Open Access. Powered by Scholars. Published by Universities.®

Nephrology Commons

Open Access. Powered by Scholars. Published by Universities.®

Zucker School of Medicine at Hofstra/Northwell

Keyword
Publication Year

Articles 61 - 90 of 92

Full-Text Articles in Nephrology

Challenges And Opportunities In Late-Stage Chronic Kidney Disease, S. Fishbane, A. D. Hazzan, C. Halinski, A. T. Mathew Jan 2015

Challenges And Opportunities In Late-Stage Chronic Kidney Disease, S. Fishbane, A. D. Hazzan, C. Halinski, A. T. Mathew

Journal Articles

There is increasing recognition that chronic diseases are a major challenge for health delivery systems and treasuries. These are highly prevalent and costly diseases and frequency is expected to increase greatly as the population of many countries ages. Chronic kidney disease (CKD) has not received the same attention as other chronic diseases such as congestive heart failure; yet, the prevalence and costs of CKD are substantial. Greater recognition and support for CKD may require that the disease no longer be viewed as one continuous disease state. Early CKD stages require less complex care and generate lower costs. In contrast, late-stage …


A Review Of The Nonpressor And Nonantidiuretic Actions Of The Hormone Vasopressin, G. P. Mavani, M. V. Devita, M. F. Michelis Jan 2015

A Review Of The Nonpressor And Nonantidiuretic Actions Of The Hormone Vasopressin, G. P. Mavani, M. V. Devita, M. F. Michelis

Journal Articles

The pressor and antidiuretic actions of arginine vasopressin (AVP) have been well documented. This review focuses on the less widely appreciated actions of AVP which also have important physiologic functions and when better understood may provide important insights into common disease states. These actions include effects on pain perception and bone structure as well as important relationships to the varied components of metabolic syndrome. These include effects on blood glucose, lipid levels, and blood pressure. AVP may also play a role in the progression of chronic kidney disease and effect physiologic changes relating to aging, abnormal social behavior, and cognitive …


Tubular Cell Phenotype In Hiv-Associated Nephropathy: Role Of Phospholipid Lysophosphatidic Acid, K. R. Ayasolla, P. Rai, S. Rahimipour, M. Hussain, A. Malhotra, P. C. Singhal Jan 2015

Tubular Cell Phenotype In Hiv-Associated Nephropathy: Role Of Phospholipid Lysophosphatidic Acid, K. R. Ayasolla, P. Rai, S. Rahimipour, M. Hussain, A. Malhotra, P. C. Singhal

Journal Articles

Collapsing glomerulopathy and microcysts are characteristic histological features of HIV-associated nephropathy (HIVAN). We have previously reported the role of epithelial mesenchymal transition (EMT) in the development of glomerular and tubular cell phenotypes in HIVAN. Since persistent tubular cell activation of NF kappa B has been reported in HIVAN, we now hypothesize that HIV may be contributing to tubular cell phenotype via lysophosphatidic acid (LPA) mediated downstream signaling. Interestingly, LPA and its receptors have also been implicated in the tubular interstitial cell fibrosis (TIF) and cyst formation in autosomal dominant polycystic kidney disease (PKD). Primary human proximal tubular cells (HRPTCs) were …


Vascular Smooth Muscle Cells Contribute To Apol1-Induced Podocyte Injury In Hiv Milieu, X. Lan, H. Wen, M. A. Saleem, J. Mikulak, A. Malhotra, K. Skorecki, P. C. Singhal Jan 2015

Vascular Smooth Muscle Cells Contribute To Apol1-Induced Podocyte Injury In Hiv Milieu, X. Lan, H. Wen, M. A. Saleem, J. Mikulak, A. Malhotra, K. Skorecki, P. C. Singhal

Journal Articles

Clinical reports have demonstrated that higher rates of non-diabetic glomerulosclerosis in African Americans can be attributed to two coding sequence variants (G1 and G2) in the APOL1 gene; however, the underlying mechanism is still unknown. Kidney biopsy data suggest enhanced expression of APOL1/APOL1 variants (Vs) in smooth muscle cells (SMCs) of renal vasculature. Since APOL1 is a secretory protein of relatively low molecular weight (41kDa), SMCs may be a contributory endocrine/paracrine source of APOL1 wild type (WT)/APOL1Vs in the glomerular capillary perfusate percolating podocytes. In the present study, we tested the hypothesis that an HIV milieu stimulated secretion of APOL1 …


Vitamin D Receptor And Epigenetics In Hiv Infection And Drug Abuse, N. Chandel, A. Malhotra, P. C. Singhal Jan 2015

Vitamin D Receptor And Epigenetics In Hiv Infection And Drug Abuse, N. Chandel, A. Malhotra, P. C. Singhal

Journal Articles

Illicit drug abuse is highly prevalent and serves as a powerful co-factor for HIV exacerbation. Epigenetic alterations in drug abuse and HIV infection determine expression of several critical genes such as vitamin D receptor (VDR), which participates in proliferation, differentiation, cell death under both physiological and pathological conditions. On that account, active vitamin D, the ligand of VDR, is used as an adjuvant therapy to control infection, slow down progression of chronic kidney diseases, and cancer chemotherapy. Interestingly, vitamin D may not be able to augment VDR expression optimally in several instances where epigenetic contributes to down regulation of VDR; …


An Overlapping Case Of Lupus Nephritis And Igg4-Related Kidney Disease, M. Zaarour, C. Weerasinghe, A. Eter, S. El-Sayegh, E. El-Charabaty Jan 2015

An Overlapping Case Of Lupus Nephritis And Igg4-Related Kidney Disease, M. Zaarour, C. Weerasinghe, A. Eter, S. El-Sayegh, E. El-Charabaty

Journal Articles

We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulonephritis was found, along with autoimmune tubulointerstitial nephritis (TIN) with a "full-house" pattern of immune deposits. These findings were suggestive of lupus interstitial nephritis. However, IgG4+ plasma …


Presence Of Anti-Glomerular Basement Membrane Antibodies And Myeloperoxidase Anti-Neutrophilic Cytoplasmic Antibodies In A Case Of Rapidly Progressive Glomerulonephritis, G. P. Mavani, M. Pommier, S. Win, M. F. Michelis, J. Rosenstock Jan 2015

Presence Of Anti-Glomerular Basement Membrane Antibodies And Myeloperoxidase Anti-Neutrophilic Cytoplasmic Antibodies In A Case Of Rapidly Progressive Glomerulonephritis, G. P. Mavani, M. Pommier, S. Win, M. F. Michelis, J. Rosenstock

Journal Articles

A 69-year-old male had initially presented with low-grade proteinuria, microhematuria, and a positive myeloperoxidase anti-neutrophilic antibody (ANCA). He subsequently developed deterioration of kidney function and developed uremic symptoms. Creatinine was 486.2 mumol/L (5.5 mg/dL). Anti-MPO was positive (titer >8 U, normal


Protein Domains Of Apol1 And Its Risk Variants, X. Q. Lan, H. X. Wen, R. Lederman, A. Malhotra, J. Mikulak, W. Popik, K. Skorecki, P. C. Singhal Jan 2015

Protein Domains Of Apol1 And Its Risk Variants, X. Q. Lan, H. X. Wen, R. Lederman, A. Malhotra, J. Mikulak, W. Popik, K. Skorecki, P. C. Singhal

Journal Articles

Increasing lines of evidence have demonstrated that the development of higher rates of non-diabetic glomerulosclerosis (GS) in African Americans can be attributed to two coding sequence variants (G1 and G2) in the Apolipoprotein L1 (APOL) gene. Recent studies indicate that the gene products of these APOL1 risk variants have augmented toxicity to kidney cells. However, the biological characteristics of APOL1 and its risk variants are not well elucidated. The APOL1 protein can be divided into several functional domains, including signal peptide (SP), pore forming domain (PFD), membrane address domain (MAD), and SEA-interacting domain. To investigate the relative contribution of each …


Epigenetic Modulation Of Human Podocyte Vitamin D Receptor In Hiv Milieu, N. Chandel, K. S. Ayasolla, X. Lan, M. Sultana-Syed, A. Chawla, R. Lederman, V. Vethantham, M. A. Saleem, A. Malhotra, P. C. Singhal, +1 Additional Author Jan 2015

Epigenetic Modulation Of Human Podocyte Vitamin D Receptor In Hiv Milieu, N. Chandel, K. S. Ayasolla, X. Lan, M. Sultana-Syed, A. Chawla, R. Lederman, V. Vethantham, M. A. Saleem, A. Malhotra, P. C. Singhal, +1 Additional Author

Journal Articles

HIV (human immunodeficiency virus) has been reported to induce podocyte injury through down regulation of vitamin D receptor (VDR) and activation of renin angiotensin system; however, the involved mechanism is not clear. Since HIV has been reported to modulate gene expression via epigenetic phenomena, we asked whether epigenetic factors contribute to down regulation of VDR. Kidney cells in HIV transgenic mice and HIV-infected podocytes (HIV/HPs) displayed enhanced expression of SNAIL, a repressor of VDR. To elucidate the mechanism, we studied the effect of HIV on expression of molecules involved in SNAIL repressor complex formation and demonstrated that HIV enhances expression …


Fungal Infections In Renal Transplant Patients, A. Khan, E. El-Charabaty, S. El-Sayegh Jan 2015

Fungal Infections In Renal Transplant Patients, A. Khan, E. El-Charabaty, S. El-Sayegh

Journal Articles

Organ transplantation has always been considered to be the standard therapeutic interventions in patients with end-stage organ failure. In 2008, more than 29,000 organ transplants were performed in US. Survival rates among transplant recipients have greatly improved due to better understanding of transplant biology and more effective immunosuppressive agents. After transplant, the extent of the immune response is influenced by the amount of interleukin 2 (IL-2) being produced by the T-helper cells. Transplant immunosuppressive therapy primarily targets T cell-mediated graft rejection. Calcineurin inhibitor, which includes cyclosporine, pimecrolimus and tacrolimus, impairs calcineurin-induced up-regulation of IL-2 expression, resulting in increased susceptibility to …


Iga-Dominant Post-Infectious Glomerulonephritis Presenting As A Fatal Pulmonary-Renal Syndrome, M. Saad, M. Daoud, P. Nasr, R. Syed, S. El-Sayegh Jan 2015

Iga-Dominant Post-Infectious Glomerulonephritis Presenting As A Fatal Pulmonary-Renal Syndrome, M. Saad, M. Daoud, P. Nasr, R. Syed, S. El-Sayegh

Journal Articles

Over the last decades, post-infectious glomerulonephritis underwent major changes in its epidemiology, pathophysiology, and outcomes. We are reporting a case of IgA-dominant post-infectious glomerulonephritis (IgA-PIGN) presenting as a fatal pulmonary-renal syndrome. An 86-year-old Filipino man presented with worsening dyspnea, hemoptysis, and decreased urine output over 2 weeks. Past medical history is significant for hypertension, chronic kidney disease stage III, and pneumonia 3 weeks prior treated with intravenous cefazolin for methicillin-sensitive Staphylococcus aureus bacteremia. Physical examination was remarkable for heart rate of 109/min and respiratory rate of 25/min saturating 99% on 3 liters via nasal cannula. There were bibasilar rales in …


At(1)R Blockade In Adverse Milieus: Role Of Smrt And Corepressor Complexes, T. Singh, K. Ayasolla, P. Rai, N. Chandel, S. Haque, R. Lederman, M. Husain, V. Vethantham, A. Chawla, H. Vashistha, M. A. Saleem, G. Ding, P. N. Chander, A. Malhotra, L. G. Meggs, P. C. Singhal Jan 2015

At(1)R Blockade In Adverse Milieus: Role Of Smrt And Corepressor Complexes, T. Singh, K. Ayasolla, P. Rai, N. Chandel, S. Haque, R. Lederman, M. Husain, V. Vethantham, A. Chawla, H. Vashistha, M. A. Saleem, G. Ding, P. N. Chander, A. Malhotra, L. G. Meggs, P. C. Singhal

Journal Articles

ANG II type 1 receptor blockade (AT(1)R-BLK) is used extensively to slow down the progression of proteinuric kidney diseases. We hypothesized that AT(1)R-BLK provides podocyte protection through regulation of silencing mediator of retinoic acid and thyroid hormone receptor (SMRT) and vitamin D receptor (VDR) expression under adverse milieus such as high glucose and human immunodeficiency virus infection. Both AT(1)R-BLK and VDR agonists (VDAs) stimulated VDR complex formation that differed not only in their composition but also in their functionality. AT(1)R-BLK-induced VDR complexes contained predominantly unliganded VDR, SMRT, and phosphorylated histone deacetylase 3, whereas VDA-VDR complexes were constituted by liganded VDR …


Iqgap1 Regulates Actin Cytoskeleton Organization In Podocytes Through Interaction With Nephrin, Y. P. Liu, W. Liang, Y. J. Yang, Y. B. Pan, Q. Yang, X. H. Chen, P. C. Singhal, G. H. Ding Jan 2015

Iqgap1 Regulates Actin Cytoskeleton Organization In Podocytes Through Interaction With Nephrin, Y. P. Liu, W. Liang, Y. J. Yang, Y. B. Pan, Q. Yang, X. H. Chen, P. C. Singhal, G. H. Ding

Journal Articles

Increasing data has shown that the cytoskeletal reorganization of podocytes is involved in the onset of proteinuria and the progression of glomerular disease. Nephrin behaves as a signal sensor of the slit diaphragm to transmit cytoskeletal signals to maintain the unique structure of podocytes. However, the nephrin signaling cascade deserves further study. IQGAP1 is a scaffolding protein with the ability to regulate cytoskeletal organization. It is hypothesized that IQGAP1 contributes to actin reorganization in podocytes through interaction with nephrin. IQGAP1 expression and IQGAP1-nephrin colocalization in glomeruli were progressively decreased and then gradually recovered in line with the development of foot …


Exon 4-Encoded Sequence Is A Major Determinant Of Cytotoxicity Of Apolipoprotein L1, A. K. Khatua, A. M. Cheatham, E. D. Kruzel, P. C. Singhal, K. Skorecki, W. Popik Jan 2015

Exon 4-Encoded Sequence Is A Major Determinant Of Cytotoxicity Of Apolipoprotein L1, A. K. Khatua, A. M. Cheatham, E. D. Kruzel, P. C. Singhal, K. Skorecki, W. Popik

Journal Articles

The apolipoprotein L1 (APOL1) gene (APOL1) product is toxic to kidney cells, and its G1 and G2 alleles are strongly associated with increased risk for kidney disease progression in African Americans. Variable penetrance of the G1 and G2 risk alleles highlights the significance of additional factors that trigger or modify the progression of disease. In this regard, the effect of alternative splicing in the absence or presence of G1 or G2 alleles is unknown. In this study we investigated whether alternative splicing of non-G1, non-G2 APOL1 (APOL1 G0) affects its biological activity. Among seven APOL1 exons, exons 2 and 4 …


Risk Prediction For Chronic Kidney Disease Progression Using Heterogeneous Electronic Health Record Data And Time Series Analysis, A. Perotte, R. Ranganath, J. S. Hirsch, D. Blei, N. Elhadad Jan 2015

Risk Prediction For Chronic Kidney Disease Progression Using Heterogeneous Electronic Health Record Data And Time Series Analysis, A. Perotte, R. Ranganath, J. S. Hirsch, D. Blei, N. Elhadad

Journal Articles

BACKGROUND: As adoption of electronic health records continues to increase, there is an opportunity to incorporate clinical documentation as well as laboratory values and demographics into risk prediction modeling. OBJECTIVE: The authors develop a risk prediction model for chronic kidney disease (CKD) progression from stage III to stage IV that includes longitudinal data and features drawn from clinical documentation. METHODS: The study cohort consisted of 2908 primary-care clinic patients who had at least three visits prior to January 1, 2013 and developed CKD stage III during their documented history. Development and validation cohorts were randomly selected from this cohort and …


Update On Membranoproliferative Gn, N. Masani, K. D. Jhaveri, S. Fishbane Jan 2014

Update On Membranoproliferative Gn, N. Masani, K. D. Jhaveri, S. Fishbane

Journal Articles

Membranoproliferative GN represents a pattern of injury seen on light microscopy. Historically, findings on electron microscopy have been used to further subclassify this pathologic entity. Recent advances in understanding of the underlying pathobiology have led to a proposed classification scheme based on immunofluorescence findings. Dysregulation of the complement system has been shown to be a major risk factor for the development of a membranoproliferative GN pattern of injury on kidney biopsy. Evaluation and treatment of this complex disorder rest on defining the underlying mechanisms.


The Authors Reply, K. D. Jhaveri, H. H. Shah, J. Radhakrishnan Jan 2014

The Authors Reply, K. D. Jhaveri, H. H. Shah, J. Radhakrishnan

Journal Articles

No abstract provided.


Glomerular Diseases: Entering A New Era, K. D. Jhaveri, S. Fishbane Jan 2014

Glomerular Diseases: Entering A New Era, K. D. Jhaveri, S. Fishbane

Journal Articles

No abstract provided.


Intravenous Iron Exposure And Outcomes In Patients On Hemodialysis, S. Fishbane, A. T. Mathew, R. Wanchoo Jan 2014

Intravenous Iron Exposure And Outcomes In Patients On Hemodialysis, S. Fishbane, A. T. Mathew, R. Wanchoo

Journal Articles

No abstract provided.


Apol1 Risk Variants Enhance Podocyte Necrosis Through Compromising Lysosomal Membrane Permeability, X. Q. Lan, A. Jhaveri, K. Cheng, H. X. Wen, M. A. Saleem, P. W. Mathieson, S. Aviram, A. Malhotra, K. Skorecki, P. C. Singhal, +1 Additional Author Jan 2014

Apol1 Risk Variants Enhance Podocyte Necrosis Through Compromising Lysosomal Membrane Permeability, X. Q. Lan, A. Jhaveri, K. Cheng, H. X. Wen, M. A. Saleem, P. W. Mathieson, S. Aviram, A. Malhotra, K. Skorecki, P. C. Singhal, +1 Additional Author

Journal Articles

Development of higher rates of nondiabetic glomerulosclerosis (GS) in African Americans has been attributed to two coding sequence variants (G1 and G2) in the APOL1 gene. To date, the cellular function and the role of APOL1 variants (Vs) in GS are still unknown. In this study, we examined the effects of overexpressing wild-type (G0) and kidney disease risk variants (G1 and G2) of APOL1 in human podocytes using a lentivirus expression system. Interestingly, G0 inflicted podocyte injury only at a higher concentration; however, G1 and G2 promoted moderate podocyte injury at lower and higher concentrations. APOL1Vs expressing podocytes displayed diffuse …


Chief's Seminar: Turning Interns Into Clinicians, C. Dittus, V. Grover, G. Panagopoulos, K. Jhaveri Jan 2014

Chief's Seminar: Turning Interns Into Clinicians, C. Dittus, V. Grover, G. Panagopoulos, K. Jhaveri

Journal Articles

BACKGROUND: Recent changes in healthcare delivery have necessitated residency education reform. To adapt to these changes, graduate medical education can adopt a chief resident-led clinical curriculum. Chief residents are ideal clinical instructors, as they are recent graduates who have excelled in their residency programs. To effectively use the limited time available for education, chief residents can implement active learning techniques. We present a chief resident-led, small-group, problem-based curriculum for teaching first-year internal medicine residents, and provide preliminary data supporting the efficacy of this approach. METHODS: The seminar consisted of 11 4-week modules. Week 1 was a team-based crossword competition. Weeks …


Intravenous Albumin Infusion Is An Effective Therapy For Hyponatremia In Patient With Malignant Ascites, K. D. Jhaveri, A. Chawla, C. Xu, A. Hazzan Jan 2014

Intravenous Albumin Infusion Is An Effective Therapy For Hyponatremia In Patient With Malignant Ascites, K. D. Jhaveri, A. Chawla, C. Xu, A. Hazzan

Journal Articles

There are few reports about the treatment of moderate to severe hyponatremia associated with malignant liver metastasis. Here, we report using intravenous salt poor albumin infusion to treat hypervolemic cirrhosis related hyponatremia. A 58-year-old female with ascites secondary to metastatic breast cancer was referred to our department with symptomatic hyponatremia (serum sodium concentration of 121 mEq/L). The serum sodium level was corrected slowly over 2 days with intravenous albumin infusion and the patient's symptoms - fatigue, nausea, dizziness and headache improved.


Magnesium Protects Against Cisplatin-Induced Acute Kidney Injury By Regulating Platinum Accumulation, M. H. Solanki, P. K. Chatterjee, M. Gupta, X. Y. Xue, A. Plagov, M. H. Metz, R. Mintz, P. C. Singhal, C. N. Metz Jan 2014

Magnesium Protects Against Cisplatin-Induced Acute Kidney Injury By Regulating Platinum Accumulation, M. H. Solanki, P. K. Chatterjee, M. Gupta, X. Y. Xue, A. Plagov, M. H. Metz, R. Mintz, P. C. Singhal, C. N. Metz

Journal Articles

Despite its success as a potent antineoplastic agent, similar to 25% of patients receiving cisplatin experience acute kidney injury (AKI) and must discontinue therapy. Impaired magnesium homeostasis has been linked to cisplatin-mediated AKI, and because magnesium deficiency is widespread, we examined the effect of magnesium deficiency and replacement on cisplatin-induced AKI in physiologically relevant older female mice. Magnesium deficiency significantly increased cisplatin-associated weight loss and markers of renal damage (plasma blood urea nitrogen and creatinine), histological changes, inflammation, and renal cell apoptosis and modulated signaling pathways (e.g., ERK1/2, p53, and STAT3). Conversely, these damaging effects were reversed by magnesium. Magnesium …


Modulation Of Renin Angiotensin System Predominantly Alters Sclerotic Phenotype Of Glomeruli In Hivan, A. Plagov, X. Q. Lan, P. Rai, D. Kumar, R. Lederman, S. Rehman, A. Malhotra, G. H. Ding, P. N. Chander, P. C. Singhal Jan 2014

Modulation Of Renin Angiotensin System Predominantly Alters Sclerotic Phenotype Of Glomeruli In Hivan, A. Plagov, X. Q. Lan, P. Rai, D. Kumar, R. Lederman, S. Rehman, A. Malhotra, G. H. Ding, P. N. Chander, P. C. Singhal

Journal Articles

HIV-associated nephropathy (HIVAN) is a common complication of HIV-1 infection in patients with African ancestry in general and with APOL1 gene risk variants in particular. Although collapsing glomerulopathy is considered a hallmark of HIVAN, significant numbers of glomeruli in patients with HIVAN also display other variants of focal segmental glomerulosclerosis (FSGS). We propose that collapsed glomeruli as well as glomeruli with other variants of FSGS are manifestations of HIVAN and their prevalence depends on associated host factors. We explored the role of the renin-angiotensin system (RAS) in the manifestation of any specific glomerular phenotype in HIVAN. To evaluate the role …


Necrotizing Rpgn With Linear Anti Igg Deposits In A Patient With History Of Granulomatosis With Polyangiitis: A Case Report, N. Parekh, E. Epstein, S. El-Sayegh Jan 2014

Necrotizing Rpgn With Linear Anti Igg Deposits In A Patient With History Of Granulomatosis With Polyangiitis: A Case Report, N. Parekh, E. Epstein, S. El-Sayegh

Journal Articles

INTRODUCTION: Diagnosing the etiology of a rapidly progressive glomerulonephritis is of vital importance to guide appropriate therapeutic management. This case highlights the complexity involved in establishing diagnosis when presentation is atypical. In certain cases diagnosis cannot be established based on clinical presentation or biopsy findings alone, and critical analysis of biopsy findings in context of clinical presentation is crucial to guide the clinical decision-making process. CASE PRESENTATION: A 47-year-old Hispanic male with history of granulomatosis with polyangiitis (GPA) in remission on azathioprine, presented with fatigue and lethargy. Physical examination was unremarkable. Laboratory data revealed elevated creatinine and otherwise normal electrolytes. …


Renin Angiotensin System Modulates Mtor Pathway Through At2r In Hivan, P. Rai, R. Lederman, S. Hague, S. Rehman, V. Kumar, K. Sataranatrajan, A. Malhotra, B. S. Kasinath, P. C. Singhal Jan 2014

Renin Angiotensin System Modulates Mtor Pathway Through At2r In Hivan, P. Rai, R. Lederman, S. Hague, S. Rehman, V. Kumar, K. Sataranatrajan, A. Malhotra, B. S. Kasinath, P. C. Singhal

Journal Articles

Mammalian target of rapamycin (mTOR) has been reported to contribute to the development of HIV-associated nephropathy (HI VAN). We hypothesized that HIV may be activating renal tissue mTOR pathway through renin angiotensin system (RAS) via Angiotensin Receptor Type II receptor (AT2R). Renal tissues of Vpr transgenic and Tg26 (HIVAN) mice displayed enhanced phosphorylation of mTOR and p70S6K. Aliskiren, a renin inhibitor attenuated phosphotylation of both mTOR and p70S6K in renal tissues of HIVAN mice. Interestingly, Angiotensin Receptor Type I (AT1R) blockade did not modulate renal tissue phosphorylation of mTOR in HIVAN mice; on the other hand, AT2R blockade attenuated renal …


A 12-Week, Double-Blind, Placebo-Controlled Trial Of Ferric Citrate For The Treatment Of Iron Deficiency Anemia And Reduction Of Serum Phosphate In Patients With Ckd Stages 3-5, G. A. Block, S. Fishbane, M. Rodriguez, G. Smits, S. Shemesh, P. E. Pergola, M. Wolf, G. M. Chertow Jan 2014

A 12-Week, Double-Blind, Placebo-Controlled Trial Of Ferric Citrate For The Treatment Of Iron Deficiency Anemia And Reduction Of Serum Phosphate In Patients With Ckd Stages 3-5, G. A. Block, S. Fishbane, M. Rodriguez, G. Smits, S. Shemesh, P. E. Pergola, M. Wolf, G. M. Chertow

Journal Articles

BACKGROUND: Iron deficiency anemia and serum phosphate levels > 4.0mg/dL are relatively common in chronic kidney disease stages 3 to 5 and are associated with higher risks of progressive loss of kidney function, cardiovascular events, and mortality. STUDY DESIGN: Double-blind, placebo-controlled, randomized trial. SETTING & PARTICIPANTS: 149 patients with estimated glomerular filtration rates < 60mL/min/1.73m2, iron deficiency anemia (hemoglobin, 9.0-12.0g/dL; transferrin saturation [TSAT]/= 4.0 to 6.0mg/dL. Use of intravenous iron or erythropoiesis-stimulating agents was prohibited. INTERVENTION: Randomization to treatment for 12 weeks with ferric citrate coordination complex (ferric citrate) or placebo. OUTCOMES & MEASUREMENTS: Coprimary end points were change in TSAT and serum phosphate level from baseline to end of study. Secondary outcomes included change from baseline to end of treatment in values for ferritin, hemoglobin, intact fibroblast growth factor 23 (FGF-23), urinary phosphate excretion, and estimated glomerular filtration rate. RESULTS: Ferric citrate treatment increased mean TSAT from 22% +/- 7% (SD) to 32% +/- 14% and reduced serum phosphate levels from 4.5+/-0.6 to 3.9+/-0.6mg/dL, while placebo exerted no effect on TSAT (21% +/- 8% to 20% +/- 8%) and less effect on serum phosphate level (4.7+/-0.6 to 4.4+/-0.8mg/dL; between-group P


Hypersensitivity Reactions To Intravenous Iron: Guidance For Risk Minimization And Management, D. Rampton, J. Folkersen, S. Fishbane, M. Hedenus, S. Howaldt, F. Locatelli, S. Patni, J. Szebeni, G. Weiss Jan 2014

Hypersensitivity Reactions To Intravenous Iron: Guidance For Risk Minimization And Management, D. Rampton, J. Folkersen, S. Fishbane, M. Hedenus, S. Howaldt, F. Locatelli, S. Patni, J. Szebeni, G. Weiss

Journal Articles

Intravenous iron is widely used for the treatment of iron deficiency anemia when oral iron is inappropriate, ineffective or poorly tolerated. Acute hypersensitivity reactions during iron infusions are very rare but can be life-threatening. This paper reviews their frequency, pathogenesis and risk factors, and provides recommendations about their management and prevention. Complement activation-related pseudo-allergy triggered by iron nanoparticles is probably a more frequent pathogenetic mechanism in acute reactions to current formulations of intravenous iron than is an immunological IgE-mediated response. Major risk factors for hypersensitivity reactions include a previous reaction to an iron infusion, a fast iron infusion rate, multiple …


A Letter To The Master Clinician, K. D. Jhaveri Jan 2014

A Letter To The Master Clinician, K. D. Jhaveri

Journal Articles

In this commentary, the author writes a letter to the Master Clinician about his concerns regarding the teaching responsibilities of current faculty members during ward rounds. This short essay highlights the transition that has been noticed in medical training in the last decade.


Spla2 Ib Induces Human Podocyte Apoptosis Via The M-Type Phospholipase A2 Receptor, Y. B. Pan, J. X. Wan, Y. P. Liu, Q. Yang, W. Liang, P. C. Singhal, M. A. Saleem, G. H. Ding Jan 2014

Spla2 Ib Induces Human Podocyte Apoptosis Via The M-Type Phospholipase A2 Receptor, Y. B. Pan, J. X. Wan, Y. P. Liu, Q. Yang, W. Liang, P. C. Singhal, M. A. Saleem, G. H. Ding

Journal Articles

The M-type phospholipase A2 receptor (PLA2R) is expressed in podocytes in human glomeruli. Group IB secretory phospholipase A2 (sPLA2 IB), which is one of the ligands of the PLA2R, is more highly expressed in chronic renal failure patients than in controls. However, the roles of the PLA2R and sPLA2 IB in the pathogenesis of glomerular diseases are unknown. In the present study, we found that more podocyte apoptosis occurs in the kidneys of patients with higher PLA2R and serum sPLA2 IB levels. In vitro, we demonstrated that human podocyte cells expressed the PLA2R in the cell membrane. After binding with …