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Purpose: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a randomized clinical trial designed to determine the effects of a bestpractice hearing intervention versus a successful aging health education control intervention on cognitive decline among community-dwelling older adults with untreated mild-to-moderate hearing loss. We describe the baseline audiologic characteristics of the ACHIEVE participants. Method: Participants aged 70-84 years (N = 977; Mage = 76.8) were enrolled at four U.S. sites through two recruitment routes: (a) an ongoing longitudinal study and (b) de novo through the community. Participants underwent diagnostic evaluation including otoscopy, tympanometry, pure-tone and speech audiometry, speech-in-noise testing, and provided self-reported hearing abilities. Baseline characteristics are reported as frequencies (percentages) for categorical variables or medians (interquartiles, Q1-Q3) for continuous variables. Between-groups comparisons were conducted using chi-square tests for categorical variables or Kruskal--Wallis test for continuous variables. Spearman correlations assessed relationships between measured hearing function and self-reported hearing handicap. Results: The median four-frequency pure-tone average of the better ear was 39 dB HL, and the median speech-in-noise performance was a 6-dB SNR loss, indicating mild speech-in-noise difficulty. No clinically meaningful differences were found across sites. Significant differences in subjective measures were found for recruitment route. Expected correlations between hearing measurements and self-reported handicap were found. Conclusions: The extensive baseline audiologic characteristics reported here will inform future analyses examining associations between hearing loss and cognitive decline. The final ACHIEVE data set will be publicly available for use among the scientific community. [ABSTRACT FROM AUTHOR]

Kidney transplantation (KT) is the best treatment for patients with kidney failure, associated with improved survival and quality of life compared with maintenance dialysis. However, despite constant improvements in the assessment and management of the alloimmune response, KT patients frequently demonstrate a reduced estimated glomerular filtration rate. Therefore, the usual complications of chronic kidney disease (CKD), such as anemia, hypertension, metabolic acidosis, hyperkalemia, or persistent secondary hyperparathyroidism, are highly prevalent after KT. However, their underlying mechanisms are different in the transplant setting (compared with the nontransplanted CKD population), and management recommendations are based on relatively poor-quality data. In recent years, new therapies have emerged, significantly improving kidney and cardiovascular outcomes of non-KT patients with CKD. Whether those new drugs could improve the outcomes of KT patients has largely been under investigated so far. In this review, we will address the challenges of the management of a KT patient with a reduced estimated glomerular filtration rate, cover the published evidence, and highlight the critical knowledge gaps., Competing Interests: T.D. reports research support from the Fonds National de Recherche Scientifique – FNRS (F.R.S.-FNRS) as well as travel support from Organ Recovery Systems, Diegem, Belgium. E.G. reports research support from Baxter Healthcare, conference support from Baxter Healthcare, Fresenius, Nx Stage, Dirinco, and AstraZeneca; and consulting fees from Amgen, Astellas, AstraZeneca, Bayer, Baxter Healthcare, Fresenius, NxStage, and Dirinco. M.J. reports research support from AstraZeneca, speaker fees from AstraZeneca, Bayer, Boehringer-Ingelheim, and Menarini; consulting fees from Astellas, AstraZeneca, Bayer, Boehringer-Ingelheim, Cardiorenal, CSL Vifor, GlaxoSmithKline, Stada-Eurogenerics, and Vertex; and other: co-chair of Kidney Disease Improving Global Outcomes (KDIGO) since January 2019. A.D. reports consultancy fees from Alnylam and Merck. E.V.R. reports support from CSL Vifor and Pharmacosmos; speaker fees from Baxter Healthcare, Astellas, and Bayer; and consulting fees from Bayer. N.K. reports consulting fees from Hansa Biopharm. The other authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)