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Nephrology, Dialysis, Transplantation

Miguel Bigotte Vieira, Rita Magriço, Catarina Viegas Dias, Lia Leitão, João Sérgio Neves
Background: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains uncertain. Methods: We analysed 4863 non-institutionalized USA adults with CKD [defined by an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m2 and/or a urinary albumin:creatinine ratio >30 mg/g] in a nationwide study using the National Health and Nutrition Examination Survey (NHANES) 1999-2010...
September 12, 2018: Nephrology, Dialysis, Transplantation
Austin G Stack, Xia Li, Mohammed A Kaballo, Mohamed E Elsayed, Howard Johnson, Patrick T Murray, Rajiv Saran, Leonard D Browne
No abstract text is available yet for this article.
September 11, 2018: Nephrology, Dialysis, Transplantation
Edouard L Fu, Rolf H H Groenwold, Carmine Zoccali, Kitty J Jager, Merel van Diepen, Friedo W Dekker
Proper adjustment for confounding is essential when estimating the effects of treatments or risk factors on health outcomes in observational data. To this end, various statistical methods have been developed. In the past couple of years, the use of propensity scores (PSs) to control for confounding has increased. Proper understanding of this method is necessary to critically appraise research in which it is applied. In this article, we provide an overview of PS methods, explaining their concept, advantages and possible disadvantages...
September 11, 2018: Nephrology, Dialysis, Transplantation
Samira Bell, Michelle Lim
No abstract text is available yet for this article.
September 11, 2018: Nephrology, Dialysis, Transplantation
Desmond Y H Yap, Chun Hay Tam, Susan Yung, Sunny Wong, Colin S O Tang, Temy M Y Mok, Catherine K Y Yuen, Maggie K M Ma, Chak Sing Lau, Tak Mao Chan
Background: There is little data on mycophenolic acid (MPA) pharmacokinetics and pharmacogenomics and optimal MPA exposure in lupus nephritis (LN) patients during long-term maintenance. Methods: We measured blood MPA levels at 1, 2, 4, 8, 10 and 12-h post-dose (i.e. C1, C2, C4, C8, C10 and C12) in 88 stable LN patients receiving maintenance prednisolone and mycophenolate mofetil, repeated every 6 months. The relationship between MPA exposure and single nucleotide polymorphisms (SNPs) of adenosine triphosphate-binding cassette subfamily C member 2 (ABCC2; rs2273697, rs3740066, rs717620 and rs17222723), organic anion-transporting polypeptides (OATPs; rs7311358 and rs4149117) and uridine diphosphate glucuronosyltransferase (UGT; rs17863762, rs6714486, rs17868320 and rs72551330) was also investigated...
September 11, 2018: Nephrology, Dialysis, Transplantation
Cédric Villain, René Ecochard, Jean-Louis Bouchet, Eric Daugas, Tilman B Drueke, Thierry Hannedouche, Guillaume Jean, Gérard London, Hubert Roth, Denis Fouque
Background: The prognostic impact of nutrition and chronic kidney disease (CKD) complications has already been described in elderly haemodialysis patients but their relative weights on risk of death remain uncertain. Using structural equation models (SEMs), we aimed to model a single variable for nutrition, each CKD complication and cardiovascular comorbidities to compare their relative impact on elderly haemodialysis patients' survival. Methods: This prospective study recruited 3165 incident haemodialysis patients ≥75 years of age from 178 French dialysis units...
September 8, 2018: Nephrology, Dialysis, Transplantation
Maria Pippias, Kitty J Jager, Anders Åsberg, Stefan P Berger, Patrik Finne, James G Heaf, Julia Kerschbaum, Marko Lempinen, Ángela Magaz, Ziad A Massy, Vianda S Stel
Background: Updated survival outcomes of young recipients receiving young or old deceased donor kidneys are required when considering accepting a deceased donor kidney. Methods: We examined outcomes in 6448 European kidney allografts donated from younger (≥20-<50 years) and older (≥50-<70 years) deceased donors when transplanted into very young (≥20-<35 years) or young (≥35-<50 years) adult recipients. Outcomes of first kidney transplantations during 2000-13 and followed-up to 2015 were determined via competing risk, restricted mean survival and Cox regression methods...
September 7, 2018: Nephrology, Dialysis, Transplantation
Thomas Crépin, Mathieu Legendre, Clémence Carron, Clément Vachey, Cécile Courivaud, Jean-Michel Rebibou, Christophe Ferrand, Caroline Laheurte, Charline Vauchy, Emilie Gaiffe, Philippe Saas, Didier Ducloux, Jamal Bamoulid
Background: Patients with chronic kidney disease (CKD) are more prone to develop premature age-related diseases. Data on immune senescence are scarce in CKD populations, except in end-stage renal disease and dialysis. We designed a longitudinal prospective study to evaluate immune senescence at different CKD stages and its influence on CKD patient outcomes. Methods: Clinical and biological data collections were performed on 222 patients at different CKD stages [1-2 (n = 85), 4 (n = 53) and 5 (n = 84)]...
September 6, 2018: Nephrology, Dialysis, Transplantation
Natalia Carrillo-López, Sara Panizo, Cristina Alonso-Montes, Laura Martínez-Arias, Noelia Avello, Patricia Sosa, Adriana S Dusso, Jorge B Cannata-Andía, Manuel Naves-Díaz
Background: In chronic kidney disease (CKD), increases in serum phosphate and parathyroid hormone (PTH) aggravate vascular calcification (VC) and bone loss. This study was designed to discriminate high phosphorus (HP) and PTH contribution to VC and bone loss. Methods: Nephrectomized rats fed a HP diet underwent either sham operation or parathyroidectomy and PTH 1-34 supplementation to normalize serum PTH. Results: In uraemic rats fed a HP diet, parathyroidectomy with serum PTH 1-34 supplementation resulted in (i) reduced aortic calcium (80%) by attenuating osteogenic differentiation (higher α-actin; reduced Runx2 and BMP2) and increasing the Wnt inhibitor Sclerostin, despite a similar degree of hyperphosphataemia, renal damage and serum Klotho; (ii) prevention of bone loss mostly by attenuating bone resorption and increases in Wnt inhibitors; and (iii) a 70% decrease in serum calcitriol levels despite significantly reduced serum Fgf23, calcium and renal 24-hydroxylase, which questions that Fgf23 is the main regulator of renal calcitriol production...
September 5, 2018: Nephrology, Dialysis, Transplantation
Anne Leuppi-Taegtmeyer, Urs Duthaler, Felix Hammann, Yasmin Schmid, Michael Dickenmann, Patricia Amico, Andreas W Jehle, Stefan Kalbermatter, Christoph Lenherr, Henriette E Meyer Zu Schwabedissen, Manuel Haschke, Matthias E Liechti, Stephan Krähenbühl
Background: The pharmacokinetics of oxycodone in patients with end-stage renal disease (ESRD) requiring haemodialysis are largely unknown. Therefore, we investigated the pharmacokinetics of oxycodone/naloxone prolonged release and their metabolites in patients with ESRD during and between haemodialysis sessions. Methods: Single doses of oxycodone/naloxone (5/2.5 or 10/5 mg) were administered in nine patients with ESRD using a cross-over design on the day of dialysis and on a day between dialysis sessions...
September 5, 2018: Nephrology, Dialysis, Transplantation
Pantelis A Sarafidis, Charalampos Loutradis, Antonios Karpetas, Georgios Tzanis, Athanasios Bikos, Vasilios Raptis, Christos Syrgkanis, Vasilios Liakopoulos, Aikaterini Papagianni, George Bakris, Gianfranco Parati
Background: Long-term pre-dialysis blood pressure variability (BPV) in haemodialysis patients is associated with increased cardiovascular risk. The association of the main haemodynamic culprit in dialysis, that is, short-term BPV, with outcomes has not been investigated. We examine the prognostic role of short-term BPV for mortality and cardiovascular events in this population. Methods: A total of 227 haemodialysis patients underwent 44-h ambulatory monitoring during a standard interval and were followed-up for 30...
September 3, 2018: Nephrology, Dialysis, Transplantation
Nienke M A Idzerda, Michelle J Pena, Hans-Henrik Parving, Dick de Zeeuw, Hiddo J L Heerspink
Background: Statins have shown multiple effects on different renal risk factors such as lowering of total cholesterol (TC) and lowering of urine protein:creatinine ratio (UPCR). We assessed whether these effects of statins vary between individuals, the extent of discordance of treatment effects on both TC and UPCR within an individual, and the association of responses in TC and UPCR with estimated glomerular filtration rate (eGFR) decline. Methods: The PLANET I and II (Renal effects of Rosuvastatin and Atorvastatin in Patients Who Have Progressive Renal Disease) trials examined effects of atorvastatin and rosuvastatin on proteinuria and renal function in patients with proteinuria...
September 1, 2018: Nephrology, Dialysis, Transplantation
Marieke H C van Rijn, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann, Jan A J G van den Brand, Marc Froissart, Benedicte Stengel
Background: Glomerular filtration rate (GFR) is commonly used to monitor chronic kidney disease (CKD) progression, but its validity for evaluating kidney function changes over time has not been comprehensively evaluated. We assessed the performance of creatinine-based equations for estimating GFR slope according to patient characteristics and specific CKD diagnosis. Methods: In the NephroTest cohort study, we measured GFR 5324 times by chromium 51-labeled ethylenediamine tetraacetic acid renal clearance in 1955 adult patients with CKD Stages 1-4 referred to nephrologists (Stages 1-2, 19%) and simultaneously estimated GFR with both the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations for isotope dilution mass spectrometry traceable creatinine; absolute and relative GFR slopes were calculated using a linear mixed model...
September 1, 2018: Nephrology, Dialysis, Transplantation
Nicola Wearne, Ikechi Okpechi, Charles Swanepoel
No abstract text is available yet for this article.
August 31, 2018: Nephrology, Dialysis, Transplantation
Doloretta Piras, Marco Masala, Alessandro Delitala, Silvana A M Urru, Nicolò Curreli, Lenuta Balaci, Liana P Ferreli, Francesco Loi, Alice Atzeni, Gianfranca Cabiddu, Walter Racugno, Laura Ventura, Magdalena Zoledziewska, Maristella Steri, Edoardo Fiorillo, Maria G Pilia, David Schlessinger, Francesco Cucca, Andrew D Rule, Antonello Pani
Background: The relationship of kidney size to ageing, kidney function and kidney disease risk factors is not fully understood. Methods: Ultrasound length and parenchymal kidney volume were determined from a population-based sample of 3972 Sardinians (age range 18-100 years). We then identified the subset of 2256 'healthy' subjects to define age- and sex-specific reference ranges (2.5-97.5 percentile) of kidney volume. Logistic regression (accounting for family clustering) was used to identify the clinical characteristics associated with abnormally large kidneys or abnormally small kidneys...
August 29, 2018: Nephrology, Dialysis, Transplantation
Cristina Martin-Higueras, Isis Ludwig-Portugall, Bernd Hoppe, Christian Kurts
The primary hyperoxalurias (PHs) are inborn errors of glyoxylate metabolism characterized by endogenous oxalate overproduction in the liver, and thus elevated urinary oxalate excretion. The urinary calcium-oxalate (CaOx) supersaturation and the continuous renal accumulation of insoluble CaOx crystals yield a progressive decline in renal function that often ends with renal failure. In PH Type 1 (AGXT mutated), the most frequent and severe condition, patients typically progress to end-stage renal disease (ESRD); in PH Type 2 (GRHPR mutated), 20% of patients develop ESRD, while only one patient with PH Type 3 (HOGA1 mutated) has been reported with ESRD so far...
August 29, 2018: Nephrology, Dialysis, Transplantation
Cédric Villain, Marie Metzger, Christian Combe, Denis Fouque, Luc Frimat, Christian Jacquelinet, Maurice Laville, Serge Briançon, Julie Klein, Joost P Schanstra, Bruce M Robinson, Nicolas Mansencal, Bénédicte Stengel, Ziad A Massy
Background: Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKD patients. Methods: We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3-4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease)...
August 28, 2018: Nephrology, Dialysis, Transplantation
Krzysztof Batko, Jolanta Malyszko, Artur Jurczyszyn, David H Vesole, Morie A Gertz, Xavier Leleu, Anna Suska, Marcin Krzanowski, Wladyslaw Sulowicz, Jacek S Malyszko, Katarzyna Krzanowska
Monoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone...
August 28, 2018: Nephrology, Dialysis, Transplantation
Orit Kliuk-Ben Bassat, Ariel Finkelstein, Samuel Bazan, Amir Halkin, Itzhak Herz, Dalit Salzer Gotler, Dor Ravid, Odelia Hakakian, Gad Keren, Shmuel Banai, Yaron Arbel
Background: Acute kidney injury (AKI) complicating transcatheter aortic valve implantation (TAVI) is relatively frequent and associated with significant morbidity. Previous studies have shown a higher 30-day and 1-year mortality risk in patients with periprocedural AKI. Our aim was to identify the prognostic impact of periprocedural AKI on long-term follow-up. Methods: This is a single-center prospective study evaluating patients undergoing TAVI for severe aortic stenosis...
August 28, 2018: Nephrology, Dialysis, Transplantation
Uchenna Anyanwagu, Richard Donnelly, Iskandar Idris
Background: Albuminuria is a recognized diagnostic and prognostic marker of chronic kidney disease and cardiovascular (CV) risk but the well-known relationship between increments in urinary albumin:creatinine ratio (UACR) and CV outcomes and mortality has not been fully explored in insulin-treated patients with type 2 diabetes (T2D) in routine clinical care. Methods: We investigated data for insulin users with T2D from UK general practices between 2007 and 2014...
August 28, 2018: Nephrology, Dialysis, Transplantation
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