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https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#1
Steven Guest, John K Leypoldt, Michelle E Cassin, Martin J Schreiber
♦ Background: Incremental peritoneal dialysis (PD), the gradual introduction of dialysate exchanges at less than full-dose therapy, has been infrequently described in clinical reports. One concern with less than full-dose dialysis is whether urea clearance targets are achievable with an incremental regimen. In this report, we used a large database of PD patients, across all membrane transport types, and performed urea kinetic modeling determinations of possible incremental regimens for an individual membrane type...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28092350/long-term-renal-survival-in-patients-undergoing-t-cell-depleted-versus-conventional-hematopoietic-stem-cell-transplants
#2
I G Glezerman, S Devlin, M Maloy, M Bui, E A Jaimes, S A Giralt, A A Jakubowski
Calcineurin inhibitor (CNI)-sparing T-cell depleted (TCD) hematopoietic stem cell transplants (HSCTs) are presumed to be less nephrotoxic than conventional HSCTs. We evaluated incidence and risk factors for kidney failure and chronic kidney disease (CKD) in 231 TCD and 212 conventional HSCT recipients. Kidney failure required a median glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) for ⩾100 days anytime after 180-days post-HSCT. Two-year cumulative incidence (CI) of kidney failure was 42% in the conventional versus 31% in the TCD group (P=0...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28073780/chronic-kidney-disease-and-obesity-bias-surrogate-estimates-of-insulin-sensitivity-compared-to-the-hyperinsulinemic-euglycemic-clamp
#3
Iram Ahmad, Leila R Zelnick, Nicole R Robinson, Adriana M Hung, Bryan Kestenbaum, Kristina M Utzschneider, Steven E Kahn, Ian H de Boer
INTRODUCTION: Insulin sensitivity can be measured by procedures such as the hyperinsulinemic-euglycemic clamp or using surrogate indices. Chronic kidney disease (CKD) and obesity may differentially affect these measurements because of changes in insulin kinetics and organ-specific effects on insulin sensitivity. METHODS: In a cross-sectional study of 59 subjects with non-diabetic CKD (estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m(2)) and 39 matched healthy controls, we quantified insulin sensitivity by clamp (SIclamp), oral glucose tolerance test, and fasting glucose and insulin...
January 10, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28070716/pharmacokinetics-and-saturable-absorption-of-gabapentin-in-nursing-home-elderly-patients
#4
Ghada F Ahmed, Sai Praneeth R Bathena, Richard C Brundage, Ilo E Leppik, Jeannine M Conway, Janice B Schwartz, Angela K Birnbaum
Pharmacokinetic data of gabapentin (GBP) in community-dwelling elderly patients show a significant effect of advanced age on GBP pharmacokinetics due to altered renal function. However, there are no data in elderly nursing home (NH) patients to evaluate gabapentin absorption and elimination. Our objective was to characterize the pharmacokinetics of GBP in elderly nursing home patients maintained on GBP therapy. This was a prospective pharmacokinetic study in elderly nursing home patients (≥60 years) receiving GBP for the management of chronic pain or epilepsy from seven nursing homes...
January 9, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28060893/positioning-of-tacrolimus-for-the-treatment-of-diabetic-nephropathy-based-on-computational-network-analysis
#5
Constantin Aschauer, Paul Perco, Andreas Heinzel, Judith Sunzenauer, Rainer Oberbauer
OBJECTIVE: To evaluate tacrolimus as therapeutic option for diabetic nephropathy (DN) based on molecular profile and network-based molecular model comparisons. MATERIALS AND METHODS: We generated molecular models representing pathophysiological mechanisms of DN and tacrolimus mechanism of action (MoA) based on literature derived data and transcriptomics datasets. Shared enriched molecular pathways were identified based on both model datasets. A newly generated transcriptomics dataset studying the effect of tacrolimus on mesangial cells in vitro was added to identify mechanisms in DN pathophysiology...
2017: PloS One
https://www.readbyqxmd.com/read/28049448/international-collaboration-for-the-epidemiology-of-egfr-in-low-and-middle-income-populations-rationale-and-core-protocol-for-the-disadvantaged-populations-egfr-epidemiology-study-degree
#6
Ben Caplin, Kristina Jakobsson, Jason Glaser, Dorothea Nitsch, Vivekanand Jha, Ajay Singh, Ricardo Correa-Rotter, Neil Pearce
BACKGROUND: There is an increasing recognition of epidemics of primarily tubular-interstitial chronic kidney disease (CKD) clustering in agricultural communities in low- and middle-income countries (LMICs). Although it is currently unclear whether there is a unified underlying aetiology, these conditions have been collectively termed CKD of undetermined cause (CKDu). CKDu is estimated to have led to the premature deaths of tens to hundreds of thousands of young men and women over the last 2 decades...
January 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28011276/excised-parenchymal-mass-during-partial-nephrectomy-functional-implications
#7
W Dong, Z Zhang, J Zhao, J Wu, C Suk-Ouichai, D Aguilar Palacios, E Carabello Antonio, S Babbar, E M Remer, J Li, S Isharwal, J Zabell, S C Campbell
OBJECTIVE: To evaluate whether excised parenchymal mass (EPM) during partial nephrectomy (PN) correlates with functional decline and can serve as a surrogate for functional outcomes. MATERIALS AND METHODS: All 215 patients managed with PN for unifocal renal mass with necessary studies to determine EPM and percent glomerular filtration rate (GFR) and parenchymal mass preserved (both global and specific to the operated kidney) were analyzed. EPM was estimated from the pathologic specimen by subtracting the tumor mass from specimen mass, with both calculated using the elliptical formula...
December 20, 2016: Urology
https://www.readbyqxmd.com/read/27992823/the-effect-of-renal-dysfunction-on-short-term-outcomes-after-lumbar-fusion
#8
Taylor E Purvis, Remi A Kessler, Christine Boone, Benjamin D Elder, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE: To compare post-lumbar decompression and fusion complication rates and mortality for patients without preoperative hemodialysis (HD) use with and without renal dysfunction as estimated by glomerular filtration rate (GFR) and creatinine levels. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for patients over the age of 18 who underwent non-emergent lumbar fusion surgery...
December 6, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27965825/aminoaciduria-in-the-prediction-of-ifosfamide-induced-tubulopathy-after-childhood-cancer-a-feasibility-study
#9
Jessica E Morgan, Karl McKeever, Kay S Tyerman, Michael Henderson, Susan Picton, Robert S Phillips
BACKGROUND: Ifosfamide, an alkylating agent used widely in the treatment of childhood malignancy, can cause many side effects including a proximal tubulopathy. Studies suggest that aminoaciduria is seen most commonly of all the biochemical abnormalities of ifosfamide-induced tubulopathy. A recent systematic review has found a paucity of data regarding the value of early markers indicating clinically significant tubulopathy. We undertook a pilot study to determine the feasibility of examining whether patients can be risk-stratified on the basis of aminoaciduria for the development of future significant ifosfamide-induced tubulopathy, to allow the evolution of appropriate follow-up strategies...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27943221/a-population-pharmacokinetic-model-for-51-cr-edta-to-estimate-renal-function
#10
Isabelle H S Kuan, Stephen B Duffull, Tracey L Putt, John B W Schollum, Robert J Walker, Daniel F B Wright
BACKGROUND AND OBJECTIVES: (51)Cr EDTA clearance (CL) from plasma is used to estimate glomerular filtration rate (GFR). We propose that current methods for analysing the raw (51)Cr EDTA measurements over-simplifies the disposition of (51)Cr EDTA and therefore could produce biased GFR estimates. The aim of this study was to develop a population pharmacokinetic model for (51)Cr EDTA disposition and to compare model-predicted GFR to other methods of estimating renal function. PATIENTS AND METHODS: Data from 40 individuals who received ~7...
December 9, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27932106/assessment-of-kidney-graft-function-evolution-measured-by-creatinine-and-cystatin-c
#11
M A Ramos-Barron, I Hernandez Bejarano, E Rodrigo, E Cruz Iglesias, A Benito Hernandez, C Agueros Blanco, A I Morales Martin, M Prieto Vicente, F Lopez Hernandez, M Arias, C Gomez-Alamillo
INTRODUCTION: The 2013 Kidney Disease Outcomes Quality Initiative Clinical Practice Guideline suggests measuring cystatin C (sCys) in adults with glomerular filtration rate (GFR) based on creatinine (sCr) between 45 and 59 mL/min/1.73 m(2) if confirmation of chronic kidney disease (CKD) is required. There is not enough evidence to recommend the use of sCys or sCr to estimate GFR in kidney transplant recipients. OBJECTIVES: Our aims were to describe the evolution of sCr, sCys, and GFR in a group of kidney transplant patients and to determine their association with some markers of morbidity at 1 year...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932098/urinary-clara-cell-protein-in-kidney-transplant-patients-a-preliminary-study
#12
P M García-García, E Martín-Izquierdo, C M-F de Basoa, A Jarque-López, G Pérez-Suárez, A Rivero-González, J M González-Posadas, M Macía-Heras, V M García-Nieto, J F Navarro-Gónzález
OBJECTIVE: The aim of this exploratory study was to analyze the urinary excretion of Clara cell protein (CC16), a new marker of proximal tubular dysfunction (PTD), in kidney transplantation (KT). MATERIALS AND METHODS: Urinary concentrations of CC16, β2-microglobulin (β2m), and N-acetyl-glucosaminidase (NAG) were measured in 50 KT patients (72% men; mean age 50.4 ± 12.4 years; diabetes in 24%; duration of KT 4.3 ± 3.1 years) and 10 healthy controls (6 men; mean age 33...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931097/novel-chlorinated-polyfluorinated-ether-sulfonates-and-legacy-per-polyfluoroalkyl-substances-placental-transfer-and-relationship-with-serum-albumin-and-glomerular-filtration-rate
#13
Yitao Pan, Yingshuang Zhu, Tongzhang Zheng, Qianqian Cui, Stephen L Buka, Bin Zhang, Yong Guo, Wei Xia, Leo W Y Yeung, Yuanyuan Li, Aifen Zhou, Lin Qiu, Hongxiu Liu, Minmin Jiang, Chuansha Wu, Shunqing Xu, Jiayin Dai
Per- and polyfluoroalkyl substances (PFASs) may cross the placental barrier and lead to fetal exposure. However, little is known about the factors that influence maternal-fetal transfer of these chemicals. PFAS concentrations were analyzed in 100 paired samples of human maternal sera collected in each trimester and cord sera at delivery; these samples were collected in Wuhan, China, 2014. Linear regression was used to estimate associations of transfer efficiencies with factors. Chlorinated polyfluorinated ether sulfonates (Cl-PFAESs, 6:2 and 8:2) were frequently detected (>99%) in maternal and cord sera...
January 3, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/27927602/acute-change-in-glomerular-filtration-rate-with%C3%A2-inhibition-of-the-renin-angiotensin-system-does-not%C3%A2-predict-subsequent-renal-and-cardiovascular%C3%A2-outcomes
#14
Catherine M Clase, Joshua Barzilay, Peggy Gao, Andrew Smyth, Roland E Schmieder, Sheldon Tobe, Koon K Teo, Salim Yusuf, Johannes F E Mann
Initiation of blockade of the renin-angiotensin system may cause an acute decrease in glomerular filtration rate (GFR): the prognostic significance of this is unknown. We did a post hoc analysis of patients with, or at risk for, vascular disease, in two randomized controlled trials: Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and the Telmisartan Randomized AssessmeNt Study in ACE iNtolerant participants with cardiovascular Disease (TRANSCEND), whose median follow-up was 56 months...
December 4, 2016: Kidney International
https://www.readbyqxmd.com/read/27927186/diet-as-a-system-an-observational-study-investigating-a-multi-choice-system-of-moderately-restricted-low-protein-diets
#15
Giorgina Barbara Piccoli, Marta Nazha, Irene Capizzi, Federica Neve Vigotti, Stefania Scognamiglio, Valentina Consiglio, Elena Mongilardi, Marilisa Bilocati, Paolo Avagnina, Elisabetta Versino
BACKGROUND: There is no single, gold-standard, low-protein diet (LPD) for CKD patients; the best compliance is probably obtained by personalization. This study tests the hypothesis that a multiple choice diet network allows patients to attain a good compliance level, and that, in an open-choice system, overall results are not dependent upon the specific diet, but upon the clinical characteristics of the patients. METHODS: Observational study: Three LPD options were offered to all patients with severe or rapidly progressive CKD: vegan diets supplemented with alpha-ketoacids and essential aminoacids; protein-free food in substitution of normal bread and pasta; other (traditional, vegan non supplemented and tailored)...
December 7, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27925141/nutritional-interventions-that-slow-the-age-associated-decline-in-renal-function-in-a-canine-geriatric-model-for-elderly-humans
#16
J A Hall, M Yerramilli, E Obare, M Yerramilli, K S Panickar, G Bobe, D E Jewell
OBJECTIVE: To determine the effects of feeding traditional and renal protective foods (RPF) supplemented with functional food bioactives on glomerular filtration rate (GFR), lean body percent (LB%), and selected circulating biomarker and metabolite concentrations in a geriatric dog model. DESIGN: Randomized block design and cross-sectional study. SETTING: Hill's Pet Nutrition, Inc. dog colony. PARTICIPANTS: Eighty-one geriatric dogs (mean age, 10...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27920153/urine-osmolality-response-to-tolvaptan-and-outcome-in-autosomal-dominant-polycystic-kidney-disease-results-from-the-tempo-3-4-trial
#17
Olivier Devuyst, Arlene B Chapman, Ron T Gansevoort, Eiji Higashihara, Ronald D Perrone, Vicente E Torres, Jaime D Blais, Wen Zhou, John Ouyang, Frank S Czerwiec
The vasopressin-cAMP-osmolality axis is abnormal in autosomal dominant polycystic kidney disease (ADPKD). In the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes 3:4 Trial, a 3-year randomized, placebo-controlled trial in adults, the vasopressin V2 receptor antagonist tolvaptan slowed ADPKD progression in patients with preserved GFR. Here, we investigated the determinants of baseline urine osmolality (Uosm) and its value as a severity marker of ADPKD, the factors influencing the response to tolvaptan, and whether change in Uosm associated with key trial end points...
December 5, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27900942/association-between-chronic-kidney-disease-and-cancer-mortality-a-report-from-the-allhat
#18
Dhruti P Chen, Barry R Davis, Lara M Simpson, William C Cushman, Jeffrey A Cutler, Mirela Dobre, Charles E Ford, Gail T Louis, Paul Muntner, Suzanne Oparil, Linda B Piller, Sara L Pressel, Mark J Sarnak, Paul K Whelton, Jackson T Wright, Mahboob Rahman
BACKGROUND/OBJECTIVES: Chronic kidney disease (CKD) and cancer are both common in older patients; whether CKD increases risk for cancer is unclear. This study evaluated CKD as a risk factor for cancer mortality in a large cohort of hypertensive patients. STUDY DESIGN: We did post-hoc analyses of in-trial and post-trial data from participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). SETTING AND PARTICIPANTS: Participants were ≥ 55 years old with hypertension and one other additional risk factor for coronary heart disease...
January 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/27898000/patient-survival-and-costs-on-moderately-restricted-low-protein-diets-in-advanced-ckd-equivalent-survival-at-lower-costs
#19
Giorgina Barbara Piccoli, Marta Nazha, Irene Capizzi, Federica Neve Vigotti, Elena Mongilardi, Marilisa Bilocati, Paolo Avagnina, Elisabetta Versino
The indications for delaying the start of dialysis have revived interest in low-protein diets (LPDs). In this observational prospective study, we enrolled all patients with chronic kidney disease (CKD) who followed a moderately restricted LPD in 2007-2015 in a nephrology unit in Italy: 449 patients, 847 years of observation. At the start of the diet, the median glomerular filtration rate (GFR) was 20 mL/min, the median age was 70, the median Charlson Index was 7. Standardized mortality rates for the "on-diet" population were significantly lower than for patients on dialysis (United States Renal Data System (USRDS): 0...
November 25, 2016: Nutrients
https://www.readbyqxmd.com/read/27894952/comparison-of-creatinine-and-cystatin-c-based-egfr-in-the-estimation-of-glomerular-filtration-rate-in-indigenous-australians-the-egfr-study
#20
Elizabeth Lm Barr, Louise J Maple-Brown, Federica Barzi, Jaquelyne T Hughes, George Jerums, Elif I Ekinci, Andrew G Ellis, Graham Rd Jones, Paul D Lawton, Cherian Sajiv, Sandawana W Majoni, Alex Dh Brown, Wendy E Hoy, Kerin O'Dea, Alan Cass, Richard J MacIsaac
BACKGROUND: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation that combines creatinine and cystatin C is superior to equations that include either measure alone in estimating glomerular filtration rate (GFR). However, whether cystatin C can provide any additional benefits in estimating GFR for Indigenous Australians, a population at high risk of end-stage kidney disease (ESKD) is unknown. METHODS: Using a cross-sectional analysis from the eGFR Study of 654 Indigenous Australians at high risk of ESKD, eGFR was calculated using the CKD-EPI equations for serum creatinine (eGFRcr), cystatin C (eGFRcysC) and combined creatinine and cystatin C (eGFRcysC+cr)...
November 25, 2016: Clinical Biochemistry
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