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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Radmila Žeravica, Branislava Ilinčić, Velibor Čabarkapa, Isidora Radosavkić, Jelena Samac, Katarina Nikoletić, Zoran Stošić
AIM: Elevated fractional excretion of magnesium (FEMg) is a noninvasive biomarker of kidney damage, but its association with kidney functional parameters in nondiabetic chronic kidney disease (CKD) patients has not been sufficiently explored thus far. METHODS: We enrolled 111 adult patients with nondiabetic CKD and 30 controls. To precisely investigate kidney function, the following parameters were assessed measured glomerular filtration rate (mGFR), effective renal plasma flow (ERPF), Cystatin C, albuminuria, and fractional excretion of magnesium (FEMg)...
May 1, 2018: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
Lesley A Inker, Morgan E Grams, Andrew S Levey, Josef Coresh, Massimo Cirillo, John F Collins, Ron T Gansevoort, Orlando M Gutierrez, Takayuki Hamano, Gunnar H Heine, Shizukiyo Ishikawa, Sun Ha Jee, Florian Kronenberg, Martin J Landray, Katsuyuki Miura, Girish N Nadkarni, Carmen A Peralta, Dietrich Rothenbacher, Elke Schaeffner, Sanaz Sedaghat, Michael G Shlipak, Luxia Zhang, Arjan D van Zuilen, Stein I Hallan, Csaba P Kovesdy, Mark Woodward, Adeera Levin
RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. STUDY DESIGN: Cross-sectional individual participant-level analyses in a global consortium. SETTING & STUDY POPULATIONS: 17 CKD and 38 general population and high-risk cohorts...
October 19, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ying Zheng, Li Tang, Weiguang Zhang, Delong Zhao, Dong Zhang, Li Zhang, Guangyan Cai, Xiangmei Chen
Background: The 2017 high blood pressure (BP) clinical practice guideline reported by the American College of Cardiology/American Heart Association put forward new categories of BP. This study aimed to assess the applicability of the new guideline in a nondialysis chronic kidney disease (CKD) population. Methods: This is a nationwide, multicenter, cross-sectional study with a large sample. A total of 8927 nondialysis CKD patients in 61 tertiary hospitals in all 31 provinces, municipalities and autonomous regions of China (except Hong Kong, Macao and Taiwan) were analyzed...
October 9, 2018: Nephrology, Dialysis, Transplantation
Qi Qian
Our knowledge on sodium and water homeostasis and regulation continues to evolve. A considerable amount of new information in this area has emerged in recent years. This review summarizes existing and new literature and discusses complex multi-organ effects of high-salt and low-water intake and role of arginine vasopressin in this process, as well as the potential clinical significance of non-osmotic sodium storage pool and rhythmicity of urine sodium excretion. It has become clear that sodium and water dysregulation can exert profound effects on kidney and vascular health, far greater than previously recognized...
October 2018: Nephrology
Patrick Harnett, Matthew Jones, Michael Almond, Gowrie Ballasubramaniam, Vinni Kunnath
Chronic kidney disease (CKD) is common. A small proportion of patients with CKD progress to require interventions, which may include dialysis. Monitoring patients with CKD is supported by national guidelines. Monitoring systems to plan management of CKD vary in form. A novel monitoring system, the virtual CKD clinic (VC) was introduced at our hospital. The VC is a non-face-to-face results review of patients with CKD. We found that the VC was an effective monitoring system. None of the patients from the VC required emergency dialysis, suggesting robust surveillance...
October 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Harry H Liu, Sophia Zhao
No abstract text is available yet for this article.
November 2018: Journal of the American Society of Nephrology: JASN
Ziad A Massy, Sophie Liabeuf
Uraemic toxins seem to play an important role in the genesis of cardiovascular and renal damage in chronic kidney disease patients. This short article is divided into two thematic sections. The first part focuses on a selection of 'old' toxins for which recent data (published between 2016 and 2018) have provided a better understanding of the associated harmful mechanisms and which, in our opinion, nephrologists should be more aware of. The second part highlights new perspectives for identifying and quantifying these compounds using 'omics' techniques...
October 1, 2018: Nephrology, Dialysis, Transplantation
Jonathon R Campbell, James C Johnston, Lisa A Ronald, Mohsen Sadatsafavi, Robert F Balshaw, Victoria J Cook, Adeera Levin, Fawziah Marra
RATIONALE & OBJECTIVE: In countries with a low tuberculosis (TB) incidence, TB disproportionately affects populations born abroad. TB persists in these populations through reactivation of latent TB infection (LTBI) acquired before immigration. Those with chronic kidney disease (CKD) are at increased risk for reactivation and may benefit from LTBI screening and treatment. STUDY DESIGN: Health administrative data from British Columbia, Canada, were used to inform a cost-effectiveness analysis evaluating LTBI screening in those diagnosed with stage 4 or 5 CKD not requiring dialysis (late-stage CKD) and those who began dialysis therapy...
September 28, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Francesca Viazzi, Giovanna Leoncini, Guido Grassi, Roberto Pontremoli
A bidirectional relationship between hypertension and kidney disease, with one exacerbating the effect of the other, is well established. Elevated blood pressure (BP) is a well-recognized, modifiable risk factor for cardiovascular (CV) disease as well as for development and progression of chronic kidney disease and, therefore, the identification of optimal BP target is a key issue in the management of renal patients. Recent large trials and real life cohort studies have indicated that below a definite BP value renal protection seems to plateau and too low levels may even be associated with a paradoxical increase in renal morbidity, thus reviving the debate about the so called BP -renal function J-curve relationship...
September 28, 2018: Journal of Clinical Hypertension
Junichi Ishigami, Marco Trevisan, Hong Xu, Josef Coresh, Kunihiro Matsushita, Juan-Jesus Carrero
RATIONALE & OBJECTIVE: Low estimated glomerular filtration rate (eGFR) increases infection risk, but its contribution to hospital-acquired infection following major surgery is unknown. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Residents of Stockholm, Sweden, 18 years or older with at least 1 recorded serum creatinine measurement, no recent diagnoses of infection, and hospitalized for orthopedic, abdominal, cardiothoracic and vascular, or neurologic surgery between January 2007 and December 2011...
September 7, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Anna Jonsson, Helena Norberg, Ellinor Bergdahl, Krister Lindmark
AIM: Previous studies and national assessments indicate an undertreatment of mineralocorticoid receptor antagonists (MRA) in heart failure with reduced ejection fraction (HFrEF). This study aimed to investigate why MRA is not used to full extent. METHODS: A complete community-based heart failure population was studied. Several variables were collected, and medical records were scrutinized to identify reasons for not prescribing MRA. RESULTS: Of 2029 patients, 812 had EF ≤40%...
October 2018: Cardiovascular Therapeutics
Melissa Corson, Ashley Moch, Sammy Saab
An important interplay exists between hepatitis C virus (HCV) infection and chronic kidney disease (CKD). HCV infection is associated with an increased risk of morbidity and mortality in patients coinfected with CKD, and patients with CKD have an increased risk of HCV infection. Direct-acting antiviral (DAA) agents have changed the landscape of treatment with excellent sustained virologic response rates and fewer side effects than previously seen. An increasing number of studies demonstrate that DAA agents are efficacious and safe both in patients on dialysis and in patients who have undergone kidney transplantation...
May 2018: Gastroenterology & Hepatology
Gabriela Ferreira Dias, Natalia Borges Bonan, Thiago Maass Steiner, Sara Soares Tozoni, Silvia Rodrigues, Lia Sumie Nakao, Viktoriya Kuntsevich, Roberto Pecoits Filho, Peter Kotanko, Andréa N Moreno-Amaral
It is hypothesized that the uremic toxin indoxyl sulfate (IS) plays a role in the pathogenesis of renal anemia. To further explore that hypothesis, we examined the effects of IS on reactive oxygen species (ROS) production, levels of reduced glutathione (GSH), and erythrocyte death (eryptosis) in red blood cells (RBC) from healthy controls (CON-RBC) and hemodialyzed patients (HD-RBC), respectively. RBC were incubated either in either TRIS-Glc-BSA buffer or IS at concentrations of 0.01, 0.09, and 0.17 mM, respectively...
July 5, 2018: Toxins
Kaori Morimoto, Yuuta Tominaga, Yuta Agatsuma, Masanari Miyamoto, Shota Kashiwagura, Akira Takahashi, Yoshimi Sano, Kentaro Yano, Chihaya Kakinuma, Takuo Ogihara, Mikio Tomita
Indoxyl sulfate (IS) is a protein-bound uremic toxin that progressively accumulates in plasma during chronic kidney disease (CKD), and its accumulation is associated with the progression of CKD. This study examined the intestinal secretion of IS using in situ single-pass intestinal perfusion in a rat model of renal insufficiency, MRP2- and BCRP-overexpressing Sf9 membrane vesicles, and Caco-2 cell monolayers. An in situ single-pass perfusion study in CKD model rats demonstrated that a small amount of IS is secreted into intestinal lumen after iv administration of IS, and the clearance increased AUC-dependently...
July 2018: Biopharmaceutics & Drug Disposition
Jennifer A Hirst, Maria Dla Vazquez Montes, Clare J Taylor, José M Ordóñez-Mena, Emma Ogburn, Vanshika Sharma, Brian Shine, Tim James, Fd Richard Hobbs
BACKGROUND: Chronic kidney disease (CKD) is diagnosed using the estimated glomerular filtration rate (eGFR) and the urinary albumin:creatinine ratio (ACR). The eGFR is calculated from serum creatinine levels using the Modification of Diet in Renal Disease (MDRD) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. AIM: To compare the performance of one versus two eGFR/ACR measurements, and the impact of equation choice, on CKD diagnosis and classification...
August 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Amanda Reis, Caitlyn Luecke, Thomas Keefe Davis, Aadil Kakajiwala
Pain is a common problem in children with chronic kidney disease (CKD); however, limited data exist regarding its management. Although most pain is managed pharmacologically, in some instances non-pharmacologic management can aid in safely ameliorating discomfort. Because of the accumulation of toxic metabolites, many common pain medications have adverse effects on kidney function or altered pharmacokinetics in the setting of CKD. Decreased clearance impacts safe dosing of analgesics. The pain management of patients on renal replacement therapy requires an understanding of drug clearance due to the different modalities of dialysis...
May 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Maarten W Taal
PURPOSE OF REVIEW: The prevalence of chronic kidney disease (CKD) steeply rises with age but there is controversy regarding the diagnosis and clinical significance of CKD in older people. This article reviews recent advances in our understanding with respect to the diagnosis, aetiology and adverse outcomes associated with CKD in older people. RECENT FINDINGS: Comparisons with measured glomerular filtration rate in a cohort of older people found that the Chronic Kidney Disease Epidemiology Collaboration equation using creatinine and cystatin C performs at least as well as other equations developed to estimate glomerular filtration rate in older populations...
November 2015: Current Opinion in Nephrology and Hypertension
Fabio Angeli, Giorgio Gentile, Monica Trapasso, Paolo Verdecchia, Gianpaolo Reboldi
Hypertension is a key risk factor for chronic kidney disease (CKD), but can also be a detrimental consequence of established CKD. Unsurprisingly, the majority of subjects with abnormal creatinine in the general population are also hypertensive, with a huge toll on national health care systems worldwide due to a staggering increase in the risk of cardiovascular complications and end-stage renal disease requiring renal replacement therapy. In this setting, a comprehensive and careful assessment of the whole 24-h blood pressure (BP) profile could be of paramount importance in ensuring a timely diagnosis of hypertension and an optimal therapeutic control...
September 2018: Journal of Human Hypertension
Claire Trivin-Avillach, Éric Thervet
Chronic kidney disease (CKD) is associated with significant infectious complications leading to adverse health outcomes. This increased susceptibility to infection can be related to the nephropathy itself as observed in nephrotic syndrome, to the treatment especially in situations requiring immunosuppressive drugs or related to dialysis. Despite a less effective response to vaccination, some data emphasize similar benefits from immunization among people with CKD to the general population. However, some situations encountered in nephrology require adaptation of immunization practices...
June 7, 2018: Néphrologie & Thérapeutique
Nishank Jain, Robert F Reilly
Oral anticoagulants are commonly used drugs in patients with CKD and patients with ESKD to treat atrial fibrillation to reduce stroke and systemic embolism. Some of these drugs are used to treat or prevent deep venous thrombosis and pulmonary embolism in patients with CKD who undergo knee and hip replacement surgeries. Warfarin is the only anticoagulant that is approved for use by the Food and Drug Administration in individuals with mechanical heart valves. Each oral anticoagulant affects the coagulation profile in the laboratory uniquely...
May 25, 2018: Clinical Journal of the American Society of Nephrology: CJASN
2018-06-12 12:06:18
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