American Journal of Kidney Diseases

No abstract text is available yet for this article.

RATIONALE & OBJECTIVE: Staphylococcus aureus (S. aureus) bacteremia (SAB) is associated with morbidity and mortality in patients receiving maintenance hemodialysis (HD). We evaluated changes in clinical and bacterial characteristics, and their associations with clinical outcomes following SAB in this population over a 21-year period. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 453 hospitalized, non-neutropenic, adults receiving maintenance HD who developed monomicrobial SAB between 1995 and 2015...

RATIONALE & OBJECTIVE: The utility of conventional upper reference limits (URL) for N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hsTnT) in chronic kidney disease (CKD) remains debated. We analyzed the distribution of hsTnT and NT-proBNP in people with CKD in ambulatory settings to examine the diagnostic value of conventional URL in this population. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: We studied participants of the Chronic Renal Insufficiency Cohort with CKD and no self-reported history of cardiovascular disease (CVD)...

RATIONALE AND OBJECTIVE: High anion gap acidosis frequently develops in patients with advanced chronic kidney disease (CKD) and might be involved in kidney injury. Its impact on kidney outcomes, however, has not been well studied. We sought to examine the association between time-updated anion gap and the risk of kidney failure with replacement therapy (KFRT) among patients with advanced CKD. STUDY DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: 1,168 patients with CKD stages G3b-G5 who had available data on anion gap...

SARS-CoV-2 continues to spread around the world. As of June 28th 2021, there are approximately 181 million confirmed cases and more than 3.9 million deaths across the globe. The colossal impact of COVID19 is driving the biggest vaccination campaign in human history. All three vaccines (Pfizer-BioNTech, Moderna and J&J) authorized for emergency use by FDA have been thoroughly studied and found to be safe and effective in preventing severe COVID-19 cases. While short-term side effects of COVID-19 vaccine resemble those of other vaccines, long-term side effects remain unknown...

Medications are an important part of the management of patients with kidney disease. When used appropriately, pharmacotherapy can slow disease progression and reduce morbidity and mortality. Unfortunately, reduced kidney function can significantly alter the pharmacokinetics and pharmacodynamics of many medications, putting patients at risk for drug toxicity if modifications to therapy are not appropriately managed. Adding complexity to the appropriateness of medication and dosage selection is the difficulty in estimating kidney function and the discordance between the Cockcroft-Gault-derived dosing cut points in most medication package inserts and the estimations of glomerular filtration rate by newer and generally more accurate guideline-recommended equations...

RATIONALE OBJECTIVE: Patients on home hemodialysis (HHD) may eventually return to in-center hemodialysis (ICHD) for clinical, technical or psycho-social reasons. We studied the mortality of patients returning to ICHD after HHD comparing it to the mortality experience among patients receiving HHD and patients receiving ICHD without prior treatment with HHD. STUDY DESIGN: Retrospective cohort study. SETTING PARTICIPANTS: All patients represented in the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry who commenced HD during 2005-2015 and were treated for >90 days...

No abstract text is available yet for this article.

RATIONALE AND OBJECTIVE: Clinical trial data have demonstrated the efficacy of etelcalcetide for reducing parathyroid hormone (PTH) levels in hemodialysis (HD) patients. We provide a real-world summary of etelcalcetide utilization, dosing, effectiveness, and discontinuation since its US introduction in April 2017. STUDY DESIGN: New-user design within prospective cohort. SETTING PARTICIPANTS: 2596 new users of etelcalcetide from April 2017 through August 2019 in a national sample of adult, chronic HD patients in the US Dialysis Outcomes and Practice Patterns Study (DOPPS)...

No abstract text is available yet for this article.

RATIONALE & OBJECTIVE: The Kidney Disease Improving Global Outcomes (KDIGO) definition of Acute Kidney Injury (AKI) is frequently used in studies to examine the epidemiology of AKI. This definition is variably interpreted and applied to routinely collected healthcare data. The aim of this study was to examine this variation and to achieve consensus in how AKI should be defined for research using routinely collected healthcare data. SOURCES OF EVIDENCE AND STUDY DESIGN: A scoping review was performed by searching MEDLINE and EMBASE for studies using healthcare data to examine AKI by utilizing the KDIGO creatinine-based definition...

RATIONALE & OBJECTIVE: Stratification of chronic kidney disease (CKD) patients at risk for progressing to end-stage kidney disease (ESKD) requiring kidney replacement therapy (KRT) is important for clinical decision-making and trial enrollment. STUDY DESIGN: Four independent prospective observational cohort studies. SETTING & PARTICIPANTS: The development cohort was comprised of 4,915 CKD patients and three independent validation cohorts were comprised of a total of 3,063...

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide. The diagnostic histologic hallmark is dominant or codominant IgA staining on kidney biopsy; however, patients may present with various clinical syndromes ranging from asymptomatic abnormalities noted on urinalysis to rapidly progressive glomerulonephritis. Given substantial heterogeneity in the clinical course of disease, online risk calculators are available that may assist in prognostication and inform discussions with patients...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Massively Parallel Sequencing identifies pathogenic variants in the genes affected in Alport syndrome (COL4A3 - COL4A5) in up to 30 % of individuals with focal and segmental glomerulosclerosis (FSGS), 10 % of those with kidney failure of unknown cause and 20 % with familial IgA glomerulonephritis. FSGS associated with COL4A3 - COL4A5 variants is usually present by kidney failure onset and may develop because the abnormal glomerular membranes result in podocyte loss and secondary hyperfiltration. The association of COL4A3 - COL4A5 variants with kidney failure or IgA glomerulonephritis may be coincidental and not pathogenic...

Primary hyperoxaluria (PH) is a group of genetic disorders that result in an increased hepatic production of oxalate. PH type 3 (PH3) is the most recently identified subtype and results from mutations in the mitochondrial 4-hydroxy-2-oxoglutarate aldolase (HOGA1) gene. To date, there have been two cases of kidney failure reported in PH3 patients. We present a case of a young man with a history of recurrent UTIs and voiding dysfunction who developed kidney failure at 33 years of age. He developed a bladder stone and bilateral staghorn calculi at 12 years of age...

We report a CASE of minimal change disease (MCD) with severe acute kidney injury (AKI) following the first injection of the ChAdOx1 nCoV-19/AZD1222 vaccine (Oxford-AstraZeneca). A 71-year-old man with history of dyslipidemia and a baseline serum creatinine of 0.7 mg/dl presented with nephrotic syndrome, AKI, and severe hypertension 13 days after receiving the Oxford-AstraZeneca vaccine. Refractory hyperkalemia and hypervolemia with oligoanuria prompted initiation of hemodialysis. His serum albumin was 2.6 g/dL and his urinary protein-creatinine ratio was 2321 mg/mmol...

No abstract text is available yet for this article.