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John J Sim, Hui Zhou, Jiaxiao Shi, Sally F Shaw, Shayna L Henry, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen
PURPOSE: The early period after chronic kidney disease (CKD) patients transition to end-stage renal disease (ESRD) represents the highest mortality risk but is variable among different patient populations and clinical circumstances. We compared early mortality outcomes among a diverse CKD population that transitioned to ESRD. METHODS: A retrospective cohort study (1/1/2002 through 12/31/2013) of CKD patients (age ≥ 18 years) who transitioned to peritoneal dialysis (PD), hemodialysis (HD) with arteriovenous fistula/grafts, and HD with catheters was performed...
March 12, 2018: International Urology and Nephrology
Ilan Rozenberg, Andres Kotliroff, Tania Zahavi, Sydney Benchetrit
BACKGROUND: Idiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome (NS) in Caucasian adults. Most patients have good renal prognosis, but 30-40% may progress to end stage renal disease (ESRD). OBJECTIVES: To evaluate the efficacy and safety of immunosuppressive treatment (IST) in high-risk patients. METHODS: All IMN patients diagnosed by kidney biopsy from 2004-2010 were included. Clinical and laboratory data were collected at each follow-up visit...
March 2018: Israel Medical Association Journal: IMAJ
Jose Kuzhively, Bettina Tahsin, Peter Hart, Leon Fogelfeld
AIM: Evaluate legacy effect on renal outcomes after the end of a multifactorial-multidisciplinary intervention in patients with advanced diabetic nephropathy (ADN trial) CKD 3-4. METHODS: A retrospective electronic review was conducted of 72 patients who completed the ADN trial ESRD-free with subsequent follow-up of two years or until ESRD development. RESULTS: At baseline, reflecting ADN trial end, 38 post-intervention and 34 post-control patients were similar except for lower HbA1c, SBP and age in the post-intervention group...
February 10, 2018: Journal of Diabetes and its Complications
Otto A Sanchez, Laine K Ferrara, Sarah Rein, Danielle Berglund, Arthur J Matas, Hassan N Ibrahim
Incidence of post-donation hypertension, risk factors associated with its development and impact of type of treatment received on renal outcomes were determined in 3700 kidney donors. Using Cox proportional hazard model, adjusted hazard ratios (HRs) for cardiovascular disease (CVD), estimated glomerular filtration rate (eGFR) <60, <45, <30 mL/min/1.73m2 , end stage renal disease (ESRD) and death in hypertensive donors were determined. After a mean (SD) of 16.6 (11.9) years of follow-up, 1126 (26.8%) donors developed hypertension and 894 were receiving anti-hypertensive medications...
March 2, 2018: American Journal of Transplantation
M S Ansari, Sandeep Kumar Nunia, Ankur Bansal, Prempal Singh, Virender Sekhon, Dharmveer Singh, Rahul Soni, Priyank Yadav
INTRODUCTION: Posterior urethral valve (PUV) is the most common cause of pediatric end stage renal disease (ESRD), imposing a major health burden on medical community caregivers and adversely affecting the quality of life of patients. Chronic kidney disease (CKD) stage III or estimated GFR of <60 mL/min/1.73 m2 is known to be associated with more adverse renal, cardiovascular, and clinical outcomes. Thus, it is desirable to identify factors predicting the rapid and early progression of disease...
November 22, 2017: Journal of Pediatric Urology
Sunil Taneja, Ajay Duseja, Arka De, Manu Mehta, Raja Ramachandran, Vivek Kumar, Harbir Singh Kohli, Krishan Lal Gupta, Radha Krishan Dhiman, Yogesh Chawla
BACKGROUND AND AIMS: There is sparse data on the use of Sofosbuvir based directly acting antiviral (DAA) drug regimens in chronic hepatitis C (CHC) patients with chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m2 . We evaluated the safety and efficacy of low-dose Sofosbuvir plus full-dose Daclatasvir in CHC patients with CKD. METHODS: Sixty-five CHC patients with CKD with eGFR less than 30 mL/min/1.73 m2 [54 (83%) patients with ESRD on hemodialysis] were included...
February 26, 2018: Digestive Diseases and Sciences
Wei Deng, Xiaojun Tan, Qian Zhou, Zhen Ai, Wenting Liu, Wei Chen, Xueqing Yu, Qiongqiong Yang
BACKGROUND: The prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear. We explored gender-related differences in clinicopathological features and renal outcomes in IgAN. METHODS: This was a single-centre retrospective study. Patients were divided into two groups according to gender. The clinicopathological features at biopsy and renal outcomes during the follow-up were collected and analysed. Renal outcomes were defined as the doubling of baseline serum creatinine and end-stage renal disease (ESRD) (estimated glomerular filtration rate < 15 mL/min/1...
February 7, 2018: BMC Nephrology
Melanie P Chin, George L Bakris, Geoffrey A Block, Glenn M Chertow, Angie Goldsberry, Lesley A Inker, Hiddo J L Heerspink, Megan O'Grady, Pablo E Pergola, Christoph Wanner, David G Warnock, Colin J Meyer
BACKGROUND: Increases in measured inulin clearance, measured creatinine clearance, and estimated glomerular filtration rate (eGFR) have been observed with bardoxolone methyl in 7 studies enrolling approximately 2,600 patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The largest of these studies was Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes (BEACON), a multinational, randomized, double-blind, placebo-controlled phase 3 trial which enrolled patients with T2D and CKD stage 4...
2018: American Journal of Nephrology
John J Sim, Simran K Bhandari, Michael Batech, Aviv Hever, Teresa N Harrison, Yu-Hsiang Shu, Dean A Kujubu, Tracy Y Jonelis, Michael H Kanter, Steven J Jacobsen
OBJECTIVE: To compare renal function decline, incident end-stage renal disease (ESRD), and mortality among patients with 5 common glomerular diseases in a large diverse population. PATIENTS AND METHODS: A retrospective cohort study (between January 1, 2000, and December 31, 2011) of patients with glomerulonephropathy using the electronic health record of an integrated health system was performed. Estimated glomerular filtration rate (eGFR) change, incident ESRD, and mortality were compared among patients with biopsy-proven focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MN), minimal change disease (MCD), immunoglobulin A nephropathy (IgAN), and lupus nephritis (LN)...
January 9, 2018: Mayo Clinic Proceedings
Kunitoshi Iseki
BACKGROUND: Chronic kidney disease (CKD) is a risk factor of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Early detection and management of risk factors of incidence and progression of CKD are necessary. We have been studying these risk factors among community-based screening participants in Okinawa, Japan. Okinawa was one of the longevity areas in the world; however, the incidence and prevalence of ESRD increased. In Japan, the incidence of ESRD is 2 times higher in men compared to that in women...
2018: Contributions to Nephrology
Jennifer L Wainright, Amanda M Robinson, Amber R Wilk, David K Klassen, Wida S Cherikh, Darren E Stewart
We studied End Stage Renal Disease (ESRD) in living kidney donors (LKDs) who donated in the US between 1994 and 2016 (n=123,526), using Organ Procurement and Transplantation Network and Centers for Medicare and Medicaid Services data. 218 LKDs developed ESRD, with a median of 11.1 years between donation and ESRD. Absolute 20-year risk was low but not uniform, with risk associated with race, age, and sex and increasing exponentially over time. LKDs had increased risk of ESRD if they were male (adjusted Hazard Ratio(aHR): 1...
February 2, 2018: American Journal of Transplantation
Arthur J Matas, Danielle M Berglund, David M Vock, Hassan N Ibrahim
End stage renal disease (ESRD) is a risk after kidney donation. We sought, in a large cohort of kidney donors to determine the causes of donor ESRD, the interval from donation to ESRD, the role of donor/recipient relationship, and the trajectory of the estimated GFR (eGFR) from donation to ESRD. Between 1/1/1963 thru 12/31/2015, 4030 patients underwent living donor nephrectomy at our center, and have had ascertainment of ESRD status. Of these, 39 have developed ESRD (mean age at ESRD, 62.4 ± 14.1 years; mean interval between donation and ESRD, 27...
January 25, 2018: American Journal of Transplantation
Joshua I Barzilay, Barry R Davis, Sara L Pressel, Alokananda Ghosh, Mahboob Rahman, Paula T Einhorn, William C Cushman, Paul K Whelton, Jackson T Wright
BACKGROUND: Impaired renal function is a risk factor for cardiovascular disease, end-stage renal disease (ESRD), and mortality. The impact of short-term renal function decline on outcomes is less well studied. The association of antihypertensive medications with the impact of short-term estimated glomerular filtration rate (eGFR) decline is not known. METHODS: We examined 20,207 hypertensive participants with baseline and 2-year creatinine levels from which eGFR changes were estimated...
January 19, 2018: American Journal of Hypertension
Mona D Doshi, Mariella Ortigosa-Goggins, Amit X Garg, Lihua Li, Emilio D Poggio, Cheryl A Winkler, Jeffrey B Kopp
Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n =19; 14%) or low-risk (one or zero risk alleles; n =117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1...
January 16, 2018: Journal of the American Society of Nephrology: JASN
Allon N Friedman, Abdus S Wahed, Junyao Wang, Anita P Courcoulas, Gregory Dakin, Marcelo W Hinojosa, Paul L Kimmel, James E Mitchell, Alfons Pomp, Walter J Pories, Jonathan Q Purnell, Carel le Roux, Konstantinos Spaniolas, Kristine J Steffen, Richard Thirlby, Bruce Wolfe
Obesity is linked to the development and progression of CKD, but whether bariatric surgery protects against CKD is poorly understood. We, therefore, examined whether bariatric surgery influences CKD risk. The study included 2144 adults who underwent bariatric surgery from March of 2006 to April of 2009 and participated in the Longitudinal Assessment of Bariatric Surgery-2 Study cohort. The primary outcome was CKD risk categories as assessed by the Kidney Disease Improving Global Outcomes (KDIGO) consortium criteria using a combination of eGFR and albuminuria...
January 15, 2018: Journal of the American Society of Nephrology: JASN
Amy B Karger, Lesley A Inker, Josef Coresh, Andrew S Levey, John H Eckfeldt
Creatinine-based glomerular filtration rate estimation (eGFRcr ) has been improved and refined since the 1970s through both the Modification of Diet in Renal Disease (MDRD) Study equation in 1999 and the CKD Epidemiology Collaboration (CKD-EPI) equation in 2009, with current clinical practice dependent primarily on eGFR for accurate assessment of GFR. However, researchers and clinicians have recognized limitations of relying on creatinine as the only filtration marker, which can lead to inaccurate GFR estimates in certain populations due to the influence of non-GFR determinants of serum or plasma creatinine...
December 2017: EJIFCC
Lucia de Stephanis, Alessandra Mangolini, Miriam Servello, Peter C Harris, Lucio Dell'Atti, Paolo Pinton, Gianluca Aguiari
Cell proliferation and apoptosis are typical hallmarks of autosomal dominant polycystic kidney disease (ADPKD) and cause the development of kidney cysts that lead to end-stage renal disease (ESRD). Many factors, impaired by polycystin complex loss of function, may promote these biological processes, including cAMP, mTOR and EGFR signalling pathways. In addition, microRNAs (miRs) may also regulate the ADPKD related signalling network and their dysregulation contributes to disease progression. However, the role of miRs in ADPKD pathogenesis has not been fully understood, but also the function of p53 is quite obscure, especially its regulatory contribution on cell proliferation and apoptosis...
January 11, 2018: Journal of Cellular Physiology
Tzu-Han Yang, Tsai-Hung Wu, Yuh-Lih Chang, Hsien-Tzung Liao, Chia-Chen Hsu, Chang-Youh Tsai, Yueh-Ching Chou
AIMS: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). MATERIALS AND METHODS: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded...
January 10, 2018: Clinical Nephrology
Christopher M Rubino, Sujata M Bhavnani, Jeffery S Loutit, Brooke Lohse, Michael N Dudley, David C Griffith
Vaborbactam is a member of a new class of β-lactamase inhibitors with inhibitory activity against serine carbapenemases (e.g., Klebsiella pneumoniae carbapenemase) that has been developed in combination with meropenem. The pharmacokinetics of the combination was evaluated in 41 subjects with chronic renal impairment in a phase 1, open-label, single-dose study. Subjects were assigned to one of five groups based on renal function: normal (creatinine clearance of ≥90 ml/min), mild (estimated glomerular filtration rate [eGFR] of 60 to 89 ml/min/1...
March 2018: Antimicrobial Agents and Chemotherapy
Carl P Walther, Orlando M Gutiérrez, Mary Cushman, Suzanne E Judd, Joshua Lang, William McClellan, Paul Muntner, Mark J Sarnak, Michael G Shlipak, David G Warnock, Ronit Katz, Joachim H Ix
Background: Serum albumin concentration is a commonly available biomarker with prognostic value in many disease states. It is uncertain whether serum albumin concentrations are associated with incident end-stage renal disease (ESRD) independently of urine albumin-to-creatinine ratio (ACR). Methods: A longitudinal evaluation was performed of a population-based community-living cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study...
December 20, 2017: Nephrology, Dialysis, Transplantation
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