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Clinical Kidney Journal

Hernán Trimarchi, Romina Canzonieri, Cristian Costales-Collaguazo, Juan Politei, Anibal Stern, Matias Paulero, Ivan González-Hoyos, Amalia Schiel, Tatiana Rengel, Mariano Forrester, Fernando Lombi, Vanesa Pomeranz, Romina Iriarte, Alexis Muryan, Elsa Zotta
Background: In Fabry nephropathy, podocyturia is an early event that may lead to glomerulosclerosis and chronic kidney disease. The glycocalyx is a potential podocyte damaged compartment in glomerulopathies. We investigated glycocalyx podocalyxin in urinary detached podocytes compared with cytoplasmic synaptopodin. Methods: This was a cross-sectional study including 68 individuals: Controls ( n  = 20) and Fabry patients ( n  = 48), 15 untreated and 33 treated...
February 2019: Clinical Kidney Journal
Tereza Cairns, Christoph Wanner
Despite several attempts at setting up a standardized disease severity score for Fabry disease in the past, none have been established in routine clinical practice due to the multisystem nature and complexity of this inherited enzyme deficiency disorder. In this issue, Mignani et al . report a large multicentre application of the FASTEX, an online tool to assess disease progress over time that offers simple data inputting and graphic illustration of disease progression or stabilization. Mignani et al. succeeded in validating the tool in a large cohort of Fabry patients, including females and non-classical phenotypes, building on the first FASTEX introduction in 2016...
February 2019: Clinical Kidney Journal
Lida M Rodas, Ana Matas-García, Xoana Barros, Miquel Blasco, Odette Viñas, Arturo Llobell, Nadia Martin, Luis F Quintana
Background: M-type phospholipase A2 receptor (APLA2R) is considered the major antigen involved in the pathogenesis of adult primary membranous nephropathy (MN), which is the leading cause of non-diabetic nephrotic syndrome. Antibodies to this antigen have been proved to be an excellent biomarker of disease activity in primary MN. In fact, preliminary data suggest that the higher the antibody level the more proteinuria, and that a decrease in antibody level precedes the remission of proteinuria, but more solid evidence is needed...
February 2019: Clinical Kidney Journal
Montserrat Diaz, Irene Agraz, Maria Jose Soler
Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in native kidney biopsies from adults. In 2009, antibodies to the M-type receptor of phospholipase A2 (anti-PLA2R) were identified in idiopathic MN patients, both within the kidney and in the circulation. The clinical course of idiopathic MN is variable and ranges from spontaneous remission to end-stage renal disease. Clinical variables such as proteinuria levels, patient sex, age and renal function at diagnosis have been associated with renal MN progression...
February 2019: Clinical Kidney Journal
Jan Havlin, Svetlana Vankova
Background: The diffusion gradient between ionized calcium (iCa) in the inlet dialysate and blood is considered to be the main driving force of calcium mass balance (CMB). The intradialytic change of parathyroid hormone (PTH) level corresponds to the change in plasma iCa. In contrast to the widely discussed calcium concentration of dialysis solution, the dialysate pH and bicarbonate concentration (DHCO3 ), important factors affecting the level of iCa, have not been studied with respect to the intradialytic change of plasma PTH level (ΔPTH) and CMB...
February 2019: Clinical Kidney Journal
Amy M Meadowcroft, Borut Cizman, Louis Holdstock, Nandita Biswas, Brendan M Johnson, Delyth Jones, A Kaldun Nossuli, John J Lepore, Michael Aarup, Alexander R Cobitz
Background: This study evaluated the hemoglobin dose response, other efficacy measures and safety of daprodustat, an orally administered, hypoxia-inducible factor prolyl hydroxylase inhibitor in development for anemia of chronic kidney disease. Methods: Participants ( n  = 216) with baseline hemoglobin levels of 9-11.5 g/dL on hemodialysis (HD) previously receiving stable doses of recombinant human erythropoietin (rhEPO) were randomized in a 24-week dose-range, efficacy and safety study...
February 2019: Clinical Kidney Journal
Louis Holdstock, Borut Cizman, Amy M Meadowcroft, Nandita Biswas, Brendan M Johnson, Delyth Jones, Sung Gyun Kim, Steven Zeig, John J Lepore, Alexander R Cobitz
Background: This study assessed the short-term safety and efficacy of daprodustat (an oral hypoxia-inducible factor-prolyl hydroxylase inhibitor) to achieve a target hemoglobin in patients with anemia of chronic kidney disease (CKD). Methods: Patients ( n  = 252) with Stages 3-5 CKD not receiving dialysis were enrolled in this 24-week, multicenter trial [hemoglobin entry criteria: 8-10 g/dL (Cohort 1) or 8-11 g/dL (Cohort 2) for recombinant human erythropoietin (rhEPO)-naïve participants; 9-10...
February 2019: Clinical Kidney Journal
Amy L Clarke, Francesco Zaccardi, Douglas W Gould, Katherine L Hull, Alice C Smith, James O Burton, Thomas Yates
Background: Reduced physical function is associated with an increased risk of mortality among patients with chronic kidney disease (CKD) not requiring renal replacement therapy (RRT). Assessments of physical performance can help to identify those at risk for adverse events. However, objective measures are not always feasible and self-reported measures may provide a suitable surrogate. Methods: We performed a cohort study examining associations between self-reported physical function and walking behaviour with survival in patients with CKD not requiring RRT...
February 2019: Clinical Kidney Journal
Thomas J Wilkinson, Emma L Watson, Douglas W Gould, Soteris Xenophontos, Amy L Clarke, Barbara P Vogt, João L Viana, Alice C Smith
Background: Chronic kidney disease (CKD) patients experience a high symptom burden including fatigue, sleep difficulties, muscle weakness and pain. These symptoms reduce levels of physical function (PF) and activity, and contribute to poor health-related quality of life (HRQoL). Despite the gathering evidence of positive physiological changes following exercise in CKD, there is limited evidence on its effect on self-reported symptom burden, fatigue, HRQoL and physical activity. Methods: Thirty-six patients [mean ± SD 61...
February 2019: Clinical Kidney Journal
Alberto Ortiz, Maria Dolores Sanchez-Niño
Sarcopenia and frailty are recognized as key risk factors for adverse outcomes in patients on renal replacement therapy or with non-dialysis chronic kidney disease (CKD). However, there is still debate about their pathogenesis and, thus, about the best therapeutic approaches, as well as the impact on outcomes of current approaches based on different exercise programmes. In the past two issues of Clinical Kidney Journal , several manuscripts address the issue of sarcopenia in CKD from the point of view of pathogenesis and new therapeutic approaches, monitoring of results, implementation of exercise programmes and specific potential benefits of exercise programmes in dialysis and non-dialysis CKD patients, as assessed by clinical trials...
February 2019: Clinical Kidney Journal
Guillaume Jeantet, Vincent Pernin, Vincent Brunot, Arnaud Roccabianca, Anouk Macombe, Ilan Szwarc, Kada Klouche, Chantal Loirat, Georges Mourad, Véronique Frémeaux-Bacchi, Moglie Le Quintrec
Haemolytic uraemic syndrome (HUS) is a rare complication of invasive infection by Streptococcus pneumoniae (SP-HUS), especially in adults. Here we report an unusual case of a 53-year-old man presenting SP-HUS with severe multivisceral involvement. After failure of supportive care and plasma exchanges, eculizumab (anti-C5 antibody) resulted in a favourable outcome.
February 2019: Clinical Kidney Journal
John H Ahn, Jennifer L Waller, Stephanie L Baer, Rhonda E Colombo, Mufaddal F Kheda, N Stanley Nahman, Jake E Turrentine
Background: End-stage renal disease (ESRD) patients have increased risk of developing herpes zoster (zoster) compared with the general population, but mortality risk is unknown. We assessed the risk of mortality in hospitalized ESRD patients with a diagnosis of zoster from the inpatient hospital files (as opposed to outpatient records) of the United States Renal Data System. Methods: This study analyzed incident ESRD patients from 2006 to 2009. Based on an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of zoster infection, we determined 2-year mortality following an inpatient diagnosis...
February 2019: Clinical Kidney Journal
Ramy M Hanna, Eduardo A Lopez, Huma Hasnain, Umut Selamet, James Wilson, Peter N Youssef, Nermeen Akladeous, Suphamai Bunnapradist, Michael B Gorin
Vascular endothelial growth factor (VEGF) receptor inhibition is a commonly used tool to prevent vascular proliferation in tumors and retinal diseases. The antiangiogenic effects of these drugs have made them potent adjunct therapies when given systemically for malignancies. They are also useful tools to ameliorate diminishing eyesight in retinopathy. Hypertension and proteinuria have been observed in systemic VEGF inhibitor therapy, with rarer presentations involving nephrotic-range proteinuria due to glomerulopathies...
February 2019: Clinical Kidney Journal
Robert Greite, Konstantin Deutsch, Jan Hinrich Bräsen, Sibylle von Vietinghoff
Two patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and rapid onset of high fever, tachycardia and systemic hypotension accompanied by elevated laboratory markers of infection were diagnosed with azathioprine hypersensitivity syndrome only after repeat exposure. Azathioprine hypersensitivity can closely mimic sepsis and/or vasculitis activity and should be considered in AAV, a condition with frequent use of this drug. We discuss the pitfalls in diagnosis and the possible pathophysiologic background...
February 2019: Clinical Kidney Journal
Hassan Izzedine, Alexis Mathian, Stephane Champiat, Cécile Picard, Christine Mateus, Emilie Routier, Andrea Varga, David Malka, Alexandra Leary, Judith Michels, Jean-Marie Michot, Aurélien Marabelle, Olivier Lambotte, Zahir Amoura, Jean-Charles Soria, Sihem Kaaki, Nathalie Quellard, Jean-Michel Goujon, Isabelle Brocheriou
Objective: Expanded clinical experience with patients treated by pembrolizumab has accumulated. However, renal toxicities associated with this anti-programmed cell death 1 agent are poorly described because kidney histology is rarely sought. As a nephrology referral centre, we aimed to describe the clinic-biological and histopathological characteristics of pembrolizumab-related nephropathy and its response to treatment. Methods: We conducted a monocentric large case series study, including all pembrolizumab-treated cancer patients presenting a renal toxicity addressed to our centre from 2015 to 2017...
February 2019: Clinical Kidney Journal
Ben Sprangers
Checkpoint inhibitors are increasingly used to treat different types of malignancy and have been associated with renal toxicities. In this issue, Izzedine et al. report on the incidence of pembrolizumab-associated renal toxicity in a French single-centre nephrology referral centre. They report an estimated incidence of pembrolizumab-related renal toxicities of 1.77% and most notably the most common histologic lesion was acute tubular injury (not acute tubulo-interstitial nephritis). This study further highlights the importance of performing a thorough nephrological workup including kidney biopsy in patients experiencing renal toxicities while receiving pembrolizumab treatment...
February 2019: Clinical Kidney Journal
Marie E Edwards, Jaime D Blais, Frank S Czerwiec, Bradley J Erickson, Vicente E Torres, Timothy L Kline
Background: The ability of unstandardized methods to track kidney growth in clinical trials for autosomal dominant polycystic kidney disease (ADPKD) has not been critically evaluated. Methods: The Tolvaptan Efficacy and Safety Management of ADPKD and its Outcomes (TEMPO) 3:4 study involved baseline and annual magnetic resonance follow-up imaging yearly for 3 years. Total kidney volume (TKV) measurements were performed on these four time points in addition to the baseline imaging in TEMPO 4:4, initially by Perceptive Informatics (Waltham, MA, USA) using planimetry (original dataset) and for this study by the Mayo Translational PKD Center using semiautomated and complementary automated methods (sequential dataset)...
February 2019: Clinical Kidney Journal
Steven Whatmough, Sophie Fernandez, Niamh Sweeney, Laura Howell, Ajay Dhaygude
Background: Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is a multisystem autoimmune disorder associated with significant morbidity and mortality. Approximately 80-90% of patients have circulating ANCAs. Long-term outcomes appear to be improving. This retrospective study analyses the incidence and patient outcomes over a period of 23 years at a single tertiary centre. Methods: Outcomes of patients diagnosed with AAV between 1 January 1988 and 31 December 2010 were collected retrospectively...
February 2019: Clinical Kidney Journal
Baris Afsar, Rengin Elsurer Afsar, Asiye Kanbay, Adrian Covic, Alberto Ortiz, Mehmet Kanbay
Along with amazing technological advances, the industrial revolution of the mid-19th century introduced new sources of pollution. By the mid-20th century, the effects of these changes were beginning to be felt around the world. Among these changes, health problems due to environmental air pollution are increasingly recognized. At the beginning, respiratory and cardiovascular diseases were emphasized. However, accumulated data indicate that every organ system in the body may be involved, and the kidney is no exception...
February 2019: Clinical Kidney Journal
Vincenzo Montinaro, Marica Giliberti, Chiara Villani, Adriano Montinaro
Background: The number of citations of a scientific article is considered a weight of that work in the field of interest. Bibliometric analysis of the most cited articles conducted in some medical disciplines has identified the most relevant scientific contributions that pushed forward knowledge and clinical practice of that discipline. Methods: We conducted a bibliometric analysis of the most cited articles in nephrology, by extracting relevant words that identify issues of nephrological interest and querying the Google Scholar database...
February 2019: Clinical Kidney Journal
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