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https://www.readbyqxmd.com/read/28432691/tenapanor-administration-and-the-activity-of-the-h-coupled-transporter-pept1-in-healthy-volunteers
#1
Susanne Johansson, David P Rosenbaum, Johan Palm, Bergur Stefansson, Mikael Knutsson, Eleanor A Lisbon, Constanze Hilgendorf
AIM: Tenapanor (RDX5791/AZD1722), an inhibitor of gastrointestinal Na(+) /H(+) exchanger NHE3, is being evaluated for the treatment of patients with constipation-predominant irritable bowel syndrome and the treatment of hyperphosphataemia in patients with chronic kidney disease on dialysis. By reducing intestinal H(+) secretion, inhibition of NHE3 by tenapanor could indirectly affect H(+) -coupled transporter activity, leading to drug-drug interactions. We investigated the effect of tenapanor on the activity of the H(+) -coupled peptide transporter PepT1 via assessment of the pharmacokinetics of cefadroxil - a compound transported by PepT1 - in healthy volunteers...
April 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28431809/pilot-study-of-changes-in-presepsin-concentrations-compared-with-changes-in-procalcitonin-and-c-reactive-protein-concentrations-after-cardiovascular-surgery
#2
Junichi Saito, Eiji Hashiba, Akio Mikami, Tomoyuki Kudo, Hidetomo Niwa, Kazuyoshi Hirota
OBJECTIVE: The authors investigated the presepsin-concentration profile after cardiac surgery compared with those of procalcitonin (PCT) and C-reactive protein (CRP). DESIGN: A single-center, prospective, observational clinical study. SETTING: Hirosaki University Hospital. PARTICIPANTS: Patients who underwent cardiovascular surgery without preoperative infection and end-stage kidney disease requiring dialysis. The patients also were subdivided into 2 groups with respect to the use of cardiopulmonary bypass (CPB)...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28431568/a-case-report-of-severe-calciphylaxis-suggested-approach-for-diagnosis-and-treatment
#3
Margret Patecki, Gabriele Lehmann, Jan Hinrich Bräsen, Jessica Schmitz, Anna Bertram, Lars Daniel Berthold, Hermann Haller, Wilfried Gwinner
BACKGROUND: Calciphylaxis is a serious complication in patients with chronic kidney disease associated mineral and bone disorder. It can occur in conditions with low and high bone turnover. So far, there are no definite diagnostic and therapeutic guidelines which may prevent the devastating outcome in many calciphylaxis patients. We report a case which clearly illustrates that knowledge of the underlying bone disorder is essential for a directed treatment. Based on this experience we discuss a systematic diagnostic and therapeutic approach in patients with calciphylaxis...
April 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28431138/cardiovascular-outcome-trials-in-patients-with-chronic-kidney-disease-challenges-associated-with-selection-of-patients-and-endpoints
#4
Patrick Rossignol, Rajiv Agarwal, Bernard Canaud, Alan Charney, Gilles Chatellier, Jonathan C Craig, William C Cushman, Ronald T Gansevoort, Bengt Fellström, Dahlia Garza, Nicolas Guzman, Frank A Holtkamp, Gerard M London, Ziad A Massy, Alexandre Mebazaa, Peter G M Mol, Marc A Pfeffer, Yves Rosenberg, Luis M Ruilope, Jonathan Seltzer, Amil M Shah, Salim Shah, Bhupinder Singh, Bergur V Stefánsson, Norman Stockbridge, Wendy Gattis Stough, Kristian Thygesen, Michael Walsh, Christoph Wanner, David G Warnock, Christopher S Wilcox, Janet Wittes, Bertram Pitt, Aliza Thompson, Faiez Zannad
Although cardiovascular disease is a major health burden for patients with chronic kidney disease, most cardiovascular outcome trials have excluded patients with advanced chronic kidney disease. Moreover, the major cardiovascular outcome trials that have been conducted in patients with end-stage renal disease have not demonstrated a treatment benefit. Thus, clinicians have limited evidence to guide the management of cardiovascular disease in patients with chronic kidney disease, particularly those on dialysis...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430830/assessment-of-global-kidney-health-care-status
#5
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28430301/towards-a-bioengineered-kidney-recellularization-strategies-for-decellularized-native-kidney-scaffolds
#6
Michele Fedecostante, Oana G Onciu, Koen G C Westphal, Rosalinde Masereeuw
Patients with end-stage renal disease often undergo dialysis as a partial substitute for kidney function while waiting for their only treatment option: a kidney transplant. Several research directions emerged for alternatives in support of the ever-growing numbers of patients. Recent years brought big steps forward in the field, with researchers questioning and improving the current dialysis devices as well as moving towards the design of a bioengineered kidney. Whole-organ engineering is also being explored as a possibility, making use of animal or human kidney scaffolds for engineering a transplantable organ...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28429558/is-there-a-role-or-target-value-for-nutritional-vitamin-d-in-chronic-kidney-disease
#7
Wai H Lim, Emma L Duncan
Vitamin D is important for bone health in the general population but the value of vitamin D supplementation, and the role of 25-hydroxyvitamin D independently of 1,25-dihydroxyvitmain D, in individuals with chronic kidney disease (CKD), particularly in those who require dialysis, remains uncertain. Supplementation may improve some biochemical parameters, such as reducing PTH levels in patients to CKD-stage 4 who have vitamin D deficiency; but it remains to be established whether the role of nutritional vitamin D in maintaining bone health in the general population can be extrapolated to the CKD population...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#8
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#9
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429545/do-the-benefits-of-using-calcitriol-and-other-vitamin-d-receptor-activators-in-patients-with-chronic-kidney-disease-outweigh-the-harms
#10
Nigel D Toussaint, Matthew J Damasiewicz
The primary indication for administration of calcitriol or other vitamin D receptor activators (VDRA) in chronic kidney disease (CKD) is secondary hyperparathyroidism (SHPT). Prevention and treatment of SHPT appears important, as imbalances in mineral metabolism are associated with renal osteodystrophy, and higher parathyroid hormone (PTH) levels are associated with increased rates of mortality and morbidity in CKD patients. There is, however, a lack of controlled trial data that show lowering PTH with calcitriol/VDRA equates to improved clinical outcomes...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28428332/education-in-nephrology-fellowship-a-survey-based-needs-assessment
#11
Robert W Rope, Kurtis A Pivert, Mark G Parker, Stephen M Sozio, Sylvia Bereknyei Merell
Educational needs assessments for nephrology fellowship training are limited. This study assessed fellows' perceptions of current educational needs and interest in novel modalities that may improve their educational experience and quantified educational resources used by programs and fellows. We distributed a seven-question electronic survey to all United States-based fellows receiving complimentary American Society of Nephrology (ASN) membership at the end of the 2015-2016 academic year in conjunction with the ASN Nephrology Fellows Survey...
April 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28428168/testing-the-feasibility-and-usability-of-a-novel-smartphone-based-self-management-support-system-for-dialysis-patients-a-pilot-study
#12
Aki Hayashi, Satoko Yamaguchi, Kayo Waki, Katsuhito Fujiu, Norio Hanafusa, Takahiro Nishi, Hyoe Tomita, Haruka Kobayashi, Hideo Fujita, Takashi Kadowaki, Masaomi Nangaku, Kazuhiko Ohe
BACKGROUND: Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management. OBJECTIVE: Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients. METHODS: We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations...
April 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28428030/complement-inhibition-with-eculizumab-for-thrombotic-microangiopathy-rescues-a-living-donor-kidney-transplant-in-a-patient-with-antiphospholipid-antibody-syndrome
#13
Praveen Ramakrishnan Geethakumari, Patrick Mille, Rakesh Gulati, Srikanth Nagalla
Antiphospholipid antibody syndrome (APS) is an enigmatic heterogeneous disorder despite several revelations in its pathobiology. Renal transplantation in patients with APS has been notoriously difficult due to the high risk of development of thrombotic microangiopathy (TMA), which is often refractory to conventional treatment modalities such as aggressive anticoagulation and plasmapheresis. We describe a case of a 58-year-old male with secondary APS undergoing living unrelated renal transplantation for end-stage renal disease from lupus nephritis...
March 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#14
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#15
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28425578/survival-comparisons-of-intensive-vs-conventional-hemodialysis-pitfalls-and-lessons
#16
REVIEW
Amanda J Miller, Jeff Perl, Karthik K Tennankore
The optimal dose of hemodialysis (HD) has not yet been established. As a means of better approximating the physiology of native kidney function, there has been a growing interest in intensive HD (an increase in dialysis frequency and/or duration). Although many studies have demonstrated a survival benefit with intensive dialysis, results have been conflicting. This controversy stems from the challenges of randomizing patients to conventional vs. intensive HD modalities and, therefore, the reliance on observational comparisons that have been limited by varying definitions for intensive dialysis, differences in dialysis location and prescription, unavoidable treatment selection bias, and a potential lack of generalizability...
April 20, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28423972/sexual-function-and-testosterone-level-in-men-with-conservatively-treated-chronic-kidney-disease
#17
Kerstin S Fugl-Meyer, Marie Nilsson, Britta Hylander, Mikael Lehtihet
Sexual dysfunctions are common, but underrecognized, in patients with chronic kidney disease (CKD) and are inversely associated with the glomerular filtration rate (GFR). Sexual dysfunctions may affect quality of life in males with CKD. The aim of this study was to analyze the relationship among sex hormones, sexual function, and sexual satisfaction in a group of men between 18 and 50 years of age with CKD Stages 1 to 5 not treated with hemodialysis or peritoneal dialysis. Fasting blood samples for hemoglobin, testosterone, prolactin, and luteinizing hormone and questionnaire surveys (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) were evaluated in 100consecutive men...
April 1, 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28422703/differential-hemoglobin-a-sequestration-between-hemodialysis-modalities
#18
Uzma Naseeb, Shamshad Zarina, Theres Jägerbrink, Jawed Shafqat, Hans Jörnvall, Jonas Axelsson
This report evaluates plasma protein patterns, dialysates and protein analysis of used dialysis membranes from the same patient under hemodialysis in three separate modalities, using high-flux membranes in concentration-driven transport (HD), convection-driven hemofiltration (HF) and combined hemodialfiltration (HDF). The plasma protein changes induced by each of the three dialysis modalities showed small differences in proteins identified towards our previous plasma analyses of chronic kidney disease (CKD) patients...
April 19, 2017: Biomolecular Concepts
https://www.readbyqxmd.com/read/28421638/renal-replacement-therapy-and-incremental-hemodialysis-for-veterans-with-advanced-chronic-kidney-disease
#19
Kamyar Kalantar-Zadeh, Susan T Crowley, Srinivasan Beddhu, Joline L T Chen, John T Daugirdas, David S Goldfarb, Anna Jin, Csaba P Kovesdy, David J Leehey, Hamid Moradi, Sankar D Navaneethan, Keith C Norris, Yoshitsugu Obi, Ann O'Hare, Tariq Shafi, Elani Streja, Mark L Unruh, Tushar J Vachharajani, Steven Weisbord, Connie M Rhee
Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources...
April 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28420645/association-between-chronic-kidney-disease-and-rates-of-transfusion-and-progression-to-end-stage-renal-disease-in-patients-undergoing-transradial-versus-transfemoral-cardiac-catheterization-an-analysis-from-the-veterans-affairs-clinical-assessment-reporting
#20
Amit N Vora, Maggie Stanislawski, Gary K Grunwald, Mary E Plomondon, John S Rumsfeld, Thomas M Maddox, Mladen I Vidovich, Walter Woody, Brahmajee K Nallamothu, Hitinder S Gurm, Sunil V Rao
BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk for bleeding, transfusion, and dialysis after cardiac catheterization. Whether rates of these complications are increased in this high-risk population undergoing transradial access compared with transfemoral access is unknown. METHODS AND RESULTS: From the Veterans Affairs (VA) Clinical Assessment Reporting and Tracking program, we identified 229 108 patients undergoing cardiac catheterization between 2007 and 2014, of which 48 155 (21...
April 18, 2017: Journal of the American Heart Association
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