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Nephrology, Dialysis, Transplantation

Michelle C Lamarche, Wilma M Hopman, Jocelyn S Garland, Christine A White, Rachel M Holden
Background: Patients with chronic kidney disease (CKD) have higher levels of coronary artery calcification (CAC) compared with the general population. The role of CAC in renal function decline is not well understood. Methods: In this prospective cohort study of Stages 3-5 CKD patients with CAC scores kidney function decline, development of end-stage kidney disease (ESKD) and all-cause mortality were determined at 5 and 10 years. Baseline variables included markers of CKD and chronic kidney disease mineral and bone disorder (CKD-MBD), demographics and comorbidities...
July 16, 2018: Nephrology, Dialysis, Transplantation
Braden Manns, John W M Agar, Mohan Biyani, Peter G Blake, Alan Cass, Bruce Culleton, Werner Kleophas, Paul Komenda, Thierry Lobbedez, Jennifer MacRae, Mark R Marshall, Nairne Scott-Douglas, Vikas Srivastava, Peter Magner
There are advantages to home dialysis for patients, and kidney care programs, but use remains low in most countries. Health-care policy-makers have many levers to increase use of home dialysis, one of them being economic incentives. These include how health-care funding is provided to kidney care programs and dialysis facilities; how physicians are remunerated for care of home dialysis patients; and financial incentives-or removal of disincentives-for home dialysis patients. This report is based on a comprehensive literature review summarizing the impact of economic incentives for home dialysis and a workshop that brought together an international group of policy-makers, health economists and home dialysis experts to discuss how economic incentives (or removal of economic disincentives) might be used to increase the use of home dialysis...
July 13, 2018: Nephrology, Dialysis, Transplantation
José M Valdivielso, Milica Bozic, Rajesh Kumar Galimudi, Marcelino Bermudez-López, Juan F Navarro-González, Elvira Fernández, Àngels Betriu
Background: Prevalence of atherosclerotic cardiovascular disease and its rate of progression are higher in patients with chronic kidney disease (CKD) compared with the general population. Mineral metabolism parameters have been shown to be involved in the increased velocity of atheromatosis progression. The aim of this study is to determine the role of 11 single-nucleotide polymorphisms (SNPs) of the Klotho gene on the rate of atherosclerosis progression in CKD. Methods: This was a multicentre, prospective, observational study of 1439 CKD patients from the NEFRONA cohort...
July 13, 2018: Nephrology, Dialysis, Transplantation
Ran Luo, Shui-Ming Guo, Yue-Qiang Li, Yi Yang, Meng-Lan Li, Min Han, Xiao-Feng He, Shu-Wang Ge, Gang Xu
Background: A recognized noninvasive biomarker to improve risk stratification of immunoglobulin A nephropathy (IgAN) patients is scarce. Fractalkine has been shown to play a key role in glomerular disease as chemoattractant, adhesion and even fibrosis factor. The current study assessed the possibility of plasma fractalkine as a novel biomarker in IgAN patients. Methods: Plasma fractalkine was measured in 229 patients with renal biopsy consistent IgAN from 2012 to 2014, and clinical, pathological and prognostic relationships were analyzed...
July 12, 2018: Nephrology, Dialysis, Transplantation
Bin Han, Xiao Wu, Pei-Pei Huang, Fu-Xiang Zhu, Si Liu
Background: The Aquaporin 11 (AQP11) rs2276415 variant has been implicated in kidney disease in Type 2 diabetes. Association of the AQP11 variant with chronic kidney disease (CKD) beyond diabetic nephropathy is unknown, with no studies reported in the Chinese population. We explored the risk of CKD progression associated with the AQP11 rs2276415 variant in a population-based study in China. Methods: We conducted a prospective cohort study of 620 participants with CKD (Stages 2-5 and who were not receiving dialysis) at the Nephrology Center of First Affiliated Hospital of Jiaxing University between July 2011 and December 2014 and followed up for 3 years...
July 12, 2018: Nephrology, Dialysis, Transplantation
Angelo Karaboyas, Hal Morgenstern, Ronald L Pisoni, Jarcy Zee, Raymond Vanholder, Stefan H Jacobson, Masaaki Inaba, Lisa C Loram, Friedrich K Port, Bruce M Robinson
Background: The Kidney Disease: Improving Global Outcomes guidelines have cautioned against administering intravenous (IV) iron to hemodialysis patients with high serum ferritin levels due to safety concerns, but prior research has shown that the association between high ferritin and mortality could be attributed to confounding by malnutrition and inflammation. Our goal was to better understand the ferritin-mortality association and relative influence of IV iron and inflammation in the USA, where ferritin levels have recently increased dramatically, and in Europe and Japan, where ferritin levels are lower and anemia management practices differ...
July 11, 2018: Nephrology, Dialysis, Transplantation
Mark R Hanudel, Michele F Eisenga, Maxime Rappaport, Kristine Chua, Bo Qiao, Grace Jung, Victoria Gabayan, Barbara Gales, Georgina Ramos, Maarten A de Jong, Jelmer J van Zanden, Martin H de Borst, Stephan J L Bakker, Elizabeta Nemeth, Isidro B Salusky, Carlo A J M Gaillard, Tomas Ganz
Background: Erythropoietin (EPO) has been reported as a novel determinant of fibroblast growth factor 23 (FGF23) production; however, it is unknown whether FGF23 is stimulated by chronic exposure to EPO or by EPO administration in nonpolycystic chronic kidney disease (CKD) models. Methods: We analyzed the effects of chronic EPO on FGF23 in murine models with chronically high EPO levels and normal kidney function. We studied the effects of exogenous EPO on FGF23 in wild-type mice, with and without CKD, injected with EPO...
July 10, 2018: Nephrology, Dialysis, Transplantation
Jian-Jun Liu, Sylvia Liu, Resham L Gurung, Keven Ang, Wern Ee Tang, Chee Fang Sum, Subramaniam Tavintharan, Su Chi Lim
Background: The progression trajectory of renal filtration function has not been well characterized in patients with early-onset type 2 diabetes mellitus (T2DM) although albuminuria is often reported in this population. We aim to study the risk of progressive chronic kidney disease (CKD) in individuals with early-onset T2DM. Methods: In total, 1189 T2DM participants were followed for 3.9 (interquartile range 3.2-4.7) years. Progressive CKD was defined as estimated glomerular filtration rate (eGFR) decline of ≥5 mL/min/1...
July 10, 2018: Nephrology, Dialysis, Transplantation
Pantelis A Sarafidis, Francesca Mallamaci, Charalampos Loutradis, Robert Ekart, Claudia Torino, Antonios Karpetas, Vasileios Raptis, Athanasios Bikos, Aikaterini Papagianni, Olga Balafa, Konstantinos Siamopoulos, Giovanni Pisani, Massimo Morosetti, Antonio Del Giudice, Fillipo Aucella, Luca Di Lullo, Rocco Tripepi, Giovanni Tripepi, Kitty Jager, Friedo Dekker, Gerard London, Carmine Zoccali
Background: Population-specific consensus documents recommend that the diagnosis of hypertension in haemodialysis patients be based on 48-h ambulatory blood pressure (ABP) monitoring. However, until now there is just one study in the USA on the prevalence of hypertension in haemodialysis patients by 44-h recordings. Since there is a knowledge gap on the problem in European countries, we reassessed the problem in the European Cardiovascular and Renal Medicine working group Registry of the European Renal Association-European Dialysis and Transplant Association...
July 10, 2018: Nephrology, Dialysis, Transplantation
Lama M Hsaiky, Francine D Salinitri, Judy Wong, Sin-Ling T Jennings, Neha H Desai, Alison M Lobkovich, Raymond Cha
Background: Previous pharmacokinetic studies demonstrated an increase in serum ertapenem concentrations with decreasing kidney function, including patients receiving renal replacement therapy. This study evaluated the pharmacokinetic parameters of ertapenem in patients receiving hemodialysis. Methods: This prospective, single-center, open-label study examined the pharmacokinetics of a single intravenous (IV) dose of ertapenem 1 g in seven hospitalized noninfected patients undergoing hemodialysis...
July 9, 2018: Nephrology, Dialysis, Transplantation
Olivier Gribouval, Olivia Boyer, Bertrand Knebelmann, Alexandre Karras, Jacques Dantal, Cécile Fourrage, Olivier Alibeu, Julien Hogan, Claire Dossier, Marie Josèphe Tête, Corinne Antignac, Aude Servais
Background: Apolipoprotein L1 (APOL1) risk variants are strongly associated with sporadic focal segmental glomerulosclerosis (FSGS) in populations with African ancestry. We determined the frequency of G1/G2 variants in steroid-resistant nephrotic syndrome (SRNS)/FSGS patients with African or French West Indies ancestry in France and its relationships with other SRNS genes. Methods: In a cohort of 152 patients (139 families), the APOL1 risk variants were genotyped by direct Sanger sequencing and pathogenic mutations were screened by next-generation sequencing with a panel including 35 SRNS genes...
July 9, 2018: Nephrology, Dialysis, Transplantation
Anja Gäckler, Meike Kaulfuß, Hana Rohn, Ulrich Vogel, Heike Claus, Thorsten Feldkamp, Andreas Kribben, Oliver Witzke
Background: The C5 complement inhibitor eculizumab is a first-line treatment in atypical haemolytic uraemic syndrome (aHUS). Therapy with eculizumab is associated with a highly increased risk for meningococcal infection. Therefore, vaccination is highly recommended before beginning treatment. Efficacy of quadrivalent meningococcal vaccines (MenACWY) in patients treated with the C5 complement inhibitor eculizumab in aHUS has not yet been determined. Methods: Patients with aHUS received one dose of a MenACWY conjugate vaccine before eculizumab treatment commenced...
July 9, 2018: Nephrology, Dialysis, Transplantation
Abduzhappar Gaipov, Miklos Z Molnar, Praveen K Potukuchi, Keiichi Sumida, Zoltan Szabo, Oguz Akbilgic, Elani Streja, Connie M Rhee, Santhosh K G Koshy, Robert B Canada, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
Background: Previous studies reported that compared with percutaneous coronary interventions (PCIs), coronary artery bypass grafting (CABG) is associated with a reduced risk of mortality and repeat revascularization in patients with mild to moderate chronic kidney disease (CKD) and end-stage renal disease (ESRD). Information about outcomes associated with CABG versus PCI in patients with advanced stages of CKD is limited. We evaluated the incidence and relative risk of acute kidney injury (AKI) associated with CABG versus PCI in patients with advanced CKD...
July 9, 2018: Nephrology, Dialysis, Transplantation
Qian Zhang, Shensen Li, Guoxin Ye, Mengjing Wang, Li Ni, Sen Kan, Minmin Zhang, Jing Chen
Background: Secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD) is characterized by hyperplasia of the parathyroid glands (PTGs), while the underlying mechanism is not completely understood. Previously we demonstrated a relationship between cyclooxygenase 2 (COX2) overexpression and parathyroid hyperplasia and here we investigate the role of COX2 downstream metabolic product prostaglandin E2 (PGE2) and its receptor EP2 in the pathogenesis of SHPT. Methods: PTGs isolated from ESRD patients with advanced SHPT were used to test the expression of COX2-microsomal prostaglandin E synthase-1 (mPGES-1)-EP2 pathway...
July 5, 2018: Nephrology, Dialysis, Transplantation
Laura Cosmai, Camillo Porta, Mark A Perazella, Vincent Launay-Vacher, Mitchell H Rosner, Kenar D Jhaveri, Matteo Floris, Antonello Pani, Cécile Teuma, Cèzary A Szczylik, Maurizio Gallieni
Onconephrology is a rapidly evolving subspeciality that covers all areas of renal involvement in cancer patients. The complexity of the field may benefit from well-defined multidisciplinary management administered by a dedicated team. Since there is an increasing need to address the needs of this population in dedicated outpatient clinics, it is critical to highlight basic characteristics and to suggest areas of development. In this brief perspective article, we analyse the requirements of an onconephrology clinic in terms of logistics, critical mass of patients and building a multidisciplinary team...
July 5, 2018: Nephrology, Dialysis, Transplantation
Liang Feng, Hithanadura Asita de Silva, Imtiaz Jehan, Aliya Naheed, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen H Jafar
Background: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations. Method: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries...
July 5, 2018: Nephrology, Dialysis, Transplantation
Ching-Wei Tsai, Han-Chun Huang, Hsiu-Yin Chiang, Chih-Wei Chung, Hsien-Tsai Chiu, Chih-Chia Liang, Tsung Yu, Chin-Chi Kuo
Background: Scarce evidence associates the first-year estimated glomerular filtration rate (eGFR) variability and longitudinal change scales concomitantly to the risk of developing end-stage renal disease (ESRD), acute coronary syndrome (ACS) and death following pre-ESRD program enrollment in chronic kidney disease (CKD). Methods: We conducted a prospective cohort study of 5092 CKD patients receiving multidisciplinary care between 2003 and 2015 with careful ascertainment of ESRD, ACS and death during the follow-up...
July 5, 2018: Nephrology, Dialysis, Transplantation
Zhuoya Zhang, Lingying Niu, Xiaojun Tang, Ruihai Feng, Genhong Yao, Weiwei Chen, Wenchao Li, Xuebing Feng, Hongwei Chen, Lingyun Sun
Background: Podocyte injury plays a pathogenic role in the development of lupus nephritis (LN). Mesenchymal stem cells (MSCs) have shown promising therapeutic potential for LN. However, whether MSCs can prevent podocyte injury in LN remains unknown. Methods: Human umbilical cord-derived MSCs (UC-MSCs) were infused into lupus-prone B6.MRL-Faslpr (B6.lpr) mice to investigate the influences of UC-MSCs on podocyte injury in LN. Podocytes and macrophages were co-cultured with UC-MSCs in vitro to study the mechanism by which UC-MSC protect podocytes...
July 5, 2018: Nephrology, Dialysis, Transplantation
Shohei Tachibana, Masayuki Iyoda, Kei Matsumoto, Yukihiro Wada, Taihei Suzuki, Ken Iseri, Nobuhiro Kanazawa, Takanori Shibata
Background: Since recombinant human soluble thrombomodulin (RH-TM) has anti-inflammatory properties through neutralizing high-mobility group box 1 protein (HMGB1), the protective effects of RH-TM were examined in anti-glomerular basement membrane (GBM) glomerulonephritis (GN) in Wistar-Kyoto rats. Methods: Rats were injected with nephrotoxic serum (NTS) to induce anti-GBM GN on Day 0, and were given either RH-TM or vehicle from Day 0 to Day 6. Rats were sacrificed 7 days after NTS injection...
July 5, 2018: Nephrology, Dialysis, Transplantation
Philippe Chauveau, Laetitia Koppe, Christian Combe, Catherine Lasseur, Stanislas Trolonge, Michel Aparicio
While dietary restriction of protein intake has long been proposed as a possible kidney-protective treatment, the effects of changes in the quality of ingested proteins on the prevalence and risk of progression of chronic kidney disease (CKD) have been scarcely studied; these two aspects are reviewed in the present article. The prevalence of hypertension, type 2 diabetes and metabolic syndrome, which are the main causes of CKD in Western countries, is lower in vegetarian populations. Moreover, there is a negative relationship between several components of plant-based diets and numerous factors related to CKD progression such as uraemic toxins, inflammation, oxidative stress, metabolic acidosis, phosphate load and insulin resistance...
July 5, 2018: Nephrology, Dialysis, Transplantation
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