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https://www.readbyqxmd.com/read/28432691/tenapanor-administration-and-the-activity-of-the-h-coupled-transporter-pept1-in-healthy-volunteers
#1
Susanne Johansson, David P Rosenbaum, Johan Palm, Bergur Stefansson, Mikael Knutsson, Eleanor A Lisbon, Constanze Hilgendorf
AIM: Tenapanor (RDX5791/AZD1722), an inhibitor of gastrointestinal Na(+) /H(+) exchanger NHE3, is being evaluated for the treatment of patients with constipation-predominant irritable bowel syndrome and the treatment of hyperphosphataemia in patients with chronic kidney disease on dialysis. By reducing intestinal H(+) secretion, inhibition of NHE3 by tenapanor could indirectly affect H(+) -coupled transporter activity, leading to drug-drug interactions. We investigated the effect of tenapanor on the activity of the H(+) -coupled peptide transporter PepT1 via assessment of the pharmacokinetics of cefadroxil - a compound transported by PepT1 - in healthy volunteers...
April 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#2
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28418625/physical-function-was-related-to-mortality-in-patients-with-chronic-kidney-disease-and-dialysis
#3
REVIEW
Shinichiro Morishita, Atsuhiro Tsubaki, Nobuyuki Shirai
Previous studies have shown that exercise improves aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life (QOL) in patients with chronic kidney disease (CKD) and dialysis. Recently, additional studies have shown that higher physical activity contributes to survival and decreased mortality as well as physical function and QOL in patients with CKD and dialysis. Herein, we review the evidence that physical function and physical activity play an important role in mortality for patients with CKD and dialysis...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#4
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing hemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-dialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28394304/the-diet-and-haemodialysis-dyad-three-eras-four-open-questions-and-four-paradoxes-a-narrative-review-towards-a-personalized-patient-centered-approach
#5
REVIEW
Giorgina Barbara Piccoli, Maria Rita Moio, Antioco Fois, Andreea Sofronie, Lurlinys Gendrot, Gianfranca Cabiddu, Claudia D'Alessandro, Adamasco Cupisti
The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28385806/urine-ammonium-predicts-clinical-outcomes-in-hypertensive-kidney-disease
#6
Kalani L Raphael, David J Carroll, Jennifer Murray, Tom Greene, Srinivasan Beddhu
Metabolic acidosis is associated with poor outcomes in CKD. Because impaired renal ammonium excretion is important in the pathogenesis of acidosis, urine ammonium excretion might be a better and perhaps earlier acid-base indicator of risk than serum bicarbonate, particularly in patients without acidosis. We evaluated the association between baseline ammonium excretion and clinical outcomes in African American Study of Kidney Disease and Hypertension participants (n=1044). Median daily ammonium excretion was 19...
April 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28385348/the-association-between-changes-in-lifestyle-behaviors-and-the-incidence-of-chronic-kidney-disease-ckd-in-middle-aged-and-older%C3%A2-men
#7
Ryoma Michishita, Takuro Matsuda, Shotaro Kawakami, Satoshi Tanaka, Akira Kiyonaga, Hiroaki Tanaka, Natsumi Morito, Yasuki Higaki
BACKGROUND: This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD). METHODS: The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night dinner, bedtime snacking, skipping breakfast, and drinking and smoking habits...
April 3, 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28383400/protocol-of-randomized-control-trial-for-effectiveness-of-angiotensin-receptor-blockers-on-blood-pressure-control-among-euvolemic-hypertensive-hemodialysis-patients
#8
Raja Ahsan Aftab, Amer Hayat Khan, Syed Azhar Syed Sulaiman, Tahir Mehmood Khan, Azreen Syazril Adnan
INTRODUCTION: Volume overload and the renin-aldosterone-angiotensin system (RAAS) are 2 major factors contributing to hypertension (HTN) among hemodialysis (HD) patients. Although volume-dependent components of HTN can be corrected by appropriate volume removal, a proportion of HD patients experience elevated blood pressure (BP) despite achieving euvolemic and ideal dry weight. METHOD AND ANALYSIS: A single center, prospective, randomized, parallel design, single-blind trial will be conducted in the Malaysian state of Kelantan among postdialysis euvolemic hypertensive patients that are on regular dialysis at least 3 times a week...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28372955/colloids-in-cardiac-surgery-friend-or-foe
#9
Pia Katarina Ryhammer, Mariann Tang, Joachim Hoffmann-Petersen, Dovile Leonaviciute, Jacob Greisen, Marie Storebjerg Gissel, Carl-Johan Jakobsen
OBJECTIVE: The right choice of fluid replacement still is a matter of debate. Recently, two large-scale studies on the use of hydroxyethyl starches (HES) in the intensive care setting have been published, which have caused a huge shift in the daily practice of volume therapy. These results have been applied to patients outside intensive care. The aim of this study was to evaluate the impact this change has had on the outcomes in a large population of cardiac surgery patients, with a focus on the type of colloid infusion...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28356062/successful-multigravid-pregnancy-in-a-42-year-old-patient-on-continuous-ambulatory-peritoneal-dialysis-and-a-review-of-the-literature
#10
Thiam Seong Christopher Lim, Malini Shanmuganathan, Irene Wong, Bak Leong Goh
BACKGROUND: For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient's pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28355404/daily-variability-of-resting-energy-expenditure-in-acute-kidney-injury-patients-on-dialysis
#11
Cassiana Regina de Góes, Ana Claudia Soncini Sanches, André Balbi, Daniela Ponce
INTRODUCTION: It is needed for nutrition prescription correct estimate of resting energy expenditure (REE), which is a challenge given the possible daily variation in critically ill patients with acute kidney injury (AKI). OBJECTIVE: To evaluate the daily variability of REE measured by indirect calorimetry (IC) in patients with AKI and dialysis indication and identify clinical variables associated with REE. METHODS: The REE was measured on the time of dialysis indication and the subsequent four days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28346348/vitamin-d-in-chronic-kidney-disease-and-dialysis-patients
#12
REVIEW
Guillaume Jean, Jean Claude Souberbielle, Charles Chazot
Vitamin D deficiency (<20 ng/mL) and insufficiency (20-29 ng/mL) are common among patients with chronic kidney disease (CKD) or undergoing dialysis. In addition to nutritional and sunlight exposure deficits, factors that affect vitamin D deficiency include race, sex, age, obesity and impaired vitamin D synthesis and metabolism. Serum 1,25(OH)₂D levels also decrease progressively because of 25(OH)D deficiency, together with impaired availability of 25(OH)D by renal proximal tubular cells, high fibroblast growth factor (FGF)-23 and decreased functional renal tissue...
March 25, 2017: Nutrients
https://www.readbyqxmd.com/read/28343225/clinical-trial-of-vadadustat-in-patients-with-anemia-secondary-to-stage-3-or-4-chronic-kidney-disease
#13
Edouard R Martin, Mark T Smith, Bradley J Maroni, Qing C Zuraw, Emil M deGoma
BACKGROUND: Therapeutic options for the treatment of anemia secondary to chronic kidney disease (CKD) remain limited. Vadadustat (AKB-6548) is an oral hypoxia-inducible factor prolyl-hydroxylase domain (HIF-PHD) inhibitor that is being investigated for the treatment of anemia secondary to CKD. METHODS: A phase 2a, multicenter, randomized, double-blind, placebo-controlled, dose-ranging trial (NCT01381094) was undertaken in adults with anemia secondary to CKD stage 3 or 4...
March 25, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28325686/errors-in-computing-the-normalized-protein-catabolic-rate-due-to-use-of-single-pool-urea-kinetic-modeling-or-to-omission-of-the-residual-kidney-urea-clearance
#14
John T Daugirdas
OBJECTIVES: The protein catabolic rate normalized to body size (PCRn) often is computed in dialysis units to obtain information about protein ingestion. However, errors can manifest when inappropriate modeling methods are used. METHODS: We used a variable volume 2-pool urea kinetic model to examine the percent errors in PCRn due to use of a 1-pool urea kinetic model or after omission of residual urea clearance (Kru). RESULTS: When a single-pool model was used, 2 sources of errors were identified...
March 18, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28302754/apixaban-pharmacokinetics-at-steady-state-in-hemodialysis-patients
#15
Thomas A Mavrakanas, Caroline F Samer, Sharon J Nessim, Gershon Frisch, Mark L Lipman
It is unclear whether warfarin is protective or harmful in patients with ESRD and atrial fibrillation. This state of equipoise raises the question of whether alternative anticoagulants may have a therapeutic role. We aimed to determine apixaban pharmacokinetics at steady state in patients on hemodialysis. Seven patients received apixaban 2.5 mg twice daily for 8 days. Blood samples were collected before and after apixaban administration on days 1 and 8 (nondialysis days). Significant accumulation of the drug was observed between days 1 and 8 with the 2...
March 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28301096/effects-of-tenapanor-on-cytochrome-p450-mediated-drug-drug-interactions
#16
Susanne Johansson, David P Rosenbaum, Marie Ahlqvist, Helen Rollison, Mikael Knutsson, Bergur Stefansson, Marie Elebring
Tenapanor (RDX5791, AZD1722) is an inhibitor of sodium/hydrogen exchanger isoform 3 in development for the treatment of constipation-predominant irritable bowel syndrome and the treatment of hyperphosphatemia in patients with chronic kidney disease on dialysis. We aimed to investigate whether tenapanor inhibits or induces cytochrome P450s (CYPs). In vitro experiments assessing the potential of tenapanor to affect various CYPs indicated that it could inhibit CYP3A4/5 (IC50 0.4-0.7 μM). An open-label, phase 1 clinical study (NCT02140268) evaluated the pharmacokinetics of the CYP3A4 substrate midazolam when administered with and without tenapanor...
March 16, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28301073/thyroid-function-in-end-stage-renal-disease-and-effects-of-frequent-hemodialysis
#17
Joan C Lo, Gerald J Beck, George A Kaysen, Christopher T Chan, Alan S Kliger, Michael V Rocco, Minwei Li, Glenn M Chertow
INTRODUCTION: End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function. METHODS: Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD. Among those with endogenous thyroid function (without overt hyper/hypothyroidism or thyroid hormone supplementation), we examined the association of thyroid hormone concentration with multiple parameters of self-reported health status, and physical and cognitive performance, and the effects of hemodialysis frequency on serum thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) levels...
March 16, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28292607/looking-for-engineered-nanoparticles-enps-in-wastewater-treatment-systems-qualification-and-quantification-aspects
#18
Soohoon Choi, Murray V Johnston, Gen-Suh Wang, C P Huang
The current study developed a rationalized method for the quantification and identification of engineered nanoparticles (ENPs) in wastewaters. A review of current literature revealed that overall, presently available methods focused on single ENP mostly and were applicable mainly to samples of low organic loadings or under well-controlled laboratory conditions. In the present research, procedures including dialysis for desalting and low-temperature oxidation for organic removal were used to pretreat samples of high organic loadings, specifically, municipal wastewater and sludge...
March 11, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28271257/outcomes-of-diuretic-use-in-pre-dialysis-ckd-patients-with-moderate-renal-deterioration-attending-tertiary-care-referral-center
#19
Yusra Habib Khan, Azmi Sarriff, Azreen Syazril Adnan, Amer Hayat Khan, Tauqeer Hussain Mallhi
INTRODUCTION: Diuretic therapy has been the mainstay of treatment in chronic kidney disease (CKD) patients, primarily for hypertension and fluid overload. Apart from their beneficial effects, diuretic use is associated with adverse renal outcomes. The current study is aimed to determine the outcomes of diuretic therapy. METHODOLOGY: A prospective observational study was conducted by inviting pre-dialysis CKD patients. Fluid overload was assessed by Bioimpedance analysis (BIA)...
March 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28264150/blood-pressure-management-in-hemodialysis-patients-what-we-know-and-what-questions-remain
#20
REVIEW
Dana C Miskulin, Daniel E Weiner
Despite having thousands of blood pressure (BP) readings on individual dialysis patients over the course of a year, our knowledge about the optimal assessment of BP, the mechanisms underlying hypertension and its management remain incomplete. Observational studies reveal that BP is lower at home than when measured in the dialysis unit. However, we do not know if using home vs. in-center measurements to guide treatment decisions improves BP control and/or clinical outcomes. Moreover, a recent US study suggests that typical hemodialysis patients are unlikely to adhere to home monitoring over the long term...
March 6, 2017: Seminars in Dialysis
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