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
Iain C Macdougall, Amy M 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 2,964 chronic dialysis patients receiving ESA treatment (standardized to weekly intravenous [IV] epoetin) who were iron replete at baseline...
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
Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Katsuhito Fujiu, Nobuaki Michihata, Taisuke Jo, Norifumi Takeda, Hiroyuki Morita, Kentaro Kamiya, Atsuhiko Matsunaga, Junya Ako, Koichi Node, Masaomi Nangaku, Hideo Yasunaga, Issei Komuro
INTRODUCTION: We examined the association of proteinuria with the risk for heart failure (HF) and other cardiovascular disease (CVD) events in patients with prior history of breast, colorectal, or stomach cancer using a nationwide population-based database. METHODS: We conducted this retrospective observation study using the JMDC Claims Database and analyzed 55,191 patients with prior history of breast, colorectal, or stomach cancer. The median age was 54 (48-60) years, and 20,665 participants (37...
December 21, 2022: American Journal of Nephrology
Danai Faitatzidou, Konstantina Dipla, Marieta P Theodorakopoulou, Angelos Koutlas, Artemios Karagiannidis, Maria-Eleni Alexandrou, Ioannis Tsouchnikas, Panagiotis Giamalis, Chrysostomos Dimitriadis, Andreas Zafeiridis, Aikaterini Papagianni, Pantelis A Sarafidis
INTRODUCTION: Cardiac arrhythmias are the most common cause of death in hemodialysis. Autonomic dysfunction plays a central role in this arrhythmogenic background. Previous studies on hemodialysis-related changes in heart-rate-variability(HRV) give contradictory results. This study investigated HRV indices both at rest and in response to physical and mental stimulation maneuvers at multiple time-points around and during the hemodialysis procedure. METHODS: Autonomic function was assessed by linear and non-linear HRV indices at pre-dialysis, during-dialysis(3 equal time-periods), post-dialysis, and on the non-dialysis day in 36 hemodialysis patients...
December 8, 2022: American Journal of Nephrology
Mark K Tiong, Stephen G Holt, Martin L Ford, Edward R Smith
INTRODUCTION: Elevated levels of fibroblast growth factor-23 (FGF23) in chronic kidney disease (CKD) are associated with progression of CKD. FGF23 inhibits proximal tubular phosphate reabsorption, raising phosphate concentrations in the tubular fluid of functioning nephrons, predisposing to spontaneous precipitation of calcium phosphate crystals and resultant tubular injury. Calciprotein monomers (CPM) form spontaneously in biological fluids when clusters of calcium phosphate ions are bound by the liver-derived glycoprotein fetuin-A...
December 6, 2022: American Journal of Nephrology
Rajiv Agarwal, Sanjeev Anand, Kai-Uwe Eckardt, Wenli Luo, Patrick S Parfrey, Mark J Sarnak, Christine M Solinsky, Dennis L Vargo, Wolfgang C Winkelmayer, Glenn M Chertow
INTRODUCTION: Anemia frequently occurs in chronic kidney disease (CKD), is associated with poor quality of life and cardiovascular outcomes, and its treatment represents a considerable economic burden to the healthcare system. Although effective, the current standard of care for the treatment of anemia in chronic kidney disease patients with erythropoiesis-stimulating agents requires chronic/ongoing injections, making the treatment less accessible or desirable to patients not treated by in-center maintenance hemodialysis...
November 30, 2022: American Journal of Nephrology
Steven D Podos, Howard Trachtman, Gerald B Appel, Andrew S Bomback, Bradley P Dixon, Jack F M Wetzels, H Terence Cook, Samir V Parikh, Matthew C Pickering, James Tumlin, Craig B Langman, Liz Lightstone, C John Sperati, Erica Daina, Koenraad Peter Bouman, Kara Rice, Jane A Thanassi, Mingjun Huang, Carla Nester, Giuseppe Remuzzi
INTRODUCTION: C3 glomerulopathy (C3G) is a rare, progressive kidney disease resulting from dysregulation of the alternative pathway (AP) of complement. Biomarkers at baseline were investigated in patients with C3G who participated in two phase 2 studies with the factor D (FD) inhibitor, danicopan. METHODS: Patients with biopsy-confirmed C3G, proteinuria ≥500 mg/day, and estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 were enrolled into two studies (NCT03369236 and NCT03459443)...
November 18, 2022: American Journal of Nephrology
Marco Allinovi, Franco Bergesio, Francesco Cappelli, Maria Grazia Chiappini, Marisa Santostefano, Alessia Argirò, Tullio Catalucci, Alberto Parise, Mattia Zampieri, Federico Perfetto
No abstract text is available yet for this article.
November 7, 2022: American Journal of Nephrology
Nilka Ríos Burrows, Alain K Koyama, Devasmita Choudhury, Wei Yu, Meda E Pavkov, Robert Nee, Alfred K Cheung, Keith C Norris, Guofen Yan
INTRODUCTION: Mortality is an important long-term indicator of the public health impact of chronic kidney disease (CKD). We investigated the role of individual comorbidities and multimorbidity on age-specific mortality risk among US veterans with new-onset CKD. METHODS: The cohort included 892,005 veterans aged ≥18 years with incident CKD stage 3 between January 2004 and April 2018 in the US Veterans Health Administration (VHA) system and followed until death, December 2018, or up to 10 years...
October 7, 2022: American Journal of Nephrology
Quanjun Liu, Bingqing Bai, Fengyao Liu, Yilin Chen, Yu Wang, Haochen Wang, Huan Ma, Qingshan Geng
INTRODUCTION: Unhealthy lifestyle factors are known to increase the risk of chronic kidney disease (CKD) and its complications. The long-term trends in these factors are unclear. METHODS: The aim of the study was to assess temporal trends in the prevalence of risk factors in adults with CKD in the USA and identify sociodemographic subgroups at most risk. Subanalysis of data was carried out from a stratified, complex, multistage probability-based cross-sectional and nationally representative survey...
September 20, 2022: American Journal of Nephrology
Yael Einbinder, Jeffrey Perl, Naomi Nacasch, Alon Bnaya, Linda Shavit, Daniel Erez, Moshe Shashar, Tamar Halperin, Ayelet Grupper, Sydney Benchetrit, Ori Wand, Keren Cohen-Hagai
The optimal SARS-CoV-2 vaccination schedule in dialysis patients and the potential need for a fourth vaccine dose are debatable. We prospectively assessed the humoral responses to three and four doses of BNT162b2 among dialysis patients. The study included 106 dialysis patients; 60 (56.6%) and 46 (43.4%) received 3 and 4 vaccine doses, respectively. Anti-spike (anti-S) antibody titers significantly increased after the third vaccine dose, followed by a decline, yet still remained higher than all previous measurements...
July 18, 2022: American Journal of Nephrology
Katja Luettges, Marlies Bode, Jan Niklas Diemer, Juliane Schwanbeck, Eva K Wirth, Robert Klopfleisch, Kai Kappert, Arne Thiele, Daniel Ritter, Anna Foryst-Ludwig, Peter Kolkhof, Ulrich Otto Wenzel, Ulrich Kintscher
INTRODUCTION: Chronic activation of the mineralocorticoid receptor (MR) leads to pathological processes like inflammation and fibrosis during cardiorenal disease. Modulation of immunological processes in the heart or kidney may serve as a mechanistic and therapeutic interface in cardiorenal pathologies. In this study, we investigated anti-inflammatory/-fibrotic and immunological effects of the selective nonsteroidal MR antagonists finerenone (FIN) in the deoxycorticosterone acetate (DOCA)-salt model...
June 8, 2022: American Journal of Nephrology
Lu Wen, Xiaoyang Wang, Fengping Ji, Jianguo Wen, Zhanzheng Zhao
INTRODUCTION: Megalin plays an important role in proximal tubule uptake of filtered proteins. Downregulation and dysfunction of megalin were previously demonstrated in IgA nephropathy (IgAN); however, its relationship to IgAN progression remains unclear. METHODS: We measured renal megalin mRNA and miR-148b, previously identified as a regulator of megalin, in a retrospective cohort of 417 IgAN patients at the time of biopsy, and evaluated their associations with chronic kidney disease (CKD) progression event, defined as end-stage renal disease or ≥40% decline in estimated glomerular filtration rate, using Cox proportional hazard models...
June 3, 2022: American Journal of Nephrology
Charles W Bishop, Stephen A Strugnell, Philipp Csomor, Edelgard Kaiser, Akhtar Ashfaq
INTRODUCTION: Obesity increases the risk of vitamin D insufficiency, which exacerbates secondary hyperparathyroidism in chronic kidney disease. Recent studies suggest that serum total 25-hydroxyvitamin D (25OHD) levels of ≥50 ng/mL are necessary to produce significant reductions in elevated parathyroid hormone levels in nondialysis patients. Data from real-world and randomized controlled trials (RCTs) involving these patients were examined for (1) relationships between vitamin D treatments and the achieved levels of serum 25OHD and between serum 25OHD and body weight (BW)/body mass index (BMI); and (2) the impact of BW/BMI on achieving serum 25OHD levels ≥50 ng/mL with extended-release calcifediol (ERC) treatment or vitamin D supplementation (cholecalciferol or ergocalciferol)...
May 12, 2022: American Journal of Nephrology
Аnna Е Bragina, Konstantin K Osadchiy, Julia N Rodionova, Darya А Bayutina, Аlexander G Cherepanov, Valery I Podzolkov
INTRODUCTION: Accumulation of fat tissue around the kidneys is considered to be a risk factor for chronic kidney disease (CKD). The objective of the study was to investigate the association of pararenal fat tissue (PRFT) and renal dysfunction in patients without clinically significant cardiovascular diseases (CVDs). METHODS: The study included 320 patients without CVDs (mean age 63.8 ± 13.9 years). All patients underwent anthropometric measurements, standard biochemical blood tests, including a lipid panel and uric acid concentration...
May 11, 2022: American Journal of Nephrology
Charlotte Cortvrindt, Reinhart Speeckaert, Joris R Delanghe, Marijn M Speeckaert
BACKGROUND: The epidermal growth factor (EGF) is a globular protein that is generated in the kidney, especially in the loop of Henle and the distal convoluted tubule. While EGF is nonexistent or hardly detectable in plasma, it is present in normal people's urine. Until now, risk stratification and chronic kidney disease (CKD) diagnosis have relied on estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (uACR), both of which reflect glomerular function or impairment...
May 10, 2022: American Journal of Nephrology
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