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Specialty: Urology & Nephrology
Source: Kidney International

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Total 26 results found since Jan 2013.

Prevention and treatment of stroke in patients with chronic kidney disease: an overview of evidence and current guidelines
Chronic Kidney Disease (CKD) is strongly associated with an increased risk of stroke, small vessel disease, and vascular dementia. Common vascular factors for stroke, such as hypertension, diabetes, and atrial fibrillation, are more prevalent in CKD patients, accounting for this association. However, factors unique to these patients, such as uraemia, oxidative stress, mineral and bone abnormalities, as well as dialysis-related factors are also believed to contribute to risk. Despite improvements in stroke treatment and survival in the general population, the rate of improvement in patients with CKD, especially those who ar...
Source: Kidney International - October 17, 2019 Category: Urology & Nephrology Authors: Dearbhla M. Kelly, Peter M. Rothwell Tags: Review Source Type: research

The association of anticoagulation, ischemic stroke, and hemorrhage in elderly adults with chronic kidney disease and atrial fibrillation
The utility of anticoagulants for ischemic stroke prophylaxis in elderly patients with chronic kidney disease (CKD) and atrial fibrillation remains uncertain. In this population-based retrospective cohort study, we determined the association of anticoagulant use with ischemic stroke or hemorrhage in elderly patients (66 years and older) with advanced chronic kidney disease (eGFR under 45 ml/min/1.73m2) and atrial fibrillation. We followed 6,544 patients with CKD and new onset atrial fibrillation, of whom 1,475 filled a prescription for an anticoagulant.
Source: Kidney International - December 21, 2016 Category: Urology & Nephrology Authors: Vaibhav Keskar, Eric McArthur, Ron Wald, Ziv Harel, Deborah Zimmerman, Amber O. Molnar, Amit X. Garg, Ngan N. Lam, Megan K. McCallum, Sarah E. Bota, Jeffrey Perl, Manish M. Sood Tags: Clinical Investigation Source Type: research

Apixaban for stroke prevention in hemodialysis patients with non-valvular atrial fibrillation
Atrial fibrillation (AF) is a common arrhythmia among patients with kidney failure on maintenance hemodialysis (HD) and is associated with a high incidence of all-cause mortality and stroke in this population.1
Source: Kidney International - April 11, 2023 Category: Urology & Nephrology Authors: Thomas A. Mavrakanas Tags: nephrology digest Source Type: research

Apixaban for stroke prevention in hemodialysis patients with nonvalvular atrial fibrillation
Atrial fibrillation (AF) is a common arrhythmia among patients with kidney failure on maintenance hemodialysis (HD) and is associated with a high incidence of all-cause mortality and stroke in this population.1
Source: Kidney International - April 11, 2023 Category: Urology & Nephrology Authors: Thomas A. Mavrakanas Tags: Nephrology Digest Source Type: research

Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension?
Ischemic brain injury in hemodialysis patients: which is more dangerous, hypertension or intradialytic hypotension? Kidney International 87, 1109 (June 2015). doi:10.1038/ki.2015.62 Authors: Christopher W McIntyre & David J Goldsmith
Source: Kidney International - May 29, 2015 Category: Urology & Nephrology Authors: Christopher W McIntyreDavid J Goldsmith Tags: brain injury hemodialysis leukoaraiosis myocardial stunning stroke Source Type: research

Long-term effects following 4 years of randomized treatment with atorvastatin in patients with type 2 diabetes mellitus on hemodialysis
The 4D (Die Deutsche Diabetes Dialyse) Study was a randomized, double-blind trial comparing 4 years of treatment with atorvastatin to placebo in 1255 hemodialysis patients with type 2 diabetes. The primary end point of cardiovascular events (cardiac death, myocardial infarction, and stroke) was non-significantly reduced by 8%. However, long-term effects remained uncertain. Therefore, surviving patients were invited to a follow-up survey done by questionnaire. Post-trial statin therapy was at nephrologist discretion, and outcomes were centrally adjudicated and analyzed by intention to treat and time to first event in the or...
Source: Kidney International - February 17, 2016 Category: Urology & Nephrology Authors: Vera Krane, Kay-Renke Schmidt, Lena J. Gutjahr-Lengsfeld, Johannes F.E. Mann, Winfried März, Florian Swoboda, Christoph Wanner, 4D Study Investigators (the German Diabetes and Dialysis Study Investigators) Tags: Clinical Trial Source Type: research

In this Issue
The 4D Study was a randomized trial comparing 4 years of treatment with atorvastatin to placebo in 1255 hemodialysis patients with type 2 diabetes. In the original trial, atorvastatin did not significantly reduce the primary end point of cardiovascular events, including cardiac death, myocardial infarction, and stroke. To determine the long-term effects of atorvastatin in these patients, Krane and co-workers used questionnaires to assess clinical outcomes in surviving 4D participants. After median follow-up of 11.5 years, participants who had been assigned to atorvastatin had a nonsignificant trend toward fewer cardiovascu...
Source: Kidney International - May 13, 2016 Category: Urology & Nephrology Tags: In this Issue Source Type: research

Long-term versus short-term dual antiplatelet therapy was similarly associated with a lower risk of death, stroke, or infarction in patients with acute coronary syndrome regardless of underlying kidney disease
Scarce and conflicting evidence exists on whether clopidogrel is effective and whether dual antiplatelet treatment (DAPT) is safe in patients with acute coronary syndrome and chronic kidney disease (CKD). To study this, we performed an observational, prospective, multicenter cohort study of 36,001 patients of the SWEDEHEART registry. The exposure was DAPT prolonged after 3 months versus DAPT stopped at 3 months in consecutive patients with acute coronary syndrome and known serum creatinine. DAPT duration with clopidogrel and aspirin was assessed by dispensed tablets.
Source: Kidney International - November 15, 2016 Category: Urology & Nephrology Authors: Juan-Jesus Carrero, Christoph Varenhorst, Karin Jensevik, Karolina Szummer, Bo Lagerqvist, Marie Evans, Jonas Spaak, Claes Held, Stefan James, Tomas Jernberg Tags: Clinical Investigation Source Type: research

Folic acid supplementation and chronic kidney disease progression
In contrast to prior studies demonstrating no benefit or even increased harm from B vitamin supplementation in patients with chronic kidney disease, a large randomized trial from China recently demonstrated small but statistically significant reductions in the risk of first stroke and chronic kidney disease progression with the addition of folic acid to enalapril in adults with hypertension. Differences in the study population and study intervention may explain these discordant results.
Source: Kidney International - November 21, 2016 Category: Urology & Nephrology Authors: Christina M. Wyatt, J. David Spence Tags: Nephrology Digest Source Type: research

In This Issue
There has been great controversy in recent years regarding whether anticoagulation for patients with end-stage renal disease and atrial fibrillation is beneficial, ineffective, or harmful. In this issue, Keskar and colleagues report the results from a retrospective cohort study in which they examined the association of anticoagulant use with ischemic stroke or hemorrhage in 6544 patients>66 years old with estimated glomerular filtration rate
Source: Kidney International - March 16, 2017 Category: Urology & Nephrology Tags: In This Issue Source Type: research

α-galactosidase A deficiency promotes von Willebrand factor secretion in models of Fabry disease
Fabry disease results from loss of activity of the lysosomal enzyme α-galactosidase A (GLA), leading to the accumulation of globoseries glycosphingolipids in vascular endothelial cells. Thrombosis and stroke are life-threatening complications of Fabry disease; however, the mechanism of the vasculopathy remains unclear. We explored the relationship between GLA defic iency and endothelial cell von Willebrand factor (VWF) secretion in in vivo and in vitro models of Fabry disease. Plasma VWF was significantly higher at two months and increased with age in Gla-null compared to wild-type mice.
Source: Kidney International - November 20, 2018 Category: Urology & Nephrology Authors: Justin J. Kang, Nayiri M. Kaissarian, Karl C. Desch, Robert J. Kelly, Liming Shu, Peter F. Bodary, James A. Shayman Tags: Basic Research Source Type: research

mTOR inhibitors may benefit kidney transplant recipients with mitochondrial diseases
Mitochondrial diseases represent a significant clinical challenge. Substantial efforts have been devoted to identifying therapeutic strategies for mitochondrial disorders, but effective interventions have remained elusive. Recently, we reported attenuation of disease in a mouse model of the human mitochondrial disease Leigh syndrome through pharmacological inhibition of the mechanistic target of rapamycin (mTOR). The human mitochondrial disorder MELAS/MIDD (Mitochondrial Encephalopathy with Lactic Acidosis and Stroke-like Episodes/Maternally Inherited Diabetes and Deafness) shares many phenotypic characteristics with Leigh syndrome.
Source: Kidney International - November 21, 2018 Category: Urology & Nephrology Authors: Simon C. Johnson, Frank Martinez, Alessandro Bitto, Brenda Gonzalez, Cagdas Tazaerslan, Camille Cohen, Laure Delaval, Jos é Timsit, Bertrand Knebelmann, Fabiola Terzi, Tarika Mahal, Yizhou Zhu, Philip G. Morgan, Margaret M. Sedensky, Matt Kaeberlein, Chr Tags: Clinical Trial Source Type: research

The Case | Severe hypertension and hyperkalemia in a kidney transplant recipient
A 55-year-old man with a history of end-stage renal disease due to autosomal dominant polycystic kidney disease and bilateral nephrectomy without adrenalectomy underwent his first kidney transplantation after 6 years of hemodialysis. The patient had no history of donor-specific antibodies. The donor was described as a 69-year-old man with a history of active smoking and aortic valvulopathy who died of a stroke without cardiac arrest or collapse. Maintenance immunosuppressive therapy consisted of low-dose tacrolimus and everolimus.
Source: Kidney International - July 19, 2019 Category: Urology & Nephrology Authors: Vincent Dupont, Charlotte Colosio, Marguerite Hureaux, Laetitia Mokri, Betoul Schvartz, Vincent Vuiblet, Antoine Braconnier, Rosa Vargas-Poussou, Philippe Rieu Tags: Make Your Diagnosis Source Type: research

Tubuloreticular inclusions in COVID-19-related collapsing glomerulopathy
A 79-year-old male of African ancestry, with a history of hemorrhagic stroke, monoclonal gammopathy of unknown significance and chronic kidney disease stage 3 due to hypertension was admitted to Bichat hospital on day 1 after the first symptom of COVID-19 (fever). SARS-CoV 2 PCR was positive on nasal swab. At admission urinary dipstick was normal and plasma creatinine was 224 μmol/L. On day 4 plasma albumin was at 29 g/L and proteinuria was 11.4 g per gram of urinary creatinine (80% of albumin).
Source: Kidney International - April 26, 2020 Category: Urology & Nephrology Authors: Fran çois Gaillard, Sophie Ismael, Aurélie Sannier, Hassan Tarhini, Thomas Volpe, Clarisse Greze, Marie Christine Verpont, Ilyass Zouhry, Christophe Rioux, François-Xavier Lescure, David Buob, Eric Daugas Tags: nephrology image Source Type: research

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