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Nephron Extra

Inga Strand Thorsen, Inger Hjørdis Bleskestad, Grete Jonsson, Øyvind Skadberg, Lasse Gunnar Gøransson
BACKGROUND: The best treatment for end-stage renal disease (ESRD) is kidney transplantation. Twenty-seven percent of transplantations in Norway are from living donors. Recent studies have shown an increased risk of ESRD and increased mortality in donors. The aim of this study was to determine if the levels of the new biomarkers neutrophil gelatinase-associated lipocalin (NGAL), soluble Klotho (sKlotho), and fibroblast growth factor 23 (FGF23) are changed in kidney donors with normal kidney function defined as an estimated glomerular filtration rate (eGFR) >60 ml/min/1...
September 2016: Nephron Extra
Miki Nishida, Minoru Ando, Yusuke Iwamoto, Ken Tsuchiya, Kosaku Nitta
BACKGROUND: Scavenger receptors (SRs) play a pivotal role in atherogenesis. The mechanism of atherosclerosis, which is specific to hemodialysis (HD) patients, was studied on the basis of SR gene expressions. METHODS: The gene expressions of SR type A (SR-A) and CD36 were studied in peripheral monocytes by real-time reverse transcription polymerase chain reaction. Data were compared between HD (n = 30) and age-matched control subjects (n = 10). Serum levels of macrophage colony-stimulating factor (M-CSF) were measured with enzyme-linked immunosorbent assay to test its role in SR expression...
May 2016: Nephron Extra
Stephen M Korbet, William L Whittier, Edmund J Lewis
BACKGROUND/AIM: We assess the impact of serum creatinine at baseline on complete remission rate and long-term outcome in severe lupus nephritis (SLN). METHODS: A total of 86 adult patients with SLN [International Society of Nephrology/Renal Pathology Society (ISN/RPS) class IV lesions] were evaluated based on baseline serum creatinine levels (≤1.0, 1.01-1.5, 1.51-2.0, 2.01-3.0, and >3.0 mg/dl; n = 22, 23, 16, 12, and 13, respectively). The complete remission rates (serum creatinine level of ≤1...
May 2016: Nephron Extra
Leonhard Stammler, Andreas Uhl, Benjamin Mayer, Frieder Keller
PURPOSE: Uranium is a heavy metal with alpha radioactivity. We state the hypothesis that uranium exposure is harmful to human kidneys and carcinogenic to body tissues. Therefore, we review epidemiological studies from people with known long-lasting uranium exposure. MATERIALS AND METHODS: Three meta-analyses are performed using clinical studies published in the PubMed database and applying RevMan 5.3 from the Cochrane Collaboration to calculate the outcome. The first two meta-analyses examine the standardized mortality ratio (SMR) and the standardized incidence ratio for any cancers of uranium workers who were operating in areas ranging from uranium processing to the assembly of final uranium products...
January 2016: Nephron Extra
Kiyonori Ito, Susumu Ookawara, Yuichiro Ueda, Haruhisa Miyazawa, Hodaka Yamada, Sawako Goto, Hiroki Ishii, Mitsutoshi Shindo, Taisuke Kitano, Keiji Hirai, Masashi Yoshida, Yoshio Kaku, Taro Hoshino, Aoi Nabata, Honami Mori, Izumi Yoshida, Masafumi Kakei, Yoshiyuki Morishita, Kaoru Tabei
UNLABELLED: A high cardiothoracic ratio (CTR) is indicative of a cardiac disorder. However, few reports have revealed an association between the CTR and mortality in patients starting hemodialysis (HD). METHODS: Patients with HD initiation (n = 387; mean age, 66.7 ± 12.7 years) were divided into the following three groups according to their CTR at HD initiation: CTR <50%, 50% ≤ CTR < 55%, and CTR ≥55%. Kaplan-Meier analysis was performed to compare 2-year all-cause mortality among these groups...
September 2015: Nephron Extra
Henry E Wang, T Clark Powell, Orlando M Gutiérrez, Russell Griffin, Monika M Safford
BACKGROUND/AIMS: Acute kidney injury (AKI) frequently occurs in hospitalized patients. In this study, we determined prehospitalization characteristics associated with AKI in community-dwelling adults hospitalized for a serious infection. METHODS: We used prospective data from 30,239 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of community-dwelling adults ≥45 years old. We identified serious infection hospitalizations between 2003 and 2012...
September 2015: Nephron Extra
Takashi Hara, Hideyuki Mukai, Takafumi Nakashima, Rikako Sagara, Masahide Furusho, Shuhei Miura, Jiro Toyonaga, Koji Sugawara, Kazuhito Takeda
BACKGROUND: Factors contributing to erythropoietin (EPO) hyporesponsiveness in patients on long-term continuous ambulatory peritoneal dialysis are not well understood. Therefore, we investigated the factors contributing to EPO hyporesponsiveness using the EPO resistance index (ERI). METHODS: A total of 14 patients (7 males and 7 females, age 65.0 ± 11.9 years) were selected for this study. We defined ERI as the weekly dose of EPO per body weight divided by hemoglobin (U/kg/g/dl/week)...
September 2015: Nephron Extra
Fredrik Uhlin, Ingegerd Odar-Cederlöf, Elvar Theodorsson, Anders Fernström
BACKGROUND/AIMS: Plasma concentrations of the N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) are increased in end-stage renal disease. Improvement in hemodynamic stability has been reported when switching from hemodialysis (HD) to on-line hemodiafiltration (ol-HDF). The aim of this study was to investigate plasma concentrations of NT-proBNP, BNP and neuropeptide Y (NPY) during a 1-year follow-up, after a change from high-flux HD to postdilution ol-HDF. Additional variables were also studied, e...
September 2015: Nephron Extra
Eri Muso, Masatoshi Mune, Tsutomu Hirano, Motoshi Hattori, Kenjiro Kimura, Tsuyoshi Watanabe, Hitoshi Yokoyama, Hiroshi Sato, Shunya Uchida, Takashi Wada, Tetsuo Shoji, Tsukasa Takemura, Yukio Yuzawa, Satoru Ogahara, Satoshi Sugiyama, Yasuhiko Iino, Soichi Sakai, Yousuke Ogura, Susumu Yukawa, Yoshiki Nishizawa, Noriaki Yorioka, Enyu Imai, Seiichi Matsuo, Takao Saito
BACKGROUND/AIMS: LDL apheresis (LDL-A) is used for drug-resistant nephrotic syndrome (NS) as an alternative therapy to induce remission by improvement of hyperlipidemia. Several clinical studies have suggested the efficacy of LDL-A for refractory NS, but the level of evidence remains insufficient. A multicenter prospective study, POLARIS (Prospective Observational Survey on the Long-Term Effects of LDL Apheresis on Drug-Resistant Nephrotic Syndrome), was conducted to evaluate its clinical efficacy with high-level evidence...
May 2015: Nephron Extra
Vishal Dey, Mario Hair, Beng So, Elaine M Spalding
BACKGROUND: Adequate control of plasma phosphate without phosphate binders is difficult to achieve on a thrice-weekly haemodialysis schedule. The use of quotidian nocturnal dialysis is effective but not practical in the in-centre setting. This quality improvement project was set up as an exercise allowing the evaluation of small-solute clearance by combining convection with extended-hour dialysis in a thrice-weekly hospital setting. METHODS: A single-centred, prospective analysis of patients' electronic records was performed from August 2012 to July 2014...
May 2015: Nephron Extra
Yoshio Kaku, Susumu Ookawara, Haruhisa Miyazawa, Kiyonori Ito, Yuichiro Ueda, Keiji Hirai, Taro Hoshino, Honami Mori, Izumi Yoshida, Yoshiyuki Morishita, Kaoru Tabei
BACKGROUND: The following calcium (Ca) correction formula (Payne) is conventionally used for serum Ca estimation: corrected total Ca (TCa) (mg/dl) = TCa (mg/dl) + [4 - albumin (g/dl)]; however, it is inapplicable to advanced chronic kidney disease (CKD) patients. METHODS: 1,922 samples in CKD G4 + G5 patients and 341 samples in CKD G5D patients were collected. Levels of TCa (mg/day), ionized Ca(2+) (iCa(2+)) (mmol/l) and other clinical parameters were measured. We assumed the corrected TCa to be equal to eight times the iCa(2+) value (measured corrected TCa)...
May 2015: Nephron Extra
Akishi Momose, Taku Nakajima, Shigetoshi Chiba, Kenjirou Kumakawa, Yasuo Shiraiwa, Nobuhiro Sasaki, Kazuo Watanabe, Etsuko Kitano, Mitiyo Hatanaka, Hajime Kitamura
We present the first report of a case of fibrillary glomerulonephritis (FGN) associated with thrombotic microangiopathy (TMA) and anti-glomerular basement membrane antibody (anti-GBM antibody). A 54-year-old man was admitted to our hospital for high fever and anuria. On the first hospital day, we initiated hemodialysis for renal dysfunction. Laboratory data revealed normocytic-normochromic anemia with schistocytes in the peripheral smear, thrombocytopenia, increased serum lactate dehydrogenase, decreased serum haptoglobin, and negative results for both direct and indirect Coombs tests...
January 2015: Nephron Extra
Moniek C M de Goeij, Joris I Rotmans, Xanthe Matthijssen, Dinanda J de Jager, Friedo W Dekker, Nynke Halbesma
BACKGROUND: Little is known about the effect of low-density lipoprotein (LDL) cholesterol, triglyceride (TG), and high-density lipoprotein (HDL) cholesterol levels on renal function decline in patients receiving specialized pre-dialysis care. METHODS: In the prospective PREPARE-2 study, incident patients starting pre-dialysis care were included when referred to one of the 25 participating Dutch specialized pre-dialysis outpatient clinics (2004-2011). Clinical and laboratory data were collected every 6 months...
January 2015: Nephron Extra
Choon Hee Chung, Jingyi Fan, Eun Young Lee, Jeong Suk Kang, Seung Joo Lee, Petr E Pyagay, Charbel C Khoury, Tet-Kin Yeo, Mark F Khayat, Amy Wang, Sheldon Chen
BACKGROUND/AIMS: Tumor necrosis factor (TNF)-α is believed to play a role in diabetic kidney disease. This study explores the specific effects of TNF-α with regard to nephropathy-relevant parameters in the podocyte. METHODS: Cultured mouse podocytes were treated with recombinant TNF-α and assayed for production of monocyte chemoattractant protein-1 (MCP-1) by enzyme-linked immunosorbent assay (ELISA). TNF-α signaling of MCP-1 was elucidated by antibodies against TNF receptor (TNFR) 1 or TNFR2 or inhibitors of nuclear factor-kappaB (NF-κB), phosphatidylinositol 3-kinase (PI3K) or Akt...
January 2015: Nephron Extra
Javier A Neyra, Omkar U Vaidya, Allen Hendricks, Kamalanathan K Sambandam
Bisphosphonates are commonly used for the treatment of osteoporosis, Paget's disease, multiple myeloma and hypercalcemia. Collapsing focal segmental glomerulosclerosis (FSGS) is known to occur uncommonly with exposure to bisphosphonates, specifically pamidronate and alendronate; it has rarely and equivocally been reported with zoledronate therapy. We describe the case of a 36-year-old African American female with metastatic breast cancer who presented with nephrotic-range proteinuria and acute kidney injury within 2 weeks of exposure to a single dose of zoledronate...
September 2014: Nephron Extra
Charmaine E Lok, Jessica M Sontrop, Rose Faratro, Christopher T Chan, Deborah Lynn Zimmerman
BACKGROUND: Few studies have examined if infectious arteriovenous access complications vary with the cannulation technique and whether this is modified by dialysis frequency. We compared the infection rate between fistulas cannulated using buttonhole versus stepladder techniques for patients treated with short daily (SDH) or nocturnal hemodialysis at home (NHD). We also compared patients receiving conventional intermittent hemodialysis (CIHD) using stepladder cannulation. METHODS: Data were prospectively collected from 631 patients dialyzed with a fistula from 2001 to 2010 (Toronto and Ottawa, Canada)...
September 2014: Nephron Extra
Robert J H Miller, Jennifer M MacRae, Stefan Mustata
BACKGROUND: Arteriovenous fistula is an uncommon complication of central venous catheterization that often requires invasive repair. CASE REPORT: We report the case of an arteriovenous fistula that presented as ongoing pain following removal of a tunneled central venous catheter. The fistula resolved spontaneously following a period of compression and observation. CONCLUSION: Our study highlights the etiology of this uncommon complication as well as suggesting a role for conservative management...
September 2014: Nephron Extra
Jenny Hulkko, Jaakko Patrakka, Mark Lal, Karl Tryggvason, Kjell Hultenby, Annika Wernerson
BACKGROUND/AIMS: The transmembrane proteins Neph1 and nephrin form a complex in the slit diaphragm (SD) of podocytes. As recent studies indicate an involvement of this complex in the polymerization of the actin cytoskeleton and proteinuria, we wanted to study the subcellular localization of Neph1 in the normal human kidney and its expression in focal segmental glomerulosclerosis (FSGS), minimal change nephrotic syndrome (MCNS), and the corresponding experimental models of Adriamycin-induced nephropathy (ADR) and puromycin aminonucleoside nephrosis (PAN)...
September 2014: Nephron Extra
Kati Kaartinen, Jaana Syrjänen, Ilkka Pörsti, Aimo Harmoinen, Heini Huhtala, Jukka Mustonen
BACKGROUND/AIMS: Metabolic syndrome (MetS) may have an independent impact on the development of chronic kidney disease. This study examines the prevalence of MetS in subjects with IgA glomerulonephritis (IgAGN) and its impact on disease progression in a retrospective fashion. PATIENTS AND METHODS: Altogether, 174 subjects (104 males) were examined 11 years (first visit) after IgAGN diagnosis and again after 16 years (second visit; 144 subjects responded). Different glomerular filtration markers were utilized...
May 2014: Nephron Extra
Atul Bali, John Kevin Hix, Peter Kouides
Uremic platelet dysfunction rarely causes significant bleeding in adequately dialyzed patients. When encountered, the management is complicated by a lack of well-supported treatment modalities. Estrogen use in uremic platelet dysfunction has been described, but enthusiasm for the treatment has been dampened by the risk of thrombotic events in vasculopathic dialysis patients. We present a patient on long-term peritoneal dialysis with coronary disease who developed recurrent life-threatening bleeding episodes secondary to uremia, where treatment with transdermal estrogen was used safely and effectively for a 24-month period...
May 2014: Nephron Extra
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