Daniel Khan, Nan Zhang, Bassam G Abu Jawdeh, Sundararaman Swaminathan, Sumi Nair, Mira T Keddis
INTRODUCTION: This study describes patient characteristics and examines graft function of kidney transplant recipients (without primary hyperoxaluria) with elevated plasma oxalate (POx) and enteric risk factors prior to transplant at our institution. METHODS: Kidney transplant recipients between 2012 to 2020 with elevated POx at the time of kidney transplant evaluation were included. A matched control cohort was gathered using patient/donor age, living/deceased donor type, panel reactive antibody (PRA), kidney donor profile index (KDPI), and human leukocyte antigen (HLA) mismatch as matching variables...
February 13, 2023: American Journal of Nephrology
Katherine R Tuttle, Jonathan Matthew Wilson, Yanzhu Lin, Hui-Rong Qian, Federica Genovese, Morten Asser Karsdal, Kevin L Duffin, Fady T Botros
INTRODUCTION: In the AWARD-7 study in patients with type 2 diabetes and moderate-to-severe chronic kidney disease, once-weekly dulaglutide slowed the decline in estimated glomerular filtration rate (eGFR) and decreased the urine albumin/creatinine ratio compared to insulin glargine at the end of 52 weeks of treatment. In this exploratory post hoc analysis, changes in two fibrosis biomarkers, serum PRO-C6 (type VI collagen formation) and urine C3M (type III collagen degradation) were evaluated...
February 8, 2023: American Journal of Nephrology
Iain C Macdougall, Amy Mewborn Meadowcroft, Allison Blackorby, Borut Cizman, Alexander R Cobitz, Sergio Godoy, Vivekanand Jha, Kirsten L Johansen, Gearoid McMahon, Gregorio T Obrador, Muh Geot Wong, Ajay K Singh
INTRODUCTION: Hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) affects 10-15% of the chronic dialysis population. We explored baseline characteristics and predictors of ESA hyporesponsiveness in a global randomized cardiovascular outcomes study comparing an investigational hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), daprodustat, with conventional ESA treatment. METHODS: ASCEND-D (NCT02879305) recruited 2964 chronic dialysis patients receiving ESA treatment (standardized to weekly intravenous [IV] epoetin) who were iron replete at baseline...
February 3, 2023: American Journal of Nephrology
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January 19, 2023: American Journal of Nephrology
Jiajia Liu, Zhongyuan Liu, Tao Zhao, Tao Su, Qizhuang Jin
INTRODUCTION: This study aimed to elucidate the coagulation disorders in non-ICU patients with acute kidney injury (AKI) and their contribution to clotting-related outcomes of intermittent kidney replacement therapy (KRT). METHODS: We included non-ICU-admitted patients with AKI requiring intermittent KRT, clinically having a risk of bleeding and against systemic anticoagulant use during KRT between April and December 2018. The premature termination of treatment due to circuit clotting was considered a poor outcome...
2023: American Journal of Nephrology
Ashley M La, Samantha Gunning, Sharon A Trevino, Alissa Kunczt, Lui G Forni, Varsha Swamy, Alexander Zarbock, Sarah Groboske, Edward K Y Leung, Kiang-Teck J Yeo, Jay L Koyner
INTRODUCTION: Novel urinary biomarkers, including tissue inhibitor metalloprotease-2 and insulin-like growth factor binding protein 7 ([TIMP-2]*[IGFBP7]), have been developed to identify patients at risk for acute kidney injury (AKI). We investigated the "real-world" clinical utility of [TIMP-2]*[IGFBP7] in preventing AKI. METHODS: We performed a before and after single-center quality improvement study of intensive care unit (ICU) patients at risk for severe (KDIGO stage 2 or 3) AKI...
2023: American Journal of Nephrology
Kathryn E Simmons, Hari R Nair, Manali Phadke, Piruz Motamedinia, Dinesh Singh, Tinika A Montgomery, Neera K Dahl
INTRODUCTION: Kidney stone type varies with age, sex, season, and medical conditions. Lower estimate glomerular filtration rate (eGFR) leads to changes in urine chemistry, and risk factors for kidney stones are thought to vary by stone type. We explore the association between eGFR, urine risk factors, and common stone compositions. METHODS: This was a retrospective cohort study of 811 kidney stone patients seen at Yale Medicine between 1994 and 2021 with serum chemistries and 24-h urine chemistries matched within 1 year of baseline stone analysis...
2023: American Journal of Nephrology
Stuart M Sprague, Guru Reddy, Douglas Jermasek, Pramod Gupta
BACKGROUND: A key focus for chronic kidney disease management is phosphate control, but currently available binders have suboptimal phosphate-binding capacity, and their characteristics result in low adherence and poor phosphate regulation. Oxylanthanum carbonate, a novel compound that uses proprietary nanoparticle technology to deliver lanthanum, has the potential to combine high phosphate-binding capacity with good intake convenience, thus improving adherence and patient quality of life...
2023: American Journal of Nephrology
Jaejin An, Hui Zhou, Liang Ni, Teresa N Harrision, Rong Wei, Abiy Agiro, Yasmin Ghanshyam Brahmbhatt, Yemmie Oluwatosin, Craig G Schilling, John J Sim
INTRODUCTION: Discontinuation of renin-angiotensin-aldosterone system inhibitor (RAASi) is common after hyperkalemia. We evaluated the risk of kidney and mortality outcomes associated with RAASi discontinuation among patients with chronic kidney disease (CKD) and hyperkalemia. METHODS: We identified adult patients with CKD (eGFR <60 mL/min/1.73 m2) who experienced new-onset hyperkalemia (potassium ≥5.0 mEq/L) between 2016 and 2017 from Kaiser Permanente Southern California and followed them through 2019...
2023: American Journal of Nephrology
Panagiotis Theofilis, Aikaterini Vordoni, Rigas G Kalaitzidis
BACKGROUND: Individuals with end-stage renal disease on chronic hemodialysis (HD) may encounter numerous HD-associated complications, including intradialytic hypertension (IDHYPER). Although blood pressure (BP) follows a predictable course in the post-HD period, BP levels during the session may vary across the individuals. Typically, a decline in BP is noted during HD, but a significant proportion of patients exhibit a paradoxical elevation. SUMMARY: Several studies have been conducted to understand the complexity of IDHYPER, but much remains to be elucidated in the future...
2023: American Journal of Nephrology
Chen Tang, Xin-Yan Wen, Ji-Cheng Lv, Su-Fang Shi, Xu-Jie Zhou, Li-Jun Liu, Hong Zhang
BACKGROUND: Discontinuation of renin-angiotensin system (RAS) inhibitors is common in patients with chronic kidney disease (CKD), and the potential danger has been reported in several studies. However, a comprehensive analysis has not been conducted. OBJECTIVES: This study sought to evaluate the effects of discontinuation of RAS inhibitors in CKD. METHOD: Relevant studies up to November 30, 2022, were identified in the PubMed, Embase, Web of Science, and Cochrane Library databases...
2023: American Journal of Nephrology
Seok Hui Kang, Bo Yeon Kim, Eun Jung Son, Gui Ok Kim, Jun Young Do
INTRODUCTION: There were insufficient pieces of evidence regarding the effect of the two drugs (allopurinol and febuxostat) on patient survival in hemodialysis (HD) patients. Herein, we aimed to compare the efficacy of uric acid-lowering drugs (ULDs) or the type of the drug on patient survival using a representative sample of maintenance HD patients in South Korea. METHODS: This study used data from a national HD quality assessment program and the claims data. Use of ULDs was defined as more than one prescription during the 6 months of each HD quality assessment period...
2023: American Journal of Nephrology
Liu Yang, Yong Liu, Sijie Zhou, Qi Feng, Yanfang Lu, Dongwei Liu, Zhangsuo Liu
BACKGROUND: Various kidney diseases such as acute kidney injury, chronic kidney disease, polycystic kidney disease, renal cancer, and kidney stones, are an important part of the global burden, bringing a huge economic burden to people around the world. Ferroptosis is a type of nonapoptotic iron-dependent cell death caused by the excess of iron-dependent lipid peroxides and accompanied by abnormal iron metabolism and oxidative stress. Over the past few decades, several studies have shown that ferroptosis is associated with many types of kidney diseases...
2023: American Journal of Nephrology
Victor Ortiz-Soriano, Augusto Cama-Olivares, Lucas J Liu, Brian Armentrout, Durham Colohan, Ruchir Paladiya, Seda Babroudi, Juan-Carlos Aycinena, Javier A Neyra
INTRODUCTION: In 2017, the Centers for Medicare and Medicaid Services allowed survivors of hospitalized acute kidney injury requiring dialysis (AKI-D) who were ambulatory and still dependent on hemodialysis (HD) to receive treatment in outpatient dialysis facilities. This policy change generated the ongoing need to improve AKI-D care in the outpatient setting. METHODS: Quality improvement study in adult patients admitted to an outpatient HD unit with the diagnosis of AKI-D...
2023: American Journal of Nephrology
Qian Zhao, Yapeng He, Ning Wu, Lili Wang, Jinghua Dai, Juzi Wang, Ji Ma
INTRODUCTION: Chronic kidney disease is estimated to become the fifth leading cause of death globally by 2040. Due to the high incidence of fatigue in patients with end-stage renal disease without reliable pharmacological treatments, more and more studies on non-pharmacological interventions to improve physical function appear; which might be the best approach remains unknown. This study aimed to compare and rank the efficacy of all known non-pharmacological interventions on improving physical function from multiple outcomes for adults with end-stage renal disease...
2023: American Journal of Nephrology
Amit Pal Singh, Roberto S Kalil, Matthew R Weir
BACKGROUND: Diabetes mellitus and hypertension are the leading causes of cardiovascular disease in the renal transplant recipients. This review looks at the potential role of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and reviews the management strategies for hypertension in this population. SUMMARY: Large-scale clinical trials are needed to study the potential cardiorenal benefits and risks of complications in renal transplant recipients. Future clinical trials are also needed to define optimal blood pressure treatment goals and therapies and how they influence graft and patient survival...
2023: American Journal of Nephrology
Cheng-Wen Yang, Mei-Chen Lin, Kai-Hsiang Shu, Kuei-Tung Tung, Wan-Chuan Tsai, Ju-Yeh Yang, Mei-Fen Pai, Hon-Yen Wu, Yen-Ling Chiu, Yu-Sen Peng, Shih-Ping Hsu, Shi-Heng Wang, Szu-Yu Pan
INTRODUCTION: Although high-dose erythropoiesis-stimulating agent (ESA) has been shown to increase mortality risk and adverse cardiovascular events in hemodialysis patients, the safety of extremely low-dose ESA is unclear. METHODS: We retrospectively analyzed the association between ESA dose and mortality in the monthly dosing range of 0-43,000 U of equivalent epoetin alfa in 304 Taiwan hemodialysis patients by using Cox proportional hazard model and cubic spline model...
2023: American Journal of Nephrology
Ziyuan Huang, Ji Zhang, Bo Chen, Duo Li, Xiaohan You, Yin Zhou, Wenxian Qiu, Xiaokai Ding, Chaosheng Chen
INTRODUCTION: The clinical significance of persistent hematuria degrees has not been expounded in primary IgA nephropathy (IgAN) and requires further research. METHODS: From January 2003 to May 2022, a total of 684 IgAN patients with persistent hematuria were enrolled to conduct a retrospective single-center study. Patients whose hematuria degree at baseline was higher than the second tertiles of the whole were included in the high-degree hematuria cohort (Hh), and the low-degree hematuria cohort (Lh) was constructed with 1:1 matched cases from the rest according to age, gender, and estimated glomerular filtration rate (eGFR) at baseline and follow-up time...
2023: American Journal of Nephrology
Christian W Mende, Rohan Samarakoon, Paul J Higgins
BACKGROUND: Diabetic kidney disease (DKD) is a common disorder with multiple serious clinical implications, including an increased risk of end-stage kidney disease (ESKD), cardiovascular complications, heart failure, onset or worsening of hypertension, and premature death. Patients with DKD frequently require dialysis or kidney transplantation to manage their ESKD. SUMMARY: Upregulation of the renin-angiotensin-aldosterone system is an important contributor to kidney disease progression, as highlighted by the results of trials evaluating angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients with albuminuria...
2023: American Journal of Nephrology
Yosuke Nakagawa, Hirotaka Komaba, Takehiko Wada, Hiroo Takahashi, Yuichiro Takahashi, Toru Hyodo, Miho Hida, Takao Suga, Takatoshi Kakuta, Masafumi Fukagawa
INTRODUCTION: Sclerostin is an osteocyte-derived inhibitor of bone formation and is increased in kidney failure. Sclerostin might be involved in the pathogenesis of vascular calcification, but few studies have examined the association between sclerostin and mortality in hemodialysis patients. METHODS: We analyzed a prospective cohort of 654 patients undergoing maintenance hemodialysis. The primary exposure variable was the baseline serum sclerostin level measured at study enrollment...
December 27, 2022: American Journal of Nephrology
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