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Life with Sickle Cell Disease and Kidney Failure
Sasha Couch
doi : 10.2215/CJN.00500121
CJASN March 2021, 16 (3) 335-336
Post-Kidney Transplant Care and Health Outcomes of US Veterans
Namrata Krishnan and Susan T. Crowley
doi : 10.2215/CJN.00580121
CJASN March 2021, 16 (3) 337-339
Time to Procurement and Post-Kidney Transplant Outcomes
Danielle J. Haakinson
doi : 10.2215/CJN.01340121
CJASN March 2021, 16 (3) 340-342
Leveraging Deep Learning to Improve Safety of Outpatient Hemodialysis
Simon Correa and Finnian R. Mc Causland
doi : 10.2215/CJN.00450121
CJASN March 2021, 16 (3) 343-344
Recurrent Hyperkalemia in Renin-Angiotensin-Aldosterone System Inhibitor (RAASi) Treatment
Jonathan A. Bola?os and Stephen L. Seliger
doi : 10.2215/CJN.00950121
CJASN March 2021, 16 (3) 345-347
Acute Kidney Injury among Black Patients with Sickle Cell Trait and Sickle Cell Disease
Kabir O. Olaniran, Andrew S. Allegretti, Sophia H. Zhao, Sagar U. Nigwekar and Sahir Kalim
doi : 10.2215/CJN.06960520
CJASN March 2021, 16 (3) 348-355
Background and objectives Sickle cell trait and sickle cell disease are associated with faster GFR decline compared with normal hemoglobin phenotypes. We sought to compare the AKI risk in sickle cell trait/disease to normal hemoglobin phenotypes and investigate the association between AKI and GFR decline in sickle cell trait/disease.
Nocturnal Systolic Hypertension and Adverse Prognosis in Patients with CKD
Qin Wang, Yu Wang, Jinwei Wang, Luxia Zhang, Ming-Hui Zhao and the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)
doi : 10.2215/CJN.14420920
CJASN March 2021, 16 (3) 356-364
Background and objectives Nocturnal hypertension is associated with adverse outcomes in patients with CKD. However, the individual association of entities of nocturnal hypertension according to achievement of systolic and/or diastolic BP goals with kidney failure and cardiovascular outcomes of CKD is not clear.
Ambulatory Treatments for RAAS Inhibitor–Related Hyperkalemia and the 1-Year Risk of Recurrence
Gregory L. Hundemer, Robert Talarico, Navdeep Tangri, Silvia J. Leon, Sarah E. Bota, Emily Rhodes, Greg A. Knoll and Manish M. Sood
doi : 10.2215/CJN.12990820
CJASN March 2021, 16 (3) 365-373
Background and objective The optimal ambulatory management of renin-angiotensin-aldosterone system inhibitor (RAASi)–related hyperkalemia to reduce the risk of recurrence is unknown. We examined the risk of hyperkalemia recurrence on the basis of outpatient pharmacologic changes following an episode of RAASi-related hyperkalemia.
Patients with Protein-Truncating PKD1 Mutations and Mild ADPKD
Matthew B. Lanktree, Elsa Guiard, Pedram Akbari, Marina Pourafkari, Ioan-Andrei Iliuta, Syed Ahmed, Amirreza Haghighi, Ning He, Xuewen Song, Andrew D. Paterson, Korosh Khalili and York P.C. Pei
doi : 10.2215/CJN.11100720
CJASN March 2021, 16 (3) 374-383
Background and objectives Progression of autosomal dominant polycystic kidney disease (ADPKD) is highly variable. On average, protein-truncating PKD1 mutations are associated with the most severe kidney disease among all mutation classes. Here, we report that patients with protein-truncating PKD1 mutations may also have mild kidney disease, a finding not previously well recognized.
Kidney, Cardiovascular, and Safety Outcomes of Canagliflozin according to Baseline Albuminuria
Meg Jardine, Zien Zhou, Hiddo J. Lambers Heerspink, Carinna Hockham, Qiang Li, Rajiv Agarwal, George L. Bakris, Christopher P. Cannon, David M. Charytan, Tom Greene, Adeera Levin, Jing-Wei Li, Brendon L. Neuen, Bruce Neal, Richard Oh, Megumi Oshima, Carol Pollock, David C. Wheeler, Dick de Zeeuw, Hong Zhang, Bernard Zinman, Kenneth W. Mahaffey and Vlado Perkovic
doi : 10.2215/CJN.15260920
CJASN March 2021, 16 (3) 384-395
Background and objectives The kidney protective effects of renin-angiotensin system inhibitors are greater in people with higher levels of albuminuria at treatment initiation. Whether this applies to sodium-glucose cotransporter 2 (SGLT2) inhibitors is uncertain, particularly in patients with a very high urine albumin-to-creatinine ratio (UACR; ?3000 mg/g). We examined the association between baseline UACR and the effects of the SGLT2 inhibitor, canagliflozin, on efficacy and safety outcomes in the Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) randomized controlled trial.
Deep Learning Model for Real-Time Prediction of Intradialytic Hypotension
Hojun Lee, Donghwan Yun, Jayeon Yoo, Kiyoon Yoo, Yong Chul Kim, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Nojun Kwak and Seung Seok Han
doi : 10.2215/CJN.09280620
CJASN March 2021, 16 (3) 396-406
Background and objectives Intradialytic hypotension has high clinical significance. However, predicting it using conventional statistical models may be difficult because several factors have interactive and complex effects on the risk. Herein, we applied a deep learning model (recurrent neural network) to predict the risk of intradialytic hypotension using a timestamp-bearing dataset.
Mortality and Access to Kidney Transplantation in Patients with Sickle Cell Disease–Associated Kidney Failure
Sunjae Bae, Morgan Johnson, Allan B. Massie, Xun Luo, Carlton Haywood, Sophie M. Lanzkron, Morgan E. Grams, Dorry L. Segev and Tanjala S. Purnell
doi : 10.2215/CJN.02720320
CJASN March 2021, 16 (3) 407-414
Background and objectives Patients with sickle cell disease–associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population, potentially limiting their chance of receiving transplantation. We aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.
Acute Kidney Injury, Microvascular Rarefaction, and Estimated Glomerular Filtration Rate in Kidney Transplant Recipients
Alice Doreille, Féryel Azzi, Stéphanie Larivière-Beaudoin, Annie Karakeussian-Rimbaud, Dominique Trudel, Marie-Josée Hébert, Mélanie Dieudé, Natacha Patey and Héloïse Cardinal
doi : 10.2215/CJN.07270520
CJASN March 2021, 16 (3) 415-426
Background and objectives Animal studies suggest that microvascular rarefaction is a key factor in the acute kidney disease to CKD transition. Hence, delayed graft function appears as a unique human model of AKI to further explore the role of microvascular rarefaction in kidney transplant recipients. Here, we assessed whether delayed graft function is associated with peritubular capillary loss and evaluated the association between this loss and long-term kidney graft function.
The Association of Time to Organ Procurement on Short- and Long-Term Outcomes in Kidney Transplantation
Verner Eerola, Ilkka Helanter?, Anna But, Marko Lempinen, Heikki M?kisalo, Arno Nordin, Helena Isoniemi and Ville Sallinen
doi : 10.2215/CJN.11420720
CJASN March 2021, 16 (3) 427-436
Background and objectives Transplant centers in Europe aim to minimize the time from brain death to organ procurement (procurement delay), but evidence to justify this is scarce. In the United States, procurement times are significantly longer. Our objective was to analyze how procurement delay associates with kidney allograft outcomes.
Source of Post-Transplant Care and Mortality among Kidney Transplant Recipients Dually Enrolled in VA and Medicare
Winn Cashion, Walid F. Gellad, Florentina E. Sileanu, Maria K. Mor, Michael J. Fine, Jennifer Hale, Daniel E. Hall, Shari Rogal, Galen Switzer, Mohan Ramkumar, Virginia Wang, Douglas A. Bronson, Mark Wilson, William Gunnar and Steven D. Weisbord
doi : 10.2215/CJN.10020620
CJASN March 2021, 16 (3) 437-445
Background and objectives Many kidney transplant recipients enrolled in the Veterans Health Administration are also enrolled in Medicare and eligible to receive both Veterans Health Administration and private sector care. Where these patients receive transplant care and its association with mortality are unknown.
Preliminary Assessment of Acute Kidney Injury in Critically Ill Children Associated with SARS-CoV-2 Infection
Erica C. Bjornstad, Kelli A. Krallman, David Askenazi, Michael Zappitelli, Stuart L. Goldstein, Rajit K. Basu and on behalf of the SPARC Investigators
doi : 10.2215/CJN.11470720
CJASN March 2021, 16 (3) 446-448
Impact of COVID-19 Pandemic in Children with CKD or Immunosuppression
Antonio Mastrangelo, William Morello, Enrico Vidal, Isabella Guzzo, Luigi Annicchiarico Petruzzelli, Elisa Benetti, Marco Materassi, Mario Giordano, Andrea Pasini, Ciro Corrado, Giuseppe Puccio, Roberto Chimenz, Carmine Pecoraro, Laura Massella, Licia Peruzzi, Giovanni Montini and on behalf of the COVID-19 Task Force of the Italian Society of Pediatric Nephrology
doi : 10.2215/CJN.13120820
CJASN March 2021, 16 (3) 449-451
Outcomes of Patients on Maintenance Dialysis Hospitalized with COVID-19
Lili Chan, Suraj K. Jaladanki, Sulaiman Somani, Ishan Paranjpe, Arvind Kumar, Shan Zhao, Lewis Kaufman, Staci Leisman, Shuchita Sharma, John Cijiang He, Barbara Murphy, Zahi A. Fayad, Matthew A. Levin, Erwin P. Bottinger, Alexander W. Charney, Benjamin S. Glicksberg, Steven G. Coca, Girish N. Nadkarni and on behalf of the Mount Sinai COVID Informatics Center (MSCIC)
doi : 10.2215/CJN.12360720
CJASN March 2021, 16 (3) 452-455
Correction: Infection-Related Acute Care Events among Patients with Glomerular Disease
doi : 10.2215/CJN.00550121
CJASN March 2021, 16 (3) 456-457
GWAS-Based Discoveries in IgA Nephropathy, Membranous Nephropathy, and Steroid-Sensitive Nephrotic Syndrome
Elena Sanchez-Rodriguez, Christopher T. Southard and Krzysztof Kiryluk
doi : 10.2215/CJN.14031119
CJASN March 2021, 16 (3) 458-466
Over the past decade, genome-wide association studies (GWAS) have emerged as a powerful tool to understand the genetic basis of complex traits in humans. The GWAS approach has been successfully applied to primary glomerular disorders, providing numerous novel insights into the genetic architecture of IgA nephropathy, membranous nephropathy, and steroid-sensitive nephrotic syndrome. IgA nephropathy appears to have a highly complex polygenic architecture, with nearly 20 genome-wide significant loci of small-to-moderate effects discovered to date. In contrast, the genetic susceptibility to membranous nephropathy and steroid-sensitive nephrotic syndrome appears to be driven by a small number of large-effect loci. The MHC locus on chromosome 6p21 is strongly associated with genetic susceptibility to all major types of immune-mediated glomerulopathies. However, a distinct set of classical HLA alleles is associated with each individual disease type, pinpointing to specific immune mechanisms underlying each of these conditions. Additional insights from the discovery of non-HLA risk loci reinforced the role of innate and adaptive immunity in the pathogenesis of these disorders, and highlighted important susceptibility overlaps between glomerular and other autoimmune and inflammatory conditions. Despite these initial successes, much larger GWAS and sequencing studies are still needed for each individual glomerular disease type. Increased power will be critical to comprehensively test for genetic effects across the full spectrum of allelic frequencies, to detect gene-gene and gene-environment interactions, and to potentially improve the performance of polygenic risk predictors. Moreover, the existing studies are limited mostly to European and East Asian populations, stressing the urgency to expand genetic discovery efforts to more diverse populations worldwide.
Resistant Hypertension in CKD
George Thomas and Mahboob Rahman
doi : 10.2215/CJN.14610920
CJASN March 2021, 16 (3) 467-469
Children with CKD Are Not Little Adults with CKD
Alexander J. Kula, Michael J.G. Somers and on behalf of the American Society of Pediatric Nephrology
doi : 10.2215/CJN.11540720
CJASN March 2021, 16 (3) 470-472
Challenges with Providing Hospice Care for Patients Undergoing Long-Term Dialysis
Jane O. Schell and Douglas S. Johnson
doi : 10.2215/CJN.10710720
CJASN March 2021, 16 (3) 473-475
Uric Acid and CKD Progression Matures with Lessons for CKD Risk Factor Discovery
Oluwaseun Oluwo and Julia J. Scialla
doi : 10.2215/CJN.10650620
CJASN March 2021, 16 (3) 476-478
Preprint Servers in Kidney Disease Research
Caitlyn Vlasschaert, Cameron Giles, Swapnil Hiremath and Matthew B. Lanktree
doi : 10.2215/CJN.03800320
CJASN March 2021, 16 (3) 479-486
Preprint servers, such as arXiv and bioRxiv, have disrupted the scientific communication landscape by providing rapid access to research before peer review. medRxiv was launched as a free online repository for preprints in the medical, clinical, and related health sciences in 2019. In this review, we present the uptake of preprint server use in nephrology and discuss specific considerations regarding preprint server use in medicine. Distribution of kidney-related research on preprint servers is rising at an exponential rate. Survey of nephrology journals identified that 15 of 17 (88%) are publishing original research accepted submissions that have been uploaded to preprint servers. After reviewing 52 clinically impactful trials in nephrology discussed in the online Nephrology Journal Club (NephJC), an average lag of 300 days was found between study completion and publication, indicating an opportunity for faster research dissemination. Rapid review of papers discussing benefits and risks of preprint server use from the researcher, publisher, or end user perspective identified 53 papers that met criteria. Potential benefits of biomedical preprint servers included rapid dissemination, improved transparency of the peer review process, greater visibility and recognition, and collaboration. However, these benefits come at the risk of rapid spread of results not yet subjected to the rigors of peer review. Preprint servers shift the burden of critical appraisal to the reader. Media may be especially at risk due to their focus on “late-breaking” information. Preprint servers have played an even larger role when late-breaking research results are of special interest, such as during the global coronavirus disease 2019 pandemic. Coronavirus disease 2019 has brought both the benefits and risks of preprint servers to the forefront. Given the prominent online presence of the nephrology community, it is poised to lead the medicine community in appropriate use of preprint servers.
Pathophysiology and Treatment of Enteric Hyperoxaluria
Celeste Witting, Craig B. Langman, Dean Assimos, Michelle A. Baum, Annamaria Kausz, Dawn Milliner, Greg Tasian, Elaine Worcester, Meaghan Allain, Melissa West, Felix Knauf and John C. Lieske
doi : 10.2215/CJN.08000520
CJASN March 2021, 16 (3) 487-495
Enteric hyperoxaluria is a distinct entity that can occur as a result of a diverse set of gastrointestinal disorders that promote fat malabsorption. This, in turn, leads to excess absorption of dietary oxalate and increased urinary oxalate excretion. Hyperoxaluria increases the risk of kidney stones and, in more severe cases, CKD and even kidney failure. The prevalence of enteric hyperoxaluria has increased over recent decades, largely because of the increased use of malabsorptive bariatric surgical procedures for medically complicated obesity. This systematic review of enteric hyperoxaluria was completed as part of a Kidney Health Initiative–sponsored project to describe enteric hyperoxaluria pathophysiology, causes, outcomes, and therapies. Current therapeutic options are limited to correcting the underlying gastrointestinal disorder, intensive dietary modifications, and use of calcium salts to bind oxalate in the gut. Evidence for the effect of these treatments on clinically significant outcomes, including kidney stone events or CKD, is currently lacking. Thus, further research is needed to better define the precise factors that influence risk of adverse outcomes, the long-term efficacy of available treatment strategies, and to develop new therapeutic approaches.
