- N Engl J Med 2022; 387:506-513
Removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral stones resulted in less relapse than nonremoval and in similar numbers of subsequent emergency department visits.
- N Engl J Med 2022; 387:562-563
Asymptomatic kidney stones are often noted on imaging studies that are performed to screen for stones or when a patient presents with symptomatic stones. Patients frequently ask two questions about the asymptomatic stones: “Will my stones ever become symptomatic?” and “How do we get those stones to come out before...
- N Engl J Med 2022; 386:1889-1898
Genetically modified pig kidney xenografts were transplanted into two brain-dead human recipients. The xenografts functioned immediately and showed no evidence of acute rejection on serial biopsy over a period of 54 hours. The serum creatinine level decreased in both recipients.
- N Engl J Med 2022; 386:1327-1338
Oral antibacterial agents that are active against antimicrobial-resistant bacteria are needed. In this double-dummy, randomized, controlled trial, tebipenem pivoxil hydrobromide (an orally bioavailable carbapenem) was noninferior to intravenous ertapenem for the treatment of complicated urinary tract infection.
- N Engl J Med 2022; 386:1132-1142
Standard therapy for metastatic, hormone-sensitive prostate cancer is androgen-deprivation therapy, usually with docetaxel. A large, multinational, phase 3 trial assessed the addition of the androgen-receptor blocker darolutamide to standard therapy. At 4 years, survival was higher with darolutamide than with placebo (62.7% vs. 50.4%), with no major differences in the...
- N Engl J Med 2022; 386:1165-1165
A 37-year-old man with cystinuria and a recent urinary tract infection presented to the nephrology clinic for follow-up. Microscopic examination of a spun urine specimen showed concomitant triple phosphate and cystine crystals.
- N Engl J Med 2022; 386:964-975
Acute kidney injury can be accompanied by life-threatening electrolyte and metabolic abnormalities. Kidney-replacement therapy may be urgently needed to prevent death from uremia. This review considers treatment approaches, indications, and intensity in critically ill patients with AKI.
- N Engl J Med 2021; 385:1737-1749
Equations for estimating GFR with serum creatinine overestimate measured GFR in Blacks. The authors report new equations, without race as an inflation factor, using cystatin C and creatinine that reduced errors in estimation between Black participants and non-Black participants.
- N Engl J Med 2021; 385:1804-1806
In the wake of the racial reckoning since the spring of 2020 in the United States, efforts have emerged to identify hidden structural determinants of systemic racism in medicine. Such efforts have led to examination of traditional medical algorithms that incorporate race modifiers and may have led to disparities in...
- N Engl J Med 2021; 385:1603-1603
A 16-year-old boy presented with testicular pain. Operative exploration confirmed the presence of testicular torsion, with no blood flow after detorsion. Left orchiectomy and right orchiopexy were performed.
- N Engl J Med 2021; 385:1091-1103
Guiding the beta-emitting isotope lutetium-177 to prostate cancer lesions with the prostate-specific membrane antigen–targeted radioligand 177 Lu-PSMA-617 plus using standard care was compared with standard care in patients with metastatic castration-resistant prostate cancer. The radioligand therapy prolonged progression-free and overall survival. Adverse effects were more common, but quality of...
- N Engl J Med 2021; 385:908-920
Population-based screening showed that men over age 50 with PSA of 3 ng per milliliter or higher and negative MRI results could safely forgo biopsy. Detection of clinically significant cancer among men with positive MRI results who underwent MRI-directed and standard biopsies was similar to that for the standard biopsy...
- N Engl J Med 2021; 385:153-163
Hematuria comes in two main varieties: gross and microscopic. A wide range of ailments can lead to hematuria, and the central task is to rule out life-threatening disease, mainly cancer. This article suggests a useful diagnostic approach.
- N Engl J Med 2021; 384:2102-2114
In a prospective, randomized trial involving patients with urothelial carcinoma who had undergone radical surgery, adjuvant nivolumab was compared with placebo. The median disease-free survival was 20.8 months with nivolumab and 10.8 months with placebo. Treatment-related adverse events of grade 3 or higher were noted in 17.9% of patients in...
- N Engl J Med 2021; 384:1125-1135
Patients who had had a relapse after receiving platinum-containing chemotherapy and a PD-1 or PD-L1 immune checkpoint inhibitor were assigned to receive enfortumab vedotin or one of three chemotherapy agents chosen by their doctor. Enfortumab vedotin prolonged progression-free and overall survival.
- N Engl J Med 2021; 384:e24
An 80-year-old man presented with abdominal bloating, constipation, and weight loss. A CT scan of the abdomen and pelvis showed a large cystic mass, and a diagnosis of a urachal mucinous cystic tumor was made.