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Kotanko P

Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Jie Ma, Israel Campos, Peter Kotanko, Schantel Williams, Franz Kappel, Fansan Zhu, Hannah Putnam, Camille Johnson
Assessment of arterio-venous fistula (AVF) blood flow (ABF) is vital in hemodialysis (HD) patients. Currently, no non-invasive and contact-free technique is available to accurately measure ABF in routine clinical practice. In this study, we developed a novel approach using video image processing (VIP) to measure the change in optic flow in the skin. We the tested the hypothesis that the change in optical flow, expressed as the change in pixels between consecutive frames, is related to ABF. We recorded AVF videos in 40 HD patients using a digital camera and processed them by VIP technique...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Rajiv Saran, Robin L Padilla, Brenda W Gillespie, Michael Heung, Scott L Hummel, Vimal Kumar Derebail, Bertram Pitt, Nathan W Levin, Fansan Zhu, Samer R Abbas, Li Liu, Peter Kotanko, Philip Klemmer
BACKGROUND AND OBJECTIVES: Patients with chronic kidney disease (CKD) are often volume expanded and hypertensive. Few controlled studies have assessed the effects of a sodium-restricted diet (SRD) in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a randomized crossover trial to evaluate the effect of SRD (target <2 g sodium per day) versus usual diet on hydration status (by bioelectrical impedance spectroscopy) and blood pressure (BP) between May of 2009 and May of 2013...
February 16, 2017: Clinical Journal of the American Society of Nephrology: CJASN
Marijke J E Dekker, Daniele Marcelli, Bernard J Canaud, Paola Carioni, Yuedong Wang, Aileen Grassmann, Constantijn J A M Konings, Peter Kotanko, Karel M Leunissen, Nathan W Levin, Frank M van der Sande, Xiaoling Ye, Vaibhav Maheshwari, Len A Usvyat, Jeroen P Kooman
In hemodialysis patients extracellular fluid overload is a predictor of all-cause and cardiovascular mortality, and a relation with inflammation has been reported in previous studies. The magnitude and nature of this interaction and the effects of moderate fluid overload and extracellular fluid depletion on survival are still unclear. We present the results of an international cohort study in 8883 hemodialysis patients from the European MONDO initiative database where, during a three-month baseline period, fluid status was assessed using bioimpedance and inflammation by C-reactive protein...
February 13, 2017: Kidney International
Cesar Flores Gama, Laura M Rosales, Georges Ouellet, Yanna Dou, Stephan Thijssen, Len Usvyat, Hanjie Zhang, Viktoriya Kuntsevich, Nathan W Levin, Peter Kotanko
BACKGROUND: Human plasma gelsolin (pGSN) is an actin-binding protein that is secreted into the extracellular fluid, with the skeletal muscle and myocardial tissues being its major source. Depletion of pGSN has been shown to be related to a variety of inflammatory and clinical conditions. METHODS: pGSN levels were prospectively determined in prevalent maintenance hemodialysis (HD) patients from 3 U.S. dialysis centers. Demographics (age, time since dialysis initiation, race, gender, body height and weight, comorbidities), inflammatory markers (C reactive protein, CRP; interleukin 6, IL-6), free triiodothyronine (fT3), and routine laboratory parameters were obtained...
January 24, 2017: Blood Purification
Jie Ma, Yanna Dou, Hanjie Zhang, Stephan Thijssen, Schantel Williams, Viktoriya Kuntsevich, Georges Ouellet, Michelle M Y Wong, Vanja Persic, Anja Kruse, Laura Rosales, Yuedong Wang, Nathan W Levin, Peter Kotanko
BACKGROUND AND OBJECTIVES: The pathogenesis of anemia in hemodialysis (HD) patients is dependent on multiple factors, with decreased red blood cell life span (RBCLS) being a significant contributor. Although the impact of reduced RBCLS on anemia is recognized, it is still a subject that is not well researched. The objective of this study was to investigate the relationship between RBCLS and inflammatory biomarkers in chronic HD patients. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: RBCLS was calculated from alveolar carbon monoxide concentrations measured by gas chromatography...
January 24, 2017: Blood Purification
Eric Seibert, Stephan G Müller, Johanna Pattmöller, Peter Kotanko, Fansan Zhu, Nathan W Levin, Roman Fiedler, Martin K Kuhlmann, Matthias Girndt
BACKGROUND: Continuous intradialytic calf bioimpedance spectroscopy (cBIS) allows assessment of changes in calf extracellular fluid volume (ECV) to determine dry weight (DW) in hemodialysis patients. During dialysis, calf ECV decreases until excessive ECV has been removed and normalized resistivity ρN,5 rises to values comparable to those of a normal population (cBIS-DW). It is not clear whether chronic kidney disease (CKD) itself influences ρN,5 and whether normal values depend on race and ethnicity...
December 20, 2016: Nephron
Paik Seong Lim, Chang Hsu Chen, Fansan Zhu, Peter Kotanko, Yachung Jeng, Chun Yu Hu, Li Shu Chiu, Hui-Chen Chang
OBJECTIVE: Obesity is becoming increasingly common in hemodialysis (HD) patients and is associated with inflammation and increased mortality. The primary aim of the present study was to evaluate the accuracy and variability of the bioimpedance device in measuring body fat in Taiwanese dialysis patients. DESIGN: Cross-sectional study. SUBJECTS: One hundred twenty-two adult patients receiving HD in a single hospital in Taiwan. SETTING: We compared the results of fat mass (FM) measured by dual-energy x-ray absorptiometry (DEXA) and bioelectrical impedance spectroscopy device (Body composition monitor, BCM)...
January 2017: Journal of Renal Nutrition
M J E Dekker, D Marcelli, B Canaud, C J A M Konings, K M Leunissen, N W Levin, P Carioni, V Maheshwari, J G Raimann, F M van der Sande, L A Usvyat, P Kotanko, J P Kooman
BACKGROUND/OBJECTIVES: Hyponatremia is a risk factor for mortality in hemodialysis (HD) patients. It is not well known to which extent the comorbidities, malnutrition, fluid status imbalance and inflammation are related to hyponatremia and affect outcomes. SUBJECTS/METHODS: We studied 8883 patients from the European subset of the international MONitoring Dialysis Outcomes initiative. Nutritional and fluid statuses were assessed by bioimpedance spectroscopy. Fluid depletion was defined as overhydration⩽-1...
July 2016: European Journal of Clinical Nutrition
Maria Ferris, Keisha Gibson, Brett Plattner, Debbie S Gipson, Peter Kotanko, Daniele Marcelli, Cristina Marelli, Michael Etter, Paola Carioni, Gero von Gersdorff, Xiaoqi Xu, Jeroen P Kooman, Qingqing Xiao, Frank M van der Sande, Albert Power, Roberto Picoits-Filho, Lucimary Sylvestre, Katherine Westreich, Len Usvyat
BACKGROUND: The aim of this study was to describe the experience of pediatric and young adult hemodialysis (HD) patients from a global cohort. METHODS: The Pediatric Investigation and Close Collaborative Consortium for Ongoing Life Outcomes for MONitoring Dialysis Outcomes (PICCOLO MONDO) study provided de-identified electronic information of 3244 patients, ages 0-30 years from 2000 to 2012 in four regions: Asia, Europe, North America and South America. The study sample was categorized into pediatric (≤18 years old) and young adult (19-30 years old) groups based on the age at dialysis initiation...
April 2016: Clinical Kidney Journal
Andreja Marn Pernat, Vanja Peršič, Len Usvyat, Lynn Saunders, John Rogus, Franklin W Maddux, Eduardo Lacson, Peter Kotanko
OBJECTIVE: Patients with diabetes are at increased risk of foot ulcers, which may result in limb amputations. While regular foot care prevents ulcerations and amputation in those patients with diabetes not on dialysis, evidence is limited in diabetic hemodialysis patients. We investigated the association between the implementation of a routine foot check program in diabetic incident hemodialysis patients, and major lower limb amputations. METHODS: In 1/2008, monthly intradialytic foot checks were implemented as part of standard clinic care in all Fresenius Medical Care North America hemodialysis facilities...
2016: BMJ Open Diabetes Research & Care
Natalia Borges Bonan, Thiago M Steiner, Viktoriya Kuntsevich, Grazia Maria Virzì, Marina Azevedo, Lia Sumie Nakao, Fellype Carvalho Barreto, Claudio Ronco, Stephan Thijssen, Peter Kotanko, Roberto Pecoits-Filho, Andréa N Moreno-Amaral
BACKGROUND: We tested the effect of uremia on red blood cell (RBC) eryptosis, CD14++/CD16+ monocytes and erythrophagocytosis. DESIGN: RBC and monocytes from chronic kidney disease (CKD) stages 3/4 (P-CKD3/4) or hemodialysis (HD) patients and healthy controls (HCs) cells incubated with sera pools from patients with CKD stages 2/3 (S-CKD2/3) or 4/5 (S-CKD4/5) were evaluated to assess eryptosis, monocyte phenotypes and reactive oxygen species (ROS) by cytometer. Erythrophagocytosis was evaluated by subsequent co-incubation of preincubated HC-monocytes and autologous-RBC...
2016: Blood Purification
Dugan W Maddux, Len A Usvyat, Daniel DeFalco, Peter Kotanko, Jeroen P Kooman, Frank M van der Sande, Franklin W Maddux
BACKGROUND: Pre-dialysis chronic kidney disease (CKD) care impacts dialysis start and incident dialysis outcomes. We describe the use of late stage CKD population data coupled with CKD case management to improve dialysis start. METHODS: The Renal Care Coordinator (RCC) program is a nephrology practice and Fresenius Medical Care North America (FMCNA) partnership involving a case manager resource and data analytics. We studied patients starting dialysis between August 1, 2009 and February 28, 2013 in 9 nephrology practices partnering in the RCC program...
March 2016: Clinical Nephrology
Adrian M Guinsburg, Len A Usvyat, Michael Etter, Xiaoqi Xu, Stephan Thijssen, Daniele Marcelli, Bernard Canaud, Cristina Marelli, Claudia Barth, Yuedong Wang, Paola Carioni, Frank M van der Sande, Peter Kotanko, Jeroen P Kooman
BACKGROUND: Seasonal mortality differences have been reported in US hemodialysis (HD) patients. Here we examine the effect of seasons on mortality, clinical and laboratory parameters on a global scale. METHODS: Databases from the international Monitoring Dialysis Outcomes (MONDO) consortium were queried to identify patients who received in-center HD for at least 1 year. Clinics were stratified by hemisphere and climate zone (tropical or temperate). We recorded mortality and computed averages of pre-dialysis systolic blood pressure (pre-SBP), interdialytic weight gain (IDWG), serum albumin, and log C-reactive protein (CRP)...
2015: BMC Nephrology
J G Raimann, B Canaud, M Etter, J P Kooman, N W Levin, D Marcelli, C Marelli, A Power, N Duncan, F M van der Sande, P Carioni, S Thijssen, X Xu, L A Usvyat, Y Wang, P Kotanko
A recent study from the United Kingdom indicates an association between pre hemodialysis (HD) serum sodium (SNa(+)) and systolic and diastolic blood pressure (SBP and DBP) in chronic HD patients. We extend this analysis to an international cohort of incident HD patients. The Monitoring Dialysis Outcomes initiative encompasses patients from 41 countries. Over 2 years monthly pre-HD SNa(+) levels were used as predictors of pre-HD SBP and DBP in a linear mixed model (LMM) adjusted for age, gender, interdialytic weight gain, diabetes, serum albumin and calcium...
July 2016: Journal of Human Hypertension
Rakesh Malhotra, Daniele Marcelli, Gero von Gersdorff, Aileen Grassmann, Mathias Schaller, Inga Bayh, Laura Scatizzi, Michael Etter, Adrian Guinsburg, Claudia Barth, Cristina Marelli, Paola Carioni, Frank van der Sande, Jeroen P Kooman, Eric Liu, Ted Toffelmire, Yuedong Wang, Stephan Thijssen, Len A Usvyat, Peter Kotanko
BACKGROUND/AIM: The neutrophil-to-lymphocyte ratio (NLR), defined as the neutrophil count divided by lymphocyte count, is an inexpensive and readily available parameter, which may serve as a surrogate for inflammation markers, such as C-reactive protein (CRP). The aim of this study was to determine the utility of NLR in the prediction of elevated CRP levels in hemodialysis (HD) patients. METHODS: We analyzed 43,272 HD patients from 2 distinct cohorts within the Monitoring Dialysis Outcomes research collaboration in whom contemporaneous measurements of neutrophil and lymphocyte counts, serum albumin and CRP levels were available...
2015: Nephron
Natascha J H Broers, Len A Usvyat, Jeroen P Kooman, Frank M van der Sande, Eduardo Lacson, Peter Kotanko, Franklin W Maddux
BACKGROUND/AIM: Physical component summary (PCS) and mental component summary (MCS) scores are associated with hospitalization and mortality in patients with end-stage renal disease. Most studies in these patients are cross-sectional in nature. This study aimed to assess the dynamics of health-related quality of life (HRQOL) over time, as well as determinants of changes in HRQOL. Also, the relation between changes in HRQOL with respect to both hospitalization and mortality was assessed...
2015: Nephron
Alan Hinderliter, Robin L Padilla, Brenda W Gillespie, Nathan W Levin, Peter Kotanko, Margaret Kiser, Fredric Finkelstein, Sanjay Rajagopalan, Rajiv Saran
BACKGROUND: Chronic kidney disease (CKD) is associated with accelerated atherosclerosis and an increased risk of adverse cardiovascular disease (CVD) outcomes. The relationships of intima-media thickness (IMT), a measure of subclinical atherosclerosis, with traditional and nontraditional risk factors and with adverse outcomes in CKD patients are not wellestablished. METHODS: IMT, clinical characteristics, cardiovascular risk factors, and clinical outcomes were measured in 198 subjects from the Renal Research Institute (RRI) CKD study, a four-center prospective cohort of patients with estimated glomerular filtration rate (eGFR)≤50 mL/min/1...
July 2015: Clinical Nephrology
Xia Tao, Stephan Thijssen, Nathan Levin, Peter Kotanko, Garry Handelman
BACKGROUND: Indoxyl sulfate is a protein-bound uremic toxin and its dialytic clearance is comparatively low. We propose a method to increase indoxyl sulfate dialytic clearance. METHODS: Human serum albumin, preloaded with indoxyl sulfate, was circulated on the blood side of an F40S dialyzer with single-pass counter-current dialysate flow. Tryptophan or docosahexaenoic acid (DHA), which are binding competitors to indoxyl sulfate, were infused into the blood-side circuit upstream of the dialyzer, and their abilities to increase the removal of indoxyl sulfate determined...
2015: Blood Purification
Marco Ladino, David Roth
Idiopathic membranous glomerulonephritis (IMGN) is one of the most common causes of nephrotic syndrome in adults. Disease progression is associated with the magnitude and duration of proteinuria [Reichert LJ, Koene RA, Wetzels JF. Prognostic factors in idiopathic membranous nephropathy. Am J Kidney Dis 1998; 31: 1-11]. Membranous nephropathy is also one of the glomerular diseases that is well described to recur in the transplanted kidney [Kotanko P, Pusey CD, Levy JB. Recurrent glomerulonephritis following renal transplantation...
October 2009: NDT Plus
Daniele Marcelli, Len A Usvyat, Peter Kotanko, Inga Bayh, Bernard Canaud, Michael Etter, Emanuele Gatti, Aileen Grassmann, Yuedong Wang, Cristina Marelli, Laura Scatizzi, Andrea Stopper, Frank M van der Sande, Jeroen Kooman
BACKGROUND AND OBJECTIVES: High body mass index appears protective in hemodialysis patients, but uncertainty prevails regarding which components of body composition, fat or lean body mass, are primarily associated with survival. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data between April 2006 and December 2012 were extracted from the Fresenius Medical Care Europe subset of the international MONitoring Dialysis Outcomes initiative. Fresenius Medical Care Europe archives a unique repository of predialysis body composition measurements determined by multifrequency bioimpedance (BCM Body Composition Monitor)...
July 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
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