Nephrology Commons^™

The Effect Of Antihypertensive Dose On Blood Pressure Control In Children With Chronic Kidney Disease, Benjamin A. Matta

Presentations

This presentation describes a study to determine the effect of antihypertensive dosing on blood pressure control in children with chronic kidney disease. The original version of this presentation is a prezi show at https://prezi.com/view/4qluDL1gMKFELOf1nLVA/

Erratum. Sodium-Glucose Cotransporter 2 Inhibition And Diabetic Kidney Disease. Diabetes 2019;68:248-257., Radica Alicic, Joshua J Neumiller, Emily J Cox, Brad P Dieter, Katherine Tuttle

Articles, Abstracts, and Reports

No abstract provided.

Novel Mechanisms And Biomarkers In Alcohol-Induced Organ Injury., Christine E. Dolin

Electronic Theses and Dissertations

Background. Ethanol (EtOH) consumption is known to affect multiple organs; this is unsurprising, as the concentration of EtOH in the blood at relevant doses reaches the millimolar range. The overarching goal of this dissertation was to elucidate mechanisms of alcohol-induced organ injury, specifically the effects of alcohol on the hepatic extracellular matrix (ECM) proteome, the alcoholic hepatitis (AH) plasma peptidome, and the effects of alcohol on the renal cortex proteome and transcriptome. Methods. Mice were pair-fed ethanol-containing liquid diet chronically, and then some mice were administered lipopolysaccharide (LPS). Liver sections from these mice were processed in a series of increasingly …

Relapsing Hcv Associated Glomerulonephritis Despite Sustained Virologic Response (Svr) To Direct-Acting Antivirals (Daa), Joseph Scurozo Do, Wael Hanna Md, Grace Chong Do, Frederick S. Fleszler Md

Department of Medicine

No abstract provided.

Health-Related Quality Of Life In Glomerular Disease., Pietro A. Canetta, Jonathan P. Troost, Shannon Mahoney, Amy J. Kogon, Noelle Carlozzi, Sharon M. Bartosh, Yi Cai, T Keefe Davis, Hilda Fernandez, Alessia Fornoni, Rasheed A. Gbadegesin, Emily Herreshoff, John D. Mahan, Patrick H. Nachman, David T. Selewski, Christine B. Sethna, Tarak Srivastava, Katherine R. Tuttle, Chia-Shi Wang, Ronald J. Falk, Ali G. Gharavi, Brenda W. Gillespie, Larry A. Greenbaum, Lawrence B. Holzman, Matthias Kretzler, Bruce M. Robinson, William E. Smoyer, Lisa M. Guay-Woodford, Bryce Reeve, Debbie S. Gipson, Curegn Consortium

Manuscripts, Articles, Book Chapters and Other Papers

There is scant literature describing the effect of glomerular disease on health-related quality of life (HRQOL). The Cure Glomerulonephropathy study (CureGN) is an international longitudinal cohort study of children and adults with four primary glomerular diseases (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy). HRQOL is systematically assessed using items from the Patient-Reported Outcomes Measurement Informative System (PROMIS). We assessed the relationship between HRQOL and demographic and clinical variables in 478 children and 1115 adults at the time of enrollment into CureGN. Domains measured by PROMIS items included global assessments of health, mobility, anxiety, fatigue, and sleep …

The Effect Of Antihypertensive Dosing On Hypertension In Children With Chronic Kidney Disease, Benjamin A. Matta, Uri S. Alon, Bradley Warady Md, Tarak Srivastava, Darcy Weidemann

Posters

Background

Hypertension (HTN) is a highly prevalent and major risk factor for poor cardiovascular and renal outcomes in chronic kidney disease (CKD). Previous research suggests that HTN is underdiagnosed and undertreated in children with CKD. To our knowledge no studies have investigated the effect of antihypertensive (antiHTN) dose on blood pressure (BP) control in this population.

Objective

To determine the effect of antiHTN dose on HTN status in children with CKD.

Methods

Study population: 255 participants studied in the Chronic Kidney Disease in Children (CKiD) study at their 3rd visit, taking at least 1 antiHTN drug.

Cumulative Drug Dose Index …

Xanthogranulomatous Pyelonephritis: Presentation And Management, Răzvan C. Petca, Răzvan I. Popescu, Cristian Mareș, Claudia Mehedințu, Bogdan Mastalier, Dumitru Cristinel Badiu, Nicoleta Măru, Vlad D. Constantin, Aida Petca

Journal of Mind and Medical Sciences

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and …

Microbiota Signatures In Type-2 Diabetic Patients With Chronic Kidney Disease - A Pilot Study, Gratiela P. Gradisteanu, Roxana A. Stoica, Laura Petcu, Ariana Picu, Adrian P. Suceveanu, Teodor Salmen, Diana S. Stefan, Cristian Serafinceanu, Mariana Carmen Chifiriuc, Anca P. Stoian

Journal of Mind and Medical Sciences

The human microbiota is paramount for normal host physiology. Altered host-microbiome interactions are part of the pathogenesis of numerous common ailments. Currently, much emphasis is placed on the involvement of the microbiome in the pathogenesis of type-2 diabetes mellitus (T2DM), impaired glucose tolerance, and other metabolic disorders (i.e. obesity). Several studies found highly significant correlations of specific intestinal bacteria with T2DM. A better understanding of the role of the microbiome in diabetes and its complications might provide new insights in the development of new therapeutic principles.

Our pilot study investigates the microbiota patterns in Romanian type-2 diabetic patients with diabetic …

Primary Renal Hydatid Cyst – A Review, Lucian Iorga, Radu Anghel, Dragos Marcu, Bogdan Socea, Camelia C. Diaconu, Ovidiu G. Bratu, Liliana F. Andronache, Stana Paunica, Dan Liviu Dorel Mischianu

Journal of Mind and Medical Sciences

The aim of this study was to analyze the clinical presentation, diagnosis and treatment of primary renal hydatidosis. A thorough review of the literature was made using the PubMed database. Cystic echinococcosis is a disease that results from infection with the larval stage of Echinococcus granulosus, a tiny tapeworm found in dogs (definitive host), sheep, cattle, goats, foxes and pigs, amongst others (intermediate hosts).

Humans are accidentally intermediate hosts, who become infected by direct contact with infected dogs, by ingesting contaminated raw or undercooked vegetables or by drinking contaminated water. Renal involvement by hydatid disease is uncommon (less than 3-4%), …

Peritoneal Dialysis Vintage And Glucose Exposure But Not Peritonitis Episodes Drive Peritoneal Membrane Transformation During The First Years Of Pd., Maria Bartosova, Betti Schaefer, Karel Vondrak, Peter Sallay, Christina Taylan, Rimante Cerkauskiene, Maria Dzierzega, Gordana Milosevski-Lomic, Rainer Büscher, Ariane Zaloszyc, Philipp Romero, Felix Lasitschka, Bradley A. Warady, Franz Schaefer, Akos Ujszaszi, Claus Peter Schmitt

Manuscripts, Articles, Book Chapters and Other Papers

The impact of peritoneal dialysis (PD) associated peritonitis on peritoneal membrane integrity is incompletely understood. Children are particularly suited to address this question, since they are largely devoid of preexisting tissue damage and life-style related alterations. Within the International Peritoneal Biobank, 85 standardized parietal peritoneal tissue samples were obtained from 82 children on neutral pH PD fluids with low glucose degradation product (GDP) content. 37 patients had a history of peritonitis and 16 of the 37 had two or more episodes. Time interval between tissue sampling and the last peritonitis episode was 9 (4, 36) weeks. Tissue specimen underwent digital …

Tamsulosin Use After Shock Wave Lithotripsy: A Systematic Review, Katherine Harte

Senior Honors Projects

Urolithiasis, or the formation of stones in the urinary tract, is a potentially painful process that impacts many people across the world. However, the results of clinical trials disagree on the proper treatment and management of kidney stones. One way to help those who have kidney stones is to perform extracorporeal shock wave lithotripsy (SWL), a medical procedure in which shock waves are directed towards kidney stones to prevent them from migrating and causing pain. Following SWL, patients are sometimes given additional medications, such as alpha blockers (e.g., tamsulosin), to aid in the passage of the stones. However, the benefits …

Dr. Warady Wins 2019 Karl D. Nolph Lifetime Achievement Award In Dialysis, Children's Mercy Hospital

Our Story Continues

Bradley Warady, MD, Division Director-Pediatric Nephrology and Director-Dialysis and Transplantation, recently was presented with the 2019 Karl D. Nolph Lifetime Achievement Award in Dialysis at the 39th Annual Dialysis Conference in Dallas.

The Nolph award recognizes individuals whose academic achievements exemplify the academic life of Dr. Nolph and have contributed to unique and broader understanding and application of renal replacement therapies, including peritoneal dialysis.

Global Variation Of Nutritional Status In Children Undergoing Chronic Peritoneal Dialysis: A Longitudinal Study Of The International Pediatric Peritoneal Dialysis Network., Franz Schaefer, Laura Benner, Dagmara Borzych-Dużałka, Joshua Zaritsky, Hong Xu, Lesley Rees, Zenaida L Antonio, Erkin Serdaroglu, Nakysa Hooman, Hiren Patel, Lale Sever, Karel Vondrak, Joseph Flynn, Anabella Rébori, William Wong, Tuula Hölttä, Zeynep Yuruk Yildirim, Bruno Ranchin, Ryszard Grenda, Sara Testa, Dorota Drożdz, Attila J. Szabo, Loai Eid, Biswanath Basu, Renata Vitkevic, Cynthia Wong, Stephen J. Pottoore, Dominik Müller, Ruhan Dusunsel, Claudia Gonzalez Celedon, Marc Fila, Lisa Sartz, Anja Sander, Bradley A. Warady, International Pediatric Peritoneal Dialysis Network (Ippn) Registry

Manuscripts, Articles, Book Chapters and Other Papers

While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was …

Bisphosphonates Can Be Safely Given To Patients With Hypercalcemia And Renal Insufficiency Secondary To Multiple Myeloma, Matthew J. Miller

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Itou K, Fukuyama T, Sasabuchi Y, et al. Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. Journal of Anesthesia. 2012;26(1):20-27. doi: 10.1007/s00540-011-1261-x.

Cystatin C And Risk Of New-Onset Depressive Symptoms Among Individuals With A Normal Creatinine-Based Estimated Glomerular Filtration Rate: A Prospective Cohort Study, Li Haibin, Wang Anxin, Qi Gao, Guo Jin, Li Xia, Wei Wang, Xiang Yutao, Guo Xiuhua

Research outputs 2014 to 2021

The association between cystatin C and depressive symptoms in the general population has not been thoroughly elucidated to date. We investigated the association of cystatin C with new-onset depressive symptoms among individuals with normal creatinine-based estimated glomerular filtration rates (eGFR). In the China Health and Retirement Longitudinal Study, 5111 participants without depressive symptoms or renal dysfunction (eGFR < 60 ml/min/1.73 m

A Survey Study Of Self-Rated Patients' Knowledge About Aki In A Post-Discharge Aki Clinic, Victor M. Ortiz-Soriano, Joseph L. Alcorn Iii, Xilong Li, Madona Elias, Taha Ayach, B. Peter Sawaya, Hartmut H. Malluche, Ron Wald, Samuel A. Silver, Javier A. Neyra

Internal Medicine Faculty Publications

Background: Survivors of acute kidney injury (AKI) are at risk of adverse outcomes. Post-discharge nephrology care may improve patients’ AKI knowledge and prevent post-AKI complications.

Objective: The purpose of this study was to examine patients’ awareness about their AKI diagnosis and self-rated knowledge and severity of AKI before and after their first post-discharge AKI Clinic encounter.

Design: We conducted a pre- and post-survey study among AKI survivors who attended a post-discharge AKI Clinic.

Setting: AKI Clinic at the University of Kentucky Medical Center (October 2016 to December 2017). Education about AKI was based on transformative learning theory and provided through …

Maternal And Gestational Influences On Childhood Blood Pressure., Bonita Falkner

Department of Medicine Faculty Papers

Exposures that contribute to a sub-optimal intrauterine environment can have an effect on the developing fetus. Impaired fetal growth that results in low birth weight is an established risk factor for cardio-metabolic disorders later in life. Recent epidemiologic and prospective cohort studies that include the maternal and gestational period have identified maternal and gestational conditions that confer increased risk for subsequent cardio-metabolic disorders in the absence of low birth weight. Maternal pre-conception health status, including chronic obesity and type 2 diabetes, increase risk for childhood obesity and obesity-related higher blood pressure (BP) in child offspring. Maternal gestational exposures, including gestational …

Blood Volume Analysis As A Guide For Dry Weight Determination In Chronic Hemodialysis Patients: A Crossover Study, Line Malha, Hasan Fattah, Frank Modersitzki, David S. Goldfarb

Internal Medicine Faculty Publications

Background: Volume overload and depletion both lead to high morbidity and mortality. Achieving euvolemia is a challenge in patients with end stage kidney disease on hemodialysis (HD). Blood volume analysis (BVA) uses radiolabeled albumin to determine intravascular blood volume (BV). The measured BV is compared to an ideal BV (validated in healthy controls). We hypothesized that BVA could be used in HD to evaluate the adequacy of the current clinically prescribed “estimated dry weight” (EDW) and to titrate EDW in order to improve overall volume status. We were also interested in the reproducibility of BVA results in end stage kidney …

Ombitasvir, Paritaprevir, Ritonavir, And Dasabuvir With Or Without Ribavirin In Patients With Kidney Disease., David E Bernstein, Albert Tran, Paul Martin, Kris V Kowdley, Marc Bourliere, Mark S Sulkowski, Paul J Pockros, Boris Renjifo, Deli Wang, Diana L Shuster, Daniel E Cohen, Ira M Jacobson

Articles, Abstracts, and Reports

Introduction: Patients with hepatitis C virus (HCV) infection and chronic kidney disease (CKD) are a high-priority population for treatment.

Methods: We performed a

Results: SVR12 rates in patients with stage 1, 2, and 3 CKD were 97% (439/453), 98% (536/547), and 97% (32/33), respectively, with OBV/PTV/r + DSV; and, 96% (1172/1221), 96% (1208/1254), and 93% (55/59), respectively, with OBV/PTV/r + DSV + RBV. Overall rates of serious AEs and renal AEs were 3% (95/3567) and 2% (56/3567), respectively. Factors associated with an eGFR increase of ≥10 ml/min per 1.73 m

Conclusion: OBV/PTV/r + DSV ± RBV achieved high SVR rates …

Editorial Perspective., Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

Candidemia Following Ureteric Stent Placement In A Patient With Type 2 Diabetes Treated With Canagliflozin, Rishi Raj, Jon Hendrie, Aasems Jacob, Derick Adams

Internal Medicine Faculty Publications

A 38-year-old female patient with well-controlled type 2 diabetes mellitus treated with canagliflozin underwent ureteral stent placement for obstructive renal calculi. Ten days following ureteroscopy and ureteral stenting, she developed fevers and blood cultures grew Candida glabrata (C. glabrata). The patient was successfully treated with an extended course of broad-spectrum antibiotics and antifungal agents. The clinical presentation of candidemia is indistinguishable from bacteremia resulting in delay in diagnosis and treatment. Candiduria is commonly seen in patients with type 2 diabetes, however it rarely leads to candidemia in an otherwise healthy person following a relatively simple urologic procedure. Sodium-glucose …

Randomized Controlled Trial Of Subcutaneous Epoetin Alfa-Epbx Versus Epoetin Alfa In End-Stage Kidney Disease, S. Fishbane, B. S. Spinowitz, W. A. Wisemandle, N. E. Martin

Journal Articles

© 2019 Introduction: This double-blind, randomized controlled trial compared the safety and efficacy of subcutaneous epoetin alfa-epbx, an epoetin alfa biosimilar, with the reference product, epoetin alfa, in hemodialysis patients with end-stage kidney disease (ESKD) and anemia who were receiving epoetin alfa maintenance treatment. Methods: Eligible patients (n = 320) were randomized (1:1) to subcutaneous epoetin alfa-epbx or epoetin alfa in a titration phase; patients who demonstrated stable subcutaneous dosing (n = 246) were re-randomized to receive subcutaneous epoetin alfa-epbx or epoetin alfa 1 to 3 times per week in a 16-week maintenance phase. Co-primary endpoints were least-squares mean difference …

Disruption Of Apol1-Mir193a Axis Induces Disorganization Of Podocyte Actin Cytoskeleton, V. Kumar, N. Paliwal, K. Ayasolla, H. Vashistha, A. Jha, N. Chandel, S. Chowdhary, M. A. Saleem, A. Malhotra, P. C. Singhal, +2 Additional Authors

Journal Articles

No abstract provided.

A 30-Year-Old Carrier Of Gaucher Disease With Multiple Myeloma., J. Chadha, T. Sahai, J. Schwimmer, D. Shani

Journal Articles

We are reporting a case of a 30-year-old male with no past medical history who presented with new onset of renal failure, anemia, and splenomegaly and was diagnosed with multiple myeloma. Given the splenomegaly and the patient's Jewish heritage, blood tests were done and the patient was found to be a Gaucher disease carrier. The association of Gaucher disease and multiple myeloma has previously been reported; however, we want to describe the case of a young Gaucher disease carrier who developed multiple myeloma and provide a review of the literature.

Fibrillary Glomerulonephritis: An Update, J. L. Rosenstock, G. S. Markowitz

Journal Articles

© 2019 International Society of Nephrology Fibrillary glomerulonephritis (FGN) is a rare proliferative form of glomerular disease characterized by randomly oriented fibrillar deposits with a mean diameter of 20 nm. By immunofluorescence (IF), the deposits stain for IgG, C3, and κ and λ light chains, suggesting that the fibrils may be composed of antigen-antibody immune complexes. A recent major advance in our understanding of the pathogenesis of FGN resulted from the discovery that a major component of the fibrils is DNA-J heat-shock protein family member B9 (DNAJB9), and immunohistochemical staining for DNAJB9 now makes it possible to diagnose FGN in …

Prediction Of Cardiovascular Outcomes With Machine Learning Techniques: Application To The Cardiovascular Outcomes In Renal Atherosclerotic Lesions (Coral) Study., Tian Chen, Pamela Brewster, Katherine Tuttle, Lance D Dworkin, William Henrich, Barbara A Greco, Michael Steffes, Sheldon Tobe, Kenneth Jamerson, Karol Pencina, Joseph M Massaro, Ralph B D'Agostino, Donald E Cutlip, Timothy P Murphy, Christopher J Cooper, Joseph I Shapiro

Articles, Abstracts, and Reports

Background: Data derived from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study were analyzed in an effort to employ machine learning methods to predict the composite endpoint described in the original study.

Methods: We identified 573 CORAL subjects with complete baseline data and the presence or absence of a composite endpoint for the study. These data were subjected to several models including a generalized linear (logistic-linear) model, support vector machine, decision tree, feed-forward neural network, and random forest, in an effort to attempt to predict the composite endpoint. The subjects were arbitrarily divided into training and testing subsets according …

Serum Amyloid A And Janus Kinase 2 In A Mouse Model Of Diabetic Kidney Disease., Brad P Dieter, Rick L Meek, Robert J Anderberg, Sheryl K Cooney, Jen L Bergin, Hongyu Zhang, Viji Nair, Matthias Kretzler, Frank C Brosius, Katherine Tuttle

Articles, Abstracts, and Reports

BACKGROUND: Serum amyloid A (SAA), a potent inflammatory mediator, and Janus kinase 2 (JAK2), an intracellular signaling kinase, are increased by diabetes. The aims were to elucidate: 1) a JAK2-mediated pathway for increased SAA in the kidneys of diabetic mice; 2) a JAK2-SAA pathway for inflammation in podocytes.

METHODS: Akita diabetic mice (129S6) with podocyte JAK2 overexpression and angiotensin II infusion (4 weeks) were given a JAK1,2 inhibitor (LY03103801, 3 mg/kg/day orally for the last two weeks). Kidneys were immunostained for SAA isoform 3 (SAA3). SAA3 knockout and control mouse podocytes were exposed to advanced glycation end products (AGE) or …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

'Nephrogenic' Systemic Fibrosis Is Mediated By Myeloid C-C Chemokine Receptor 2 Dataset, Catherine Do, Viktor Drel, Chunyan Tan, Duck-Yoon Lee, Brent Wagner

The Kidney Institute of New Mexico

This dataset presents results of an in vivo model of gadolinium-based contrast agent-induced systemic fibrosis. Figure 1 demonstrates that gadolinium-based contrast agent treatment induces dermal fibrosis and hypercellularity of the same magnitude in patients afflicted with ‘nephrogenic’ systemic fibrosis. Electron microscopy demonstrated that systemic gadolinium treatment induced the formation of multinucleated giant cells in the dermis laden with electron-dense, mesh-like nanostructures. Scanning transmission electron microscopy with energy-dispersive spectroscopy revealed that the electron-dense nanoparticles were gadolinium rich. Figure 2 represents the first chimeric model of mice and gadolinium-induced systemic fibrosis (to our knowledge). Lethally-irradiated mice with 5/6 nephrectomy (to model renal …

The Effect Of Dorsal Rhizotomy On Renal Sodium Excretion Following Dorsal Spinal Stimulation, Tanko Tijani Ahmed

All Graduate Theses, Dissertations, and Other Capstone Projects

Hypertension is one of the most common risk factors in the development of heart disease, stroke and end stage renal failure. Sympathetic overactivity is believed to be one of the main mechanism behind resistant hypertension. Renal denervation has been used to treat resistant hypertension, although this procedure is an invasive one. Spinal cord stimulation (SCS) is a known modality to treat ischemic pain, angina pectoris, and peripheral vascular diseases. In previous studies in this laboratory, unilateral spinal cord stimulation in spontaneously hypertensive rat (SHR) at 67% of the motor threshold increased urinary sodium and water excretion significantly, without affecting mean …