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Regulation of the epithelial Na+ channel by the mTORC2/SGK1 pathway
The epithelial Na+ channel (ENaC) is decisive for sodium reabsorption by the aldosterone-sensitive distal nephron (ASDN) of the kidney. ENaC is regulated by the serum- and glucocorticoid-inducible kinase 1 (SGK1), a kinase genomically upregulated by several hormones including glucocorticoids and mineralocorticoids. SGK1 is activated by the serine/threonine kinase mammalian target of rapamycin (mTOR) isoform mTORC2. SGK1 knockout (sgk1–/– mice) impairs renal Na+ retention during salt depletion. The mTOR catalytic site inhibitor, PP242, but not mTORC1 inhibitor rapamycin, inhibits ENaC, decreases Na+ flux in isol...
Source: Nephrology Dialysis Transplantation - January 25, 2016 Category: Urology & Nephrology Authors: Lang, F., Pearce, D. Tags: REVIEWS - BASIC SCIENCE AND TRANSLATIONAL NEPHROLOGY Source Type: research

Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation
Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.
Source: Nephrology Dialysis Transplantation - February 23, 2015 Category: Urology & Nephrology Authors: Genovesi, S., Rossi, E., Gallieni, M., Stella, A., Badiali, F., Conte, F., Pasquali, S., Bertoli, S., Ondei, P., Bonforte, G., Pozzi, C., Rebora, P., Valsecchi, M. G., Santoro, A. Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research

Use and safety of heparin-free maintenance hemodialysis in the USA
Conclusions Patient markers of increased risk of bleeding and facility region associated with heparin-free HD use. Despite the potential benefits of avoiding heparin use, heparin-free HD was not significantly associated with decreased hazards of death, bleeding or thrombosis, suggesting that it may be no safer than HD with heparin.
Source: Nephrology Dialysis Transplantation - June 18, 2013 Category: Urology & Nephrology Authors: Shen, J. I., Mitani, A. A., Chang, T. I., Winkelmayer, W. C. Tags: Intra- and Extracorporeal Treatment of Kidney Failure Source Type: research

Progeria syndrome in CKD/ESRD
Conclusions: Renal impairment independently associates with greater stroke disability at presentation and worse functional outcomes despite modern stroke care. Nonetheless these patients are also less likely to be thrombolysed for acute ischaemic stroke, which suggests a possible inequity in access to healthcare that requires urgent study.
Source: Nephrology Dialysis Transplantation - May 10, 2013 Category: Urology & Nephrology Authors: Power, A., Gill, D., Wietek, N., Lim, J., Tanna, R., Duncan, N., Troyano Suarez, N., Del Nogal Avila, M., Mora Valenciano, I., Olmos Centenero, G., Diez-Marques, M. L., Cortes, M., Lopez Ongil, S., Martin Sanchez, P., Rodriguez Puyol, D., Ruiz Torres, M. Tags: Abstracts Source Type: research

Sailing between Scylla and Charybdis: oral long-term anticoagulation in dialysis patients
End-stage renal disease (ESRD) patients exhibit an increased risk of bleeding compared with non-chronic kidney disease (CKD) patients due to uraemic platelet dysfunction, altered vessel architecture and other factors. This renders any long-term oral anticoagulation potentially difficult. While there is little doubt that ESRD patients with recurrent thromboembolism or a mechanical cardiac valve should receive vitamin K antagonists (coumarins), the use of coumarins in ESRD patients with atrial fibrillation is a matter of debate. In non-CKD patients, current guidelines strongly recommend the use of oral anticoagulants for str...
Source: Nephrology Dialysis Transplantation - March 5, 2013 Category: Urology & Nephrology Authors: Kruger, T., Brandenburg, V., Schlieper, G., Marx, N., Floege, J. Tags: CLINICAL SCIENCE AND OUTCOME RESEARCH IN NEPHROLOGY Source Type: research