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Maria Kalafateli, Fred Wickham, Maria Burniston, Evangelos Cholongitas, Eleni Theocharidou, Matteo Garcovich, James O'Beirne, Rachel Westbrook, Gioacchino Leandro, Andrew K Burroughs, Emmanuel A Tsochatzis
: Current expressions based on serum creatinine concentration overestimate kidney function in cirrhosis leading to significant differences between "true" and calculated glomerular filtration rate (GFR). We compared the performance of MDRD-4, MDRD-6 and CKD-EPI with "true" GFR and the impact of this difference on MELD calculation. We subsequently developed and validated a GFR equation specifically for cirrhosis and compared the performance of the new derived formula with existing GFR formulas...
October 25, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Bharat V Shah, Zamurrud M Patel
BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem and more so in India. With limited availability and high cost of therapy, barely 10 % of patients with incident end stage renal disease (ESRD) cases get treatment in India. Therefore, all possible efforts should be made to retard progression of CKD. This article reviews the role of low protein diet (LPD) in management of CKD subjects and suggests how to apply it in clinical practice. DISCUSSION: The role of LPD in retarding progression of CKD is well established in animal experimental studies...
October 21, 2016: BMC Nephrology
Jérôme Dumortier, François Bailly, Georges-Philippe Pageaux, Anaïs Vallet-Pichard, Sylvie Radenne, François Habersetzer, Marie-Claude Gagnieu, Jean-Didier Grangé, Anne Minello, Olivier Guillaud, Nassim Kamar, Laurent Alric, Vincent Leroy
BACKGROUND: Chronic hepatitis C virus (HCV) infection is the most common chronic liver disease in patients with end-stage renal disease (ESRD). Over the last few years, second-generation direct-acting antivirals have been revolutionary in the treatment of hepatitis C, and sofosbuvir (SOF) is the backbone of most modern treatment strategies. Since SOF is eliminated through the kidney, the aim of this multicentre retrospective study was to assess its antiviral efficacy and safety in HCV-infected patients with severe renal failure [including haemodialysis (HD) patients]...
October 19, 2016: Nephrology, Dialysis, Transplantation
Meixue Chen, Jumei Xia, Guangchang Pei, Ying Zhang, Shuting Wu, Yushuang Qin, Yuanjun Deng, Shuiming Guo, Yanyan Guo, Gang Xu, Min Han
BACKGROUND: Researchers have developed several equations to predict glomerular filtration rate (GFR) in patients with chronic kidney diseases (CKD). However, there are scarcely any studies performed to discern the best equation to estimate GFR in patients with pure obstructive nephropathy. In present study, we assessed the suitability of six prediction equations and compared their performance in eGFR evaluation for Chinese patients with obstructive nephropathy. METHODS: A total of 245 adult patients with obstructive nephropathy were enrolled...
October 18, 2016: BMC Nephrology
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Mumtaz Takir, Aslı Dogruk Unal, Osman Kostek, Nilufer Bayraktar, Nilgun Guvener Demirag
OBJECTIVE: To evaluate renal impairment in type 2 diabetic patients with normoalbuminuria or microalbuminuria by detection of serum cystatin C and serum and urinary TGF-β levels. METHODS: Cross-sectional study conducted at the Department of Endocrinology in Baskent University School of Medicine. Patients with type 2 diabetes mellitus without known overt diabetic nephropathy were included in the study. Recruited patients were stratified into four groups, matched in terms of age, gender, microalbuminuria level and estimated GFR calculated with MDRD...
October 13, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Cyril Garrouste, Dany Anglicheau, Nassim Kamar, Claire Bachelier, Joseph Rivalan, Bruno Pereira, Sophie Caillard, Julien Aniort, Philippe Gatault, Martin Soubrier, Johnny Sayegh, Charlotte Colosio, Anthony Buisson, Eric Thervet, Nicolas Bouvier, Anne Elisabeth Heng
Anti-tumor necrosis factor-α (TNFα) therapy has improved the prognosis of many chronic inflammatory diseases. It appears to be well-tolerated by liver-transplant patients. However, their use and their safety in kidney-transplant patients have yet to be determined.In this retrospective study, we identified 16 adult kidney-transplant patients aged 46.5 years (34-51.8) who received anti-TNFα therapy from 7 kidney transplantation centers. The indications for this treatment included: chronic inflammatory bowel disease (n = 8), inflammatory arthritis (n = 5), AA amyloidosis (n = 1), psoriasis (n = 1), and microscopic polyangiitis (n = 1)...
October 2016: Medicine (Baltimore)
Simon R Knight, Samia Hussain
Early measures of graft function are increasingly used to assess efficacy in clinical trials of kidney transplant immunosuppression. This study aimed to assess the variability and quality of reporting of these endpoints in contemporary trials. Data regarding renal function endpoints were extracted from 213 reports from randomised controlled trials comparing immunosuppressive interventions in renal transplant recipients published between 2010 and 2014. 174 (81.7%) reports included a measure of renal function; in 44 (20...
October 14, 2016: Clinical Transplantation
Wei Zheng, Geng Qian, Wenjun Hao, Xiaodong Geng, Quan Hong, Guangyan Cai, Xiangmei Chen, Di Wu
METHODS: A total of 2426 study subjects from rural China aged 35 years and above (934 men and 1492 women) were enrolled in a cross-sectional survey. The eGFR calculation was based on the Modification of Diet in Renal Disease (MDRD) equation. The strength of the association between cardiovascular metabolic risk factors and eGFR was analyzed using a linear regression model. RESULTS: Cardiovascular metabolic risk factors, including age, body weight, waist circumference, fasting plasma glucose (FPG), creatinine (Cr), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), systolic pressure, and diastolic pressure, were associated with eGFR...
October 12, 2016: Lipids in Health and Disease
Elias David-Neto, Ana Heloisa Kamada Triboni, Fernanda Ramos, Fabiana Agena, Nelson Zocoler Galante, Marcelo Altona, Francine Brambate Carvalhinho Lemos, Marcelo Tatit Sapienza, William Carlos Nahas
Equations to estimate glomerular filtration rate (eGFR) were developed in patients using the variables: age, body weight and serum creatinine which may be different in the elderly. Elderly renal transplant patients (EG; n=70; mean age 65±4y) who measured plasma (51) Cr-EDTA-Clearance (mGFR) had mGFR compared to eGFR obtained by the Cockcroft-Gault corrected by body surface area (CG-BSA), the Modification of Diet in Renal Disease (MDRD-4), the Berlin Initiative Study (BIS-1) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)...
October 11, 2016: Clinical Transplantation
Ricardo Brandina, Katia Ramos Moreira Leite, Emerson Pereira Gregório, Karen Barros Parron Fernandes, Miguel Srougi
OBJECTIVES: To assess the association of histopathological parameters in non-neoplastic renal parenchyma with development of new onset chronic kidney disease (CKD) after radical nephrectomy. METHODS: Data were extracted from 222 patients who underwent radical nephrectomy. The Modification of Diet in Renal Disease (MDRD) formula was used. The study end point was development of CKD, defined as an estimated glomerular filtration rate (eGFR) of less than 60ml/minute/1,73m(2)...
October 7, 2016: Urology
Gianluca Gessoni, Sara Valverde, Francesca Gessoni, Letizia Valle, Roberto Valle
BACKGROUND: In this paper we evaluated the relationship between trough DAB concentration with eGFR calculated using CRE and CYS based formulas. MATERIALS AND METHODS: We considered 100 patients. eGFR was calculated using CKD-EPIcreat, CG, MDRD, CKD-EPIcys and CKD-EPIcombined equations. DAB dosage was selected on the basis of CKD-EPIcreat and relationship between trough DAB concentration and eGFRs was evaluated. RESULTS: Trough DAB concentration roughly correlates with eGFR calculated using various formulas...
October 3, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Éric Sagou Yayo, Mireille Aye, Jean-Louis Konan, Arlette Emième, Marie-Laure Attoungbre, Appolinaire Gnionsahé, Étienne Cavalier, Dagui Monnet, Pierre Delanaye
Glomerular filtration rate (GFR) estimation is fundamental in clinical nephrology. It is usually estimated from equations based on serum creatinine. An ethnic factor is currently recommended for the black population for the two most used equations, i.e. the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations. However, these factors were determined from African-American subjects. Therefore, their use in the African subject (non-American) remained questionable...
September 24, 2016: Néphrologie & Thérapeutique
Xun Liu, Meredith C Foster, Hocine Tighiouart, Amanda H Anderson, Gerald J Beck, Gabriel Contreras, Josef Coresh, John H Eckfeldt, Harold I Feldman, Tom Greene, L Lee Hamm, Jiang He, Edward Horwitz, Julia Lewis, Ana C Ricardo, Haochang Shou, Raymond R Townsend, Matthew R Weir, Lesley A Inker, Andrew S Levey
BACKGROUND: Unlike the case with creatinine, conditions affecting the non-glomerular filtration rate (GFR) determinants of low-molecular-weight serum proteins, β-trace protein (BTP), β2-microglobulin (B2M), and cystatin C, are not well characterized. STUDY DESIGN: Pooled cross-sectional analysis of 3 studies. SETTING & PARTICIPANTS: 3,156 persons with chronic kidney disease from the MDRD (Modification of Diet in Renal Disease) Study, AASK (African American Study of Kidney Disease and Hypertension), and CRIC (Chronic Renal Insufficiency Cohort) Study...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Asli Tufan, Fatih Tufan, Timur Selcuk Akpinar, Birkan Ilhan, Gulistan Bahat, Mehmet Akif Karan
INTRODUCTION: We aimed to evaluate the association of a decreased glomerular-filtration-rate (GFR <60 ml/min/1.73 m(2)), estimated using Modification of Diet in Renal Disease (MDRD), creatinine- and cystatin C-based (CKDEPI-CR and CKDEPI-CC) Chronic Kidney Disease Epidemiology Collaboration equations with handgrip strength (HGS). METHODS: Community-dwelling males aged ≥60 years admitted to outpatient clinic were included. We used MDRD, CKDEPI-CR, and CKDEPI-CC formulas for GFR estimation and corrected these for body surface area...
September 20, 2016: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
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
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Marcelino Rivera, Chris Jaeger, Daniel Yelfimov, Amy Krambeck
OBJECTIVE: To study brushite stone formers (BSF) change in renal function and overall risk of progression to chronic kidney disease (CKD) over time. MATERIALS AND METHODS: A retrospective review of all patients with urolithiasis on stone analysis was performed from 1995-2003. Stones were classified as brushite if they had at least 10% brushite composition on analysis. Patients with a minimum of 6 years clinical follow-up were included in the study. BSF were matched 1:3 to idiopathic calcium oxalate stone formers (CaOxSF) over the same time period...
September 12, 2016: Urology
Karl J Neff, Gregory Baud, Violeta Raverdy, Robert Caiazzo, Helene Verkindt, François Pattou, Carel W le Roux, Christian Noel
PURPOSE: This study examines the effect of Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) on renal function for at least 5 years post-operatively in a tertiary referral center for bariatric surgery. MATERIALS AND METHODS: This prospective cohort study of patients undergoing RYGB and LAGB measured renal function, blood pressure, and diabetes status pre-operatively and then 1 and 5 years post-operatively. Renal function was assessed using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault formulae...
September 14, 2016: Obesity Surgery
Raul Fernandez-Prado, Esmeralda Castillo-Rodriguez, Fernando Javier Velez-Arribas, Carolina Gracia-Iguacel, Alberto Ortiz
Direct oral anticoagulants (DOACs) may require dose reduction or avoidance when glomerular filtration rate is low. However, glomerular filtration rate is not usually measured in routine clinical practice. Rather, equations that incorporate different variables use serum creatinine to estimate either creatinine clearance in mL/minute or glomerular filtration rate in mL/minute/1.73m(2). The Cockcroft-Gault equation estimates creatinine clearance and incorporates weight into the equation. By contrast, the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations estimate glomerular filtration rate and incorporate ethnicity but not weight...
September 6, 2016: American Journal of Medicine
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