Optimized Calcium Supplementation Approach for Regional Citrate Anticoagulation
Conclusion: The optimized calcium supplementation approach could provide a more precise and practical method to estimate the amount of extracorporeal calcium removal with regard to different modalities and dosages of RCA.Nephron (Source: Nephron)
Source: Nephron - November 16, 2018 Category: Urology & Nephrology Source Type: research

The Clinical Effects of Sildenafil for Erection in Patients after Kidney Transplantation: A Meta-Analysis
Conclusion: In conclusion, this study showed that treatment with sildena fil in renal allograft recipients with erectile dysfunction is a valid and safe option.Nephron (Source: Nephron)
Source: Nephron - November 13, 2018 Category: Urology & Nephrology Source Type: research

Icodextrin is Associated with a Lower Risk of Stroke in Peritoneal Dialysis Patients
Conclusion: The use of icodextrin is associated with a lower incidence and risk of stroke in PD patients.Nephron (Source: Nephron)
Source: Nephron - November 13, 2018 Category: Urology & Nephrology Source Type: research

Low Skeletal Muscle Mass Predicts Incident Dipstick Albuminuria in Korean Adults without Chronic Kidney Disease: A Prospective Cohort Study
Conclusions: Low skeletal muscle mass was independently associated with the development of dipstick albuminuria after 4 years in Korean adults without CKD. Further research is needed to verify the role of low muscle mass in the development of albuminuria and renal injury.Nephron (Source: Nephron)
Source: Nephron - November 9, 2018 Category: Urology & Nephrology Source Type: research

Nephrological Care Extended to Immigrants
Nephron (Source: Nephron)
Source: Nephron - November 9, 2018 Category: Urology & Nephrology Source Type: research

Increased Weight Gain During the Long Interdialytic Period Is Associated with Minor Effects on Blood Pressure Control in Clinically Stable In-Centre Haemodialysis Patients
Conclusion: In stable cHD patients, the greater IDWG that occurred during the long IDP was not associated with overtly inferior BP control as reflected in pre-dialysis BP measurements. However, modestly higher daytime SBP was evident towards the end of the long IDP by 24 h ABPM. Thus, while fluid gain has well-documented associations with hypertension and adverse cardiovascular outcomes, the excess IDWG that occurs during the long IDP exerts relatively minor effects on BP control in patients on well-established dialysis regimens that are better identified by ambulatory monitoring.Nephron (Source: Nephron)
Source: Nephron - November 9, 2018 Category: Urology & Nephrology Source Type: research

Geriatric Assessment in Elderly Patients with End-Stage Kidney Disease
Conclusions: Geriatric impairments are highly prevalent in the elderly ESKD population. Since impairments can be missed when not searched for in regular (pre)dialysis care, the first step of improving nephrologic care is awareness of the extensiveness of geriatric impairment.Nephron (Source: Nephron)
Source: Nephron - November 1, 2018 Category: Urology & Nephrology Source Type: research

Increased Risk for Cardiovascular Events in Patients with Diabetic Kidney Disease and Non-Alcoholic Fatty Liver Disease
Conclusion: In  our cohort of patients with advanced DKD, NAFLD showed a strong independent association with cardiovascular outcomes. Further prospective studies are warranted to strengthen these associations and plan a strategy for screening NAFLD in this high-risk group.Nephron (Source: Nephron)
Source: Nephron - November 1, 2018 Category: Urology & Nephrology Source Type: research

Co-Inheritance of Autosomal Dominant Polycystic Kidney Disease and Naevoid Basal Cell Carcinoma Syndrome: Effects on Renal Progression
The calcium signalling and hedgehog (HH) signalling pathways operate in the primary cilium. Abnormalities in these pathways cause autosomal dominant polycystic kidney disease (ADPKD) and naevoid basal cell carcinoma syndrome (NBCCS) respectively. Several reports have proposed that hyperactivation of the HH pathway in animal models of polycystic kidney disease affects normal renal development and renal cyst phenotype. A family with 2 cases (a proband and her sister) of ADPKD and NBCCS coinheritance led us to investigate whether interactions may be present in the 2 pathways. The effect of HH pathway hyperactivation (due to c...
Source: Nephron - October 26, 2018 Category: Urology & Nephrology Source Type: research

Intra-Arterial versus Intravenous Contrast and Renal Injury in Chronic Kidney Disease: A Propensity-Matched Analysis
Conclusion: The administration of both IV and intra-arterial contrast is associated with a risk of AKI. Multifactorial AKI was associated with worse outcomes, while CIN was associated with better outcomes.Nephron (Source: Nephron)
Source: Nephron - October 26, 2018 Category: Urology & Nephrology Source Type: research

Early and Severe Polycystic Kidney Disease and Related Ciliopathies: An Emerging Field of Interest
Early and severe forms of polycystic kidney disease (PKD) do already manifest during childhood or adolescence. They are characterized by enlarged kidneys and diminished renal function that prenatally may result in Potter ’s oligohydramnios sequence. Genetically, various defects can mimic this phenotype. Most common arePKHD1 mutations that lead to autosomal recessive PKD (ARPKD). About the same number of children do carry mutations in the dominant autosomal dominant polycystic kidney disease (ADPKD) genes,PKD1 and less frequentPKD2, often arise de novo or may affect both disease alleles in a recessive mode. Mutations ...
Source: Nephron - October 25, 2018 Category: Urology & Nephrology Source Type: research

Childhood Obesity and Impact on the Kidney
Obesity is known to be associated with a myriad of cardiovascular and metabolic comorbidities. In children, several longitudinal studies have shown that obesity consequences start early in life and accompany the obese child into adulthood, implying a higher risk of adverse cardiovascular events. More recently, data related to the possible role of obesity in the risk of kidney disease in adults, independently of diabetes, has started to become more available. In children, the evidence is scarcer, but it has also been acknowledged that obesity acts as a risk factor for disease progression when kidney impairment already exist...
Source: Nephron - October 25, 2018 Category: Urology & Nephrology Source Type: research

Incidence and Characteristics of de novo Renal Cryoglobulinemia After Direct-Acting Antivirals Treatment in an Egyptian Hepatitis C Cohort
Conclusion: De novo cryoglobulinemic glomerulonephritis and progression to CKD may rarely complicate successful treatment of HCV using direct-acting antivirals.Nephron (Source: Nephron)
Source: Nephron - October 25, 2018 Category: Urology & Nephrology Source Type: research

Long-Term Mortality and Bone Safety in Patients with End-Stage Renal Disease Receiving Lanthanum Carbonate
Conclusions: LaC was not associated with increased risk of mortality, bone fractures, or any secondary outcome.Nephron (Source: Nephron)
Source: Nephron - October 24, 2018 Category: Urology & Nephrology Source Type: research

Incidence and Prognosis of Acute Kidney Injury After Cardiac Arrest in Children
Conclusions: The frequency of AKI in children after recovering a CA is moderate. AKI that needs CCRT before or after CA is associated with a higher mortality.Nephron (Source: Nephron)
Source: Nephron - October 19, 2018 Category: Urology & Nephrology Source Type: research

Dialysate Calcium Concentration below 3.0 mEq/L Is Not Associated with Improved Outcomes in the Japanese Dialysis Outcomes and Practice Patterns Study
Conclusion: Lowering D-Ca level below 3.0 mEq/L seems not to have a meaningful effect on patient outcomes.Nephron (Source: Nephron)
Source: Nephron - October 19, 2018 Category: Urology & Nephrology Source Type: research

Circulating miR-421 Targeting Leucocytic Angiotensin Converting Enzyme 2 Is Elevated in Patients with Chronic Kidney Disease
Conclusions: Uremic patients show an enhanced expression of serum miR-421 as compared to healthy individuals. A strong association of circulating miR-421 with decreased transcripts of ACE2 may contribute to the low expression of the enzyme in leukocytes of CKD patients, further supporting the development of atherosclerotic events.Nephron (Source: Nephron)
Source: Nephron - October 16, 2018 Category: Urology & Nephrology Source Type: research

Serum Glutaredoxin Activity as a Marker of Oxidative Stress in Chronic Kidney Disease: A Pilot Study
Conclusion: Our pilot study indicates that Grx may be a useful marker for assessing the degree of oxidative stress in CKD, however this needs further investigation in a larger prospective patient cohort.Nephron (Source: Nephron)
Source: Nephron - October 5, 2018 Category: Urology & Nephrology Source Type: research

Development of a Simple Risk Score Model to Predict Renal Artery Stenosis
Conclusion: This model assesses the risk of RAS using available information. This model can be used for both clinical and research purposes.Nephron (Source: Nephron)
Source: Nephron - October 5, 2018 Category: Urology & Nephrology Source Type: research

The Future: Experimental Therapies for Renal Disease in Diabetes
This article will seek to outline the main advancem ents in each of these experimental therapies for diabetic nephropathy.Results: Abnormal vascular remodelling, inflammation and oxidative stress seem to be the 3 main sources from which future new drugs for diabetic kidney disease will originate.Nephron (Source: Nephron)
Source: Nephron - October 5, 2018 Category: Urology & Nephrology Source Type: research

Inflammation in Diabetic Kidney Disease
Background: Diabetes is a growing public health problem. Diabetic kidney disease (DKD) is the most prevalent chronic renal disease and the major cause of end-stage renal failure worldwide, predominantly due to the increase of Type 2 diabetes associated with obesity. The intimate mechanisms leading to the development and progression of renal injury in DKD are not well understood, but current knowledge indicates that its pathogenesis is multifactorial, where the immune response and inflammation appear to be relevant factors.Summary: This review summarizes the role of relevant inflammatory molecules and pathways that particip...
Source: Nephron - October 5, 2018 Category: Urology & Nephrology Source Type: research

Using the Kinetic Estimating Glomerular Filtration Rate Equation for Estimating Glomerular Filtration Rate and Detecting Acute Kidney Injury: A Pilot Study
Conclusion: The KeGFR equation can be readily applied to estimate GFR in the non-steady state. A KeGFR-based criterion successfully detected ongoing and in-hospital AKI in this study. Community acquired AKI that did not progress after admission was not detected by the KeGFR criterion.Nephron (Source: Nephron)
Source: Nephron - September 19, 2018 Category: Urology & Nephrology Source Type: research

Role of Albumin Assay on Calcium Levels and Prescription of Phosphate Binders in Chronic Hemodialysis Patients
Conclusion: These findings suggest that calcium levels are not corrected for albumin in clinical practice when considering the prescription of calcium-free or calcium-based phosphate-binders in dialysis patients.Nephron (Source: Nephron)
Source: Nephron - September 17, 2018 Category: Urology & Nephrology Source Type: research

Diagnosing Alport Syndrome: Lessons from the Pediatric Ward
Conclusions: Atypical presentation of Alport syndrome was quite common in mothers of our pediatric patients. To enable earlier diagnosis of Alport syndrome, nephrologists should look for a positive diagnosis in any patient with persistent renal symptoms, especially if there is a positive family history of (any) renal disease.Nephron (Source: Nephron)
Source: Nephron - September 17, 2018 Category: Urology & Nephrology Source Type: research

Community Acquired Acute Kidney Injury in Mansoura Nephrology Dialysis Unit: One Year Prospective Observational Study
Conclusion: Community acquired AKI is a major health problem with high morbidity and mortality.Nephron (Source: Nephron)
Source: Nephron - September 11, 2018 Category: Urology & Nephrology Source Type: research

Temporal Regulation of Glomerular and Cortical Tubulointerstitial Genes Involved in the Development of Nephrotoxic Serum Nephritis
Conclusion: This study demonstrates several regulated genes in pathways important for the pathogenesis of the NTN model and that LMD identifies structure-specific changes in gene expression during disease development. Furthermore, this study shows the benefits of isolating glomeruli and cortical tubulointerstitium in order to identify gene regulation.Nephron (Source: Nephron)
Source: Nephron - September 11, 2018 Category: Urology & Nephrology Source Type: research

Endpoints for Clinical Trials of Acute Kidney Injury
Background: The selection of appropriate endpoints is critical to the success of any clinical trial. Endpoints need to be precisely defined and need to provide an appropriate balance between sensitivity for detection of the effects of the intervention of interest and specificity for the outcome of interest.Summary: In acute kidney injury (AKI), the 2 most common endpoints utilized either rely on small, short-term changes in serum creatinine or are a composite of longer term major adverse kidney events, including death, need for dialysis, and a persistent decline in kidney function.Key messages: Numerous issues affecting th...
Source: Nephron - September 11, 2018 Category: Urology & Nephrology Source Type: research

Changing Paradigms in Acute Kidney Injury: From Mechanisms to Management: Proceedings of the 8th Annual UAB-UCSD O ’Brien Center Symposium
Nephron 2018;140:1 –2 (Source: Nephron)
Source: Nephron - September 10, 2018 Category: Urology & Nephrology Source Type: research

Assessing Renal Recovery after Acute Kidney Injury: Can Biomarkers Help?
While there are no clear definitions of recovery, it is clear that the goals of recovery depend on the severity of acute kidney injury and the clinical context. The degree of renal recovery affects both renal and clinical prognosis. There are presently few guidelines on recovery targets, which range in extent from dialysis independence via normalization of serum creatinine to recovery of renal functional reserve. However, while there are no validated biomarkers for predicting recovery, evidence suggests that both functional and damage biomarkers can aid the assessment of recovery.Nephron (Source: Nephron)
Source: Nephron - September 2, 2018 Category: Urology & Nephrology Source Type: research

Increased Mortality Rate after Hospitalization Among Chronic Hemodialysis Patients: A Prospective Cohort Study
Conclusion: A higher cumulative number of hospitalizations is associated with increased post-discharge mortality in chronic hemodialysis patients. The cause-specific hospitalizations category of “infectious disease” showed an impact on mortality similar to that of hospitalization for “cancer.” Therefore, physicians should pay more attention to reducing preventable hospitalizations.Nephron (Source: Nephron)
Source: Nephron - September 2, 2018 Category: Urology & Nephrology Source Type: research

Incidence, Prevalence, and Duration of Chronic Kidney Disease in Taiwan: Results from a Community-Based Screening Program of 106,094 Individuals
Conclusions: The prevalence and incidence of CKD in Taiwan are high. Moreover, ADT in CKD stages 3 –5 varied according to sex, age, and comorbidity. Further exploration of the factors associated with the shifting of this duration will shed light on effective CKD management.Nephron (Source: Nephron)
Source: Nephron - August 23, 2018 Category: Urology & Nephrology Source Type: research

Acute Kidney Injury in Real Time: Prediction, Alerts, and Clinical Decision Support
Broad adoption of electronic health record (EHR) systems has facilitated acute kidney injury (AKI) research in 2 ways. First, the detection of AKI based on changes in serum creatinine has largely replaced the sensitive but nonspecific administrative coding of AKI that predominated in earlier studies. Second, the ability to implement real-time AKI interventions such as alerts and best-practice advisories has emerged as a promising tool to fight against the harmful sequela of AKI, which include short-term adverse outcomes as well as progression to chronic kidney disease, dialysis, and death. In this review, we discuss the cu...
Source: Nephron - August 2, 2018 Category: Urology & Nephrology Source Type: research

Contents Vol. 139, 2018
Nephron 2018;139:I –VI (Source: Nephron)
Source: Nephron - July 31, 2018 Category: Urology & Nephrology Source Type: research

Clinical Management of Chronic Kidney Disease Patients in Italy: Results from the IRIDE Study
Conclusions: This is the first Italian prospective study performed with a large cohort of CKD patients over a 3-year period. Considering the multifactorial burden of diseases associated with CKD patients, the need for greater attention to CKD and related disorders is paramount.Nephron (Source: Nephron)
Source: Nephron - July 17, 2018 Category: Urology & Nephrology Source Type: research

Delayed Graft Function: The AKI of Kidney Transplantation
With the growing wait list of individuals waiting for kidney transplantation, there has been renewed interest in the quality and function of donor organs. In particular, concern about the development of delayed allograft function (DGF) after transplantation continues to lead to the avoidance of donor organs offered to a transplant center. DGF is associated with worse short-and long-term outcomes and associated with higher rejection rates. There are no FDA-approved therapies to mitigate the ischemic injury that occurs. Risk factors include both donor and recipient characteristics, although their prediction is not precise. W...
Source: Nephron - July 13, 2018 Category: Urology & Nephrology Source Type: research

Ventilator-Induced Kidney Injury: Are Novel Biomarkers the Key to Prevention?
Mechanical ventilation is associated with significant increases in the risk of acute kidney injury (AKI). The rate of AKI due to mechanical ventilation and the associated mortality remain unacceptably high. Preventative and therapeutic strategies are clearly lacking. Ventilator-induced kidney injury is believed to occur due to changes in hemodynamics that impair renal perfusion, neurohumoral-mediated alterations in intra-renal blood flow, and systemic inflammatory mediators generated by ventilator-induced lung injury. The risk of injury to the kidney by these mechanisms may be modified by open lung protective ventilation w...
Source: Nephron - July 11, 2018 Category: Urology & Nephrology Source Type: research

Appendix I Acronyms and Abbreviations used in the Annual Report
Nephron 2018;139:363 –368 (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Appendix J Laboratory Conversion Factors
Nephron 2018;139:369 –370 (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Appendix K Renal Centre Names and Abbreviations used in the Figures and Data Tables
Nephron 2018;139:371 –372 (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Severe Solute Depletion in Patients with Hyponatremia Due to Diuretics Despite Biochemical Pictures Similar Than Those Observed in the Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Conclusion: We therefore suggest that diuretic induced hyponatremia with an SIADH-like biochemical profile, should be treated mainly by solute ­repletion.Nephron (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Expanding Phenotype of Nephronophthisis-Related Ciliopathy: an Elderly Patient with Homozygous < b > < i > RPGRIP1L < /i > < /b > Mutation
Nephronophthisis-related ciliopathies (NPHP-RC) are autosomal recessive disorders characterized by renal corticomedullary cysts with the extrarenal symptoms. Typically, patients with NPHP-RC reach end-stage kidney disease (ESKD) before the age of 30 years. We herein report a Japanese woman with NPHP-RC who had unusually delayed progression to ESKD after 6 decades. She exhibited liver dysfunction at the age of 23 years. She also showed mild renal dysfunction at the age of 43 years. Ultrasonography revealed bilateral multiple renal cysts with loss of corticomedullary differentiation. Her liver and renal functions gradually d...
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Effect of Sucroferric Oxyhydroxide on Fibroblast Growth Factor 23 Levels in Hemodialysis Patients
Conclusions: Treatment of hyperphosphatemia with sucroferric oxyhydroxide was effective in patients on hemodialysis, resulting in decreased serum FGF-23 levels and a reduction in the required dose of saccharated ferric oxide.Nephron (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Trace Albumin in the Urine Dipstick Test is Associated with Coronary Artery Calcification in Korean Adults
Conclusion: Even a trace level of albumin in the urine dipstick test was associated with subclinical CAC in Korean adults. Low-grade dipstick albuminuria should not be overlooked.Nephron (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Proteomic Analysis for Identification of Biomarkers that Predict Severe Acute Kidney Injury
The search for acute kidney injury (AKI) biomarkers has identified a number of urine proteins that can be used to predict the presence of AKI but has struggled to identify proteins that are prognostic for severe AKI. In this review, we discuss 2 currently available biomarkers and the designs of the studies in which they were identified and relate this to the AKI characteristics they predict clinically. We discuss recent advances in mass spectrometry and sample preparation, which have improved the ability to identify low abundance proteins as well as the ability to characterize more of the protein by mass spectrometry. We s...
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Optogenetics in Understanding Mechanisms of Acute Kidney Injury
Background: No approved pharmacological agents are available for the treatment and prevention of acute kidney injury (AKI). The nervous system has been reported to play an important role, directly or indirectly via the immune system, in the pathophysiology of AKI. Neuromodulation, such as vagus nerve stimulation and pulsed ultrasound, is emerging as an innovative therapeutic treatment for various diseases including AKI. However, lack of effective methods to selectively stimulate or inhibit neurons has hampered the complete understanding of the roles of the nervous system in AKI because electrical stimulation is nonspecific...
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Prelims
Nephron ;139:I –XIV (Source: Nephron)
Source: Nephron - July 10, 2018 Category: Urology & Nephrology Source Type: research

Immunomodulatory and Kidney-Protective Effects of the Human Chorionic Gonadotropin Derivate EA-230
The systemic inflammatory response following infectious or non-infectious insults is related to morbidity (including acute kidney injury) and mortality. Pregnancy is associated with immunotolerance and an increased glomerular filtration rate. EA-230, a linear tetrapeptide (Alanine-Glutamine-Glycine-Valine), derived from the β-chain of the human chorionic gonadotropin hormone, has shown immunomodulatory and renoprotective properties in several pre-clinical animal models of systemic inflammation. Furthermore, an excellent safety profile of EA-230 was observed in phase 1 studies in humans, and the immunomodulatory effect...
Source: Nephron - July 6, 2018 Category: Urology & Nephrology Source Type: research

Iron Homeostasis Pathways as Therapeutic Targets in Acute Kidney Injury
Background: Iron is critical for fundamental biologic functions such as cell division and mitochondrial electron transport. However, by the virtue of its ability to donate electrons, iron is probably the most effective oxidant in biologic systems.Summary: To avoid damage from iron-mediated oxidative injury or ferroptosis, multiple defense mechanisms exist including iron binding proteins and robust glutathione-dependent intracellular pathways. Hepcidin, through its ability to sequester iron within macrophages and induce H-ferritin, serves as an endogenous protective molecule against ferroptosis.Key Messages: Recent studies ...
Source: Nephron - July 6, 2018 Category: Urology & Nephrology Source Type: research

Dyskalemia in Chronic Kidney Disease: How Concerned Should We Be?
Context: The widespread use of diuretics, potassium supplements, and medications that block renin angiotensin system puts the chronic kidney disease (CKD) population at high risk for dyskalemia, both hyperkalemia and hypokalemia. The optimal potassium level in a CKD patient is unknown.Subject of review: Two recent studies found conflicting results on the association of dyskalemia with outcomes. The Renal Research Institute CKD study [Clin J Am Soc Nephrol 2010; 5: 762 –769] found increased mortality and incidence of end-stage renal disease (ESRD) with mild to moderate hypokalemia, whereas hyperkalemia was not signifi...
Source: Nephron - July 4, 2018 Category: Urology & Nephrology Source Type: research

Rationale and Design of a Randomized Placebo-Controlled Clinical Trial Assessing the Renoprotective Effects of Potassium Supplementation in Chronic Kidney Disease
Conclusion: The K+ in the CKD study will demonstrate if K+ supplementation has a renoprotective effect in progressive CKD, and whether alkali therapy has additional beneficial effects.Nephron (Source: Nephron)
Source: Nephron - June 29, 2018 Category: Urology & Nephrology Source Type: research