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Creatinine and esrd

Debmalya Sanyal, Sudip Chatterjee
Introduction: It is generally accepted that renal and eye changes in diabetes are concordant. There are however a fair number of patients with diabetes who have end-stage renal disease (ESRD) without any of the typical eye changes. The present study highlights the discordance between retinopathy and nephropathy and describes a series of patients of long-standing diabetes undergoing renal transplant who had little or no evidence of retinopathy. Methods: All patients with ESRD undergoing renal transplants underwent comprehensive fundus evaluation including dilated indirect ophthalmoscopy, slit lamp biomicroscopy, and fundus photography...
March 2018: Indian Journal of Endocrinology and Metabolism
Katherine R Tuttle, Mark C Lakshmanan, Brian Rayner, Robert S Busch, Alan G Zimmermann, D Bradley Woodward, Fady T Botros
BACKGROUND: Many antihyperglycaemic drugs, including insulin, are primarily cleared by the kidneys, restricting treatment options for patients with kidney disease. Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist that is not cleared by the kidneys, and confers a lower risk of hypoglycaemia than does insulin. We assessed the efficacy and safety of dulaglutide in patients with type 2 diabetes and moderate-to-severe chronic kidney disease. METHODS: AWARD-7 was a multicentre, open-label trial done at 99 sites in nine countries...
June 14, 2018: Lancet Diabetes & Endocrinology
Zhaoli Gao, Guangyi Liu, Zhao Hu, Weiwei Shi, Binbin Chen, Peimei Zou, Xianhua Li
Diabetic nephropathy (DN) is by far the most common cause of end‑stage renal disease (ESRD) in industrial countries, accounting for ~45% of all new ESRD cases in the United States. Grape seed proanthocyanidin extracts (GSPE) are powerful antioxidants, with an antioxidant ability 50‑fold greater than that of vitamin E and 20‑fold greater than that of vitamin C. The present study investigated whether GSPE can protect against streptozotocin (STZ)‑induced DN and aimed to elucidate a possible mechanism...
June 6, 2018: Molecular Medicine Reports
Fabio Angeli, Giorgio Gentile, Monica Trapasso, Paolo Verdecchia, Gianpaolo Reboldi
Hypertension is a key risk factor for chronic kidney disease (CKD), but can also be a detrimental consequence of established CKD. Unsurprisingly, the majority of subjects with abnormal creatinine in the general population are also hypertensive, with a huge toll on national health care systems worldwide due to a staggering increase in the risk of cardiovascular complications and end-stage renal disease requiring renal replacement therapy. In this setting, a comprehensive and careful assessment of the whole 24-h blood pressure (BP) profile could be of paramount importance in ensuring a timely diagnosis of hypertension and an optimal therapeutic control...
June 13, 2018: Journal of Human Hypertension
Alaleh Gheissari, Rokhsareh Meamar, Amin Abedini, Peyman Roomizadeh, Mohammad Shafiei, Zahra Samaninobandegani, Zhale Tabrizi, Farhad Mahmoudi, Alireza Merrikhi, Esfandiar Najafi Tavana
INTRODUCTION: Cardiovascular disease (CVD) is the main cause of death in children with end-stage renal disease (ESRD). Matrix metalloproteinases (MMP-2 and MMP-9) are members of endopeptidases which contribute to CVD. The aim of this study was to evaluate the association of MMP-2 and MMP-9 with markers of endothelial dysfunction, soluble E-selectin and brachial flow-mediated dilatation; several biochemical risk factors of CVD; and thrombotic incidents in children with ESRD. MATERIALS AND METHODS: Thirty-one children with ESRD and 18 healthy age- and sex-adjusted controls underwent measurement of serum levels of MMP-2, MMP-9, soluble E-selectin, phosphorus, calcium, parathyroid hormone, lipid profile, thrombotic factors, and albumin...
May 2018: Iranian Journal of Kidney Diseases
Tony Lu, Stephanie G Yi, Jean Bismuth, Richard J Knight, A Osama Gaber, Carlos F Bechara
Renal transplantation remains the definitive treatment for end stage renal disease (ESRD). The shorter renal vein in right donor nephrectomies is associated with higher incidence of technical failure. We present here our experience with autologous internal jugular vein (IJV) conduits to facilitate living-donor transplants. Six patients underwent right, living-donor kidney transplant with simultaneous IJV harvest over a one year period. All had bilateral jugular duplex scans preoperatively, and were placed on aspirin 81 mg postoperatively...
June 11, 2018: Clinical Transplantation
Anmao Li, Junya Mu, Mingxia Huang, Zengjun Zhang, Jixin Liu, Ming Zhang
Depression and cognitive control deficits were frequently reported in concurrent end-stage renal disease (ESRD) patients. Neuroimaging studies indicated depression could be a risk factor for cognitive control deficits, and amygdala-related circuitry may play a critical role in this abnormal interaction. To investigate the potential relationship between depressive symptoms and cognitive control reduction in ESRD patients, T1-weighted and resting fMRI images were obtained in 29 ESRD patients and 29 healthy controls...
June 4, 2018: Metabolic Brain Disease
Min Pan, QiongXiu Zhou, ShuBei Zheng, XiaoHan You, Duo Li, Ji Zhang, ChaoSheng Chen, FeiFei Xu, ZhanYuan Li, ZhiHong Zhou, JianNa Zhang
IgA nephropathy (IgAN) is an autoimmune disease associated with complement activation. It is unclear whether the ratio of serum C3 and C4 concentrations (C3/C4 ratio) can predict renal outcomes in IgAN patients. A total of 1503 patients diagnosed with IgAN via renal biopsy were recorded in this study. Poor renal outcomes were defined as > 50% decrease in the baseline estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD) during follow-up. In total, 712 patients meeting the exclusion/inclusion criteria were selected, and the mean follow-up period was 40...
May 30, 2018: Immunologic Research
Qiang Xiao, Jinlong Li, Kai Zhou, Tingxian Ling, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
Objective: To evaluate the safety and efficacy of total hip arthroplasty (THA) in patients with end stage renal disease (ESRD). Methods: Between December 2009 and May 2016, 30 THAs were performed in 28 patients with dialysis-dependent renal failure (18 patients) or renal transplantation (10 patients). A retrospective case control study was carried out to compare these 28 ESRD patients (ESRD group) with a matched cohort of 28 nonrenal patients (control group). There was no significant difference in gender, age, hip side, American Society of Anesthesiology (ASA) classification, comorbidities, and preoperative Harris score and hemoglobin (Hb) level between 2 groups ( P >0...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Aviya Lanis, Eric Kerns, Susie L Hu, Margaret H Bublitz, Patricia Risica, Susan Martin, Jeffrey Parker, Richard Millman, Lance D Dworkin, Ghada Bourjeily
PURPOSE: Obstructive sleep apnea is common in patients with end-stage renal disease, and there is increasing evidence that clinical factors specific to end-stage renal disease contribute pathophysiologically to obstructive sleep apnea. It is not known whether circumstances specific to dialysis modality, in this case peritoneal dialysis, affect obstructive sleep apnea. Our study aimed to investigate the prevalence of obstructive sleep apnea in the peritoneal dialysis population and the relevance of dialysis-specific measures and kidney function in assessing this bidirectional relationship...
May 26, 2018: Lung
Sixiu Liu, Shanshan Liang, Hua Liu, Lei Chen, Lingshuang Sun, Meng Wei, Hongli Jiang, Jing Wang
BACKGROUND/AIMS: Recently, the colon has been recognized as an important source of various uremic toxins in patients with end stage renal disease. Medicinal charcoal tablets are an oral adsorbent that are widely used in patients with chronic kidney disease in China to remove creatinine and urea from the colon. A parallel fecal and serum metabolomics study was performed to determine comprehensive metabolic profiles of patients receiving hemodialysis (HD). The effects of medicinal charcoal tablets on the fecal and serum metabolomes of HD patients were also investigated...
May 22, 2018: Kidney & Blood Pressure Research
Mingyan Zhang, Zhibin Yan, Lili Bu, Chunmei An, Dan Wang, Xin Liu, Jianfeng Zhang, Wenle Yang, Bochuan Deng, Junqiu Xie, Bangzhi Zhang
Introduction: Kidney fibrosis is the main pathologic change in diabetic nephropathy (DN), which is the major cause of end-stage renal disease. Current therapeutic strategies slow down but cannot reverse the progression of renal dysfunction in DN. Plant-derived bioactive peptides in foodstuffs are widely used in many fields because of their potential pharmaceutical and nutraceutical benefits. However, this type of peptide has not yet been studied in renal fibrosis of DN. Previous studies have indicated that the peptide YWDHNNPQIR (named RAP), a natural peptide derived from rapeseed protein, has an antioxidative stress effect...
2018: Drug Design, Development and Therapy
Kanran Wang, Jinbo Hu, Ting Luo, Yue Wang, Shumin Yang, Hua Qing, Qingfeng Cheng, Qifu Li
BACKGROUND/AIMS: Whether angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) could benefit patients with diabetes and albuminuria remains controversial. A systematic review and meta-analysis were conducted to answer this question by comparing ACE inhibitors or ARB with placebo among these patients. METHODS: In this meta-analysis, electronic data sources (Medline, the Cochrane Collaboration, and EMBASE) were searched. Randomized controlled trials (RCTs) comparing ACE inhibitors or ARB with placebo in subjects with diabetes and albuminuria (defined as urinary albumin-to-creatinine ratio, UACR≥30mg/g Cr) were included...
May 22, 2018: Kidney & Blood Pressure Research
Masayuki Yamanouchi, Junichi Hoshino, Yoshifumi Ubara, Kenmei Takaichi, Keiichi Kinowaki, Takeshi Fujii, Kenichi Ohashi, Koki Mise, Tadashi Toyama, Akinori Hara, Miho Shimizu, Kengo Furuichi, Takashi Wada
Background: Biopsy-based studies on nephrosclerosis are lacking and the clinicopathological predictors for progression of chronic kidney disease (CKD) are not well established. Methods: We retrospectively assessed 401 patients with biopsy-proven nephrosclerosis in Japan. Progression of CKD was defined as new-onset end-stage renal disease, decrease of estimated glomerular filtration rate (eGFR) by  ≥50% or doubling of serum creatinine, and the sub-distribution hazard ratio (SHR) with 95% confidence interval (CI) for CKD progression was determined for various clinical and histological characteristics in competing risks analysis...
May 19, 2018: Nephrology, Dialysis, Transplantation
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
Wonsun Hwang, Mi Sook Cho, Ji Eun Oh, Ji Hyun Lee, Jong Cheol Jeong, Gyu-Tae Shin, Heungsoo Kim, Inwhee Park
INTRODUCTION: Malnutrition is prevalent in hemodialysis (HD) patients, and the risk of mortality is strongly correlated with malnutrition. Current methods of nutritional evaluation are mostly subjective, time-consuming, and cumbersome. Creatinine index (CI) and geriatric nutritional risk index (GNRI) are very simple and objective methods to assess the nutritional status of HD patients. The present study compares the performance of CI and GNRI as nutritional risk assessment tools. METHODS: Eighty-eight patients with end-stage renal disease on HD were recruited from a single tertiary center...
May 18, 2018: Hemodialysis International
Jeung-Min Park, Jong-Hak Lee, Hye Min Jang, Yeongwoo Park, Yon Su Kim, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Eugene Kwon, Hyun-Ji Kim, Ji-Eun Lee, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Jang-Hee Cho, Yong-Lim Kim
BACKGROUND: The association of a higher body mass index (BMI) with better survival is a well-known "obesity paradox" in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of gender on the obesity-mortality relationship in Korean patients on HD. METHODS: This study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970)...
2018: PloS One
Shiho Ishizuka, Shinya Sakata, Chieko Yoshida, Akira Takaki, Sho Saeki, Kazuyoshi Nakamura, Kazuhiko Fujii
We report a 66-year-old Japanese male with end-stage renal disease (ESRD) and advanced non-small cell lung cancer (NSCLC) who was on hemodialysis. The patient harbored high programmed death ligand 1 (PD-L1) expression and was successfully treated with pembrolizumab. Laboratory examination upon diagnosis showed elevated serum creatinine (6.58 mg/dL). We administered pembrolizumab (200 mg/body) and repeated every 3 weeks. His renal dysfunction gradually progressed, hemodialysis was initiated after eight courses of pembrolizumab, and the antitumor effect was maintained at five months after hemodialysis initiation...
May 10, 2018: Respiratory Investigation
B Obrișcă, R Jurubiță, A Andronesi, B Sorohan, C Achim, R Bobeica, M Gherghiceanu, E Mandache, G Ismail
Introduction Lupus nephritis (LN) affects nearly 60% of patients with systemic lupus erythematosus and up to 30% of them will progress to end-stage renal disease (ESRD), despite receiving aggressive immunosuppressive therapy. The prognostic value of ISN/RPS classification is controversial. Therefore, we aimed to identify clinical and pathological predictors of outcome in LN patients independent of this classification. Material and methods Thirty-seven patients with LN who underwent percutaneous kidney biopsy between 1997 and 2016 were included in this study...
January 1, 2018: Lupus
Teng-Hung Yu, Wei-Hua Tang, Yung-Chuan Lu, Chao-Ping Wang, Wei-Chin Hung, Cheng-Ching Wu, I-Ting Tsai, Fu-Mei Chung, Jer-Yiing Houng, Wen-Chun Lan, Yau-Jiunn Lee
BACKGROUND: Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end-stage renal disease. Hippuric acid (HA), a harmful uremic toxin, is known to be elevated in patients with uremia, and serum HA levels are associated with neurological symptoms, metabolic acidosis, and accelerated renal damage associated with chronic kidney disease. However, the pathophysiological role of HA in patients with uremia remains unclear. We investigated the association between serum HA levels and echocardiographic measurements in patients undergoing hemodialysis (HD) treatment...
May 11, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
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