Internal Medicine

KDIGO has published a 2026 update to its 2012 clinical practice guideline on evaluating and managing anemia in chronic kidney disease, based on a systematic evidence review through October 2024 graded using GRADE methodology and informed by public stakeholder feedback. The guideline states that intravenous iron is preferred over oral iron in people receiving hemodialysis, correctable causes of anemia should be addressed before starting an ESA or HIF-PHI, ESAs are recommended over HIF-PHIs as first-line therapy, hemoglobin thresholds for ESA initiation should be individualized, and an upper hemoglobin target below 11.5 g/dL is specified during ESA maintenance therapy. The synopsis covers 8 graded recommendations along with 49 practice points reflecting expert consensus where evidence was limited.title:KDIGO Updates 2026 Guideline on Anemia Management in CKD

Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.

The VA and DoD released an updated 2025 clinical practice guideline on lipid management for cardiovascular disease risk reduction, replacing the 2020 version with 24 new evidence-based recommendations graded using GRADE methodology. The guideline now recommends the PREVENT calculator for primary prevention risk estimation, removes a prior recommendation against routine lipid monitoring, and adds coronary artery calcium testing for select patients with clinical uncertainty plus one-time lipoprotein(a) testing to identify enhanced cardiovascular risk. For secondary prevention, the guideline shifts toward more intensive therapy, suggesting combination treatment with high-intensity or maximally tolerated statins plus ezetimibe and/or PCSK9 inhibitors for very high-risk atherosclerotic cardiovascular disease patients, and lists bempedoic acid, ezetimibe, fibrates, or PCSK9 monoclonal antibodies as options for statin-intolerant patients; a new recommendation also suggests moderate-intensity statins for adults with HIV even at low calculated 10-year risk.

Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.

A review in JAMA describes idiopathic normal pressure hydrocephalus as a progressive disorder affecting an estimated 1% to 4% of adults 65 and older, characterized by gait impairment (85%-95% of patients), urinary dysfunction (75%-90%), and cognitive decline (60%-80%). The review states diagnosis relies on clinical findings plus imaging showing ventricular enlargement, with large-volume lumbar puncture or extended lumbar drainage used to predict shunt responsiveness, and notes that imaging findings alone are not reliably linked to treatment response. The authors report that after shunt placement, approximately 75%-80% of patients show gait improvement and 50%-70% show cognitive or urinary improvement, while complications such as overdrainage/underdrainage, shunt malfunction, and infection occur in a minority of cases.

Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.

Baxter Healthcare Corporation has issued a Class II recall for Vasopressin in 0.9% Sodium Chloride Injection, 40 units per 100 mL (0.4 units/mL), supplied in 100 mL single-dose containers under NDC 0338-9647-12. The recall notice cites current good manufacturing practice (CGMP) deviations as the reason for the action. No additional clinical details were provided in the source notice.

Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.

Baxter Healthcare Corporation has issued a Class II recall for Nexterone (amiodarone HCI), 360 mg/200 mL (1.8 mg/mL) in GALAXY Single-Dose Container, a sterile, nonpyrogenic, iso-osmotic solution in Dextrose, NDC 43066-360-20. The recall notice cites CGMP deviations as the reason for the action. The product is manufactured by Baxter Healthcare Corporation in Deerfield, IL, and made in the USA.

Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.