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Kotanko P

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
Sang-Woong Han, Anca Tilea, Brenda W Gillespie, Fredric O Finkelstein, Margaret A Kiser, George Eisele, Peter Kotanko, Nathan Levin, Rajiv Saran
BACKGROUND: Chronic kidney disease (CKD) patients are prone to both hypo- and hypernatremia. Little has been published on the epidemiology of hypo- and hypernatremia in ambulatory patients with non-dialysis CKD. METHODS: Data collected in two contemporaneous CKD cohort studies, the Renal Research Institute (RRI)-CKD study (n = 834) and the Study of Treatment of Renal Insufficiency: Data and Evaluation (STRIDE) (n = 1,348) were combined and analyzed to study the association between serum sodium (Na(+)) and clinical outcomes...
2015: American Journal of Nephrology
Laura Rosales, Stephan Thijssen, Anja Kruse, Murat Hairy Sipahioglu, Padam Hirachan, Jochen G Raimann, Viktoriya Kuntsevich, Mary Carter, Nathan W Levin, Peter Kotanko
Inflammation is common and associated with morbidity and mortality in hemodialysis (HD) patients. Exposure to endotoxin contained in the dialysate may trigger inflammation. Dialysate volume is substantially reduced in sorbent HD compared with standard single-pass dialysis. In this prospective study (, number: NCT00788905), we compared the inflammatory response to single-pass and sorbent HD. Patients receiving single-pass HD were studied during 1 week of sorbent HD (Allient system; Renal Solutions, Warrendale, PA) and 1 week of single-pass HD...
July 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Natascha J H Broers, Len A Usvyat, Daniele Marcelli, Inga Bayh, Laura Scatizzi, Bernard Canaud, Frank M van der Sande, Peter Kotanko, Ulrich Moissl, Jeroen P Kooman
BACKGROUND: Seasonal variations in blood pressure (BP) and inter-dialytic weight gain (IDWG) are well established in dialysis patients. However, no study has assessed changes in body composition (BC) in this population. METHODS: In this survey, seasonal variations in fat mass (FM), lean tissue mass (LTM), extracellular water (ECW) and fluid overload (FO) were assessed in 42 099 dialysis patients (mean age 61.2 years, 58% males) from the Fresenius Medical Care Europe database, as part of the MONitoring Dialysis Outcomes (MONDO) consortium, in relation to other nutritional parameters, IDWG and BP...
April 2015: Nephrology, Dialysis, Transplantation
Viviane Calice-Silva, Marcos A Vieira, Jochen G Raimann, Mary Carter, John Callegari, Nathan W Levin, Peter Kotanko, Roberto Pecoits-Filho
BACKGROUND AND AIMS: Measurement of saliva urea nitrogen (SUN) may be valuable in the screening of kidney failure. Here we evaluate the diagnostic performance of SUN dipsticks in patients with acute kidney injury (AKI). MATERIAL AND METHODS: We measured SUN and blood urea nitrogen (BUN) in hospitalized patients diagnosed with AKI based on Acute Kidney Injury Network (AKIN)-criteria. After collection, saliva was transferred to a colorimetric SUN dipstick. We then compared the resultant test-pad color to six standardized color fields indicating SUN of 5 - 14 (#1), 15 - 24 (#2), 25 - 34 (#3), 35 - 54 (#4), 55 - 74 (#5), and ≥ 75 (#6) mg/dL, respectively...
December 2014: Clinical Nephrology
Jeroen P Kooman, Peter Kotanko, Annemie M W J Schols, Paul G Shiels, Peter Stenvinkel
Chronic kidney disease (CKD) shares many phenotypic similarities with other chronic diseases, including heart failure, chronic obstructive pulmonary disease, HIV infection and rheumatoid arthritis. The most apparent similarity is premature ageing, involving accelerated vascular disease and muscle wasting. We propose that in addition to a sedentary lifestyle and psychosocial and socioeconomic determinants, four major disease-induced mechanisms underlie premature ageing in CKD: an increase in allostatic load, activation of the 'stress resistance response', activation of age-promoting mechanisms and impairment of anti-ageing pathways...
December 2014: Nature Reviews. Nephrology
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