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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)                     

Showing 1 - 155 of 155 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 11)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 42)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 36)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 35)
BMC Nephrology     Open Access   (Followers: 9)
BMC Urology     Open Access   (Followers: 15)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 6)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 19)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 7)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 38)
European Urology Focus     Hybrid Journal   (Followers: 6)
European Urology Supplements     Full-text available via subscription   (Followers: 15)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 3)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 3)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 29)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 27)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 53)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 44)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 19)
Nature Reviews Urology     Full-text available via subscription   (Followers: 13)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 12)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 25)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 5)
Open Journal of Urology     Open Access   (Followers: 7)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 8)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 2)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 34)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 12)

           

Similar Journals
Journal Cover
Nephrology Dialysis Transplantation
Journal Prestige (SJR): 2.142
Citation Impact (citeScore): 4
Number of Followers: 25  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0931-0509 - ISSN (Online) 1460-2385
Published by Oxford University Press Homepage  [412 journals]
  • Editorial: Implementing low protein diets in clinical practice in patients
           with chronic kidney disease
    • Authors: Fouque D; Ikizler T.
      Pages: 1643 - 1645
      PubDate: Tue, 06 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa242
      Issue No: Vol. 35, No. 10 (2020)
       
  • Not even a peripheral role for statins in end-stage renal disease'
    • Authors: Lee K; Chan G, Tang S.
      Pages: 1645 - 1647
      Abstract: Peripheral arterial disease (PAD) results in significant morbidity and mortality in patients with kidney failure [1, 2]. The traditional risk factors for PAD in the general population include age, gender, diabetes mellitus (DM), hyperlipidemia (HL), hypertension and smoking. In patients with kidney failure, there may be additional interplay, such as elevated homocysteine levels [3], with vascular calcification from chronic inflammation and mineral bone disease [4]. Currently, statin therapy is recommended in patients with PAD [5], and there exist ample data to demonstrate lipid-lowering by statins to confer cardiovascular (CV) protection. Robust clinical trials in the general population have provided irrefutable evidence for statin therapy in both primary [6, 7] and secondary prevention [8, 9]. However, CV benefits were not observed in major clinical trials attesting statin therapy in kidney failure cohorts [10–12]. In the Study of Heart and Renal Protection (SHARP) [10], for example, though a fixed dose of simvastatin and ezetimibe among >6000 predialysis CKD subjects and >3000 dialysis patients resulted in a 17% reduction in atherosclerotic events, as compared with placebo, the clear benefit in event reduction observed in predialysis patients was lost in patients on dialysis.
      PubDate: Mon, 06 Apr 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa051
      Issue No: Vol. 35, No. 10 (2020)
       
  • Patient-centeredness and the Pareto principle: getting at the matter of
           what matters to our patients
    • Authors: Briggs J.
      Pages: 1647 - 1648
      Abstract: The Pareto principle (also known as the 80/20 rule, the law of the vital few, or the principle of factor sparsity) states that for many events, roughly 80% of the effects comes from 20% of the causes.                           —Wikipedia
      PubDate: Thu, 21 May 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa052
      Issue No: Vol. 35, No. 10 (2020)
       
  • The young, the uremic and the broken
    • Authors: Khairallah P; Nickolas T.
      Pages: 1649 - 1651
      Abstract: Chronic kidney disease (CKD) affects >37 million individuals in the USA and >850 million individuals worldwide [1, 2]. CKD is associated with a number of major complications, including bone disease [3]. CKD–mineral and bone disease (MBD) is common in patients with early CKD and is universally present in patients with advanced CKD and on dialysis [3]. Parathyroid hormone, fibroblast growth factor 23, 1,25-dihydroxyvitamin D and α-klotho regulate calcium and phosphorus levels, ensuring the availability of these minerals for bone remodeling. Renal osteodystrophy (ROD) refers to the bone histological lesions that affect patients whose kidneys are unable to maintain mineral metabolite and vitamin D homeostasis [3]. In early CKD, MBD and the accompanying ROD often go unrecognized since the disease is asymptomatic. As CKD progresses, bone loss and fractures occur and increase in severity with more severe degrees of kidney dysfunction [4].
      PubDate: Mon, 29 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa068
      Issue No: Vol. 35, No. 10 (2020)
       
  • Targeting acute kidney injury in COVID-19
    • Authors: Kellum J; van Till J, Mulligan G.
      Pages: 1652 - 1662
      Abstract: As of 15 August 2020, Coronavirus disease 2019 (COVID-19) has been reported in >21 million people world-wide and is responsible for more than 750,000 deaths. The occurrence of acute kidney injury (AKI) in patients hospitalized with COVID-19 has been reported to be as high as 43%. This is comparable to AKI in other forms of pneumonia requiring hospitalization, as well as in non-infectious conditions like cardiac surgery. The impact of AKI on COVID-19 outcomes is difficult to assess at present but, similar to other forms of sepsis, AKI is strongly associated with hospital mortality. Indeed, mortality is reported to be very low in COVID-19 patients without AKI. Given that AKI contributes to fluid and acid–base imbalances, compromises immune response and may impair resolution of inflammation, it seems likely that AKI contributes to mortality in these patients. The pathophysiologic mechanisms of AKI in COVID-19 are thought to be multifactorial including systemic immune and inflammatory responses induced by viral infection, systemic tissue hypoxia, reduced renal perfusion, endothelial damage and direct epithelial infection with Severe Acute Respiratory Syndrome Coronavirus 2. Mitochondria play a central role in the metabolic deregulation in the adaptive response to the systemic inflammation and are also found to be vital in response to both direct viral damage and tissue reperfusion. These stress conditions are associated with increased glycolysis and reduced fatty acid oxidation. Thus, there is a strong rationale to target AKI for therapy in COVID-19. Furthermore, many approaches that have been developed for other etiologies of AKI such as sepsis, inflammation and ischemia–reperfusion, have relevance in the treatment of COVID-19 AKI and could be rapidly pivoted to this new disease.
      PubDate: Tue, 06 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa231
      Issue No: Vol. 35, No. 10 (2020)
       
  • Chronic hypoxia exacerbates diabetic glomerulosclerosis through
           mesangiolysis and podocyte injury in db/db mice
    • Authors: Takahashi N; Yoshida H, Kimura H, et al.
      Pages: 1678 - 1688
      Abstract: BackgroundChronic hypoxia may play a pivotal role in the development of diabetic nephropathy (DN). However, the precise mechanisms underlying progressive hypoxia-induced glomerular injury remain unclear.MethodsWe housed db/db mice in a hypoxia chamber (12% O2) for up to 16 weeks beginning at 8 weeks of age. Various urine, serum and kidney abnormalities and glomerular messenger RNA (mRNA) expression were compared with those in age-matched db/db mice housed under normoxia.ResultsLevels of urinary albumin and podocalyxin (PCX) were significantly higher in hypoxic mice early during hypoxia. Ultracentrifugation of urine samples revealed that podocytes in the hypoxic mice shed PCX-positive microparticles into the urine. After 16 weeks of hypoxia, the mice also had higher hematocrits with lower serum glucose and various degrees of mesangiolytic glomerulosclerosis with microaneurysms and the infrequent occurrence of nodular lesions. Immunohistologically, hypoxic mice showed significantly decreased endothelial cell densities early during hypoxia and decreased podocyte densities later. In both hypoxic and normoxic mice, glomerular macrophage and transforming growth factor-β1 (TGF-β1) staining significantly increased with aging, without changes in vascular endothelial growth factor or endothelial nitric oxide synthase (eNOS). Glomerular mRNA expression of monocyte chemoattractant protein-1, eNOS and TGF-β1 was significantly enhanced in the hypoxic mice.ConclusionsThese results indicate that chronic hypoxia induces advanced glomerulosclerosis with accelerated albuminuria triggered by mesangiolysis and podocyte injury in a murine model of DN.
      PubDate: Mon, 29 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa074
      Issue No: Vol. 35, No. 10 (2020)
       
  • Renoprotective effects of sucroferric oxyhydroxide in a rat model of
           chronic renal failure
    • Authors: Neven E; Corremans R, Vervaet B, et al.
      Pages: 1689 - 1699
      Abstract: IntroductionSucroferric oxyhydroxide (PA21) is an efficacious, well-tolerated iron-based phosphate binder and a promising alternative to existing compounds. We compared the effects of PA21 with those of a conventional phosphate binder on renal function, mineral homeostasis and vascular calcification in a chronic kidney disease–mineral and bone disorder (CKD-MBD) rat model.MethodsTo induce stable renal failure, rats were administered a 0.25% adenine diet for 8 weeks. Concomitantly, rats were treated with vehicle, 2.5 g/kg/day PA21, 5.0 g/kg/day PA21 or 3.0 g/kg/day calcium carbonate (CaCO3). Renal function and calcium/phosphorus/iron metabolism were evaluated during the study course. Renal fibrosis, inflammation, vascular calcifications and bone histomorphometry were quantified.ResultsRats treated with 2.5 or 5.0 g/kg/day PA21 showed significantly lower serum creatinine and phosphorus and higher ionized calcium levels after 8 weeks of treatment compared with vehicle-treated rats. The better preserved renal function with PA21 went along with less severe anaemia, which was not observed with CaCO3. Both PA21 doses, in contrast to CaCO3, prevented a dramatic increase in fibroblast growth factor (FGF)-23 and significantly reduced the vascular calcium content while both compounds ameliorated CKD-related hyperparathyroid bone.ConclusionsPA21 treatment prevented an increase in serum FGF-23 and had, aside from its phosphate-lowering capacity, a beneficial impact on renal function decline (as assessed by the renal creatinine clearance) and related disorders. The protective effect of this iron-based phosphate binder on the kidney in rats, together with its low pill burden in humans, led us to investigate its use in patients with impaired renal function not yet on dialysis.
      PubDate: Fri, 10 Jul 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa080
      Issue No: Vol. 35, No. 10 (2020)
       
  • The dapagliflozin and prevention of adverse outcomes in chronic kidney
           disease (DAPA-CKD) trial: baseline characteristics
    • Authors: Wheeler D; Stefansson B, Batiushin M, et al.
      Pages: 1700 - 1711
      Abstract: BackgroundThe Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD; NCT03036150) trial was designed to assess the effect of the sodium–glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin on kidney and cardiovascular events in participants with CKD with and without type 2 diabetes (T2D). This analysis reports the baseline characteristics of those recruited, comparing them with those enrolled in other trials.MethodsIn DAPA-CKD, 4304 participants with a urinary albumin:creatinine ratio (UACR) ≥200 mg/g and estimated glomerular filtration rate (eGFR) between 25 and 75 mL/min/1.73 m2 were randomized to dapagliflozin 10 mg once daily or placebo. Mean eGFR was 43.1 mL/min/1.73 m2 and median UACR was 949 mg/g (108 mg/mmol).ResultsOverall, 2906 participants (68%) had a diagnosis of T2D and of these, 396 had CKD ascribed to a cause other than diabetes. The most common causes of CKD after diabetes (n = 2510) were ischaemic/hypertensive nephropathy (n = 687) and chronic glomerulonephritis (n = 695), of which immunoglobulin A nephropathy (n = 270) was the most common. A total of 4174 participants (97%) were receiving an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 1882 (43.7%) diuretics, 229 (5.3%) mineralocorticoid receptor antagonists and 122 (2.8%) glucagon-like peptide 1 receptor agonists. In contrast to the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE), the DAPA-CKD trial enrolled participants with CKD due to diabetes and to causes other than diabetes. The mean eGFR of participants in the DAPA-CKD trial was 13.1 mL/min/1.73 m2 lower than in CREDENCE, similar to that in the Finerenone in Reducing Kidney Failure and Disease Progression in DKD (FIDELIO-DKD) trial and the Study Of diabetic Nephropathy with AtRasentan (SONAR).ConclusionsParticipants with a wide range of underlying kidney diseases receiving renin–angiotensin system blocking therapy have been enrolled in the DAPA-CKD trial. The trial will examine the efficacy and safety of dapagliflozin in participants with CKD Stages 2–4 and increased albuminuria, with and without T2D.
      PubDate: Sun, 30 Aug 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa234
      Issue No: Vol. 35, No. 10 (2020)
       
  • Incidence of fractures in middle-aged individuals with early chronic
           kidney disease: a population-based analysis of CARTaGENE
    • Authors: Desbiens L; Goupil R, Madore F, et al.
      Pages: 1712 - 1721
      Abstract: BackgroundPrevious studies evaluating fractures in chronic kidney disease (CKD) have mostly focused on hip or major fractures in aged populations with moderate to advanced CKD. We aimed at evaluating the association between early CKD and fracture incidence at all sites across age and sex in middle-aged individuals.MethodsWe analyzed CARTaGENE, a prospective population-based survey of 40- to 69-year-old individuals from Quebec (Canada). Estimated glomerular filtration rate (eGFR) at baseline was evaluated categorically or continuously using restricted cubic splines. Fractures at any site (except toes, hand and craniofacial) for up to 7 years of follow-up were identified through administrative databases using a validated algorithm. Adjusted Cox models were used to evaluate the association of CKD with fracture. Interaction terms for age and sex were also added.ResultsA total of 19 391 individuals (756 CKD Stage 3; 9114 Stage 2; 9521 non-CKD) were included and 829 fractures occurred during a median follow-up of 70 months. Compared with the median eGFR of 90 mL/min/1.73 m2, eGFRs of ≤60 mL/min/1.73 m2 were associated with increased fracture incidence in unadjusted and adjusted models [adjusted hazard ratio (HR) = 1.25 (95% confidence interval 1.05–1.49) for 60 mL/min/1.73 m2; 1.65 (1.14–2.37) for 45 mL/min/1.73 m2]. The eGFR was linearly associated with fracture incidence <75 mL/min/1.73 m2 [HR = 1.18 (1.04–1.34) per 10 mL/min/1.73 m2 decrease] but not above [HR = 0.98 (0.91–1.06) per 10 mL/min/1.73 m2 decrease). The effect of decreased eGFR on fracture incidence was more pronounced in younger individuals [HR = 2.45 (1.28–4.67) at 45 years; 1.11 (0.73–1.67) at 65 years] and in men.ConclusionsEven early CKD increases fracture incidence, especially in younger individuals and in men.
      PubDate: Fri, 17 Jan 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfz259
      Issue No: Vol. 35, No. 10 (2020)
       
  • Identifying critically important cardiovascular outcomes for trials in
           hemodialysis: an international survey with patients, caregivers and health
           professionals
    • Authors: O’Lone E; , Howell M, et al.
      Pages: 1761 - 1769
      Abstract: BackgroundCardiovascular disease (CVD) is a major contributor to morbidity and mortality in people on hemodialysis (HD). Cardiovascular outcomes are reported infrequently and inconsistently across trials in HD. This study aimed to identify the priorities of patients/caregivers and health professionals (HPs) for CVD outcomes to be incorporated into a core outcome set reported in all HD trials.MethodsIn an international online survey, participants rated the absolute importance of 10 cardiovascular outcomes (derived from a systematic review) on a 9-point Likert scale, with 7–9 being critically important. The relative importance was determined using a best–worst scale. Likert means, medians and proportions and best–worst preference scores were calculated for each outcome. Comments were thematically analyzed.ResultsParticipants included 127 (19%) patients/caregivers and 549 (81%) HPs from 53 countries, of whom 530 (78%) completed the survey in English and 146 (22%) in Chinese. All but one cardiovascular outcome (‘valve replacement’) was rated as critically important (Likert 7–9) by all participants; ‘sudden cardiac death’, ‘heart attack’, ‘stroke’ and ‘heart failure’ were all rated at the top by patients/caregivers (median Likert score 9). Patients/caregivers ranked the same four outcomes as the most important outcomes with mean preference scores of 6.2 (95% confidence interval 4.8–7.5), 5.9 (4.6–7.2), 5.3 (4.0–6.6) and 4.9 (3.6–6.3), respectively. The same four outcomes were ranked most highly by HPs. We identified five themes underpinning the prioritization of outcomes: ‘clinical equipoise and potential for intervention’, ‘specific or attributable to HD’, ‘severity or impact on the quality of life’, ‘strengthen knowledge and education’, and ‘inextricably linked burden and risk’.ConclusionsPatients and HPs believe that all cardiovascular outcomes are of critical importance but consistently identify sudden cardiac death, myocardial infarction, stroke and heart failure as the most important outcomes to be measured in all HD trials.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa008
      Issue No: Vol. 35, No. 10 (2020)
       
  • Cognitive impairment, endothelial biomarkers and mortality in maintenance
           haemodialysis patients: a prospective cohort study
    • Authors: Freire de Medeiros C; Diógenes da Silva B, Costa B, et al.
      Pages: 1779 - 1785
      Abstract: BackgroundHaemodialysis (HD) patients have a high prevalence of cardiovascular disease risk factors as well as cognitive impairment. The objective of the present study was to evaluate the interrelationship between cognitive impairment, endothelium-related biomarkers and cardiovascular/non-cardiovascular mortality.MethodsA total of 216 outpatients were recruited from three centres in a dialysis network in Brazil between June 2016 and June 2019. Sociodemographic and clinical data were obtained by applying a patient questionnaire, reviewing medical records data and conducting patient interviews. Cognitive function was assessed using the Cambridge Cognitive Examination. Plasma endothelium-related biomarkers [syndecan-1, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion protein-1 (VCAM-1) and angiopoietin-2 (AGPT2)] were measured. Patients were followed for 30 months. Cox proportional hazards regression models were used to assess the associations of the cognitive function scores and each endothelium-related biomarker with cardiovascular/non-cardiovascular mortality.ResultsCognitive function was associated with cardiovascular mortality {each standard deviation [SD] better cognitive score was associated with a 69% lower risk for cardiovascular mortality [hazard ratio (HR) 0.31 [95% confidence interval (CI) 0.17–0.58]} but not with non-cardiovascular mortality. Moreover, cognitive function was also correlated with all endothelial-related biomarkers, except VCAM-1. ICAM-1, AGPT2 and syndecan-1 were also associated with cardiovascular mortality. The association between cognitive function and cardiovascular mortality remained significant with no HR value attenuation [fully adjusted HR 0.32 (95% CI 0.16–0.59)] after individually including each endothelial-related biomarker in the Cox model.ConclusionsIn conclusion, cognitive impairment was associated with several endothelium-related biomarkers. Moreover, cognitive impairment was associated with cardiovascular mortality but not with non-cardiovascular mortality, and the association between cognitive impairment and cardiovascular mortality in HD patients was not explained by any of the endothelial-related biomarkers.
      PubDate: Thu, 07 May 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa040
      Issue No: Vol. 35, No. 10 (2020)
       
  • Estimated glomerular filtration rate at dialysis initiation and subsequent
           decline in residual kidney function among incident hemodialysis patients
    • Authors: Lertdumrongluk P; Tantisattamo E, Obi Y, et al.
      Pages: 1786 - 1793
      Abstract: BackgroundHigher estimated glomerular filtration rate (eGFR) at dialysis initiation, known as earlier start of dialysis, is often a surrogate of poor outcomes including higher mortality. We hypothesized that earlier dialysis initiation is associated with a faster decline in residual kidney function (RKF), which is also associated with higher mortality among incident hemodialysis (HD) patients.MethodsIn a cohort of 4911 incident HD patients who initiated HD over a 5-year period (July 2001 to June 2006), we examined the trajectories of RKF, ascertained by renal urea clearance (KRU), over 2 years after HD initiation across strata of eGFR at HD initiation using case-mix adjusted linear mixed-effect models. We then investigated the association between annual change in RKF and mortality using Cox proportional hazard models.ResultsThe median (interquartile range) baseline KRU was 2.20 (1.13–3.63)  mL/min/1.73 m2. The decline of KRU was faster in patients who initiated HD at higher eGFR. The relative changes with 95% confidence intervals (CIs) in KRU at 1 year after HD initiation were −1.29 (−1.28 to −1.30), −1.17 (−1.16 to −1.18), −1.11 (−1.10 to −1.12) and −0.78 (−0.78 to −0.79)  mL/min/1.73 m2 in the eGFR categories of ≥10, 8–<10, 6–<8 and <6 mL/min/1.73 m2, respectively. The faster decline of KRU at 1 year was associated with higher all-cause mortality (reference: ≥0 mL/min/1.73 m2): hazard ratios (95% CIs) for change in KRU of −1.5 to <0, −3 to less than −1.5 and less than −3 mL/min/1.73 m2 were 1.20 (1.03–1.40), 1.42 (1.17–1.72) and 1.88 (1.47–2.40), respectively.ConclusionsThe faster decline of RKF happens with earlier dialysis initiation and is associated with higher all-cause mortality.
      PubDate: Sun, 10 May 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa055
      Issue No: Vol. 35, No. 10 (2020)
       
  • Impact of longer term phosphorus control on cardiovascular mortality in
           hemodialysis patients using an area under the curve approach: results from
           the DOPPS
    • Authors: Lopes M; Karaboyas A, Bieber B, et al.
      Pages: 1794 - 1801
      Abstract: BackgroundSerial assessment of phosphorus is currently recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, but its additional value versus a single measurement is uncertain.MethodsWe studied data from 17 414 HD patients in the Dialysis Outcomes and Practice Patterns Study, a prospective cohort study, and calculated the area under the curve (AUC) by multiplying the time spent with serum phosphorus >4.5 mg/dL over a 6-month run-in period by the extent to which this threshold was exceeded. We estimated the association between the monthly average AUC and cardiovascular (CV) mortality using Cox regression. We formally assessed whether AUC was a better predictor of CV mortality than other measures of phosphorus control according to the Akaike information criterion.ResultsCompared with the reference group of AUC = 0, the adjusted hazard ratio (HR) of CV mortality was 1.12 [95% confidence interval (CI) 0.90–1.40] for AUC > 0–0.5, 1.26 (95% CI 0.99–1.62) for AUC > 0.5–1, 1.44 (95% CI 1.11–1.86) for AUC > 1–2 and 2.03 (95% CI 1.53–2.69) for AUC > 2. The AUC was predictive of CV mortality within strata of the most recent phosphorus level and had a better model fit than other serial measures of phosphorus control (mean phosphorus, months out of target).ConclusionsWe conclude that worse phosphorus control over a 6-month period was strongly associated with CV mortality. The more phosphorus values do not exceed 4.5 mg/dL the better is survival. Phosphorus AUC is a better predictor of CV death than the single most recent phosphorus level, supporting with real-world data KDIGO’s recommendation of serial assessment of phosphorus to guide clinical decisions.
      PubDate: Mon, 29 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa054
      Issue No: Vol. 35, No. 10 (2020)
       
  • Cancer survival in kidney transplant recipients in Ireland
    • Authors: Murray S; O’Leary E, De Bhailís Á, et al.
      Pages: 1802 - 1810
      Abstract: BackgroundTransplantation is a well-known risk factor for malignancy. However, outcomes of cancer in transplant recipients compared with non-transplant recipients are less well studied. We aim to study the survival in kidney transplant recipients who develop cancer and compare this with cancer outcomes in the general population.MethodsWe linked data from the National Cancer Registry Ireland with the National Kidney Transplant Database. The period of observation was from 1 January 1994 until 31 December 2014. Transplant recipients were considered at risk from the time of diagnosing cancer. We administratively censored data at 10 years post-cancer diagnosis. Survival was compared with all patients in the general population that had a recorded diagnosis of cancer. ResultsThere were 907 renal transplant recipients and 426679 individuals in the general population diagnosed with cancer between 1 January 1994 and 31 December 2014. In those with non-melanoma skin cancer, the hazard ratio (HR) for 10-year, all-cause mortality [HR = 3.06, 95% confidence interval (CI) 2.66–3.52] and cancer-specific mortality (HR = 3.91, 95% CI 2.57–5.96) was significantly higher among transplant recipients than the general population. Patients who developed non-Hodgkin lymphoma (HR = 2.89, 95% CI 1.96–4.25) and prostate cancer (HR = 4.32, 95% CI 2.39–7.82) had increased all-cause but not cancer-specific mortality. Colorectal, lung, breast and renal cell cancer did not show an increased risk of death in transplant recipients.ConclusionCancer-attributable mortality is higher in kidney transplant recipients with non-melanoma skin cancer compared with non-transplant patients. The American Joint Committee on Cancer staging should reflect the increased hazard of death in these immunosuppressed patients.
      PubDate: Wed, 08 Jul 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa109
      Issue No: Vol. 35, No. 10 (2020)
       
  • Impact of cardiovascular risk stratification strategies in kidney
           transplantation over time
    • Authors: Deak A; Ionita F, Kirsch A, et al.
      Pages: 1810 - 1818
      Abstract: BackgroundKidney transplant recipients exhibit a dramatically increased cardiovascular (CV) risk. In 2007, Austrian centres implemented a consensus of comprehensive CV screening programme prior to kidney transplantation (KT). The consensus placed a particular emphasis on screening for coronary artery disease (CAD) with cardiac computed tomography (CT) or coronary angiography (CAG) in patients with diabetes mellitus, known CAD or those having multiple conventional CV risk factors. Here, we investigate if this affected risk stratification and post-transplant CV outcomes. MethodsIn a retrospective chart review, we evaluated 551 KTs performed from 2003 to 2015 in our centre. Patients were categorized into three groups: KT before (2003–07), directly after (2008–11) and 5 years after (2012–15) implementation of the consensus. We analysed clinical characteristics, the rate of cardiac CTs and CAGs prior to KT as well as major adverse cardiac events (MACEs) during a 2-year follow-up after KT. ResultsThe three study groups showed a homogeneous distribution of comorbidities and age. Significantly more cardiac CTs (13.6% versus 10.2% versus 44.8%; P = 0.002) and CAGs (39.6% versus 43.9% versus 56.2%; P = 0.003) were performed after the consensus. Coronary interventions were performed during 42 out of 260 CAGs (16.2%), the cumulative 2-year MACE incidence was 8.7%. Regarding MACE occurrence, no significant difference between the three groups was found.ConclusionCV risk stratification has become more rigorous and invasive after the implementation of the consensus; however, this was not associated with an improvement in CV outcome.
      PubDate: Tue, 06 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa131
      Issue No: Vol. 35, No. 10 (2020)
       
  • Sustained effects of a clinical decision support system for acute kidney
           injury
    • Authors: Bataineh A; Dealmeida D, Bilderback A, et al.
      Pages: 1819 - 1821
      Abstract: Acute kidney injury (AKI) complicates 55–60% of intensive care unit (ICU) admissions [1] and 5–23% of all hospital admissions [2, 3]. While AKI recognition is increasing, it can be missed by clinicians in close to a quarter of cases [4, 5]. Early intervention can improve outcome and reduce the risk of further worsening of kidney function [6, 7].
      PubDate: Tue, 23 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa099
      Issue No: Vol. 35, No. 10 (2020)
       
  • Acute acid load in chronic kidney disease increases plasma potassium,
           plasma aldosterone and urinary renin
    • Authors: Bovée D; Janssen J, Zietse R, et al.
      Pages: 1821 - 1823
      Abstract: Metabolic acidosis is common in patients with chronic kidney disease (CKD) and may contribute to progression of CKD and all-cause mortality [1]. However, little is known about how CKD changes the response to an acute acid load and whether an altered response could contribute to adverse outcomes [2]. Therefore, our aim was to characterize the differences between the response to an acute oral acid load (to mimic the dietary acid load) in patients with CKD and healthy subjects.
      PubDate: Sat, 25 Jul 2020 00:00:00 GMT
      DOI: 10.1093/ndt/gfaa136
      Issue No: Vol. 35, No. 10 (2020)
       
 
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