Nephrology Commons^™

Faktor Prediktif Post Dialysis Fatigue Sedang Pada Pasien Yang Menjalani Hemodialisis Reguler, Ivan Virnanda Amu, Maruhum Bonar H Marbun, Pringgodigdo Nugroho, Ikhwan Rinaldi, Hamzah Shatri, Nunuk Mardiana, Rudy Hidayat, Endang Susalit, Evy Yunihastuti, Dyah Purnamasari, Elizabeth Y. Wardoyo

Jurnal Penyakit Dalam Indonesia

Introduction. Fatigue is often found in patients with CKD-HD. Fatigue serves as an indicator of mortality and may be a viable target in a treatment strategy. Current research has not established the determinants of moderate PDF in individuals with CKD who are undergoing HD. Therefore, this study was conducted to prove the predictor factors of moderate PDF.

Methods. A retrospective cohort study in CKD-HD patients at Fatmawati Central General Hospital during the period of November-December 2024. The independent variables of this study are comorbidities, MIS, depression, intradialytic SBPV, dialysis vintage, UFG, IDWG, and anemia status. Primary data from …

The Effectiveness Of A Chronic Care Management Program On Hospitalization Rates And Quality Of Life In Chronic Kidney Disease Patients, Sophie Burris

Doctoral Projects

Chronic Kidney Disease (CKD) is a progressive condition that distinctively affects underserved rural communities due to limited access to healthcare, provider shortages, and transportation barriers. Chronic Care Management (CCM) has emerged as a patient-centered, initiative-taking approach that emphasizes care coordination and self-management support. The purpose of this doctoral project was to evaluate the impact of implementing a CCM program in Caucasian females over the age of 40 with CKD residing in an underserved rural community post hospitalization. The Chronic Care Model (CCM) is the framework that guides the doctoral project which compared outcomes in patients enrolled in a CCM program …

Knowledge Mapping And Visualized Analysis Of Research Progress In Onconephrology: A Bibliometric Analysis, Yiwei Wang, Shuling Fan, Wei Wang

Faculty, Staff and Student Publications

Objectives: Onconephrology is an expanding subspecialty focused on the management of cancer patients with renal injury. This study used a comprehensive bibliometric analysis to emphasize the need for cooperation between oncologists and nephrologists, exploring current trends and future research areas in onconephrology.

Methods: Relevant literature on onconephrology published between 1 January 2000 and 27 April 2024 was retrieved from the Science Citation Index Expanded of the Web of Science Core Collection, followed by manual screening. Bibliometric analyses were performed using CiteSpace, VOSviewer, and Bibliometrix software.

Results: A total of 1,853 publications, including 1,647 articles and 206 reviews, by 11,606 authors …

Clinical Characteristics And Risk Factors Associated With Acute Kidney Injury Among Hospitalized Primary Covid-19 Infected Patients, Monchai Siribamrungwong, Kamontip Chaikomon

Chulalongkorn Medical Journal

Background: Coronavirus disease 19 (COVID-19) mainly affects to respiratory system from mild to severe symptoms. Additionally, acute kidney injury (AKI) is an important complication causing substantially high morbidity and mortality. During the pandemic of COVID-19, Public health care in Thailand experienced many cases and complications.

Objectives: This study demonstrated an incidence, clinical characteristic, independent risk factors of AKI and mortality in hospitalized COVID-19 patients with AKI and non-AKI patients.

Methods: A retrospective, observational study was performed in Lesdsin Hospital from August 2021 to August 2022. A total of 576 hospitalized patients with diagnosis of COVID-19 infection were analyzed. AKI was …

Association Of Acute Kidney Injury Risk And Same-Day Discharge Practices After Percutaneous Coronary Intervention., Anezi Uzendu, Rayan El Zein, Jennifer A Rymer, Dan D Nguyen, R Angel Garcia, Nobuhiro Ikemura, Neel Butala, Howard M Julien, Saket Girotra, Dharam J Kumbhani, Oladipupo Olafiranye, Rebecca Young, Leo Brothers, John A Spertus

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after percutaneous coronary intervention (PCI) may be altered when complications occur. We sought to determine whether risk of the most common complication, acute kidney injury (AKI), is associated with SDD in practice.

METHODS: Using the NCDR (National Cardiovascular Data Registry) CathPCI registry, we calculated the AKI risk for elective PCIs from 2018 to 2022 using the NCDR prediction model. Hierarchical logistic regression models were constructed to predict SDD with AKI risk and procedural variables as fixed effects, and site as a random effect. Trends in SDD rate across AKI risk categories were described and variability across …

Centrally Inserted Central Catheter Placement Using A Novel, Handheld, Image-Guided, Robotic Device: Results Of Initial Feasibility Trial In Patients, James P Herlihy, William E Cohn, Adrian Ebner

Faculty, Staff and Students Publications

Background: Central venous access devices (CVADs) are an essential and widely used tool for the treatment of the critically ill, patients undergoing major surgery, and for many patients requiring hemodialysis. Automation of centrally inserted central catheters (CICCs) could potentially make CVAD placement safer, more effective, and more accessible. A new device that uses ultrasound image-guided, robotic needle placement, in addition to traditional Seldinger technique, to place a CICC is described.

Objective: The device was used in a small, first-in-human, trial for placing non-tunneled hemodialysis catheters (NTHDCs), in order to determine feasibility of clinical use.

Methods: Consecutive patients requiring a NTHDC, …

Nonglomerular Hypocomplementemic Interstitial Nephritis, Tyler Hemphill, Yogesh Sanghvi

HCA Healthcare Journal of Medicine

Background

Acute interstitial nephritis (AIN) is the most common cause of acute kidney injury (AKI) with subsequent renal impairment and is often underdiagnosed. Acute interstitial nephritis presents with a decline in kidney function and is characterized by an inflammatory infiltrate in the kidney interstitium. It is most often induced by drug therapy and is sometimes followed by infections with unknown causes. In a typical presentation of AIN, there is no evidence of hypocomplementemia; low complement is associated most commonly with autoimmune etiologies. Renal biopsy serves as the most definitive test for both the diagnosis and prognosis of AIN.

Case Presentation …

Metabolic Acidosis And Cardiovascular Disease Risk In Children With Ckd., Denver D. Brown, Jennifer Roem, Kimberly Reidy, Susan Furth, Bradley A. Warady, Michal Melamed, Tammy Brady, Ckid Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

KEY POINTS: Metabolic acidosis may be associated with adverse cardiovascular disease risk. Prospective studies of the benefit of alkali therapy on cardiovascular disease risk are needed.

BACKGROUND: The link between metabolic acidosis (MA) and cardiovascular disease (CVD) outcomes has been studied in adults but not in children with CKD where MA is a common and early finding. Using longitudinal BP and cardiac measurement data, we evaluated whether low serum bicarbonate (a surrogate for MA) is associated with adverse CVD risk.

METHODS: This study used data from children age 1 year and older with eGFRs between 30 and 90 ml/min per …

Assessment And Management Of Magnesium And Trace Element Status In Children With Ckd Stages 2-5, On Dialysis And Post-Transplantation: Clinical Practice Points From The Pediatric Renal Nutrition Taskforce., Jetta Tuokkola, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R Wong Vega, Matthew Harmer, Lyndsay A. Harshman, Christina L. Nelms, Barry Toole, An Desloovere, Fabio Paglialonga, Nonnie Polderman, José Renken-Terhaerdt, Rukshana Shroff, Evelien Snauwaert, Stella Stabouli, Johan Vande Walle, Bradley A. Warady, Vanessa Shaw, Larry A. Greenbaum

Manuscripts, Articles, Book Chapters and Other Papers

Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were …

Serum Factors In Primary Podocytopathies, Edward J. Filippone, John L. Farber

Division of Nephrology Faculty Papers

Primary podocytopathies, including minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), are caused by a circulating factor or factors injurious to the podocyte. An immunologic origin seems likely based on responsiveness to corticosteroids or other immunosuppressive agents, including calcineurin inhibitors targeting T-cells and rituximab targeting B-cells. Potential non-antibody-mediated circulating factors have been identified, including cardiotrophin-like cytokine 1, soluble urokinase plasminogen activator receptor, and angiopoietin-like 4, among others. More recent research supports a primary antibody pathogenesis, with anti-nephrin antibodies found in a significant percentage of cases. Such antibodies also predict recurrence after transplantation. Other potential antigenic targets besides nephrin include …

Cervical Cancer Disparities In Hispanic Women: A Multilevel Analysis Using Seer And Texas State Data, Aura M. C. Calderon, Ivan Mogollon, Shubhank Goyal, Jose Loayza, Everardo Cobos, Diane Nguyen

Research Colloquium

Background: Cervical carcinoma continues to exert a disproportionate burden on Hispanic women within the United States, notably in jurisdictions such as Texas, where individuals of Hispanic descent constitute more than 40% of the demographic populace. Notwithstanding progress in screening methodologies and preventive measures, considerable disparities persist in incidence rates, mortality figures, and survival outcomes when assessed through the lens of racial and ethnic stratifications.

Objective: To examine and visually communicate disparities in cervical cancer burden among Hispanic women through a combination of national survival data and Texas state-level incidence and mortality statistics.

Methods: Publicly accessible datasets were employed from the …

Case Report: Familial Hypomagnesemia In A Patient With History Of Hodgkin Lymphoma, Aura M. C. Calderon, Ivan Mogollon, Catherine Matos, Jose Loayza, Everardo Cobos

Research Colloquium

Introduction: Magnesium constitutes an essential electrolyte integral to the functioning of neuromuscular systems, the regulation of cardiovascular parameters, and the facilitation of metabolic processes. Chronic hypomagnesemia may precipitate significant complications, including the onset of arrhythmias and seizures. In cases where hypomagnesemia is refractory to supplementation and manifests in multiple family members, a hereditary tubulopathy, such as Gitelman syndrome (GS), warrants consideration. Gitelman syndrome is classified as an autosomal recessive disorder, resulting from mutations in the SLC12A3 gene, which impairs the thiazide-sensitive sodium-chloride cotransporter located in the distal convoluted tubule.

Case Presentation: A 39-year-old female with a history of classical Hodgkin …

Advancing Ckd Diagnosis: Race-Free Egfr, Cystatin C, And Genetic Insights, Halah Tariq Albar

Saudi Toxicology Journal

Globally, the rates of chronic kidney disease (CKD) are increasing due to the increasing incidence of hypertension, obesity, and diabetes mellitus. Early detection and treatment of kidney disease are essential in improving health outcomes. Estimate glomerular filtration rate (eGFR) is used to diagnose, stage, and manage CKD. CKD biomarkers are broadly categorized into traditional (serum creatinine), emerging (cystatin C), and disease specific (Interleukin-6). The purpose of this narrative review is to synthesize the current evidence regarding the use of eGFR in diverse populations. The initial eGFR equations included race variables, which created a controversial debate about their relevancy and has …

Clinical Uptake Of An Antigen-Based Approach To Membranous Nephropathy: A Survey Of General Nephrologists And Glomerular Disease Experts., Eibhlin Goggins, Andrew Delaat, Bryce Barr, Jonathan Taliercio, Ali Mehdi, Georges Nakhoul, Brendan Bowman, Corey Cavanaugh

Ambulatory and Primary Care Articles

BACKGROUND: In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.

METHODS: We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.

RESULT: PLA2R, THSD7A, NELL1, and EXT1/2 testing were readily available while the most common response for other antigen testing was 'Not Performed' or 'Unknown'. All respondents had tested for or treated PLA2R-positive MN. Of 79 …

A Novel “Stairstep” Approach To The Management Of Extreme Hypernatremia Using Continuous Kidney Replacement Therapy And Hypertonic Saline, Bahar Barani, Xuexin Lu, Darcy Weidemann, Judith Vansickle, Vimal Chadha, Nathan Beins

Posters

Hypernatremia is defined as a serum sodium greater than 145 mEq/L and is due to either a deficit of free water or excess sodium intake. Extreme hypernatremia (sodium level > 190 mEq/L) is immediately life–threatening with mortality rates > 60%. It is especially challenging to avoid complications, such as permanent neurological injury, respiratory failure, and profound electrolyte derangement, when children are in kidney failure. Established guidelines are lacking for correcting such extreme levels due to a paucity of information in the literature, although general recommendations are to decrease levels by no more than 10-12 mEq/L per day to prevent neurological complications. We …

The Role Of Serum Phosphate Control In Supporting Transplant Readiness In Patients On Dialysis, Laura A Williams, Stephen Z Fadem

Faculty, Staff and Students Publications

Chronic kidney disease affects over 36 million Americans, with more than 800,000 progressing to end-stage kidney disease (ESKD). Treatment with kidney transplantation offers superior survival, quality of life, and cost-effectiveness compared with dialysis, yet access remains limited. Hyperphosphatemia is a highly prevalent and modifiable complication of ESKD that contributes to cardiovascular disease, mineral bone disorder, and potential pulmonary dysfunction. Additionally, elevated serum phosphate has been linked to transplant graft failure and adverse post-transplant outcomes. Although normal phosphate levels are not formally required for transplant eligibility, they are frequently considered as part of transplant readiness assessments. Persistent gaps between clinical guideline …

Targeting Sting To Disrupt Macrophage-Mediated Adhesion In Encapsulating Peritoneal Sclerosis, Juan Sun, Yuxiang Sun, Dandan Guo, Huolin Ye, Qiang Huang, Hu Zhou, Canming Li, Mei Liao, Yujia You, Hongli Shang, Pan Zhou, Dongxuan Wu, Janusz Witowski, Zhaoyong Hu, Hui Peng

Faculty, Staff and Students Publications

Encapsulating peritoneal sclerosis (EPS) is a life-threatening fibrotic condition characterized by severe abdominal adhesions, chronic inflammation, and significant morbidity. The lack of effective treatments for EPS stems from a limited understanding of its underlying mechanisms. In this study, we developed a modified mouse model of PD-induced EPS and investigated the role of the STING signaling pathway in disease progression. Our findings reveal that STING activation in peritoneal mesothelial cells significantly increases the secretion of the macrophage chemokine CCL2, leading to enhanced macrophage infiltration and the formation of pathological adhesions. Notably, pharmacological inhibition of STING using the inhibitor H151 effectively reduced …

Cryptococcoid Sweet Syndrome Or Halogenoderma? Highlighting The Crucial Need For Serum Iodine Testing, Jacob R. Kilgore, Jonathan M. Joseph, Addie Walker, William Snider, Nicholas Culotta, Carson Bogatto, Aaron Coulon

School of Medicine Faculty Publications

No abstract provided.

Dual-Function Polyester Nanoparticles For Amplified Anti-Inflammatory Effects, Ingrid M Heyns, Abiodun T Wahab, Raghu Ganugula, David Sheikh-Hamad, M N V Ravi Kumar, Meenakshi Arora

Faculty, Staff and Students Publications

This study investigates a dual-acting drug delivery system using naringenin (NAR) as a folate receptor ligand to enhance intestinal uptake and encapsulated NAR for combating inflammation. The dual-acting systems were tested in vitro on cisplatin-induced human kidney-2 cells and in vivo in a mouse model of cisplatin-induced acute kidney injury (AKI). NAR-loaded passive nanoparticles [P2Ns(NAR)] and dual-acting systems [P2Ns-NAR(NAR)] showed notable advantages over unformulated NAR, reducing the required dose by up to 57 and 79%, respectively. These nanoparticles modulated immune responses, restored T cell function, and shifted macrophage polarization from proinflammatory M1 to tissue-repairing M2. In addition, P2Ns-NAR(NAR) alleviated AKI …

Drug Development Studies Supporting Zileuton As A Parenteral Adjuvant To Attenuate Antibiotic-Associated Nephrotoxicity, Cole S Hudson, James E Smith, Linh T Vuong, Nicholas S Teran, Nazanin Pouya, David Sheikh-Hamad, Xinli Liu, Shama Kajiji, Vincent H Tam

Faculty, Staff and Students Publications

Glycopeptide, polymyxin, and aminoglycoside antibiotics are among the most commonly used agents to treat drug-resistant bacterial infections; however, their clinical use is hindered by nephrotoxicity. We previously reported that zileuton has the potential to attenuate antibiotic-associated nephrotoxicity in an animal model. Here, we further report the development of a parenteral formulation and exploration of dosing strategies for zileuton. The solubility, stability, and multi-dose safety of two zileuton formulations were evaluated. Zileuton serum and renal tissue pharmacokinetics were evaluated after a single dose and compared to steady state after 10 days. Different dosing strategies of zileuton to attenuate vancomycin-, polymyxin B-, …