Shisheng Han, Xiaolu Zhang, Xiaojun Wang, Yi Wang, Yanqiu Xu, Li Shang
INTRODUCTION: This study aimed to investigate the relationship between circulating soluble Klotho concentration and all-cause mortality in individuals with chronic kidney disease (CKD). METHODS: We conducted a prospective cohort study involving 2,456 participants with CKD from the National Health and Nutrition Examination Survey (NHANES) cycles spanning from 2007 to 2016. Complex sampling-weighted multivariate Cox proportional hazards models were used to estimate the association between serum Klotho level and all-cause mortality, presenting hazard ratios (HR) and 95% confidence intervals (CI)...
December 16, 2023: American Journal of Nephrology
Kajohnsak Noppakun, Surapon Nochaiwong, Apichat Tantraworasin, Jiraporn Khorana, Paweena Susantitaphong, Adisorn Lumpaopong, Suchai Sritippayawan, Vuddhidej Ophascharoensuk, Chidchanok Ruengorn
BACKGROUND: Mortality following hemodialysis initiation may influence the decision to initiate hemodialysis in elderly patients. Our objective is to demonstrate mortality following hemodialysis initiation in elderly (≥70 years) and to derive a prediction risk score based on clinical and laboratory indicators to determine risk of all-cause mortality in patients aged ≥80 years. METHODS: We identified elderly (≥70 years) who initiated maintenance hemodialysis between January 2005 and December 2016 using data from the Thai Renal Replacement Therapy Registry...
December 8, 2023: American Journal of Nephrology
Elias John Elenjickal, Christoforos K Travlos, Pedro Marques, Thomas A Mavrakanas
BACKGROUND: Both atrial fibrillation and venous thromboembolic disease (VTE) are highly prevalent among patients with chronic kidney disease (CKD). Until recently, warfarin was the most commonly prescribed oral anticoagulant. Direct oral anticoagulants (DOACs) have important advantages and have been shown to be non-inferior to warfarin with respect to stroke prevention or recurrent VTE in the general population, with lower bleeding rates. This review article will provide available evidence on use of DOACs in patients with CKD...
November 30, 2023: American Journal of Nephrology
Tai Yeon Koo, Juhan Lee, Yonggu Lee, Hyung Woo Kim, Beom Seok Kim, Kyu Ha Huh, Jaeseok Yang
INTRODUCTION: ABO-incompatible (ABOi) living donor kidney transplantation (LDKT) is considered only for patients who do not have an ABO-compatible (ABOc) LD. Therefore, a clinically practical question is whether to proceed with ABOi LDKT or remain on dialysis while waiting for ABOc deceased donor kidney transplantation (DDKT). However, this issue has not been addressed in Asian countries, where ABOi LDKT programs are more active than DDKT programs. METHODS: A total of 426 patients underwent ABOi-LDKT between 2010 and 2020 at Seoul National University Hospital and Severance Hospital, Korea...
November 30, 2023: American Journal of Nephrology
Stephanie W Ong, Abhijat Kitchlu, David Z I Cherney, Karen Leung, Christopher T M Chan
BACKGROUND: Collaborative management of kidney disease relies on coordinated and effective partnerships between multiple providers. Siloed traditional health systems often result in delays, barriers to treatment access, and inefficient monitoring. METHODS: We conducted a 1-year observational mixed methods study. We included all consecutive referrals except for patients without telephone access. We assessed 4 domains of outcomes: 1. Patient and caregiver experience, 2...
November 8, 2023: American Journal of Nephrology
Firas F Alkaff, Daan Kremer, Charlotte A Te Velde-Keyzer, Jacob van den Born, Stefan P Berger, Gozewijn D Laverman, Lee-Ming Chuang, Tzu-Ling Tseng, Stephan J L Bakker
INTRODUCTION: Urinary fetuin-A has been identified as a biomarker for acute kidney injury and is proposed as a biomarker for early detection of kidney function decline. We investigated whether fetuin-A could serve as a marker of graft failure in kidney transplant recipients (KTR). METHODS: Data of KTR with a functioning graft ≥ 1 year that were enrolled in the TransplantLines Food and Nutrition Biobank and Cohort study were used. Graft failure was defined as the need of re-transplantation or (re-)initiation of dialysis)...
November 6, 2023: American Journal of Nephrology
Rima S Zahr, Akram Mohammed, Surabhi Naik, Daniel Faradji, Kenneth I Ataga, Jeffrey Lebensburger, Robert L Davis
INTRODUCTION: Acute Kidney Injury (AKI) is common among hospitalized patients with sickle cell disease (SCD) and contributes to increased morbidity and mortality. Early identification and management of AKI is essential to preventing poor outcomes. We aimed to predict AKI earlier in patients with SCD using a machine learning model that utilized continuous minute-by-minute physiological data. METHODS: 6,278 adult SCD patient encounters were admitted to inpatient units across five regional hospitals in Memphis, TN, over three years, from July 2017 to December 2020...
October 31, 2023: American Journal of Nephrology
Katherine R Tuttle, Peter Rossing, Sibylle J Hauske, Lisa Cronin, Joanna Hussain, Dick de Zeeuw, Hiddo J L Heerspink
INTRODUCTION: Aldosterone synthase (AS) inhibition may overcome increased aldosterone production in response to renin-angiotensin system inhibition. BI 690517 is an AS inhibitor under investigation for chronic kidney disease (CKD). METHODS: This multinational, Phase II, double-blind study (NCT05182840) investigated the efficacy and safety of daily oral BI 690517, with or without empagliflozin 10 mg, in participants with CKD. The primary endpoint was change from baseline in urine albumin:creatinine ratio (UACR) at week 14...
October 30, 2023: American Journal of Nephrology
Louis Baeseman, Samantha Gunning, Jay L Koyner
  Abstract: Background: Sepsis associated Acute kidney injury (AKI) is a leading comorbidity in admissions to the intensive care unit. While a gold standard definition exists, it remains imperfect and does not allow for the timely identification of patients in the setting of critical illness. This review will discuss the use of biochemical and electronic biomarkers to allow for prognostic and predictive enrichment of patients with sepsis associated AKI over and above the use of serum creatinine and urine output...
October 16, 2023: American Journal of Nephrology
Gwo-Tsann Chuang, Daan Kremer, Chi-Hsuan Huang, Firas F Alkaff, Chih-Hung Lin, Tzu-Ling Tseng, Gozewijn D Laverman, Stephan J L Bakker, Lee-Ming Chuang
Introduction There is a great clinical need for novel markers to predict kidney function decline in patients with type 2 diabetes. We explored the potential of post-translationally modified fetuin-A fragments in urine (uPTM-FetA) as such a marker. Methods We included patients with type 2 diabetes from two independent, non-overlapping prospective cohort studies. A cut-off for uPTM-FetA, measured via ELISA method, was determined using the Youden index in the primary cohort of patients with type 2 diabetes from Taiwan...
October 9, 2023: American Journal of Nephrology
Yong Wang, Xiangmei Chen, Hanyu Zhu, Zhiyong Guo, Yibin Yang, Ping Luo, Yani He, Yan Xu, Daxi Ji, Xinlu Gao, Xiuli Sun, Changying Xing, Yu Wang, Xiaohui Wang, Shuping Zhao, Yan Guan, Hongli Lin, Aimin Zhong, Hua Shui, Fengmin Shao, Lu Lv, Yuehong Yan, Xiaokun Sun, Lei Zhang
BACKGROUND: Hyperphosphatemia in CKD patients is positively associated with mortality. Ferric citrate is a potent phosphorus binder that lowers serum phosphorus level and improves iron metabolism. We compared its efficacy and safety with active drugs in Chinese CKD patients with hemodialysis. TRIAL DESIGN: This is an open-label active-drug-controlled multicenter randomized study. METHODS: Chinese patients undergoing hemodialysis were randomized into two treatment groups in a 1:1 ratio receiving either ferric citrate or sevelamer carbonate respectively for 12 weeks...
October 9, 2023: American Journal of Nephrology
Xiaohu Shi, Zhaojun Li, Weifeng Lin, Wenying Shi, Rongrong Hu, Gang Chen, Xuemei Li, Xuewang Li, Sen Zhang
INTRODUCTION: Dysbiosis of the intestinal microbiome and related metabolites have been observed in chronic kidney disease (CKD), yet their roles in idiopathic membranous nephropathy (IMN) is poorly understood. METHODS: In this study, we describe the variation of intestinal bacteria and fecal metabolites in patients with IMN in Chinese population. Stool samples are collected from 41 IMN patients at the beginning of diagnosis confirmation and 41 gender and age matched healthy control (HC)...
October 4, 2023: American Journal of Nephrology
Danai Faitatzidou, Artemios G Karagiannidis, Marieta P Theodorakopoulou, Andrew Xanthopoulos, Filippos Triposkiadis, Pantelis A Sarafidis
BACKGROUND: In patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) cardiovascular events represent the predominant cause of morbidity and mortality, with cardiac arrhythmias and sudden death being the leading causes of death in this population. Autonomic nervous system (ANS) dysfunction is listed among the non-traditional risk factors accounting for the observed high cardiovascular burden, with a plethora of complex and not yet fully understood pathophysiologic mechanisms being involved...
October 3, 2023: American Journal of Nephrology
Ning Song, Hans-Joachim Paust, Nariaki Asada, Anett Peters, Anna Kaffke, Christian F Krebs, Ulf Panzer, Jan-Hendrik Riedel
INTRODUCTION: The chemokine receptor CCR4 is expressed by divers CD4+ T cell subsets including regulatory T cells (Tregs) but its functional importance for leukocyte recruitment and the relevance of its two corresponding chemokines CCL17 and CCL22 have not been studied in immune mediated crescentic glomerulonephritis (cGN). METHODS: Utilizing the single cell RNA sequencing (scRNAseq) data in analyzing leukocytes isolated from both human and murine nephritic kidneys we identified CCL17 as a potential therapeutic target in immune mediated renal disease...
September 23, 2023: American Journal of Nephrology
Heng Shi, Xinhai Zhao, Peng Qin, Xianling Zhou, Sisi Liu, Chuanchuan Sun, Qiuyu Cao, Shiping Zhu, Shengyun Sun
BACKGROUND: Di(2-ethylhexyl) phthalate (DEHP) is a common plasticizer. Studies have revealed that DEHP exposure can cause kidney damage. Green tea is among the most popular beverages in China. Green tea polyphenols (GTPs) have been proven to have therapeutic effects on organ damage induced by heavy metal exposure. However, few studies have reported on GTP relieving DEHP-induced kidney damage. METHODS: C57BL/6J male mice aged 6-8 weeks were treated with distilled water (control group), 1500 mg/kg/d DEHP + corn oil (model group), 1500 mg/kg/d DEHP + corn oil + 70 mg/kg GTP (treatment group), corn oil (oil group), and 70 mg/kg GTP (GTP group) by gavage for 8 weeks, respectively...
September 21, 2023: American Journal of Nephrology
Rajkumar Chinnadurai, Sharmilee Rengarajan, Jeffrey J Budden, Carol Moreno Quinn, Philip A Kalra
INTRODUCTION: Guideline-directed renin-angiotensin-aldosterone system inhibitor (RAASi) therapy is rarely achieved in clinical settings, often due to hyperkalaemia. We assessed the potassium binder, patiromer, on continuation of RAASi therapy in hyperkalaemic patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) in the AMETHYST-DN trial, propensity score-matched to a real-world cohort not receiving patiromer (Salford Kidney Study). METHODS: The phase 2, open-label AMETHYST-DN trial (NCT01371747) randomized 304 adults with CKD on RAASi, T2DM, hyperkalaemia (serum potassium [sK+] >5...
September 19, 2023: American Journal of Nephrology
Amy S You, Keith C Norris, Merle Kataoka-Yahiro, James Davis, Victoria Page, Glen Hayashida, Yoko Narasaki, Shiuh Feng Cheng, Roland Ng, Linda L Wong, Felix Lee, Kamyar Kalantar-Zadeh, Connie M Rhee
INTRODUCTION: While Asians and Native Hawaiian and other Pacific Islanders (NHOPIs) have a high prevalence of kidney disease risk factors, there are sparse data examining their end-stage kidney disease (ESKD) outcomes. As Hawaii has high representation of Asians and NHOPIs, we compared their ESKD outcomes based on residence in the Mainland US vs. Hawaii/Pacific Islands (PIs). MATERIALS AND METHODS: Using United States Renal Data System data, we examined the impact of geographic residence in the Mainland vs...
September 19, 2023: American Journal of Nephrology
Shuo Zhang, Xin Chen, Zuoxian Hou, Peng Xia, Xiaoxiao Shi, Haiting Wu, Yubing Wen, Yan Qin, Xinping Tian, Limeng Chen
INTRODUCTION: Older patients with antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) commonly experience renal impairment and poor prognoses. This study aimed to establish a risk-scoring system for predicting composite renal outcomes in older patients with AAV. METHODS: This retrospective observational study included all patients with AAV hospitalized in a single-center tertiary hospital in China between January 2013 and April 2022. Patients aged ≥ 65 years were defined as older adults, and short-term composite renal outcomes included a ≥ 25% reduction in eGFR (for AKI), renal replacement therapy, provision of renal replacement therapy (long-term dialysis, kidney transplant, or sustained eGFR < 15 ml/min/1...
September 14, 2023: American Journal of Nephrology
Mayuko Hori, Hiroshi Takahashi, Chika Kondo, Yutaka Matsuoka, Makoto Tsujita, Morikuni Nishihira, Kazuharu Uchida, Asami Takeda, Kunio Morozumi, Shoichi Maruyama
INTRODUCTION: Sarcopenia and osteoporosis are highly prevalent among kidney transplant recipients (KTRs). Although osteoporosis is known to increase fracture risk in KTRs, it is unclear whether sarcopenia or osteosarcopenia is associated with this increased risk. Thus, we aimed to investigate the association of the coexistence of low muscle mass (LMM) and osteoporosis with the risk of fracture in long-term KTRs. METHODS: Exactly 342 stable KTRs underwent dual-energy X-ray absorptiometry and skeletal muscle mass index (SMI) measurement using bioelectrical impedance analysis...
September 12, 2023: American Journal of Nephrology
Michael A Weber, Dagmara Hering, David Nikoleishvili, Avtandil Imedadze, Gvantsa Dughashvili, Zurab Klimiashvili, Eter Bekaia, Tamar Shengelia, Mamuka Kabalava, Otar Goguadze, Tamar Emukhvari, Vitaly Druker, Terry Buelna, Richard Heuser, Shima Hashemian, Robert Provanzano
INTRODUCTION: We previously completed a trial of renal pelvic denervation for treating hypertension that reduced blood pressure by the 2-month primary endpoint. However, information on the durability of effectiveness is a critical requirement for device therapy and we now report data up to 12 months. METHODS: This was an open label single-arm feasibility study in patients with increased blood pressure despite taking an average of 2.7 medications. The key endpoint reported here was ambulatory blood pressure at 12 months following renal pelvic denervation...
August 31, 2023: American Journal of Nephrology
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