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Nephrology, Dialysis, Transplantation

Jérôme Dumortier, François Bailly, Georges-Philippe Pageaux, Anaïs Vallet-Pichard, Sylvie Radenne, François Habersetzer, Marie-Claude Gagnieu, Jean-Didier Grangé, Anne Minello, Olivier Guillaud, Nassim Kamar, Laurent Alric, Vincent Leroy
BACKGROUND: Chronic hepatitis C virus (HCV) infection is the most common chronic liver disease in patients with end-stage renal disease (ESRD). Over the last few years, second-generation direct-acting antivirals have been revolutionary in the treatment of hepatitis C, and sofosbuvir (SOF) is the backbone of most modern treatment strategies. Since SOF is eliminated through the kidney, the aim of this multicentre retrospective study was to assess its antiviral efficacy and safety in HCV-infected patients with severe renal failure [including haemodialysis (HD) patients]...
October 19, 2016: Nephrology, Dialysis, Transplantation
Simardeep Gill, Min Jun, Pietro Ravani
The prevalence of atrial fibrillation and the risk of stroke display an age-related increase in the chronic kidney disease (CKD) population. Evidence from large randomized controlled trials conducted in the general population supports the use of anticoagulation to reduce the risk of stroke in the setting of non-valvular atrial fibrillation. However, data in the non-dialysis-dependent and dialysis-dependent CKD populations are limited largely to observational studies, which demonstrate conflicting results regarding the risk-benefit profile of anticoagulation...
October 14, 2016: Nephrology, Dialysis, Transplantation
Luca Dello Strologo, Luisa Murer, Isabella Guzzo, Federica Morolli, Annalisa M V Pipicelli, Elisa Benetti, Germana Longo, Sara Testa, Andrea Ricci, Fabrizio Ginevri, Luciana Ghio, Massimo Cardillo, Antonina Piazza, Alessandro Nanni Costa
BACKGROUND: High levels of preformed anti-HLA antibodies dramatically diminish renal transplant outcomes. Most desensitization programmes guarantee good intermediate outcomes but quite disappointing long-term prognosis. The search for a fully compatible kidney increases time on the waiting list. METHODS: In February 2011, a nationwide hyperimmune programme (NHP) was begun in Italy: all available kidneys are primarily proposed to highly sensitized patients with a panel reactive antibody above 80%...
October 14, 2016: Nephrology, Dialysis, Transplantation
Francesco Gaetano Casino, Carlo Basile
BACKGROUND: The recent interest in incremental haemodialysis (HD) is hindered by the current prescription based on a fixed target model (FTM) for the total (dialytic + renal) equivalent continuous clearance (ECC). The latter is expressed either as standard Kt/V (stdKt/V), i.e. the pre-dialysis averaged concentration of urea-based ECC, or EKRc, i.e. the time averaged concentration-based ECC, corrected for volume (V) = 40 L. Accordingly, there are two different targets: stdKt/V = 2.3 volumes per week (v/wk) and EKRc = 13 mL/min/40 L...
October 14, 2016: Nephrology, Dialysis, Transplantation
Alessandro Gasparini, Marie Evans, Josef Coresh, Morgan E Grams, Olof Norin, Abdul R Qureshi, Björn Runesson, Peter Barany, Johan Ärnlöv, Tomas Jernberg, Björn Wettermark, Carl G Elinder, Juan-Jesüs Carrero
BACKGROUND: Chronic kidney disease (CKD) is common, but the frequency of albuminuria testing and referral to nephrology care has been difficult to measure. We here characterize CKD prevalence and recognition in a complete healthcare utilization cohort of the Stockholm region, in Sweden. METHODS: We included all adult individuals (n = 1 128 058) with at least one outpatient measurement of IDMS-calibrated serum creatinine during 2006-11. Estimated glomerular filtration rate (eGFR) was calculated via the CKD-EPI equation and CKD was solely defined as eGFR <60 mL/min/1...
October 13, 2016: Nephrology, Dialysis, Transplantation
Pantelis A Sarafidis, Vasilios Kamperidis, Charalampos Loutradis, Konstantinos Tsilonis, Fani Mpoutsiouki, Athanasios Saratzis, Georgios Giannakoulas, Georgios Sianos, Haralambos Karvounis
BACKGROUND: The effect of acute preload reduction during haemodialysis on left ventricle (LV) and right ventricle (RV) function is not well understood. This study aimed to evaluate acute changes in novel echocardiographic and tissue Doppler-derived indices of LV and RV function during the first and a standard weekly dialysis session and to examine the possible effect of acute intradialytic volume changes in LV and RV diastolic function and pulmonary circulation loading. METHODS: Forty-one adult patients receiving standard thrice-weekly haemodialysis participated in this study...
October 13, 2016: Nephrology, Dialysis, Transplantation
Channa Jayasumana, Carlos Orantes, Raul Herrera, Miguel Almaguer, Laura Lopez, Luis Carlos Silva, Pedro Ordunez, Sisira Siribaddana, Sarath Gunatilake, Marc E De Broe
Increase in the prevalence of chronic kidney disease (CKD) is observed in Central America, Sri Lanka and other tropical countries. It is named chronic interstitial nephritis in agricultural communities (CINAC). CINAC is defined as a form of CKD that affects mainly young men, occasionally women. Its aetiology is not linked to diabetes, hypertension, glomerulopathies or other known causes. CINAC patients live and work in poor agricultural communities located in CINAC endemic areas with a hot tropical climate, and are exposed to toxic agrochemicals through work, by ingestion of contaminated food and water, or by inhalation...
October 13, 2016: Nephrology, Dialysis, Transplantation
John T Daugirdas
BACKGROUND: Previous studies have suggested that a conventional two-pool model cannot be used to predict intradialysis and early postdialysis phosphorus concentrations. METHODS: A conventional two-pool urea model was modified by increasing the distal compartment volume from two-thirds to three times the total body water and by the use of a dynamically variable intercompartmental phosphorus clearance during dialysis. The phosphate solver model parameters were derived from an examination of the results in the literature, and fine-tuned using a training set (F4) of 415 Hemodialysis (HEMO) Study patients studied during a dialysis session where phosphorus was measured at 4 months of follow-up...
October 13, 2016: Nephrology, Dialysis, Transplantation
Marcin Zaniew, Arend Bökenkamp, Marcin Kołbuc, Claudio La Scola, Federico Baronio, Anna Niemirska, Maria Szczepańska, Julia Bürger, Angela La Manna, Monika Miklaszewska, Anna Rogowska-Kalisz, Jutta Gellermann, Argyroula Zampetoglou, Anna Wasilewska, Magdalena Roszak, Jerzy Moczko, Aleksandra Krzemień, Dariusz Runowski, Grzegorz Siteń, Iga Załuska-Leśniewska, Patrizia Fonduli, Franca Zurrida, Fabio Paglialonga, Zoran Gucev, Dusan Paripovic, Rina Rus, Valerie Said-Conti, Lisa Sartz, Woo Yeong Chung, Se Jin Park, Jung Won Lee, Yong Hoon Park, Yo Han Ahn, Przemysław Sikora, Constantinos J Stefanidis, Velibor Tasic, Martin Konrad, Franca Anglani, Maria Addis, Hae Il Cheong, Michael Ludwig, Detlef Bockenhauer
BACKGROUND: Lowe syndrome (LS) and Dent-2 disease (DD2) are disorders associated with mutations in the OCRL gene and characterized by progressive chronic kidney disease (CKD). Here, we aimed to investigate the long-term renal outcome and identify potential determinants of CKD and its progression in children with these tubulopathies. METHODS: Retrospective analyses were conducted of clinical and genetic data in a cohort of 106 boys (LS: 88 and DD2: 18). For genotype-phenotype analysis, we grouped mutations according to their type and localization...
October 5, 2016: Nephrology, Dialysis, Transplantation
Caroline Platt, Richard J Coward
Over the past two decades it has become clear that the glomerular podocyte is a key cell in preventing albuminuria, kidney failure and cardiovascular morbidity. Understanding the key pathways that protect the podocyte in times of glomerular stress, which can also be therapeutically manipulated, are highly attractive. In the following review we assess the evidence that the peroxisome proliferator activating receptor (PPAR) agonists are beneficial for podocyte and kidney function with a focus on PPAR-γ. We explain our current understanding of the mechanisms of action of these agonists and the evidence they are beneficial in diabetic and non-diabetic kidney disease...
October 3, 2016: Nephrology, Dialysis, Transplantation
Liselotte C R Hensen, Victoria Delgado, Suzanne E van Wijngaarden, Melissa Leung, Mihaly K de Bie, Maurits S Buiten, Martin J Schalij, Jos J Van de Kerkhof, Ton J Rabelink, Joris I Rotmans, J Wouter Jukema, Jeroen J Bax
BACKGROUND: The prevalence of atrial fibrillation (AF) in end-stage renal disease (ESRD) patients is relatively high. The present study evaluated the association between left atrial (LA) remodelling, including an increased size and myocardial fibrosis, and slow LA conduction and the occurrence of AF. METHODS: In 171 ESRD patients enrolled in the Implantable Cardioverter Defibrillators in Dialysis patients (ICD2) trial, the LA dimensions, LA conduction delay [as reflected by the time difference between P-wave onset on surface electrocardiogram and A'-wave on tissue Doppler imaging (PA-TDI)] and LA function were compared between patients who exhibited AF versus patients without AF...
September 29, 2016: Nephrology, Dialysis, Transplantation
Ji In Park, Jung Tak Park, Yong-Lim Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Yun Kyu Oh, Chun Soo Lim, Yon Su Kim, Jung Pyo Lee
BACKGROUND: Recent reports have suggested the possible benefit of beginning hemodialysis (HD) at a rate less frequent than three times weekly and incrementally increasing the dialysis dose. However, the data regarding the benefits and safety of incremental HD are insufficient. METHODS: We analyzed 927 patients with newly initiated HD from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2014. The patients were classified into a thrice-weekly initiation group or an incremental initiation group (one to two sessions per week) according to the frequency of HD per week at baseline...
September 28, 2016: Nephrology, Dialysis, Transplantation
Hirofumi Watanabe, Shin Goto, Hiroshi Mori, Koichi Higashi, Kazuyoshi Hosomichi, Naotaka Aizawa, Nao Takahashi, Masafumi Tsuchida, Yusuke Suzuki, Takuji Yamada, Arata Horii, Ituro Inoue, Ken Kurokawa, Ichiei Narita
BACKGROUND: Immunoglobulin A nephropathy (IgAN) is the most prevalent primary chronic glomerular disease, in which the mucosal immune response elicited particularly in the tonsils or intestine has been estimated to be involved in the development of the disease. To explore the relationship between IgAN and bacterial flora in the tonsils, we conducted a comprehensive microbiome analysis. METHODS: We enrolled 48 IgAN patients, 21 recurrent tonsillitis (RT) patients without urine abnormalities and 30 children with tonsillar hyperplasia (TH) who had undergone tonsillectomy previously...
September 28, 2016: Nephrology, Dialysis, Transplantation
Malte Lenders, Boris Schmitz, Jörg Stypmann, Thomas Duning, Stefan-Martin Brand, Christine Kurschat, Eva Brand
BACKGROUND: Renal and cardiac involvement is responsible for substantial morbidity and mortality in Fabry disease (FD). We analysed the incidence of FD-related renal, cardiac and neurologic end points in patients with FD on long-term enzyme replacement therapy (ERT). METHODS: A retrospective analysis of prospectively collected data from two German FD centres was performed. The impact of renal and cardiac function at ERT-naïve baseline on end point development despite ERT was analysed...
September 27, 2016: Nephrology, Dialysis, Transplantation
Marie Evans, Juan-Jesus Carrero, Rino Bellocco, Peter Barany, Abdul R Qureshi, Astrid Seeberger, Stefan H Jacobson, Britta Hylander-Rössner, Andrea Rotnitzky, Arvid Sjölander
BACKGROUND: In 2012, new clinical guidelines were introduced for use of erythropoiesis-stimulating agents (ESA) in chronic kidney disease (CKD) patients, recommending lower haemoglobin (Hb) target levels and thresholds for ESA initiation. These changes resulted in lower blood levels in these patients. However, there is limited evidence on just when ESA should be initiated and the safety of a low Hb initiation policy. METHODS: In this observational inception cohort study, Swedish, nephology-referred, ESA-naïve CKD patients (n = 6348) were enrolled when their Hb dropped below 12...
September 26, 2016: Nephrology, Dialysis, Transplantation
Luna Gargani, Rosa Sicari, Mauro Raciti, Luca Serasini, Mirko Passera, Claudia Torino, Krzysztof Letachowicz, Robert Ekart, Danilo Fliser, Adrian Covic, Olga Balafa, Aristeidis Stavroulopoulos, Ziad A Massy, Enrico Fiaccadori, Alberto Caiazza, Thomas Bachelet, Itzchak Slotki, Linda Shavit, Alberto Martinez-Castelao, Marie-Jeanne Coudert-Krier, Patrick Rossignol, Thomas Daniel Kraemer, Thierry Hannedouche, Vincenzo Panichi, Andrzej Wiecek, Giuseppe Pontoriero, Pantelis Sarafidis, Marian Klinger, Radovan Hojs, Sarah Seiler-Mußler, Fabio Lizzi, Mihai Onofriescu, Fotis Zarzoulas, Rocco Tripepi, Francesca Mallamaci, Giovanni Tripepi, Eugenio Picano, Gérard Michel London, Carmine Zoccali
Within the framework of the LUST trial (LUng water by Ultra-Sound guided Treatment to prevent death and cardiovascular events in high-risk end-stage renal disease patients), the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis Transplant Association established a central core lab aimed at training and certifying nephrologists and cardiologists participating in this trial. All participants were trained by an expert trainer with an entirely web-based programme...
September 26, 2016: Nephrology, Dialysis, Transplantation
Daniel Eriksson, Linda Karlsson, Oskar Eklund, Hans Dieperink, Eero Honkanen, Jan Melin, Kristian Selvig, Johan Lundberg
BACKGROUND: A limited number of studies have assessed health-related quality of life (HRQoL) in autosomal dominant polycystic kidney disease (ADPKD). Results to date have been conflicting and studies have generally focused on patients with later stages of the disease. This study aimed to assess HRQoL in ADPKD across all stages of the disease, from patients with early chronic kidney disease (CKD) to patients with end-stage renal disease. METHODS: A study involving cross-sectional patient-reported outcomes and retrospective clinical data was undertaken April-December 2014 in Denmark, Finland, Norway and Sweden...
September 23, 2016: Nephrology, Dialysis, Transplantation
Tariq Shafi
No abstract text is available yet for this article.
September 22, 2016: Nephrology, Dialysis, Transplantation
Jan Rossaint, Mark Unruh, Alexander Zarbock
During chronic kidney disease (CKD), bone mineral metabolism is disturbed owing in part to the endogenous hormone fibroblast growth factor 23 (FGF23). Elevated FGF23 levels are seen in CKD patients. Current research has demonstrated that FGF23 directly modulates the immune response and host defense to bacterial infections. FGF23 also impairs the activation and recruitment of neutrophils, which are the main immune effector cells required for host defense against bacterial infections. In addition, while FGF23 levels reduce leukocyte recruitment and functions, inflammatory conditions may also-in a reverse fashion-contribute to elevated FGF23 levels in the circulation...
September 22, 2016: Nephrology, Dialysis, Transplantation
Connie M Rhee, Amy S You, Tara Koontz Parsons, Amanda R Tortorici, Rachelle Bross, David E St-Jules, Jennie Jing, Martin L Lee, Debbie Benner, Csaba P Kovesdy, Rajnish Mehrotra, Joel D Kopple, Kamyar Kalantar-Zadeh
BACKGROUND: Inadequate protein intake and hypoalbuminemia, indicators of protein-energy wasting, are among the strongest mortality predictors in hemodialysis patients. Hemodialysis patients are frequently counseled on dietary phosphorus restriction, which may inadvertently lead to decreased protein intake. We hypothesized that, in hypoalbuminemic hemodialysis patients, provision of high-protein meals during hemodialysis combined with a potent phosphorus binder increases serum albumin without raising phosphorus levels...
September 22, 2016: Nephrology, Dialysis, Transplantation
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