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Edrosolan KA, Shlipak MG, Scherzer R, Estrella MM, Gustafson D, Karim R, Fisher M, Cohen M, Kassaye S, Dumond J, Abraham A, McCulloch CE, Ascher SB. Mediation analysis of chronic kidney disease risk factors using kidney biomarkers in women living with HIV. AIDS 2024; 38:813-824. [PMID: 38224361 PMCID: PMC11025668 DOI: 10.1097/qad.0000000000003839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Novel urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in persons living with HIV. However, it is unknown whether these biomarkers provide mechanistic insight into the associations between clinical risk factors for CKD and subsequent CKD risk. METHODS Among 636 women living with HIV in the Women's Interagency HIV Study with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m 2 , we used a counterfactual approach to causal mediation analysis to evaluate the extent to which systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin a1c (Hba1c) and serum albumin associations with incident CKD were mediated by eight urine proteins. These biomarkers reflect proximal tubular reabsorptive dysfunction (α1-microglobulin [a1m], β2-microglobulin, trefoil factor 3); tubular injury (interleukin 18 [IL-18], kidney injury molecule 1 [KIM-1]); kidney repair (epidermal growth factor); tubular reserve (uromodulin); and glomerular injury (urinary albumin). Incident CKD was defined as eGFR <60 ml/min/1.73 m 2 measured at two consecutive 6-month visits with an average annual eGFR decline ≥3% per year. RESULTS During a median follow-up of 7 years, 11% developed CKD. Urinary albumin and KIM-1 mediated 32% (95% CI: 13.4%, 76.6%) and 23% (6.9%, 60.7%) of the association between SBP and incident CKD, respectively; and 19% (5.1%, 42.3%) and 22% (8.1%, 45.7%) of the association between DBP and incident CKD, respectively. Urinary albumin, α1m, and IL-18 were significant mediators of the association between Hba1c and incident CKD. None of the eight biomarkers mediated the association between serum albumin and incident CKD. CONCLUSIONS Among women living with HIV, several urinary biomarkers reflecting distinct dimensions of kidney health may partially explain the associations between SBP, DBP, and Hba1c and subsequent CKD risk.
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Affiliation(s)
- Kristienne A Edrosolan
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco
| | - Michael G Shlipak
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco
| | - Rebecca Scherzer
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco
| | - Michelle M Estrella
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco
- Department of Medicine, Division of Nephrology, University of California, San Francisco, CA
| | - Deborah Gustafson
- Department of Neurology, SUNY Downstate Health Sciences University, New York, NY
| | - Roksana Karim
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Molly Fisher
- Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY
| | - Mardge Cohen
- Stroger Hospital of Cook County Health and Human Services, Chicago, IL
| | - Seble Kassaye
- Division of Infectious Diseases, Georgetown University, Washington DC
| | - Julie Dumond
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC
| | - Alison Abraham
- Department of Epidemiology, University of Colorado School of Public Health, Denver, CO
| | - Charles E McCulloch
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco
| | - Simon B Ascher
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Healthcare System and University of California, San Francisco
- Division of Hospital Medicine, University of California Davis, Sacramento, CA, USA
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Srinivasa NK, Mishra RK, Bhadrinarayan V, Kulanthaivelu K. Hippocampal volume and recovery profile following propofol sedation in children undergoing magnetic resonance imaging: An exploratory study. Saudi J Anaesth 2024; 18:12-16. [PMID: 38313727 PMCID: PMC10833008 DOI: 10.4103/sja.sja_108_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/26/2023] [Indexed: 02/06/2024] Open
Abstract
Background Reduction in the hippocampal volume may contribute to agitated and delayed emergence after anesthesia in epilepsy surgery. We hypothesized that hippocampal volume and the duration of various recovery parameters after a short duration of sedation may be correlated. The primary objective was to evaluate the correlation between hippocampal volumes with time to recovery after the stoppage of propofol infusion. Methods After obtaining Institute Ethical Clearance, we included all children of the age group 5-17 years, who needed sedation for brain magnetic resonance imaging (MRI) for at least 20-60 minutes for the evaluation of epilepsy. The hippocampal volume was estimated bilaterally in the pre-contrast volumetric magnetization-prepared rapid gradient-echo (MPRAGE) brain imaging by the radiologist using statistical parametric mapping. The correlation of hippocampal volume with recovery and time to discharge (assessed by the modified Aldrete score (MAS)) was obtained using Spearman's correlation coefficient (rho). A rho > ± 0.5 was considered a good correlation between the variables. Results Data on a total of 18 children (10 males and 8 females) who required sedation for an MRI were studied over a period of six months. The correlation coefficients of right and left corrected hippocampal volumes with time to spontaneous eye opening were -0.052 and -0.195, respectively. The correlation coefficients of right and left corrected hippocampal volumes with time to respond to oral commands were -0.017 and -0.219, respectively. Conclusion There was a weak negative correlation between hippocampal volumes and recovery parameters after a short duration of sedation with propofol in children.
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Affiliation(s)
| | - Rajeeb Kumar Mishra
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Varadarajan Bhadrinarayan
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Karthik Kulanthaivelu
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Koprululu Kucuk G, Guney AI, Sunbul M, Guctekin T, Koç G, Kirac D. Il-6 and UGT1A1 variations may related to furosemide resistance in heart failure patients. IUBMB Life 2023; 75:830-843. [PMID: 37260062 DOI: 10.1002/iub.2732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/07/2023] [Indexed: 06/02/2023]
Abstract
Furosemide is a diuretic and is used for the treatment of patients with heart failure (HF). It has been found that in some HF patients, the drug does not treat patients efficiently. This condition is named as furosemide resistance. In this study, it is aimed to investigate the relationship between UDP-glucuronosyltransferase 1 (UGT1A1) and interleukine-6 (IL-6) variations with furosemide resistance in HF patients. Sixty HF patients using furosemide (patient group) and 30 healthy individuals (control group) were enrolled in this study. Patients were divided into two subgroups as non-responders (furosemide resistant) group (n = 30) and the responders (non-resistant) group (n = 30) according to the presence of furosemide resistance (n = 30). Variations in the first exon of UGT1A1 and rs1800795 and rs1800796 variations in IL-6 were analyzed by direct sequencing and real-time polymerase chain reaction (RT-PCR), respectively. The effects of newly detected mutations on 3-D protein structure were analyzed by in silico analysis. At the end of the study, 11 variations were detected in UGT1A1, of which nine of them are novel and eight of them cause amino acid change. Also, rs1800795 and rs1800796 variations were detected in all the groups. When patient and control groups were compared with each other, rs1800796 mutation in IL-6 was found statistically high in the patient group (p = 0.027). When the three groups were compared with each other, similarly, rs1800796 mutation in IL-6 was found statistically high in the non-responders group (p = 0.043). When allele distributions were compared between the patient and control groups, the C allele of rs1800795 mutation in IL-6 was found statistically high in the patient group (p = 0.032). When allele distributions were compared between the three groups, 55T-insertion in UGT1A1 was found statistically high in the non-responders group (p = 0.017). According to in silico analysis results, two variations were found deleterious and six variations were detected as probably damaging to protein functions. Our study may contribute to the elucidation of pharmacogenetic features (drug response-gene relationship) and the development of individual-specific treatment strategies in HF patients using furosemide.
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Affiliation(s)
- G Koprululu Kucuk
- Faculty of Medicine, Department of Medical Biology, Yeditepe University, Istanbul, Turkey
- Department of Radiotherapy, Istanbul Sisli Vocational School, Istanbul, Turkey
| | - A I Guney
- Faculty of Medicine, Department of Medical Genetics, Marmara University, Istanbul, Turkey
| | - M Sunbul
- Faculty of Medicine, Department of Cardiology, Marmara University, Istanbul, Turkey
| | - T Guctekin
- Faculty of Medicine, Department of Cardiology, Marmara University, Istanbul, Turkey
| | - G Koç
- Faculty of Medicine, Department of Medical Biology, Istanbul Aydın University, Istanbul, Turkey
| | - D Kirac
- Faculty of Medicine, Department of Medical Biology, Yeditepe University, Istanbul, Turkey
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Jiménez-Coll V, El Kaaoui El Band J, Llorente S, González-López R, Fernández-González M, Martínez-Banaclocha H, Galián JA, Botella C, Moya-Quiles MR, Minguela A, Legaz I, Muro M. All That Glitters in cfDNA Analysis Is Not Gold or Its Utility Is Completely Established Due to Graft Damage: A Critical Review in the Field of Transplantation. Diagnostics (Basel) 2023; 13:1982. [PMID: 37370877 DOI: 10.3390/diagnostics13121982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/24/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
In kidney transplantation, a biopsy is currently the gold standard for monitoring the transplanted organ. However, this is far from an ideal screening method given its invasive nature and the discomfort it can cause the patient. Large-scale studies in renal transplantation show that approximately 1% of biopsies generate major complications, with a risk of macroscopic hematuria greater than 3.5%. It would not be until 2011 that a method to detect donor-derived cell-free DNA (dd-cfDNA) employing digital PCR was devised based on analyzing the differences in SNPs between the donor and recipient. In addition, since the initial validation studies were carried out at the specific moments in which rejection was suspected, there is still not a good understanding of how dd-cfDNA levels naturally evolve post-transplant. In addition, various factors, both in the recipient and the donor, can influence dd-cfDNA levels and cause increases in the levels of dd-cfDNA themselves without suspicion of rejection. All that glitters in this technology is not gold; therefore, in this article, we discuss the current state of clinical studies, the benefits, and disadvantages.
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Affiliation(s)
- Victor Jiménez-Coll
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Jaouad El Kaaoui El Band
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Santiago Llorente
- Nephrology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Rosana González-López
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Marina Fernández-González
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Helios Martínez-Banaclocha
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - José Antonio Galián
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Carmen Botella
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María Rosa Moya-Quiles
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Alfredo Minguela
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute of Murcia (IMIB), Faculty of Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100 Murcia, Spain
| | - Manuel Muro
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
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Zhao L, Han S, Chai C. Huangkui capsule alleviates doxorubicin-induced proteinuria via protecting against podocyte damage and inhibiting JAK/STAT signaling. JOURNAL OF ETHNOPHARMACOLOGY 2023; 306:116150. [PMID: 36608778 DOI: 10.1016/j.jep.2023.116150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/21/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Huangkui capsule (HKC), a Chinese patent medicine, has been widely used in China as adjuvant therapy for chronic kidney disease (CKD). It displays superior anti-proteinuria efficacy than losartan in patients with CKD at stages 1-2, however, the mechanism of HKC alleviating proteinuria has not been well elucidated. AIM OF THE STUDY This study aims to confirm the therapeutic effect and investigate associated underlying mechanism of HKC against proteinuria by in vivo and in vitro experiments. MATERIALS AND METHODS We established a doxorubicin (DOX) induced proteinuria mouse model to evaluate kidney function by biochemical markers measurement and to observe histopathological alterations by hematoxylin and eosin (H&E), Masson's trichrome and Periodic Acid-Schiff (PAS)-stained sections of renal, respectively. Moreover, the expressions of Nephrin and Podocin were measured by immunohistochemistry (IHC) and western blotting analysis to investigate podocyte damage. Furthermore, we established Mouse Podocyte Clone-5 (MPC-5) injury model to identify the active components of HKC against podocyte damage by detecting the expressions of Nephrin, Podocin, and ZO-1 proteins. At last, the key protein levels of Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway were assessed by western blotting analysis to explore the underlying mechanism of HKC against proteinuria. RESULTS Our results showed that HKC administration for three consecutive weeks dose-dependently ameliorated both renal function and histopathological damages, elevated the expressions of Nephrin and Podocin, the pivotal molecules maintaining filtration function of the podocyte, indicating the promising protective effect against podocyte injury under DOX exposure. Consistently, in vitro experiments showed HKC administration effectively reversed the abnormal expressions of Nephrin and Podocin in MPC-5 cells treated with DOX, suggesting its protective effect against podocyte injury to maintain filtration barrier integrity. In addition, Hibifolin was identified as the most active ingredients in HKC, which suppressed upstream JAK2/STAT3 and PI3K/Akt pathway phosphorylation to maintain the structural and functional integrity of podocyte filtration barrier. Of note, AG490, a selective JAK2 inhibitor, was used to further affirm the role of Hibifolin involving in regulation JAK2/STAT3. CONCLUSIONS Our study suggested that HKC may protect podocytes via JAK2/STAT3 and PI3K/Akt pathway to display its effects of ameliorating proteinuria.
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Affiliation(s)
- Lei Zhao
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Research, School of Traditional Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China
| | - Siyuan Han
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Research, School of Traditional Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China
| | - Chengzhi Chai
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Research, School of Traditional Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 211198, China.
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6
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Chen Z, Wu S, Zeng Y, Li X, Wang M, Chen Z, Chen M. The antifibrotic and anti-inflammatory effects of FZHY prescription on the kidney in rats after unilateral ureteral obstruction. Acta Cir Bras 2023; 37:e371003. [PMID: 36629622 PMCID: PMC9829242 DOI: 10.1590/acb371003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/13/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To explore the potential impact of traditional Chinese herb FuZhengHuaYuJiangZhuTongLuo recipe (FZHY) on renal interstitial fibrosis (RIF) in chronic kidney disease (CKD) at cellular and molecular levels. METHODS Unilateral ureteral obstruction (UUO) rats were established as the RIF model in vivo. The rats were given intragastric administration with FZHY once a day for consecutive 7, 14 and 21 days, respectively. The renal function parameters and inflammation indicators in kidney tissues were measured using enzyme-linked immunosorbent assay, the CD4+/CD8+ T cells in peripheral blood was detected using flow cytometry, the renal fibrosis degree was estimated using Masson's staining, and the fibrosis-related genes' expression was detected using quantitative polymerase chain reaction, western blotting, and immunohistochemistry analyses. RESULTS FZHY prescription reduced the serum creatinine and blood urea nitrogen, decreased the levels of c-reactive protein, interleukin-1, interleukin-6 and tumor necrosis factor-α in kidney tissues, and increased the ratio of CD4+/CD8+ T cells in peripheral blood. FZHY prescription suppressed the renal tissue fibrosis and reduced the levels of laminin, fibronectin, collagen I and collagen III. CONCLUSIONS FZHY prescription suppressed the renal fibrosis and improved the condition of "Healthy Qi Deficiency and Evil Qi Excess" in rats with UUO, which may provide an effective method for CKD treatment.
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Affiliation(s)
- Ziwei Chen
- M.M. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Affiliated Integrated TCM and Western Medicine Hospital of Chengdu – Chengdu Integrated TCM and Western Medicine Hospital – Chengdu First People’s Hospital – Chengdu, China.,Corresponding author:
- (86) 18980880236
| | - Shaobo Wu
- M.M. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Hospital of Chengdu – Chengdu, China
| | - Yu Zeng
- B.S. Chengdu University of Traditional Chinese Medicine – Department of Clinical Laboratory – Hospital of Chengdu – Chengdu, China
| | - Xueying Li
- M.M. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Hospital of Chengdu – Chengdu, China
| | - Mengping Wang
- M.M. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Hospital of Chengdu – Chengdu, China
| | - Zejun Chen
- M.D. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Affiliated Integrated TCM and Western Medicine Hospital of Chengdu – Chengdu Integrated TCM and Western Medicine Hospital – Chengdu First People’s Hospital – Chengdu, China
| | - Ming Chen
- M.M. Chengdu University of Traditional Chinese Medicine – Department of Nephrology – Hospital of Chengdu – Chengdu, China.,Corresponding author:
- (86) 18980880236
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7
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Campion D, Rizzi F, Bonetto S, Giovo I, Roma M, Saracco GM, Alessandria C. Assessment of glomerular filtration rate in patients with cirrhosis: Available tools and perspectives. Liver Int 2022; 42:2360-2376. [PMID: 35182100 DOI: 10.1111/liv.15198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/08/2021] [Accepted: 12/09/2021] [Indexed: 12/07/2022]
Abstract
Renal dysfunction often complicates the course of liver disease, resulting in higher morbidity and mortality. The accurate assessment of kidney function in these patients is essential to early identify, stage and treat renal impairment as well as to better predict the prognosis, prioritize the patients for liver transplantation and decide whether to opt for simultaneous liver-kidney transplants. This review analyses the available tools for direct or indirect assessment of glomerular filtration rate, focusing on the flaws and strengths of each method in the specific setting of cirrhosis. The aim is to deliver a clear-cut view on this complex issue, trying to point out which strategies to prefer in this context, especially in the peculiar setting of liver transplantation. Moreover, a glance is given at future promising tools for glomerular filtration rate assessment, including new biomarkers and new equations specifically modelled for the cirrhotic population.
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Affiliation(s)
- Daniela Campion
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Felice Rizzi
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Silvia Bonetto
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Ilaria Giovo
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Michele Roma
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Giorgio M Saracco
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Carlo Alessandria
- Department of Gastroenterology and Hepatology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
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Abu Bakar SA, Syed Mohamed Shahruddin SNS, Ismail N, Wan Md Adnan WAH. Biological age for chronic kidney disease patients using index model. PeerJ 2022; 10:e13694. [PMID: 35935256 PMCID: PMC9351620 DOI: 10.7717/peerj.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/16/2022] [Indexed: 01/17/2023] Open
Abstract
The estimation of biological age (BA) is an important asymptomatic measure that can be used to understand the physical changes and the aging process of a living being. Factors that contribute towards profiling the human biological age can be diverse. Therefore, this study focuses on developing a BA model for patients with Chronic Kidney Disease (CKD). The procedure commences with the selection of significant biomarkers using a correlation test. Appropriate weighting is then assigned to each selected biomarker using the indexing method to produce a BA index. The BA index is matched to the age variation within the sample to acquire additional terms for the chronological age leading ultimately to the estimated BA. From a sample of 190 patients (133 trained data and 57 testing data) obtained from the University of Malaya Medical Centre (UMMC), Malaysia, the intensity of the BA is found to be between three to nine years from the chronological age. Visual observations further validate the high similarities between the training and testing data sets.
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Affiliation(s)
- Shaiful Anuar Abu Bakar
- Institute of Mathematical Sciences, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Noriszura Ismail
- Department of Mathematical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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9
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Lin L, Dekkers IA, Huang L, Tao Q, Paiman EHM, Bizino MB, Jazet IM, Lamb HJ. Renal sinus fat volume in type 2 diabetes mellitus is associated with glycated hemoglobin and metabolic risk factors. J Diabetes Complications 2021; 35:107973. [PMID: 34217586 DOI: 10.1016/j.jdiacomp.2021.107973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022]
Abstract
AIMS We aimed to compare renal sinus fat volume assessed by MRI between patients with type 2 diabetes and healthy volunteers, and investigate the association between renal sinus fat and metabolic traits. METHODS In this cross-sectional study, renal sinus fat and parenchyma volumes measured on abdominal MRI were compared between patients and controls using analysis of covariance. Associations of renal parameters with clinical characteristics were analyzed using linear regression analysis. RESULTS A total of 146 participants were enrolled, consisting of 95 type 2 diabetes patients (57.2±8.8years, 49.5% male) and 51 controls (54.0±9.2years, 43.1% male). Patients with diabetes demonstrated larger sinus fat volumes (15.4±7.5cm3 vs. 10.3±7.1cm3, p<0.001) and sinus fat-parenchyma ratio than controls. In the total population, renal sinus fat was positively associated with HbA1c, abdominal VAT, cholesterol and triglycerides, after adjustment for age, sex, ethnicity and type 2 diabetes. In type 2 diabetes patients, increased sinus fat volume was significantly associated with urinary albumin-to-creatinine ratio. CONCLUSION Renal sinus fat volume is positively associated with several metabolic risk factors including HbA1c level and urinary albumin-to-creatinine ratio in type 2 diabetes patients, indicating a potential role of renal sinus fat in the development of diabetic nephropathy. Future studies are needed to investigate whether sinus fat volume can serve as an early biomarker for diabetic nephropathy.
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Affiliation(s)
- Ling Lin
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands.
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Lu Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Qiaokou District, Wuhan, Hubei, China
| | - Qian Tao
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Elisabeth H M Paiman
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Maurice B Bizino
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Ingrid M Jazet
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
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10
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Ueda S, Sakasegawa SI. A novel assay for serum creatinine using a creatine kinase cycling reaction. Biosci Biotechnol Biochem 2021; 85:1063-1068. [PMID: 33629709 DOI: 10.1093/bbb/zbab027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/07/2021] [Indexed: 11/12/2022]
Abstract
For assaying serum creatinine, the enzymatic method is regarded as accurate. However, a reliable measurement of low levels is problematic. We have developed a new method that utilizes an enzymatic cycling reaction involving creatine kinase (CK) in the presence of excess ATP and IDP and implicated the application to a serum creatinine assay by incorporating with creatininase. Here, we evaluated applying the CK cycling method to a serum creatinine assay. In this study, we focused on assessing whether an accurate measurement could be achieved, especially in the reference interval and the lower concentration range. The effective sensitivity of the assay using 30 U/mL CK was approximately 4-fold greater than that of a commercial reagent. Under these conditions, 0.19 mg/dL of creatinine was accurately detected. The correlation coefficient of the comparison study with an existing commercial reagent was 0.995. Moreover, the effect of the increased signal intensity on accuracy and precision was assured.
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Affiliation(s)
- Shigeru Ueda
- Department of Health and Medical Sciences, Faculty of Risk and Crisis Management, Chiba Institute of Science, Choshi, Chiba, Japan
| | - Shin-Ichi Sakasegawa
- R&D Group, Diagnostics Department, Asahi Kasei Pharma Corporation, Izunokuni-shi, Shizuoka, Japan
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Sukhang M, Junkuy A, Buckley N, Mohamed F, Wunnapuk K. An LC-MS/MS method for creatine and creatinine analysis in paraquat-intoxicated patients. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2019; 55:273-282. [PMID: 31744381 DOI: 10.1080/03601234.2019.1690342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A sudden increase in serum creatinine after paraquat intoxication has been reported in several clinical studies. However, this dramatic change of creatinine may be possibly due to an interconversion of creatine-creatinine in relation to paraquat toxicity. In order to investigate the creatine-creatinine relationship, a liquid chromatography tandem mass spectrometry in combination with electrospray ionization was developed and validated for simultaneous determination of creatine and creatinine in the serum. The chromatographic separation was achieved on a Gemini® C6-Phenyl column with a gradient elution consisting of 0.1% formic acid in ultrapure water and methanol as the mobile phase. The method yielded suitable levels of specificity and selectivity, and calibration curves of creatine and creatinine in serum were linear over the concentration range of 0.5-200 µg mL-1. The limit of quantification of both compounds was 0.5 µg mL-1, and the method was accurate within the recovery range of 96.23-102.75%, indicating the robustness of the method. The method was successfully applied to toxicological samples from paraquat-intoxicated patients, and the concentrations of creatine and creatinine were quantified. High creatine concentrations in serum samples were observed which may lead to high serum creatinine despite normal kidney function as creatine is converted to creatinine in proportion to its concentration.
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Affiliation(s)
- Mukdawan Sukhang
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Anongphan Junkuy
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicholas Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Klintean Wunnapuk
- Toxicology Unit, Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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12
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Fiseha T, Mengesha T, Girma R, Kebede E, Gebreweld A. Estimation of renal function in adult outpatients with normal serum creatinine. BMC Res Notes 2019; 12:462. [PMID: 31358035 PMCID: PMC6664564 DOI: 10.1186/s13104-019-4487-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to estimate the prevalence of renal insufficiency using estimated glomerular filtration rate (eGFR) among adult outpatients with normal SCr. RESULTS A total of 414 patients with normal SCr were included in the study. Mean GFR (ml/min/1.73 m2) was 116.8 ± 43.5 using the MDRD equation and 90.5 ± 33.1 by the C-G formula. According to the MDRD formula, mild renal insufficiency (i.e. eGFR 60-89.9 ml/min/1.73 m2) was found in 21.5% of the patients and moderate renal insufficiency (i.e. eGFR 30-59.9 ml/min/1.73 m2) was found in 7.7%. According to the Cockcroft-Gault (C-G) formula, mild renal insufficiency was found in 38.2% and moderate renal insufficiency in 16.9% of the patients with normal SCr. In multivariate analysis, older age, female sex, a family history of kidney disease or other chronic diseases and high systolic blood pressure were associated with prevalent renal insufficiency depending on the formula used to estimate GFR. This study demonstrates the substantial prevalence of impaired renal function among Ethiopian adult outpatients with normal SCr. Including calculated estimates of GFR in routine laboratory reporting may help to facilitate the identification and thus optimal management of patients with renal insufficiency.
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Affiliation(s)
- Temesgen Fiseha
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tizita Mengesha
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Rahel Girma
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Edosa Kebede
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Angesom Gebreweld
- Department of Clinical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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13
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Muiru AN, Shlipak MG, Scherzer R, Zhang WR, Ascher SB, Jotwani V, Grunfeld C, Parikh CR, Ng D, Palella FJ, Ho K, Kassaye S, Sharma A, Cohen M, Wang R, Qi Q, Estrella MM. Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; a cross-sectional study. BMC Nephrol 2019; 20:4. [PMID: 30606136 PMCID: PMC6318986 DOI: 10.1186/s12882-018-1192-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
Background HIV-positive persons bear an excess burden of chronic kidney disease (CKD); however, conventional methods to assess kidney health are insensitive and non-specific for detecting early kidney injury. Urinary biomarkers can detect early kidney injury, and may help mitigate the risk of overt CKD. Methods Cross-sectional study of HIV-positive persons in the Multicenter AIDS Cohort Study and the Women’s Interagency HIV Study. We measured levels of 14 biomarkers, capturing multiple dimensions of kidney injury. We then evaluated associations of known CKD risk factors with urine biomarkers using separate multivariable adjusted models for each biomarker. Results Of the 198 participants, one third were on HAART and virally suppressed. The vast majority (95%) had preserved kidney function as assessed by serum creatinine, with a median eGFR of 103 ml/min/1.73 m2 (interquartile range (IQR): 88, 116). In our multivariable analyses, the associations of each CKD risk factor with urinary biomarker levels varied in magnitude. For example, HIV viral load was predominantly associated with elevations in interleukin(IL)-18, and albuminuria, while higher CD4 levels were associated with lower monocyte chemoattractant protein-1 (MCP-1) and β2-microglobulin. In contrast, older age was significantly associated with elevations in α1-microglobulin, kidney injury marker-1, clusterin, MCP-1, and chitinase-3-like protein-1 levels, as well as lower epidermal growth factor, and uromodulin levels. Conclusions Among HIV-positive persons, CKD risk factors are associated with unique and heterogeneous patterns of changes in urine biomarkers levels. Additional work is needed to develop parsimonious algorithms that integrate multiple biomarkers and clinical data to discern the risk of overt CKD and its progression. Electronic supplementary material The online version of this article (10.1186/s12882-018-1192-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony N Muiru
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA.
| | - Michael G Shlipak
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA.,Department Epidemiology, and Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca Scherzer
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA
| | - William R Zhang
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA
| | - Simon B Ascher
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA.,Department of Medicine, University of California, Los Angeles, CA, USA
| | - Vasantha Jotwani
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA
| | - Carl Grunfeld
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA
| | - Chirag R Parikh
- Department of Medicine, Section of Nephrology, Yale University, New Haven, CT, USA
| | - Derek Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank J Palella
- Division of Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ken Ho
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Seble Kassaye
- Georgetown University Medical Center, Washington, DC, USA
| | - Anjali Sharma
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mardge Cohen
- Department of Medicine, Stroger Hospital and Rush University, Chicago, IL, USA
| | - Ruibin Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michelle M Estrella
- Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA
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14
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Predictive Value of Cortical Thickness Measured by Ultrasonography for Renal Impairment: A Longitudinal Study in Chronic Kidney Disease. J Clin Med 2018; 7:jcm7120527. [PMID: 30544567 PMCID: PMC6306756 DOI: 10.3390/jcm7120527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/02/2018] [Accepted: 12/04/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Kidney size is associated with renal function, however it is not elucidated whether kidney size is a risk for the progression of chronic kidney disease. The aim of this study was to investigate the predictive value of morphological evaluation of kidney size by ultrasonography for the progression of renal dysfunction. Methods: Morphological parameters including kidney length, volume, cortical thickness, and medullary thickness were measured by ultrasonography in 87 patients with chronic kidney disease, and adjusted by body size. Renal functions at baseline and after 2 years were measured and the associations of morphological parameters to decline in renal function over 2 years were analyzed. Results: Height-adjusted cortical thickness was correlated to decline in renal function (r = 0.426, p < 0.001). Height-adjusted cortical thickness could predict renal dysfunction with the area under the curve of 0.786, and height-adjusted cortical thickness of 4.0 mm/cm was a cut off value with a sensitivity of 72.5% and a specificity of 80.0% for the risk of a more than 30% decline in renal function or initiation of dialysis. Conclusions: We provide new insights into the utility of measuring cortical thickness by ultrasonography for predict future renal impairment.
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15
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Jhee JH, Hwang SD, Song JH, Lee SW. Upper Normal Serum Creatinine Concentrations as a Predictor for Chronic Kidney Disease: Analysis of 14 Years' Korean Genome and Epidemiology Study (KoGES). J Clin Med 2018; 7:E463. [PMID: 30469454 PMCID: PMC6262490 DOI: 10.3390/jcm7110463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/10/2023] Open
Abstract
Both serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) have been used to assess kidney function in public health check-ups. However, when the sCr is within the normal levels but the eGFR is <60 mL/min/1.73 m², a dilemma arises, as the patients might progress to chronic kidney disease (CKD) after several years. We aimed to evaluate the association between normal sCr and the risk of incident CKD in the general population. For this, 9445 subjects from the Korean Genome and Epidemiology Study, with normal sCr and eGFR of >60 mL/min/1.73 m² were analyzed. The subjects were classified into quartiles based on sCr levels. The primary outcome was the development of eGFR <60 mL/min/1.73 m² on two consecutive measures. During a mean follow-up of 8.4 ± 4.3 years, 779 (8.2%) subjects developed eGFR <60 mL/min/1.73 m². The incidence of the development of eGFR <60 mL/min/1.73 m² was higher in the higher quartiles than in the lowest quartile. In multivariable Cox analysis, the highest quartile was associated with an increased risk for the development of eGFR <60 mL/min/1.73 m² (hazard ratio (HR), 4.71; 95% confidence interval (CI), 3.29⁻6.74 in females; HR, 12.77; 95% CI, 7.69⁻21.23 in males). In the receiver operating characteristic curve analysis, adding sCr to the traditional risk factors for CKD improved the accuracy of predicting the development of eGFR <60 mL/min/1.73 m² (area under the curve, 0.83 vs. 0.80 in females and 0.85 vs. 0.78 in males), and the cutoff value of sCr was 0.75 mg/dL and 0.78 mg/dL in females and males. Cautious interpretation is necessary when sCr is within the normal range, considering that the upper normal range of sCr has a higher risk of CKD development.
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Affiliation(s)
- Jong Hyun Jhee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University, College of Medicine, Incheon 22332, Korea.
| | - Seun Deuk Hwang
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University, College of Medicine, Incheon 22332, Korea.
| | - Joon Ho Song
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University, College of Medicine, Incheon 22332, Korea.
| | - Seoung Woo Lee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University, College of Medicine, Incheon 22332, Korea.
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16
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Pletz J, Enoch SJ, Jais DM, Mellor CL, Pawar G, Firman JW, Madden JC, Webb SD, Tagliati CA, Cronin MTD. A critical review of adverse effects to the kidney: mechanisms, data sources, and in silico tools to assist prediction. Expert Opin Drug Metab Toxicol 2018; 14:1225-1253. [PMID: 30345815 DOI: 10.1080/17425255.2018.1539076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The kidney is a major target for toxicity elicited by pharmaceuticals and environmental pollutants. Standard testing which often does not investigate underlying mechanisms has proven not to be an adequate hazard assessment approach. As such, there is an opportunity for the application of computational approaches that utilize multiscale data based on the Adverse Outcome Pathway (AOP) paradigm, coupled with an understanding of the chemistry underpinning the molecular initiating event (MIE) to provide a deep understanding of how structural fragments of molecules relate to specific mechanisms of nephrotoxicity. Aims covered: The aim of this investigation was to review the current scientific landscape related to computational methods, including mechanistic data, AOPs, publicly available knowledge bases and current in silico models, for the assessment of pharmaceuticals and other chemicals with regard to their potential to elicit nephrotoxicity. A list of over 250 nephrotoxicants enriched with, where possible, mechanistic and AOP-derived understanding was compiled. Expert opinion: Whilst little mechanistic evidence has been translated into AOPs, this review identified a number of data sources of in vitro, in vivo, and human data that may assist in the development of in silico models which in turn may shed light on the interrelationships between nephrotoxicity mechanisms.
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Affiliation(s)
- Julia Pletz
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Steven J Enoch
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Diviya M Jais
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Claire L Mellor
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Gopal Pawar
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - James W Firman
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Judith C Madden
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
| | - Steven D Webb
- b Department of Applied Mathematics , Liverpool John Moores University , Liverpool , UK
| | - Carlos A Tagliati
- c Departamento de Análises Clínicas e Toxicológicas , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Mark T D Cronin
- a School of Pharmacy and Biomolecular Sciences , Liverpool John Moores University , Liverpool , UK
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17
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Tartof SY, Hsu JW, Wei R, Rubenstein KB, Hu H, Arduino JM, Horberg M, Derose SF, Qian L, Rodriguez CV. Kidney Function Decline in Patients with CKD and Untreated Hepatitis C Infection. Clin J Am Soc Nephrol 2018; 13:1471-1478. [PMID: 30242027 PMCID: PMC6218821 DOI: 10.2215/cjn.01530218] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/27/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Studies evaluating the role of hepatitis C viral (HCV) infection on the progression of CKD are few and conflicting. Therefore, we evaluated the association of untreated HCV on kidney function decline in patients with stage 3-5 CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This retrospective cohort study included members of Kaiser Permanente Southern California and Kaiser Permanente Mid-Atlantic States aged ≥18 years, with incident HCV and CKD diagnoses from January 1, 2004 to December 31, 2014. We used generalized estimating equations to compare the rate of change in eGFR between those with HCV and CKD versus CKD alone, adjusting for covariates. Cox proportional hazards models compared the risk of 25% decrease in eGFR and ESKD (defined as progression to eGFR<15 ml/min per 1.73 m2 on two or more occasions, at least 90 days apart) in those with HCV and CKD versus CKD alone, adjusting for covariates. RESULTS We identified 151,974 patients with CKD only and 1603 patients with HCV and CKD who met the study criteria. The adjusted annual decline of eGFR among patients with HCV and CKD was greater by 0.58 (95% confidence interval [95% CI], 0.31 to 0.84) ml/min per 1.73 m2, compared with that in the CKD-only population (HCV and CKD, -1.61; 95% CI, -1.87 to -1.35 ml/min; CKD only, -1.04; 95% CI, -1.06 to -1.01 ml/min). Adjusted for covariates, the hazard for a 25% decline in eGFR and for ESKD were 1.87 (95% CI, 1.75 to 2.00) and 1.93 (95% CI, 1.64 to 2.27) times higher among those with HCV and CKD, respectively, compared with those with CKD only. CONCLUSIONS Untreated HCV infection was associated with greater kidney function decline in patients with stage 3-5 CKD.
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Affiliation(s)
- Sara Yee Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Jin-Wen Hsu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Rong Wei
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Kevin B Rubenstein
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland; and
| | - Haihong Hu
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland; and
| | - Jean Marie Arduino
- Jean Marie Arduino, Center for Observational and Real-world Evidence, Merck Research Laboratories, Merck & Co., Inc., Kenilworth, New Jersey
| | - Michael Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland; and
| | - Stephen F Derose
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Lei Qian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Carla V Rodriguez
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland; and
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18
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Liu B, Ding F, Hu D, Zhou Y, Long C, Shen L, Zhang Y, Zhang D, Wei G. Human umbilical cord mesenchymal stem cell conditioned medium attenuates renal fibrosis by reducing inflammation and epithelial-to-mesenchymal transition via the TLR4/NF-κB signaling pathway in vivo and in vitro. Stem Cell Res Ther 2018; 9:7. [PMID: 29329595 PMCID: PMC5767037 DOI: 10.1186/s13287-017-0760-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/16/2017] [Accepted: 12/20/2017] [Indexed: 02/07/2023] Open
Abstract
Background Renal fibrosis is characterized by infiltration of interstitial inflammatory cells and release of inflammatory mediators, activation and proliferation of fibroblasts, and deposition of excessive extracellular matrix (ECM). The aim of this study was to evaluate the effect of human umbilical cord-derived mesenchymal stem cell (hucMSC) conditioned medium (CM) on renal tubulointerstitial inflammation and fibrosis. Methods Renal interstitial fibrosis was prepared in vivo using the unilateral ureteral obstruction (UUO). Rats were divided randomly into Sham group, Sham group with CM, UUO group, and UUO group with CM. The effect of hucMSC-CM on kidney injury induced by UUO was assessed by detecting kidney histopathology, serum creatinine (SCr), and blood urea nitrogen (BUN). The levels of TNF-α, IL-6, and IL-1β in serum and kidney tissues were detected by ELISA. The expression of proteins associated with fibrosis and renal inflammation was investigated using immunohistochemical staining and western blotting. The effects of hucMSC-CM on the TGF-β1-induced epithelial–mesenchymal transition (EMT) process and on inflammation in NRK-52E cells were investigated by immunofluorescent staining, ELISA, and western blotting. Results hucMSC-CM reduced extracellular matrix deposition and inflammatory cell infiltration as well as release of inflammatory factors in UUO-induced renal fibrosis. Furthermore, hucMSC-CM markedly attenuated the EMT process and proinflammatory cytokines in rats with UUO and TGF-β1-induced NRK-52E cells. hucMSC-CM also inhibited the TLR4/NF-κB signaling pathway in vivo and in vitro. Conclusions Our results suggest that hucMSC-CM has protective effects against UUO-induced renal fibrosis and that hucMSC-CM exhibits its anti-inflammatory effects through inhibiting TLR4/NF-κB signaling pathway activation. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0760-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bo Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Fengxia Ding
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2 RD, Yuzhong District, Chongqing, 400014, China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China.
| | - Dong Hu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Yu Zhou
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Chunlan Long
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Lianju Shen
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - Deying Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, 400014, China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
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19
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Littera R, Piredda G, Argiolas D, Lai S, Congeddu E, Ragatzu P, Melis M, Carta E, Michittu MB, Valentini D, Cappai L, Porcella R, Alba F, Serra M, Loi V, Maddi R, Orrù S, La Nasa G, Caocci G, Cusano R, Arras M, Frongia M, Pani A, Carcassi C. KIR and their HLA Class I ligands: Two more pieces towards completing the puzzle of chronic rejection and graft loss in kidney transplantation. PLoS One 2017; 12:e0180831. [PMID: 28686681 PMCID: PMC5501603 DOI: 10.1371/journal.pone.0180831] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 05/15/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function. Within this context, a growing amount of evidence shows that alloreactive natural killer (NK) cells play a critical role in the immune response mechanisms elicited by the allograft. Killer immunoglobulin-like receptors (KIRs) are prominent mediators of NK cell alloreactivity. METHODS AND FINDINGS A cohort of 174 first cadaveric kidney allograft recipients and their donors were selected from a total cohort of 657 transplanted patients for retrospective immunogenetic analyses. Patients with HLA Class II mismatches were excluded. HLA Class I allele frequencies were compared among patients with chronic rejection, patients with stable graft function and a group of 2388 healthy controls. Activating and inhibitory KIR gene frequencies, KIR haplotypes, KIR-HLA ligand matches/mismatches and combinations of recipient KIRs and donor HLA Class I ligands were compared among patients with and without chronic rejection and a group of 221 healthy controls. Patients transplanted from donors homozygous for HLA-C1 antigens had a significantly higher risk for chronic rejection than patients transplanted from donors homozygous or heterozygous for HLA-C2 antigens or with epitopes belonging to the HLA-Bw4 ligand group. The Kaplan-Meier curves obtained by dividing the patients into 3 groups according to the presence or absence of one or both of the combinations of recipient KIRs and donor HLA ligands (rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4) showed a significantly higher cumulative incidence of chronic rejection in the group of patients completely lacking these functional units. These patients showed a progressively stronger decline in modification of diet in renal disease-estimated glomerular filtration rate. CONCLUSIONS KIR genotyping should be performed at the time of enrolment of patients on the waiting list for organ transplantation. In our study, a significantly higher risk of chronic rejection after kidney transplantation was observed when recipient (r) and donor (d) pairs completely lacked the two functional rKIR-dHLA ligand combinations rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4. This immunogenetic profile corresponds to low levels of NK cell inhibition. Therefore, patients with this high risk profile could benefit from immunosuppressive therapy aimed at reducing NK-cell cytotoxicity.
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MESH Headings
- Adult
- Cadaver
- Case-Control Studies
- Female
- Gene Expression
- Glomerular Filtration Rate
- Graft Rejection/genetics
- Graft Rejection/immunology
- Graft Rejection/pathology
- Graft Survival/genetics
- HLA-B Antigens/genetics
- HLA-B Antigens/immunology
- HLA-C Antigens/genetics
- HLA-C Antigens/immunology
- Histocompatibility
- Humans
- Kidney Failure, Chronic/immunology
- Kidney Failure, Chronic/pathology
- Kidney Failure, Chronic/surgery
- Kidney Transplantation
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Ligands
- Male
- Middle Aged
- Receptors, KIR2DL1/genetics
- Receptors, KIR2DL1/immunology
- Receptors, KIR3DL1/genetics
- Receptors, KIR3DL1/immunology
- Transplantation, Homologous
- Unrelated Donors
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Affiliation(s)
- Roberto Littera
- Regional Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- * E-mail:
| | - Gianbenedetto Piredda
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Davide Argiolas
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Elena Congeddu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Paola Ragatzu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Maurizio Melis
- Regional Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Elisabetta Carta
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Maria Benigna Michittu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | | | - Luisella Cappai
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Rita Porcella
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Francesco Alba
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Maria Serra
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Valentina Loi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Roberta Maddi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Sandro Orrù
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giorgio La Nasa
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Hematology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Caocci
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Hematology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- Center for Advanced Studies, Research and Development (CRS4) Biomedical Sector, "Polaris" Technology Park, Pula, Cagliari, Italy
| | - Marcella Arras
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Mauro Frongia
- Complex Structure of Urology, Kidney Transplantation and Robotic Surgery, G. Brotzu Hospital, Cagliari, Italy
| | - Antonello Pani
- Complex Structure of Nephrology and Dialysis, Department of Renal Diseases, G. Brotzu Hospital, Cagliari, Italy
| | - Carlo Carcassi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Nusshag C, Weigand MA, Zeier M, Morath C, Brenner T. Issues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative Review. Int J Mol Sci 2017; 18:E1387. [PMID: 28657585 PMCID: PMC5535880 DOI: 10.3390/ijms18071387] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 06/24/2017] [Accepted: 06/24/2017] [Indexed: 12/19/2022] Open
Abstract
Acute kidney injury (AKI) has a high incidence on intensive care units around the world and is a major complication in critically ill patients suffering from sepsis or septic shock. The short- and long-term complications are thereby devastating and impair the quality of life. Especially in terms of AKI staging, the determination of kidney function and the timing of dialytic AKI management outside of life-threatening indications are ongoing matters of debate. Despite several studies, a major problem remains in distinguishing between beneficial and unnecessary "early" or even harmful renal replacement therapy (RRT). The latter might prolong disease course and renal recovery. AKI scores, however, provide an insufficient outcome-predicting ability and the related estimation of kidney function via serum creatinine or blood urea nitrogen (BUN)/urea is not reliable in AKI and critical illness. Kidney independent alterations of creatinine- and BUN/urea-levels further complicate the situation. This review critically assesses the current AKI staging, issues and pitfalls of the determination of kidney function and RRT timing, as well as the potential harm reflected by unnecessary RRT. A better understanding is mandatory to improve future study designs and avoid unnecessary RRT for higher patient safety and lower health care costs.
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Affiliation(s)
- Christian Nusshag
- Department of Nephrology, Heidelberg University Hospital, 162, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
| | - Markus A Weigand
- Department of Anesthesiology, Heidelberg University Hospital, 110, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
| | - Martin Zeier
- Department of Nephrology, Heidelberg University Hospital, 162, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
| | - Christian Morath
- Department of Nephrology, Heidelberg University Hospital, 162, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
| | - Thorsten Brenner
- Department of Anesthesiology, Heidelberg University Hospital, 110, Im Neuenheimer Feld, D-69120 Heidelberg, Germany.
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21
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Deskur-Smielecka E, Kotlinska-Lemieszek A, Chudek J, Wieczorowska-Tobis K. Assessment of renal function in geriatric palliative care patients - comparison of creatinine-based estimation equations. Clin Interv Aging 2017; 12:977-983. [PMID: 28694691 PMCID: PMC5491613 DOI: 10.2147/cia.s130583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Renal function impairment is common in geriatric palliative care patients. Accurate assessment of renal function is necessary for appropriate drug dosage. Several equations are used to estimate kidney function. AIMS 1) To investigate the differences (Δ) in kidney function assessed with simplified Modifi-cation of Diet in Renal Disease (MDRD), Berlin Initiative Study (BIS1), and Cockcroft-Gault (C-G) formulas in geriatric palliative care patients, and 2) to assess factors that may influence these differences. METHODS A retrospective analysis of data of patients aged ≥70 years admitted to a palliative care in-patient unit. The agreement between C-G, MDRD, and BIS1 equations was assessed with Bland-Altman analysis. Partial correlation analysis was used to analyze factors influencing the discordance. RESULTS A total of 174 patients (67 men; mean age 77.9±5.8 years) were enrolled. The mean Δ MDRD and C-G was 18.6 (95% limits of agreement 55.3 and -18.2). The mean Δ BIS1 and C-G was 6.1 (25.7 and -13.5), and the mean Δ MDRD and BIS1 was 12.5 (40.6 and -15.6). According to the National Kidney Foundation classification, 61 (35.1%) patients were differently staged using MDRD and C-G, whilê20% of patients were differently staged with BIS1 and C-G and MDRD and BIS1. Serum creatinine (SCr) and body mass index (BMI) had the most important influence on variability of Δ MDRD and C-G (partial R2 37.7% and 28.4%). Variability of Δ BIS1 and C-G was mostly influenced by BMI (34.8%) and variability of Δ MDRD and BIS1 by SCr (42.2%). Age had relatively low influence on differences between equations (3.1%-9.5%). CONCLUSION There is a considerable disagreement between renal function estimation formulas, especially MDRD and C-G in geriatric palliative care patients, which may lead to errors in drug dosage adjustment. The magnitude of discrepancy increases with lower SCr, lower BMI, and higher age.
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Affiliation(s)
- Ewa Deskur-Smielecka
- Department of Palliative Medicine, Poznan University of Medical Sciences
- Palliative Medicine Unit, University Hospital of Lord’s Transfiguration, Poznan
| | - Aleksandra Kotlinska-Lemieszek
- Department of Palliative Medicine, Poznan University of Medical Sciences
- Palliative Medicine Unit, University Hospital of Lord’s Transfiguration, Poznan
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Wieczorowska-Tobis
- Department of Palliative Medicine, Poznan University of Medical Sciences
- Palliative Medicine Unit, University Hospital of Lord’s Transfiguration, Poznan
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Udhayarasu M, Ramakrishnan K, Periasamy S. Assessment of chronic kidney disease using skin texture as a key parameter: for South Indian population. Healthc Technol Lett 2017; 4:223-227. [PMID: 29383256 PMCID: PMC5761315 DOI: 10.1049/htl.2016.0098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 11/19/2022] Open
Abstract
Periodical monitoring of renal function, specifically for subjects with history of diabetic or hypertension would prevent them from entering into chronic kidney disease (CKD) condition. The recent increase in numbers may be due to food habits or lack of physical exercise, necessitates a rapid kidney function monitoring system. Presently, it is determined by evaluating glomerular filtration rate (GFR) that is mainly dependent on serum creatinine value and demographic parameters and ethnic value. Attempted here is to develop ethnic parameter based on skin texture for every individual. This value when used in GFR computation, the results are much agreeable with GFR obtained through standard modification of diet in renal disease and CKD epidemiology collaboration equations. Once correlation between CKD and skin texture is established, classification tool using artificial neural network is built to categorise CKD level based on demographic values and parameter obtained through skin texture (without using creatinine). This network when tested gives almost at par results with the network that is trained with demographic and creatinine values. The results of this Letter demonstrate the possibility of non-invasively determining kidney function and hence for making a device that would readily assess the kidney function even at home.
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Affiliation(s)
- Madhanlal Udhayarasu
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, India
| | - Kalpana Ramakrishnan
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Chennai, India
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23
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Degen DA, Janardan J, Barraclough KA, Schneider HG, Barber T, Barton H, Snell G, Levvey B, Walker RG. Predictive performance of different kidney function estimation equations in lung transplant patients. Clin Biochem 2017; 50:385-393. [DOI: 10.1016/j.clinbiochem.2017.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/09/2017] [Accepted: 01/16/2017] [Indexed: 10/20/2022]
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24
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Moreira Galdino P, Nunes Alexandre L, Fernanda Pacheco L, de Souza Lino Junior R, de Paula JR, Rodrigues Pedrino G, Henrique Xavier C, Maria Ferreira P. Nephroprotective effect of Rudgea viburnoides (Cham.) Benth leaves on gentamicin-induced nephrotoxicity in rats. JOURNAL OF ETHNOPHARMACOLOGY 2017; 201:100-107. [PMID: 28242383 DOI: 10.1016/j.jep.2017.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/10/2017] [Accepted: 02/23/2017] [Indexed: 06/06/2023]
Abstract
RELEVANCE Rudgea viburnoides, popularly known as "congonha-de-bugre" or "erva de bugre", is used in folk medicine as hypotensive, blood depurative, anti-rheumatic, diuretic and in the treatment of kidney and bladder pain. AIM Based on the popularly acclaimed nephron-protective effect of R. viburnoides, we investigated, using rats, the protective effect of this plant extract on gentamicin-induced kidney injury. MATERIAL AND METHODS Urinary volume, water and food intakes were assessed in adult male Wistar rats (naive or gentamicin-induced model of nephrotoxicity) treated with R. viburnoides extract. Also blood and kidney samples were collected for further laboratory and histological analyses. RESULTS R. viburnoides leaves extract improved renal function. It also improved the renal function impairments caused by gentamicin-induced nephrotoxicity, as revealed by glomerular filtration rate, urine output and proteinuria. CONCLUSION R. viburnoides exert renoprotective effect, which may support its popular use for renal diseases treatment.
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Affiliation(s)
| | - Layse Nunes Alexandre
- Laboratório de Fisiologia e Terapêutica Cardiovascular, ICB, UFG, Goiânia, GO, Brazil
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25
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Lindberg L, Brødbæk K, Hägerström EG, Bentzen J, Kristensen B, Zerahn B. Comparison of methods for estimating glomerular filtration rate in head and neck cancer patients treated with cisplatin. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:237-246. [DOI: 10.1080/00365513.2017.1298001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Anticancer Dose Adjustment for Patients with Renal and Hepatic Dysfunction: From Scientific Evidence to Clinical Application. Sci Pharm 2017; 85:scipharm85010008. [PMID: 28264440 PMCID: PMC5388145 DOI: 10.3390/scipharm85010008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/04/2017] [Accepted: 02/20/2017] [Indexed: 12/19/2022] Open
Abstract
Most anticancer agents exhibit a narrow therapeutic index, i.e., a small change in plasma concentrations can lead to a less efficacious treatment or an unacceptable degree of toxicity. This study aimed at providing health professionals with a feasible and time-saving tool to adapt the dose of anticancer agents for patients with renal or hepatic dysfunction. A guideline for anticancer agents was developed based on a literature search. An algorithm was generated to enhance the efficiency of the dose adaptation process. Finally, the dosing guideline was converted into an easy-to-use ExcelTM tool. The concept was applied to a total of 105 adult patients at the Centre for Integrated Oncology, Bonn, Germany. In total, 392 recommendations for dose adaptation were made and 320 (81.6%) recommendations were responded to by the oncologists. 98.4% of the recommendations were accepted. The algorithm simplifies the decision and screening process for high-risk patients. Moreover, it provides the possibility to quickly decide which laboratory tests are required and whether a dose adjustment for a particular anticancer drug is needed. The ExcelTM tool provides a recommended individual dose for patients with renal or hepatic dysfunction. The effectiveness of this strategy to reduce toxicity should be investigated in further studies before being adopted for routine use.
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27
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Hu J, Liu J. Licochalcone A Attenuates Lipopolysaccharide-Induced Acute Kidney Injury by Inhibiting NF-κB Activation. Inflammation 2017; 39:569-74. [PMID: 26552405 DOI: 10.1007/s10753-015-0281-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Licochalcone A (Lico A), a flavonoid found in licorice root (Glycyrrhiza glabra), has been reported to have anti-inflammatory activity. However, the protective effects of Lico A on lipopolysaccharide (LPS)-induced acute kidney injury (AKI) remains unclear. In this study, using a mouse model of LPS-induced AKI, we investigated the protective effects and mechanism of Lico A on LPS-induced AKI in mice. LPS-induced kidney injury was assessed by detecting kidney histological study, blood urea nitrogen (BUN), and creatinine levels. The production of inflammatory cytokines TNF-α, IL-6, and IL-1β in serum and kidney tissues was detected by ELISA. The activation of NF-κB was measured by western blot analysis. Our results showed that Lico A dose-dependently attenuated LPS-induced kidney histopathologic changes, serum BUN, and creatinine levels. Lico A also suppressed LPS-induced TNF-α, IL-6, and IL-1β production both in serum and kidney tissues. Furthermore, our results showed that Lico A significantly inhibited LPS-induced NF-κB activation. In conclusion, our results suggest that Lico A has protective effects against LPS-induced AKI and Lico A exhibits its anti-inflammatory effects through inhibiting LPS-induced NF-κB activation.
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Affiliation(s)
- Jun Hu
- Department of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510000, China
| | - Jun Liu
- Department of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510000, China.
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Imam TH, Fischer H, Jing B, Burchette R, Henry S, DeRose SF, Coleman KJ. Estimated GFR Before and After Bariatric Surgery in CKD. Am J Kidney Dis 2016; 69:380-388. [PMID: 27927587 DOI: 10.1053/j.ajkd.2016.09.020] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/12/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several reviews have recently detailed the beneficial effects of weight loss surgery for kidney function. However, these studies have a number of limitations, including small sample size, few done in chronic kidney disease (CKD) stages 3 and 4, and many not including the main bariatric surgery procedures used in the United States today. STUDY DESIGN This was an observational retrospective cohort study comparing propensity score-matched bariatric surgery patients and nonsurgery control patients who were referred for, but did not have, surgery. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy were also compared using propensity matching. SETTING & PARTICIPANTS Patients (714 surgery patients; 714 controls) were from a large integrated health care system, a mean of 58±8 (SD) years old, and mostly women (77%) and non-Hispanic whites (56%) and had diabetes mellitus (66%) and/or hypertension (91%). PREDICTOR Predictors at the time of surgery or referral to surgery were age, sex, race/ethnicity, weight, and presence of diabetes and/or hypertension. OUTCOMES The primary outcome for this study was change in estimated glomerular filtration rate (eGFR) from serum creatinine level over a median 3-year follow-up period. MEASUREMENTS Serum creatinine was used to calculate eGFR using the CKD-EPI (CKD Epidemiology Collaboration) creatinine equation. RESULTS Surgery patients had 9.84 (95% CI, 8.05-11.62) mL/min/1.73m2 greater eGFRs than controls at a median 3 years' follow-up and RYGB patients had 6.60 (95% CI, 3.42-9.78) mL/min/1.73m2 greater eGFRs than sleeve gastrectomy patients during the same period. LIMITATIONS This study is limited by its nonrandomized observational study design, estimation of GFR, and large changes in muscle mass, which may affect serum creatinine level independent of changes in kidney function. CONCLUSIONS Bariatric surgery, especially the RYGB procedure, results in significant improvements for up to 3 years in eGFRs for patients with CKD stages 3 and 4.
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Affiliation(s)
- Talha H Imam
- Department of Nephrology, Fontana Medical Center, Kaiser Permanente Southern California, Fontana.
| | - Heidi Fischer
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Bocheng Jing
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Raoul Burchette
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Shayna Henry
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Stephen F DeRose
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
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Chu Y, Luo Y, Qu L, Zhao C, Jiang M. Application of vancomycin in patients with varying renal function, especially those with augmented renal clearance. PHARMACEUTICAL BIOLOGY 2016; 54:2802-2806. [PMID: 27251880 DOI: 10.1080/13880209.2016.1183684] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 04/23/2016] [Indexed: 06/05/2023]
Abstract
CONTEXT Augmented renal clearance (ARC) refers to enhanced renal elimination of circulating solute, and has attracted wide attention in recent years. OBJECTIVE This study evaluates the effects of ARC on serum vancomycin concentration in patients administered vancomycin. MATERIALS AND METHODS This was a retrospective study in patients receiving vancomycin treatment at a dose of 1000 mg in every 12 h and undergoing serum monitoring admitted over a 2-year period (May 2013 to May 2015), in order to estimate the influence of ARC on serum vancomycin concentration. In this study, statistical comparisons were made on the results from patients grouped according to creatinine clearance (CLcr). RESULTS One hundred forty-eight patients were enrolled in our study. The results showed that ARC patients were significantly younger, with a significantly lower Scr and higher GFR. The CLcr and steady-state trough concentrations of serum vancomycin exhibited a logarithmic correlation (Rs = -0.699, R2 = 0.488, p < 0.01) in the patients included in our study. The trough vancomycin concentrations of 62.9% patients in high CLcr group were under 10 μg/mL. DISCUSSION AND CONCLUSION Since ARC was significantly associated with subtherapeutic serum vancomycin concentration, it was necessary to devise adjusted dosage regimens for these patients based on their CLcr.
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Affiliation(s)
- Yang Chu
- a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China
- b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China
| | - Yifan Luo
- a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China
- b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China
| | - Lianyue Qu
- a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China
- b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China
| | - Chunyang Zhao
- a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China
- b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China
| | - Mingyan Jiang
- a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China
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30
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The relationship between simple renal cysts and glomerular filtration rate in the elderly. Int Urol Nephrol 2016; 49:313-317. [DOI: 10.1007/s11255-016-1414-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 09/01/2016] [Indexed: 10/21/2022]
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31
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Blumenstiel B, DeFelice M, Birsoy O, Bleyer AJ, Kmoch S, Carter TA, Gnirke A, Kidd K, Rehm HL, Ronco L, Lander ES, Gabriel S, Lennon NJ. Development and Validation of a Mass Spectrometry–Based Assay for the Molecular Diagnosis of Mucin-1 Kidney Disease. J Mol Diagn 2016; 18:566-71. [DOI: 10.1016/j.jmoldx.2016.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/03/2016] [Accepted: 03/09/2016] [Indexed: 11/28/2022] Open
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32
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Kaestner S, Sewell G. Dose-banding of carboplatin: rationale and proposed banding scheme. J Oncol Pharm Pract 2016; 13:109-17. [PMID: 17873111 DOI: 10.1177/1078155207080801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. In dose-banding (DB) prescribed doses of cancer chemotherapy are fitted to doseranges or ‘bands’ and standard doses for each band are provided using a selection of pre-filled infusions or syringes, either singly or in combination. DB is used for several drugs where dose is based on body surface area. No DB-scheme has been reported for carboplatin, which, in clinical practice, is routinely dosed according to renal function. Study objective. To assess the rationale for DB of carboplatin with regards to factors that influence dosing accuracy, develop a DB scheme, and discuss its potential use and limitations. Methods. Prospective evaluations of carboplatin area under the plasma concentration – time curve (AUC) following application of the Calvert-formula were identified by a literature search. A relevant carboplatin dose range for construction of a DB-scheme with Calvert-formula based doses was obtained from published glomerular filtration rate distributions for patients receiving carboplatin. Results. A DB-scheme was developed for individually calculated carboplatin doses of 358–1232 mg, with 35 mg increments between each standard dose and a maximum deviation of 4.7% from prescribed dose. The proposed DB-scheme covers the GFR-ranges 47–221 mL/min and 26–151 mL/min for patients receiving doses based on the target AUCs of 5 and 7 mg/mL/min, respectively. Conclusion. There is a strong scientific rationale to support DB of carboplatin. The proposed banding scheme could introduce benefits to patients and healthcare staff but, as with other DB schemes, should be validated with prospective clinical and pharmacokinetic studies to confirm safety and efficacy.
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Affiliation(s)
- Sabine Kaestner
- Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, UK
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Al-Wakeel JS. Accuracy and precision of the CKD-EPI and MDRD predictive equations compared with glomerular filtration rate measured by inulin clearance in a Saudi population. Ann Saudi Med 2016; 36:128-34. [PMID: 27018810 PMCID: PMC6074387 DOI: 10.5144/0256-4947.2016.28.3.1715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Predictive equations for estimating glomerular filtration rate (GFR) in different clinical conditions should be validated by comparing with the measurement of GFR using inulin clearance, a highly accurate measure of GFR. OBJECTIVES Our aim was to validate the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations by comparing it to the GFR measured using inulin clearance in chronic kidney disease (CKD) patients. DESIGN Cross-sectional study performed in adult Saudi patients with CKD. SETTING King Saud University Affiliated Hospital, Riyadh, Saudi Arabia in 2014. PATIENTS AND METHODS We compared GFR measured by inulin clearance with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas. MAIN OUTCOME MEASURE(S) Correlation, bias, precision and accuracy between the estimated GFR and inulin clearance. RESULTS Comparisons were made in 31 participants (23 CKD and 8 transplanted), including 19 males (mean age 42.2 [15] years and weight 68.7 [18] kg). GFR using inulin was 51.54 (33.8) mL/min/1.73 m2 in comparison to inulin clearance, the GFR by the predictive equations was: CKD-EPI creatinine 52.6 (34.4) mL/ min/1.73 m2 (P=.490), CKD-EPI cystatin C 41.39 (30.30) mL/min/1.73 m2 (P=.002), CKD creatinine-cystatin C 45.03 (30.9) mL/min/1.73 m2 (P=.004) and MDRD GFR 48.35 (31.5) mL/min/1.73 m2 (P=.028) (statistical comparisons vs inulin). Bland-Altman plots demonstrated that GFR estimated by the CKD-EPI creatinine was the most accurate compared with inulin clearance, having a mean difference (estimated bias) and limits of agreement of -1.1 (15.6,-17.7). By comparison the mean differences for predictive equations were: CKD-EPI cystatin C 10.2 (43.7,-23.4), CKD creatinine-cystatin C 6.5 (29.3,-16.3) and MDRD 3.2 (18.3,-11.9). except for CKD-EPI creatinine, all of the equations underestimated GFR in comparison with inulin clearance. CONCLUSIONS When compared with inulin clearance, the CKD-EPI creatinine equation is the most accurate, precise and least biased equation for estimation of GFR in the Saudi population and in all subgroups by age, stage of CKD and transplantation status. LIMITATIONS Small sample size and the study did not include patients with comorbid diseases such as diabetes, hepatitis C virus infection, and other co-morbidities as well as old age ( > 80 years).
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Affiliation(s)
- Jamal Saleh Al-Wakeel
- Professor Jamal Saleh Al-Wakeel, Nephrology Unit,, Department of Medicine,, King Saud University, PO Box 2925 Riyadh, 11461 Saudi Arabia, T: 0096614671531, F: 0096614672671,
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Scherzer R, Lin H, Abraham A, Thiessen-Philbrook H, Parikh CR, Bennett M, Cohen MH, Nowicki M, Gustafson DR, Sharma A, Young M, Tien P, Jotwani V, Shlipak MG. Use of urine biomarker-derived clusters to predict the risk of chronic kidney disease and all-cause mortality in HIV-infected women. Nephrol Dial Transplant 2016; 31:1478-85. [PMID: 26754833 DOI: 10.1093/ndt/gfv426] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/20/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although individual urine biomarkers are associated with chronic kidney disease (CKD) incidence and all-cause mortality in the setting of HIV infection, their combined utility for prediction remains unknown. METHODS We measured eight urine biomarkers shown previously to be associated with incident CKD and mortality risk among 902 HIV-infected women in the Women's Interagency HIV Study: N-acetyl-β-d-glucosaminidase (NAG), kidney injury molecule-1 (KIM-1), alpha-1 microglobulin (α1m), interleukin 18, neutrophil gelatinase-associated lipocalin, albumin-to-creatinine ratio, liver fatty acid-binding protein and α-1-acid-glycoprotein. A group-based cluster method classified participants into three distinct clusters using the three most distinguishing biomarkers (NAG, KIM-1 and α1m), independent of the study outcomes. We then evaluated associations of each cluster with incident CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2) by cystatin C) and all-cause mortality, adjusting for traditional and HIV-related risk factors. RESULTS Over 8 years of follow-up, 177 CKD events and 128 deaths occurred. The first set of clusters partitioned women into three groups, containing 301 (Cluster 1), 470 (Cluster 2) and 131 (Cluster 3) participants. The rate of CKD incidence was 13, 21 and 50% across the three clusters; mortality rates were 7.3, 13 and 34%. After multivariable adjustment, Cluster 3 remained associated with a nearly 3-fold increased risk of both CKD and mortality, relative to Cluster 1 (both P < 0.001). The addition of the multi-biomarker cluster to the multivariable model improved discrimination for CKD (c-statistic = 0.72-0.76, P = 0.0029), but only modestly for mortality (c = 0.79-0.80, P = 0.099). Clusters derived with all eight markers were no better for discrimination than the three-biomarker clusters. CONCLUSIONS For predicting incident CKD in HIV-infected women, clusters developed from three urine-based kidney disease biomarkers were as effective as an eight-marker panel in improving risk discrimination.
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Affiliation(s)
- Rebecca Scherzer
- University of California and Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Haiqun Lin
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
| | - Alison Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Chirag R Parikh
- Section of Nephrology, Department of Medicine, Program of Applied Translational Research, Yale University, New Haven, CT, USA
| | - Michael Bennett
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mardge H Cohen
- Department of Medicine, Stroger Hospital and Rush University, Chicago, IL, USA
| | - Marek Nowicki
- Department of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Deborah R Gustafson
- Department of Neurology, State University of New York-Downstate Medical Center, Brooklyn, NY, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mary Young
- Division of Infectious Diseases and Travel Medicine, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Phyllis Tien
- University of California and Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Vasantha Jotwani
- University of California and Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Michael G Shlipak
- University of California and Veterans Affairs Medical Center, San Francisco, CA, USA
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Fawwad A, Siddiqui IA, Basit A, Zeeshan NF, Shahid SM, Nawab SN, Siddiqui S. Common variant within the FTO gene, rs9939609, obesity and type 2 diabetes in population of Karachi, Pakistan. Diabetes Metab Syndr 2016; 10:43-47. [PMID: 25757373 DOI: 10.1016/j.dsx.2015.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To determine the effect of genetic variants within the FTO gene (rs9939609) on obesity related traits and type 2 diabetes in South Asian population of Karachi, Pakistan. METHODS A case-control study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University situated in Karachi. A total of 296 patients with known type 2 diabetes and 198 controls aged greater than and equal to 45 years were recruited. The Anthropometric, clinical and biochemical data was collected on a structured questionnaire. Single nucleotide polymorphism (SNP) in FTO gene was identified by Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR). Association between the single nucleotide polymorphism and categorical variables such as type 2 diabetes and obesity category was tested through logistic regression analysis. RESULTS We observed a strong association of the minor allele A at rs9939609 with type 2 diabetes. Significant difference was observed in frequency of FTO genotype when diabetic subjects were compared with controls in co dominant, dominant and recessive models. This association remained significant even after adjusting for body mass index (BMI) and for waist circumference. The frequency of homozygous risk Alleles (AA) was found to be higher in obese & overweight (≥ 23 kg/m(2)) and females with central obesity in our study population. The association of FTO variant with BMI and central obesity does not reach to statistical significance. CONCLUSION In the study population of South Asian ancestry, variants of the FTO gene predispose to type 2 diabetes, but not entirely through their effect on BMI.
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Affiliation(s)
- Asher Fawwad
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No. 2, Karachi 74600, Pakistan; Department of Biochemistry, Baqai Medical University, 51, Deh Tor, Gadap Road, Near Toll Plaza, Super Highway, P.O. Box No 2407, Karachi 74600, Pakistan.
| | - Iftikhar Ahmed Siddiqui
- Department of Biochemistry, Baqai Medical University, 51, Deh Tor, Gadap Road, Near Toll Plaza, Super Highway, P.O. Box No 2407, Karachi 74600, Pakistan
| | - Abdul Basit
- Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No. 2, Karachi 74600, Pakistan
| | - Nimra Fatima Zeeshan
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No. 2, Karachi 74600, Pakistan
| | - Syed Muhammad Shahid
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
| | - Syeda Nuzhat Nawab
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
| | - Sidra Siddiqui
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No. 2, Karachi 74600, Pakistan
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Tarantini L, Barbati G, Cioffi G, McAlister FA, Ezekowitz JA, Mazzone C, Faganello G, Russo G, Franceschini Grisolia E, Di Lenarda A. Clinical implications of the CKD epidemiology collaboration (CKD-EPI) equation compared with the modification of diet in renal disease (MDRD) study equation for the estimation of renal dysfunction in patients with cardiovascular disease. Intern Emerg Med 2015; 10:955-63. [PMID: 26123617 DOI: 10.1007/s11739-015-1260-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 05/12/2015] [Indexed: 11/25/2022]
Abstract
The CKD-EPI equation is more accurate than the MDRD equation in the general population. We performed this study to establish whether chronic kidney disease (CKD) is commonly recognized by clinicians and whether the CKD-EPI equation improves prognosis estimation in patients with chronic cardiovascular disease (CVD). We analyzed data on 12394 CVD patients consecutively examined at the Cardiovascular Center of Trieste (Italy) between November 2009 and October 2013. The outcomes were all-cause death and a composite outcome of death/hospitalization for CV events (D+cvH). CKD-EPI formula reclassified 1786 (14.4 %) patients between KDIGO categories compared to the MDRD: 2.3 % (n = 280) placed in a lower risk and 12.1 % (n = 1506) into a higher risk group. CKD, defined as eGFR-CKD-EPI formula <60 ml/min, was present in 3083 patients (24.9 %) but not recognized by clinicians in 1946 (63.1 % of patients with CKD). The lack of recognition of CKD was inversely proportional to the KDIGO class for both equations. There were 986 deaths and 2726 D+cvH during 24 months follow-up. The incidence of death and D+cvH was about twice as high in patients with unrecognized CKD than in those with normal renal function (31 % vs. 17.1 %, aHR: 1.35, 95 % CI: 1.15 to 1.60), even in those patients with eGFR-MDRD >60 but eGFR-CKD-EPI formula <60 (31.1 % vs 17.1 %, p < 0.001). CKD-EPI equation provides more accurate risk stratification than MDRD equation in patients with CVD. CKD was unrecognized in nearly two-thirds of these patients but clinical outcomes were similar in those for patients with recognized CKD.
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Affiliation(s)
- Luigi Tarantini
- UOC Cardiologia Azienda ULSS numero 1 Belluno, Belluno, Italy
| | | | - Giovanni Cioffi
- Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
| | - Finlay Aleck McAlister
- Department of Medicine and Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Justin Adrian Ezekowitz
- Department of Medicine and Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | | | | | - Giulia Russo
- Cardiovascular Center, ASS 1 Trieste, Trieste, Italy
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Takata T, Koda M, Sugihara T, Sugihara S, Okamoto T, Miyoshi K, Hodotsuka M, Fujise Y, Matono T, Okano J, Hosho K, Iyama T, Fukui T, Fukuda S, Munemura C, Isomoto H. Left Renal Cortical Thickness Measured by Ultrasound Can Predict Early Progression of Chronic Kidney Disease. Nephron Clin Pract 2015; 132:25-32. [PMID: 26581096 DOI: 10.1159/000441957] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/24/2015] [Indexed: 11/19/2022] Open
Abstract
AIMS The kidney becomes atrophic in advanced chronic kidney disease, and renal size and parenchymal volume correlate with renal function. However, alterations in renal parenchymal volume have not been adequately studied in terms of the renal cortex and medulla. We investigated the relationship between the changes in the renal cortex and medulla and renal function. METHODS Renal ultrasound (US) parameters including renal length, parenchymal thickness, cortical thickness and medullary thickness were assessed in 176 subjects, who were categorized into 4 groups based on the estimated glomerular filtration rate (ml/min/1.73 m2): group 1, ≥ 90; group 2, ≥ 60 but < 90; group 3, ≥ 30 but < 60; and group 4, < 30. Renal US parameters in both kidneys were compared among the 4 groups. RESULTS We found stepwise associations in renal length, cortical thickness and parenchymal thickness with decreased renal function. Medullary thickness showed no changes among groups 1-3. Multiple linear regression analysis including sex, age and renal US parameters showed that only renal length was an independent predictor of renal function. When analyzed in groups 1-3, cortical thickness was the strongest associated parameter. Lower cortical left/right ratio (left cortical thickness/right cortical thickness) showed a stepwise association with a decrease in renal function. CONCLUSION Renal length and cortical thickness measured by US were correlated with renal function. In particular, left cortical thickness could help to detect early changes in renal function.
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Affiliation(s)
- Tomoaki Takata
- Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan
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Rundfeldt C, Tipold A, Löscher W. Efficacy, safety, and tolerability of imepitoin in dogs with newly diagnosed epilepsy in a randomized controlled clinical study with long-term follow up. BMC Vet Res 2015; 11:228. [PMID: 26330063 PMCID: PMC4556053 DOI: 10.1186/s12917-015-0548-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/26/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Imepitoin is a novel antiepileptic drug for the treatment of canine idiopathic epilepsy. The present study was conducted to demonstrate superior antiepileptic activity of a high dose of 30 mg/kg BID over a low dose of 1 mg/kg BID of imepitoin during 12 weeks of treatment under double blind conditions in a field population of dogs with previously untreated epilepsy. In a consecutive 12 weeks open label follow up (phase 2), all animals received 30 mg/kg BID, to evaluate the persistence of the antiepileptic activity, and to evaluate the effect of a dose step up to 30 mg/kg in the former low-dose animals. RESULTS A treatment with 30 mg/kg BID resulted in a significantly greater reduction in monthly seizure frequency relative to baseline data as compared to the 1 mg/kg dose. Both generalized and partial seizures but not cluster seizures were significantly less frequent in the high dose group. The antiepileptic activity was maintained during study phase 2 in the high dose group. An increase to 30 mg/kg BID in the low- dose animals resulted in a significant reduction in generalized and partial seizures, but not cluster seizures. At the end of study phase 2, 32.1 and 46.8 % of dogs of the former high and former low-dose groups respectively, remained free of generalized tonic-clonic seizures. Imepitoin was well tolerated. The frequency of dogs with any adverse drug reactions was higher in the 30 mg/kg BID dose (59 % vs. 41 %, p = 0.041), and the main target organ was the central nervous system (CNS). The occurrence of CNS related adverse reactions was transient and findings were mostly restricted to the first weeks of treatment. No hepatic enzyme increase and no other organ toxicity were observed. CONCLUSION The administration of imepitoin twice daily at a dose of 30 mg/kg results in significant and persistent antiepileptic effects in patients with newly diagnosed epilepsy and generalized tonic-clonic seizures, as observed over a study period of up to 6 months. Imepitoin was well tolerated. Most CNS related adverse drug reactions were transient. Both the antiepileptic activity and the safety profile make the drug suitable for long-term clinical use.
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Affiliation(s)
- Chris Rundfeldt
- Drug-Consulting Network, 01445, Coswig, Germany. .,Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany. .,Center for Systems Neuroscience, 30559, Hannover, Germany.
| | - Wolfgang Löscher
- Center for Systems Neuroscience, 30559, Hannover, Germany. .,Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, 30559, Hannover, Germany.
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Wunnapuk K, Mohammed F, Gawarammana I, Liu X, Verbeeck RK, Buckley NA, Roberts MS, Musuamba FT. Prediction of paraquat exposure and toxicity in clinically ill poisoned patients: a model based approach. Br J Clin Pharmacol 2015; 78:855-66. [PMID: 24697850 DOI: 10.1111/bcp.12389] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/25/2014] [Indexed: 11/28/2022] Open
Abstract
AIMS Paraquat poisoning is a medical problem in many parts of Asia and the Pacific. The mortality rate is extremely high as there is no effective treatment. We analyzed data collected during an ongoing cohort study on self-poisoning and from a randomized controlled trial assessing the efficacy of immunosuppressive therapy in hospitalized paraquat-intoxicated patients. The aim of this analysis was to characterize the toxicokinetics and toxicodynamics of paraquat in this population. METHODS A non-linear mixed effects approach was used to perform a toxicokinetic/toxicodynamic population analysis in a cohort of 78 patients. RESULTS The paraquat plasma concentrations were best fitted by a two compartment toxicokinetic structural model with first order absorption and first order elimination. Changes in renal function were used for the assessment of paraquat toxicodynamics. The estimates of toxicokinetic parameters for the apparent clearance, the apparent volume of distribution and elimination half-life were 1.17 l h(-1) , 2.4 l kg(-1) and 87 h, respectively. Renal function, namely creatinine clearance, was the most significant covariate to explain between patient variability in paraquat clearance.This model suggested that a reduction in paraquat clearance occurred within 24 to 48 h after poison ingestion, and afterwards the clearance was constant over time. The model estimated that a paraquat concentration of 429 μg l(-1) caused 50% of maximum renal toxicity. The immunosuppressive therapy tested during this study was associated with only 8% improvement of renal function. CONCLUSION The developed models may be useful as prognostic tools to predict patient outcome based on patient characteristics on admission and to assess drug effectiveness during antidote drug development.
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Affiliation(s)
- Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Association of relative telomere length with progression of chronic kidney disease in two cohorts: effect modification by smoking and diabetes. Sci Rep 2015; 5:11887. [PMID: 26149682 PMCID: PMC4493689 DOI: 10.1038/srep11887] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/09/2015] [Indexed: 01/18/2023] Open
Abstract
Chronic kidney disease (CKD) is a highly progressive disease. We studied the association between relative telomere length (RTL) and CKD progression and tested whether this association is modified by smoking and diabetes mellitus. RTL was measured by qPCR in two prospective cohort studies, the MMKD-Study (n = 166) and the CRISIS-Study (n = 889) with a median follow-up of 4.5 and 2.8 years, respectively. Progression was defined as doubling of baseline serum creatinine (MMKD-Study) and/or end stage renal disease (both studies). 59 and 105 of the patients from MMKD and CRISIS experienced a progression of CKD. Mean standardized pooled RTL was 0.74 ± 0.29. In the meta-analysis shorter RTL at baseline showed a borderline association with CKD progression (HR = 1.07 [95%CI 1.00-1.15]; p = 0.06). We observed an effect modification of RTL and CKD progression by smoking and diabetes (p-values of interaction p = 0.02 and p = 0.09, respectively). Each 0.1 unit shorter RTL was significantly associated with an increased hazard for CKD progression in active-smokers by 44% (HR = 1.44 [1.16-1.81]; p = 0.001) and in patients with diabetes mellitus by 16% (HR = 1.16 [1.01-1.34]; p = 0.03). Estimates were adjusted for baseline age, sex, proteinuria and GFR. This study in two independent cohorts reinforces that RTL is a marker and potentially a pathogenetic factor for CKD progression.
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Glaser N, Deckert A, Phiri S, Rothenbacher D, Neuhann F. Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings? PLoS One 2015; 10:e0130453. [PMID: 26083345 PMCID: PMC4470826 DOI: 10.1371/journal.pone.0130453] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/20/2015] [Indexed: 11/15/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates. Methods This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive. Results Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and –negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives. Conclusions Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.
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Affiliation(s)
- Nicola Glaser
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
- * E-mail: (NG); (AD)
| | - Andreas Deckert
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
- * E-mail: (NG); (AD)
| | - Sam Phiri
- The Lighthouse Trust, Lilongwe, Malawi
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | | | - Florian Neuhann
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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Bruniera FR, Ferreira FM, Savioli LRM, Bacci MR, Feder D, Pereira EC, Pedreira MLG, Peterlini MAS, Perazzo FF, Azzalis LA, Rosa PCP, Junqueira VBC, Sato MA, Fonseca FLA. Endothelial, renal and hepatic variables in Wistar rats treated with Vancomycin. AN ACAD BRAS CIENC 2015; 86:1963-72. [PMID: 25590732 DOI: 10.1590/0001-3765201420140204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 07/29/2014] [Indexed: 12/22/2022] Open
Abstract
Vancomycin (VCM) is indicated in combat against Gram-positive infections, but it is not considered a first-choice drug because of its adverse effects. It is believed that oxidative stress is the primary mechanism of endothelial injury and the consequent VCM toxicity, which varies from phlebitis to nephrotoxicity. Moreover, dose recommendations, dilution, rates and types of infusion are still controversial. The aim of this study was to determine the effect of different VCM dilutions in endothelial, liver and kidney injuries by biochemical parameters and histopathological analysis. Wistar rats were randomly divided into six groups and subjected to femoral vein cannulation for drug administration. Control groups received 0.9 ml of saline and the others received VCM (10mg/Kg/day) at dilutions of 5.0 and 10.0 mg/mL for 3 and 7 days. Homocysteine, hs-CRP, AST, ALT, GGT, urea, creatinine, lycopene, alpha-tocopherol, beta-carotene and retinol were analyzed. Kidney, liver and cannulated femoral vein fragments were collected.This study showed alterations in ALT which featured hepatotoxicity. However, drug dilutions were not able to show changes in other biochemical parameters. In contrast, kidney and endothelium pathological changes were observed. More studies are needed to characterize VCM induced kidney and endothelium toxicity and biochemical markers able to show such morphological modifications.
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Affiliation(s)
- Felipe R Bruniera
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Felipe M Ferreira
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Luiz R M Savioli
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Marcelo R Bacci
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - David Feder
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Edimar C Pereira
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Mavilde L G Pedreira
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Maria A S Peterlini
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Fábio F Perazzo
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Exatas e da Terra, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Ligia A Azzalis
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Exatas e da Terra, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Paulo C P Rosa
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Exatas e da Terra, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Virginia B C Junqueira
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Monica A Sato
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
| | - Fernando L A Fonseca
- Disciplina de Farmacologia, Departamento de Morfologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
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da Silva LS, Cotta RMM, Moreira TR, da Silva RG, Rosa CDOB. Assessment of different detection methods of chronic kidney disease and their importance for an early diagnosis. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0674-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Holditch SJ, Schreiber CA, Nini R, Tonne JM, Peng KW, Geurts A, Jacob HJ, Burnett JC, Cataliotti A, Ikeda Y. B-Type Natriuretic Peptide Deletion Leads to Progressive Hypertension, Associated Organ Damage, and Reduced Survival: Novel Model for Human Hypertension. Hypertension 2015; 66:199-210. [PMID: 26063669 DOI: 10.1161/hypertensionaha.115.05610] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/17/2015] [Indexed: 12/14/2022]
Abstract
Altered myocardial structure and function, secondary to chronically elevated blood pressure, are leading causes of heart failure and death. B-type natriuretic peptide (BNP), a guanylyl cyclase A agonist, is a cardiac hormone integral to cardiovascular regulation. Studies have demonstrated a causal relationship between reduced production or impaired BNP release and the development of human hypertension. However, the consequences of BNP insufficiency on blood pressure and hypertension-associated complications remain poorly understood. Therefore, the goal of this study was to create and characterize a novel model of BNP deficiency to investigate the effects of BNP absence on cardiac and renal structure, function, and survival. Genetic BNP deletion was generated in Dahl salt-sensitive rats. Compared with age-matched controls, BNP knockout rats demonstrated adult-onset hypertension. Increased left ventricular mass with hypertrophy and substantially augmented hypertrophy signaling pathway genes, developed in young adult knockout rats, which preceded hypertension. Prolonged hypertension led to increased cardiac stiffness, cardiac fibrosis, and thrombi formation. Significant elongation of the QT interval was detected at 9 months in knockout rats. Progressive nephropathy was also noted with proteinuria, fibrosis, and glomerular alterations in BNP knockout rats. End-organ damage contributed to a significant decline in overall survival. Systemic BNP overexpression reversed the phenotype of genetic BNP deletion. Our results demonstrate the critical role of BNP defect in the development of systemic hypertension and associated end-organ damage in adulthood.
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Affiliation(s)
- Sara J Holditch
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Claire A Schreiber
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Ryan Nini
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Jason M Tonne
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Kah-Whye Peng
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Aron Geurts
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Howard J Jacob
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - John C Burnett
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Alessandro Cataliotti
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.)
| | - Yasuhiro Ikeda
- From the Department of Molecular Medicine (S.J.H., C.A.S., R.N., J.M.T., K.-W.P., Y.I.) and Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Medicine and Physiology (J.C.B., A.C.), Mayo Clinic, College of Medicine, Rochester, MN; Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (A.G., H.J.J.); and Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway (A.C.).
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Maillard N, Delanaye P, Mariat C. Exploration de la fonction glomérulaire rénale : estimation du débit de filtration glomérulaire. Nephrol Ther 2015; 11:54-67. [DOI: 10.1016/j.nephro.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
Although kidney size can be important in the evaluation of renal disease, it has not been carefully studied and true volume is rarely measured, and good normative data are lacking. Wang et al. measured both cortical and medullary volumes in potential transplant donors and correlate these with physiologic, morphometric, and metabolic parameters. The results reveal interesting and potentially important correlations and differential responses between the two compartments, providing a framework for future investigation.
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Affiliation(s)
- W Charles O'Neill
- Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA
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Cheng MH, Zeng FW, Xie LJ, Li JF, Zhang F, Jiang H. A new quantitative method for estimating glomerular filtration rate and its clinical value. Clin Physiol Funct Imaging 2014; 36:118-25. [PMID: 25412856 DOI: 10.1111/cpf.12204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM The estimation of the glomerular filtration rate (GFR) is essential for the renal function. However, all estimation methods for GFR have advantages and disadvantages. The aim of this study was to develop a new quantitative method for estimating GFR and evaluate its clinical value. METHODS The new GFR was estimated by quantifying the accumulation of Tc-99m DTPA in the dual kidneys and bladder during a gamma camera renogram study in 116 patients with chronic kidney disease. GFR was determined by this new method (nGFR), Gates' gamma camera technique (gGFR), a two-plasma sampling method (tGFR) and creatinine-based clearance as estimated by Cockcroft-Gault (cGFR) and abbreviated MDRD (aGFR) formulae. The correlation analysis, Bland-Altman analysis and receiver-operating characteristic (ROC) plots were carried out among above methods. RESULTS The nGFR value has significant correlation with tGRF (r = 0·827, P<0·01). The nGFR had the best overall performances with a lowest bias deviation (3·1 ml min(-1) /1·73 m(2) ), better precision (53·0 ml min(-1) /1·73 m(2) ), narrowest interquartile range (13·5 ml min(-1) /1·73 m(2) ) and best accuracy (68·1%) within 30% of the tGFR, compared with those of gGFR, cGFR and aGFR. The new method had the similar maximum accuracy with the Gates' method and creatinine clearance as estimated by Cockcroft-Gault and abbreviated modification of diet in renal disease (MDRD) method. The new method had better repeatability characteristic compared with the Gates' method. CONCLUSIONS The new method for estimating GFR had the better performances compared with the Gates' method and creatinine clearance as estimated by Cockcroft-Gault and MDRD method.
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Affiliation(s)
- Mu-Hua Cheng
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
| | - Feng-Wei Zeng
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
| | - Liang-Jun Xie
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
| | - Jian-Fang Li
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
| | - Feng Zhang
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
| | - Hang Jiang
- Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China
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Reza T, Aktar S, Al Amin H, Rahman M, Arefin A, Chandra Mohanto N, Alam S, Al Mamun A, Habib A, Asafudullah, Nikkon F, Hossain K, Saud ZA. In vivo analysis of toxic effect of hydrose used in food preparations in Bangladesh. Asian Pac J Trop Biomed 2014. [DOI: 10.12980/apjtb.4.201414b366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Oxidative status imbalance in patients with metabolic syndrome: role of the myeloperoxidase/hydrogen peroxide axis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2014; 2014:898501. [PMID: 25386227 PMCID: PMC4216703 DOI: 10.1155/2014/898501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/17/2014] [Accepted: 09/11/2014] [Indexed: 02/07/2023]
Abstract
The present study evaluated the cardiometabolic and redox balance profiles in patients with Metabolic Syndrome compared to apparently healthy individuals, and the participation of the myeloperoxidase/hydrogen peroxide axis in systemic lipid peroxidation. Twenty-four patients with Metabolic Syndrome and eighteen controls underwent a full clinical assessment. Venous blood samples were collected for general biochemical dosages, as well as for the oxidative stress analyses (superoxide dismutase, catalase, and arginase activities; and lipid peroxidation, myeloperoxidase activity, nitrite, and hydrogen peroxide concentrations in plasma). Arterial stiffness was assessed by radial artery applanation tonometry. Plasma lipid peroxidation, erythrocyte superoxide dismutase activity, myeloperoxidase activity, and hydrogen peroxide concentrations were shown to be increased in Metabolic Syndrome patients, without significant differences for the other enzymes, plasma nitrite concentrations, and arterial stiffness. Linear regression analysis revealed a positive and significant correlation between lipid peroxidation and myeloperoxidase and also between this enzyme and hydrogen peroxide. In contrast, such correlation was not observed between lipid peroxidation and hydrogen peroxide. In summary, Metabolic Syndrome patients exhibited evident systemic redox imbalance compared to controls, with the possible participation of the myeloperoxidase/hydrogen peroxide axis as a contributor in lipid peroxidation.
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50
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Effects of unidentified renal insufficiency on the safety and efficacy of chemotherapy for metastatic colorectal cancer patients: a prospective, observational study. Support Care Cancer 2014; 23:1043-8. [DOI: 10.1007/s00520-014-2461-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022]
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