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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: 28)
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)

           

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Journal Cover
Kidney International Reports
Journal Prestige (SJR): 0.632
Citation Impact (citeScore): 1
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2468-0249
Published by Elsevier Homepage  [3201 journals]
  • Urinary Tissue Inhibitor of Metalloproteinases-2 and Insulin-Like Growth
           Factor-Binding Protein 7 Do Not Correlate With Disease Severity in ADPKD
           Patients

    • Abstract: Publication date: Available online 22 March 2019Source: Kidney International ReportsAuthor(s): Shosha E.I. Dekker, L. Renee Ruhaak, Fred P.H.T.M. Romijn, Esther Meijer, Christa M. Cobbaert, Johan W. De Fijter, Darius Soonawala, DIPAK Consortium IntroductionAutosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive cyst formation and variable renal function decline that frequently leads to end-stage renal failure. With the advent of renoprotective treatment, there is renewed interest in non-invasive biomarkers to help identify patients at risk of rapid disease progression at early stages. Urinary tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been validated as early markers of acute kidney injury. Since these markers are associated with tubular damage, we studied the performance of both markers in a cohort with chronic tubular pathology. We investigated whether these biomarkers may be useful to evaluate disease severity in ADPKD.MethodsIn a cross-sectional analysis, we measured TIMP-2 and IGFBP7 in stored spot urine samples of ADPKD patients with various stages of chronic kidney disease (CKD) and healthy controls by enzyme-linked immunosorbent assay. Renal function was estimated using the CKD-EPI equation. Patients were stratified according to the KDOQI classification for CKD. In a subset of patients, total kidney volume (TKV; using MRI) was measured.ResultsIn 296 ADPKD patients (45.5 ± 11.5 years, 51.0% female, serum creatinine 106 (85-147) μmol/L), urine levels of TIMP-2 and IGFBP7 were not increased or tended to be lower as compared with 71 healthy controls (46.5 ± 18.5 years, 72.6% female). The levels did not differ across CKD stages, which remained so after correcting for urine creatinine or osmolality, and for age, gender and urine protein in multivariable analyses.ConclusionsUrinary levels of TIMP-2 and IGFBP7 were not higher in patients with ADPKD, and did not correlate with disease severity.
       
  • Clinical value of complement activation biomarkers in overt diabetic
           nephropathy

    • Abstract: Publication date: Available online 20 March 2019Source: Kidney International ReportsAuthor(s): Karyne Pelletier, Arnaud Bonnefoy, Hugo Chapdelaine, Vincent Pichette, Matthieu Lejars, François Madore, Soumeya Brachemi, Stéphan Troyanov BackgroundExperimental studies support a role of complement activation in diabetic nephropathy (DN), yet little clinical correlates exist. We evaluated urinary levels of sC5b-9 membrane attack complex (MAC) in patients with overt DN, and examined its association with the GFR decline, proteinuria and inflammatory biomarkers. We explored different complement pathways and compared our findings to autoimmune glomerulonephritis.MethodsWe prospectively followed 83 patients with DN and obtained repeated measurements of proteinuria, complement fragments (sC5b-9, C4a, C1q, MASP-1 and factor Bb) and MCP-1 and TGF-β1. We assessed independence and interactions using general linear models and repeated measures analyses and compared levels to subjects with active FSGS, ANCA associated vasculitis, membranous and IgA nephropathies (n=63).ResultsThe diabetic cohort had an initial GFR of 25±9 mL/min/1.73m2 and a renal function decline of 2.9±3.0 mL/min/1.73m2/year. All complement biomarkers were strongly intercorrelated and associated with biomarkers inflammation and fibrosis, proteinuria and the rate of renal function decline. There was a significant interaction (p=0.03) between the level of proteinuria and urinary sC5b-9: in individuals with higher levels of urinary MAC, the relationship between proteinuria and the rate of renal function decline was more pronounced than in those with low urinary MAC. Finally, patients with DN had levels of urinary sC5b-9 comparable to auto-immune glomerulonephritis, when stratified by the level of proteinuria.ConclusionsUrinary MAC is present in patients with overt DN at levels comparable to autoimmune glomerulonephritis and correlates with the GFR decline, supporting that complement activation and its measurement are clinically relevant in DN.Graphical abstractGraphical abstract for this article
       
  • Dietary Fiber Intake, Myocardial Injury and Major Adverse Cardiovascular
           Events among End-Stage Kidney Disease Patients: A Prospective Cohort Study
           

    • Abstract: Publication date: Available online 20 March 2019Source: Kidney International ReportsAuthor(s): Angela Yee-Moon Wang, Mandy Man-Mei Sea, Kenway Ng, Mei Wang, Iris Hiu-Shuen Chan, Christopher Wai-Kei Lam, John E. Sanderson, Jean Woo IntroductionDialysis patients are frequently advised to restrict fruits and vegetables intake due to their high potassium content. This study aimed to evaluate the association between dietary fiber intake and major adverse cardiovascular events (MACE) among dialysis patients.MethodsTwo hundred and nineteen prevalent dialysis patients were prospectively recruited from a major university teaching hospital and regional dialysis center in Hong Kong. Dietary fiber intake estimated using a 7-day locally validated food frequency questionnaire was examined in relation to a primary composite outcome of MACE over a follow-up period of 4 years.ResultsOne hundred and twenty-seven patients were complicated with one or more MACE. In the multivariable Cox regression analysis, every 1gram higher fiber intake and every 1gram per day /1000kcal higher fiber intake density were associated with an 11% (95% confidence intervals [CI], 0.81 – 0.97) and a 13% lower risk of MACE (95% CI, 0.77 – 0.99), respectively, independent of clinical, demographic, biochemical, hemodynamic, adequacy parameters, dietary protein, energy intake, inflammatory and cardiac markers. Patients in the lower tertile of fiber intake density showed an increased hazard for MACE (adjusted hazard ratio, 1.78, 95% CI, 1.13 – 2.80) than those in the upper tertile.ConclusionsHigher fiber intake and fiber intake density may be associated with less inflammation, less myocardial hypertrophy, injury and lower risk of MACE in dialysis patients. These data form an important basis for a randomized controlled trial to examine fiber supplementation on cardiovascular outcomes in the dialysis population.Graphical abstractGraphical abstract for this article
       
  • Apol1-Associated Kidney Disease in Brazil

    • Abstract: Publication date: Available online 20 March 2019Source: Kidney International ReportsAuthor(s): Cristian Riella, Tobias A. Siemens, Minxian Wang, Rodrigo P. Campos, Thyago P. Moraes, Leonardo V. Riella, David J. Friedman, Miguel C. Riella, Martin R. Pollak IntroductionCoding variants in apolipoprotein L-1 (APOL1) are associated with an increased risk of end-stage kidney disease (ESRD) in African Americans under a recessive model of inheritance. The effect of the APOL1 risk alleles on kidney disease has been observed in studies in African-American and African populations. Despite the 130 million individuals of recent African ancestry in South America, the impact of APOL1 has not been explored.MethodsIn this case-control study, we tested APOL1 genotype in 106 Brazilian hemodialysis patients with African ancestry and compared risk allele frequency with 106 healthy first-degree relatives. The association of risk alleles and ESRD was calculated with a linear mixed model and was adjusted for relatedness and additional confounders. In a broader survey, the age of dialysis initiation and APOL1 variants were analyzed in 274 hemodialysis patients.ResultsTwo APOL1 risk alleles was ten times more common in ESRD patients than in controls (9.4% versus 0.9%; odds ratio=10.95, standard error=1.49, p-value=0.0017). Carriers of two risk alleles initiated dialysis twelve years earlier than patients with zero risk alleles.ConclusionThe APOL1 risk variants were less frequent in dialysis patients of African ancestry in Brazil than in the United States. Nonetheless, carriers of two risk variants had 10-fold higher odds of ESRD. Age of dialysis initiation was markedly lower in two-risk allele carriers, suggesting a more aggressive disease phenotype. The Brazilian population represents an opportunity to identify different sets of genetic modifiers or environmental triggers that might be present in more extensively-studied populations.
       
  • Pre-dialysis care and cardiovascular outcomes: Why the lead up to dialysis
           matters

    • Abstract: Publication date: Available online 20 March 2019Source: Kidney International ReportsAuthor(s): Gregory L. Hundemer, Manish M. Sood
       
  • Isolated liver transplantation – a worthy choice for atypical HUS in
           resource restricted settings

    • Abstract: Publication date: Available online 19 March 2019Source: Kidney International ReportsAuthor(s): Ranjani Ravi, Satish Balan, Praveen Murlidharan, Kasi Viswesaran, Venugopal B, Shabeerali T U, Shiraz R
       
  • Somatic Mosaicism in a Male Patient with X-linked Alport Syndrome

    • Abstract: Publication date: Available online 14 March 2019Source: Kidney International ReportsAuthor(s): Lihong Bu, Judy Chen, Andrew C. Nelson, Avi Katz, Clifford E. Kashtan, Youngki Kim, Mary Ella Pierpont
       
  • Diabetes Mellitus Modifies the Associations of Serum Magnesium
           Concentration with Arterial Calcification and Stiffness in Incident
           Hemodialysis Patients

    • Abstract: Publication date: Available online 13 March 2019Source: Kidney International ReportsAuthor(s): Wei Chen, Jessica Fitzpatrick, Jose M. Monroy-Trujillo, Stephen M. Sozio, Bernard G. Jaar, Michelle M. Estrella, Tong Tong Wu, Michal L. Melamed, Rulan S. Parekh, David A. Bushinsky IntroductionMagnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus.MethodsWe performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI:>1.4 or incompressible vessels), pulse wave velocity (PWV) and pulse pressure.ResultsMean Mg was 1.8±0.2 mEq/L and 58% had diabetes. Among non-diabetics, per 0.1 mEq/L higher Mg, non-zero CAC score was lower [% difference: -15.4% (95%CI -28%, -0.55%), p=0.03], the odds of having TAC score>0 and the odds of having high ABI were lower [OR: 0.66 (95%CI 0.47, 0.93), p=0.02 and 0.23 (95%CI 0.06, 0.83), p=0.03, respectively] while adjusting for demographics, co-morbidities, markers of mineral metabolism and dialysis clearance. Among diabetics, per 0.1 mEq/L higher Mg, the odds of having TAC score>0 was higher [OR 1.57 (95% CI 1.09, 2.26), p=0.02]. Mg was not associated with PWV or pulse pressure regardless of diabetes status.ConclusionsDiabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among non-diabetics, but Mg was only associated with TAC among diabetics with higher Mg being associated with higher likelihood of having TAC score>0.
       
  • Efficacy of Rituximab in a patient with partial clinical remission and
           persistent circulating PLA2R-Ab

    • Abstract: Publication date: Available online 13 March 2019Source: Kidney International ReportsAuthor(s): Elodie Georges, Catherine Johanet, Emmanuelle Plaisier, Hanna Debiec, Pierre Ronco, Karine Dahan
       
  • Outcomes following treatment of maternal hypercalcemia due to
           CYP24A1 pathogenic variants

    • Abstract: Publication date: Available online 8 March 2019Source: Kidney International ReportsAuthor(s): Lucy McBride, Christine Houlihan, Catherine Quinlan, Betty Messazos, Zornitza Stark, Amy Crosthwaite
       
  • Cancer-Associated AA Amyloidosis Presenting as Crescentic
           Glomerulonephritis

    • Abstract: Publication date: Available online 4 March 2019Source: Kidney International ReportsAuthor(s): Jonathan E. Zuckerman, Fenghua Peng, Bethany E. Karl, Carl E. Schulze, Anthony Sisk
       
  • Mushroom Poisoning Presenting With Acute Kidney Injury and Elevated
           Transaminases

    • Abstract: Publication date: Available online 4 March 2019Source: Kidney International ReportsAuthor(s): Mathilde Beaumier, Jean-Philippe Rioult, Marie Georges, Isabelle Brocheriou, Thierry Lobbedez, Antoine Lanot
       
  • Meneghini M, Melilli E, Martorell J, et al. Combining sensitive
           crossmatch assays with donor/recipient human leukocyte antigen eplet
           matching predicts living-donor kidney transplant outcome. Kidney Int Rep.
           2018;3:926–938

    • Abstract: Publication date: Available online 4 March 2019Source: Kidney International ReportsAuthor(s):
       
  • Nutritional Mobile Applications for CKD Patients: Systematic Review

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Sarah Daisy Kosa, Jillian Monize, Mitchell D'Souza, Arundhati Joshi, Kaylyssa Philip, Samiha Reza, Simranjit Samra, Bridgette Serrago, Lehana Thabane, Amiram Gafni, Charmaine E. LokIntroductionMobile health applications offer the potential to help people living with chronic kidney disease (CKD) manage diet-related challenges. This systematic review examined CKD dietary mobile app interventions; specifically, app characteristics, feasibility, and effectiveness in changing user behavior, as well as user satisfaction.MethodsThis review was reported in accordance with PRISMA guidelines. We searched scholarly databases, as well as the gray literature, for all randomized controlled trials, observational studies, needs assessments, and pilot testing/studies/trials focused on the development or evaluation of CKD dietary mobile app interventions. The characteristics, user satisfaction with, usability/feasibility, and effectiveness in changing dietary behavior of the mobile application were summarized using descriptive statistics and in a narrative manner.ResultsThirteen full-text studies were included, of which 11 were single center, with a mean sample size of 23. Of the 7 studies that measured usability/feasibility, all found at least some aspects of the application feasible/useful. Of the 5 studies that reported an evaluation of changes in behavior/diet related to self-management, all reported some positive change.ConclusionAccording to current studies, nutritional apps show promise in CKD self-management.
       
  • Paying for Hemodialysis in Kerala, India: A Description of Household
           Financial Hardship in the Context of Medical Subsidy

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Christina Bradshaw, Noble Gracious, Ranjit Narayanan, Sajith Narayanan, Mohammed Safeer, Geetha M. Nair, Praveen Murlidharan, Aiswarya Sundaresan, Syamraj Retnaraj Santhi, Dorairaj Prabhakaran, Manjula Kurella Tamura, Vivekanand Jha, Glenn M. Chertow, Panniyammakal Jeemon, Shuchi AnandIntroductionMany low- and middle-income countries are implementing strategies to increase dialysis availability as growing numbers of people reach end-stage renal disease. Despite efforts to subsidize care, the economic sustainability of chronic dialysis in these settings remains uncertain. We evaluated the association of medical subsidy with household financial hardship related to hemodialysis in Kerala, India, a state with high penetrance of procedure-based subsidies for patients on dialysis.MethodsPatients on maintenance hemodialysis at 15 facilities in Kerala were administered a questionnaire that ascertained demographics, dialysis details, and household finances. We estimated direct and indirect costs of hemodialysis, and described the use of medical subsidy. We evaluated whether presence of subsidy (private, charity, or government-sponsored) was associated with lower catastrophic health expenditure (defined as ≥40% of nonsubsistence expenditure spent on dialysis) or distress financing.ResultsOf the 835 patients surveyed, 759 (91%) reported their households experienced catastrophic health expenditure, and 644 (77%) engaged in distress financing. Median dialysis-related expenditure was 80% (25th–75th percentile: 60%–90%) of household nonsubsistence expenditure. Government subsidies were used by 238 (29%) of households, 139 (58%) of which were in the lowest income category. Catastrophic health expenditure was present in 215 (90%) of households receiving government subsidy and 332 (93%) without subsidy.ConclusionsProvision of medical subsidy in Kerala, India was not associated with lower rates of household financial hardship related to long-term hemodialysis therapy. Transparent counseling on impending costs and innovative strategies to mitigate household financial distress are necessary for persons with end-stage renal disease in resource-limited settings.
       
  • High Prevalence of CKD of Unknown Etiology in Uddanam, India

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Ravi Raju Tatapudi, Satyanarayana Rentala, Prasad Gullipalli, Aruna Lakshmi Komarraju, Ajay K. Singh, Vasishta S. Tatapudi, Krishna Babu Goru, Devi Madhavi Bhimarasetty, Hanumanth NarniIntroductionThere were concerns raised regarding a high prevalence of chronic kidney disease (CKD) in Uddanam, a fertile subtropical low-altitude territory in the southern Indian state of Andhra Pradesh. The present study was undertaken to ascertain the prevalence of CKD, disease characteristics, and risk factor profile in this area.MethodsWe selected 2210 subjects (age>18 years) using multistage sampling. After obtaining demographic and anthropometric data, urinary protein-creatinine ratio, serum creatinine, and blood glucose were measured in all the subjects. Glomerular filtration rate was estimated (eGFR) using the Modification of Diet in Renal Disease equation.ResultsMean age of the subjects was 43.2 ± 14.2 years (range: 18–98), 44.3% were men and 55.7% were women. Mean eGFR of subjects was 94.3 ± 33.4. Low eGFR (
       
  • Burden, Access, and Disparities in Kidney Disease

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Deidra C. Crews, Aminu K. Bello, Gamal Saadi, Philip Kam Tao Li, Guillermo Garcia-Garcia, Sharon Andreoli, Deidra Crews, Kamyar Kalantar-Zadeh, Charles Kernahan, Latha Kumaraswami, Gamal Saadi, Luisa Strani
       
  • Long-term Use of Eculizumab in Kidney Transplant Recipients

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Sabrina Milan Manani, Grazia Maria Virzì, Claudio Ronco
       
  • CKD of Unknown Cause: A Global Epidemic'

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Neil Pearce, Ben Caplin, Nalika Gunawardena, Prabhdeep Kaur, Cristina O’Callaghan-Gordo, Thilanga Ruwanpathirana
       
  • The Importance of Considering Total Patient Economics
           for Hemodialysis

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Mahesh Krishnan
       
  • Universal Care for Kidney Diseases: Sustainable Development or Path
           to Financial Ruin'

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Blake Angell, Vivekanand Jha
       
  • Hyponatremia in the Dialysis Population

    • Abstract: Publication date: Available online 1 March 2019Source: Kidney International ReportsAuthor(s): Connie M. Rhee, Juan Carlos Ayus, Kamyar Kalantar-ZadehSodium derangements are among the most frequently encountered electrolyte disorders in patients with end-stage renal disease. As dialysis patients are predisposed to hyponatremia via multiple pathways, assessment of extracellular volume status is an essential first step in disentangling potential etiologic factors. In addition, multiple large population-based studies indicate that proxies of malnutrition (e.g., low body mass index, serum albumin, and serum creatinine levels) and loss of residual kidney function are important determinants of hyponatremia in dialysis patients. Among hemodialysis and peritoneal dialysis patients, evidence suggests that incrementally lower sodium levels are associated with increasingly higher death risk, highlighting the long-term risk of hyponatremia. Whereas in conventional survival models incrementally lower serum sodium concentrations are associated with worse mortality in hemodialysis patients, studies that have examined repeated measures of predialysis sodium have demonstrated mixed associations of time-varying sodium with higher mortality risk (i.e., U-shaped vs. inverse linear relationships). Although the causality of the hyponatremia-mortality association in dialysis patients remains uncertain, there are several plausible pathways by which lower sodium levels may lead to higher death risk, including central nervous system toxicity, falls and fractures, infection-related complications, and impaired cardiac function. Areas of uncertainty ripe for future studies include the following: (1) mechanistic pathways by which lower serum sodium levels are linked with higher mortality in dialysis patients, (ii) whether correction of sodium derangements improves outcomes, (iii) the optimal sodium target, and (iv) the impact of age and other sociodemographic factors on hyponatremia-outcome associations.
       
  • The Authors Reply

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Rosa Ramos, Angel L.M. de Francisco, Jose Ignacio Merello, Bernard Canaud, Javier Varas, Stefano Stuard, Julio Pascual, Pedro Aljama P, Optimizing Results in Dialysis (ORD) group
       
  • Dabigatran Toxicity in Acute Kidney Injury: Hemodialysis and Idarucizumab
           Required

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Lucy McBride, Julie Wang, Prahlad Ho, David Langsford
       
  • Severe Acute Kidney Injury and Double Tubulopathy Due to Dual Toxicity
           Caused by Combination Antiretroviral Therapy

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Karina Soto, Pedro Campos, Rita Manso, Alexandra M.M. Antunes, Judit Morello, Mark A. Perazella
       
  • A Novel Case of Pseudohyponatremia Caused by Hypercholesterolemia

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Lu Song, Ramy M. Hanna, Minhtri K. Nguyen, Ira Kurtz, James Wilson
       
  • Iatrogenic Hypercalcemia Postrenal Transplantation

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Yvelynne P. Kelly, Ana Onuchic-Whitford, Ivy A. Rosales, Winfred W. Williams
       
  • Cyclophosphamide-Induced Lung Injury

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Dan Pugh, Tariq E. Farrah, Peter J. Gallacher, David C. Kluth, Neeraj Dhaun
       
  • Interleukin-6 Contributes to the Development of Anemia in Juvenile CKD

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Oleh Akchurin, Edwin Patino, Vidhi Dalal, Kelly Meza, Divya Bhatia, Simon Brovender, Yuan-Shan Zhu, Susanna Cunningham-Rundles, Eduardo Perelstein, Juhi Kumar, Stefano Rivella, Mary E. ChoiIntroductionAnemia is a common complication of chronic kidney disease (CKD) in children; however, the role of inflammation in its pathogenesis remains incompletely understood.MethodsTo elucidate the role of interleukin (IL)-6 in renal anemia, we induced CKD by adenine diet in juvenile wild-type (WT) and IL-6 deficient (Il6KO) mice, and examined serum IL-6 and relevant parameters in children with CKD.ResultsWT-CKD mice developed anemia despite increases in serum erythropoietin and displayed low serum iron and elevated serum IL-6. IL-6 deficiency resulted in a significant improvement of red blood cell count and hemoglobin in CKD mice. This effect was associated with improvement of hypoferremia by Il6 deletion, likely mediated by hepcidin. However, correction of hypoferremia by oral iron supplementation in WT-CKD mice did not fully replicate the protective effects of Il6 deletion, suggesting an additional iron-independent role for IL-6 in CKD-anemia. Indeed, Il6 deletion mitigated the severity of renal fibrosis and alleviated relative erythropoietin insufficiency in CKD mice. Cytokine profiling in a pediatric CKD cohort demonstrated that of 10 cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, tumor necrosis factor (TNF)-α, and interferon-γ), only IL-6 was significantly (inversely) associated with hemoglobin when adjusted for glomerular filtration rate (GFR). The association between IL-6 and hemoglobin in children with CKD remained significant after adjustment for CKD stage, iron therapy, and hepcidin.DiscussionIL-6 contributes to development of anemia in juvenile CKD, through mechanisms that include induction of hypoferremia, aggravation of renal fibrosis, and alteration of the erythropoietin axis. IL-6 appears to be a promising therapeutic target in the management of CKD-anemia.
       
  • Impact of Induction Therapy on Circulating T Follicular Helper Cells and
           Subsequent Donor-Specific Antibody Formation After Kidney Transplant

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Camila Macedo, Kevin Hadi, John Walters, Beth Elinoff, Marilyn Marrari, Adriana Zeevi, Bala Ramaswami, Geetha Chalasani, Douglas Landsittel, Adele Shields, Rita Alloway, Fadi G. Lakkis, E. Steve Woodle, Diana MetesIntroductionThe cellular events that contribute to generation of donor-specific anti-HLA antibodies (DSA) post-kidney transplantation (KTx) are not well understood. Characterization of such mechanisms could allow tailoring of immunosuppression to benefit sensitized patients.MethodsWe prospectively monitored circulating T follicular helper (cTFH) cells in KTx recipients who received T-cell depleting (thymoglobulin, n = 54) or T-cell nondepleting (basiliximab, n = 20) induction therapy from pre-KTx to 1 year post-KTx and assessed their phenotypic changes due to induction and DSA occurrence, in addition to healthy controls (n = 13), for a total of 307 blood samples.ResultsBefore KTx, patients displayed comparable levels of resting, central memory cTFH cells with similar polarization to those of healthy controls. Unlike basiliximab induction, thymoglobulin induction significantly depleted cTFH cells, triggered lymphopenia-induced proliferation that skewed cTFH cells toward increased Th1 polarization, effector memory, and elevated programmed cell death protein 1 (PD-1)int/hi expression, resembling activated phenotypes. Regardless of induction, patients who developed DSA post-KTx, harbored pre-KTx donor-reactive memory interleukin (IL)-21+ cTFH cells and showed higher % cTFH and lower % of T regulatory (TREG) cells post-KTx resulting in elevated cTFH:TREG ratio at DSA occurrence.ConclusionInduction therapy distinctly shapes cTFH cell phenotype post-KTx. Monitoring cTFH cells before and after KTx may help detect those patients prone to DSA generation post-KTx.Graphical abstractGraphical abstract for this article
       
  • Eculizumab Use for Kidney Transplantation in Patients With a Diagnosis of
           Atypical Hemolytic Uremic Syndrome

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Andrew M. Siedlecki, Nicole Isbel, Johan Vande Walle, Jennifer James Eggleston, David J. Cohen, Christoph Licht, Véronique Frémeaux-Bacchi, Gema Ariceta, Gianluigi Ardissino, Fadi Fakhouri, Larry Greenbaum, Sally Johnson, Franz Schaefer, Marie Ann Scully, Leonard Woodward, Masayo Ogawa, Christoph Gasteyger, Miquel Blasco, Donata Cresseri, Galina GenerolovaIntroductionRecurrence of atypical hemolytic uremic syndrome (aHUS) in renal allografts is common, leading to dialysis and graft failure. Pretransplant versus posttransplant initiation of eculizumab treatment in patients with aHUS has not been rigorously investigated. We hypothesized eculizumab pretransplant would reduce dialysis incidence posttransplant.MethodsOf patients enrolled in the Global aHUS Registry (n = 1549), 344 had ≥1 kidney transplant. Of these, 188 had received eculizumab. Eighty-eight patients (47%) were diagnosed with aHUS and received eculizumab before, and during, their most recent transplant (group 1). A total of 100 patients (53%; group 2) initiated eculizumab posttransplantation. This second group was subdivided into those diagnosed with aHUS before (n = 52; group 2a) or after (n = 48; group 2b) their most recent transplant.ResultsWithin 5 years of transplantation, 47 patients required dialysis; the risk of dialysis after transplantation was significantly increased in group 2b (hazard ratio [HR] 4.6; confidence interval [CI] 1.7–12.4) but not 2a (HR 2.3; CI 0.9–6.2). Graft function within 6 months of transplantation was significantly better in group 1 (median estimated glomerular filtration rate of 60.6 ml/min per 1.73 m2) compared with 31.5 and 9.6 ml/min per 1.73 m2 in groups 2a (P = 0.004) and 2b (P = 0.0001), respectively. One meningococcal infection (resolved with treatment) and 3 deaths (deemed unrelated to eculizumab) were reported.ConclusionsOutcomes for transplant patients with aHUS treated with eculizumab were improved compared with previous reports of patients with aHUS not treated with eculizumab. Our findings suggest delayed aHUS diagnosis and therefore treatment is associated with an increased risk of dialysis posttransplantation and reduced allograft function.Graphical abstractGraphical abstract for this article
       
  • Increased Proton Pump Inhibitors−Induced Mortality Risk
           in Hemodialysis Patients

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Jonas T. Sertorio, Jose E. Tanus-Santos
       
  • Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes
           in Black Americans

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Joseph Lunyera, Clemontina A. Davenport, Chandra L. Jackson, Dayna A. Johnson, Nrupen A. Bhavsar, Mario Sims, Julia J. Scialla, John W. Stanifer, Jane Pendergast, Ciaran J. McMullan, Ana C. Ricardo, L. Ebony Boulware, Clarissa J. DiamantidisIntroductionPoor sleep associates with adverse chronic kidney disease (CKD) outcomes yet the biological mechanisms underlying this relation remain unclear. One proposed mechanism is via allostatic load, a cumulative biologic measure of stress.MethodsUsing data from 5177 Jackson Heart Study participants with sleep measures available, we examined the association of self-reported sleep duration: very short, short, recommended, and long (≤5, 6, 7–8, or ≥9 hours per 24 hours, respectively) and sleep quality (high, moderate, low) with prevalent baseline CKD, and estimated glomerular filtration rate (eGFR) decline and incident CKD at follow-up. CKD was defined as eGFR 
       
  • Postpartum Renal Cortical Necrosis Is Associated With Atypical Hemolytic
           Uremic Syndrome in Developing Countries

    • Abstract: Publication date: March 2019Source: Kidney International Reports, Volume 4, Issue 3Author(s): Raja Ramachandran, Saurabh Nayak, Hari P. Anakutti, Ashok K. Yadav, Ritambhra Nada, Vanita Jain, Krishan L. Gupta, Vivekanand JhaIntroductionPregnancy-related acute kidney injury is the most common cause of renal cortical necrosis (RCN). Atypical hemolytic uremic syndrome (aHUS) as a cause of RCN in pregnant/postpartum is underevaluated. In the current article, we describe a series of cases of pregnancy-related RCN.MethodsAll cases with acute kidney injury (AKI) in the setting of pregnancy and postpartum state were included. Diagnosis of RCN was made by contrast-enhanced computerized tomography (nonenhancing renal cortex, enhancing medulla, and no excretion of contrast medium) or on a renal biopsy. aHUS was diagnosed in the presence of microangiopathic hemolytic anemia (thrombocytopenia, elevated lactate dehydrogenase with schistocytes on peripheral smear examination, or low haptoglobin).ResultsA total of 21 (17.5%) patients presented with RCN during pregnancy, all in the postpartum state. Twenty patients (95.2%) showed microangiopathic hemolytic anemia consistent with HUS and 1 (4.8%) patient had biopsy-proven thrombotic microangiopathy. Low complement 3 or activation of an alternate complement pathway was seen in 9 of 15 patients in which it was done. At the end of 6 months, only 2 (9.5%) patients had partial recovery of renal functions, 5 (23.8%) patients died, and 14 remained (66.7%) on hemodialysis.ConclusionThe clinical and laboratory features are highly suggestive of aHUS in more than three-fourths of cases with postpartum RCN. Investigations are needed to look for genetic abnormalities in the complement pathway.
       
  • Emergent Arboviruses and Renal Transplantation: A Global Challenge

    • Abstract: Publication date: Available online 28 February 2019Source: Kidney International ReportsAuthor(s): José A. Moura-Neto, Cassiano Augusto Braga Silva, Ana Flavia Moura, José Hermógenes Rocco SuassunaIn recent years, Zika, Chikungunya, Dengue, West Nile Fever, and Yellow Fever epidemics have generated some concerns. Besides difficulties related to vector control, there are challenges related to behavior of pathologies not yet fully understood. The transplanted population requires additional care due to immunosuppressive drugs. Furthermore, the potential risk of transmission during donation is another source of uncertainty and generates debate among nephrologists in transplant centers. Do the clinical outcomes and prognoses of these infections tend to be more aggressive in this population' Is there a risk of viral transmission via kidney donation' In this review article, we address these issues and discuss the relationship between arbovirus and renal transplantation.
       
  • Predicting Outcomes in Acute Kidney Injury Survivors: Searching
           for the Crystal Ball

    • Abstract: Publication date: Available online 28 February 2019Source: Kidney International ReportsAuthor(s): William Beaubien-Souligny, Ron Wald
       
  • Epidemiology and outcome of Chronic Kidney Disease in Omani children

    • Abstract: Publication date: Available online 27 February 2019Source: Kidney International ReportsAuthor(s): Mohamed S. Al Riyami, Maryam Al Shehhi, Marwa Al Riyami, Thuraya Al Selemi, Latifa Al Mamary, Naifain Al Kalbani, Badria Al Ghaithi, Anisa Al Maskari, Sulaiman Al Saidi
       
  • Transplant Glomerulopathy With Glomerular C3 Deposits: Why the Worse
           Outcome'

    • Abstract: Publication date: Available online 25 February 2019Source: Kidney International ReportsAuthor(s): Michifumi Yamashita, Mark Haas
       
  • Estimating GFR by Serum Creatinine, Cystatin C, and β2-Microglobulin in
           Older Adults: Results from the Canadian Study of Longevity in Type 1
           Diabetes

    • Abstract: Publication date: Available online 21 February 2019Source: Kidney International ReportsAuthor(s): Daniel Scarr, Petter Bjornstad, Leif E. Lovblom, Julie A. Lovshin, Genevieve Boulet, Yuliya Lytvyn, Mohammed A. Farooqi, Vesta Lai, Andrej Orszag, Alanna Weisman, Hillary A. Keenan, Michael H. Brent, Narinder Paul, Vera Bril, David Z.I. Cherney, Bruce A. PerkinsIntroductionGlomerular filtration rate (GFR) is routinely used for clinical assessment of kidney function. However, the accuracy of estimating equations in older adults is uncertain.MethodsIn 66 adults with ≥50 years type 1 diabetes (T1D) duration and 73 nondiabetic controls from age/sex-matched subgroups (65 ± 8 years old and 77[55%] were women) we evaluated the performance of estimated GFR (eGFR) by creatinine (Modification of Diet and Renal Disease [MDRD], Chronic Kidney Disease–Epidemiology [CKD-EPI]cr), cystatin C (CKD-EPIcys, CKD-EPIcr-cys), and β2-microglobulin (β2M) compared with measured GFR by inulin clearance (mGFR). Performance was evaluated using metrics of bias (mean difference), precision (SD), and accuracy (proportion of eGFR that differed by>20% of mGFR).ResultsMean mGFR was 104 ± 18 ml/min per 1.73 m2 (range: 70–154 ml/min per 1.73 m2) and was not different between T1D and controls (103 ± 17 vs. 105 ± 19 ml/min per 1.73 m2, P = 0.39). All equations significantly underestimated mGFR (bias: −15 to −30 ml/min per 1.73 m2, P < 0.001 for all comparisons) except for β2M, which had bias of 1.9 ml/min per 1.73 m2 (P = 0.61). Bias was greatest in cystatin C–based equations. Precision was lowest for β2M (SD: 43.5 ml/min per 1.73 m2, P < 0.001 for each comparison). Accuracy was lowest for CKD-EPIcysC (69.1%, P < 0.001 for each comparison). Cystatin C–based equations demonstrated greater bias and lower accuracy in older age subgroups (
       
  • High Dietary Intake of Vegetable Protein Is Associated With Lower
           Prevalence of Renal Function Impairment: Results of the Dutch DIALECT-1
           Cohort

    • Abstract: Publication date: Available online 21 February 2019Source: Kidney International ReportsAuthor(s): Milou M. Oosterwijk, Sabita S. Soedamah-Muthu, Johanna M. Geleijnse, Stephan J.L. Bakker, Gerjan Navis, S. Heleen Binnenmars, Christina M. Gant, Gozewijn D. LavermanIntroductionDietary protein intake may influence development of renal function impairment in diabetes mellitus type 2 (T2DM). We assessed the association between sources of protein and prevalence of renal function impairment.MethodsCross-sectional analyses were performed in baseline data of 420 patients of the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1) study. Protein intake was assessed using a Food Frequency Questionnaire, modified for accurate assessment of protein intake, including types and sources of protein. Renal function impairment was defined as estimated glomerular filtration rate (eGFR) 
       
  • Estimating the Change in Renal Function During the First Year of Therapy
           in Antineutrophil Cytoplasmic Autoantibody–Associated Vasculitis

    • Abstract: Publication date: Available online 13 February 2019Source: Kidney International ReportsAuthor(s): Fanny Lepeytre, Virginie Royal, Pierre-Luc Lavoie, Guillaume Bollée, François Gougeon, Stéphanie Beauchemin, Maxime Rhéaume, Soumeya Brachemi, Louis-Philippe Laurin, Stéphan TroyanovIntroductionStudies in antineutrophil cytoplasmic autoantibody (ANCA)–associated vasculitis (AAV) consistently show that the months following diagnosis have the greatest impact on the long-term renal function. Yet, it remains uncertain how much early gain should be expected with treatment. We sought to determine the factors associated with the change in glomerular filtration rate (GFR) throughout the first year.MethodsWe retrospectively reviewed patients from 3 university hospitals who received treatments. We assessed the proportions of glomeruli with crescents, with global sclerosis, the AAV glomerulonephritis classification, the severity of chronic vascular and tubulo-interstitial disease, and the presence of acute tubular injury (ATI). We used repeated-measures analyses of variance (ANOVAs) to determine factors associated with the change in GFR throughout the first year.ResultsThere were 162 individuals with AAV identified, 96 with a valid renal biopsy and 82 with at least 12 months of follow-up. The initial GFR of 30 ± 25 ml/min per 1.73 m2 rose by 15 ± 20 during the first year. The severity of pathology findings, myeloperoxidase positivity, and those with kidney- and lung-limited disease presented with a lower GFR. Younger patients with a lower initial GFR and the presence of ATI correlated with a greater increase in GFR by 12 months. A higher proportion of crescents did not predict the change in GFR, contrary to global glomerulosclerosis, where each 10% increase added a loss of 2.7 ± 1.3 ml/min per 1.73 m2 per year (P = 0.03). These factors remained independent of each other.ConclusionMultiple factors influence renal recovery during the first year of therapy. Estimating the change in GFR early on will help identify and reassess outliers.
       
  • Predialysis Nephrology Care and Incident Atrial Fibrillation in Older
           Patients with ESKD Initiating Dialysis

    • Abstract: Publication date: Available online 13 February 2019Source: Kidney International ReportsAuthor(s): Samaya Anumudu, Medha Airy, Kevin F. Erickson, Sankar D. Navaneethan, Tara I. Chang, Wolfgang C. Winkelmayer, Jingbo NiuBackgroundAtrial fibrillation (AF) is common in patients with end-stage kidney disease (ESKD) on dialysis. Whether pre-ESKD nephrology care associates with AF is uncertain.MethodsWe conducted a retrospective cohort study of older US patients (≥67 years) with Medicare A&B who initiated dialysis (1996–2011) without a prior diagnosis of AF. Patients were categorized by the duration and number of predialysis nephrology outpatient visits. Patients were followed for 1 year for a new diagnosis of AF. We used multivariable Cox proportional hazards regression while accounting for competing risks of kidney transplantation and death.ResultsWe identified 316,067 patients with ESKD initiating dialysis between 1996 and 2013 who had no prior AF diagnosis. In this cohort, 66.9% had any pre-ESKD outpatient nephrology care, with the first outpatient nephrology visit before dialysis initiation occurring at ≤6 months in 17.9%, 7 to 12 months in 9.4%, and>12 months in 39.6%. Outpatient pre-ESKD nephrology care for ≤6, 7 to 12, and>12 months versus none yielded adjusted cause-specific hazard ratios (HRs) of 0.87 (95% CI: 0.84–0.89), 0.83 (95% CI: 0.81–0.86), and 0.85 (95% CI: 0.83–0.87) of nephrology care, respectively. Further, having 1 to 4 pre-ESKD outpatient nephrology visits, 5 to 9 visits, and ≥10 visits versus none yielded adjusted cause-specific HRs of of 0.89 (95% CI: 0.86–0.91), 0.86 (95% CI: 0.83–0.88), and 0.81 (95% CI: 0.79–0.83), respectively.ConclusionsHaving any predialysis nephrology care before initiation of dialysis was associated with slightly lower adjusted rates of incident AF over the first year of dialysis. The optimal timing and intensity of nephrology care to reduce the incidence of AF and other adverse health events requires further study.
       
  • Plasmacytoma-Like Posttransplant Lymphoproliferative Disease in a Disused
           Arteriovenous Fistula: The Importance of Histopathology

    • Abstract: Publication date: Available online 13 February 2019Source: Kidney International ReportsAuthor(s): Andreas Kousios, Rowland Storey, Ethan Troy-Barnes, Mohamad Hamady, Emma Salisbury, Neill Duncan, Rawya Charif, Frederick W.K. Tam, H. Terrence Cook, Jeremy Crane, Aristeidis Chaidos, Candice Roufosse, Rashpal Flora
       
  • The Utility of a National Surveillance Network to Estimate CKD Prevalence
           and Identify High-Risk Populations in Primary Care

    • Abstract: Publication date: Available online 12 February 2019Source: Kidney International ReportsAuthor(s): Maya K. Rao
       
  • Nephrotic Syndrome in South African Children: Changing Perspectives in the
           New Millennium

    • Abstract: Publication date: Available online 12 February 2019Source: Kidney International ReportsAuthor(s): Louansha Nandlal, Thajasvarie Naicker, Rajendra BhimmaThe epidemiological landscape of nephrotic syndrome (NS) in South Africa has changed drastically in the New Millennium. Although the pattern of disease in the 3 main non-Black racial groups (White, Indian, and Mixed race) mirror that seen in Western countries, Black African children show a pattern of disease that is at variance with these 3 racial groups. The incidence of infectious diseases, particularly hepatitis B virus associated nephropathy has sharply declined to being almost extinct in Black children in the New Millennium whereas HIV-related nephropathy surfaced. However, following the widespread use of anti-retroviral therapy, its incidence has also decreased dramatically. Focal segmental glomerulosclerosis (FSGS), which was once uncommon, has, in the New Millennium, emerged as one of the most challenging forms of NS across all racial groups, particularly in Black children. Although the introduction of calcineurin inhibitors, mycophenolate mofetil and monoclonal antibodies (e.g., rituximab) has improved the outcome of children with FSGS, the reponse in Black children is less than optimal, with those having single gene mutations being universally unresponsive to all forms of immunosuppression.
       
  • Performance of the Automated Urinalysis in Diagnosis of Proliferative
           Glomerulonephritis

    • Abstract: Publication date: Available online 12 February 2019Source: Kidney International ReportsAuthor(s): Ragnar Palsson, Anand Srivastava, Sushrut S. Waikar
       
  • Glomerular C3 Deposition Is an Independent Risk Factor for Allograft
           Failure in Kidney Transplant Recipients With Transplant Glomerulopathy

    • Abstract: Publication date: Available online 4 February 2019Source: Kidney International ReportsAuthor(s): Sarah E. Panzer, Emily Joachim, Sandesh Parajuli, Weixiong Zhong, Brad C. Astor, Arjang DjamaliIntroductionTransplant glomerulopathy (TG) becomes increasingly prevalent in kidney transplant recipients over time, and it is strongly associated with allograft failure. To date, our prognostic biomarkers and understanding of the processes of immunologic injury in TG are limited.MethodsThis is a retrospective cohort analysis of kidney transplant recipients with TG (double contours of the glomerular basement membrane as defined by the chronic glomerulopathy score). Glomerular deposition of the complement protein C3 was determined, and its association with allograft survival was analyzed by Cox regression analysis.ResultsOf the 111 patients with TG, 72 (65%) had allograft failure, with a median follow-up time of 3 years from biopsy diagnosis of TG. C3-positive compared to C3-negative patients did not differ with respect to cause of end-stage renal disease, induction or maintenance immunosuppression, or sensitization. A greater proportion of patients with glomerular C3 deposition developed allograft failure compared to those with no C3 deposition (78% vs. 55%, P = 0.01). C3 deposition was independently associated with allograft failure in multivariate analyses (adjusted hazard ratio [HR] = 1.38, 95% confidence interval [CI] = 1.13−1.69, P = 0.002). There was no association between C4d or C1q deposition and allograft failure. Chronicity score was also associated with allograft failure in multivariate analysis (adjusted HR 1.26, 95% CI 1.12-1.41, P = 0.0001).ConclusionIn this cohort of patients with TG, glomerular C3 deposition was independently associated with a higher risk of allograft failure. These findings identify glomerular C3 as a novel prognostic indicator in patients with TG.Graphical abstractGraphical abstract for this article
       
  • Racial/Ethnic Trends in Prevalence of Diabetic Kidney Disease in the
           United States

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Jenny Pena Dias, Michelle Shardell, Sherita Hill Golden, Rexford S. Ahima, Deidra C. Crews
       
  • Bile Cast Nephropathy in a Patient With Obstructive Jaundice

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Samuel Chan, Edward S. Spraggon, Leo Francis, Martin J. Wolley
       
  • Granulomatosis With Polyangiitis Induced by Infection

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Kaori Kohatsu, Tomo Suzuki, Masahiko Yazawa, Koichi Yahagi, Daisuke Ichikawa, Junki Koike, Takashi Oda, Yugo Shibagaki
       
  • Treatment of Severe Amlodipine Toxicity With Molecular Adsorbent
           Recirculating System

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Venessa L. Pinto, Scott E. Wenderfer, Jennifer Morris, Ayse Akcan-Arikan
       
  • Unusual Case of Lipoprotein Glomerulopathy First Diagnosed in a Protocol
           Kidney Allograft Biopsy

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Ibrahim Batal, Gaia Fakhoury, Emily Groopman, Vivette D. D’Agati, Heather Morris
       
  • Immune Check Point Inhibitor–Associated Glomerulonephritis

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Tarek Ashour, Georges Nakhoul, Pradnya Patil, Pauline Funchain, Leal Herlitz
       
  • Ibuprofen-Induced Renal Tubular Acidosis

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Toru Watanabe
       
  • The Authors Reply

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Manisha Singh, Michele Krause
       
  • Efficacy and Safety of Ombitasvir/Paritaprevir/Ritonavir in Patients With
           Hepatitis C Virus Genotype 1 or 4 Infection and Advanced Kidney Disease

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Eric Lawitz, Edward Gane, Eric Cohen, John Vierling, Kosh Agarwal, Tarek Hassanein, Parvez S. Mantry, Paul J. Pockros, Michael Bennett, Nyingi Kemmer, Giuseppe Morelli, Jiuhong Zha, Deli Wang, Nancy S. Shulman, Daniel E. Cohen, K. Rajender ReddyIntroductionHepatitis C virus (HCV) infection is common in patients with end-stage renal disease. We investigated the safety and efficacy of ombitasvir (OBV)/paritaprevir (PTV)/ritonavir (r) ± dasabuvir (DSV) ± ribavirin (RBV) in 2 phase 3, open-label, multicenter studies in patients with stage 4 or 5 chronic kidney disease (CKD).MethodsRUBY-I, Cohort 2 enrolled treatment-naïve or -experienced patients with HCV genotype (GT) 1a or 1b infection, with or without cirrhosis. Patients received 12 weeks (24 weeks for GT1a patients with cirrhosis) of OBV/PTV/r + DSV; all GT1a patients received RBV. RUBY-II enrolled treatment-naïve patients with GT1a or GT4 infection without cirrhosis. All patients received 12 weeks of RBV-free treatment: OBV/PTV/r + DSV for GT1a-infected patients; OBV/PTV/r for GT4-infected patients. The primary endpoint was sustained virologic response at posttreatment week 12 (SVR12).ResultsRUBY-I, Cohort 2 and RUBY-II enrolled 66 patients, including 50 (76%) on dialysis; 15 (23%) had compensated cirrhosis. Overall, the SVR12 rate was 95% (63/66); 1 patient had virologic failure. There were 3 discontinuations due to adverse events. Seventy-three percent (27/37) of patients receiving RBV had adverse events leading to RBV dose modification. The RBV-free RUBY-II study had no hemoglobin-associated adverse events.ConclusionTreatment with OBV/PTV/r ± DSV ± RBV was well tolerated and patients with HCV GT1 or 4 infection and stage 4 or 5 CKD had high SVR12 rates, including patients with compensated cirrhosis and/or prior treatment experience.
       
  • Treatment of Calciphylaxis in CKD: A Systematic Review and
           Meta-analysis

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Suwasin Udomkarnjananun, Kitravee Kongnatthasate, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Bertrand L. Jaber, Paweena SusantitaphongBackgroundCalciphylaxis is a life-threatening complication of chronic kidney disease (CKD). To inform clinical practice, we performed a systematic review of case reports, case series, and cohort studies to synthesize the available treatment modalities and outcomes of calciphylaxis in patients with CKD.MethodsElectronic databases were searched for studies that examined the uses of sodium thiosulfate, surgical parathyroidectomy, calcimimetics, hyperbaric oxygen therapy, and bisphosphonates for calciphylaxis in patients with CKD, including end-stage renal disease. For cohort studies, the results were synthesized quantitatively by performing random-effects model meta-analyses.ResultsA total of 147 articles met the inclusion criteria and were included in the systematic review. There were 90 case reports (90 patients), 20 case series (423 patients), and 37 cohort studies (343 patients). In the pooled cohorts, case series, and case reports, 50.3% of patients received sodium thiosulfate, 28.7% underwent surgical parathyroidectomy, 25.3% received cinacalcet, 15.3% underwent hyperbaric oxygen therapy, and 5.9% received bisphosphonates. For the subset of cohort studies, by meta-analysis, the pooled risk ratio for mortality was not significantly different among patients who received sodium thiosulfate (pooled risk ratio [RR] 0.89; 95% confidence interval [CI] 0.71–1.12), cinacalcet (pooled RR 1.04; 95% CI 0.75–1.42), hyperbaric oxygen therapy (pooled RR 0.89; 95% CI 0.71–1.12), and bisphosphonates (pooled RR 0.77; 95% CI 0.44–1.32), and those who underwent surgical parathyroidectomy (pooled RR 0.88; 95% CI 0.69–1.13).ConclusionThis systematic review found no significant clinical benefit of the 5 most frequently used treatment modalities for calciphylaxis in patients with CKD. Randomized controlled trials are needed to test the efficacy of these therapies.
       
  • Depressive Symptoms Associate With Race and All-Cause Mortality in
           Patients With CKD

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Delphine S. Tuot, Feng Lin, Keith Norris, Jennifer Gassman, Miroslaw Smogorzewski, Elaine KuIntroductionDepression is common but underrecognized in patients with chronic kidney disease (CKD), especially among racial/ethnic minorities. We examined the association between depressive symptoms and all-cause mortality (including deaths before and after end-stage renal disease [ESRD]) and whether antidepressant use impacts this association, overall, and by race/ethnicity.MethodsWe ascertained whether the presence of depressive symptoms, defined by a Beck Depression Inventory II (BDI) score of>14 at cohort enrollment, was associated with all-cause mortality (before or after ESRD) among study participants of the Chronic Renal Insufficient Cohort (CRIC) overall and by race/ethnicity. Models were adjusted for socioeconomic factors, baseline CKD severity, time-updated comorbid conditions, and time-updated antidepressant use. Confirmatory analyses were performed among African American Study of Kidney Disease and Hypertension (AASK) participants.ResultsAmong 3739 CRIC participants, 16.3% had a baseline BDI of>14; 18.2% reported antidepressant use. Crude mortality rate was 3.16 per 100 person-years during 6.8 years of median follow-up. Baseline BDI>14 was independently associated with higher risk of all-cause mortality (adjusted hazard ratio [aHR]: 1.27; 95% confidence interval: 1.07–1.52) without attenuation by antidepressant use. Differences among white and black individuals were noted (Pinteraction= 0.02) but not among white versus Hispanic individuals (Pinteraction = 0.43) or black versus Hispanic individuals (Pinteraction = 0.22). Depressive symptoms were associated with higher mortality among white individuals (aHR: 1.66; 1.21–2.28), but not Hispanic individuals (aHR: 1.47; 0.95–2.28) or black individuals (aHR: 1.06; 0.82–1.37). Similar results were noted among 611 AASK participants (aHR: 0.99; 0.69–1.42).ConclusionsThe presence of depressive symptoms is a risk factor for all-cause mortality among patients with mild-moderate CKD, particularly among white individuals. Further studies are needed to understand the heterogeneity in the response to the presence of depressive symptoms by race.
       
  • Multimarker Panels in Diabetic Kidney Disease: The Way to Improved
           Clinical Trial Design and Clinical Practice'

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Paul Perco, Michelle Pena, Hiddo J.L. Heerspink, Gert Mayer, BEAt-DKD ConsortiumDiabetic kidney disease (DKD) is a complex and multifactorial disorder associated with deregulations in a large number of different biological pathways on the molecular level. Using the 2 established biomarkers, estimated glomerular filtration rate (eGFR) and albuminuria will not allow allocating patients to tailored therapy. Molecular multimarker panels as sensors for the deregulation of the various disease mechanisms combined with a better understanding of how investigational as well as approved drugs interfere with these disease processes forms the basis for platform trials in DKD. In these platform trials, patients with DKD are assigned to the most suitable treatment arm based on their molecular marker profile. Close monitoring of biomarkers after treatment initiation together with assessment of renal function and “off-target” effects will allow identification of therapy responders, with nonresponders shifted to the next-best treatment arm based on their molecular profile. In this viewpoint article, we summarize evidence on the variation of DKD disease progression as well as the response to therapy and outline procedures to model disease pathophysiology supporting biomarker panel construction. Finally, the use of biomarkers in clinical trial setup is discussed.
       
  • Clinical Implications of Excessive Neutrophil Extracellular Trap Formation
           in Renal Autoimmune Diseases

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Laura S. van Dam, Ton J. Rabelink, Cees van Kooten, Y.K. Onno TengNeutrophil extracellular traps (NETs) are extracellular DNA structures covered with antimicrobial peptides, danger molecules, and autoantigens that can be released by neutrophils. NETs are an important first-line defense mechanism against bacterial, viral, fungal, and parasitic infections, but they can also play a role in autoimmune diseases. NETs are immunogenic and toxic structures that are recognized by the autoantibodies of patients with antineutrophil cytoplasmic antibodies−associated vasculitis (AAV) (i.e., against myeloperoxidase or proteinase-3) and systemic lupus erythematosus (SLE) (i.e., against double-stranded DNA, histones, or nucleosomes). There is cumulating preclinical and clinical evidence that both excessive formation and impaired degradation of NETs are involved in the pathophysiology of AAV and SLE. These autoimmune diseases give rise to 2 clinically and pathologically distinct forms of glomerulonephritis (GN), respectively, crescentic pauci-immune GN and immune complex−mediated GN. Therefore, it is relevant to understand the different roles NET formation can play in the pathophysiology of these most prevalent renal autoimmune diseases. This review summarizes the current concepts on the role of NET formation in the pathophysiology of AAV and SLE, and provides a translational perspective on the clinical implications of NETs, such as potential therapeutic approaches that target NET formation in these renal autoimmune diseases.
       
  • Integrative Omics for Identifying Dysfunctional Pathways in CKD

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Adrienne Tin, Morgan E. Grams
       
  • Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir With or Without
           Ribavirin in Patients With Kidney Disease

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): David E. Bernstein, Albert Tran, Paul Martin, Kris V. Kowdley, Marc Bourliere, Mark S. Sulkowski, Paul J. Pockros, Boris Renjifo, Deli Wang, Diana L. Shuster, Daniel E. Cohen, Ira M. JacobsonIntroductionPatients with hepatitis C virus (HCV) infection and chronic kidney disease (CKD) are a high-priority population for treatment.MethodsWe performed a post hoc pooled efficacy and safety analysis that included HCV genotype 1–infected patients with compensated liver disease and CKD stages 1 to 3 who received the all-oral 3–direct-acting antiviral regimen of ombitasvir, paritaprevir, ritonavir, and dasabuvir ± ribavirin (OBV/PTV/r + DSV ± RBV) in 11 phase 3 clinical trials. Sustained virologic response rates at posttreatment week 12 (SVR12) and treatment-related adverse events (AEs), serious AEs, and renal-associated AEs are reported. Mean changes from baseline in serum creatinine and estimated glomerular filtration rate (eGFR) were calculated to assess changes in renal function. Factors associated with improved eGFR were assessed by stepwise logistic regression analysis of data from 7 trials in which baseline urinalysis was collected.ResultsSVR12 rates in patients with stage 1, 2, and 3 CKD were 97% (439/453), 98% (536/547), and 97% (32/33), respectively, with OBV/PTV/r + DSV; and, 96% (1172/1221), 96% (1208/1254), and 93% (55/59), respectively, with OBV/PTV/r + DSV + RBV. Overall rates of serious AEs and renal AEs were 3% (95/3567) and 2% (56/3567), respectively. Factors associated with an eGFR increase of ≥10 ml/min per 1.73 m2 were baseline proteinuria, body mass index, nonblack race, and history of diabetes.ConclusionOBV/PTV/r + DSV ± RBV achieved high SVR rates and was generally well tolerated irrespective of CKD stage.
       
  • Safety and Efficacy of Paritaprevir/Ritonavir, Ombitasvir, and Dasabuvir
           for Hepatitis C Virus Infection Across All Levels of Kidney Function

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Meghan E. Sise
       
  • Depression in CKD: Understanding the Mechanisms of Disease

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Shayan Shirazian
       
  • Left Ventricular Structure in Patients With Mild-to-Moderate CKD—a
           Magnetic Resonance Imaging Study

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Markus P. Schneider, Johannes B. Scheppach, Ulrike Raff, Sebastian Toncar, Christian Ritter, Thorsten Klink, Stefan Störk, Christoph Wanner, Georg Schlieper, Turgay Saritas, Sebastian D. Reinartz, Jürgen Floege, Nele Friedrich, Rolf Janka, Michael Uder, Roland E. Schmieder, Kai-Uwe EckardtIntroductionThe high burden of left ventricular (LV) abnormalities in patients with advanced chronic kidney disease (CKD) is well established. However, less is known about the prevalence, patterns, and determinants of LV abnormalities in patients with early CKD.MethodsWe examined LV structure in 290 patients with a median estimated glomerular filtration rate (eGFR) of 51 ml/min per 1.73 m2 by magnetic resonance imaging (MRI). We explored associations with clinical and hemodynamic parameters, hydration (bioimpedance), endothelial function, inflammation (including C-reactive protein and tumor necrosis factor−α and its soluble receptors) and mineral bone disease (MBD) markers (including vitamin D, parathyroid hormone, α-klotho and fibroblast growth factor−23).ResultsNormal geometry was found in 56% of patients, dilation in 4%, concentric remodeling in 10%, and LV hypertrophy in 29%. Linear regression analysis revealed that greater LV mass was independently associated with male sex, greater body mass index (BMI), and higher 24-hour systolic blood pressure (24-hour SBP). Concentric remodeling was independently associated with age, male sex, higher 24-hour SBP, and greater hemoglobin levels. Surprisingly, neither hydration status, nor endothelial function, nor any of the inflammatory or MBD parameters added significantly to these models.ConclusionAbnormal LV structure was found in almost one-half of the patients. Reducing BMI and 24-hour SBP and avoiding high hemoglobin concentrations appear to be the key factors to prevent abnormal LV remodeling in patients with mild-to-moderate CKD.
       
  • Higher Physical Activity Is Associated With Less Fatigue and Insomnia
           Among Patients on Hemodialysis

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Anoop Sheshadri, Piyawan Kittiskulnam, Kirsten L. JohansenIntroductionPatients on hemodialysis experience a heavy burden of symptoms that may be related to the low levels of physical activity reported in this population. We hypothesized that physical activity would be inversely related to symptom severity and that depression might mediate this association.MethodsWe designed a cross-sectional study of 48 patients receiving hemodialysis at 3 San Francisco dialysis clinics. Physical activity was measured using pedometers and recorded within 1 week of symptom assessment. Symptoms were assessed using total symptom burden and severity on the Dialysis Symptom Index (DSI; burden 0–29, severity 0–145), individual symptoms on the DSI (0–5), Kidney Disease Quality of Life Vitality scores, (0–100), and the Center for Epidemiologic Study-Depression (0–60).ResultsMedian daily step count was 2631 (25th, 75th percentile 1125, 5278). Seventy-three percent of patients reported fatigue. After adjustment for age, sex, diabetes, and serum albumin, physical activity was associated with 0.2 points lower fatigue severity per 1000 steps per day (95% confidence interval [CI] −0.3 to 0.0), P = 0.04. Physical activity was also associated with higher Vitality score (2.36 points per 1000 steps; 95% CI 0.07–4.65) and lower insomnia scores (−0.1 points per 1000 steps; 95% CI −0.3 to 0.0], P < 0.05) in our adjusted models. Physical activity was not associated with other symptoms.ConclusionBecause the study was cross-sectional, we cannot determine whether physical activity lowers fatigue and insomnia or whether less insomnia and fatigue increase physical activity. However, interventions to increase physical activity should be considered alongside current strategies as a possible approach to managing fatigue and insomnia.Graphical abstractGraphical abstract for this article
       
  • Supporting the Establishment of New Home Dialysis Programs Through the
           Explore Home Dialysis Program

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Plinio P. Morita, Kathy Huynh, Areeba Zakir, Joseph A. Cafazzo, Rory F. McQuillan, Joanne M. Bargman, Christopher T.M. ChanIntroductionThe globally increasing prevalence of chronic kidney disease has resulted in an ever-growing demand for renal replacement therapy. Although programs are present around the world, there is a paucity of immersive educational programs that train clinicians and administrators to develop new home dialysis programs. Explore Home Dialysis (EHD) is a program created to fill this gap.MethodsWe present the results of the evaluation of the EHD program. Our team interviewed 23 clinicians and administrators who participated in the EHD program. We also assessed country-specific needs and challenges associated with home dialysis.ResultsThe 4 main findings include (i) the evaluation of the effectiveness of the EHD program; (ii) the need for an educational program to train individuals on how to deploy home dialysis programs; (iii) evidence that such an educational program is beneficial to participants and for the establishment of new home dialysis programs; and (iv) the identification of barriers to the development of home dialysis programs in countries represented in this study. The data show an increased demand, with strong patient and provider interest in establishing new programs, interest in accessing resources to train clinical and administrative staff in how to run a home dialysis program, and positive feedback about the EHD program in general.ConclusionsThe data from this study were used in the next iteration of the EHD program, to inform clinicians about challenges in the deployment of new home dialysis programs, and to present educational resources that need to be developed in the future.
       
  • A Single-Center Retrospective Study of Acute Kidney Injury Incidence in
           Patients With Advanced Malignancies Treated With Antimitochondrial
           Targeted Drug

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Elizabeth M. Anderson, Jin Zhang, Greg Russell, Isai G. Bowline, Braghadheeswar Thyagarajan, DengFeng Li, Lijun Ma, Erica R. Anderson, Mariana MureaIntroductionMitochondrial dysfunction plays an important role in the pathophysiology of kidney disease. Inhibitors of mitochondrial metabolism are being developed for the treatment of solid organ and hematologic malignancies. We describe the incidence and clinical features of acute kidney injury (AKI) in patients treated with the antimitochondrial drug CPI-613.MethodsWe identified 33 patients with relapsed or refractory malignancy, previously enrolled in 3 open-label phase II studies, who received single-agent CPI-613 chemotherapy. AKI was defined by the Kidney Disease Improving Global Outcomes serum creatinine criteria. Participants were followed for a median (25th–75th percentile) of 120.0 (74.0–301.0) days. Risk factors for AKI were assessed by proportional hazards regression using univariate and multivariate analyses.ResultsParticipants had baseline mean (SD) age of 63.8 (11.6) years and serum creatinine 0.9 (0.3) mg/dl. AKI developed in 9 (27%) patients; chart review failed to identify a potential cause of AKI other than CPI-613 administration in 5 (15%) patients, of whom 1 had AKI stage 1, 1 had AKI stage 2, and 3 experienced AKI stage 3. Time from initiation of CPI-613 treatment to AKI was 51.0 (16.0–58.0) days. Age, per 5-year increase, was associated with higher risk of AKI (adjusted hazard ratio 2.01, 95% confidence interval 1.06–3.79, P = 0.03). Follow-up serum creatinine was available in 4 participants 174.8 (139.6) days after the episode of AKI; 3 patients had complete recovery in kidney function and 1 had partial recovery.ConclusionAKI is a possible complication during treatment with mitochondria-targeted chemotherapy.Graphical abstractGraphical abstract for this article
       
  • Gene Expression Studies and Targeted Metabolomics Reveal Disturbed Serine,
           

    • Abstract: Publication date: February 2019Source: Kidney International Reports, Volume 4, Issue 2Author(s): Marius A. Øvrehus, Per Bruheim, Wenjun Ju, Leila R. Zelnick, Knut A. Langlo, Kumar Sharma, Ian H. de Boer, Stein I. HallanIntroductionHypertensive nephrosclerosis is among the leading causes of end-stage renal disease, but its pathophysiology is poorly understood. We wanted to explore early metabolic changes using gene expression and targeted metabolomics analysis.MethodsWe analyzed gene expression in kidneys biopsied from 20 patients with nephrosclerosis and 31 healthy controls with an Affymetrix array. Thirty-one amino acids were measured by liquid chromatography coupled with mass spectrometry (LC-MS) in urine samples from 62 patients with clinical hypertensive nephrosclerosis and 33 age- and sex-matched healthy controls, and major findings were confirmed in an independent cohort of 45 cases and 15 controls.ResultsAmino acid catabolism and synthesis were strongly underexpressed in hypertensive nephrosclerosis (13- and 7-fold, respectively), and these patients also showed gene expression patterns indicating decreased fatty acid oxidation (12-fold) and increased interferon gamma (10-fold) and cellular defense response (8-fold). Metabolomics analysis revealed significant distribution differences in 11 amino acids in hypertensive nephrosclerosis, among them tyrosine, phenylalanine, dopamine, homocysteine, and serine, with 30% to 70% lower urine excretion. These findings were replicated in the independent cohort. Integrated gene-metabolite pathway analysis showed perturbations of renal dopamine biosynthesis. There were also significant differences in homocysteine/methionine homeostasis and the serine pathway, which have strong influence on 1-carbon metabolism. Several of these disturbances could be interconnected through reduced regeneration of tetrahydrofolate and tetrahydrobiopterin.ConclusionEarly hypertensive nephrosclerosis showed perturbations of intrarenal biosynthesis of dopamine, which regulates natriuresis and blood pressure. There were also disturbances in serine/glycine and methionine/homocysteine metabolism, which may contribute to endothelial dysfunction, atherosclerosis, and renal fibrosis.Graphical abstractGraphical abstract for this article
       
  • Angiotensin II Type 1 Receptor Antibodies Trigger Inflammation in Renal
           Transplantation

    • Abstract: Publication date: Available online 30 January 2019Source: Kidney International ReportsAuthor(s): Aurelie Philippe
       
  • Understanding Long-term Remission Off Therapy in Antineutrophil
           Cytoplasmic Antibody-Associated Vasculitis

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Susan L. Hogan, Patrick H. Nachman, Caroline J. Poulton, Yichun Hu, Lauren N. Blazek, Meghan E. Free, J. Charles Jennette, Ronald J. FalkIntroductionIn antineutrophil cytoplasmic antibody-associated (ANCA) vasculitis, relapse risk and long-term immunosuppressive therapy are problematic. Stopping immunotherapy has not been well described.MethodsThe Glomerular Disease Collaborative Network ANCA vasculitis inception cohort was evaluated. Patients who stopped all immunotherapy and those continuously on immunotherapy (≥2 years) were included. Time to first period off therapy was modeled with end-stage kidney disease and death as competing risks to understand influences of stopping therapy. Cause-specific hazard ratios (HRs) with 95% confidence intervals (CI) and P values are reported. Models controlled for age, sex, ANCA specificity, organ involvement, diagnosis era, and treatments (yes/no). Repeated events analysis was used to assess the time-dependent variable of time off treatment on recurrent relapse with HRs, 95% CIs, and P values are reported (same control variables without treatments).ResultsIn 427 patients, 277 (65%) stopped therapy (median 20 months from initial induction); 14% for ≥2 different periods of time and 23% for periods ≥5 years. In multivariable models of time to discontinuation of treatment, women (HR 1.33; 95% CI 1.04–1.70; P = 0.024) and those treated with pulse methylprednisolone (HR 1.39; 95% CI 1.05–1.84; P = 0.020) were more likely to stop. The time-dependent variable of time off treatment was associated with fewer recurrent relapses (HR 0.51; 95% CI 0.41–0.63; P < 0.001).ConclusionsStopping immunotherapy was common. Women and those treated with methylprednisolone stop treatment more often, but underlying mechanisms are unknown. Stopping treatment was associated with fewer relapses, suggesting that even without guidelines there may be benefits without an untoward detriment of relapse.Graphical abstractGraphical abstract for this article
       
  • Rheumatoid Nodule Formation in the Kidney: A Diagnosis of Exclusion and a
           Rare Manifestation of Rheumatoid Arthritis Involving the Kidney

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Miroslav Sekulic, Michael E. Weinblatt, Helmut G. Rennke
       
  • Short-term Changes in Urine Beta 2 Microglobulin Following Recovery of
           Acute Kidney Injury Resulting From Snake Envenomation

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Challa Jaswanth, P.S. Priyamvada, Bobby Zachariah, Sathish Haridasan, Sreejith Parameswaran, R.P. SwaminathanIntroductionUrine β2 microglobulin (β2m) is a validated marker to diagnose sepsis and toxin-related acute kidney injury (AKI). In the current study, we used urine β2m as a potential marker to identify persistent tubular dysfunction following a clinical recovery from snake venom–related AKI.MethodsA total of 42 patients who developed AKI following hemotoxic envenomation were followed up for a period of 6 months. Urine albumin excretion, estimated glomerular filtration rate (eGFR), and urine β2m levels were measured at 2 weeks, 3 months, and 6 months following discharge.ResultsAt the end of 6 months of follow-up, 6 patients (14.3 %) progressed to chronic kidney disease (CKD) (eGFR < 60 ml and/or urine albumin excretion> 30 mg/d). The urine β2m levels were 1590 μg/l (interquartile range [IQR] 425–5260), 610 μg/l (IQR 210–1850), 850 μg/l (IQR 270–2780) at 2 weeks, 3 months, and 6 months, respectively (P = 0.020). The levels of urine β2m in the study population at the end of 6 months remained significantly higher compared with the levels in healthy control population (850 μg/l [IQR 270–2780] vs. 210 μg/l [IQR 150–480]; P = 0.001). The proportion of patients with urine β2m levels exceeding the 95th percentile of control population (>644 µg/l) during the 3 follow-up visits were 70.7% (n = 29), 48.8 % (n = 20), and 51.2% (n = 21). Similar trends were noticed in a sensitivity analysis, after excluding patients with CKD.ConclusionsUrine β2m levels remain persistently elevated in approximately half of the individuals who recover from AKI due to snake envenomation.Graphical abstractGraphical abstract for this article
       
  • Metabolomic Patterns in Adolescents With Mild to Moderate CKD

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Ellen R. Brooks, David A. Lin, Craig B. Langman, J. Will Thompson, Lisa St. John-Williams, Susan L. Furth, Bradley Warady, Shannon Haymond
       
  • Renal Health: An Innovative Application to Increase Adherence to
           Treatment Through Self-monitoring for Patients With CKD and Provide
           Information for the General Population

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Juliana Gomes Ramalho de Oliveira, Marjan Askari, Geraldo Bezerra da Silva Junior, Ronaldo Almeida de Freitas Filho, José Eurico Vasconcelos Filho
       
  • Pigment Nephropathy in a Patient With PYGM Gene Mutation

    • Abstract: Publication date: Available online 28 January 2019Source: Kidney International ReportsAuthor(s): Varun Mamidi, Indumathi E., Manikantan Shekar, Ramprasad Elumalai, Vamsi Krishna Makkena, Jaiju James Chakola, Varun Kumar Bandi, Niranjana Joy, Jayakumar Matcha
       
  • Another Victim of Rapid Weight Loss'

    • Abstract: Publication date: Available online 23 January 2019Source: Kidney International ReportsAuthor(s): Ozant Helvaci, Berfu Korucu, Turgay Arinsoy
       
  • Classical and Modern Genetic Approach to Kidney Stone Disease

    • Abstract: Publication date: Available online 17 January 2019Source: Kidney International ReportsAuthor(s): Giuseppe Vezzoli, Teresa Arcidiacono, Lorena Citterio
       
  • Pregnancy in a Kidney Transplant Woman Under Treatment With Eculizumab
           for Atypical Hemolytic Uremic Syndrome: Is It Safe'

    • Abstract: Publication date: Available online 15 January 2019Source: Kidney International ReportsAuthor(s): Anna Duval, Jérôme Olagne, Noëlle Cognard, Gabriela Gautier Vargas, Mélanie Joly, Peggy Perrin, Gabrielle Fritz, Marion Fourtage, Bruno Moulin, Sophie Caillard
       
  • The Effect of Enlarged Kidneys on Calculated Body Mass Index
           Categorization in Transplant Recipients With ADPKD

    • Abstract: Publication date: Available online 14 January 2019Source: Kidney International ReportsAuthor(s): Jonathan Freise, Mehdi Tavakol, Ying Gao, Oana Klein, Brian K. Lee, Chris Freise, Meyeon Park
       
  • Cumulative Exposure to Frequent Intradialytic Hypotension Associates With
           New-Onset Dementia Among Elderly Hemodialysis Patients

    • Abstract: Publication date: Available online 14 January 2019Source: Kidney International ReportsAuthor(s): Magdalene M. Assimon, Lily Wang, Jennifer E. Flythe
       
  • Pauci-Immune Crescentic Glomerulonephritis due to Disseminated
           Histoplasmosis

    • Abstract: Publication date: Available online 9 January 2019Source: Kidney International ReportsAuthor(s): Samar M. Said, Dennis Dobyan, Audrey N. Schuetz, Samih H. Nasr
       
  • Cytokine Profiles Associated With Angiotensin II Type 1 Receptor
           Antibodies

    • Abstract: Publication date: Available online 21 December 2018Source: Kidney International ReportsAuthor(s): Meghan H. Pearl, Jonathan Grotts, Maura Rossetti, Qiuheng Zhang, David W. Gjertson, Patricia Weng, David Elashoff, Elaine F. Reed, Eileen Tsai ChambersIntroductionAngiotensin II type 1 receptor antibody (AT1R-Ab), is a non–human leukocyte antigen (HLA) antibody implicated in poor renal allograft outcomes, although its actions may be mediated through a different pathway than HLA donor-specific antibodies (DSAs). Our aim was to examine serum cytokine profiles associated with AT1R-Ab and distinguish them from those associated with HLA DSA in serially collected blood samples from a cohort of pediatric renal transplant recipients.MethodsBlood samples from 65 pediatric renal transplant recipients drawn during the first 3 months posttransplant, at 6, 12, and 24 months posttransplant, and during suspected episodes of kidney transplant rejection were tested for AT1R-Ab, HLA DSA, and a panel of 6 cytokines (tumor necrosis factor [TNF]-α, interferon [IFN]-γ, interleukin [IL]-8, IL-1β, IL-6, and IL-17). Associations between antibodies and cytokines were evaluated.ResultsAT1R-Ab, but not HLA DSA, was associated with elevations in TNF-α, IFN-γ, IL-8, IL-1β, IL-6, and IL-17. This relationship remained significant even after controlling for relevant clinical factors and was consistent across all time points. In contrast to HLA DSA, AT1R-Ab was associated with elevations in vascular inflammatory cytokines in the first 2 years posttransplant.ConclusionsThis profile of vascular cytokines may be informative for clinical monitoring and designing future studies to delineate the distinct pathophysiology of AT1R-Ab–mediated allograft injury in kidney transplantation.Graphical abstractGraphical abstract for this article
       
  • Adenine Phosphoribosyltransferase Deficiency Due to Novel Mutation

    • Abstract: Publication date: Available online 18 December 2018Source: Kidney International ReportsAuthor(s): Irène Ceballos-Picot, Abhijeet Saha, Nimisha Arora, Kanika Kapoor, Manpreet Kaur, Rachita Singh Dhull, Samridhi Goyal
       
  • Collapsing Glomerulopathy Associated With Hydrophilic Polymer Emboli

    • Abstract: Publication date: Available online 18 December 2018Source: Kidney International ReportsAuthor(s): Satoru Kudose, Emmanuel A. Adomako, Vivette D. D’Agati, Dominick Santoriello
       
  • Rituximab for Anti–Glomerular Basement Membrane Disease

    • Abstract: Publication date: Available online 17 December 2018Source: Kidney International ReportsAuthor(s): Rashmi Jain, Hanna Dgheim, Andrew S. Bomback
       
  • A Twin Study of Genetic Influences on Nephrolithiasis in Women and
           Men

    • Abstract: Publication date: Available online 29 November 2018Source: Kidney International ReportsAuthor(s): David S. Goldfarb, Ally R. Avery, Lada Beara-Lasic, Glen E. Duncan, Jack GoldbergBackgroundNephrolithiasis is a complex phenotype influenced by both genetic and environmental factors. Previously we found a genetic component to stone disease using a sample of male twin pairs. We now report on the genetic contribution to stones in a sample of female and male twin pairs.MethodsWe conducted a classic twin study of kidney stones using the Washington State Twin Registry. Data were collected by questionnaire to obtain self-reported history of kidney stones. Univariate structural equation modeling was used to determine the relative contributions of additive genetics, common environment, and unique environment.ResultsThere were 7053 same-sex pairs with kidney stone data. The mean age of the sample was 39 years, similar in women and men. The prevalence of stones was 4.9% of women and 6.2% of men. We found significant contributions from genetics and the unique environment (P < 0.05 for both) for the risk for stone disease in women and men. There was no significant contribution of the common environment for either sex. After adjusting for age, heritability was 46% (95% confidence interval 0.36–0.56) in women and 57% (0.46–0.68) in men, which was significantly different (P < 0.05).ConclusionsNephrolithiasis in women has a heritable component less than that we again demonstrate in men. This finding may in part explain why more stone formers are men than women. Women twins demonstrated a greater effect of the unique environment on stone prevalence. The specific environmental risk factors that account for this effect are not currently known.
       
 
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