Nephrology, Dialysis, Transplantation

Arjan van der Tol, Vianda S Stel, Kitty J Jager, Norbert Lameire, Rachael L Morton, Wim Van Biesen, Raymond Vanholder
BACKGROUND: We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. METHODS: This was a cross-sectional survey among nephrologists conducted online July-December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data...
March 30, 2020: Nephrology, Dialysis, Transplantation
Hiroyuki Kadoya, Minoru Satoh, Yuko Nishi, Megumi Kondo, Yoshihisa Wada, Yuji Sogawa, Kengo Kidokoro, Hajime Nagasu, Tamaki Sasaki, Naoki Kashihara
BACKGROUND: Long-term exposure to bioincompatible peritoneal dialysate causes the loss of mesothelial cells and accumulation of matrix proteins, leading to an increase in the thickness of the submesothelial layer, thereby limiting the long-term effectiveness of peritoneal dialysis (PD). However, the detailed molecular mechanisms underlying the process of peritoneal fibrosis have not been clearly elucidated. Wnt/β-catenin signaling pathway activation has been suggested to play a pivotal role in the development of organ fibrosis...
March 28, 2020: Nephrology, Dialysis, Transplantation
Claudio Ponticelli, Passerini Patrizia, Lucia Del Vecchio, Francesco Locatelli
Primary membranous nephropathy (MN) is a frequent cause of nephrotic syndrome (NS) in adults. In untreated patients, the outcome is variable, with one-third of the patients entering remission while the remaining ones show persisting proteinuria or progression to end-stage renal disease. Randomized clinical trials reported the efficacy of a 6-month regimen alternating intravenous and oral glucocorticoids with an alkylating agent every other month. The potential side effects of this regimen were limited by the fact that the use of glucocorticoids and alkylating agent did not exceed 3 months each...
March 24, 2020: Nephrology, Dialysis, Transplantation
Francesco Locatelli, Lucia Del Vecchio, Luca De Nicola, Roberto Minutolo
Erythropoiesis-stimulating agents (ESAs) are effective drugs to correct and maintain haemoglobin (Hb) levels, however, their use at doses to reach high Hb targets has been associated with an increased risk of cardiovascular adverse events, mortality and cancer. Presently used ESAs have a common mechanism of action but different pharmacokinetic and pharmacodynamic characteristics. Accordingly, the mode of activation of the erythropoietin (EPO) receptor can exert marked differences in downstream events. It is unknown whether the various ESA molecules have different efficacy/safety profiles...
March 24, 2020: Nephrology, Dialysis, Transplantation
Carlo Basile, Christian Combe, Francesco Pizzarelli, Adrian Covic, Andrew Davenport, Mehmet Kanbay, Dimitrios Kirmizis, Daniel Schneditz, Frank van der Sande, Sandip Mitra
COVID-19, a disease caused by a novel coronavirus, is a major global human threat that has turned into a pandemic. This novel coronavirus has specifically high morbidity in the elderly and in comorbid populations. Uraemic patients on dialysis combine an intrinsic fragility and a very frequent burden of comorbidities with a specific setting in which many patients are repeatedly treated in the same area (haemodialysis centres). Moreover, if infected, the intensity of dialysis requiring specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under exceptional additional strain...
March 20, 2020: Nephrology, Dialysis, Transplantation
Lihong Bu, James Mirocha, Mark Haas
BACKGROUND: Some renal biopsies cannot distinguish minimal change disease (MCD) from primary focal segmental glomerulosclerosis (FSGS) because of inadequate sampling and/or a lack of sampled glomeruli with segmental sclerosis. As protein excretion in MCD has been described as being albumin-selective, we examined whether the ratio of immunoglobulin G (IgG)/albumin staining in protein reabsorption droplets (tPRD) might help distinguish MCD from FSGS. METHODS: Frozen tissue from 144 native renal biopsies from patients with nephrotic syndrome and a diagnosis of MCD or FSGS [73 MCD, 30 FSGS tip variant (FSGS-tip), 38 FSGS-not otherwise specified (FSGS-NOS), 3 FSGS collapsing] was retrospectively stained by direct immunofluorescence for IgG and albumin; none of these samples showed diagnostic lesions of FSGS...
March 19, 2020: Nephrology, Dialysis, Transplantation
Meera N Harhay, Maya K Rao, Kenneth J Woodside, Kirsten L Johansen, Krista L Lentine, Stefan G Tullius, Ronald F Parsons, Tarek Alhamad, Joseph Berger, XingXing S Cheng, Jaqueline Lappin, Raymond Lynch, Sandesh Parajuli, Jane C Tan, Dorry L Segev, Bruce Kaplan, Jon Kobashigawa, Darshana M Dadhania, Mara A McAdams-DeMarco
The construct of frailty was first developed in gerontology to help identify older adults with increased vulnerability when confronted with a health stressor. This article is a review of studies in which frailty has been applied to pre- and post-kidney transplantation (KT) populations. Although KT is the optimal treatment for end-stage kidney disease (ESKD), KT candidates often must overcome numerous health challenges associated with ESKD before receiving KT. After KT, the impacts of surgery and immunosuppression represent additional health stressors that disproportionately impact individuals with frailty...
March 19, 2020: Nephrology, Dialysis, Transplantation
Steven Menez, Ning Ding, Morgan E Grams, Pamela L Lutsey, Gerardo Heiss, Aaron R Folsom, Elizabeth Selvin, Josef Coresh, Bernard G Jaar, Kunihiro Matsushita
BACKGROUND: Few studies have investigated the association of magnesium levels with incident peripheral artery disease (PAD) despite emerging evidence of magnesium contributing to vascular calcification. Moreover, no data are available on whether the magnesium-PAD relationship is independent of or modified by kidney function. METHODS: A cohort of 11 839 participants free of PAD in the Atherosclerosis Risk in Communities Study at Visit 2 (1990-92) was studied. We investigated the association of serum magnesium and other bone-mineral metabolism markers [calcium, phosphorus, intact parathyroid hormone (iPTH) and intact fibroblast growth factor-23] with incident PAD using multivariable Cox proportional hazards regression...
March 19, 2020: Nephrology, Dialysis, Transplantation
Annabel Boyer, Ivonne Solis-Trapala, Matthew Tabinor, Simon J Davies, Mark Lambie
BACKGROUND: There is limited information available on the impact that provision of an assisted peritoneal dialysis (PD) service has on the initiation of PD. The aim of this study was to assess this impact in a centre following initiation of assisted PD in 2011. METHODS: This retrospective, single-centre study analysed 1576 patients incident to renal replacement therapies (RRTs) between January 2002 and 2017. Adjusted Cox regression with a time-varying explanatory variable and a Fine and Gray model were used to examine the effect of assisted PD use on the rates and cumulative incidence of PD initiation, accounting for the non-linear impact of RRT starting time and the competing risks (transplant and death)...
March 17, 2020: Nephrology, Dialysis, Transplantation
Wim Van Biesen, Norbert Lameire
No abstract text is available yet for this article.
March 17, 2020: Nephrology, Dialysis, Transplantation
Sarah Y A Ng, Richard Haynes, William G Herrington
No abstract text is available yet for this article.
March 14, 2020: Nephrology, Dialysis, Transplantation
Marco Bonani, Rita Achermann, Harald Seeger, Michael Scharfe, Thomas Müller, Stefan Schaub, Isabelle Binet, Uyen Huynh-Do, Suzan Dahdal, Dela Golshayan, Karine Hadaya, Rudolf P Wüthrich, Thomas Fehr, Stephan Segerer
BACKGROUND: Patients returning to dialysis after graft loss have high early morbidity and mortality. METHODS: We used data from the Swiss Transplant Cohort Study to describe the current practice and outcomes in Switzerland. All patients who received a renal allograft between May 2008 and December 2014 were included. The patients with graft loss were divided into two groups depending on whether the graft loss occurred within 1 year after transplantation (early graft loss group) or later (late graft loss group)...
March 14, 2020: Nephrology, Dialysis, Transplantation
Melanie L R Wyld, Rachael L Morton, Leyla Aouad, Dianna Magliano, Kevan R Polkinghorne, Steve Chadban
BACKGROUND: Quality-of-life is an essential outcome for clinical care. Both chronic kidney disease (CKD) and diabetes have been associated with poorer quality-of-life. The combined impact of having both diseases is less well understood. As diabetes is the most common cause of CKD, it is imperative that we deepen our understanding of their joint impact. METHODS: This was a prospective, longitudinal cohort study of community-based Australians aged ≥25 years who participated in the Australian Diabetes, Obesity and Lifestyle study...
March 14, 2020: Nephrology, Dialysis, Transplantation
Lynda Cheddani, Sophie Liabeuf, Marie Essig, Renaud Snanoudj, Christian Jacquelinet, Clarisse Kerleau, Marie Metzger, Beverley Balkau, Tilman B Drüeke, Maryvonne Hourmant, Ziad A Massy
BACKGROUND: Although kidney transplantation prolongs survival relative to dialysis, it is associated with a higher death rate than in the general population. The objective of the present study was to assess and compare the risk of mortality and frequency of non-lethal cardiovascular (CV) events in kidney transplant recipients (KTRs) beyond 1 year after successful transplantation versus patients with chronic kidney disease (CKD) using propensity score-matched analysis of estimated glomerular filtration rate (eGFR) and other parameters...
March 12, 2020: Nephrology, Dialysis, Transplantation
Charles Ginsberg, Leila R Zelnick, Geoffrey A Block, Glenn M Chertow, Michel Chonchol, Andrew Hoofnagle, Bryan Kestenbaum, Ian H de Boer
BACKGROUND: Phosphate binders are commonly used in the treatment of patients with hyperphosphatemia. While phosphate binders are used to lower phosphate, the effects of specific phosphate binder types on vitamin D metabolism are unknown. METHODS: We performed a secondary analysis of the Phosphate Normalization Trial in which patients with moderate to advanced chronic kidney disease were randomized to receive either placebo, sevelamer carbonate, lanthanum carbonate or calcium acetate for 9 months...
March 11, 2020: Nephrology, Dialysis, Transplantation
Csaba P Kovesdy
No abstract text is available yet for this article.
March 11, 2020: Nephrology, Dialysis, Transplantation
Lena Berchtold, Lindsey A Crowe, Iris Friedli, David Legouis, Solange Moll, Thomas de Perrot, Pierre-Yves Martin, Jean-Paul Vallée, Sophie de Seigneux
No abstract text is available yet for this article.
March 11, 2020: Nephrology, Dialysis, Transplantation
Erika Opingari, Subodh Verma, Kim A Connelly, Cyril David Mazer, Hwee Teoh, Adrian Quan, Fei Zuo, Yi Pan, Deepak L Bhatt, Bernard Zinman, Lawrence A Leiter, Andrew T Yan, David Z I Cherney, Richard E Gilbert
No abstract text is available yet for this article.
March 11, 2020: Nephrology, Dialysis, Transplantation
Maarten A De Jong, Michele F Eisenga, Adriana J van Ballegooijen, Joline W J Beulens, Marc G Vervloet, Gerjan Navis, Ron T Gansevoort, Stephan J L Bakker, Martin H De Borst
BACKGROUND: Fibroblast growth factor 23 (FGF23), a phosphate-regulating hormone that increases early in the course of chronic kidney disease (CKD), is associated with disease progression in patients with established CKD. Here we aimed to investigate the association between plasma FGF23 and new-onset CKD in the general population. METHODS: We included 5253 individuals without CKD who participated in the Prevention of Renal and Vascular Endstage Disease study, a prospective, population-based cohort...
March 3, 2020: Nephrology, Dialysis, Transplantation
Gabriel Morin, Christophe Legendre, Guillaume Canaud
No abstract text is available yet for this article.
February 22, 2020: Nephrology, Dialysis, Transplantation
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