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eGFR and slope

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
Afshin Parsa, Peter A Kanetsky, Rui Xiao, Jayanta Gupta, Nandita Mitra, Sophie Limou, Dawei Xie, Huichun Xu, Amanda Hyre Anderson, Akinlolu Ojo, John W Kusek, Claudia M Lora, L Lee Hamm, Jiang He, Niina Sandholm, Janina Jeff, Dominic E Raj, Carsten A Böger, Erwin Bottinger, Shabnam Salimi, Rulan S Parekh, Sharon G Adler, Carl D Langefeld, Donald W Bowden, Per-Henrik Groop, Carol Forsblom, Barry I Freedman, Michael Lipkowitz, Caroline S Fox, Cheryl A Winkler, Harold I Feldman
The rate of decline of renal function varies significantly among individuals with CKD. To understand better the contribution of genetics to CKD progression, we performed a genome-wide association study among participants in the Chronic Renal Insufficiency Cohort Study. Our outcome of interest was CKD progression measured as change in eGFR over time among 1331 blacks and 1476 whites with CKD. We stratified all analyses by race and subsequently, diabetes status. Single-nucleotide polymorphisms (SNPs) that surpassed a significance threshold of P<1×10(-6) for association with eGFR slope were selected as candidates for follow-up and secondarily tested for association with proteinuria and time to ESRD...
October 11, 2016: Journal of the American Society of Nephrology: JASN
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
M Okuno, E Hatano, H Nishino, S Seo, K Taura, S Uemoto
PURPOSE: This study aimed to evaluate whether the response rate of chemotherapy with molecular target agents correlates with the conversion rate, R0 resection rate, and survival in patients with initially unresectable colorectal liver metastases (CRLM). METHODS: We reviewed the literature of prospective, controlled trials of systemic chemotherapy for patients with unresectable liver-only CRLM, including resectable extrahepatic metastases. Pearson's correlation coefficients were calculated...
August 31, 2016: European Journal of Surgical Oncology
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
M Hassanain, E Simoneau, S A Doi, M-J Hebert, P Metrakos, J Tchervenkov
BACKGROUND: The impact of renal function recovery on graft survival was examined using estimated glomerular filtration rate (eGFR) slope after kidney transplantation (GAP classification); this was compared to the conventional classification of immediate graft function (IGF), slow graft function (SGF), and delayed graft function (DGF). MATERIALS AND METHODS: Overall, 541 cases of cadaveric renal transplants were reviewed from a prospective transplant database. eGFR and its slope were measured using the harmonic mean over the first week post-transplantation...
July 2016: Transplantation Proceedings
Rosanna Coppo, Danilo Lofaro, Roberta R Camilla, Shubha Bellur, Daniel Cattran, H Terence Cook, Ian S D Roberts, Licia Peruzzi, Alessandro Amore, Francesco Emma, Laura Fuiano, Ulla Berg, Rezan Topaloglu, Yelda Bilginer, Loreto Gesualdo, Rosaria Polci, Malgorzata Mizerska-Wasiak, Yasar Caliskan, Sigrid Lundberg, Giovanni Cancarini, Colin Geddes, Jack Wetzels, Andrzej Wiecek, Magdalena Durlik, Stefano Cusinato, Cristiana Rollino, Milena Maggio, Manuel Praga, Hilde K Smerud, Vladimir Tesar, Dita Maixnerova, Jonathan Barratt, Teresa Papalia, Renzo Bonofiglio, Gianna Mazzucco, Costantinos Giannakakis, Magnus Soderberg, Diclehan Orhan, Anna Maria Di Palma, Jadwiga Maldyk, Yasemin Ozluk, Birgitta Sudelin, Regina Tardanico, David Kipgen, Eric Steenbergen, Henryk Karkoszka, Agnieszka Perkowska-Ptasinska, Franco Ferrario, Eduardo Gutierrez, Eva Honsova
BACKGROUND: There is a need for early identification of children with immunoglobulin A nephropathy (IgAN) at risk of progression of kidney disease. METHODS: Data on 261 young patients [age <23 years; mean follow-up of 4.9 (range 2.5-8.1) years] enrolled in VALIGA, a study designed to validate the Oxford Classification of IgAN, were assessed. Renal biopsies were scored for the presence of mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis (T1-2) (MEST score) and crescents (C1)...
August 25, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
B Milani, A Ansaloni, S Sousa-Guimaraes, M Piskunowicz, B Vogt, M Stuber, M Burnier, M Pruijm
OBJECTIVE: The determination of renal tissue oxygenation by BOLD-MRI in chronic kidney disease (CKD) patients has given heterogeneous results, possibly due to the lack of a widely accepted procedure to analyze the R2* maps. We present a new technique for the analysis of renal BOLD-MRI called the twelve-layer concentric objects method (TLCO). We measured its reproducibility and assessed whether differences in the intra-renal distribution of R2* as a measure of oxygenation were detected between CKD patients and controls...
September 2016: Journal of Hypertension
Jinghua Wang, Peng Xie, Jian-Min Huang, Yan Qu, Fang Zhang, Ling-Ge Wei, Peng Fu, Xiao-Jie Huang
OBJECTIVE: To verify whether the new Asian modified CKD-EPI equation improved the performance of original one in determining GFR in Chinese patients with CKD. METHOD: A well-designed paired cohort was set up. Measured GFR (mGFR) was the result of (99m)Tc-diethylene triamine pentaacetic acid ((99m)Tc-DTPA) dual plasma sample clearance method. The estimated GFR (eGFR) was the result of the CKD-EPI equation (eGFR1) and the new Asian modified CKD-EPI equation (eGFR2)...
August 3, 2016: International Urology and Nephrology
Jian-Jun Liu, Sylvia Liu, Melvin D S Wong, Resham Lal Gurung, Su Chi Lim
CONTEXT: A recent study suggested that urinary haptoglobin may be a novel biomarker to improve predictive performance of albuminuria in type 2 diabetes mellitus (T2DM). However, the finding has not been externally validated. OBJECTIVE: The objective of the study was to evaluate whether urinary haptoglobin improves predictive performance of albuminuria in Asian T2DM with an estimated glomerular filtration rate (eGFR) of 30 mL/min per 1.73 m(2) or greater. DESIGN AND PARTICIPANTS: This was a prospective study with 269 T2DM nonprogressors (eGFR changes 0...
October 2016: Journal of Clinical Endocrinology and Metabolism
Alexander Zemchenkov, Irina N Konakova
BACKGROUND: Renal replacement therapy (RRT) is growing by 10 % per year in Russia, but pre-dialysis care which can retard CKD progression and delay the start of RRT remains limited. We evaluate the effect of Essential Amino Acids and Keto-analogues (EAA/KA) on CKD progression. METHODS: The effect of low protein diet (LPD), supplemented by EAA/KA, on GFR slope changes between first and second treatment period (five sequential visits per period) in 96 patients withs CKD Stage 3B-5 was compared to GFR slope changes in the control group of 96 patients, randomly selected from matched (by gender, age, diagnosis and CKD Stage) cohort of 320 patients from the city Registry...
2016: BMC Nephrology
Nicola Gianotti, Laura Galli, Andrea Poli, Stefania Salpietro, Silvia Nozza, Alessia Carbone, Marco Merli, Marco Ripa, Adriano Lazzarin, Antonella Castagna
The aim of the study was to evaluate in human immunodeficiency virus (HIV)-infected patients estimated glomerular filtration rate (eGFR) trajectories during treatment with different protease inhibitors (PIs) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus tenofovir (TDF) or abacavir (ABC) and lamivudine or emtricitabine (xTC).Retrospective study of patients followed at a single clinical center; all patients who started TDF or ABC for the first time with a NNRTI or lopinavir/r (LPV/r) or atazanavir/r (ATV/r) or darunavir/r (DRV/r), for whom at least 1 eGFR value before the start and during the studied treatment was known, were included in this analysis...
May 2016: Medicine (Baltimore)
Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Vanessa A Ravel, Melissa Soohoo, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Prior studies have suggested that arteriovenous fistula (AVF) or graft (AVG) creation may be associated with slowing of estimated glomerular filtration rate (eGFR) decline. It is unclear if this is attributable to the physiological benefits of a mature access on systemic circulation versus confounding factors. METHODS: We examined a nationwide cohort of 3026 US veterans with advanced chronic kidney disease (CKD) transitioning to dialysis between 2007 and 2011 who had a pre-dialysis AVF/AVG and had at least three outpatient eGFR measurements both before and after AVF/AVG creation...
May 30, 2016: Nephrology, Dialysis, Transplantation
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
Eugene P Rhee, Clary B Clish, Julia Wenger, Jason Roy, Sammy Elmariah, Kerry A Pierce, Kevin Bullock, Amanda H Anderson, Robert E Gerszten, Harold I Feldman
BACKGROUND: Whereas several longitudinal metabolomics studies have been conducted in individuals with normal estimated glomerular filtration rate (eGFR) at baseline, disease progression among individuals with established chronic kidney disease (CKD) has not been rigorously examined. METHODS: We performed a nested case-control study of rapid CKD progression in the Chronic Renal Insufficiency Cohort Study, profiling baseline plasma from 200 individuals each with eGFR slope <-3 ml/min/1...
2016: American Journal of Nephrology
Michael J Fischer, Jesse Y Hsu, Claudia M Lora, Ana C Ricardo, Amanda H Anderson, Lydia Bazzano, Magdalena M Cuevas, Chi-Yuan Hsu, John W Kusek, Amada Renteria, Akinlolu O Ojo, Dominic S Raj, Sylvia E Rosas, Qiang Pan, Kristine Yaffe, Alan S Go, James P Lash
Although recommended approaches to CKD management are achieved less often in Hispanics than in non-Hispanics, whether long-term outcomes differ between these groups is unclear. In a prospective longitudinal analysis of participants enrolled into the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies, we used Cox proportional hazards models to determine the association between race/ethnicity, CKD progression (50% eGFR loss or incident ESRD), incident ESRD, and all-cause mortality, and linear mixed-effects models to assess differences in eGFR slope...
May 5, 2016: Journal of the American Society of Nephrology: JASN
M Chatterjee, D C Turner, E Felip, H Lena, F Cappuzzo, L Horn, E B Garon, R Hui, H-T Arkenau, M A Gubens, M D Hellmann, D Dong, C Li, K Mayawala, T Freshwater, M Ahamadi, J Stone, G M Lubiniecki, J Zhang, E Im, D P De Alwis, A G Kondic, Ø Fløtten
BACKGROUND: In the phase I KEYNOTE-001 study, pembrolizumab demonstrated durable antitumor activity in patients with advanced non-small-cell lung cancer (NSCLC). We sought to characterize the relationship between pembrolizumab dose, exposure, and response to define an effective dose for these patients. PATIENTS AND METHODS: Patients received pembrolizumab 2 mg/kg every 3 weeks (Q3W) (n = 55), 10 mg/kg Q3W (n = 238), or 10 mg/kg Q2W (n = 156). Response (RECIST v1...
July 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Vanessa Ravel, Seyed-Foad Ahmadi, Elani Streja, Jonathan A Sosnov, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Joline L T Chen
BACKGROUND: Chronic pain is a common condition in the general population. However, large epidemiologic studies examining the role of pain in the deterioration of kidney function, development of chronic kidney disease, and risk for death are lacking. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: A nationally representative cohort of 2,360,056 US veterans with baseline estimated glomerular filtration rates (eGFRs) ≥ 60mL/min/1...
August 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jung-ho Shin, Jung Eun Lee, Ji Hyeon Park, Sharon Lim, Hye Ryoun Jang, Ghee Young Kwon, Wooseong Huh, Sin-Ho Jung, Yoon-Goo Kim, Ha Young Oh, Dae Joong Kim
BACKGROUND: IgA nephropathy (IgAN) is not always benign, and some patients at high risk of end-stage renal disease (ESRD) experience a rapid decline in renal function. This study retrospectively examined the beneficial effects of cytotoxic therapy. METHODS: We identified 102 patients with progressive IgAN despite optimal conservative management. Of these, 31 who received cytotoxic therapy and 55 who were managed conservatively were included. RESULTS: Median eGFR and urinary protein-to-creatinine ratio (uPCR) at baseline did not differ between the groups (p = 0...
2016: Annals of Medicine
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