Clinical journal of the American Society of Nephrology : CJASN
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Clin J Am Soc Nephrol · Oct 2011
Urinary hepcidin-25 and risk of acute kidney injury following cardiopulmonary bypass.
Acute kidney injury (AKI) complicating cardiopulmonary bypass (CPB) results in increased morbidity and mortality. Urinary hepcidin-25 has been shown to be elevated in patients who do not develop AKI after CPB using semiquantitative mass spectrometry (SELDI TOF-MS). The goals of this study were to quantitatively validate these findings with ELISA and evaluate the diagnostic performance of hepcidin-25 for AKI. ⋯ Elevated urinary hepcidin-25 on POD 1 is a strong predictor of avoidance of AKI beyond postoperative day 1.
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Clin J Am Soc Nephrol · Oct 2011
Glomerular hyperfiltration and renal progression in children with autosomal dominant polycystic kidney disease.
The purpose of this study was to determine whether glomerular hyperfiltration (GH) occurring early in autosomal dominant polycystic kidney disease (ADPKD) is indicative of more rapid disease progression in children. ⋯ This study revealed that occurrence of GH in ADPKD children is associated with a significantly faster decline in renal function and higher rate of kidney enlargement over time. GH combined with the increased renal volume may therefore be used as an early marker for a more severe progression of ADPKD in children.
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Clin J Am Soc Nephrol · Oct 2011
Multicenter Study Controlled Clinical TrialTolvaptan in autosomal dominant polycystic kidney disease: three years' experience.
Autosomal dominant polycystic kidney disease (ADPKD), a frequent cause of end-stage renal disease, has no cure. V2-specific vasopressin receptor antagonists delay disease progression in animal models. ⋯ ADPKD cyst growth progresses more slowly with tolvaptan than in historical controls, but AEs are common.
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Clin J Am Soc Nephrol · Oct 2011
Multicenter StudyPrognosis of CKD patients receiving outpatient nephrology care in Italy.
Prognosis in nondialysis chronic kidney disease (CKD) patients under regular nephrology care is rarely investigated. Design, setting, participants, & measurements We prospectively followed from 2003 to death or June 2010 a cohort of 1248 patients with CKD stages 3 to 5 and previous nephrology care ≥1 year in 25 Italian outpatient nephrology clinics. Cumulative incidence of ESRD or death before ESRD were estimated using the competing-risk approach. ⋯ In patients receiving continuity of care in Italian nephrology clinics, ESRD was a more frequent outcome than death in stage 4 and 5 CKD, but the opposite was true in stage 3. Outcomes were predicted by modifiable risk factors specific to CKD. Proteinuria used in conjunction with estimated GFR refined risk stratification. These findings provide information, specific to CKD patients under regular outpatient nephrology care, for risk stratification that complement recent observations in the general population.
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Clin J Am Soc Nephrol · Oct 2011
Albuminuria and estimated glomerular filtration rate as predictors of diabetic end-stage renal disease and death.
We investigated predictive value of albuminuria and estimated GFR (eGFR) for ESRD in Pima Indians with type 2 diabetes. ⋯ These results suggest that incorporation of quantitative information about albuminuria into staging systems based on eGFR adds significant prognostic information about risk for diabetic ESRD and death.