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eGFR rate of decline

Salvatore De Cosmo, Francesca Viazzi, Antonio Pacilli, Carlo Giorda, Antonio Ceriello, Sandro Gentile, Giuseppina Russo, Maria C Rossi, Antonio Nicolucci, Pietro Guida, Roberto Pontremoli
: The identification of clinical predictors for the development of chronic kidney disease is a critical issue in the management of patients with type 2 diabetes mellitus.We evaluated 27,029 patients with type 2 diabetes mellitus and estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m and normoalbuminuria from the database of the Italian Association of Clinical Diabetologists network. Primary outcomes were eGFR <60 mL/min/1.73 m and normoalbuminuria; albuminuria and eGFR ≥60 mL/min/1...
July 2016: Medicine (Baltimore)
Do Hee Kim, Hee Jin Kwon, Sang A Ji, Hye Ryoun Jang, Sin-Ho Jung, Jung-Han Kim, Jae Hyeon Kim, Jung Eun Lee, Wooseong Huh, Yoon-Goo Kim, Dae Joong Kim, Ha Young Oh
Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. Risk factors associated with postoperative renal impairment in patients with PA were analyzed...
July 2016: Medicine (Baltimore)
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
Barrett Jeffers, Duo Zho
OBJECTIVE: High blood pressure variability (BPV) and worsening kidney function have both independently been linked to a higher risk for cardiovascular events. We aimed to investigate the impact of kidney function on BPV (using estimated glomerular filtration rate, eGFR), via a retrospective post hoc analysis of patients with hypertension. DESIGN AND METHOD: Subject level data were extracted from the ASCOT-BPLA (N = 18,852) and ALLHAT (N = 26,441) databases; both were randomized, active controlled studies, and treatment duration for hypertension was at least 4-years...
September 2016: Journal of Hypertension
Dagmara Hering, Petra Marusic, Jacqueline Duval, Yusuke Sata, Murray Esler, Antony Walton, Markus Schlaich
OBJECTIVE: Previous studies have shown that renal denervation has the potential to reduce blood pressure (BP) and slow the decline of renal function in chronic kidney disease (CKD) patients up to 12 months post procedure. The effects of RDN on estimated glomerular filtration rate (eGFR) and BP reduction beyond the first year remain unknown. This study investigated the effects of RDN on renal function and BP in CKD patients (eGFR ≤ 60 ml/min/1.73 m) out to 24 months post procedure. DESIGN AND METHOD: eGFR from the previous 60 months were retrospectively collected from 46 CKD patients who were scheduled for RDN...
September 2016: Journal of Hypertension
Katsuhiro Makino, Tohru Nakagawa, Atsushi Kanatani, Taketo Kawai, Satoru Taguchi, Masafumi Otsuka, Akihiko Matsumoto, Hideyo Miyazaki, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Yukio Homma
BACKGROUND: We evaluated short- and long-term renal function in patients after radical cystectomy with urinary diversion and identified risk factors for the deterioration of renal function. METHODS: This retrospective study comprised 91 patients who underwent radical cystectomy and urinary diversion for bladder cancer and survived ≥3 years after surgery. The estimated glomerular filtration rate (eGFR) was calculated, and longitudinal changes of eGFR were assessed...
October 17, 2016: International Journal of Clinical Oncology
Jan H Cornel, George L Bakris, Susanna R Stevens, Michael Alvarsson, Willem A Bax, Lee-Ming Chuang, Samuel S Engel, Renato D Lopes, Darren K McGuire, Axel Riefflin, Helena Wachslicht Rodbard, Isaac Sinay, Tsvetalina Tankova, Julio Wainstein, Eric D Peterson, Rury R Holman
OBJECTIVE: To evaluate chronic kidney disease (CKD) and cardiovascular outcomes in TECOS (Clinical trial reg. no. NCT00790205, participants with type 2 diabetes and cardiovascular disease treated with sitagliptin, a dipeptidyl peptidase 4 inhibitor, according to baseline estimated glomerular filtration rate (eGFR). RESEARCH DESIGN AND METHODS: We used data from 14,671 TECOS participants assigned in a double-blind design to receive sitagliptin or placebo added to existing therapy, while aiming for glycemic equipoise between groups...
October 14, 2016: Diabetes Care
Sandesh Parajuli, Dana F Clark, Arjang Djamali
Patients with CKD are at increased risk for cardiovascular events, hospitalizations, and mortality. Kidney transplantation (KTx) is the preferred treatment for end-stage kidney disease. Although comorbidities including anemia and bone and mineral disease improve or are even halted after KTx, kidney transplant recipients carry higher cardiovascular mortality risk than the general population, as well as an increased risk of infections, malignancies, fractures, and obesity. When comparing CKD with CKD after transplantation (CKD-T), the rate of decline of estimated glomerular filtration rate (eGFR) is significantly lower in CKD-T...
September 2016: Advances in Chronic Kidney Disease
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
Shiromani Janki, Leonienke F C Dols, Reinier Timman, Evalyn E A P Mulder, Ine M M Dooper, Jacqueline van de Wetering, Jan N M IJzermans
To establish the outcome of live kidney donors five years after donation we investigated the risk for progressive renal function decline and quality of life (QoL). Data on estimated glomerular filtration rate (eGFR), creatinine, hypertension, QoL, and survival were assessed in a prospective cohort of 190 donors, who donated between 2008-2010.Data was available for >90%. The mean age pre-donation was 52.8±11.5years, 30 donors having pre-existent hypertension. The mean follow-up was 5.1±0.9 years. Eight donors had died due to non-donation related causes...
October 7, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Amandine Cournil, Arsène Hema, Sabrina Eymard-Duvernay, Laura Ciaffi, Stéphanie Badiou, Firmin N Kabore, Assane Diouf, Liliane Ayangma, Vincent Le Moing, Jacques Reynes, Sinata Koulla-Shiro, Eric Delaporte
BACKGROUND: To investigate change in renal function in African patients initiating second line ART including ritonavir-boosted protease inhibitor (PI/r) with or without tenofovir disoproxil fumarate (TDF). METHODS: HIV-1 positive adults, failing standard first line ART were randomized to either TDF/FTC+LPV/r; ABC+ddI+LPV/r or TDF/FTC+DRV/r and followed until 18 months. Patients with an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1,73m(2) at baseline were included in this analysis...
October 5, 2016: Antiviral Therapy
Valentina Corradi, Fiorella Gastaldon, Carlotta Caprara, Anna Giuliani, Francesca Martino, Fiorenza Ferrari, Claudio Ronco
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic diseases with a reported prevalence of 1:400 to 1:1000. Since the intact kidneys can compensate for the loss of glomerular filtration in ADPKD patients, renal insufficiency usually remains undetected until almost the fourth decade of life. Hereafter, reliable diagnostic and prognostic biomarkers to identify ADPKD progression are urgently needed. Several studies and systematic reviews tried to identify markers or predictors of rapid disease progression of ADPKD...
October 4, 2016: Minerva Medica
Paul M Palevsky, Jane H Zhang, Stephen L Seliger, Nicholas Emanuele, Linda F Fried
BACKGROUND AND OBJECTIVES: The benefit of dual blockade of the renin-angiotensin system is limited by adverse effects. We performed a secondary analysis of the Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) Study to describe the effect of increased intensity of renin-angiotensin system blockade on the incidence, risk factors, and outcomes of AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In the VA NEPHRON-D Study, we randomized 1148 veterans receiving outpatient care with type 2 diabetes mellitus, eGFR of between 30 and 89...
September 27, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Ya-Yun Cheng, Neng-Chyan Huang, Yu-Tzu Chang, Junne-Ming Sung, Kun-Hung Shen, Chang-Chih Tsai, How-Ran Guo
To evaluate the associations between exposure to arsenic in drinking water and the progression of chronic kidney disease (CKD), we conducted a study in Taiwan. We recruited 8854 participants from a nationwide health screening program from 2000 to 2009 who were at least 20 years old and had two checkups in a 24-month period with at least 12 months apart. We defined CKD as having an estimated glomerular filtration rate (eGFR)<90ml/min/1.73m(2) or renal dysfunction demonstrated by proteinuria and a rapid progression of CKD as a decline in eGFR>5ml/min/1...
September 14, 2016: Journal of Hazardous Materials
Kunihiro Matsushita, Jingsha Chen, Yingying Sang, Shoshana H Ballew, Ryutaro Shimazaki, Masafumi Fukagawa, Enyu Imai, Josef Coresh, Akira Hishida
Predominantly based on North American and European studies, 30% to 40% declines in estimated glomerular filtration rate (eGFR) over a few years are strongly associated with the risk of end-stage renal disease (ESRD) and have been proposed as surrogate endpoints of ESRD for clinical research. However, this association has not been systematically quantified in Asian populations. To do this we studied adult Japanese patients with baseline eGFR 10-59 ml/min/1.73m(2). Changes in eGFR from baseline measured by centrally assessed serum creatinine were linked to subsequent ESRD in 2410 patients after one year and in 2079 patients after year 2...
November 2016: Kidney International
Juan Pablo Huidobro E, Jorge Vega
BACKGROUND: Death with a functioning kidney graft is now the leading cause of graft loss after renal transplantation. AIM: To determine if renal function at the last outpatient visit before the recipient’s death was different according to the following causes of death: infections, cardiovascular diseases, gastrointestinal disorders or cancer. PATIENTS AND METHODS: Retrospective cooperative cohort study conducted in two kidney transplant centers...
July 2016: Revista Médica de Chile
Bart J Kramers, Cornelis Kramers, Jacques W M Lenders, Jaap Deinum
Longstanding primary aldosteronism (PA) has deleterious effects on renal function, often masked until treatment (adrenalectomy or spironolactone) is initiated. It has been suggested that PA causes relative glomerular hyperfiltration, explaining the decline in estimated glomerular filtration rate (eGFR) after treatment. In this retrospective study, the authors retrieved the clinical characteristics and eGFR of 134 PA patients before and 6 months after treatment. Using multiple regression analysis, the predictors for eGFR decline and the predictors of ultimately attained renal function in 113 patients was assessed...
September 23, 2016: Journal of Clinical Hypertension
Adam Shardlow, Natasha J McIntyre, Richard J Fluck, Christopher W McIntyre, Maarten W Taal
BACKGROUND: Chronic kidney disease (CKD) is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD) and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance. METHODS AND FINDINGS: In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom...
September 2016: PLoS Medicine
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
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