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Publisher: Elsevier   (Total: 3034 journals)

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Showing 1 - 200 of 3034 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 19, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 81, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 322, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 200, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 22, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 122, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 43, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 20, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 24)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 34, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 21, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 58)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 337, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 309, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 393, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 50, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 46, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 45, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 30, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 44, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 180, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 54, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 33, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 51, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 161, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 151, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Kidney Diseases
  [SJR: 2.313]   [H-I: 172]   [32 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0272-6386 - ISSN (Online) 1523-6838
   Published by Elsevier Homepage  [3034 journals]
  • Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis
           Access: Results of the Prospective, Multicenter Novel Endovascular Access
           Trial (NEAT)
    • Authors: Charmaine Lok; Dheeraj Rajan Jason Clement Mercedeh Kiaii Ravi Sidhu
      Abstract: Publication date: Available online 14 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Charmaine E. Lok, Dheeraj K. Rajan, Jason Clement, Mercedeh Kiaii, Ravi Sidhu, Ken Thomson, George Buldo, Christine Dipchand, Louise Moist, Joanna Sasal
      Background Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. Study Design Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). Settings & Participants Consecutive adult non−dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand. Intervention Using catheter-based endovascular technology and radiofrequency energy, an anastomosis was created between target vessels, resulting in an endovascular AVF (endoAVF). Outcomes Safety, efficacy, functional usability, and patency end points. Measurements Safety as percentage of device-related serious adverse events; efficacy as percentage of endoAVFs physiologically suitable (brachial artery flow ≥ 500mL/min, vein diameter ≥ 4mm) for dialysis within 3 months; functional usability of endoAVFs to provide prescribed dialysis via 2-needle cannulation; primary and cumulative endoAVF patencies per standardized definitions. Results 80 patients were enrolled (20 roll-in and 60 participants in the full analysis set; the latter are reported). EndoAVFs were created in 98% of participants; 8% had a serious procedure-related adverse event (2% device related). 87% were physiologically suitable for dialysis (eg, mean brachial artery flow, 918mL/min; endoAVF vein diameter, 5.2mm [cephalic vein]). EndoAVF functional usability was 64% in participants who received dialysis. 12-month primary and cumulative patencies were 69% and 84%, respectively. Limitations Due to the unique anatomy and vessels used to create endoAVFs, this was a single-arm study without a surgical comparator. Conclusions An endoAVF can be reliably created using a radiofrequency magnetic catheter-based system, without open surgery and with minimal complications. The endoAVF can be successfully used for hemodialysis and demonstrated high 12-month cumulative patencies. It may be a viable alternative option for achieving AVFs for hemodialysis patients in need of vascular access.

      PubDate: 2017-06-19T05:42:00Z
       
  • Treating to Target in Older Hypertensive Patients: Where Is the
           Bull’s Eye'
    • Authors: Gary Schwartz
      Abstract: Publication date: Available online 10 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Gary L. Schwartz


      PubDate: 2017-06-14T05:37:21Z
       
  • Cognitive Function and Kidney Disease: Baseline Data From the Systolic
           Blood Pressure Intervention Trial (SPRINT)
    • Authors: Daniel Weiner; Sarah Gaussoin John Nord Alexander Auchus Gordon Chelune
      Abstract: Publication date: Available online 9 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Daniel E. Weiner, Sarah A. Gaussoin, John Nord, Alexander P. Auchus, Gordon J. Chelune, Michel Chonchol, Laura Coker, William E. Haley, Anthony A. Killeen, Paul L. Kimmel, Alan J. Lerner, Suzanne Oparil, Mohammad G. Saklayen, Yelena M. Slinin, Clinton B. Wright, Jeff D. Williamson, Manjula Kurella Tamura
      Background Chronic kidney disease is common and is associated with cardiovascular disease, cerebrovascular disease, and cognitive function, although the nature of this relationship remains uncertain. Study Design Cross-sectional cohort using baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT). Setting & Participants Participants in SPRINT, a randomized clinical trial of blood pressure targets in older community-dwelling adults with cardiovascular disease, chronic kidney disease, or high cardiovascular disease risk and without diabetes or known stroke, who underwent detailed neurocognitive testing in the cognition substudy, SPRINT−Memory and Cognition in Decreased Hypertension (SPRINT-MIND). Predictors Urine albumin-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Outcomes Cognitive function, a priori defined as 5 cognitive domains based on 11 cognitive tests using z scores, and abnormal white matter volume quantified by brain magnetic resonance imaging. Results Of 9,361 SPRINT participants, 2,800 participated in SPRINT-MIND and 2,707 had complete data; 637 had brain imaging. Mean age was 68 years, 37% were women, 30% were black, and 20% had known cardiovascular disease. Mean eGFR was 70.8±20.9mL/min/1.73m2 and median urine ACR was 9.7 (IQR, 5.7-22.5) mg/g. In adjusted analyses, higher ACR was associated with worse global cognitive function, executive function, memory, and attention, such that each doubling of urine ACR had the same association with cognitive performance as being 7, 10, 6, and 14 months older, respectively. Lower eGFR was independently associated with worse global cognitive function and memory. In adjusted models, higher ACR, but not eGFR, was associated with larger abnormal white matter volume. Limitations Cross-sectional only, no patients with diabetes were included. Conclusions In older adults, higher urine ACR and lower eGFR have independent associations with global cognitive performance with different affected domains. Albuminuria concurrently identifies a higher burden of abnormal brain white matter disease, suggesting that vascular disease may mediate these relationships.

      PubDate: 2017-06-14T05:37:21Z
       
  • ESRD After Heart Failure, Myocardial Infarction, or Stroke in Type 2
           Diabetic Patients With CKD
    • Authors: David Charytan; Scott Solomon Peter Ivanovich Giuseppe Remuzzi Mark Cooper
      Abstract: Publication date: Available online 7 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J.V. McMurray, Brian Claggett, Eldrin F. Lewis, Marc A. Pfeffer
      Background How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. Study Design Observational study. Setting & Participants 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). Predictor Postrandomization CV events. Outcomes ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event. Limitations Population limited to clinical trial participants with diabetes and anemia. Results 155 of 652 (23.8%) ESRD cases occurred after an intercurrent CV event; 110 (16.9%) cases followed heart failure, 28 (4.3%) followed myocardial infarction, 12 (1.84%) followed stroke, and 5 (0.77%) followed multiple CV events. ESRD rate was higher within 30 days in individuals with an intercurrent CV event compared with those without an intercurrent event (HR, 22.2; 95% CI, 17.0-29.0). Compared to no intercurrent CV events, relative risks for ESRD were higher after the occurrence of heart failure overall (HR, 3.4; 95% CI, 2.7-4.2) and at 30 days (HR, 20.1; 95% CI, 14.5-27.9) than after myocardial infarction or stroke (P <0.001). Compared with individuals without pre-ESRD events, those with ESRD following intercurrent CV events were older, were more likely to have prior CV disease, and had higher (24.4 vs 23.1mL/min/1.73m2; P =0.01) baseline estimated glomerular filtration rates (eGFRs) and higher eGFRs at last measurement before ESRD (18.6 vs 15.2mL/min/1.73m2; P <0.001), whereas race, sex, and medication use were similar. Post-ESRD mortality was similar (P =0.3) with and without preceding CV events. Conclusions Most ESRD cases occurred in individuals without intercurrent CV events who had lower eGFRs than individuals with intercurrent CV events, but similar post-ESRD mortality. Nevertheless, intercurrent CV events, particularly heart failure, are strongly associated with risk for ESRD. These findings underscore the need for kidney-specific therapies in addition to treatment of CV risk factors to lower ESRD incidence in diabetes.

      PubDate: 2017-06-08T18:59:50Z
       
  • Metabolic Acidosis or Respiratory Alkalosis? Evaluation of a Low Plasma
           Bicarbonate Using the Urine Anion Gap
    • Authors: Daniel Batlle; Jamie Chin-Theodorou Bryan Tucker
      Abstract: Publication date: Available online 7 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Daniel Batlle, Jamie Chin-Theodorou, Bryan M. Tucker
      Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history. The information derived from the urinary response to the prevailing acid-base disorder is useful to arrive at the correct diagnosis. We discuss the use of urine anion gap, as a surrogate marker of urine ammonium excretion, in the evaluation of a patient with low plasma bicarbonate concentration to differentiate between metabolic acidosis and chronic respiratory alkalosis. The interpretation and limitations of urine acid-base indexes at bedside (urine pH, urine bicarbonate, and urine anion gap) to evaluate urine acidification are discussed.

      PubDate: 2017-06-08T18:59:50Z
       
  • Reflections on a Question: “Would You Offer Dialysis?”
    • Authors: Aaron Wightman
      Abstract: Publication date: Available online 2 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Aaron G. Wightman


      PubDate: 2017-06-03T18:48:11Z
       
  • An Interactive Ambulatory Nephrology Curriculum for Internal Medicine
           Interns: Design, Implementation, and Participant Feedback
    • Authors: Alexis Gomez; Karen Warburton Rachel Miller Dan Negoianu Jordana Cohen
      Abstract: Publication date: Available online 2 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Alexis C. Gomez, Karen M. Warburton, Rachel K. Miller, Dan Negoianu, Jordana B. Cohen
      While diminishing nephrology fellow recruitment is a known issue, more work is needed to evaluate possible interventions to reverse this trend. We designed and implemented a curriculum to increase exposure to ambulatory nephrology among internal medicine interns. The curriculum focused on key aspects of outpatient nephrology practice, including supervised clinic visits, formal themed didactic content, and an online interactive forum with assigned evidence-based readings and small-group responses to relevant cases. We obtained postcourse surveys from all participating interns. Of the 43 interns who took part in the first year of the ambulatory nephrology curriculum, 100% reported a positive didactic experience and 91% reported a positive interactive online experience. 77% reported an improvement in their familiarity with clinical nephrology practice (median 2-point increase in familiarity score on a 7-point scale, P <0.001 by signed rank testing). Qualitative feedback included praise for the high-yield topics covered by the lectures and energizing teachers. In conclusion, we successfully implemented an ambulatory nephrology curriculum using a framework that integrated formal didactics, interactive online learning, and key clinical components of outpatient nephrology care. Future investigation will evaluate whether early implementation of this curriculum is associated with increased pursuit of nephrology as a career.

      PubDate: 2017-06-03T18:48:11Z
       
  • Atazanavir-Associated Crystalline Nephropathy
    • Authors: Dominick Santoriello; Majdi Al-Nabulsi Aravinda Reddy Julius Salamera Vivette Glen
      Abstract: Publication date: Available online 2 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Dominick Santoriello, Majdi Al-Nabulsi, Aravinda Reddy, Julius Salamera, Vivette D. D’Agati, Glen S. Markowitz
      Crystalline nephropathy can occur following treatment with multiple therapeutic agents. We describe a human immunodeficiency virus (HIV)-infected patient treated for 2 years with combination antiretroviral therapy including atazanavir (ATV). Kidney biopsy revealed a crystalline nephropathy associated with diffuse chronic and granulomatous interstitial inflammation. Following the biopsy, treatment with ATV was discontinued and kidney function returned to pretreatment baseline levels. ATV, which has a well-established association with nephrolithiasis, is a rare but important cause of crystalline nephropathy. Recognition of this association and prompt withdrawal of the offending agent are critical to optimize outcomes.

      PubDate: 2017-06-03T18:48:11Z
       
  • Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality,
           or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of
           the FAVORIT Trial Cohort
    • Authors: Basma Merhi; Theresa Shireman Myra Carpenter John Kusek Paul Jacques
      Abstract: Publication date: Available online 2 June 2017
      Source:American Journal of Kidney Diseases
      Author(s): Basma Merhi, Theresa Shireman, Myra A. Carpenter, John W. Kusek, Paul Jacques, Marc Pfeffer, Madhumathi Rao, Meredith C. Foster, S. Joseph Kim, Todd E. Pesavento, Stephen R. Smith, Clifton E. Kew, Andrew A. House, Reginald Gohh, Daniel E. Weiner, Andrew S. Levey, Joachim H. Ix, Andrew Bostom
      Background Mild hyperphosphatemia is a putative risk factor for cardiovascular disease [CVD], loss of kidney function, and mortality. Very limited data are available from sizable multicenter kidney transplant recipient (KTR) cohorts assessing the potential relationships between serum phosphorus levels and the development of CVD outcomes, transplant failure, or all-cause mortality. Study Design Cohort study. Setting & Participants The Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial, a large, multicenter, multiethnic, controlled clinical trial that provided definitive evidence that high-dose vitamin B−based lowering of plasma homocysteine levels did not reduce CVD events, transplant failure, or total mortality in stable KTRs. Predictor Serum phosphorus levels were determined in 3,138 FAVORIT trial participants at randomization. Results During a median follow-up of 4.0 years, the cohort had 436 CVD events, 238 transplant failures, and 348 deaths. Proportional hazards modeling revealed that each 1-mg/dL higher serum phosphorus level was not associated with a significant increase in CVD risk (HR, 1.06; 95% CI, 0.92-1.22), but increased transplant failure (HR, 1.36; 95% CI, 1.15-1.62) and total mortality risk associations (HR, 1.21; 95% CI, 1.04-1.40) when adjusted for treatment allocation, traditional CVD risk factors, kidney measures, type of kidney transplant, transplant vintage, and use of calcineurin inhibitors, steroids, or lipid-lowering drugs. These associations were strengthened in models without kidney measures: CVD (HR, 1.14; 95% CI, 1.00-1.31), transplant failure (HR, 1.72; 95% CI, 1.46-2.01), and mortality (HR, 1.34; 95% CI, 1.15-1.54). Limitations We lacked data for concentrations of parathyroid hormone, fibroblast growth factor 23, or vitamin D metabolites. Conclusions Serum phosphorus level is marginally associated with CVD and more strongly associated with transplant failure and total mortality in long-term KTRs. A randomized controlled clinical trial in KTRs that assesses the potential impact of phosphorus-lowering therapy on these hard outcomes may be warranted.

      PubDate: 2017-06-03T18:48:11Z
       
  • Detailed Contents
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • The China Kidney Disease Network (CK-NET): “Big Data—Big
           Dreams”
    • Authors: Rajiv Saran; Diane Steffick Jennifer Bragg-Gresham
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Rajiv Saran, Diane Steffick, Jennifer Bragg-Gresham


      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 1: Patients With CKD in the Hospitalized Population
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Amazing and Fantastic Infection Control: The Case of Dialyzer Reuse
    • Authors: Ezra Gabbay; Klemens Meyer
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Ezra Gabbay, Klemens B. Meyer


      PubDate: 2017-05-19T13:45:00Z
       
  • Warfarin, Atrial Fibrillation, and CKD: Effective and Safe, but Soon
           Extinct?
    • Authors: John Larkin; Kevin Chan
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): John W. Larkin, Kevin E. Chan


      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 2: Treatment of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Genetics of Blood Pressure: New Insights Into a Complex Trait
    • Authors: Adam Bress; Marguerite Irvin Paul Muntner
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Adam P. Bress, Marguerite R. Irvin, Paul Muntner


      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 3: Disease Causes &amp; Geographic Distribution of Patients
           With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Hemodialyzer Reuse and Gram-Negative Bloodstream Infections
    • Authors: Chris Edens; Jacklyn Wong Meghan Lyman Kyle Rizzo Duc Nguyen
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Chris Edens, Jacklyn Wong, Meghan Lyman, Kyle Rizzo, Duc Nguyen, Michela Blain, Sam Horwich-Scholefield, Heather Moulton-Meissner, Erin Epson, Jon Rosenberg, Priti R. Patel
      Background Clusters of bloodstream infections caused by Burkholderia cepacia and Stenotrophomonas maltophilia are uncommon, but have been previously identified in hemodialysis centers that reprocessed dialyzers for reuse on patients. We investigated an outbreak of bloodstream infections caused by B cepacia and S maltophilia among hemodialysis patients in clinics of a dialysis organization. Study Design Outbreak investigation, including matched case-control study. Setting & Participants Hemodialysis patients treated in multiple outpatient clinics owned by a dialysis organization. Predictors Main predictors were dialyzer reuse, dialyzer model, and dialyzer reprocessing practice. Outcomes Case patients had a bloodstream infection caused by B cepacia or S maltophilia; controls were patients without infection dialyzed at the same clinic on the same day as a case; results of environmental cultures and organism typing. Results 17 cases (9 B cepacia and 8 S maltophilia bloodstream infections) occurred in 5 clinics owned by the same dialysis organization. Case patients were more likely to have received hemodialysis with a dialyzer that had been used more than 6 times (matched OR, 7.03; 95% CI, 1.38-69.76) and to have been dialyzed with a specific reusable dialyzer (Model R) with sealed ends (OR, 22.87; 95% CI, 4.49-∞). No major lapses during dialyzer reprocessing were identified that could explain the outbreak. B cepacia was isolated from samples collected from a dialyzer header-cleaning machine from a clinic with cases and was indistinguishable from a patient isolate collected from the same clinic, by pulsed-field gel electrophoresis. Gram-negative bacteria were isolated from 2 reused Model R dialyzers that had undergone the facility’s reprocessing procedure. Limitations Limited statistical power and overmatching; few patient isolates and dialyzers available for testing. Conclusions This outbreak was likely caused by contamination during reprocessing of reused dialyzers. Results of this and previous investigations demonstrate that exposing patients to reused dialyzers increases the risk for bloodstream infections. To reduce infection risk, providers should consider implementing single dialyzer use whenever possible.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 4: Comorbid Conditions of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Warfarin Initiation, Atrial Fibrillation, and Kidney
           Function: Comparative Effectiveness and Safety
           of Warfarin in Older Adults With Newly Diagnosed Atrial Fibrillation
           
    • Authors: Min Jun; Matthew James Zhihai Jianguo Zhang Marcello Tonelli Finlay
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Min Jun, Matthew T. James, Zhihai Ma, Jianguo Zhang, Marcello Tonelli, Finlay A. McAlister, Braden J. Manns, Pietro Ravani, Robert R. Quinn, Natasha Wiebe, Vlado Perkovic, Stephen B. Wilton, Wolfgang C. Winkelmayer, Brenda R. Hemmelgarn
      Background The effectiveness and safety of warfarin use among patients with atrial fibrillation (AF) and reduced kidney function are uncertain. Study Design Community-based retrospective cohort study (May 1, 2003, to March 31, 2012) using province-wide laboratory and administrative data in Alberta, Canada. Setting & Participants 14,892 adults 66 years or older with new AF and a measurement of kidney function. Long-term dialysis patients or kidney transplant recipients were excluded. Predictor Propensity scores were used to construct a matched-pairs cohort of patients with AF who did and did not have a warfarin prescription within a 60-day period surrounding their AF diagnosis. Outcomes Within 1 year of initiating warfarin therapy (or the matched date for nonusers): (1) the composite of all-cause death, ischemic stroke, or transient ischemic attack (also assessed as separate end points) and (2) first hospitalization or emergency department visit for a major bleeding episode defined as an intracranial, upper or lower gastrointestinal, or other bleeding. Measurements Baseline glomerular filtration rate (GFR) was estimated using the CKD-EPI creatinine equation. Patients were matched within estimated GFR (eGFR) categories: ≥90, 60 to 89, 45 to 59, 30 to 44, and <30mL/min/1.73m2. Information for baseline characteristics (sociodemographics, comorbid conditions, and prescription drug use) was obtained. Results Across eGFR categories, warfarin therapy initiation was associated with lower risk for the composite outcome compared to nonuse (adjusted HRs [95% CI] for eGFR categories ≥ 90, 60-89, 45-59, 30-44, and <30mL/min/1.73m2: 0.59 [0.35-1.01], 0.61 [0.54-0.70], 0.55 [0.47-0.65], 0.54 [0.44-0.67], and 0.64 [0.47-0.87] mL/min/1.73m2, respectively). Compared to nonuse, warfarin therapy was not associated with higher risk for major bleeding except for those with eGFRs of 60 to 89mL/min/1.73m2 (HR, 1.36; 95% CI, 1.13-1.64). Limitations Selection bias. Conclusions Among older adults with AF, warfarin therapy initiation was associated with a significantly lower 1-year risk for the composite outcome across all strata of kidney function. The risk for major bleeding associated with warfarin use was increased only among those with eGFRs of 60 to 89mL/min/1.73m2.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 5: Cardiovascular Disease in Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Urinary Uromodulin and Risk of Urinary Tract Infections:
           The Cardiovascular Health Study
    • Authors: Pranav Garimella; Traci Bartz Joachim Michel Chonchol Michael Shlipak Prasad
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Pranav S. Garimella, Traci M. Bartz, Joachim H. Ix, Michel Chonchol, Michael G. Shlipak, Prasad Devarajan, Michael R. Bennett, Mark J. Sarnak
      Background Laboratory studies suggest that urinary uromodulin, the most common protein in the urine of healthy adults, may protect against urinary tract infection (UTI). Epidemiologic studies evaluating this relationship in humans are lacking. Study Design Prospective longitudinal cohort study. Setting & Participants 953 participants enrolled in the Cardiovascular Health Study. Predictor Uromodulin assayed using enzyme-linked immunosorbent assay in spot urine samples. Outcomes Composite of outpatient UTI events or UTI-related hospitalizations and each of them individually identified using International Classification of Diseases, Ninth Revision (ICD-9) codes using negative binomial regression with robust standard errors adjusted for age, race, sex, body mass index, diabetes, estimated glomerular filtration rate, and urinary albumin and urinary creatinine excretion. Results Median uromodulin level was 25.9 (IQR, 17.3-38.9) μg/mL, mean age of participants was 78 years, 61% were women, and 15% were black. There were 331 outpatient UTI events and 87 UTI-related hospitalizations among 186 participants during a median 9.9 years of follow-up. Persons in the highest quartile (>38.93μg/mL) of uromodulin concentration had a significantly lower risk for the composite outcome (incidence rate ratio [IRR], 0.47; 95% CI, 0.29-0.79) compared with those in the lowest quartile (≤17.26μg/mL). This association remained significant for outpatient UTI events (highest vs lowest quartile even after excluding those with prior UTI: IRR, 0.42; 95% CI, 0.23-0.77). The direction of association with UTI hospitalization was similar, but not statistically significant (IRR, 0.78; 95% CI, 0.39-1.58). Limitations Use of ICD-9 codes to identify outcomes and lack of generalizability to younger populations. Conclusions High urinary uromodulin levels are associated with lower risk for UTI in older community-dwelling adults independent of traditional UTI risk factors. This finding supports prior laboratory data indicating a protective role of uromodulin against UTI. Further research is needed to understand if this may lead to new treatments to prevent or treat UTI.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 6: In-hospital Mortality of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 7: Length-of-Stay of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • CKD and Risk for Hospitalization With Infection: The Atherosclerosis Risk
           in Communities (ARIC) Study
    • Authors: Junichi Ishigami; Morgan Grams Alexander Chang Juan Carrero Josef Coresh
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Junichi Ishigami, Morgan E. Grams, Alexander R. Chang, Juan J. Carrero, Josef Coresh, Kunihiro Matsushita
      Background Individuals on dialysis therapy have a high risk for infection, but risk for infection in earlier stages of chronic kidney disease has not been comprehensively described. Study Design Observational cohort study. Setting & Participants 9,697 participants (aged 53-75 years) in the Atherosclerosis Risk in Communities (ARIC) Study. Participants were followed up from 1996 to 1998 through 2011. Predictors Estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (ACR). Outcomes Risk for hospitalization with infection and death during or within 30 days of hospitalization with infection. Results During follow-up (median, 13.6 years), there were 2,701 incident hospitalizations with infection (incidence rate, 23.6/1,000 person-years) and 523 infection-related deaths. In multivariable analysis, HRs of incident hospitalization with infection as compared to eGFRs≥90mL/min/1.73m2 were 2.55 (95% CI, 1.43-4.55), 1.48 (95% CI, 1.28-1.71), and 1.07 (95% CI, 0.98-1.16) for eGFRs of 15 to 29, 30 to 59, and 60 to 89mL/min/1.73m2, respectively. Corresponding HRs were 3.76 (95% CI, 1.48-9.58), 1.62 (95% CI, 1.20-2.19), and 0.99 (95% CI, 0.80-1.21) for infection-related death. Compared to ACRs<10mg/g, HRs of incident hospitalization with infection were 2.30 (95% CI, 1.81-2.91), 1.56 (95% CI, 1.36-1.78), and 1.34 (95% CI, 1.20-1.50) for ACRs≥300, 30 to 299, and 10 to 29mg/g, respectively. Corresponding HRs were 3.44 (95% CI, 2.28-5.19), 1.57 (95% CI, 1.18-2.09), and 1.39 (95% CI, 1.09-1.78) for infection-related death. Results were consistent when separately assessing risk for pneumonia, kidney and urinary tract infections, bloodstream infections, and cellulitis and when taking into account recurrent episodes of infection. Limitations Outcome ascertainment relied on diagnostic codes at time of discharge. Conclusions Increasing provider awareness of chronic kidney disease as a risk factor for infection is needed to reduce infection-related morbidity and mortality.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 8: Costs of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • A Randomized, Single-Blind, Crossover Trial of Recovery Time in High-Flux
           Hemodialysis and Hemodiafiltration
    • Authors: James Smith; Norica Zimmer Elizabeth Bell Bernard Francq Alex McConnachie
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): James R. Smith, Norica Zimmer, Elizabeth Bell, Bernard G. Francq, Alex McConnachie, Robert Mactier
      Background The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. Study Design Randomized patient-blinded crossover trial. Settings & Participants 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom. Intervention 8 weeks of HD followed by 8 weeks of online postdilution HDF or vice versa. Outcomes Posttreatment recovery time, symptomatic hypotension events, dialysis circuit clotting events, and biochemical parameters. Measurements Patient-reported recovery time in minutes, incidence of adverse events during treatments, hematology and biochemistry results, quality-of-life questionnaire. Results There was no overall difference in recovery time between treatments (medians for HDF vs HD of 47.5 [IQR, 0-240] vs 30 [IQR, 0-210] minutes, respectively; P =0.9). During HDF treatment, there were significant increases in rates of symptomatic hypotension (8.0% in HDF vs 5.3% in HD; relative risk [RR], 1.52; 95% CI, 1.2-1.9; P <0.001) and intradialytic tendency to clotting (1.8% in HDF vs 0.7% in HD; RR, 2.7; 95% CI, 1.5-5.0; P =0.002). Serum albumin level was significantly lower during HDF (3.2 vs 3.3g/dL; P <0.001). Health-related quality-of-life scores were equivalent. Limitations Single center; mean achieved HDF convection volume, 20.6L. Conclusions Patients blinded to whether they were receiving HD or HDF in a randomized controlled crossover study reported similar posttreatment recovery times and health-related quality-of-life scores.

      PubDate: 2017-05-19T13:45:00Z
       
  • Safety of Intravenous Iron in Hemodialysis: Longer-term Comparisons of
           Iron Sucrose Versus Sodium Ferric Gluconate Complex
    • Authors: Wolfgang Winkelmayer; Benjamin Goldstein Aya Mitani Victoria Ding Medha Airy
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Wolfgang C. Winkelmayer, Benjamin A. Goldstein, Aya A. Mitani, Victoria Y. Ding, Medha Airy, Sreedhar Mandayam, Tara I. Chang, M. Alan Brookhart, Steven Fishbane
      Background Controversy exists about any differences in longer-term safety across different intravenous iron formulations routinely used in hemodialysis (HD) patients. We exploited a natural experiment to compare outcomes of patients initiating HD therapy in facilities that predominantly (in ≥90% of their patients) used iron sucrose versus sodium ferric gluconate complex. Study Design Retrospective cohort study of incident HD patients. Setting & Participants Using the US Renal Data System, we hard-matched on geographic region and center characteristics HD facilities predominantly using ferric gluconate with similar ones using iron sucrose. Subsequently, incident HD patients were assigned to their facility iron formulation exposure. Intervention Facility-level use of iron sucrose versus ferric gluconate. Outcomes Patients were followed up for mortality from any, cardiovascular, or infectious causes. Medicare-insured patients were followed up for infectious and cardiovascular (stroke or myocardial infarction) hospitalizations and for composite outcomes with the corresponding cause-specific deaths. Measurements HRs. Results We matched 2,015 iron sucrose facilities with 2,015 ferric gluconate facilities, in which 51,603 patients (iron sucrose, 24,911; ferric gluconate, 26,692) subsequently initiated HD therapy. All recorded patient characteristics were balanced between groups. Over 49,989 person-years, 10,381 deaths (3,908 cardiovascular and 1,209 infectious) occurred. Adjusted all-cause (HR, 0.98; 95% CI, 0.93-1.03), cardiovascular (HR, 0.96; 95% CI, 0.89-1.03), and infectious mortality (HR, 0.98; 95% CI, 0.86-1.13) did not differ between iron sucrose and ferric gluconate facilities. Among Medicare beneficiaries, no differences between ferric gluconate and iron sucrose facilities were observed in fatal or nonfatal cardiovascular events (HR, 1.01; 95% CI, 0.93-1.09). The composite infectious end point occurred less frequently in iron sucrose versus ferric gluconate facilities (HR, 0.92; 95% CI, 0.88-0.96). Limitations Unobserved selection bias from nonrandom treatment assignment. Conclusions Patients initiating HD therapy in facilities almost exclusively using iron sucrose versus ferric gluconate had similar longer-term outcomes. However, there was a small decrease in infectious hospitalizations and deaths in patients dialyzing in facilities predominantly using iron sucrose. This difference may be due to residual confounding, random chance, or a causal effect.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 9: Other Aspects of Patients With CKD
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Cognitive Decline and Its Risk Factors in Prevalent
           Hemodialysis Patients
    • Authors: David Drew; Daniel Weiner Hocine Tighiouart Sarah Duncan Aditi Gupta
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): David A. Drew, Daniel E. Weiner, Hocine Tighiouart, Sarah Duncan, Aditi Gupta, Tammy Scott, Mark J. Sarnak
      Background Cognitive impairment is common in patients treated with hemodialysis. The trajectory of cognitive function and risk factors for cognitive decline remain uncertain in this population. Study Design Longitudinal cohort. Setting & Participants 314 prevalent hemodialysis patients. Predictors Age, sex, race, education level, hemodialysis vintage, cause of end-stage renal disease, and baseline history of cardiovascular disease. Outcomes Cognitive function as determined by a comprehensive neurocognitive battery, administered at baseline and yearly when possible. Individual cognitive test results were reduced into 2 domain scores using principal components analysis, representing memory and executive function, which were used as our coprimary outcomes and by definition have a mean of zero and SD of 1. Results Mean age was 63 years; 54% were men, 22% were black, and 90% had at least a high school education. During a median follow-up of 2.1 (IQR, 0.9-4.2) years, 196 had at least 1 follow-up test, 156 died, and 43 received a kidney transplant. Linear mixed models and joint models, which accounted for competing risks from death, dropout, or kidney transplantation, showed nearly identical results. The joint model demonstrated a decline in executive function (−0.09 [95% CI, −0.13 to −0.05] SD per year), whereas memory improved slightly (0.05 [95% CI, 0.02 to 0.08] SD per year). A significant yearly decline was also seen in the Mini-Mental State Examination score (median change, −0.41; 95% CI, −0.57 to −0.25). Older age was the only significant risk factor for steeper executive function decline (−0.04 [95% CI, −0.06 to −0.02] SD steeper annual decline for each 10 years of age). Limitations Prevalent hemodialysis patients only, limited follow-up testing due to high mortality rate, and exclusion of participants with severe cognitive deficits or dementia. Conclusions Prevalent hemodialysis patients demonstrate significant cognitive decline, particularly within tests of executive function. Older age was the only statistically significant risk factor for steeper cognitive decline, which may have important clinical consequences for patient management and education. Future studies should evaluate strategies to maintain or improve cognitive function.

      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 10: Acute Kidney Injury
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Chapter 11: Kidney Transplant Waiting List
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Mycophenolate Mofetil Combined With Prednisone Versus Full-Dose Prednisone
           in IgA Nephropathy With Active Proliferative Lesions: A Randomized
           Controlled Trial
    • Authors: Jin-Hua Hou; Wei-Bo Nan Chen Wei-Ming Wang Zhang-Suo Liu Dong
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Jin-Hua Hou, Wei-Bo Le, Nan Chen, Wei-Ming Wang, Zhang-Suo Liu, Dong Liu, Jiang-Hua Chen, Jiong Tian, Ping Fu, Zhang-Xue Hu, Cai-Hong Zeng, Shao-Shan Liang, Min-Lin Zhou, Hai-Tao Zhang, Zhi-Hong Liu
      Background Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) with active proliferative lesions show a good response to immunosuppressive treatment. Study Design Multicenter, prospective, randomized, controlled trial. Setting & Participants 176 patients with IgAN with active proliferative lesions (cellular and fibrocellular crescents, endocapillary hypercellularity, or necrosis), proteinuria with protein excretion ≥ 1.0g/24h, and estimated glomerular filtration rate > 30mL/min/1.73m2. Intervention Mycophenolate mofetil (MMF) group: MMF, 1.5g/d, for 6 months and prednisone, 0.4 to 0.6mg/kg/d, for 2 months and then tapered by 20% per month for the next 4 months; prednisone group: prednisone, 0.8 to 1.0mg/kg/d, for 2 months and then tapered by 20% per month for the next 4 months. All patients were followed up for another 6 months. Outcomes The primary end point was complete remission rate at 6 and 12 months. Results At baseline, median estimated glomerular filtration rates were 90.2 and 94.3mL/min/1.73m2 and mean proteinuria was protein excretion of 2.37 and 2.47g/24h in the MMF and prednisone groups, respectively. At 6 months, complete remission rates were 37% (32 of 86 patients) and 38% (33 of 88 patients); the between-group difference was not statistically significant (P =0.9). At 12 months, complete remission rates were 48% (35 of 73 patients) and 53% (38 of 72 patients) in the MMF and prednisone groups, respectively; the between-group difference was not statistically significant (P =0.6). Incidences of Cushing syndrome and newly diagnosed diabetes mellitus were lower in the MMF group than in the prednisone group. Limitations Not all participants were treated with renin-angiotensin system blockers, relatively short follow-up. Conclusions MMF plus prednisone versus full-dose prednisone did not differ in reducing proteinuria, but patients treated with the former had fewer adverse events in patients with IgAN with active proliferative lesions.

      PubDate: 2017-05-19T13:45:00Z
       
  • Appendixes
    • Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2


      PubDate: 2017-05-19T13:45:00Z
       
  • Chlorthalidone Versus Amlodipine for Hypertension in Kidney Transplant
           Recipients Treated With Tacrolimus: A Randomized Crossover Trial
    • Authors: Arthur Moes; Dennis Hesselink Anton van den Meiracker Robert Zietse
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Arthur D. Moes, Dennis A. Hesselink, Anton H. van den Meiracker, Robert Zietse, Ewout J. Hoorn
      Background Chlorthalidone is a very effective antihypertensive drug, but it has not been studied prospectively in kidney transplant recipients with hypertension. Recent data indicate that calcineurin inhibitors activate the thiazide-sensitive sodium chloride cotransporter, providing further rationale to test thiazides in this population. Study Design Randomized noninferiority crossover trial (noninferiority margin, −2.8mmHg). Setting & Participants Hypertensive kidney transplant recipients using tacrolimus (median duration, 2.4 years after transplantation; mean estimated glomerular filtration rate, 63±27 [SD] mL/min/1.73m2; mean systolic blood pressure [SBP], 151±12mmHg). Intervention Amlodipine (5-10mg) and chlorthalidone (12.5-25mg) for 8 weeks (separated by 2-week washout). Outcomes Average daytime (9 am to 9 pm) ambulatory SBP. Measurements Blood pressure and laboratory parameters. Results 88 patients underwent ambulatory blood pressure monitoring, of whom 49 (56%) with average daytime SBP>140mmHg were enrolled. 41 patients completed the study. Amlodipine and chlorthalidone both reduced ambulatory SBP after 8 weeks (mean changes of 150±12 to 137±12 [SD] vs 151±12 to 141±13mmHg; effect size, −4.2 [95% CI, −7.3 to 1.1] mmHg). Despite these similar blood pressure responses, chlorthalidone reduced proteinuria by 30% (effect size, −65 [95% CI, −108 to −35] mg/g) and also reduced physician-assessed peripheral edema (22% to 10%; P <0.05 for both). In contrast, chlorthalidone temporarily reduced kidney function and increased both serum uric acid and glycated hemoglobin levels. Limitations Open-label design, short follow-up, per-protocol analysis. Conclusions Chlorthalidone is an antihypertensive drug equally effective as amlodipine after kidney transplantation.

      PubDate: 2017-05-19T13:45:00Z
       
  • Association of Vitamin D Metabolites With Arterial Function in the
           Hemodialysis Fistula Maturation Study
    • Authors: Adriana van; Ballegooijen Leila Zelnick Andrew Hoofnagle Naomi Hamburg Cassiane
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Adriana J. van Ballegooijen, Leila Zelnick, Andrew N. Hoofnagle, Naomi M. Hamburg, Cassiane Robinson-Cohen, Prabir Roy-Chaudhury, Alfred K. Cheung, Yan-Ting Shiu, Ian H. de Boer, Jonathan Himmelfarb, Gerald Beck, Peter B. Imrey, John W. Kusek, Bryan Kestenbaum
      Background Disturbances in vitamin D metabolism are common in patients with end-stage renal disease and may contribute to vascular dysfunction. Study Design Cross-sectional. Setting & Participants We evaluated 558 of 602 participants at baseline of the Hemodialysis Fistula Maturation (HFM) Study, a 7-center prospective cohort study of a cohort of patients with chronic kidney disease awaiting arteriovenous fistula (AVF) creation surgery. Factor 4 vitamin D metabolites measured with liquid chromatography–tandem mass spectroscopy from samples obtained within 4 weeks prior to AVF surgery. Outcomes Vasodilator functions and measurements of arterial stiffness. Measurements Trained HFM Study personnel measured brachial artery flow-mediated dilation, nitroglycerin-mediated dilation, and carotid-femoral and carotid-radial pulse wave velocities (PWVs) prior to AVF creation. We evaluated associations after basic adjustment for sex, age, and clinical site and more fully adjusted additionally for baseline education, smoking, body mass index, diabetes, dialysis status, and medication use. Results Mean participant age was 55±13 (SD) years and 65% were receiving maintenance dialysis. None of the vitamin D metabolites were significantly associated with flow-mediated dilation, carotid-femoral PWV, or carotid-radial PWV in basic or fully adjusted analyses. Higher serum concentrations of bioavailable vitamin D and 1,25-dihydroxyvitamin D were associated with 0.62% and 0.58% greater nitroglycerin-mediated dilation values, respectively, in basic models; however, these associations were no longer statistically significant with full adjustment. There were no significant associations of vitamin D metabolites with carotid-femoral or carotid-radial PWV in fully adjusted analyses. Limitations Cross-sectional ascertainment of vitamin D metabolites and vascular functions late during the course of kidney disease. Conclusions Serum concentrations of vitamin D metabolites are not associated with vasodilator functions or vascular stiffness at baseline in a cohort study of patients with chronic kidney disease awaiting AVF creation surgery. Laboratory measurements of vitamin D metabolites are unlikely to provide useful information regarding vascular functions in this setting.

      PubDate: 2017-05-19T13:45:00Z
       
  • Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors: A Potential New
           Treatment for Anemia in Patients With CKD
    • Authors: Nupur Gupta; Jay Wish
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Nupur Gupta, Jay B. Wish
      Erythropoiesis-stimulating agents (ESAs) increase hemoglobin levels, reduce transfusion requirements, and have been the standard of treatment for anemia in patients with chronic kidney disease (CKD) since 1989. Many safety concerns have emerged regarding the use of ESAs, including an increased occurrence of cardiovascular events and vascular access thrombosis. Hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzyme inhibitors are a new class of agents for the treatment of anemia in CKD. These agents work by stabilizing the HIF complex and stimulating endogenous erythropoietin production even in patients with end-stage kidney disease. HIF-PH inhibitors improve iron mobilization to the bone marrow. They are administered orally, which may be a more favorable route for patients not undergoing hemodialysis. By inducing considerably lower but more consistent blood erythropoietin levels than ESAs, HIF-PH inhibitors may be associated with fewer adverse cardiovascular effects at comparable hemoglobin levels, although this has yet to be proved in long-term clinical trials. One significant concern regarding the long-term use of these agents is their possible effect on tumor growth. There are 4 such agents undergoing phase 2 and 3 clinical trials in the United States; this report provides a focused review of HIF-PH inhibitors and their potential clinical utility in the management of anemia of CKD.

      PubDate: 2017-05-19T13:45:00Z
       
  • The Evolution of the Journal Club: From Osler to Twitter
    • Authors: Joel Topf; Matthew Sparks Paul Phelan Nikhil Shah Edgar Lerma
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Joel M. Topf, Matthew A. Sparks, Paul J. Phelan, Nikhil Shah, Edgar V. Lerma, Matthew P.M. Graham-Brown, Hector Madariaga, Francesco Iannuzzella, Michelle N. Rheault, Thomas Oates, Kenar D. Jhaveri, Swapnil Hiremath
      Journal clubs have typically been held within the walls of academic institutions and in medicine have served the dual purpose of fostering critical appraisal of literature and disseminating new findings. In the last decade and especially the last few years, online and virtual journal clubs have been started and are flourishing, especially those harnessing the advantages of social media tools and customs. This article reviews the history and recent innovations of journal clubs. In addition, the authors describe their experience developing and implementing NephJC, an online nephrology journal club conducted on Twitter.

      PubDate: 2017-05-19T13:45:00Z
       
  • China Kidney Disease Network (CK-NET) 2014 Annual Data Report
    • Authors: Luxia Zhang; Haibo Wang Jianyan Long Ying Shi Kunhao Bai
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6, Supplement 2
      Author(s): Luxia Zhang, Haibo Wang, Jianyan Long, Ying Shi, Kunhao Bai, Wenshi Jiang, Xiangxiang He, Zhiyue Zhou, Jinwei Wang, Fang Wang, Minghui Zhao


      PubDate: 2017-05-19T13:45:00Z
       
  • Exercise and CKD: Skeletal Muscle Dysfunction and Practical Application of
           Exercise to Prevent and Treat Physical Impairments in CKD
    • Authors: Baback Roshanravan; Jorge Gamboa Kenneth Wilund
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Baback Roshanravan, Jorge Gamboa, Kenneth Wilund
      Patients with chronic kidney disease experience substantial loss of muscle mass, weakness, and poor physical performance. As kidney disease progresses, skeletal muscle dysfunction forms a common pathway for mobility limitation, loss of functional independence, and vulnerability to disease complications. Screening for those at high risk for mobility disability by self-reported and objective measures of function is an essential first step in developing an interdisciplinary approach to treatment that includes rehabilitative therapies and counseling on physical activity. Exercise has beneficial effects on systemic inflammation, muscle, and physical performance in chronic kidney disease. Kidney health providers need to identify patient and care delivery barriers to exercise in order to effectively counsel patients on physical activity. A thorough medical evaluation and assessment of baseline function using self-reported and objective function assessment is essential to guide an effective individualized exercise prescription to prevent function decline in persons with kidney disease. This review focuses on the impact of kidney disease on skeletal muscle dysfunction in the context of the disablement process and reviews screening and treatment strategies that kidney health professionals can use in clinical practice to prevent functional decline and disability.

      PubDate: 2017-05-19T13:45:00Z
       
  • Reset Osmostat: The Result of Chronic Desmopressin Abuse?
    • Authors: Daniel Andreoli; William Whittier
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Daniel C. Andreoli, William L. Whittier
      A reset osmostat as a cause of hyponatremia can be found in a variety of clinical settings, including pulmonary and neurologic diseases, as well as in physiologic circumstances such as pregnancy. This teaching case describes a 72-year-old white man with a long-standing history of self-medicating with desmopressin acetate (DDAVP) who presented with profound hyponatremia. On discontinuation of DDAVP treatment, he was found to have a reset osmostat. The mild hyponatremia persisted on follow-up. We theorize that the reset osmostat may have developed secondary to long-standing DDAVP use.

      PubDate: 2017-05-19T13:45:00Z
       
  • International Normalized Ratio Control in Patients With Atrial
           Fibrillation and CKD
    • Authors: Simonetta Genovesi; Juan Jesus Carrero
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Simonetta Genovesi, Juan Jesus Carrero


      PubDate: 2017-05-19T13:45:00Z
       
  • In Reply to ‘International Normalized Ratio Control in Patients With
           Atrial Fibrillation and CKD’
    • Authors: Min Jun; Brenda Hemmelgarn
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Min Jun, Brenda R. Hemmelgarn


      PubDate: 2017-05-19T13:45:00Z
       
  • Why ELAIN and AKIKI Should Not Be Compared: Resolving Discordant Studies
    • Authors: Didier Dreyfuss; David Hajage Gaudry
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Didier Dreyfuss, David Hajage, Stéphane Gaudry


      PubDate: 2017-05-19T13:45:00Z
       
  • In Reply to ‘Why ELAIN and AKIKI Should Not Be Compared: Resolving
           Discordant Studies’
    • Authors: Ron Wald; Martin Gallagher Sean Bagshaw
      Abstract: Publication date: June 2017
      Source:American Journal of Kidney Diseases, Volume 69, Issue 6
      Author(s): Ron Wald, Martin Gallagher, Sean M. Bagshaw


      PubDate: 2017-05-19T13:45:00Z
       
 
 
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