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Rogers KL, Roncal-Jimenez CA, Leiva R, Stem A, Wijkstrom J, Serpas L, González-Quiroz MA, Sasai F, Wernerson A, Schaeffer J, Fox J, Ray M, Bansal A, Urra M, Butler-Dawson J, Lucia S, Newman LS, Glaser J, Johnson RJ, Brown JM. Silica Nanoparticles and Mesoamerican Nephropathy: A Case Series. Am J Kidney Dis 2024; 83:420-423. [PMID: 37877930 DOI: 10.1053/j.ajkd.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Keegan L Rogers
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Carlos A Roncal-Jimenez
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ricardo Leiva
- Department of Nephrology, Hospital Rosales, San Salvador, El Salvador
| | - Arthur Stem
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Julia Wijkstrom
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Lissbeth Serpas
- Department of Pathology, Hospital Rosales, San Salvador, El Salvador
| | - Marvin A González-Quiroz
- Department of Renal Medicine, University College London, London, United Kingdom; School of Medicine, Universidad Nacional de Chimborazo, Riobamba, Ecuador
| | - Fumihiko Sasai
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Annika Wernerson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Joshua Schaeffer
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jacob Fox
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Matthew Ray
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anip Bansal
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Manuel Urra
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jaime Butler-Dawson
- Center for Health, Work, & Environment and Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | - Scott Lucia
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lee S Newman
- Center for Health, Work, & Environment and Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | | | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Jared M Brown
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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Roncal-Jimenez CA, Rogers KL, Stem A, Wijkstrom J, Wernerson A, Fox J, Garcia Trabanino R, Brindley S, Garcia G, Miyazaki M, Miyazaki-Anzai S, Sasai F, Urra M, Cara-Fuentes G, Sánchez-Lozada LG, Rodriguez-Iturbe B, Butler Dawson J, Madero M, Brown JM, Johnson RJ. Intranasal Administration of Sugarcane Ash Causes Chronic Kidney Disease in Rats. Am J Physiol Renal Physiol 2024; 326:F477-F484. [PMID: 38234297 DOI: 10.1152/ajprenal.00251.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/15/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024] Open
Abstract
Background. Silica nanoparticles found in sugarcane ash have been postulated to be a toxicant contributing to chronic kidney disease of unknown etiology (CKDu). However, while the administration of manufactured silica nanoparticles is known to cause chronic tubulointerstitial disease in rats, the effect of administering sugarcane ash on kidney pathology remains unknown. Here we investigate whether sugarcane ash can induce CKD in rats. Methods. Sugarcane ash was administered for 13 weeks into the nares of rats (5 mg/day for 5d/week), and blood, urine and kidney tissues were collected at 13 weeks (at the end of ash administration) and in a separate group of rats at 24 weeks (11 weeks after stopping ash administration). Kidney histology was evaluated, and inflammation and fibrosis (collagen deposition) measured. Results. Sugarcane ash exposure led to the accumulation of silica in the kidneys, lungs, liver and spleen of rats. Mild proteinuria developed although renal function was largely maintained. However, biopsies showed focal glomeruli with segmental glomerulosclerosis, and tubulointerstitial inflammation and fibrosis that tended to worsen even after the ash administration had been stopped. Staining for the lysosomal marker, LAMP-1, showed decreased staining in ash administered rats consistent with lysosomal activation. Conclusion. Sugarcane ash containing silica nanoparticles can cause CKD in rats.
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Affiliation(s)
- Carlos A Roncal-Jimenez
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Keegan L Rogers
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Arthur Stem
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Adams County, United States
| | - Julia Wijkstrom
- CLINTEC, Division of renal medicine, Karolinska Institute, Stockholm, Sweden
| | - Annika Wernerson
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Jacob Fox
- Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | | | - Stephen Brindley
- Toxicology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Gabriela Garcia
- Medicine-Nephrology, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - Makoto Miyazaki
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Auroa, United States
| | - Shinobu Miyazaki-Anzai
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, United States
| | - Fumihiko Sasai
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Manuel Urra
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Gabriel Cara-Fuentes
- Medicine-Nephrology, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - L Gabriela Sánchez-Lozada
- Department of Cardio-Renal Physiopathology, Instituto Nacional de CardiologÃ-a, Mexico City, D.F., Mexico
| | - Bernardo Rodriguez-Iturbe
- Nefrología y MetaboismoMineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Ciudad de Mexico, Mexico
| | - Jaime Butler Dawson
- Center for Work, Health, and Environment, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - Magdalena Madero
- Division of Nephrology, Instituto Nacional de Cardiologia Ignacio Chávez, Mexico City, Mexico
| | - Jared M Brown
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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McIlvennan CK, Urra M, Helmkamp L, Messenger JC, Raymer D, Ream KS, Oldemeyer JB, Ambardekar AV, Barnes K, Allen LA. Magnitude of troponin elevation in patients with biomarker evidence of myocardial injury: relative frequency and outcomes in a cohort study across a large healthcare system. BMC Cardiovasc Disord 2023; 23:151. [PMID: 36959555 PMCID: PMC10037877 DOI: 10.1186/s12872-023-03168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/03/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Serum troponin levels correlate with the extent of myocyte necrosis in acute myocardial infarction (AMI) and predict adverse outcomes. However, thresholds of cardiac troponin elevation that could portend to poor outcomes have not been established. METHODS In this cohort study, we characterized all cardiac troponin elevations > 0.04 ng/mL (upper limit of normal [ULN]) from patients hospitalized with an ICD-9/10 diagnosis of AMI across our health system from 2012-2019. We grouped events into exponential categories of peak cardiac troponin and evaluated the association of these troponin categories with all-cause mortality, heart transplants, or durable left ventricular assist devices (LVAD). Patients with cardiac troponin > 10,000 × ULN were manually chart reviewed and described. RESULTS There were 18,194 AMI hospitalizations with elevated cardiac troponin. Peak troponin was 1-10 × ULN in 21.1%, 10-100 × ULN in 34.8%, 100-1,000 × ULN in 30.1%, 1,000-10,000 × ULN in 13.1%, and > 10,000 × ULN in 0.9% of patients. One-year mortality was 17-21% across groups, except in > 10,000 × ULN group where it was 33% (adjusted hazard ratio (99%CI) for > 10,000 × ULN group compared to all others: 1.86 (1.21, 2.86)). Hazards of one-year transplant and MCS were also significantly elevated in the > 10,000 × ULN group. CONCLUSIONS Elevation in cardiac troponin levels post AMI that are > 10,000 × ULN was rare but identified patients at particularly high risk of adverse events. These patients may benefit from clarification of goals of care and early referral for advanced heart failure therapies. These data have implications for conversion to newer high-sensitivity cardiac troponin assays whose maximum assay limit is often lower than traditional assays.
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Affiliation(s)
- Colleen K McIlvennan
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Manuel Urra
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
| | - Laura Helmkamp
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John C Messenger
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
| | - David Raymer
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
| | - Karen S Ream
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
| | | | - Amrut V Ambardekar
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
| | - Kathleen Barnes
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA
- Colorado Center for Personalized Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Larry A Allen
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12631 East 17 Avenue, B130, Aurora, CO, 80045, USA.
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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Urra M, McIlvennan C, Helmkamp L, Messenger J, Raymer D, Ream K, Oldemeyer JB, Ambardekar A, Barnes K, Allen L. TROPONIN LEVELS OVER 10,000 TIMES UPPER LIMIT OF NORMAL: FREQUENCY, CAUSES, OUTCOMES, AND IMPLICATIONS OF BIOMARKER EVIDENCE FOR MASSIVE CARDIAC INJURY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bhatty O, Selim M, Kassim T, Chintalacheruvu L, Urra M, Shah S, Haggerty J, Gross J, Jhand A, Pershwitz G, Gupta J. A Case of Imatinib-Induced Hepatitis. Cureus 2017; 9:e1302. [PMID: 28690936 PMCID: PMC5493456 DOI: 10.7759/cureus.1302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A 71-year-old female with a past medical history of Philadelphia chromosome-positive chronic myelogenous leukemia on imatinib therapy, Sjogren’s syndrome, and hypothyroidism presents with acute hepatitis. After a comprehensive workup ruling out viral, infectious and metabolic etiologies imatinib is stopped which results in immediate improvement. The biopsy is consistent with drug-induced liver damage; the patient is started on oral prednisone and discharged. Unfortunately, our patient’s liver function does not improve over the course of the next week and she is readmitted for hepatic and renal failure. During this second admission patient’s condition continues to deteriorate with concomitant gastric bleeding, renal injury, and cellulitis. She ultimately chooses a palliative approach.
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Affiliation(s)
| | - Mohammad Selim
- Internal Medicine, Creighton University School of Medicine
| | - Thamer Kassim
- Internal Medicine, CHI Creighton University Medical Center
| | | | - Manuel Urra
- Internal Medicine, Creighton University School of Medicine
| | - Sonia Shah
- Internal Medicine, Creighton University School of Medicine
| | | | - John Gross
- Pathology, Creighton University School of Medicine
| | - Aravdeep Jhand
- Internal Medicine, CHI Creighton University Medical Center
| | - Gene Pershwitz
- Internal Medicine, Creighton University School of Medicine
| | - Jaya Gupta
- Internal Medicine, Creighton University School of Medicine
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Batllori M, Urra M, Uriarte E, Romero C, Pueyo J, López-Olaondo L, Cambra K, Ibáñez B. Randomized comparison of three transducer orientation approaches for ultrasound guided internal jugular venous cannulation. Br J Anaesth 2016; 116:370-6. [DOI: 10.1093/bja/aev399] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 11/13/2022] Open
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Cardona S, De Martino A, Urra M, Jeffrey M, De las Heras M. An Outbreak of Congenital Poxvirus Infection in a Commercial Pig Breeding Herd. J Comp Pathol 2013. [DOI: 10.1016/j.jcpa.2012.11.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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García Masdeval MD, Fidalgo I, Arrieta A, Urra M, Vázquez C. [HLA antigens in infants with bronchiolitis]. An Esp Pediatr 1983; 18:358-63. [PMID: 6604476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The frequency distribution of HLA antigen in 100 infants with bronchiolitis is compared to a control population of 100 healthy blood donors. No differences were found in the frequency distribution of both A and B antigens, but B 7 antigen was more frequently present in patients with bronchiolitis and increased serum IgE (47% VS 17% in the control group with normal serum IgE). Serum IgE was increased in 27% of the patients with bronchiolitis. The incidence of recurrent respiratory episodes was 62% in infants carrying the B 7 antigen whereas it was only of 14,5% in the whole series (pc less than 0,05). All infants with increased serum levels of IgE and recurrent respiratory episodes had the B 7 antigen. We believe that the presence of IgE and recurrent respiratory episodes had the B 7 antigen. We believe that the presence of B 7 antigen influence the clinical course of bronchiolitis in the sense that a high percent will present with recurrent respiratory episodes and increased levels of serum IgE.
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