. Anderberg, Sheryl K. Cooney, Rick L. Meek
American Journal of Nephrology 2009;29:171-180

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