Nephrology, Dialysis, Transplantation

Mark Sampson, Nuno Faria, Jonathan J Powell
BACKGROUND: Hyperphosphataemia is a common complication of chronic kidney disease (CKD). PT20 (ferric iron oxide adipate) is an investigational molecule engineered to offer enhanced phosphate-binding properties relative to other phosphate binders. METHODS: In this double-blind, parallel-group, placebo-controlled, dose-ranging study ( identifier NCT02151643), the efficacy and safety of 28 days of oral PT20 treatment were evaluated in patients with dialysis-dependent CKD...
July 11, 2020: Nephrology, Dialysis, Transplantation
Yuki Yokoe, Naotake Tsuboi, Takahiro Imaizumi, Akimitsu Kitagawa, Munetoshi Karasawa, Takaya Ozeki, Nobuhide Endo, Yuriko Sawa, Sawako Kato, Takayuki Katsuno, Shoichi Maruyama, Kunihiro Yamagata, Joichi Usui, Michio Nagata, Ken-Ei Sada, Hitoshi Sugiyama, Koichi Amano, Yoshihiro Arimura, Tatsuya Atsumi, Yukio Yuzawa, Hiroaki Dobashi, Yoshinari Takasaki, Masayoshi Harigai, Hitoshi Hasegawa, Hirofumi Makino, Seiichi Matsuo
BACKGROUND: The detection of leukocyte-derived CD11b (α subunit of integrin Mac-1) and CD163 (scavenger receptor) in urine may reflect renal inflammation in antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). The objective of this study was to evaluate the clinical significance of urinary CD11b (U-CD11b) and CD163 (U-CD163) in ANCA-GN. METHODS: U-CD11b and U-CD163 were examined using enzyme-linked immunosorbent assay in ANCA-GN urine samples from our institutional cohort (n = 88) and a nationwide cohort (n = 138), and their association with renal histology was subsequently analyzed...
July 8, 2020: Nephrology, Dialysis, Transplantation
Susan L Murray, Eamonn O'Leary, Áine M De Bhailís, Sandra Deady, Fergus E Daly, Patrick O'Kelly, Yvonne Williams, James P O'Neill, Donal J Sexton, Peter J Conlon
BACKGROUND: Transplantation is a well-known risk factor for malignancy. However, outcomes of cancer in transplant recipients compared with non-transplant recipients are less well studied. We aim to study the survival in kidney transplant recipients who develop cancer and compare this with cancer outcomes in the general population. METHODS: We linked data from the National Cancer Registry Ireland with the National Kidney Transplant Database. The period of observation was from 1 January 1994 until 31 December 2014...
July 8, 2020: Nephrology, Dialysis, Transplantation
Stephen B Erickson, Ladan Zand, Samih H Nasr, Mariam P Alexander, Nelson Leung, Maria Eleni Drosou, Fernando C Fervenza
BACKGROUND: Fibrillary glomerulonephritis (FGN) is a rare type of glomerulonephritis with poor prognosis, with no known effective therapies available for treatment. The objective of the study was to evaluate the efficacy and safety of rituximab in treatment of patients with FGN and to investigate the effect of rituximab on DNAJB9 levels. METHODS: This was a pilot prospective clinical trial in which patients with idiopathic FGN were treated with two courses of rituximab (1 g each) 2 weeks apart at the beginning and then again at 6 months...
July 2, 2020: Nephrology, Dialysis, Transplantation
Sydney C W Tang, Kam Wa Chan, Dennis K M Ip, Desmond Y H Yap, Maggie K M Ma, Maggie M Y Mok, Gary C W Chan, Sidney Tam, Kar Neng Lai
BACKGROUND: The potential long-term safety and efficacy of aliskiren in nondiabetic chronic kidney disease (CKD) are unknown. We sought to investigate the renoprotective effect of aliskiren on nondiabetic CKD patients. METHODS: In this open-label, parallel, randomized controlled trial, nondiabetic CKD Stages 3-4 patients were randomized to receive aliskiren added to an angiotensin II receptor blocker (ARB) at the maximal tolerated dose, or ARB alone. Primary outcome was the rate of change in estimated glomerular filtration rate (eGFR)...
July 2, 2020: Nephrology, Dialysis, Transplantation
Marie Essig, Morgan Matt, Ziad Massy
No abstract text is available yet for this article.
July 2, 2020: Nephrology, Dialysis, Transplantation
Luca Neri, Francesco Bellocchio, Fatih Kircelli, Tomas Jirka, Martial Levannier, Jean Guillaume, David Attaf, Carlo Barbieri, Mario Garbelli, Stefano Stuard, Bernard Canaud, Charles Chazot
BACKGROUND: Citric acid-based bicarbonate dialysate (CiD) is increasingly used in haemodialysis (HD) to improve haemodynamic tolerance and haemocompatibility associated with acetic acid-based bicarbonate dialysate. Safety concerns over CiD have been raised recently after a French ecological study reported higher mortality hazard in HD clinics with high CiD consumption. Therefore, we evaluated the mortality risk associated with various acidifiers (AcD, CiD) of bicarbonate dialysate. METHODS: In this multicentre, historical cohort study, we included adult incident HD patients (European, Middle-East and Africa Fresenius Medical Care network; 1 January 2014 to 31 October 2018)...
July 2, 2020: Nephrology, Dialysis, Transplantation
Laura S van Dam, Ebru Dirikgil, Edwin W Bredewold, Argho Ray, Jaap A Bakker, Cees van Kooten, Ton J Rabelink, Yoe K Onno Teng
BACKGROUND: The primary challenge of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patient care is the early detection of relapses to prevent organ damage and increase survival. Potential biomarkers for relapses are ANCA and B cells, but their predictive value is a matter of debate. Therefore this study investigated how ANCA and B-cell status related to relapses in AAV patients treated with rituximab (RTX) as remission induction (RI). METHODS: This single-centre cohort study identified 110 ANCA-positive AAV patients treated with RTX between 2006 and 2018...
June 30, 2020: Nephrology, Dialysis, Transplantation
Anthony Bonavia, Gregory Vece, Kunal Karamchandani
The traditional taxonomy of acute kidney injury (AKI) has remained pervasive in clinical nephrology. While the terms 'prerenal', 'intrarenal' and 'postrenal' highlight the diverse pathophysiology underlying AKI, they also imply discrete disease pathways and de-emphasize the nature of AKI as an evolving clinical syndrome with multiple, often simultaneous and overlapping, causes. In a similar vein, prerenal AKI comprises a diverse spectrum of kidney disorders, albeit one that is often managed by using a standardized clinical algorithm...
June 29, 2020: Nephrology, Dialysis, Transplantation
Rasmus Dreier, Bahareh Abdolalizadeh, Camilla L Asferg, Lisbet R Hölmich, Niels H Buus, Julie L Forman, Ulrik B Andersen, Martin Egfjord, Majid Sheykhzade, Jørgen L Jeppesen
BACKGROUND: Increased potassium intake lowers blood pressure (BP) in hypertensive patients. The underlying mechanism is not fully understood but must be complex because increased potassium intake elevates circulating concentrations of the BP-raising hormone aldosterone. METHODS: In a randomized placebo-controlled crossover study in 25 normotensive men, we investigated the effect of 4 weeks of potassium supplement (90 mmol/day) compared with 4 weeks of placebo on the renin-angiotensin-aldosterone system (RAAS), urine composition and 24-h ambulatory BP...
June 29, 2020: Nephrology, Dialysis, Transplantation
Naoki Takahashi, Haruyoshi Yoshida, Hideki Kimura, Kazuko Kamiyama, Tomomi Kurose, Hidehiro Sugimoto, Toshio Imura, Seiji Yokoi, Daisuke Mikami, Kenji Kasuno, Hiroyuki Kurosawa, Yoshiaki Hirayama, Hironobu Naiki, Masanori Hara, Masayuki Iwano
BACKGROUND: Chronic hypoxia may play a pivotal role in the development of diabetic nephropathy (DN). However, the precise mechanisms underlying progressive hypoxia-induced glomerular injury remain unclear. METHODS: We housed db/db mice in a hypoxia chamber (12% O2) for up to 16 weeks beginning at 8 weeks of age. Various urine, serum and kidney abnormalities and glomerular messenger RNA (mRNA) expression were compared with those in age-matched db/db mice housed under normoxia...
June 29, 2020: Nephrology, Dialysis, Transplantation
Marcelo Barreto Lopes, Angelo Karaboyas, Brian Bieber, Ronald L Pisoni, Sebastian Walpen, Masafumi Fukagawa, Anders Christensson, Pieter Evenepoel, Marisa Pegoraro, Bruce M Robinson, Roberto Pecoits-Filho
BACKGROUND: Serial assessment of phosphorus is currently recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, but its additional value versus a single measurement is uncertain. METHODS: We studied data from 17 414 HD patients in the Dialysis Outcomes and Practice Patterns Study, a prospective cohort study, and calculated the area under the curve (AUC) by multiplying the time spent with serum phosphorus >4.5 mg/dL over a 6-month run-in period by the extent to which this threshold was exceeded...
June 29, 2020: Nephrology, Dialysis, Transplantation
Elisabet Van Loon, Evelyne Lerut, Henriette de Loor, Dirk Kuypers, Marie-Paule Emonds, Dany Anglicheau, Wilfried Gwinner, Marie Essig, Pierre Marquet, Maarten Naesens
BACKGROUND: Recently a peripheral blood 8-gene expression assay was developed for non-invasive detection of antibody-mediated rejection (ABMR) after kidney transplantation. Its value has not yet been evaluated in detail in clinical scenarios with different baseline disease probability [human leucocyte antigen donor-specific antibodies (HLA-DSA)-positive versus HLA-DSA-negative cases at the time of stable graft function versus graft dysfunction]. METHODS: Here we investigated the diagnostic accuracy of the 8-gene expression assay for histology of ABMR (ABMRh) with or without HLA-DSA in a cross-sectional cohort study of 387 blood samples with a concomitant graft biopsy...
June 29, 2020: Nephrology, Dialysis, Transplantation
Pascale Khairallah, Thomas L Nickolas
No abstract text is available yet for this article.
June 29, 2020: Nephrology, Dialysis, Transplantation
Carlos K H Wong, Tingting Wu, Simon K H Wong, Betty T T Law, Eleanor Grieve, Enders K W Ng, Olivia Wu, Cindy L K Lam
BACKGROUND: Bariatric surgery has been widely indicated for the management of obesity and related comorbidities. However, there are uncertainties pertaining to the risks of post-bariatric severe hypoglycaemia (SH), cardiovascular diseases (CVDs), end-stage kidney diseases (ESKDs) and all-cause mortality in obese patients with Type 2 diabetes mellitus (T2DM), especially among Asian populations. METHODS: A retrospective population-based cohort of 1702 obese T2DM patients who were free of CVD and ESKD were assembled based on the 2006-17 Hospital Authority database...
June 27, 2020: Nephrology, Dialysis, Transplantation
Nicholas C Chesnaye, Friedo W Dekker, Marie Evans, Fergus J Caskey, Claudia Torino, Maurizio Postorino, Maciej Szymczak, Chava L Ramspek, Christiane Drechsler, Christoph Wanner, Kitty J Jager
INTRODUCTION: Understanding the mechanisms underlying the differences in renal decline between men and women may improve sex-specific clinical monitoring and management. To this end, we aimed to compare the slope of renal function decline in older men and women in chronic kidney disease (CKD) Stages 4 and 5, taking into account informative censoring related to the sex-specific risks of mortality and dialysis initiation. METHODS: The European QUALity Study on treatment in advanced CKD (EQUAL) study is an observational prospective cohort study in Stages 4 and 5 CKD patients ≥65 years not on dialysis...
June 27, 2020: Nephrology, Dialysis, Transplantation
Tineke Kraaij, Eline J Arends, Laura S van Dam, Sylvia W A Kamerling, Paul L A van Daele, Obbo W Bredewold, Argho Ray, Jaap A Bakker, Hans U Scherer, Tom J W Huizinga, Ton J Rabelink, Cees van Kooten, Y K Onno Teng
BACKGROUND: Anti-CD20 B-cell depletion has not shown superior efficacy to standard immunosuppression in patients with systemic lupus erythematosus (SLE). Besides trial design, potential explanations are incomplete B-cell depletion in relation to substantial surges in B-cell-activating factor (BAFF). To improve B-cell targeting strategies, we conducted the first study in SLE patients aimed at investigating immunological effects and feasibility of combining rituximab (RTX; anti-CD20) and belimumab (BLM; anti-BAFF)...
June 27, 2020: Nephrology, Dialysis, Transplantation
Simon D Roger, Bruce S Spinowitz, Edgar V Lerma, Steven Fishbane, Stephen R Ash, Julian G Martins, Carol Moreno Quinn, David K Packham
BACKGROUND: Sodium zirconium cyclosilicate (SZC) binds potassium and ammonium in the gastrointestinal tract. In addition to serum potassium reduction, Phase 2 trial data have shown increased serum bicarbonate with SZC, which may be clinically beneficial because maintaining serum bicarbonate ≥22 mmol/L preserves kidney function. This exploratory analysis examined serum bicarbonate and urea, and urine pH data from three SZC randomized, placebo-controlled Phase 3 studies among patients with hyperkalaemia [ZS-003 (n = 753), HARMONIZE (n = 258) and HARMONIZE-Global (n = 267)]...
June 26, 2020: Nephrology, Dialysis, Transplantation
Minjung Kang, Eunjeong Kang, Hyunjin Ryu, Yeji Hong, Seung Seok Han, Sue K Park, Young Youl Hyun, Su Ah Sung, Soo Wan Kim, Tae-Hyun Yoo, Jayoun Kim, Curie Ahn, Kook-Hwan Oh
BACKGROUND: Diet is a modifiable factor of chronic kidney disease (CKD) progression. However, the effect of dietary salt intake on CKD progression remains unclear. Therefore, we analyzed the effect of dietary salt intake on renal outcome in Korean patients with CKD. METHODS: We measured 24-h urinary sodium (Na) excretion as a marker of dietary salt intake in the prospective, multi-center, longitudinal KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD)...
June 24, 2020: Nephrology, Dialysis, Transplantation
Lucile Mercadal, Oriane Lambert, Cécile Couchoud, Marie Metzger, Stéphane Edet, Sylvie Merle, Christian Jacquelinet, Bénédicte Stengel
BACKGROUND: Management of potassium disorders in patients on haemodialysis (HD) is complex. We studied prescription patterns of dialysate potassium and potassium binders, and their associations with patient survival. METHODS: This national registry-based study included 25 629 incident adult patients alive after 3 months of HD from 2010 through 2013 and followed-up through 31 December 2014. We used Cox proportional hazard models to estimate multiadjusted mortality hazard ratios (HRs) associated with time-dependent exposure to facility-level dialysate potassium concentrations and patient-level potassium binder exposure...
June 24, 2020: Nephrology, Dialysis, Transplantation
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