Nephrology Commons^™

Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes

Faculty & Staff Scholarship

Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.

Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration …

Mortality And Hospitalizations In Intensive Dialysis: A Systematic Review And Meta-Analysis, A. Mathew, J. A. Mcleggon, N. Mehta, S. Leung, V. Barta, T. Mcginn, G. Nesrallah

Journal Articles

© The Author(s) 2018. Background: Survival and hospitalization are critically important outcomes considered when choosing between intensive hemodialysis (HD), conventional HD, and peritoneal dialysis (PD). However, the comparative effectiveness of these modalities is unclear. Objective: We had the following aims: (1) to compare the association of mortality and hospitalization in patients undergoing intensive HD, compared with conventional HD or PD and (2) to appraise the methodological quality of the supporting evidence. Data Sources: MEDLINE, Embase, ISI Web of Science, CENTRAL, and nephrology conference abstracts. Study Eligibility, Participants, and Interventions: We included cohort studies with comparator arm, and randomized controlled trials …

Barriers To Peritoneal Dialysis In Aboriginal Patients, A. T. Mathew, J. Park, M. Sachdeva, M. M. Sood, K. Yeates

Journal Articles

© The Author(s) 2018. Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study. Setting: The setting involves 3 predialysis clinics in Winnipeg, Kingston, and Moose Factory. Patients: The patients were 99 individuals (67 non-Aboriginal and 32 Aboriginal) who were …

Potentially Avoidable Readmissions In United States Hemodialysis Patients, A. T. Mathew, L. Rosen, R. Pekmezaris, A. Kozikowski, D. W. Ross, T. Mcginn, K. Kalantar-Zadeh, S. Fishbane

Journal Articles

© 2017 International Society of Nephrology Introduction: Patients with end-stage kidney disease have a high risk of 30-day readmission to hospital. These readmissions are financially costly to health care systems and are associated with poor health-related quality of life. The objective of this study was to describe and analyze the frequency, causes, and predictors of 30-day potentially avoidable readmission to hospital in patients on hemodialysis. Methods: We conducted a retrospective cohort study using the US Renal Data System data from January 1, 2008, to December 31, 2008. A total of 107,940 prevalent United States hemodialysis patients with 248,680 index hospital …

Nephropathology Education During Nephrology Fellowship Training In The United States, V. Mechery, T. Hernandez, A. T. Mathew, R. Wanchoo, S. V. Seshan, K. D. Jhaveri, H. H. Shah

Journal Articles

No abstract provided.

Prevalence Of Proteinuria And Albuminuria In An Obese Population And Associated Risk Factors., J. L. Rosenstock, M. Pommier, G. Stoffels, S. Patel, M. F. Michelis

Journal Articles

Obesity has been increasingly recognized as a risk factor for kidney disease and both proteinuria and microalbuminuria have been associated with obesity. The actual prevalence of microalbuminuria and proteinuria in obese patients in the United States (US) has not been clearly described in the literature. Furthermore, obesity is associated with risk factors of kidney disease, such as diabetes and hypertension (HTN), and the prevalence of proteinuria and albuminuria excluding these risk factors is uncertain. In this study, we collected urine albumin/creatinine and urine protein/creatinine ratios on obese patients undergoing bariatric surgery to determine the prevalence of albuminuria and proteinuria in …

Nicotine Enhances Mesangial Cell Proliferation And Fibronectin Production In High Glucose Milieu Via Activation Of Wnt/Beta-Catenin Pathway, X. Lan, H. Wen, R. Aslam, S. S. Shoshtari, A. Mishra, V. Kumar, H. Wang, G. Wu, A. Malhotra, P. C. Singhal, +1 Additional Author

Journal Articles

No abstract provided.

Prevalence Of Proteinuria And Albuminuria In An Obese Population And Associated Risk Factors, J. L. Rosenstock, M. Pommier, G. Stoffels, S. Patel, M. F. Michelis

Journal Articles

©2018 Rosenstock, Pommier, Stoffels, Patel and Michelis. Obesity has been increasingly recognized as a risk factor for kidney disease and both proteinuria and microalbuminuria have been associated with obesity. The actual prevalence of microalbuminuria and proteinuria in obese patients in the United States (US) has not been clearly described in the literature. Furthermore, obesity is associated with risk factors of kidney disease, such as diabetes and hypertension (HTN), and the prevalence of proteinuria and albuminuria excluding these risk factors is uncertain. In this study, we collected urine albumin/creatinine and urine protein/creatinine ratios on obese patients undergoing bariatric surgery to determine …

Modulation Of Apolipoprotein L1-Microrna-193a Axis Prevents Podocyte Dedifferentiation In High-Glucose Milieu, A. Mishra, K. Ayasolla, V. Kumar, X. Lan, H. Vashistha, R. Aslam, A. Hussain, S. Chowdhary, A. Malhotra, P. C. Singhal, +6 Additional Authors

Journal Articles

No abstract provided.

Intravenous Epoetin Alfa-Epbx Versus Epoetin Alfa For Treatment Of Anemia In End-Stage Kidney Disease, S. Fishbane, B. Singh, S. Kumbhat, W. A. Wisemandle, N. E. Martin

Journal Articles

© 2018 by the American Society of Nephrology. Background and objectives This study was conducted to compare the safety and efficacy of intravenous epoetin alfa-epbx, an epoetin alfa biosimilar, to epoetin alfa in patients on hemodialysis with ESKD and anemia. Design, setting, participants, & measurements In this 24-week, multicenter, double-blind comparative efficacy and safety study, 612 patients on hemodialysis with ESKD and anemia who had stable hemoglobin and were receiving stable doses of intravenous epoetin alfa were randomized (1:1) to intravenous epoetin alfa or epoetin alfa-epbx. Dosing was adjusted according to the epoetin alfa prescribing information. The coprimary efficacy endpoints …

Apol1 Risk Variants Cause Podocytes Injury Through Enhancing Endoplasmic Reticulum Stress, H. Wen, V. Kumar, X. Lan, S. S. Shoshtari, J. M. Eng, X. Zhou, F. Wang, H. Wang, A. Malhotra, P. C. Singhal, +4 Additional Authors

Journal Articles

c 2018 The Author(s). Two coding sequence variants (G1 and G2) of Apolipoprotein L1 (APOL1) gene have been implicated as a higher risk factor for chronic kidney diseases (CKD) in African Americans when compared with European Americans. Previous studies have suggested that the APOL1 G1 and G2 variant proteins are more toxic to kidney cells than the wild-type APOL1 G0, but the underlying mechanisms are poorly understood. To determine whether endoplasmic reticulum (ER) stress contributes to podocyte toxicity, we generated human podocytes (HPs) that stably overexpressed APOL1 G0, G1, or G2 (Vec/HPs, G0/HPs, G1/HPs, and G2/HPs). Propidium iodide staining showed …

Relevance Of B-Lines On Lung Ultrasound In Volume Overload And Pulmonary Congestion: Clinical Correlations And Outcomes In Patients On Hemodialysis., Marc M Saad, Jeanne Kamal, E. Moussaly, B. Karam, W. Mansour, Emad Gobran, Saqib Hussen Abbasi, Ahmed Mahgoub, Puja Singh, Ross Hardy, D. Das, C. Brown, M. Kapoor, S. Demissie, M. J. Kleiner, E. El Charabaty, S. E. El Sayegh

Journal Articles

BACKGROUND: Volume overload in patients on hemodialysis (HD) is an independent risk factor for cardiovascular mortality. B-lines detected on lung ultrasound (BLUS) assess extravascular lung water. This raises interest in its utility for assessing volume status and cardiovascular outcomes.

METHODS: End-stage renal disease patients on HD at the Island Rehab Center being older than 18 years were screened. Patients achieving their dry weight (DW) had a lung ultrasound in a supine position. Scores were classified as mild (0-14), moderate (15-30), and severe (>30) for pulmonary congestion. Patients with more than 60 were further classified as very severe. Patients were …

The Social Media Revolution In Nephrology Education, G. B. Colbert, J. Topf, K. D. Jhaveri, T. Oates, M. N. Rheault, S. Shah, S. Hiremath, M. A. Sparks

Journal Articles

© 2018 International Society of Nephrology The past decade has been marked by the increasing use of social media platforms, often on mobile devices. In the nephrology community, this has resulted in the organic and continued growth of individuals interested in using these platforms for education and professional development. Here, we review several social media educational resources used in nephrology education and tools including Twitter, videos, blogs, and visual abstracts. We will also review how these tools are used together in the form of games (NephMadness), online journal clubs (NephJC), interactive learning (GlomCon), and digital mentorship (Nephrology Social Media Collective …

Chimeric Antigen Receptor T Cell Therapy And The Kidney What The Nephrologist Needs To Know, K. D. Jhaveri, M. H. Rosner

Journal Articles

No abstract provided.

Lung Ultrasonography In End-Stage Renal Disease: Moving From Evidence To Practice-A Narrative Review, D. W. Ross, M. M. Abbasi, K. D. Jhaveri, M. Sachdeva, I. Miller, R. Barnett, M. Narasimhan, P. Mayo, M. Merzkani, A. T. Mathew

Journal Articles

© The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. Traditionally, point of care ultrasonography in nephrology has been used for renal biopsies and dialysis line placement. However, there is an emerging literature supporting the value of point of care lung ultrasonography in the assessment of volume status for dialysis patients.We conducted a review and identified 12 studies that examined the utility of lung ultrasonography in assessing volume status in patients with end-stage renal disease.We conclude that lung ultrasonography can be used to determine volume status in chronic dialysis patients by identifying lung congestion using the B-line …

Opportunities For Increasing The Rate Of Preemptive Kidney Transplantation, S. Fishbane, V. Nair

Journal Articles

No abstract provided.

Medication Discrepancies In Late-Stage Chronic Kidney Disease., J. Ibrahim, A. D. Hazzan, A. T. Mathew, V. Sakhiya, M. Zhang, C. Halinski, S. Fishbane

Journal Articles

Background: Late-stage chronic kidney disease (LS-CKD) can be defined by glomerular filtration rate (GFR) 0-30 mL/min. It is a period of risk for medication discrepancies because of frequent hospitalizations, fragmented medical care, inadequate communication and polypharmacy. In this study, we sought to characterize medication discrepancies in LS-CKD.

Methods: We analyzed all patients enrolled in Northwell Health's Healthy Transitions in LS-CKD program. All patients had estimated GFR 0-30 mL/min, not on dialysis. Medications were reviewed by a nurse at a home visit. Patients' medication usage and practice were compared with nephrologists' medication lists, and discrepancies were characterized. Patients were categorized as …

Nephrocutaneous Fistula Due To Xanthogranulomatous Pyelonephritis, Simcha Weissman, Madeeha Ghaffar, Dana Safavian, Sharma Rubal, Anthony Khabut, Mohammad G. Maruf, Michael Krzyzak

Touro College of Osteopathic Medicine (New York) Publications and Research

While the development of a fistulous tract from the kidney to the proximal adjacent organs is relatively common, a tract leading to the skin is a rare occurrence. The primary cause of a fistula is prior surgical intervention or malignancy leading to abscess formation. Our case involves Xanthogranulomatous pyelonephritis (XGP) causing a longstanding lobulated abscess, ultimately leading to the formation of a fistulous tract.

Gut Microbiota And Cardiovascular Uremic Toxicities, Manuel T. Velasquez, Patricia Centron, Ian Barrows, Rama Dwivedi, Dominic S. Raj

Medicine Faculty Publications

Cardiovascular disease (CVD) remains a major cause of high morbidity and mortality in patients with chronic kidney disease (CKD). Numerous CVD risk factors in CKD patients have been described, but these do not fully explain the high pervasiveness of CVD or increased mortality rates in CKD patients. In CKD the loss of urinary excretory function results in the retention of various substances referred to as “uremic retention solutes”. Many of these molecules have been found to exert toxicity on virtually all organ systems of the human body, leading to the clinical syndrome of uremia. In recent years, an increasing body …

Reducing Discard Blood Draw Volumes From Subcutaneously Implanted Ports (Port) In Patients With End Stage Renal Disease (Esrd), Uttam Garg, Tyson Moore, Renita Trujillo, Penny Monachino, Amy Wiebold, Angela Ferguson, Gabor Oroszi, Vimal Chadha

Posters

Background
•To monitor clinical status, dialysis and transplant patients with ESRD frequently require blood draws.
•To preserve their veins and to avoid frequent intravenous access, these patients, especially young children, require PORT placement.
•The PORT is flushed with saline and filled with heparinized saline to prevent blood clotting between blood draws.
•To avoid contamination from PORT fluids, a fixed amount of blood is withdrawn and discarded before the blood sample is drawn for laboratory analyses. Currently, the recommended discard blood volume is 5 mL (five times the reservoir volume of most PORTs and attached catheters.)
•The volume of discarded blood …