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CKD, eGFR and Slope

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https://www.readbyqxmd.com/read/27823902/pth-levels-and-not-serum-phosphorus-levels-are-a-predictor-of-the-progression-of-kidney-disease-in-elderly-patients-with-advanced-chronic-kidney-disease
#1
Néstor Gabriel Toapanta Gaibor, Nathasha Carolina Nava Pérez, Yeleine Martínez Echevers, Rafael Montes Delgado, María Ángeles Guerrero Riscos
BACKGROUND: At present, there is a high incidence of elderly patients with advanced chronic kidney disease (CKD) and it is important to know the long term progression and the factors that influence it. OBJECTIVES: To analyse the progression of advanced CKD in elderly patients and the influence of bone-mineral metabolism. METHODS: Retrospective study of 125 patients ≥70years of age with CKD stages 4-5 who started follow-up from January 1, 2007 to December 31, 2008, showing the progression of CKD (measured by the slope of the regression line of the estimated glomerular filtration rate [eGFR] by MDRD-4) over 5years...
November 4, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27798200/reduction-of-cortical-oxygenation-in-chronic-kidney-disease-evidence-obtained-with-a-new-analysis-method-of-blood-oxygenation-level-dependent-magnetic-resonance-imaging
#2
Bastien Milani, Annalisa Ansaloni, Sofia Sousa-Guimaraes, Nima Vakilzadeh, Maciej Piskunowicz, Bruno Vogt, Matthias Stuber, Michel Burnier, Menno Pruijm
BACKGROUND: Determinations of renal oxygenation by blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) in chronic kidney disease (CKD) patients have given heterogeneous results, possibly due to the lack of a reproducible method to analyse BOLD-MRI. It therefore remains uncertain whether patients with CKD have a reduced renal tissue oxygenation. We developed a new method to analyse BOLD-MRI signals and applied it to CKD patients and controls. METHODS: MRI was performed under standardized conditions before and 15 min after IV furosemide in 104 CKD patients, 61 hypertensives and 42 controls...
October 17, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27754262/os-37-05-long-term-visit-to-visit-variability-of-systolic-blood-pressure-and-decline-in-renal-function-in-hypertensive-patients-over-15-years
#3
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
https://www.readbyqxmd.com/read/27729571/genome-wide-association-of-ckd-progression-the-chronic-renal-insufficiency-cohort-study
#4
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
https://www.readbyqxmd.com/read/27643227/os-37-05-long-term-visit-to-visit-variability-of-systolic-blood-pressure-and-decline-in-renal-function-in-hypertensive-patients-over-15-years
#5
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
https://www.readbyqxmd.com/read/27508725/-op-4d-06-reduction-of-cortical-oxygenation-in-chronic-kidney-disease-evidence-obtained-with-bold-mri-and-a-new-analytic-technique
#6
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
https://www.readbyqxmd.com/read/27488612/the-new-asian-modified-ckd-epi-equation-leads-to-more-accurate-gfr-estimation-in-chinese-patients-with-ckd
#7
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
https://www.readbyqxmd.com/read/27389019/efficacy-of-the-essential-amino-acids-and-keto-analogues-on-the-ckd-progression-rate-in-real-practice-in-russia-city-nephrology-registry-data-for-outpatient-clinic
#8
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
https://www.readbyqxmd.com/read/27258510/estimated-glomerular-filtration-rate-trajectories-in-hiv-infected-subjects-treated-with-different-ritonavir-boosted-protease-inhibitors-and-tenofovir-disoproxil-fumarate-or-abacavir
#9
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)
https://www.readbyqxmd.com/read/27242372/association-between-vascular-access-creation-and-deceleration-of-estimated-glomerular-filtration-rate-decline-in-late-stage-chronic-kidney-disease-patients-transitioning-to-end-stage-renal-disease
#10
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
https://www.readbyqxmd.com/read/27222502/dynamic-changes-in-renal-function-are-associated-with-major-cardiovascular-events-in-patients-with-type-2-diabetes
#11
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
https://www.readbyqxmd.com/read/27172772/metabolomics-of-chronic-kidney-disease-progression-a-case-control-analysis-in-the-chronic-renal-insufficiency-cohort-study
#12
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
https://www.readbyqxmd.com/read/27151925/ckd-progression-and-mortality-among-hispanics-and-non-hispanics
#13
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...
November 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26993562/childhood-albuminuria-and-chronic-kidney-disease-is-associated-with-mortality-and-end-stage-renal-disease
#14
Ching-Yuang Lin, Shiuh-Ming Huang
BACKGROUND: We do not yet fully grasp the significance of childhood albuminuria. Based on mass urinary screening (MUS) using albumin-specific dipsticks in school children, we studied the independent association of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in children with chronic kidney disease (CKD). METHODS: A prospective cohort of 5351 children with albuminuria detected by school MSU during the period 1992-1996, followed up to 2009...
August 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/26900691/renal-function-trajectories-in-patients-with-prior-improved-egfr-slopes-and-risk-of-death
#15
Yan Xie, Benjamin Bowe, Hong Xian, Sumitra Balasubramanian, Ziyad Al-Aly
BACKGROUND: Multiple prior studies demonstrated that patients with early Chronic Kidney Disease (CKD) and positive estimated Glomerular Filtration Rate (eGFR) slopes experience increased risk of death. We sought to characterize patients with positive eGFR slopes, examine the renal function trajectory that follows the time period where positive slope is observed, and examine the association between different trajectories and risk of death. METHODS AND FINDINGS: We built a cohort of 204,132 United States veterans with early CKD stage 3; eGFR slopes were defined based on Bayesian mixed-effects models using outpatient eGFR measurements between October 1999 and September 2004; to build renal function trajectories, patients were followed longitudinally thereafter (from October 2004) until September 2013...
2016: PloS One
https://www.readbyqxmd.com/read/26724837/kidney-disease-in-adenine-phosphoribosyltransferase-deficiency
#16
Hrafnhildur Linnet Runolfsdottir, Runolfur Palsson, Inger M Agustsdottir, Olafur S Indridason, Vidar O Edvardsson
BACKGROUND: Adenine phosphoribosyltransferase (APRT) deficiency is a purine metabolism disorder causing kidney stones and chronic kidney disease (CKD). The course of nephrolithiasis and CKD has not been well characterized. The objective of this study was to examine long-term kidney outcomes in patients with APRT deficiency. STUDY DESIGN: An observational cohort study. SETTING & PARTICIPANTS: All patients enrolled in the APRT Deficiency Registry of the Rare Kidney Stone Consortium...
March 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26657867/past-decline-versus-current-egfr-and-subsequent-esrd-risk
#17
Csaba P Kovesdy, Josef Coresh, Shoshana H Ballew, Mark Woodward, Adeera Levin, David M J Naimark, Joseph Nally, Dietrich Rothenbacher, Benedicte Stengel, Kunitoshi Iseki, Kunihiro Matsushita, Andrew S Levey
eGFR is a robust predictor of ESRD risk. However, the prognostic information gained from the past trajectory (slope) beyond that of the current eGFR is unclear. We examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. We modeled hazard ratios as a spline function of slopes, adjusting for demographic variables, eGFR, and comorbidities. We used random effects meta-analyses to combine results across studies stratified by cohort type. We calculated the absolute risk of ESRD at 5 years after the last eGFR using the weighted average baseline risk...
August 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26657865/past-decline-versus-current-egfr-and-subsequent-mortality-risk
#18
David M J Naimark, Morgan E Grams, Kunihiro Matsushita, Corri Black, Iefke Drion, Caroline S Fox, Lesley A Inker, Areef Ishani, Sun Ha Jee, Akihiko Kitamura, Janice P Lea, Joseph Nally, Carmen Alicia Peralta, Dietrich Rothenbacher, Seungho Ryu, Marcello Tonelli, Hiroshi Yatsuya, Josef Coresh, Ron T Gansevoort, David G Warnock, Mark Woodward, Paul E de Jong
A single determination of eGFR associates with subsequent mortality risk. Prior decline in eGFR indicates loss of kidney function, but the relationship to mortality risk is uncertain. We conducted an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope, adjusting for established risk factors, including last eGFR, among 1.2 million subjects from 12 CKD and 22 other cohorts within the CKD Prognosis Consortium. Over a 3-year antecedent period, 12% of participants in the CKD cohorts and 11% in the other cohorts had an eGFR slope <-5 ml/min per 1...
August 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26624901/comparison-of-the-rate-of-renal-function-decline-in-nonproteinuric-patients-with-and-without-diabetes
#19
Liliane Hobeika, Kelly J Hunt, Benjamin A Neely, John M Arthur
BACKGROUND: Patients with diabetes and chronic kidney disease (CKD) without proteinuria are often believed to have a cause of CKD other than diabetes. It was hypothesized that if this is true, the rate of renal function decline should be similar among nonproteinuric patients with and without diabetes. METHODS: Patients seen in the nephrology, endocrinology and general internal medicine clinics at the Medical University of South Carolina (MUSC) between 2008 and 2012 with hypertension and diabetes were identified by ICD9 diagnosis codes...
December 2015: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/26370877/interankle-systolic-blood-pressure-difference-and-renal-outcomes-in-patients-with-chronic-kidney-disease
#20
Szu-Chia Chen, Yi-Chun Tsai, Jiun-Chi Huang, Su-Chu Lee, Jer-Ming Chang, Shang-Jyh Hwang, Hung-Chun Chen
AIM: Interankle blood pressure (BP) difference has been associated with peripheral artery disease and adverse cardiovascular outcomes. However, the relationship between interankle BP difference and renal outcomes in chronic kidney disease (CKD) has never been evaluated. The purpose of this study was to determine whether interankle BP difference is associated with the rate of renal function decline and progression to renal end points in patients with stage 3-5 CKD. METHODS: We enrolled 144 patients with CKD from one regional hospital...
May 2016: Nephrology
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