Nephrology Commons^™

Mtor Inhibitors Induce Erythropoietin Resistance In Renal Transplant Recipients, Reece Jefferies, Harish Puttagunta, Anoushka Krishnan, Ashley Irish, Ramyasuda Swaminathan, John K. Olynyk

Research outputs 2022 to 2026

Aim: To elucidate the role of mTOR inhibitors on iron, hepcidin and erythropoietin-mediated regulation of hemopoiesis in stable renal transplant recipients (RTR). Background: Impaired hemopoiesis is common following renal transplantation managed using mTOR inhibitors. The mechanisms responsible are uncertain but include direct effects on iron, hepcidin or erythropoietin-mediated hemopoiesis. Methods: We conducted a single center prospective case-control study of 26 adult RTR with stable allograft function. RTR received stable mTOR dosing (cases, 11/26 [42%]) or stable tacrolimus dosing (controls, 15/26 [58%]). Baseline demographics, full blood count, renal function, iron studies, hepcidin-25, Interleukin-6 (IL-6) and erythropoietin (EPO) levels were determined. Results: …

Four Faces Of Cell-Surface Hla Class-I: Their Antigenic And Immunogenic Divergence Generating Novel Targets For Vaccines, Mepur H Ravindranath, Narendranath M Ravindranath, Senthamil R Selvan, Edward J Filippone, Carly J Amato-Menker, Fatiha El Hilali

Department of Medicine Faculty Papers

Leukocyte cell-surface HLA-I molecules, involved in antigen presentation of peptides to CD8+ T-cells, consist of a heavy chain (HC) non-covalently linked to β2-microglobulin (β2m) (Face-1). The HC amino acid composition varies across all six isoforms of HLA-I, while that of β2m remains the same. Each HLA-allele differs in one or more amino acid sequences on the HC α1 and α2 helices, while several sequences among the three helices are conserved. HCs without β2m (Face-2) are also observed on human cells activated by malignancy, viral transformation, and cytokine or chemokine-mediated inflammation. In the absence of β2m, the monomeric Face-2 exposes immunogenic …

Glomerular Biomechanical Stress And Lipid Mediators During Cellular Changes Leading To Chronic Kidney Disease., Mukut Sharma, Vikas Singh, Ram Sharma, Arnav Koul, Ellen T. Mccarthy, Virginia J. Savin, Trupti Joshi, Tarak Srivastava

Manuscripts, Articles, Book Chapters and Other Papers

Hyperfiltration is an important underlying cause of glomerular dysfunction associated with several systemic and intrinsic glomerular conditions leading to chronic kidney disease (CKD). These include obesity, diabetes, hypertension, focal segmental glomerulosclerosis (FSGS), congenital abnormalities and reduced renal mass (low nephron number). Hyperfiltration-associated biomechanical forces directly impact the cell membrane, generating tensile and fluid flow shear stresses in multiple segments of the nephron. Ongoing research suggests these biomechanical forces as the initial mediators of hyperfiltration-induced deterioration of podocyte structure and function leading to their detachment and irreplaceable loss from the glomerular filtration barrier. Membrane lipid-derived polyunsaturated fatty acids (PUFA) and their …

Glomerular Biomechanical Stress And Lipid Mediators During Cellular Changes Leading To Chronic Kidney Disease, Mukut Sharma, Vikas Singh, Ram Sharma, Arnav Koul, Ellen T. Mccarthy, Virginia J. Savin, Trupti Joshi, Tarak Srivastava

Biomedical Sciences

Hyperfiltration is an important underlying cause of glomerular dysfunction associated with several systemic and intrinsic glomerular conditions leading to chronic kidney disease (CKD). These include obesity, diabetes, hypertension, focal segmental glomerulosclerosis (FSGS), congenital abnormalities and reduced renal mass (low nephron number). Hyperfiltration-associated biomechanical forces directly impact the cell membrane, generating tensile and fluid flow shear stresses in multiple segments of the nephron. Ongoing research suggests these biomechanical forces as the initial mediators of hyperfiltration-induced deterioration of podocyte structure and function leading to their detachment and irreplaceable loss from the glomerular filtration barrier. Membrane lipid-derived polyunsaturated fatty acids (PUFA) and their …

Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe

Master of Science in Nursing Theses and Projects

Infection in the dialysis access of a patient can be detrimental to the health of a dialysis patient. For this reason, infection control is extremely important in the outpatient hemodialysis setting. The goal of this project is to prevent infection during dialysis treatment initiation. This goal will be achieved during a 5-week project in which staff of an outpatient hemodialysis unit will be directly observed and then educated on the importance of infection control during treatment initiation. Staff will be given education on areas that need improvement regarding infection control during treatment initiation. The staff will be able to use …

Does Tight Glycemic Control Slow The Progression Of Chronic Kidney Disease?, Elani Dodd

Graduate Research Projects

No abstract provided.

Syndrome Or Secret: An Up-Close Look At Nephrotic Syndrome, Jin Yun, Do, Claire Kassakian, Md, Vanderleen Kung, Md

Poster Presentations

No abstract provided.

Kidney Disease After Heart And Lung Transplantation, Carlos M Zapata, Hassan N Ibrahim

Faculty, Staff and Student Publications

Chronic kidney disease (CKD) is not only common after lung and heart transplantation but also is associated with increased morbidity and mortality due to multiple pre-, peri- and post-transplant factors. While the exact incidence of CKD in this population is not well-defined, it seems to have gradually increased over the years as older recipients are more frequently considered. The increasing success of the procedure and expanding transplant candidate pool has allowed many with comorbid conditions to receive a transplant, which was considered prohibitive in the past. This review presents risk factors that have been linked to CKD as well as …

#Askrenal: Use Of An Automated Twitter Account To Crowdsource Nephrology Queries, Jade M. Teakell, Alicja Rosolowska, Swapnil Hiremath, Matthew A. Sparks, Edgar V. Lerma, Joel M. Topf, Nikhil A. Shah

Conference Presentation Abstracts

Background: Social media platforms are used in contemporary crowdsourcing, and Twitter is apt for reaching a large number of people with a common interest. Users, especially those with a small follower count may find it challenging to reach a large audience. #AskRenal was developed as a Twitter crowdsourcing tool to help users get answers to nephrology questions. We hypothesized that the #AskRenal hashtag could be used by anyone to receive helpful and timely responses to simple or complex nephrology questions posed on the social media platform. Methods: A Twitter account @AskRenal, and an online Twitter bot that automatically retweeted any …

Impact Of Difelikefalin On 5d-Itch Domains In Patients With Ckd-Associated Pruritus, Anjay Rastogi, Joel M. Topf, Thilo Schaufler, Isabelle Morin, Frederique Menzaghi, Warren Wen, Kieran Mccafferty

Conference Presentation Abstracts

Background: Chronic kidney disease-associated pruritus (CKD-aP) is common in hemodialysis (HD) patients, impacting quality of life (QoL). In the Phase 3 KALM studies, difelikefalin (DFK), a selective kappa opioid receptor agonist approved in the United States and Europe for the treatment of moderate–severe pruritus in adults undergoing HD, improved itch intensity and QoL. The impact of DFK treatment on the subdomains of the 5D-itch scale (a multidimensional questionnaire validated in patients with chronic pruritus) were explored.

Methods: In this pooled KALM-1 and KALM-2 analysis (n=712), HD patients with moderate–severe CKD-aP were randomized 1:1 to receive intravenous DFK 0.5 µg/kg or …

Renal Disease And The Heart, Hassan N Ibrahim

Faculty, Staff and Student Publications

No abstract provided.

Urinary T Cells Are Detected In Patients With Immune Checkpoint Inhibitor-Associated Immune Nephritis That Are Clonotypically Identical To Kidney T Cell Infiltrates, Shailbala Singh, Leticia C Clemente, Edwin R Parra, Amanda Tchakarov, Chao Yang, Yisheng Li, James P Long, Cassian Yee, Jamie S Lin

Faculty, Staff and Student Publications

Acute kidney injury (AKI) occurs in ~20% of patients receiving immune checkpoint inhibitor (ICI) therapy; however, only 2-5% will develop ICI-mediated immune nephritis. Conventional tests are nonspecific in diagnosing disease pathology and invasive procedures (i.e. kidney biopsy) may not be feasible. In other autoimmune renal diseases, urinary immune cells correlated with the pathology or were predictive of disease activity. Corresponding evidence and analysis are absent for ICI-mediated immune nephritis. We report the first investigation analyzing immune cell profiles of matched kidney biopsies and urine of patients with ICI-AKI. We demonstrated the presence of urinary T cells in patients with immune …

Dual Paraneoplastic Syndrome In Small Lung Cancer, Kamil Sardarli, Austin M. Morris, Jamal Abukhaled

Conference Presentation Abstracts

Introduction: Small cell lung cancer (SCLC) is an aggressive neuroendocrine lung cancer associated with paraneoplastic syndromes – syndrome of inappropriate ADH (SIADH) in 7-16% of cases and Ectopic ACTH Syndrome (EAS) in 3.5-4.3% of cases. Both syndromes are associated with a poor prognosis in patients with SCLC. We describe a patient who presented with SIADH, leading to a diagnosis of SCLC who subsequently developed EAS. Case Description: A 71-year-old female with a past medical history of hypertension, depression, and tobacco use presented with lethargy. She noted headache, but otherwise was unable to provide history due to altered mentation. Per her …

The Similarities And Differences Between Glomerular Vs. Non-Glomerular Diagnoses On Intelligence And Executive Functions In Pediatric Chronic Kidney Disease: A Brief Report., Stephen R. Hooper, Rebecca J. Johnson, Marc Lande, Matthew Matheson, Shlomo Shinnar, Amy J. Kogon, Lyndsay Harshman, Joann Spinale, Arlene C. Gerson, Bradley A. Warady, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

Pediatric chronic kidney disease (CKD) appears to be a heterogeneous group of conditions, but this heterogeneity has not been explored with respect to its impact on neurocognitive functioning. This study investigated the neurocognitive functioning of those with glomerular (G) vs. non-glomerular (NG) diagnoses. Data from the North American CKiD Study were employed and the current study included 1,003 children and adolescents with mild to moderate CKD. The G Group included 260 participants (median age = 14.7 years) and the NG Group included 743 individuals (median age = 9.0 years). Neurocognitive measures assessed IQ, inhibitory control, attention regulation, problem solving, working …

The Association Of Rs187238, Rs19465518 And Rs1946519 Il-8 Polymorphisms With Acute Kidney Injury In Preterm Infants, Fiva Aprilia Kadi

BioMedicine

ABSTRACT

Background: Interleukin 18 (IL-18) promoter polymorphisms (-656G>T, -607C>A, and -137G>C) affect serum IL-18 (sIL-18) levels and are associated with renal injury.

Purpose: This study aimed to determine the diagnostic utility of sIL-18 and urine IL-18 (uIL-18) as biomarkers for acute kidney injury (AKI) and analyse the association of IL-18 polymorphisms to AKI in preterm infants.

Methods: Blood and urine samples were collected from 56 preterm infants with AKI and 56 without AKI to measure serum creatinine (SCr), sIL-18, and uIL-18. Genotyping of polymorphisms was performed and analysed, with AUC-ROCs analysis used to evaluate …

Dna Damage Is Overcome By Trip13 Overexpression During Cisplatin Nephrotoxicity, Taketsugu Hama, Prashanth K.B. Nagesh, Pallabita Chowdhury, Bob M. Moore Ii, Murali M. Yallapu, Kevin R. Regner, Frank Park

School of Medicine Publications

Cisplatin is a commonly used chemotherapeutic agent to treat a wide array of cancers that is frequently associated with toxic injury to the kidney due to oxidative DNA damage and perturbations in cell cycle progression leading to cell death. In this study, we investigated whether thyroid receptor interacting protein 13 (TRIP13) plays a central role in the protection of the tubular epithelia following cisplatin treatment by circumventing DNA damage. Following cisplatin treatment, double-stranded DNA repair pathways were inhibited using selective blockers to proteins involved in either homologous recombination or non-homologous end joining. This led to increased blood markers of acute …

Thrombotic Microangiopathy, An Unusual Form Of Monoclonal Gammopathy Of Renal Significance: Report Of 3 Cases And Literature Review., Edward J. Filippone, Eric D. Newman, Li Li, Rakesh Gulati, John L. Farber

Department of Medicine Faculty Papers

Monoclonal gammopathies result from neoplastic clones of the B-cell lineage and may cause kidney disease by various mechanisms. When the underlying clone does not meet criteria for a malignancy requiring treatment, the paraprotein is called a monoclonal gammopathy of renal significance (MGRS). One rarely reported kidney lesion associated with benign paraproteins is thrombotic microangiopathy (TMA), provisionally considered as a combination signifying MGRS. Such cases may lack systemic features of TMA, such as a microangiopathic hemolytic anemia, and the disease may be kidney limited. There is no direct deposition of the paraprotein in the kidney, and the presumed mechanism is disordered …

Acute Kidney Injury: Analysis Of 175 Cases In Al-Mukalla, Hadhramout, Hussein Saeed Alghazali, Ahmed Mubark Daakik, Abdalrahim Abdulla Bahashwan, Mohammed Rasheed Bamekhlah

Hadhramout University Journal of Natural & Applied Sciences

This was a retrospective descriptive study of acute kidney injury patients admitted at Al-Mukalla Central Hospitals, Hadhramout, between January 2017 and April 2019. All cases were 175; divided to two groups, patients with age less than 40 years (Group I) 44.6%, and patients of age more than 40 years (Group II) were 55.4%. Age of male patients ranged between 18-39 years and age of female patients ranged between 18-38 years. Group I included 28 males (31.1%) and 50 females (58.8%), Group II included 62 males (68.9%) and 35 females (41.2%). Risk factors in relation to age groups were: diabetes mellitus …

Recurrent Focal Segmental Glomeruloscleosis Progressing To Collapsing Glomerulopathy In Renal Graft Of An Autopsy Study, C Thorburn, K J Jabbar, W Li, H Kanaan, P Zhang

Conference Presentation Abstracts

Introduction/Objective: Collapsing glomerulopathy (CGN) mainly occurs in patients of African descent because a majority of these patients have APOL-1 gene mutations that results in damage of terminally differentiated podocytes, diffuse fusion of foot processes, and podocyte hyperplasia. Idiopathic FSGS is associated with high rates of recurrent FSGS in renal transplants and can be seen in patients with APOL-1 gene mutations as well, but recurrent FSGS progressing to CGN is not reported. Here we report an autopsy case with renal transplant showing recurrent FSGS progressing to CGN. Methods/Case Report: Our patient was a 32 year old African American man who had …

A Review Of Mobile Apps For Chronic Kidney Disease Patients, Clarisse Zigan, Carl Russell Iii, Kirsten Wozniak, Kshaunish Soni

The Journal of Purdue Undergraduate Research

No abstract provided.