NDT Plus最新文献

{"title":"Will another trial CONVINCE nephrologists to adopt high-dose haemodiafiltration over conventional haemodialysis?","authors":"Kaitlin J Mayne, Claudio Ronco","doi":"10.1093/ckj/sfad258","DOIUrl":"https://doi.org/10.1093/ckj/sfad258","url":null,"abstract":"Haemodialysis ( HD ) relies on diffusion for solute clearance us-ing either low-flux or high-flux membranes. High-flux dialysers have increased permeability to middle molecular weight solutes. Haemodiafiltration ( HDF ) employs diffusion and convection in combination thereby allowing even greater clearance of middle and large molecules versus high-flux HD [ 1 ]. Both are accepted treatments for kidney failure, but high-flux HD is much more widely used. The enhanced clearance achieved by HDF may improve haemodynamic stability and survival though high-quality randomised evidence is lacking [ 1 ]. Previous trials have tested whether high-dose HDF confers survival advantage over high-flux HD but with several limitations [ 2 ]. Survival benefits have been linked to higher convection volumes of which there are many determinants [ 2 ]; these are largely modifiable treatment-related factors such as vascular access ( Fig. 1 ) ; however, the observation that higher convection volumes are typically achieved in healthier patients has been cited as a potential confounder in previous trials [ 2 ]. The recently reported CONVINCE trial attempted to overcome this limitation by mandating candidacy for convection volumes ≥ 23 litres in post-dilution mode for enrolment [ 3","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136212816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matrix Gla protein polymorphism rs1800802 is associated with atheroma plaque progression and with cardiovascular events in a chronic kidney disease cohort","authors":"Serafí Cambray, Marcelino Bermúdez-López, Alicia Garcia-Carrasco, Jose M Valdivielso, Ma José Aladrén Regidor, Jaume Almirall, Esther Ponz, Jesús Arteaga Coloma, Ma Auxiliadora Bajo Rubio, Raquel Díaz, Montserrat Belart Rodríguez, Antonio Gascón, Jordi Bover Sanjuan, Josep Bronsoms Artero, Juan B Cabezuelo Romero, Salomé Muray Cases, Jesús Calviño Varela, Pilar Caro Acevedo, Jordi Carreras Bassa, Aleix Cases Amenós, Elisabet Massó Jiménez, Rosario Moreno López, Secundino Cigarrán Guldris, Saray López Prieto, Lourdes Comas Mongay, Isabel Comerma, Ma Teresa Compte Jové, Marta Cuberes Izquierdo, Fernando de Álvaro, Covadonga Hevia Ojanguren, Gabriel de Arriba de la Fuente, Ma Dolores del Pino y Pino, Rafael Diaz-Tejeiro Izquierdo, Francisco Ahijado Hormigos, Marta Dotori, Verónica Duarte, Sara Estupiñan Torres, Ma José Fernández Reyes, Ma Loreto Fernández Rodríguez, Guillermina Fernández, Antonio Galán Serrano, Cesar García Cantón, Antonio L García Herrera, Mercedes García Mena, Luis Gil Sacaluga, Maria Aguilar, José Luis Górriz, Emma Huarte Loza, José Luis Lerma, Antonio Liebana Cañada, Jesús Pedro Marín Álvarez, Nàdia Martín Alemany, Jesús Martín García, Alberto Martínez Castelao, María Martínez Villaescusa, Isabel Martínez, Iñigo Moina Eguren, Silvia Moreno Los Huertos, Ricardo Mouzo Mirco, Antonia Munar Vila, Ana Beatriz Muñoz Díaz, Juan F Navarro González, Javier Nieto, Agustín Carreño, Enrique Novoa Fernández, Alberto Ortiz, Beatriz Fernandez, Vicente Paraíso, Miguel Pérez Fontán, Ana Peris Domingo, Celestino Piñera Haces, Ma Dolores Prados Garrido, Mario Prieto Velasco, Carmina Puig Marí, Maite Rivera Gorrín, Esther Rubio, Ruiz Pilar, Mercedes Salgueira Lazo, Ana Isabel Martínez Puerto, José Antonio Sánchez Tomero, José Emilio Sánchez, Ramon Sans Lorman, Ramon Saracho, Maria Sarrias, Daniel Serón, María José Soler, Clara Barrios, Fernando Sousa, Daniel Toran, Fernando Tornero Molina, José Javier Usón Carrasco, Ildefonso Valera Cortes, Ma Merce Vilaprinyo del Perugia, Rafael C Virto Ruiz, Vicente Pallarés Carratalá, Miguel Artigao, Inés Gil, Francisco Adan, Emilio García Criado, Rafael Durá Belinchón","doi":"10.1093/ckj/sfad257","DOIUrl":"https://doi.org/10.1093/ckj/sfad257","url":null,"abstract":"ABSTRACT Background Chronic kidney disease (CKD) is associated with increased atherosclerotic burden and higher risk for cardiovascular events (CVE). Atherosclerosis has a significant genetic component and, in CKD, it is influenced by mineral metabolism alterations. Therefore, genetic modifications of mineral metabolism–related proteins could affect atherosclerosis in CKD patients. In the present study we investigated the role of single nucleotide polymorphisms (SNPs) of the matrix gamma-carboxy glutamic acid protein (MGP) on atherosclerosis progression and CVE in a CKD cohort. Methods A total of 2187 CKD patients from the Observatorio Nacional de Aterosclerosis en Nefrologia (NEFRONA) study were genotyped for SNPs present in the matrix gamma-carboxy glutamic acid (Gla) protein (MGP) gene. Atheromatosis was detected by vascular ultrasound. Progression of atheromatosis, defined as an increase in territories with plaque, was assessed after 24 months. Patients were followed for 48 months for CVE. Association of SNPs with plaque progression was assessed by logistic regression and their capacity to predict CVE by Cox regression. Results Three SNPs of the MGP gene were analyzed. No association of the rs4236 or the rs1800801 SNPs was detected with any of the outcomes. However, patients homozygotes for the minor allele of the rs1800802 SNP showed higher adjusted risk for plaque progression [odds ratio 2.3 (95% confidence interval 1.06–4.9)] and higher risk of suffering a CVE [hazard ratio 2.16 (95% confidence interval 1.13–4.12)] compared with the rest of genotypes. No association of the SNP with total or dp-ucMGP levels was found in a subsample. Conclusions The rs1800802 polymorphism of MGP is associated with plaque progression and CVE in CKD patients.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136292633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender specific risk factors and outcomes of hyperkalemia in CKD patients: smoking as a driver of hyperkalemia in men","authors":"Jose M Valdivielso, Sol Carriazo, Marisa Martin, Beatriz Fernandez-Fernandez, Marcelino Bermudez-López, Alberto Ortiz, Ma José Aladrén Regidor, Jaume Almirall, Esther Ponz, Jesús Arteaga Coloma, Ma Auxiliadora Bajo Rubio, Raquel Díaz, Montserrat Belart Rodríguez, Antonio Gascón, Jordi Bover Sanjuan, Josep Bronsoms Artero, Juan B Cabezuelo Romero, Salomé Muray Cases, Jesús Calviño Varela, Pilar Caro Acevedo, Jordi Carreras Bassa, Aleix Cases Amenós, Elisabet Massó Jiménez, Rosario Moreno López, Secundino Cigarrán Guldris, Saray López Prieto, Lourdes Comas Mongay, Isabel Comerma, Ma Teresa Compte Jové, Marta Cuberes Izquierdo, Fernando de Álvaro, Covadonga Hevia Ojanguren, Gabriel de Arriba de la Fuente, Ma Dolores del Pino y Pino, Rafael Diaz-Tejeiro Izquierdo, Francisco Ahijado Hormigos, Marta Dotori, Verónica Duarte, Sara Estupiñan Torres, Ma José Fernández Reyes, Ma Loreto Fernández Rodríguez, Guillermina Fernández, Antonio Galán Serrano, Cesar García Cantón, Antonio L García Herrera, Mercedes García Mena, Luis Gil Sacaluga, Maria Aguilar, José Luis Górriz, Emma Huarte Loza, José Luis Lerma, Antonio Liebana Cañada, Jesús Pedro Marín Álvarez, Nàdia Martín Alemany, Jesús Martín García, Alberto Martínez Castelao, María Martínez Villaescusa, Isabel Martínez, Iñigo Moina Eguren, Silvia Moreno Los Huertos, Ricardo Mouzo Mirco, Antonia Munar Vila, Ana Beatriz Muñoz Díaz, Juan F Navarro González, Javier Nieto, Agustín Carreño, Enrique Novoa Fernández, Alberto Ortiz, Beatriz Fernandez, Vicente Paraíso, Miguel Pérez Fontán, Ana Peris Domingo, Celestino Piñera Haces, Ma Dolores Prados Garrido, Mario Prieto Velasco, Carmina Puig Marí, Maite Rivera Gorrín, Esther Rubio, Ruiz Pilar, Mercedes Salgueira Lazo, Ana Isabel Martínez Puerto, José Antonio Sánchez Tomero, José Emilio Sánchez, Ramon Sans Lorman, Ramon Saracho, Maria Sarrias, Daniel Serón, María José Soler, Clara Barrios, Fernando Sousa, Daniel Toran, Fernando Tornero Molina, José Javier Usón Carrasco, Ildefonso Valera Cortes, Ma Merce Vilaprinyo del Perugia, Rafael C Virto Ruiz, Vicente Pallarés Carratalá, Miguel Artigao, Inés Gil, Francisco Adan","doi":"10.1093/ckj/sfad212","DOIUrl":"https://doi.org/10.1093/ckj/sfad212","url":null,"abstract":"Abstract Background Hyperkalemia is common among patients with chronic kidney disease (CKD) but there is scarce information on differential risk factors and outcomes for men and women. For instance, smoking has been suggested to be a risk factor for hyperkalemia, but specific analysis of the sex-specific impact of smoking on hyperkalemia in CKD are lacking. Methods We studied serum potassium levels in 2891 participants from the NEFRONA cohort: 483 controls (47% women) and 2408 CKD patients (38% women) without prior cardiovascular disease (CVD), assessing whether smoking is a risk factor for hyperkalemia, and if hyperkalemia is associated with outcomes separately for men and women. Results Median potassium levels and prevalence of hypo and hyperkalemia were higher in CKD participants than in controls. Serum potassium levels were higher and hyperkalemia and severe hyperkalemia more prevalent in men than in women with non-dialysis CKD (G3-G5). The highest prevalence of hyperkalemia for each gender was found in CKD G4-G5 and hemodialysis patients for men (46%) and in hemodialysis (54%) for women. Gender-specific etiological multivariate analysis identified current smoking as a risk factor for hyperkalemia only in men. Hyperkalemia was independently associated with stopping RAASi, an outcome which was more common in women. Hyperkalemia was also associated to higher risk of cardiovascular events within 4 years in men. Conclusions In conclusion, hyperkalemia is common among men and women with CKD, but the prevalence, risk factors and outcomes may differ by gender. Specifically, current smoking is a driver of hyperkalemia in men.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"278 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135045777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of music therapy intervention on anxiety and pain during percutaneous renal biopsy: a randomized controlled trial","authors":"Filippo Giordano, Adele Mitrotti, Antonia Losurdo, Flavia Esposito, Antonio Granata, Alessandra Pesino, Michele Rossini, Patrizia Natale, Vincenzo Dileo, Marco Fiorentino, Loreto Gesualdo","doi":"10.1093/ckj/sfad246","DOIUrl":"https://doi.org/10.1093/ckj/sfad246","url":null,"abstract":"ABSTRACT Background Percutaneous renal biopsy (PRB) may subject patients to emotional distress and pain before and during the biopsy. The aim of this study was to evaluate the effects of complementary/non-pharmacological interventions such as music therapy (MT) on anxiety, pain and satisfaction in renal patients undergoing PRB. Methods A prospective, single-centre, single-blind, randomized controlled two-arm trial was conducted. Patients ≥18 years of age, hospitalized at the Nephrology, Dialysis and Transplantation Unit (Bari, Italy) and scheduled for PRB were screened. Participants were assigned to standard treatment (CG) or to the music therapy (MT) intervention group. Participants in the MT group received standard care and an MT intervention by a certified music therapist qualified in guided imagery and music. The CG patients received the standard of care. MT and CG patients were subjected to identical measurements (pre/post) of the parameters in the State Trait Anxiety Inventory Y1 (STAI-Y1), visual analogue scale for pain (VAS-P) and satisfaction (VAS-S) and heart rate variability. Results A statistically significant difference in the anxiety scores after PRB between MT and CG patients (STAI-Y1 35.4 ± 6.2 versus 42.9 ± 9.0) was observed. MT also had strong and significant effects on VAS-P compared with CG (5.0 ± 1.4 versus 6.3 ± 1.3, respectively; P < .001) and VAS-S (7.8 ± 1.0 versus 6.0 ± 0.9, respectively; P < .001). Decreased activity of the sympathetic nervous system and increased activity of the parasympathetic nervous system was observed after PRB in the MT group. Conclusion Our study supports the use of MT to mitigate the psychological anxiety, pain and sympathetic activation associated with PRB.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134944045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease in older women with CKD","authors":"Alice Radley, Jennifer S Lees, Kate I Stevens","doi":"10.1093/ckj/sfad235","DOIUrl":"https://doi.org/10.1093/ckj/sfad235","url":null,"abstract":"","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135744357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral anticoagulant treatment and risk of kidney disease – a nationwide, population-based cohort study","authors":"Ane Emilie Friis Vestergaard, Kok SimonJensen, Uffe Heide-Jørgensen, Kasper Adelborg, Henrik Birn, Juan-Jesus Carrero, Christian Fynbo Christiansen","doi":"10.1093/ckj/sfad252","DOIUrl":"https://doi.org/10.1093/ckj/sfad252","url":null,"abstract":"ABSTRACT Background Direct oral anticoagulants (DOACs) are recommended as first-line treatment of atrial fibrillation. Whether DOAC use is associated with lower risks of kidney complications compared with vitamin K antagonists (VKAs) remains unclear. We examined this association in a nationwide, population-based cohort study. Methods We conducted a cohort study including patients initiating oral anticoagulant treatment within 3 months after an atrial fibrillation diagnosis in Denmark during 2012–18. Using routinely collected creatinine measurements from laboratory databases, we followed patients in an intention-to-treat approach for acute kidney injury (AKI) and chronic kidney disease (CKD) progression. We used propensity-score weighting to balance baseline confounders, computed weighted risks and weighted hazard ratios (HRs) with 95% confidence intervals (CIs) comparing DOACs with VKAs. We performed several subgroup analyses and a per-protocol analysis. Results We included 32 781 persons with atrial fibrillation initiating oral anticoagulation (77% initiating DOACs). The median age was 75 years, 25% had a baseline estimated glomerular filtration rate <60 mL/min/1.73 m2, and median follow-up was 2.3 (interquartile range 1.1–3.9) years. The weighted 1-year risks of AKI were 13.6% in DOAC users and 15.0% in VKA users (HR 0.86, 95% CI 0.82; 0.91). The weighted 5-year risks of CKD progression were 13.9% in DOAC users and 15.4% in VKA users (HR 0.85, 95% CI 0.79; 0.92). Results were similar across subgroups and in the per-protocol analysis. Conclusions Initiation of DOACs was associated with a decreased risk of AKI and CKD progression compared with VKAs. Despite the potential limitations of observational studies, our findings support the need for increased clinical awareness to prevent kidney complications among patients who initiate oral anticoagulants.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effects of rheumatoid arthritis or ankylosing spondylitis on membranous nephropathy: a two-sample mendelian randomization study","authors":"Xiu-Fen Wang, Shao-Bin Duan, Jian He, Xi Wu, Ting Wu","doi":"10.1093/ckj/sfad209","DOIUrl":"https://doi.org/10.1093/ckj/sfad209","url":null,"abstract":"ABSTRACT Background Membranous nephropathy (MN) is the leading cause of adult-onset nephrotic syndrome, with primary MN of unclear cause accounting for 80% of cases. Retrospective clinical research reported that MN occurring in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients was triggered by nephrotoxic drugs or of unknown cause. However, whether RA or AS itself increases the risk of developing MN is unknown. Methods We conducted mendelian randomization (MR) analysis to evaluate the causal effects of RA or AS on MN using genome-wide association study (GWAS) statistics. The inverse variance weighted (IVW) method was the primary analysis, and several supplementary analyses and sensitivity analyses were performed to test the causal estimates. Results We obtained 30 valid instrumental variables (IVs) of RA and 16 valid IVs of AS from large-scale open-access GWASs. The genetically predicted RA significantly increased the risk of MN [IVW odds ratios (OR) = 1.327, 95% confidence interval (CI) = (1.124, 1.565), P = 8.051 × 10−4]. Three supplementary MR analyses provided the consistent positive causal effect of RA on MN (all P < 0.05). No horizontal pleiotropy was detected by MR Egger intercept analysis (P = 0.411). However, the genetically predicted AS had no causal effect on MN by IVW and supplementary analysis (all P > 0.05). Conclusions Genetically predicted RA could increase the risk of MN, but genetically predicted AS was not associated with MN. Screening for kidney involvement in RA patients should be noted, and active treatment of RA will reduce the public health burden of MN.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135246970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the association between serum levels of kynurenine and cardiovascular outcomes and overall mortality in chronic kidney disease","authors":"Carolla El Chamieh, Islam Amine Larabi, Natalia Alencar De Pinho, Oriane Lambert, Christian Combe, Denis Fouque, Luc Frimat, Christian Jacquelinet, Maurice Laville, Solène Laville, Céline Lange, Jean-Claude Alvarez, Ziad A Massy, Sophie Liabeuf","doi":"10.1093/ckj/sfad248","DOIUrl":"https://doi.org/10.1093/ckj/sfad248","url":null,"abstract":"ABSTRACT Background Kynurenine is a protein-bound uremic toxin. Its circulating levels are increased in chronic kidney disease (CKD). Experimental studies showed that it exerted deleterious cardiovascular effects. We sought to evaluate an association between serum kynurenine levels and adverse fatal or nonfatal cardiovascular events and all-cause mortality in CKD patients. Methods The CKD-REIN study is a prospective cohort of people with CKD having an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m². Baseline frozen samples of total and free fractions of kynurenine and tryptophan were measured using a validated liquid chromatography tandem mass spectrometry technique. Cause-specific Cox models were used to estimate hazard ratios (HRs) for each outcome. Results Of the 2406 included patients (median age: 68 years; median eGFR: 25 ml/min/1.73 m2), 52% had a history of cardiovascular disease. A doubling of serum-free kynurenine levels was associated with an 18% increased hazard of cardiovascular events [466 events, HR (95%CI):1.18(1.02,1.33)], independently of eGFR, serum-free tryptophan level or other uremic toxins, cardioprotective drugs, and traditional cardiovascular risk factors. Serum-free kynurenine was significantly associated with non-atheromatous cardiovascular events [HR(95%CI):1.26(1.03,1.50)], but not with atheromatous cardiovascular events [HR(95%CI):1.15(0.89,1.50)]. The association of serum-free kynurenine with cardiovascular mortality was also independently significant [87 events; adjusted HR(95%CI):1.64(1.10,2.40)]. However, the association of serum-free kynurenine with all-cause mortality was no more significant after adjustment on serum-free tryptophan [311 events, HR(95%CI):1.12(0.90, 1.40)]. Conclusions Our findings imply that serum-free kynurenine, independently of other cardiovascular risk factors (including eGFR), is associated with fatal or nonfatal cardiovascular outcomes, particularly non-atheromatous cardiovascular events; in patients with CKD. Strategies to reduce serum kynurenine levels should be evaluated in further studies.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135425443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the race-free CKD-EPI creatinine-based eGFR equation in a Danish cohort with measured GFR","authors":"Philip Vestergaard Munch, Uffe Heide-Jørgensen, Simon Kok Jensen, Henrik Birn, Søren Viborg Vestergaard, Jørgen Frøkiær, Henrik Toft Sørensen, Christian Fynbo Christiansen","doi":"10.1093/ckj/sfad253","DOIUrl":"https://doi.org/10.1093/ckj/sfad253","url":null,"abstract":"Abstract Background In 2021, an updated Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimated glomerular filtration rate (eGFR) without a coefficient for race (CKD-EPI21) was developed. The performance of this new equation has yet to be examined among specific patient groups. Methods We compared the performances of the new CKD-EPI21 equation and the 2009 equation assuming non-Black race (CKD-EPI09-NB) in patients with GFR measured by chromium-51-EDTA plasma clearance at Aarhus University Hospital in Denmark during 2010–2018. We examined bias, accuracy, precision, and correct classification of chronic kidney disease (CKD) stage using chromium-51-EDTA clearance as the reference standard. We assessed the performance in the total cohort, cancer patients, and potential living kidney donors. We also assessed the performance stratified by CKD stage in the total cohort. Results In this predominantly White population, the CKD-EPI21 equation performed slightly better than the CKD-EPI09-NB equation in both the total cohort (N = 4 668) and in cancer patients (N = 3 313) and potential living kidney donors (N = 239). In the total cohort, the CKD-EPI21 equation demonstrated a slightly lower median absolute bias (−0.2 versus −4.4 ml/min/1.73 m2), and a similar accuracy, precision, and correct classification of CKD stage compared with the CKD-EPI09-NB equation. When stratified by CKD stage, the CKD-EPI09-NB equation performed slightly better than the CKD-EPI21 equation among patients with a measured GFR <60 ml/min/1.73 m2. Conclusions In a selected cohort of Danish patients with measured GFR, the CKD-EPI21 equation performed slightly better than the CKD-EPI09-NB equation except for patients with a measured GFR <60 ml/min/1.73 m2 where CKD-EPI09-NB performed slightly better although the differences were considered clinically insignificant.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135425370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dobrava hantavirus and coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy and responding to a single dose of Eculizumab","authors":"Simon Aberger, Nicolas Kozakowski, Zoltán Proházka, Thomas Pleininger, Hermann Salmhofer","doi":"10.1093/ckj/sfad222","DOIUrl":"https://doi.org/10.1093/ckj/sfad222","url":null,"abstract":"ABSTRACT The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has refocused scientific interest on gaining insight into the pathophysiology of systemic viral diseases. Complement activation has been characterized as a driver of endothelial injury and microvascular thrombosis in acute respiratory distress syndrome as well as hantavirus hemorrhagic fever with renal syndrome. On this occasion, we wish to report a case of severe hantavirus disease with coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy with rapid response of inflammatory markers, hematologic parameters and proteinuria to eculizumab. These findings support a disease model of virus-associated endothelial injury involving alternative pathway complement activation. Future studies are needed to explore whether end organ damage can be mitigated by complement inhibition in life-threatening viral disease.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135579805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}