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Slope and creatinine

Rodrigo Hagemann, Vanessa Dos Santos Silva, Fábio Cardoso Carvalho, Pasqual Barretti, Luis Cuadrado Martin, Diana Vassallo, Philip A Kalra, Roberto Jorge da Silva Franco
BACKGROUND: To date, renal revascularization has not been shown to be advantageous when compared to optimized medical treatment in patients with atheromatous renovascular disease (ARVD). This study aims to investigate the effect of revascularization in patients with pre-intervention worsening renal function and in those with stable renal function. PATIENTS AND METHODS: In this single-centre observational study, patients who were diagnosed with at least 60% angiographic stenosis unilaterally or bilaterally between January 1996 and October 2008 and who were followed-up until February 2011 were retrospectively analysed...
October 21, 2016: Nephron
Hooi Min Lim, Yook Chin Chia, Siew Mooi Ching
OBJECTIVE: We aim to examine the relationship between visit-to-visit systolic blood pressure variability (BPV) and decline in renal function in patients with hypertension and determine the level of systolic BPV that contribute to significant renal function decline. DESIGN AND METHOD: This is a 15-year (1998-2012) retrospective cohort study of 825 hypertensive patients with normal renal function at baseline in a primary care clinic. Three monthly blood pressure readings per year were retrieved from the 15 years of clinic visits...
September 2016: Journal of Hypertension
Jill Buyon, Richard Furie, Chaim Putterman, Rosalind Ramsey-Goldman, Kenneth Kalunian, Derren Barken, John Conklin, Thierry Dervieux
BACKGROUND: The relationship between cell-bound complement activation products (CB-CAPs: EC4d, EC3d), anti-C1q, soluble complement C3/C4 and disease activity in systemic lupus erythematosus (SLE) was evaluated. METHODS: Per protocol, at baseline all SLE subjects enrolled in this longitudinal study presented with active disease and elevated CB-CAPs. At each monthly visit, the non-serological (ns) Safety of Estrogens in Lupus Erythematosus: National Assessment (SELENA-SLEDAI) and the British Isles Lupus Assessment Group (BILAG)-2004 index scores were determined as was a random urinary protein to creatinine ratio (uPCR)...
2016: Lupus Science & Medicine
Piero Ruggenenti, Paolo Cravedi, Antonietta Chianca, MariaRosa Caruso, Giuseppe Remuzzi
BACKGROUND: A multidrug treatment strategy that targets urinary proteins with an angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) up-titrated to the respective maximum tolerated dose combined with intensified blood pressure (BP) control has been found to prevent renal function loss in adults with proteinuric nephropathies. Herein, we investigated the effects of this treatment protocol in the pediatric patient population. METHODS: From May 2002 to September 2014 we included in this observational, longitudinal, cohort study 20 consecutive children with chronic nephropathies and 24-h proteinuria of >200 mg who had received ramipril and losartan up-titrated to the respective maximum approved and tolerated doses [mean (standard deviation) dose:2...
October 4, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
J Shahin, P Ferrando-Vivas, G S Power, S Biswas, S T Webb, K M Rowan, D A Harrison
The models used to predict outcome after adult general critical care may not be applicable to cardiothoracic critical care. Therefore, we analysed data from the Case Mix Programme to identify variables associated with hospital mortality after admission to cardiothoracic critical care units and to develop a risk-prediction model. We derived predictive models for hospital mortality from variables measured in 17,002 patients within 24 h of admission to five cardiothoracic critical care units. The final model included 10 variables: creatinine; white blood count; mean arterial blood pressure; functional dependency; platelet count; arterial pH; age; Glasgow Coma Score; arterial lactate; and route of admission...
September 26, 2016: Anaesthesia
Jan Skupien, James H Warram, Adam M Smiles, Robert C Stanton, Andrzej S Krolewski
OBJECTIVE: The patterns of estimated glomerular filtration rate (eGFR) decline to end-stage renal disease (ESRD) in patients with type 1 diabetes has not been conclusively described. Decline could be linearly progressive to ESRD but with a variable rate. Conversely, decline may be linear but interrupted by periods of plateaus or improvements. RESEARCH DESIGN AND METHODS: This observational study included 364 patients with type 1 diabetes attending Joslin Clinic who developed ESRD between 1991 and 2013...
September 19, 2016: Diabetes Care
Hooi Min Lim, Yook Chin Chia, Siew Mooi Ching
OBJECTIVE: We aim to examine the relationship between visit-to-visit systolic blood pressure variability (BPV) and decline in renal function in patients with hypertension and determine the level of systolic BPV that contribute to significant renal function decline. DESIGN AND METHOD: This is a 15-year (1998-2012) retrospective cohort study of 825 hypertensive patients with normal renal function at baseline in a primary care clinic. Three monthly blood pressure readings per year were retrieved from the 15 years of clinic visits...
September 2016: Journal of Hypertension
Gerald F Giesbrecht, Jiaying Liu, Maede Ejaredar, Deborah Dewey, Nicole Letourneau, Tavis Campbell, Jonathan W Martin
BACKGROUND: Bisphenol A (BPA) is associated with dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity in rodents, but evidence in humans is lacking. OBJECTIVE: To determine whether BPA exposure during pregnancy is associated with dysregulation of the HPA-axis, we examined the association between urinary BPA concentrations and diurnal salivary cortisol in pregnant women. Secondary analyses investigated whether the association between BPA and cortisol was dependent on fetal sex...
September 15, 2016: Environmental Research
Yu Pan, Song Jiang, Dandan Qiu, Jingsong Shi, Minlin Zhou, Yu An, Yongchun Ge, Honglang Xie, Zhihong Liu
AIMS: This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). METHODS: The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥90, 60-90, ≤60ml/min per 1...
November 2016: Journal of Diabetes and its Complications
A Furmańczyk-Zawiska, A Urbanowicz, A Perkowska-Ptasińska, T Bączkowska, A Sadowska, S Nazarewski, A Chmura, M Durlik
BACKGROUND: Antibody-mediated rejection (ABMR) has emerged as the leading cause of renal graft loss. The optimal treatment protocol in ABMR remains unknown. This study aimed to assess the efficacy of intravenous immunoglobulin (IVIG) for treatment of ABMR in renal recipients. METHODS: Thirty-nine ABO-compatible cross-match-negative renal recipients with biopsy-proven ABMR composed the study group. Pulses of methylprednisolone (MP) and appropriate enhancement of net state of immunosuppression were applied in all individuals; 17/39 recipients were administered IVIG (IVIG group); the remaining 22/39 patients, identified to be nonadherent or unsatisfactorily immunosuppressed, were kept on the initial treatment (MP group)...
June 2016: Transplantation Proceedings
David G Warnock, T Clark Powell, Edward D Siew, John P Donnelly, Henry E Wang, Ravindra L Mehta
BACKGROUND: Patterns of acute kidney injury (AKI) can be distinguished by the rate of changes in the serum creation concentrations during hospitalizations. We hypothesized that the timing and values of minimum and maximum serum creatinine (sCr) could be used to distinguish between transient hospital-associated AKI (THA-AKI) and hospital-acquired AKI (HA-AKI). MATERIALS AND METHODS: We evaluated adults admitted to 2 regionally distinct academic medical centers. Peak sCr during the hospitalization was used to define AKI, using absolute changes and timing from the minimum sCr...
July 26, 2016: Nephron
Miguel Silva-Ramos, Isabel Silva, José Carlos Oliveira, Paulo Correia-de-Sá
BACKGROUND: Diagnosis of bladder outflow obstruction (BOO) in patients with lower urinary tract (LUT) symptoms is challenging without using invasive urodynamic tests. Recently, we showed in vitro that urothelial strips from patients with benign prostatic hyperplasia (BPH) release more ATP than controls. Here, we tested whether urinary ATP can be used as a wall tension transducer non-invasive biomarker to detect BOO in patients with BPH. METHODS: 79 male patients with BOO and 22 asymptomatic controls were recruited prospectively...
November 2016: Prostate
Henri Merdjan, Antoine Tarral, Shampa Das, Jianguo Li
Avibactam is a non-β-lactam β-lactamase inhibitor intended for use as a fixed-dose combination with ceftazidime for the treatment of certain serious Gram-negative infections. As avibactam is primarily excreted unchanged in the urine, renal impairment may affect its pharmacokinetics. This Phase 1 study investigated the effect of renal impairment and hemodialysis on avibactam pharmacokinetics and safety. Healthy controls and subjects with increasing degrees of renal impairment received a single 30-minute IV-infusion of avibactam (100 mg)...
July 12, 2016: Journal of Clinical Pharmacology
A Bodson, P Meunier, J-M Krzesinski, F Jouret
Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease characterised by the progressive development of multiple and bilateral cysts in kidneys and other organs. Most patients with ADPKD will develop, sooner or later, end-stage renal disease (ESRD). The morbidity and mortality associated with ESRD prompt physicians to identify early ADPKD patients considered as "rapid progressors", who have the greatest risk to rapidly develop ESRD. The rate of progression can be assessed by clinical--especially with the "predicting renal outcome in polycystic kidney disease score" (PROPKD-Score)-, biological (a decline of the glomerular filtration rate (GFR) of 4...
April 2016: Revue Médicale de Liège
Tabo Sikaneta, George Wu, Mohamed Abdolell, Anita Ng, Sara Mahdavi, Anton Svendrovski, Tony Tu, Trish Mercer, Matthew Tong, Dimitrios Oreopoulos, Paul Tam
UNLABELLED:BACKGROUND AND OBJECTIVE: Residual renal function (RRF) correlates with mortality and morbidity rates in patients receiving peritoneal dialysis (PD). We examined the effect of a biocompatible PD solution (Gambrosol Trio; Gambro Lundia AB, Lund, Sweden) with lower concentrations of glucose degradation products on rates of decline in RRF. ♦ DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Incident patients at 2 centers in Canada and 1 in Hong Kong were randomized (by minimization) in an open-label parallel group trial to receive Gambrosol Trio or standard PD solution (Dianeal; Baxter Healthcare, Mississauga, Canada) for 2 years...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Stéphanie Ragot, Pierre-Jean Saulnier, Gilberto Velho, Elise Gand, Astrid de Hauteclocque, Yousri Slaoui, Louis Potier, Philippe Sosner, Jean-Michel Halimi, Philippe Zaoui, Vincent Rigalleau, Frederic Fumeron, Ronan Roussel, Michel Marre, Samy Hadjadj
OBJECTIVE: The pattern of renal function decline prior to cardiovascular (CV) events in type 2 diabetes is not well known. Our aim was to describe the association between renal function trajectories and the occurrence of a CV event. RESEARCH DESIGN AND METHODS: We considered patients with type 2 diabetes from the SURDIAGENE (Survie, Diabete de type 2 et Genetique) study (discovery cohort) and the DIABHYCAR (Non-Insulin-Dependent Diabetes, Hypertension, Microalbuminuria or Proteinuria, Cardiovascular Events, and Ramipril) study (replication cohort)...
July 2016: Diabetes Care
Martina Zaninotto, Giorgia Miolo, Adriano Guiotto, Silvia Marton, Mario Plebani
BACKGROUND: The quality performance and the comparability between results of pharmacies point-of-care-testing (POCT) and institutional laboratories have been evaluated. METHODS: Eight pharmacies participated in the project: a capillary specimen collected by the pharmacist and, simultaneously, a lithium-heparin sample drawn by a physician of laboratory medicine for the pharmacy customers (n=106) were analyzed in the pharmacy and in the laboratory, respectively. Glucose, cholesterol, HDL-cholesterol, triglycerides, creatinine, uric acid, aspartate aminotransferase, alanine aminotransferase, were measured using: Reflotron, n=5; Samsung, n=1; Cardiocheck PA, n=1; Cholestech LDX, n=1 and Cobas 8000...
May 19, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Carlos E Palant, Lakhmir S Chawla, Charles Faselis, Ping Li, Thomas L Pallone, Paul L Kimmel, Richard L Amdur
Patients with chronic kidney disease (CKD) may have nonlinear serum creatinine concentration (SC) trajectories, especially as CKD progresses. Variability in SC is associated with renal failure and death. However, present methods for measuring SC variability are unsatisfactory because they blend information about SC slope and variance. We propose an improved method for defining and calculating a patient's SC slope and variance so that they are mathematically distinct, and we test these methods in a large sample of US veterans, examining the correlation of SC slope and SC nonlinearity (SCNL) and the association of SCNL with time to stage 4 CKD (CKD4) and death...
August 1, 2016: American Journal of Physiology. Renal Physiology
Elena Z Golukhova, Olga Gromova, Marina Grigoryan, Vadim Merzlyakov, Konstantin Shumkov, Leo Bockeria, Victor L Serebruany
BACKGROUND: Prediction and potential prevention of sudden cardiac death (SCD) due to malignant ventricular arrhythmia (MVA) represent an obvious unmet medical need. We estimated the prognostic relevance of numerous biomarkers associated with future MVA development in patients with coronary artery disease (CAD) over 2 years of follow-up. METHODS: Patients with stable documented CAD (n = 97) with a mean age of 61 ± 10 years were prospectively enrolled in a single-center observational cohort study...
2016: Cardiology
Helle Linnebjerg, Siak Leng Choi, Eric Chen Quin Lam, Kenneth F Mace, Teri S Hodgson, Vikram P Sinha
The pharmacokinetics of LY2605541 (basal insulin peglispro), a novel long-acting basal insulin analogue, was evaluated in 5 groups of subjects with varying degrees of renal function based on creatinine clearance: normal renal function (>80 mL/min), mild renal impairment (51-80 mL/min), moderate renal impairment (30-50 mL/min), severe renal impairment (<30 mL/min), or end-stage renal disease (ESRD) requiring hemodialysis. Serial blood samples for pharmacokinetic analyses were collected up to 12 days following a single 0...
May 2016: Clinical Pharmacology in Drug Development
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