Clinical journal of the American Society of Nephrology : CJASN
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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.
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Clin J Am Soc Nephrol · Oct 2011
Urinary calprotectin and the distinction between prerenal and intrinsic acute kidney injury.
To date there is no reliable marker for the differentiation of prerenal and intrinsic acute kidney injury (AKI). We investigated whether urinary calprotectin, a mediator protein of the innate immune system, may serve as a diagnostic marker in AKI. ⋯ Accuracy of urinary calprotectin in the differential diagnosis of AKI is high. Whereas calprotectin levels in prerenal disease are comparable with healthy controls, intrinsic AKI leads to highly increased calprotectin concentrations.
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Clin J Am Soc Nephrol · Oct 2011
Editorial CommentThe role of catalytic iron in acute kidney injury.