Effect of Niacin on FGF23 Concentration in Chronic Kidney Disease.
Effect of Niacin on FGF23 Concentration in Chronic Kidney Disease. Am J Nephrol. 2014 May 20;39(6):484-490 Authors: Rao M, Steffes M, Bostom A, Ix JH Abstract Background: Elevated serum phosphorus and FGF23 are independent cardiovascular risk factors in patients with chronic kidney disease. In a randomized controlled trial of patients with dyslipidemia assigned to either extended release niacin (ERN) alone, ERN combined with the selective prostaglandin D2 receptor subtype 1 inhibitor laropiprant (ERN-L) or placebo, niacin lowered serum phosphorus; however, it is not known if it lowers FGF23 concentrations. Methods: This is an ancillary study to a multicenter, randomized, double-blind, placebo-controlled trial among patients with dyslipidemia and an estimated glomerular filtration rate (eGFR) of 30-74 ml/min/1.73 m(2). Participants were randomized to ERN-L (n = 162), ERN (n = 97), or placebo (n = 68) in a 3:2:1 ratio for 24 weeks. The primary outcome was a change in serum FGF23 concentrations, and secondary outcomes were changes in other mineral metabolism parameters. Results: Both the ERN and ERN-L groups showed significant declines in serum phosphorus, calcium and calcium·phosphorus product at 24 weeks compared to placebo. A significant decline from baseline (10.9%, p
Publication date: Available online 25 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Jiadela Teliewubai, Ximin Fan, Hongwei Ji, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Shikai Yu, Chen Chi, Yawei Xu, Yi ZhangAbstractBackground and AimsMetabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort.Methods and results3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associatio...
Conclusion: The SBP at 7:00 AM, in addition to the 24-hour mSBP, is also associated with eGFR deterioration in patients with diabetic CKD, particularly in those with CKD stage 3-5. PMID: 31969922 [PubMed]
Among seriously ill patients, those with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) arguably receive among the worst end-of-life care. These patients frequently die in the hospital, often after an intensive procedure like cardiopulmonary resuscitation, and with a low referral rate to hospice. There is now a concerted effort in the nephrology and palliative care communities to integrate palliative care into the treatment of these seriously ill patients. The Pathways Project is a national demonstration, funded by the Gordon and Betty Moore Foundation, to develop scalable innovations in kidney supportive care.
Guidelines recommend advance care planning (ACP) as essential to quality chronic kidney disease (CKD) management, but the nephrology community has yet to incorporate ACP upstream of the dialysis decision. Others have attempted to improve ACP for dialysis patients, but many patients report wishing they had been engaged in ACP earlier. This project tested integration of ACP coaching in the upstream setting of nephrology offices.
Authors: Kovesdy CP, Gosmanova EO, Woods SD, Fogli JJ, Rowan CG, Hansen JL, Sauer BC Abstract Objective: Patiromer is a sodium-free, non-absorbed, potassium (K+) binder approved for the treatment of hyperkalemia (HK). Among US Veterans with HK, this retrospective, observational cohort study evaluated patiromer utilization, RAASi continuation, and K+ concentration change following patiromer initiation.Methods: Using data from the Veterans Affairs Corporate Data Warehouse, Veterans with HK (K+ ≥5.1 mmol/L) were included upon patiromer initiation (index date) during the study period (1/2016-8/2018). All patien...
Hypertension often occurs in patients with chronic kidney disease (CKD). Considering the decrease in serum Klotho and increase in serum FGF23 levels in such patients, decreased Klotho and increased FGF23 levels were thought to be associated with hypertension. Presympathetic neurons at the rostral ventrolateral medulla (RVLM) contribute to sympathetic activity and regulation of blood pressure. Therefore, we hypothesized that Klotho would reduce the activities of RVLM neurons and FGF23 would stimulate them.
Publication date: Available online 24 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Darcy K. Weidemann, Alison G. Abraham, Jennifer L. Roem, Susan L. Furth, Bradley A. WaradyRationale &ObjectiveSoluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker associated with incident chronic kidney disease (CKD) and has been identified as an independent risk factor for CKD progression in children, although these findings remain preliminary, limited to a single point in time, and unreplicated in pediatric cohorts.Study DesignProspective longitudinal cohort study.Setting &Participants5...
Publication date: 25–31 January 2020Source: The Lancet, Volume 395, Issue 10220Author(s): Hiddo J L Heerspink, Hans-Henrik Parving, Dick de Zeeuw
Publication date: 25–31 January 2020Source: The Lancet, Volume 395, Issue 10220Author(s): Dongwei Liu, Zhangsuo Liu
Chronic kidney disease (CKD) is a known risk factor for post-HCT mortality. Currently, HCT-CI assigns a score of 2 for moderate-severe renal dysfunction based on serum creatinine (Cr), though Cr is not ideal marker of renal function and can be influenced by several factors. The aim of this study is to examine whether utilization of incremental degrees of renal dysfunction based on eGFR improves the utility of HCT-CI to predict allogeneic HCT outcomes.