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American Journal of Nephrology

Christine Firth, Fadi Shamoun, Stephen Cha, Nan Zhang, Salma Patel, Paul Wennberg, Hatem Amer, Hani Wadei, Raymond Heilman, Mira Keddis
BACKGROUND: We evaluated the role of increased cardiac troponin T (cTnT), vascular, and cardiac diseases in predicting 5 and 10-year all-cause mortality after kidney transplantation. METHODS: We reviewed a cohort of 764 kidney transplant recipients and analyzed pertinent cardiovascular risk factors at the time of transplant evaluation. Proportional hazards regression analysis with bootstrapping method was utilized to provide a risk stratification score for mortality...
September 20, 2018: American Journal of Nephrology
Christine E Haugen, Elizabeth A King, Sunjae Bae, Mary Grace Bowring, Courtenay M Holscher, Jacqueline Garonzik-Wang, Mara McAdams-DeMarco, Dorry L Segev
BACKGROUND: Up to 31% of kidney transplant (KT) recipients experience early hospital readmission (EHR). We hypothesized that EHR among older KT recipients is higher than younger recipients due to increased comorbidities and higher prevalence of frailty. METHODS: We identified 22,458 older (age ≥65) and 86,372 younger (18 to < 65) first-time KT recipients (December 1, 1999 - December 31, 2014) using United States Renal Data System data. We estimated the association between patient-level characteristics and EHR (30 days post-KT discharge) with modified Poisson regression among older and younger KT recipients, separately...
September 18, 2018: American Journal of Nephrology
Mercedes Cao, Bruna N Leite, Tamara Ferreiro, María Calvo, Constantino Fernández, Ángel Alonso, Alejandro Rodriguez, Pilar Salvador, Rocío Seijo, Salvador Pita, Emilia Arjona, Santiago Rodríguez de Córdoba, Francisco Valdés Cañedo
BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is a rare disease associated with congenital or acquired genetic abnormalities that result in uncontrolled complement activation, leading to thrombotic microangiopathy and kidney failure. Until recently, the only treatment was plasma exchange or plasma infusion (PE/PI), but 60% of patients died or had permanent kidney damage despite treatment. Eculizumab, a complement inhibitor, has shown promising results in aHUS. However, data are mainly extracted from case reports or studies of heterogeneous cohorts, and no direct comparison with PE/PI is available...
September 11, 2018: American Journal of Nephrology
Terumasa Hayashi, Keiko Yasuda, Tomonori Kimura, Koichi Sasaki, Karin Shimada, Nobuhiro Hashimoto, Yoshitaka Isaka
BACKGROUND: It is unclear whether asymptomatic elevation of brain natriuretic peptide (BNP) is associated with cardiovascular events (CVEs) or heart failure (HF) in predialysis chronic kidney disease (CKD) patients. METHODS: We measured BNP in 482 asymptomatic predialysis patients with CKD stages 2-5 at nephrology referral between August 2004 and October 2010, and followed them prospectively to investigate the prognostic significance of BNP using Cox models and receiver operating characteristic (ROC) analyses...
September 7, 2018: American Journal of Nephrology
Ravi Thadhani, Ruffy Guilatco, Jeffrey Hymes, Franklin W Maddux, Ajay Ahuja
BACKGROUND: For patients with anemia undergoing hemodialysis, erythropoiesis-stimulating agents (ESAs) are typically dosed via precise algorithms. Using one such algorithm, we assessed the maintenance of hemoglobin levels in patients switched from epoetin alfa reference product (Epogen®) to epoetin alfa-epbx (RetacritTM; a biosimilar to US-licensed Epogen®/Procrit®). METHODS: This randomized, open-label, non-inferiority study was conducted at Fresenius Medical Care North America (FMCNA) hemodialysis centers...
September 7, 2018: American Journal of Nephrology
Zheng Wang, Xiaolei Chen, Dongmei Zhang, Yiling Cao, Liang Zhang, Wanxin Tang
BACKGROUND: Rapidly progressive glomerulonephritis (RPGN) is caused by various diseases process, thereby resulting in extensive crescent formation, which could lead to a rapid loss of kidney function. The molecular pathogenesis of RPGN remains largely unknown and requires clarification. The weighted gene co-expression network analysis (WGCNA) is a powerful bioinformatics tool to identify meaningful molecules in diseases. METHODS: The dataset of GSE104948, which contains 22 RPGN and 18 normal samples, was obtained from Gene Expression Omnibus database...
September 6, 2018: American Journal of Nephrology
Nicholette D Palmer, Lijun Ma, Barry I Freedman
No abstract text is available yet for this article.
September 5, 2018: American Journal of Nephrology
Anna C Garza-Mayers, Radhika Shah, David B Sykes, Sagar U Nigwekar, Daniela Kroshinsky
Calciphylaxis is a disease of dermal arteriolar calcification that results in necrosis. It commonly occurs in individuals with end-stage renal disease (ESRD) on hemodialysis and is associated with a high morbidity and mortality. Warfarin use is an identified risk factor. Twenty patients with ESRD on dialysis with calciphylaxis who were treated with apixaban for indications of deep vein thrombosis or atrial fibrillation were identified. There were no reports of thrombosis. Three individuals experienced bleeding requiring a transfusion, and anticoagulation was resumed without further event...
September 3, 2018: American Journal of Nephrology
Rajiv Agarwal, Patrick Rossignol, Dahlia Garza, Martha R Mayo, Suzette Warren, Susan Arthur, Alain Romero, William B White, Bryan Williams
BACKGROUND: While chronic kidney disease (CKD) is common in resistant hypertension (RHTN), prior studies -evaluating mineralocorticoid receptor antagonists excluded patients with reduced kidney function due to risk of hyperkalemia. AMBER ( identifier NCT03071263) will evaluate if the potassium-binding polymer patiromer used concomitantly with spironolactone in patients with RHTN and CKD prevents hyperkalemia and allows more persistent spironolactone use for hypertension management...
September 3, 2018: American Journal of Nephrology
Fatima Warsame, Hao Ying, Christine E Haugen, Alvin G Thomas, Deidra C Crews, Tariq Shafi, Bernard Jaar, Nadia M Chu, Dorry L Segev, Mara A McAdams-DeMarco
BACKGROUND: Health-related quality of life (HRQOL) reflects a patient's perceived disease burden, treatment effectiveness, and health status. Given the time burden and physiologic effects of hemodialysis, patients who spend dialysis time (9-15 h/week) physically or intellectually engaged may have better HRQOL. We characterized the intradialytic activities and explored their association with HRQOL. METHODS: In a cross-sectional study of 431 hemodialysis patients, we ascertained kidney-disease-specific quality of life, measured frailty, and surveyed participants about their usual active intradialytic activities (reading, playing games, doing puzzles, chatting, or other) and passive intradialytic activities (watching TV or sleeping)...
September 3, 2018: American Journal of Nephrology
Carmine Zoccali, Francesca Mallamaci
No abstract text is available yet for this article.
September 3, 2018: American Journal of Nephrology
Aya Shinfuku, Toshiharu Shimazaki, Masanori Fujiwara, Fumihiko Sato, Hirotaka Watase, Takumi Numazaki, Yasunori Kawakita, Masaru Mutoh, Hironori Yamasaki, Noriko Takayama, Sota Kato, Tomohiro Sugimoto, Jinsei Maruyama
BACKGROUND: TP0463518 is a novel hypoxia-inducible factor prolyl hydroxylase inhibitor developed to aid in the treatment of anemia associated with chronic kidney disease (CKD) and is expected to increase erythropoietin (EPO) derived from liver. Two phase I studies were conducted in healthy volunteers (HV) and CKD patients undergoing hemodialysis (i.e., HD patients) or those not undergoing dialysis (i.e., ND patients). METHODS: Pharmacokinetics, pharmacodynamics, and safety profiles of TP0463518 were assessed...
September 3, 2018: American Journal of Nephrology
George Drosos, Fotini Ampatzidou, Pantelis Sarafidis, Theodoros Karaiskos, Athanasios Madesis, Afroditi K Boutou
BACKGROUND: Most studies evaluating predictors of renal replacement therapy (RRT) following cardiac surgery use arbitrary defined limits of preoperative serum creatinine. The aim of this study was to evaluate the effect of preoperative renal function using either estimated-glomerular filtration rate (eGFR) derived using Chronic Kidney Disease-Epidemiology (CKD-EPI) or serum creatinine alone as a predictor for RRT after cardiac surgery. METHODS: In this prospective cohort study, baseline, intraoperative, and postoperative data of all patients who underwent an elective, urgent, or emergency cardiac surgery between 2012 and 2016 in a single center were analyzed in order to identify multivariate parameters determining the need for RRT after surgery...
2018: American Journal of Nephrology
Eric S Kerns, Esther D Kim, Lucy A Meoni, Stephen M Sozio, Bernard G Jaar, Michelle M Estrella, Rulan S Parekh, Ghada Bourjeily
BACKGROUND: Mortality in end-stage renal disease (ESRD) occurs predominantly from cardiovascular disease (CVD) and sudden cardiac death (SCD). Obstructive sleep apnea (OSA) is characterized by periodic airflow limitation associated with sleep arousal and oxygen desaturation and is prevalent in patients with ESRD. Whether OSA increases the risk for SCD, cardiovascular and all-cause mortality among hemodialysis patients remains unknown. METHODS: In a prospective cohort of 558 incident hemodialysis patients, we examined the association of OSA with all-cause mortality, cardiovascular mortality, and SCD using Cox proportional hazards models controlling for traditional CVD risk factors...
2018: American Journal of Nephrology
Bin Zhu, Dong-Rong Yu, Ji-Cheng Lv, Yi Lin, Qiang Li, Jia-Zhen Yin, Yuan-Yuan Du, Xuan-Li Tang, Li-Chan Mao, Qiu-Fen Li, Yue Sun, Ling Liu, Xian-Fa Li, Dan Fei, Xin-Yi Wei, Cai-Feng Zhu, Xiao-Xia Cheng, Hong-Yu Chen, Yong-Jun Wang
BACKGROUND: The role of serum uric acid (SUA) level in the progression of Immunoglobulin A nephropathy (IgAN) remains controversial. METHODS: In a cohort of 1,965 cases with biopsy-proven IgAN, we examined the associations of SUA concentration with the primary outcome of a composite of all-cause mortality or kidney failure (defined as a reduction of estimated glomerular filtration rate [eGFR] by 40% from baseline, requirements for dialysis and transplantation), or the outcome of kidney failure alone, assessed using Cox and logistic regression models, respectively, with adjustment for confounders...
2018: American Journal of Nephrology
Dan Zhang, Jiong Zhang, Shaoshan Liang, Jinquan Wang, Zhihong Liu
BACKGROUND: Fabry disease (FD) with life-threatening complications occurs as a result of organ damage in kidneys, heart, and brain. Only a few studies, especially from Asia, report their long-term outcome. METHODS: In this monocentric study, patients with Fabry nephropathy confirmed by renal biopsy were clinically investigated in a comprehensive manner. The clinic-pathological features, progression, and risk factors for the outcome were analyzed. RESULTS: Thirty-one patients were recruited, after median 62 months (range 8-156 months) follow-up, 23 of them had stable renal function while 8 underwent renal function deterioration...
2018: American Journal of Nephrology
John T Daugirdas
BACKGROUND: Changes in plasma volume during hemodialysis are complex and have been shown to depend on the rate of fluid removal and the degree of fluid overload. We examined changes in total protein concentration during and shortly after a dialysis treatment in archived data from the HEMO study. METHODS: During follow-up months 4 and 36 of the HEMO study, additional blood samples were obtained during a typical dialysis session at 30 and 60 min after dialysis. In 315 studies from 282 patients where complete data were available, we calculated the concentration change in total protein and compared it to the modeled change in both total body water and extracellular fluid space as derived from 2-pool urea kinetic modeling...
2018: American Journal of Nephrology
Sven R Olson, Eric Lu, Emilio Sulpizio, Joseph J Shatzel, Jose F Rueda, Thomas G DeLoughery
The terminal complement-inhibitor eculizumab has dramatically changed the management of patients with atypical hemolytic uremic syndrome (aHUS), and has also shown promise for treating certain forms of secondary HUS (sHUS), including that caused by drugs and solid-organ/hematopoietic stem cell transplant. While effective, eculizumab is costly and inconvenient. In this review, we evaluate the literature on eculizumab cessation in these diseases to better inform clinicians who consider stopping therapy. Reported relapse rates in aHUS after stopping eculizumab are as high as 30%, suggesting indefinite therapy is reasonable and that patients who choose to stop should be closely monitored...
2018: American Journal of Nephrology
Tatsuyoshi Ikenoue, Kiyomi Koike, Shingo Fukuma, Satoshi Ogata, Kunitoshi Iseki, Shunichi Fukuhara
BACKGROUND: Although some clinical practice guidelines regarding hemodialysis recommend salt restriction, few studies have examined the association between salt intake and clinical outcomes in hemodialysis patients. This study aimed to clarify the association between salt intake and mortality in hemodialysis patients. METHODS: This retrospective cohort study was based on the Japanese Society for Dialysis Therapy renal data registry database (2008) and included 88,115 adult patients who had received hemodialysis for at least 2 years...
2018: American Journal of Nephrology
Ezio Movilli, Corrado Camerini, Paola Gaggia, Roberto Zubani, Giovanni Cancarini
BACKGROUND: Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK before and after the start of ACEi/ARB therapy. METHODS: In the period 1/1/2015 - 31/12/2015, 112 out of 240 prevalent HD pts on thrice weekly HD treatment followed at our institution started the ACEi/ARB therapy...
2018: American Journal of Nephrology
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