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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)                     

Showing 1 - 159 of 159 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: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 43)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 38)
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: 34)
BJUI Compass     Open Access   (Followers: 2)
BMC Nephrology     Open Access   (Followers: 11)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 8)
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: 22)
Clinical Kidney Journal     Open Access   (Followers: 4)
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: 1)
Diabetic Nephropathy     Open Access   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 33)
European Urology Focus     Hybrid Journal   (Followers: 5)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 10)
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: 2)
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: 5)
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: 31)
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: 46)
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: 47)
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: 23)
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: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
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: 6)
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: 7)
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: 1)
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: 33)
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: 11)

           

Similar Journals
Journal Cover
Clinical Kidney Journal
Journal Prestige (SJR): 1.163
Citation Impact (citeScore): 2
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2048-8505 - ISSN (Online) 2048-8513
Published by Oxford University Press Homepage  [414 journals]
  • Living well with kidney disease by patient and care partner empowerment:
           kidney health for everyone everywhere

    • Authors: Kalantar-Zadeh K; Li P, Tantisattamo E, et al.
      Pages: 476 - 481
      Abstract: Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of ‘Living Well with Kidney Disease’ in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals and policymakers, applicable to both developed and developing countries.
      PubDate: Mon, 15 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa253
      Issue No: Vol. 14, No. 2 (2021)
       
  • Real-world management of hyperphosphataemia with sucroferric
           oxyhydroxide: the VELREAL multicentre study

    • Authors: Navarro-González J; Arenas M, Henríquez-Palop F, et al.
      Pages: 681 - 687
      Abstract: BackgroundThe efficacy and safety of sucroferric oxyhydroxide (SO) have been reported in clinical trials. However, real-life data are scarce. This study presents data on the use, efficacy and safety of SO in real clinical practice.MethodsWe performed a retrospective multicentre study, without any influence on the prescription decisions, that included 220 patients from 11 Spanish centres. Demographic, treatment, analytical and nutritional parameters and adherence, side effects and dropout rates were collected during 6 months.ResultsSO was initiated due to inadequate control of serum phosphate (P) in 70% of participants and in 24.5% to reduce the number of tablets. Monotherapy with SO increased from 44% to 74.1%, with a reduction in the average daily number of sachets/tablets from six to two. Serum P decreased by 20% (4.6 ± 1.2 versus 5.8 ± 1.3 mg/dL; P < 0.001), with a significant reduction in intact parathyroid hormone levels (P < 0.01). The percentage of patients with adequate serum P control at threshold levels of 5 and 4.5 mg/dL increased by 45.4% and 35.9%, respectively. Serum ferritin was not modified, while the transferrin saturation index increased significantly (P = 0.04). Serum albumin and normalized protein catabolic rate, when normalized by serum P, increased, averaging 37% and 39%, respectively (P < 0.001). Adherent patients increased from 28.2% to 52.7%. Adverse effects were reported by 14.1% of participants, with abandonment of treatment in 9.5%.ConclusionsThe use of SO in real-life results in better control of serum P, a reduction in the number of tablets and an improvement in therapeutic adherence. In addition, it may be beneficial with regards to secondary hyperparathyroidism and nutritional status.
      PubDate: Mon, 01 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa226
      Issue No: Vol. 14, No. 2 (2021)
       
  • Simulator-based hemodialysis cannulation skills training: a new
           horizon'

    • Authors: Singapogu R; Chowdhury A, Roy-Chaudhury P, et al.
      Pages: 465 - 470
      Abstract: In accordance with the recently released Kidney Disease Outcomes Quality Initiative  (KDOQI) guidelines, there is a significant need for focused efforts on improving hemodialysis cannulation outcomes. Toward this, structured and meaningful training of our clinical personnel who cannulate in dialysis clinics is a priority. With the availability of advanced sensors and computing methods, simulators could be indispensable tools for standardized skills assessment and training. In this article we present ways in which sensor data could be used to quantify cannulation skill. As with many other medical specialties, implementation of simulator-based training holds the promise of much-needed improvement in end-stage kidney disease patient outcomes.
      PubDate: Sun, 06 Dec 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa206
      Issue No: Vol. 14, No. 2 (2020)
       
  • Anaemia and acute kidney injury: the tip of the iceberg'

    • Authors: Lombardi Y; Ridel C, Touzot M.
      Pages: 471 - 473
      Abstract: Acute kidney injury (AKI) is a common disorder that complicates the hospital course of many patients. AKI is linked with an independent risk of death, hospital length of stay and chronic kidney disease (CKD). Several preoperative predictors are found to be associated with AKI after surgery independent of its origin (cardiac versus non-cardiac). Among these, anaemia has been widely recognized and studied. Anaemia is more common within the surgical population for various reasons (iron deficiency, blood loss, anaemia of chronic disease such as inflammatory state, malignancy or CKD). Both pre- and postoperative anaemia have a deleterious impact on different clinical outcomes including AKI. In this issue, Nishimoto et al. investigated whether AKI could be a risk factor for anaemia (and not the opposite) and whether anaemia could be an independent mediator of mortality after AKI.
      PubDate: Thu, 31 Dec 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa202
      Issue No: Vol. 14, No. 2 (2020)
       
  • Do we need new phosphate binders in dialysis'

    • Authors: Cozzolino M; Galassi A, Ciceri P.
      Pages: 474 - 475
      Abstract: Patients affected by chronic kidney disease (CKD) have a greater risk of mortality than the general population. Fatal cardiovascular events are the most frequent cause of death in CKD patients, especially in the late stages of disease. Derangement of mineral metabolism and hyperphosphataemia are currently accepted as pivotal triggers of these vascular complications. Phosphate binders represent the common strategy to counteract hyperphosphataemia in dialysis patients. Several studies have reported a reduction in mortality risk in dialysis patients receiving phosphate binders compared with untreated patients, independent of the class of binder prescribed.
      PubDate: Wed, 16 Dec 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa246
      Issue No: Vol. 14, No. 2 (2020)
       
  • Challenges in primary focal segmental glomerulosclerosis diagnosis: from
           the diagnostic algorithm to novel biomarkers

    • Authors: Jacobs-Cachá C; Vergara A, García-Carro C, et al.
      Pages: 482 - 491
      Abstract: Primary or idiopathic focal segmental glomerulosclerosis (FSGS) is a kidney entity that involves the podocytes, leading to heavy proteinuria and in many cases progresses to end-stage renal disease. Idiopathic FSGS has a bad prognosis, as it involves young individuals who, in a considerably high proportion (∼15%), are resistant to corticosteroids and other immunosuppressive treatments as well. Moreover, the disease recurs in 30–50% of patients after kidney transplantation, leading to graft function impairment. It is suspected that this relapsing disease is caused by a circulating factor(s) that would permeabilize the glomerular filtration barrier. However, the exact pathologic mechanism is an unsettled issue. Besides its poor outcome, a major concern of primary FSGS is the complexity to confirm the diagnosis, as it can be confused with other variants or secondary forms of FSGS and also with other glomerular diseases, such as minimal change disease. New efforts to optimize the diagnostic approach are arising to improve knowledge in well-defined primary FSGS cohorts of patients. Follow-up of properly classified primary FSGS patients will allow risk stratification for predicting the response to different treatments. In this review we will focus on the diagnostic algorithm used in idiopathic FSGS both in native kidneys and in disease recurrence after kidney transplantation. We will emphasize those potential confusing factors as well as their detection and prevention. In addition, we will also provide an overview of ongoing studies that recruit large cohorts of glomerulopathy patients (Nephrotic Syndrome Study Network and Cure Glomerulonephropathy, among others) and the experimental studies performed to find novel reliable biomarkers to detect primary FSGS.
      PubDate: Tue, 11 Aug 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa110
      Issue No: Vol. 14, No. 2 (2020)
       
  • Opportunities in the cloud or pie in the sky' Current status and
           future perspectives of telemedicine in nephrology

    • Authors: Stauss M; Floyd L, Becker S, et al.
      Pages: 492 - 506
      Abstract: The use of telehealth to support, enhance or substitute traditional methods of delivering healthcare is becoming increasingly common in many specialties, such as stroke care, radiology and oncology. There is reason to believe that this approach remains underutilized within nephrology, which is somewhat surprising given the fact that nephrologists have always driven technological change in developing dialysis technology. Despite the obvious benefits that telehealth may provide, robust evidence remains lacking and many of the studies are anecdotal, limited to small numbers or without conclusive proof of benefit. More worryingly, quite a few studies report unexpected obstacles, pitfalls or patient dissatisfaction. However, with increasing global threats such as climate change and infectious disease, a change in approach to delivery of healthcare is needed. The current pandemic with coronavirus disease 2019 (COVID-19) has prompted the renal community to embrace telehealth to an unprecedented extent and at speed. In that sense the pandemic has already served as a disruptor, changed clinical practice and shown immense transformative potential. Here, we provide an update on current evidence and use of telehealth within various areas of nephrology globally, including the fields of dialysis, inpatient care, virtual consultation and patient empowerment. We also provide a brief primer on the use of artificial intelligence in this context and speculate about future implications. We also highlight legal aspects and pitfalls and discuss the ‘digital divide’ as a key concept that healthcare providers need to be mindful of when providing telemedicine-based approaches. Finally, we briefly discuss the immediate use of telenephrology at the onset of the COVID-19 pandemic. We hope to provide clinical nephrologists with an overview of what is currently available, as well as a glimpse into what may be expected in the future.
      PubDate: Fri, 14 Aug 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa103
      Issue No: Vol. 14, No. 2 (2020)
       
  • Oncogenic mechanisms in renal insufficiency

    • Authors: Volovat S; Volovat C, Miron I, et al.
      Pages: 507 - 515
      Abstract: The prevalence of both cancer and end-stage renal disease is increasing. In addition, medical advances have meant increased survival rates for both diseases. Many chemotherapeutics are renally excreted, and conversely, renal insufficiency promotes a pro-neoplastic state, including genitourinary and other cancers. Dialysis prolongs life while increasing cancer risk. Proposed oncogenic mechanisms include immune dysfunction, chronic inflammation, changes in gut microbiota and stimulation of the renin–angiotensin system. This review summarizes current concepts in the relationship between cancer and renal insufficiency.
      PubDate: Fri, 23 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa122
      Issue No: Vol. 14, No. 2 (2020)
       
  • Evaluation of the Oxford classification in immunoglobulin A vasculitis
           with nephritis: a cohort study and meta-analysis

    • Authors: Yu B; Shi S, Hou W, et al.
      Pages: 516 - 525
      Abstract: BackgroundSimilarities in clinicopathological presentations in immunoglobulin A (IgA) nephropathy and IgA vasculitis with nephritis (IgAVN) raise the question of the utility of the Oxford classification in the latter. The aim of this study was to evaluate the Oxford classification in IgAVN.MethodsWe conducted a retrospective cohort study and meta-analysis following systematic searching of the MEDLINE and Excerpta Medica Database (EMBASE) databases between January 2009 and September 2019. We modeled the association of 30 and 50% decline in estimated glomerular filtration rate or end-stage renal disease with pathologic lesions of the Oxford classification including mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), interstitial fibrosis/tubular atrophy (T) and crescents (C). Results were pooled using random-effects meta-analysis.ResultsThe cohort study included 132 patients, and only T lesion was an independently risk factor in IgAVN. The meta-analysis yielded six retrospective studies with 721 patients and 139 endpoints. In multivariate model, T lesion was significantly associated with renal outcome (hazard ratio = 2.45, P = 0.007). M and C lesions could not predict renal outcome without evidence of heterogeneity. E and S lesions could not predict renal outcome with evidence of heterogeneity (I2 = 66.6%; P = 0.01, and I2 = 65.8%; P = 0.03, respectively). Subgroup analysis showed that the possible reasons to the heterogeneity were from usage of immunosuppressant, sample size and follow-up time.ConclusionsThe study suggests that the Oxford classification could not be fully validated in IgAVN. Higher portion of immunosuppressant especially before renal biopsy might be the main confounder for the predictive value of Oxford classification in IgAVN.
      PubDate: Tue, 11 Aug 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa129
      Issue No: Vol. 14, No. 2 (2020)
       
  • Acute kidney injury pathology and pathophysiology: a retrospective review

    • Authors: Gaut J; Liapis H.
      Pages: 526 - 536
      Abstract: Acute kidney injury (AKI) is the clinical term used for decline or loss of renal function. It is associated with chronic kidney disease (CKD) and high morbidity and mortality. However, not all causes of AKI lead to severe consequences and some are reversible. The underlying pathology can be a guide for treatment and assessment of prognosis. The Kidney Disease: Improving Global Outcomes guidelines recommend that the cause of AKI should be identified if possible. Renal biopsy can distinguish specific AKI entities and assist in patient management. This review aims to show the pathology of AKI, including glomerular and tubular diseases.
      PubDate: Sat, 10 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa142
      Issue No: Vol. 14, No. 2 (2020)
       
  • Relationship between soluble urokinase-type plasminogen activator receptor
           and serum biomarkers of endothelial activation in patients with idiopathic
           nephrotic syndrome

    • Authors: Roca N; Jatem E, Martín M, et al.
      Pages: 543 - 549
      Abstract: BackgroundSerum levels of soluble urokinase-type plasminogen activator receptor (suPAR) are high in some patients with idiopathic nephrotic syndrome (INS). Given that suPAR constitutes a predictor of vascular disease and has been associated with endothelial dysfunction, we hypothesized that suPAR levels are related to endothelial activation or dysfunction in INS patients. The aims of this study were to evaluate the relationship between serum concentrations of endothelial biomarkers and suPAR in patients with different histological patterns of INS and healthy controls, and to determine the demographic, clinical and biochemical characteristics of INS patients that influence suPAR serum levels.MethodsThis observational, cross-sectional study included patients with INS, diagnosed with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS) or membranous nephropathy (MN) by renal biopsy. Patient demographic, clinical and biochemical characteristics were recorded and blood samples were obtained at the time of diagnosis. Measurements of suPAR and endothelial molecules via serum levels were performed using Enzyme-Linked ImmunoSorbent Assay kits.ResultsPatients with nephrotic syndrome (n = 152) caused by FSGS, MCD or MN had increased circulating levels of endothelial markers. suPAR levels positively correlated with age and the serum levels of almost all endothelial markers. Generally, endothelial cell molecules positively correlated with each other. suPAR levels were not associated with the histopathological pattern of INS.ConclusionsIn patients with INS secondary to FSGS, MCD and NM, circulating levels of suPAR are independent of the primary renal disease, and significantly associated with age, glomerular filtration rate and the levels of various endothelial markers.
      PubDate: Fri, 17 Jan 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz173
      Issue No: Vol. 14, No. 2 (2020)
       
  • Direct-acting antiviral therapy improves kidney survival in hepatitis C
           virus-associated cryoglobulinaemia: the RENALCRYOGLOBULINEMIC study

    • Authors: Pérez de José A; Carbayo J, Pocurull A, et al.
      Pages: 586 - 592
      Abstract: BackgroundDirect-acting antiviral agents (DAAs) have shown high rates of sustained virological response in chronic hepatitis C virus (HCV) infection. However, the influence of DAAs on the course of kidney involvement in HCV-associated mixed cryoglobulinaemia (HCV-MC) has been little studied. The aim of this study was to analyse the effects of antiviral treatment on kidney prognosis and evolution in patients diagnosed with HCV-MC.MethodsThe RENALCRYOGLOBULINEMIC study is an observational multicentre cohort study of 139 patients with HCV-MC from 14 Spanish centres. Clinical and laboratory parameters were measured before and after antiviral treatment. Primary endpoints were kidney survival and mortality after HCV-MC diagnosis. Secondary endpoints were clinical, immunological and virological responses after antiviral treatment.ResultsPatients were divided into three groups based on the treatment received: treatment with DAAs (n = 100) treatment with interferon (IFN) and ribavirin (RBV) (n = 24) and no treatment (n = 15). Patients were followed up for a median duration of 138 months (interquartile range 70–251. DAA treatment reduced overall mortality {hazard ratio [HR] 0.12 [95% confidence interval (CI) 0.04–0.40]; P < 0.001} and improved kidney survival [HR 0.10 ( 95% CI 0.04–0.33); P < 0.001].ConclusionsResults from the RENALCRYOGLOBULINEMIC study indicated that DAA treatment in patients with HCV-MC improves kidney survival and reduces mortality.
      PubDate: Sat, 25 Jan 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz178
      Issue No: Vol. 14, No. 2 (2020)
       
  • Imbalanced turnover of collagen type III is associated with disease
           progression and mortality in high-risk chronic kidney disease patients

    • Authors: Genovese F; Rasmussen D, Karsdal M, et al.
      Pages: 593 - 601
      Abstract: BackgroundTubulointerstitial fibrosis is a major pathological feature in chronic kidney disease (CKD) and collagen type III (COL3) is a major component of the renal fibrotic scar. We hypothesized that a dysregulated turnover of COL3 is an important determinant of CKD progression. We assessed the relationship between fragments reflecting active formation (PRO-C3) and degradation (C3M) of COL3 and CKD disease progression and mortality in a prospective cohort of CKD patients.MethodsWe measured PRO-C3 and C3M in urine (uPRO-C3 and uC3M) and serum (sPRO-C3 and sC3M) of 500 patients from the Renal Impairment in Secondary Care study. Disease progression was defined as a decline in estimated glomerular filtration rate >30% or the start of renal replacement therapy within 12 and 30 months.ResultsLevels of uC3M/creatinine decreased, whereas levels of uPRO-C3/creatinine and sPRO-C3 increased with increasing CKD stage. uC3M/creatinine was inversely and independently associated with disease progression by 12 months {odds ratio [OR] 0.39 [95% confidence interval (CI) 0.18–0.83]; P = 0.01 per doubling of uC3M/creatinine} with development of end-stage renal disease [hazard ratio (HR) 0.70 (95% CI 0.50–0.97); P = 0.03 per doubling of uC3M/creatinine]. sPRO-C3 at baseline was independently associated with increased mortality [HR 1.93 (95% CI 1.21–3.1); P = 0.006 per doubling of sPRO-C3] and disease progression by 30 months [OR 2.16 (95% CI 1.21–3.84); P = 0.009 per doubling of sPRO-C3].ConclusionsDynamic products of COL3 formation and degradation were independently associated with CKD progression and mortality and may represent an opportunity to link pathological processes with targeted treatments against fibrosis.
      PubDate: Tue, 14 Jan 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz174
      Issue No: Vol. 14, No. 2 (2020)
       
  • Kidney disease and mortality in patients with respiratory tract
           infections: a systematic review and meta-analysis

    • Authors: Su G; Iwagami M, Qin X, et al.
      Pages: 602 - 611
      Abstract: BackgroundRespiratory tract infections (RTIs) are a common reason for people to seek medical care. RTIs are associated with high short-term mortality. Inconsistent evidence exists in the association between the presence of kidney disease and the risk of death in patient with RTIs.MethodsWe searched the PubMed, Cochrane Library and Embase databases from inception through April 2019 for cohort and case–control studies investigating the presence of kidney disease (defined as medical diagnosis of kidney disease, reduced estimated glomerular filtration rate or creatinine clearance, elevated serum creatinine and proteinuria) on mortality in adults with RTIs in different settings including community, inpatient and intensive care units. We assessed the quality of the included studies using Cochrane Collaboration’s tool and conducted a meta-analysis on the relative risk (RR) of death.ResultsOf 5362 records identified, 18 studies involving 16 676 participants met the inclusion criteria, with 15 studies investigating pneumonia and 3 studies exploring influenza. The risk of bias in the available evidence was moderate. Most [17/18 (94.5%)] of studies reported positive associations of underlying chronic kidney disease with mortality. The pooled adjusted risk for all-cause mortality in patients with RTIs almost doubled [RR 1.96 (95% confidence interval 1.48–2.59)] in patients with kidney disease. Associations were consistent across different timings of kidney disease assessment and provenances of RTIs (community-acquired or healthcare-associated).ConclusionsThe presence of kidney disease is associated with higher mortality among people with RTIs, especially in those with pneumonia. The presence of kidney disease might be taken into account when considering admission for patients who present with RTIs.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz188
      Issue No: Vol. 14, No. 2 (2020)
       
  • Diagnostic accuracy of administrative codes for autosomal dominant
           polycystic kidney disease in clinic patients with cystic kidney disease

    • Authors: Kalatharan V; McArthur E, Nash D, et al.
      Pages: 612 - 616
      Abstract: BackgroundThe ability to identify patients with autosomal dominant polycystic kidney disease (ADPKD) and distinguish them from patients with similar conditions in healthcare administrative databases is uncertain. We aimed to measure the sensitivity and specificity of different ADPKD administrative coding algorithms in a clinic population with non-ADPKD and ADPKD kidney cystic disease.MethodsWe used a dataset of all patients who attended a hereditary kidney disease clinic in Toronto, Ontario, Canada between 1 January 2010 and 23 December 2014. This dataset included patients who met our reference standard definition of ADPKD or other cystic kidney disease. We linked this dataset to healthcare databases in Ontario. We developed eight algorithms to identify ADPKD using the International Classification of Diseases, 10th Revision (ICD-10) codes and provincial diagnostic billing codes. A patient was considered algorithm positive if any one of the codes in the algorithm appeared at least once between 1 April 2002 and 31 March 2015.ResultsThe ICD-10 coding algorithm had a sensitivity of 33.7% [95% confidence interval (CI) 30.0–37.7] and a specificity of 86.2% (95% CI 75.7–92.5) for the identification of ADPKD. The provincial diagnostic billing code had a sensitivity of 91.1% (95% CI 88.5–93.1) and a specificity of 10.8% (95% CI 5.3–20.6).ConclusionsICD-10 coding may be useful to identify patients with a high chance of having ADPKD but fail to identify many patients with ADPKD. Provincial diagnosis billing codes identified most patients with ADPKD and also with other types of cystic kidney disease.
      PubDate: Mon, 20 Jan 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz184
      Issue No: Vol. 14, No. 2 (2020)
       
  • Apolipoprotein B is a risk factor for end-stage renal disease

    • Authors: Kwon S; Kim D, Oh K, et al.
      Pages: 617 - 623
      Abstract: BackgroundApolipoprotein B (ApoB), a constituent of lipid particles, is known to increase the risk of cardiovascular diseases. However, the association between ApoB and end-stage renal disease (ESRD) remains to be resolved. Our objective was to determine whether the ApoB concentration has an association with the risk of ESRD.MethodsSerum ApoB, ApoA1, conventional lipid parameters and lipid subfractions were analyzed in 9403 subjects. The hazard ratio (HR) for the risk of ESRD was calculated using tertiles of ApoB concentration.ResultsESRD developed in 110 patients (1.2%) during 10 years of follow-up. Several lipid parameters were compared for their association with the risk of ESRD, of which ApoB was best and its relationship was also independent of other clinical parameters. Individuals in the second and third ApoB tertiles had a higher risk of ESRD than those in the first tertile, with HRs of 1.5 [95% confidence interval (CI) 0.89–2.61] and 2.6 (1.56–4.20), respectively. A high ApoB:ApoA1 ratio was associated with a higher risk of ESRD, but ApoA1 had no independent association. Even after adjusting the competing risk for all-cause death, high ApoB concentrations had an association with the risk of ESRD.ConclusionsHigh ApoB concentration is associated with a higher risk of ESRD, despite adjustment for other lipid and clinical parameters. Accordingly, the monitoring of ApoB may be helpful for the prediction of ESRD.
      PubDate: Tue, 11 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz186
      Issue No: Vol. 14, No. 2 (2020)
       
  • Cancer incidence and risk factors in dialysis patients with human
           immunodeficiency virus: a cohort study

    • Authors: Patel M; Waller J, Baer S, et al.
      Pages: 624 - 630
      Abstract: BackgroundPatients with human immunodeficiency virus (HIV) or end-stage renal disease receiving dialysis have an increased risk of developing malignancies, but few data are available on cancer in patients with both conditions. Thus, the objective of this study was to determine the incidence of selected malignancies and identify their potential risk factors in HIV-infected dialysis patients.MethodsThis study was a nationwide cohort analysis using the US Renal Data System. Participants included all HIV-infected patients starting dialysis from 2005 to 2011. HIV status, comorbidities and malignancies were identified using International Classification of Diseases, Ninth Revision codes. Descriptive statistics and generalized linear models quantifying risk factors were performed for the overall cohort and the three most common malignancies.ResultsOverall, 6641 HIV-infected dialysis patients were identified, with 543 (8.2%) carrying a malignancy diagnosis. The most common malignancies were non-Hodgkin’s lymphoma (NHL, 25%), Kaposi sarcoma (KS, 16%) and colorectal cancer (13%). Factors increasing the risk of any malignancy diagnosis included: history of cancer [adjusted relative risk (aRR) = 5.37], two or more acquired immunodeficiency syndrome-defining opportunistic infections (A
      DOI s) (aRR = 3.11), one A
      DOI (aRR = 2.23), cirrhosis (aRR = 2.20), male sex (aRR = 1.54) and hepatitis B (aRR = 1.52). For NHL and colorectal cancer, history of cancer (aRR = 7.05 and 9.80, respectively) was the most significant risk factor. For KS, two or more A
      DOI s (aRR = 6.78) was the largest risk factor.ConclusionsOver 8% of HIV-infected dialysis patients developed a malignancy. History of cancer and A
      DOI s were major risk factors, underscoring the significance of immune dysregulation in malignancy development.
      PubDate: Fri, 07 Feb 2020 00:00:00 GMT
      Issue No: Vol. 14, No. 2 (2020)
       
  • The effect of phosphate binder therapy with sucroferric oxyhydroxide on
           calcification propensity in chronic haemodialysis patients: a randomized,
           controlled, crossover trial

    • Authors: Thiem U; Soellradl I, Robl B, et al.
      Pages: 631 - 638
      Abstract: BackgroundCalcification propensity is associated with the risk for cardiovascular events and death in end-stage renal disease patients. Here we investigated the effect of lowering serum phosphate with oral phosphate binder therapy on calcification propensity.MethodsWe performed an open-label, randomized, controlled, crossover study in chronic haemodialysis patients with hyperphosphataemia. Patients (n = 39) were randomized in a 1:1 ratio to either low-dose (250 mg/day) sucroferric oxyhydroxide (SO) followed by high-dose (2000 mg/day) SO or vice versa, with washout phases before and after SO treatment. The primary endpoint was changed in calcification propensity as measured by calciprotein particle formation time (T50 test) between washout and high-dose SO treatment in patients with ≥85% adherence to the prescribed SO dose (per-protocol analysis).ResultsIn the primary per-protocol analysis (n = 28), 2000 mg/day SO treatment resulted in a mean increase in T50 of 66 min (95% CI 49–84 min, P < 0.0001), from 243 ± 63 to 309 ± 74 min compared with phosphate binder washout. Serum phosphate decreased from 2.28 ± 0.5 to 1.63 ± 0.43 mmol/L (P < 0.0001). SO at 250 mg/day did not influence T50 (P = 0.4) or serum phosphate concentrations (P = 0.9) compared with phosphate binder washout. The secondary intention-to-treat analysis (n = 39) showed similar results: an increase in T50 of 52 min (95% CI 31–74 min, P < 0.0001) and a decrease in serum phosphate from 2.18 ± 0.5 to 1.64 ± 0.46 mmol/L. No major adverse cardiovascular event, case of calciphylaxis or death occurred during the study.ConclusionPhosphate binder treatment with SO improves serum calcification propensity of haemodialysis patients and might lead to improved outcomes.
      PubDate: Wed, 28 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa154
      Issue No: Vol. 14, No. 2 (2020)
       
  • Impact of electronic alerts for acute kidney injury on patient outcomes:
           interrupted time-series analysis of population cohort data

    • Authors: Baird D; De Souza N, Logan R, et al.
      Pages: 639 - 646
      Abstract: BackgroundAutomated acute kidney injury (AKI) electronic alerts (e-alerts) are rule-based warnings triggered by changes in creatinine and are intended to facilitate earlier detection in AKI. We assessed the impact of the introduction in the Tayside region of UK in April 2015 of automated AKI e-alerts with an accompanying education programme.MethodsInterrupted time-series analysis using segmented regression was performed involving all adults with AKI aged ≥18 years who had a serum creatinine measured between 1 April 2013 and 31 March 2017. Analysis evaluated associations of AKI e-alert introduction on rate and severity (Stages 2–3) of AKI as well as mortality and occupied hospital bed days per patient per month in the population with AKI.ResultsThere were 32 320 episodes of AKI during the observation period. Implementation of e-alerts had no effect on the rate of any AKI [incidence rate ratio (IRR) 0.996, 95% confidence interval (CI) 0.991 to 1.001, P = 0.086] or on the rate of severe AKI (IRR 0.995, 95% CI 0.990 to 1.000, P = 0.061). Subgroup analysis found no impact on the rate or severity of AKI in hospital or in the community. Thirty-day mortality following AKI did not improve (IRR 0.998, 95% CI 0.987 to 1.009, P = 0.688). There was a slight reduction in occupied bed days (β-coefficient −0.059, 95% CI −0.094 to −0.025, P = 0.002).ConclusionsIntroduction of automated AKI e-alerts was not associated with a change in the rate, severity or mortality associated with AKI, but there was a small reduction in occupied hospital bed days.
      PubDate: Wed, 21 Oct 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa151
      Issue No: Vol. 14, No. 2 (2020)
       
  • Sodium intake and kidney function in the general population: an
           observational, population-based study

    • Authors: Cirillo M; Bilancio G, Cavallo P, et al.
      Pages: 647 - 655
      Abstract: BackgroundThe relationships of sodium intake to kidney function within the population have been poorly investigated and are the objective of the study.MethodsThis observational, population-based, cross-sectional and longitudinal study targeted 4595 adult participants of the Gubbio study with complete data at baseline exam. Of these participants, 3016 participated in the 15-year follow-up (mortality-corrected response rate 78.4%). Baseline measures included sodium:creatinine ratio in timed overnight urine collection, used as an index of sodium intake, together with serum creatinine, sex, age and other variables. Follow-up measures included serum creatinine and other variables. Estimated glomerular filtration rate (eGFR, mL/min/1.73 m2) was calculated using serum creatinine, sex and age and was taken as an index of kidney function.ResultsThe study cohort was stratified in sex- and age-controlled quintiles of baseline urine sodium:creatinine ratio. A higher quintile associated with higher baseline eGFR (P < 0.001). In multivariable analysis, the odds ratio (OR) of Stage1 kidney function (eGFR ≥90 mL/min/1.73 m2) was 1.98 times higher in Quintile 5 compared with Quintile 1 [95% confidence interval (CI) 1.50–2.59, P < 0.001]. The time from baseline to follow-up was 14.1 ± 2.5 years. Baseline to follow-up, the eGFR change was more negative along quintiles (P < 0.001). In multivariable analysis, the OR in Quintile 5 compared with Quintile 1 was 2.21 for eGFR decline ≥30% (1.18–4.13, P = 0.001) and 1.38 for worsened stage of kidney function (1.05–1.82, P = 0.006). Findings were consistent within subgroups.ConclusionsWithin the general population, an index of higher sodium intake associated cross-sectionally with higher kidney function but longitudinally with greater kidney function decline.
      PubDate: Thu, 12 Nov 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa158
      Issue No: Vol. 14, No. 2 (2020)
       
  • Can kidney parenchyma metabolites serve as prognostic biomarkers for
           long-term kidney function after nephrectomy for renal cell carcinoma'
           A preliminary study

    • Authors: Rosenzweig B; Recabal P, Gluck C, et al.
      Pages: 656 - 664
      Abstract: ObjectiveNephrectomy, the standard of care for localized renal cell carcinoma (RCC), may lead to kidney function loss. Our goal was to identify prognostic biomarkers of postoperative renal function using metabolomics.MethodsMetabolomics data from benign kidney parenchyma were collected prospectively from 138 patients with RCC who underwent nephrectomy at a single institution. The primary endpoint was the difference between the postoperative and preoperative estimated glomerular filtration (eGFR) rate divided by the elapsed time (eGFR slope). eGFR slope was calculated ∼2 years post-nephrectomy (GFR1), and at last follow-up (GFR2). A multivariate regularized regression model identified clinical characteristics and abundance of metabolites in baseline benign kidney parenchyma that were significantly associated with eGFR slope. Findings were validated by associating gene expression data with eGFR slope in an independent cohort (n = 58).ResultsData were compiled on 78 patients (median age 62.6 years, 65.4% males). The mean follow-up was 25 ± 3.4 months for GFR1 and 69.5 ± 23.5 months for GFR2 and 17 (22%) and 32 (41%) patients showed eGFR recovery, respectively. Nephrectomy type, blood lipids, gender and 23 metabolites from benign parenchyma were significantly associated with eGFR slope. Some metabolites associated with eGFR slope overlapped with previously reported chronic kidney disease-related processes. Subgroup analysis identified unique ‘metabolite signatures’ by older age, nephrectomy type and preoperative eGFR.ConclusionsNephrectomy type, gender, blood lipids and benign parenchyma metabolites at nephrectomy were associated with long-term kidney function. On further study, these metabolites may be useful as potential biomarkers and to identify novel therapeutic targets for malignancy-associated renal disease.
      PubDate: Wed, 04 Nov 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa185
      Issue No: Vol. 14, No. 2 (2020)
       
  • Survival on four compared with three times per week haemodialysis in high
           ultrafiltration patients: an observational study

    • Authors: Fotheringham J; Latimer N, Froissart M, et al.
      Pages: 665 - 672
      Abstract: BackgroundThe harm caused by the long interdialytic interval in three-times-per-week haemodialysis regimens (3×WHD) may relate to fluid accumulation and associated high ultrafiltration rate (UFR). Four-times-per-week haemodialysis (4×WHD) may offer a solution, but its impact on mortality, hospitalization and vascular access complications is unknown.MethodsFrom the AROii cohort of incident in-centre haemodialysis patients, 3×WHD patients with a UFR >10 mL/kg/h were identified. The hazard for the outcomes of mortality, hospitalization and vascular access complications in those who switched to 4×WHD compared with staying on 3×WHD was estimated using a marginal structural Cox proportional hazards model. Adjustment included baseline patient and treatment characteristics with inverse probability weighting used to adjust for time-varying UFR and cardiovascular comorbidities.ResultsFrom 10 637 European 3×WHD patients, 3842 (36%) exceeded a UFR >10 mL/kg/h. Of these, 288 (7.5%) started 4×WHD and at baseline were more comorbid. Event rates while receiving 4×WHD compared with 3×WHD were 12.6 compared with 10.8 per 100 patient years for mortality, 0.96 compared with 0.65 per year for hospitalization and 14.7 compared with 8.0 per 100 patient years for vascular access complications. Compared with 3×WHD, the unadjusted hazard ratio (HR) for mortality on 4×WHD was 1.05 [95% confidence interval (CI) 0.78–1.42]. Following adjustment for baseline demographics, time-varying treatment probability and censoring risks, this HR was 0.73 (95% CI 0.50–1.05; P = 0.095). Despite these adjustments on 4×WHD, the HR for hospitalization remained elevated and vascular access complications were similar to 3×WHD.ConclusionsThis observational study was not able to demonstrate a mortality benefit in patients switched to 4×WHD. To demonstrate the true benefits of 4×WHD requires a large, well-designed clinical trial. Our data may help in the design of such a study.
      PubDate: Mon, 28 Dec 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa250
      Issue No: Vol. 14, No. 2 (2020)
       
  • Anemia following acute kidney injury after noncardiac surgery and
           long-term outcomes: the NARA-AKI cohort study

    • Authors: Nishimoto M; Murashima M, Kokubu M, et al.
      Pages: 673 - 680
      Abstract: BackgroundThis study was conducted to investigate whether acute kidney injury (AKI) is an independent predictor of anemia and whether anemia following AKI is a mediator of mortality after AKI.MethodsThis is a retrospective cohort study. Adults with noncardiac surgery from 2007 to 2011 were included. Obstetric or urological surgery, missing data or preoperative dialysis were excluded. Subjects were followed until the end of 2015 or lost to follow-up. Exposures of interest were postoperative AKI. Outcome variables were hematocrit values at 3, 6 and 12 months postoperatively and mortality. Associations between AKI and hematocrit or association between AKI and mortality were examined by multivariable linear regression or Cox regression, respectively.ResultsAmong 6692 subjects, 445 (6.6%) developed AKI. Among those with postoperative data, AKI was independently associated with lower hematocrit at 3, 6 and 12 months postoperatively, with coefficients of −0.79 [95% confidence interval (CI) −1.47 to −0.11; n = 1750], −1.35 (−2.11 to −0.60; n = 1558) and −0.91 (−1.59 to −0.22; n = 2463), respectively. Higher stages or longer duration of AKI were associated with more severe anemia. AKI was associated with higher mortality after 3 months postoperatively with a hazard ratio of 1.54 (95% CI 1.12–2.12). Further adjustment with hematocrit at 3 months attenuated the association. The mediation effect was significant (P = 0.02) by mediation analysis.ConclusionsAKI was an independent predictor of anemia following AKI. Higher mortality associated with AKI was at least partially mediated by anemia following AKI. Whether correction of anemia following AKI improves mortality requires further research.
      PubDate: Wed, 04 Nov 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa184
      Issue No: Vol. 14, No. 2 (2020)
       
  • Upper limb isometric exercise protocolled programme and arteriovenous
           fistula maturation process

    • Authors: Tapia González I; Esteve Simó V, Ibañez Pallares S, et al.
      Pages: 688 - 695
      Abstract: IntroductionArteriovenous fistula (AVF) is the gold standard for vascular access (VA) for end-stage chronic kidney disease (CKD) patients. Post-operative exercises may help to improve maturation. Nevertheless, scarce scientific evidence has been reported about their utility to date. Our objective was to assess the effect of a post-operative isometric exercise programme on native VA maturation in patients with stage 5–5D CKD.MethodsWe performed a 24-month prospective study. After surgery, patients were randomized to the isometric exercise group (EG) or control group (CG). An isometric exercise protocolled programme was performed in the EG. The CG received usual care. Demographic data, muscle strength using a hand-grip (HG) dynamometer, main Doppler ultrasound (DUS) measurements, clinical and DUS maturation and VA complications were assessed at 4 and 8 weeks post-operatively.ResultsFor 60 sixty patients (30 in the EG), demographic data and HG and DUS measurements at baseline were similar. A significant increase in HG was observed only in the EG at the end of the study (20.7 ± 8.1 versus 25.1 ± 10.3 kg, P = 0.001). The EG obtained the highest clinical maturation at 4 (CG 33.3% versus EG 70%, P = 0.009) and 8 weeks (CG 33.3% versus EG 76.7%, P = 0.002). Similarly, DUS maturation was better in the EG at 4 (CG 40% versus EG 80%, P = 0.003) and 8 weeks (CG 43.3% versus EG 83.3%, P = 0.003) and remained so in the EG for both distal and proximal VA territories for all these periods.ConclusionsThe upper limb isometric exercise protocolled programme improved clinical and DUS maturation in our patients in both the distal and proximal VA territories. Further studies are required to support these results.
      PubDate: Wed, 05 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz194
      Issue No: Vol. 14, No. 2 (2020)
       
  • Effect of multiple episodes of acute kidney injury on mortality: an
           observational study

    • Authors: Walker H; De Souza N, Hapca S, et al.
      Pages: 696 - 703
      Abstract: BackgroundPatients who survive an episode of acute kidney injury (AKI) are more likely to have further episodes of AKI. AKI is associated with increased mortality, with a further increase with recurrent episodes. It is not clear whether this is due to AKI or as a result of other patient characteristics. The aim of this study was to establish whether recurrence of AKI is an independent risk factor for mortality or if excess mortality is explained by other factors.MethodsThis observational cohort study included adult people from the Tayside region of Scotland, with an episode of AKI between 1 January 2009 and 31 December 2009. AKI was defined using the creatinine-based Kidney Disease: Improving Global Outcomes definition. Associations between recurrent AKI and mortality were examined using a Cox proportional hazards model.ResultsSurvival was worse in the group identified to have recurrent AKI compared with those with a single episode of AKI [hazard ratio = 1.49, 95% confidence interval (CI) 1.37–1.63; P < 0.001]. After adjustment for comorbidities, stage of reference AKI, sex, age, medicines that predispose to renal impairment or, in the 3 months prior to the reference AKI, deprivation and baseline estimated glomerular filtration rate (eGFR), recurrent AKI was independently associated with an increase in mortality (hazard ratio = 1.25, 95% CI 1.14–1.37; P < 0.001). Increasing stage of reference AKI, age, deprivation, baseline eGFR, male sex, previous myocardial infarction, cerebrovascular disease and diuretic use were all associated with an increased risk of mortality in patients with recurrent AKI.ConclusionsRecurrent AKI is associated with increased mortality. After adjusting for patient characteristics, the increase in mortality is independently associated with recurrent AKI and is not solely explained by other risk factors.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfz199
      Issue No: Vol. 14, No. 2 (2020)
       
  • PAX2 variant associated with bilateral kidney agenesis and broad
           intrafamilial disease variability

    • Authors: Rasmussen M; Nielsen M, Manak J, et al.
      Pages: 704 - 706
      Abstract: Pathogenic variants in PAX2 have previously been associated with renal coloboma syndrome. Here we present a novel variant c.68T>C associated with bilateral kidney agenesis, minimal change nephropathy, ureteropelvic junction obstruction, duplex kidney with hydronephrosis of upper pole system and bilateral kidney hypoplasia within the same family. Additionally, two family members were found to have optic nerve abnormalities further supporting the impact of the PAX2 variant. This is the first report of a PAX2 variant associated with bilateral kidney agenesis.
      PubDate: Wed, 13 May 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa013
      Issue No: Vol. 14, No. 2 (2020)
       
  • Low factor H-related 5 levels contribute to infection-triggered haemolytic
           uraemic syndrome and membranoproliferative glomerulonephritis

    • Authors: Gómez Delgado I; Gutiérrez-Tenorio J, Fraga Rodríguez G, et al.
      Pages: 707 - 709
      Abstract: Dysregulation of the alternative complement pathway is a major pathogenic mechanism in two rare renal diseases: atypical haemolytic uraemic syndrome (aHUS) and membranoproliferative glomerulonephritis (MPGN). We report on a 66-year-old male with chronic hepatitis C virus (HCV) infection and a combined liver–kidney transplant that was diagnosed with MPGN at the age of 63 years and a 5-year-old boy who presented with aHUS at the age of 21 months following a Streptococcus pneumoniae infection. Both patients carried similar frameshift variants in the complement CFHR5 gene that segregate with reduced levels of factor H–related 5 (FHR-5). We conclude that low FHR-5 levels may predispose to viral and bacterial infections that then trigger different renal phenotypes.
      PubDate: Tue, 17 Mar 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa004
      Issue No: Vol. 14, No. 2 (2020)
       
  • Idarucizumab for the treatment of dabigatran-related nephropathy

    • Authors: Alsamarrai A; Eaddy N, Curry E.
      Pages: 710 - 711
      Abstract: Anticoagulant-related nephropathy (ARN) is a clinical syndrome of acute kidney injury in patients taking vitamin K antagonists or direct oral anticoagulants. It is associated with increased mortality and there is no specific treatment. We report the case of a 78-year-old man on dabigatran who developed macroscopic haematuria and acute kidney injury 2 weeks after mitral valve repair, reaching a peak creatinine of 415 µmol/L from a normal baseline, which was successfully treated with one course of idarucizumab. This case illustrates the efficacy of an anticoagulant reversal agent for the treatment of ARN.
      PubDate: Wed, 11 Mar 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa030
      Issue No: Vol. 14, No. 2 (2020)
       
  • Dabigatran overload in acute kidney injury: haemodialysis or
           idarucizumab' A case report and proposal for a decisional algorithm

    • Authors: Galassi A; Podda G, Monciino P, et al.
      Pages: 712 - 714
      Abstract: Dabigatran overload has been reported in acute kidney injury (AKI), leading to occasional major bleeding. Haemodialysis (HD) was the method used for reversing dabigatran anticoagulant effects before the approval of idarucizumab, which is now indicated for dabigatran reversal in major bleeding or surgical emergencies. There have been reports of rebound of dabigatran levels following idarucizumab administration in AKI, requiring HD to achieve effective dabigatran clearance. However, a decisional algorithm to individualize treatments for dabigatran overload seems lacking. We present a case of dabigatran accumulation in obstructive AKI with minor bleeding that was successfully treated with HD and tranexamic acid without using idarucizumab, and propose a decision-making algorithm including different pathways in the management of suspected dabigatran overload in AKI.
      PubDate: Wed, 11 Mar 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa011
      Issue No: Vol. 14, No. 2 (2020)
       
  • Iso-osmolar hyponatremia from polyethylene glycol

    • Authors: Tucker B; Pirkle J, Stefi E, et al.
      Pages: 715 - 719
      Abstract: Understanding and applying pathophysiological concepts to patient care is an important skill for physicians in the clinical setting. Here, we present a case that demonstrates how the application of common physiological concepts relating to the widely accepted hyponatremia algorithm led to an accurate diagnosis of hyponatremia. This case documents iso-osmolar hyponatremia caused by orally administered polyethylene glycol absorption in the gastrointestinal tract. Herein, we discuss the workup and differential diagnosis for iso-osmolar hyponatremia in juxtaposition with the pathophysiological mechanisms unique to this case. We discuss these pathophysiological mechanisms based on the patients’ laboratory data and responses to therapeutic interventions.
      PubDate: Mon, 13 Jul 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa087
      Issue No: Vol. 14, No. 2 (2020)
       
  • Reversal of asymptomatic cardiac dysfunction following renal
           transplantation

    • Authors: Chinnappa S; El Nahas M, Mooney A.
      Pages: 720 - 722
      Abstract: Renal transplantation (RTx) has been shown to have a favourable effect on cardiac morbidity and mortality in advanced chronic kidney disease (CKD) [1]. RTx has also been shown to cause regression of left ventricular hypertrophy (LVH) [2], raising the possibility of cardiac ‘reverse remodelling’ with RTx. However, although these structural changes have been identified, the changes in cardiac function with RTx, especially in asymptomatic patients, have not yet been studied. Our recent work showed the presence of subclinical cardiac dysfunction, the precursor of overt heart failure, in CKD even in asymptomatic patients with no known cardiac disease or diabetes mellitus [3]. We measured peak cardiac power (CPOmax) non-invasively to reveal the subclinical cardiac dysfunction. In the present study, we measured CPOmax and central haemodynamics before and after RTx to test the hypothesis that successful RTx, with improved renal function, improves subclinical cardiac dysfunction. In addition, we also evaluated the relationship between the changes in aerobic exercise capacity [maximal oxygen consumption (VO2max)] and central haemodynamic parameters following RTx.
      PubDate: Tue, 24 Mar 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa010
      Issue No: Vol. 14, No. 2 (2020)
       
  • Kidney transplantation in m.3243A&gt;G carriers has outcome
           implications

    • Authors: Finsterer J.
      Pages: 723 - 724
      Abstract: With interest we read the article by de Laat et al. about five patients with a mitochondrial disorder (MID) due to the variant m.3243A>G in MT-TL1 clinically manifesting as multisystem disease, with kidney failure as the most prominent feature leading to end-stage renal disease (ESRD) and requiring kidney transplantation [1]. The study has a number of shortcomings.
      PubDate: Fri, 21 Feb 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa025
      Issue No: Vol. 14, No. 2 (2020)
       
  • Should prospective renal transplant recipients be screened for
           Strongyloides stercoralis'

    • Authors: Arkell P; Pan D, Riley P, et al.
      Pages: 725 - 727
      Abstract: Strongyloidasis is a neglected tropical disease caused by Strongyloides stercoralis, which affects >100 million people, largely in Africa, Asia and Latin America [1, 2]. Chronic infection can persist for decades, and may be asymptomatic or cause gastrointestinal, cardiopulmonary or skin symptoms [3]. In some individuals with specific types of immune suppression (e.g. exogenous corticosteroids and organ transplantation), rapid replication and dissemination of larvae result in Strongyloides hyperinfection syndrome (SHS), a condition characterized by acute severe illness and high mortality (Figure 1) [4].
      PubDate: Mon, 15 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa047
      Issue No: Vol. 14, No. 2 (2020)
       
  • Novel pathogenic MAPKBP1 variant in a family with nephronophthisis

    • Authors: Al-Hamed M; Alzaidan H, Hussein M, et al.
      Pages: 728 - 730
      Abstract: Nephronophthisis (NPHP), an autosomal recessive ciliopathic disease that leads to end-stage kidney disease (ESKD) in childhood or adolescence, is characterized by reduced urinary concentrating ability, chronic tubulointerstitial nephritis and cystic kidney disease [1]. Around 10–20% of patients with NPHP have additional features that can include liver fibrosis, retinal degeneration, heart abnormalities or situs inversus [2, 3]. NPHP is considered to be the most common genetic cause of ESKD in children and young adults [2] and is found in populations worldwide. NPHP clinical subtypes can be classified into three categories based on the age of onset: infantile NPHP, before 3 years of age; juvenile NPHP, before 13 years of age; and adolescent/adult NPHP, before 19 years of age [4].
      PubDate: Wed, 24 Jun 2020 00:00:00 GMT
      DOI: 10.1093/ckj/sfaa090
      Issue No: Vol. 14, No. 2 (2020)
       
 
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