998 results match your criteria Advances in chronic kidney disease[Journal]


Novel Complement Therapeutics in Development as Potential Treatment for Renal Disease.

Adv Chronic Kidney Dis 2020 Mar;27(2):95-103

Apellis Pharmaceuticals, Waltham, MA.

The complement system is an evolutionarily ancient arm of the innate immune system. It remains, however, one of the last major pathways in immunology for which specific pharmaceutical antagonists have been developed. In recent years, a fundamental role for complement has been described in many different renal diseases, including both pauci-immune as well as immune-complex diseases. Read More

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http://dx.doi.org/10.1053/j.ackd.2020.02.006DOI Listing

Complement and the Kidney: An Overview.

Authors:
Joshua M Thurman

Adv Chronic Kidney Dis 2020 Mar;27(2):86-94

Department of Medicine, University of Colorado School of Medicine, Aurora, CO. Electronic address:

The complement cascade was first recognized as a downstream effector system of antibody-mediated cytotoxicity. Consistent with this view, it was discovered in the 1960s that complement is activated in the glomeruli of patients with immune complex glomerulonephritis. More recently, research has shown that complement system has many additional functions relating to regulation of the immune response, homeostasis, and metabolism. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310605PMC

O Complement, Where Aren't Thou.

Adv Chronic Kidney Dis 2020 Mar;27(2):83-85

Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

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http://dx.doi.org/10.1053/j.ackd.2020.02.001DOI Listing

Complement-Mediated Disorders in Pregnancy.

Adv Chronic Kidney Dis 2020 Mar;27(2):155-164

Department of Nephrology/Medicine, Jacobi Medical Center at Albert Einstein College of Medicine, Bronx, NY. Electronic address:

Complement-mediated disorders in pregnancy span a large spectrum and have been implicated in all three complement pathways: classical, lectin, and alternative. Our understanding of these disorders in recent years has advanced due to a better understanding of complement regulatory proteins, such as complement factor H, complement factor I, membrane cofactor protein, and thrombomodulin that particularly affect the alternative complement pathway. Enthusiasm in genotyping for mutations that encode these proteins has allowed us to study the presence of genetic variants which may predispose women to develop conditions such as pregnancy-associated hemolytic uremic syndrome (P-aHUS), thrombotic thrombocytopenic purpura, preeclampsia/hemolysis, elevated liver enzymes, low platelets (HELLP), systemic lupus erythematosus/antiphospholipid syndrome, and peripartum cardiomyopathy. Read More

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http://dx.doi.org/10.1053/j.ackd.2020.01.002DOI Listing

Complement and Renal Thrombotic Microangiopathy Associated With Hypertension and Scleroderma.

Adv Chronic Kidney Dis 2020 Mar;27(2):149-154

Department of Pathology, University of Chicago Medicine, Chicago, IL. Electronic address:

Thrombotic microangiopathy is characterized by the presence of thrombocytopenia and microangiopathic hemolytic anemia and can occur in up to 50% of patients with hypertensive emergency and 10-15% with scleroderma. This review discusses the emerging role of complement in these 2 clinical entities. Specifically, we evaluate the evidence linking complement dysregulation with the manifestation of thrombotic microangiopathy and its clinical course in these settings. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.11.002DOI Listing

Complement-Based Therapy in the Management of Antibody-Mediated Rejection.

Adv Chronic Kidney Dis 2020 Mar;27(2):138-148

Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address:

Antibody-mediated rejection (AMR) is one of the leading causes of kidney allograft failure and is usually mediated by anti-human leukocyte antigen donor-specific antibodies (DSAs). Activation of classical pathway of the complement system is responsible for downstream effects of DSA and account for significant manifestations of AMR. Currently, the treatment of AMR is based on strategies to remove preformed antibodies or to prevent their production; however, these strategies are often unsuccessful. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.12.002DOI Listing

Peri- and Post-operative Evaluation and Management of Atypical Hemolytic Uremic Syndrome (aHUS) in Kidney Transplantation.

Authors:
Anuja Java

Adv Chronic Kidney Dis 2020 Mar;27(2):128-137

Division of Nephrology St. Louis, Department of Medicine, Washington University School of Medicine in St. Louis, MO. Electronic address:

Atypical hemolytic uremic syndrome (aHUS) is a severe thrombotic microangiopathy characterized by over-activation of the alternative complement pathway. The etiology of the dysregulated complement system is commonly a genetic variant in one or more complement proteins as identified in ∼ 60%-70% patients. The risk of recurrence after a kidney transplantation is high and depends on the underlying complement abnormality. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.11.003DOI Listing

Genetic and Protein Structural Evaluation of Atypical Hemolytic Uremic Syndrome and C3 Glomerulopathy.

Adv Chronic Kidney Dis 2020 Mar;27(2):120-127.e4

Department of Structural and Molecular Biology, University College London, London, United Kingdom. Electronic address:

Atypical hemolytic uremic syndrome (aHUS) and C3 glomerulopathy (C3G) are associated with loss of regulation of the alternative pathway of complement and its resulting overactivation. As rare diseases, genetic variants leading to aHUS and C3G were previously analysed in relatively low patient numbers. To improve this analysis, data were pooled from six centres. Read More

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http://dx.doi.org/10.1053/j.ackd.2020.03.002DOI Listing

Complement in IgA Nephropathy: The Role of Complement in the Pathogenesis, Diagnosis, and Future Management of IgA Nephropathy.

Adv Chronic Kidney Dis 2020 Mar;27(2):111-119

Stanford University School of Medicine, Palo Alto, CA; Cork University Hospital, Cork, Ireland.

Immunoglobulin A (IgA) nephropathy (IgAN) is an important cause of chronic and end-stage kidney disease. IgAN pathogenesis is incompletely understood. In particular, we cannot adequately explain the heterogeneity in clinical and histologic features and severities that characterizes IgAN. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.12.004DOI Listing

C3 Glomerulopathy: Pathogenesis and Treatment.

Adv Chronic Kidney Dis 2020 Mar;27(2):104-110

Division of Nephrology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. Electronic address:

C3 glomerulopathy (C3G) is a rare set of kidney diseases with 2 patterns: C3 glomerulonephritis (C3GN) and dense deposit disease. Pathogenesis of both diseases is due to complement dysregulation in the alternative pathway. Acquired or genetic alterations of the regulatory proteins of the complement pathway result in C3G. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.12.003DOI Listing

The Association of Mesalamine With Kidney Disease.

Adv Chronic Kidney Dis 2020 01;27(1):72-76

Division of Nephrology, NYU Langone Health, New York, NY; Division of Nephrology, NYU School of Medicine, New York Harbor VA Healthcare System, New York, NY. Electronic address:

The package inserts for products containing 5-aminosalicylic acid, or mesalamine, include the following language regarding the risk of adverse kidney effects: "renal impairment, including minimal change nephropathy, acute and chronic interstitial nephritis, and rarely renal failure, has been reported in patients given products such as mesalamine delayed-release tablets that contain mesalamine or are converted to mesalamine." In this article, we review the data regarding this nephrotoxicity and the recommendations regarding appropriate monitoring. Chronic interstitial nephritis is a rare occurrence in patients treated with these drugs for Crohn disease and ulcerative colitis. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.09.002DOI Listing
January 2020

Toxicity of Herbs, Vitamins, and Supplements.

Adv Chronic Kidney Dis 2020 01;27(1):67-71

Department of Medicine/Division of Nephrology, Mount Sinai Beth Israel/Icahn School of Medicine, New York, NY. Electronic address:

In the United States, the Food and Drug Administration regulates the efficacy and safety of pharmaceutical drugs. This government agency was formed in direct response to a mass poisoning and more than 100 deaths from kidney failure due to a medicinal toxic alcohol exposure. In contrast, the Food and Drug Administration also regulates the use of vitamins, minerals, herbs, or botanicals as dietary supplements, banning specific medical claims but requiring no documentation of efficacy. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.003DOI Listing
January 2020

The Many Faces of Calcineurin Inhibitor Toxicity-What the FK?

Adv Chronic Kidney Dis 2020 01;27(1):56-66

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:

Calcineurin inhibitors (CNIs) are both the savior and Achilles' heel of kidney transplantation. Although CNIs have significantly reduced rates of acute rejection, their numerous toxicities can plague kidney transplant recipients. By 10 years, virtually all allografts will have evidence of CNI nephrotoxicity. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080294PMC
January 2020

Radiocontrast Toxicity.

Authors:
Staci Leisman

Adv Chronic Kidney Dis 2020 01;27(1):50-55

Division of Nephrology, Department of Medicine, Mount Sinai Hospital/Icahn School of Medicine, New York, NY. Electronic address:

Intravenous and intraarterial contrast media are invaluable tools in the diagnosis of anatomic lesions. However, they have been associated with deleterious renal events, ranging from acute kidney injury (iodinated contrast) to nephrogenic systemic fibrosis (gadolinium-containing agents). Contrast-associated acute kidney injury has a wide incidence, likely due to differences in populations studied, with incidence likely overstated due to comorbid conditions at the time of contrast exposure. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.002DOI Listing
January 2020

Nephrotoxic Chemotherapy Agents: Old and New.

Adv Chronic Kidney Dis 2020 01;27(1):38-49

Department of Internal Medicine, Mount Sinai Beth Israel/Icahn School of Medicine, New York, NY. Electronic address:

In the last several decades, advancements in chemotherapy have improved the overall survival of cancer patients. These agents, however, are associated with adverse effects, including various kidney lesions. This review summarizes the nephrotoxic potential of chemotherapy agents, old and new, as well as the different factors that contribute to kidney injury. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.005DOI Listing
January 2020

Nephrotoxicity of Antimicrobials and Antibiotics.

Adv Chronic Kidney Dis 2020 01;27(1):31-37

Icahn School of Medicine at Mount Sinai Beth Israel, New York, NY. Electronic address:

Medication-induced nephrotoxicity remains one of the most common causes of acute kidney injury (AKI) among hospitalized patients. Within the extensive group of medications associated with AKI, antibiotics and other antimicrobials are well recognized triggers of structural and functional renal impairment. Clinical manifestations range from mild forms of tubular injury to significant deterioration of kidney function requiring acute renal replacement therapy. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.001DOI Listing
January 2020

Poisoning, Toxicology, and the Nephrologist.

Authors:
Nikolas Harbord

Adv Chronic Kidney Dis 2020 01;27(1):3-4

Mount Sinai Beth Israel/Icahn School of Medicine, New York, NY.

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http://dx.doi.org/10.1053/j.ackd.2019.10.002DOI Listing
January 2020

Toxicity of Metformin and Hypoglycemic Therapies.

Adv Chronic Kidney Dis 2020 01;27(1):18-30

Mount Sinai Beth Israel, New York, NY.

Metformin along with other antidiabetic medications provide benefit to patients in the treatment of type 2 diabetes mellitus, but caution is advised in certain scenarios to avoid toxicity in kidney disease. Renal dosing, monitoring of kidney function, and evaluating the risk of developing serious side effects are warranted with some agents. The available literature with regard to incidence of adverse events and toxicity of hypoglycemic therapies is reviewed. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.004DOI Listing
January 2020

Common Toxidromes and the Role of Extracorporeal Detoxification.

Authors:
Nikolas Harbord

Adv Chronic Kidney Dis 2020 01;27(1):11-17

Department of Medicine/Nephrology, Mount Sinai Beth Israel/Icahn School of Medicine, New York, NY. Electronic address:

Extracorporeal modalities have been used for detoxification for decades, with hemodialysis the preferred and most commonly used modality. Salicylates, lithium, methanol, and ethylene glycol are the most common poisonings treated with dialysis. For each of these common poisonings, a description of the toxidrome including pharmacokinetics, clinical presentation, an overview of treatment, and the role and application of dialysis is outlined. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.016DOI Listing
January 2020

Toxicology and Kidney: Not so Innocent Bystander.

Adv Chronic Kidney Dis 2020 01;27(1):1-2

Division of Nephrology, University of Cincinnati, Renal Section, Cincinnati VAMC, Cincinnati OH.

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http://dx.doi.org/10.1053/j.ackd.2020.01.001DOI Listing
January 2020

Calciphylaxis: Approach to Diagnosis and Management.

Adv Chronic Kidney Dis 2019 11;26(6):484-490

Department of Medicine, Division of Nephrology, University of Iowa, Iowa City, IA. Electronic address:

Calciphylaxis is a rare disorder of poor prognosis that can lead to intense, painful lesions involving the skin and subcutaneous tissue. Although mostly described in dialysis patients, it can affect patients with normal kidney function. The diagnosis of calciphylaxis is complicated by the absence of a gold standard marker of disease such as a clear histopathological finding. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.09.005DOI Listing
November 2019

Bone-Vascular Axis in Chronic Kidney Disease.

Adv Chronic Kidney Dis 2019 11;26(6):472-483

Department of Biomedical Sciences, Laboratory of Pathophysiology, University of Antwerp, Antwerp, Belgium.

Patients with chronic kidney disease (CKD) are at increased risk of osteoporosis and vascular calcification. Bone demineralization and vascular mineralization go often hand in hand in CKD, similar to as in the general population. This contradictory association is independent of aging and is commonly referred to as the "calcification paradox" or the bone-vascular axis. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.09.006DOI Listing
November 2019

Valvular Calcification in Chronic Kidney Disease.

Adv Chronic Kidney Dis 2019 11;26(6):464-471

Department of Nephrology, University Hospital RWTH Aachen, Aachen, Germany; Department of Internal Medicine, Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, the Netherlands.

Accelerated and premature cardiovascular calcification is a hallmark of patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD). The presence and the amount of cardiovascular calcification are among the driving forces of increased morbidity and mortality in renal patients. Cardiovascular calcification occurs at different sites, including the cardiac valves-a location that is of particular importance for both the patient and the treating physician. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.10.004DOI Listing
November 2019

Diagnostic Tests for Vascular Calcification.

Adv Chronic Kidney Dis 2019 11;26(6):445-463

Department of Nephrology, The Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine, University of Melbourne, Parkville, VIC, Australia.

Vascular calcification (VC) is the heterogeneous endpoint of multiple vascular insults, which varies by arterial bed, the layer of the arterial wall affected, and is propagated by diverse cellular and biochemical mechanisms. A variety of in vivo and ex vivo techniques have been applied to the analysis of VC in preclinical studies, but clinical examination has principally relied on a number of noninvasive and invasive imaging modalities for detection and quantitation. Most imaging methods suffer from suboptimal spatial resolution, leading to the inability to distinguish medial from intimal VC and insufficient sensitivity to detect microcalcifications that are indicative of active mineral deposition and of vulnerable plaques which may be prone to rupture. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.07.001DOI Listing
November 2019

The Role of Vitamin K in Vascular Calcification.

Adv Chronic Kidney Dis 2019 11;26(6):437-444

Nephrology Dialysis and Renal Transplant Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), S. Orsola Hospital, University of Bologna, Bologna, Italy.

Vascular calcification (VC) is common in advanced chronic kidney disease (CKD), contributes to cardiovascular disease (CVD), and associates with increased mortality. Major risk factors for VC in CKD are increasing age, dialysis vintage, and positive net calcium-phosphate balance. To date, no specific therapy that prevents progression or facilitates regression of VC beyond careful attention to calcium and phosphate balance exists. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.10.005DOI Listing
November 2019

The Role of Nonenzymatic Post-translational Protein Modifications in Uremic Vascular Calcification.

Adv Chronic Kidney Dis 2019 11;26(6):427-436

Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA. Electronic address:

Considerable technological advances have enabled the identification and linkage of nonenzymatic post-translationally modified proteins to the pathogenesis of cardiovascular disease (CVD) in patients with kidney failure. Through processes such as the nonenzymatic carbamylation reaction as well as the formation of advanced glycation end products, we now know that protein modifications are invariably associated with the development of CVD beyond a mere epiphenomenon and this has become an important focus of nephrology research in recent years. Although the specific mechanisms by which protein modifications occurring in kidney failure that may contribute to CVD are diverse and include pathways such as inflammation and fibrosis, vascular calcification has emerged as a distinct pathological sequelae of protein modifications. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.10.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993873PMC
November 2019

Mechanisms of Vascular Calcification in Kidney Disease.

Adv Chronic Kidney Dis 2019 11;26(6):417-426

Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

The increase in prevalence and severity of vascular calcification in chronic kidney disease is a result of complex interactions between changes in the vascular bed, mineral metabolites, and other uremic factors. Vascular calcification can occur in the intima and the media of arterial wall. Under permissive conditions, vascular smooth muscle cells (VSMCs) can transform to osteoblast-like phenotype. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.014DOI Listing
November 2019

Mineral Bone Abnormalities and Vascular Calcifications.

Adv Chronic Kidney Dis 2019 11;26(6):409-416

Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; Renal Section, Medicine Service, Rocky Mountain Regional VA Medical Center, Aurora, CO. Electronic address:

Vascular calcification (VC) is common in chronic kidney disease, increases in prevalence as patients progress to end-stage renal disease, and is significantly associated with mortality. VC is a complex and highly regulated process similar to bone formation whereby hydroxyapatite crystals deposit in the intimal or medial layer of arteries. Mineral bone abnormalities are common in chronic kidney disease; reduction in glomerular filtration rate and changes in vitamin D, parathyroid hormone, and fibroblast growth factor 23 result in the dysregulation of phosphorus and calcium metabolism. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.09.004DOI Listing
November 2019

Cardiovascular Calcifications Among Patients With Uremia: Answers to Hard Questions.

Authors:
Sagar U Nigwekar

Adv Chronic Kidney Dis 2019 11;26(6):407-408

Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.

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http://dx.doi.org/10.1053/j.ackd.2019.11.001DOI Listing
November 2019

Advances in Chronic Kidney Disease as Syntopicon.

Authors:
Jerry Yee

Adv Chronic Kidney Dis 2019 11;26(6):405-406

Henry Ford Hospital, Detroit, MI; Professor of Clinical Medicine, Wayne State University, Detroit, MI.

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http://dx.doi.org/10.1053/j.ackd.2019.05.004DOI Listing
November 2019

Membranous Lupus Nephritis: A Clinical Review.

Adv Chronic Kidney Dis 2019 09;26(5):393-403

Division of Nephrology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH. Electronic address:

Membranous lupus nephritis (MLN) (Class V lupus nephritis [LN]) is a distinct form of LN defined by the presence of subepithelial immune complex deposits seen on kidney biopsy. MLN is often associated with the nephrotic syndrome. The histology of MLN closely resembles that of idiopathic (primary) membranous nephropathy (pMN). Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.009DOI Listing
September 2019

Lupus Nephritis: Duration of Therapy and Possibility of Withdrawal.

Adv Chronic Kidney Dis 2019 09;26(5):387-392

Oklahoma Medical Research Foundation, Oklahoma City, OK. Electronic address:

Lupus nephritis is the most common organ-threatening manifestation of systemic lupus erythematosus, affecting more than one-third of patients. Induction of remission and maintenance of relapse-free disease have been and continue to be a critical focus of investigation. Because the need for renal replacement therapy in those with an insufficient response to therapy is associated with significantly increased morbidity and mortality, providers and patients are willing to accept moderate to high levels of adverse events associated with treatment. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.010DOI Listing
September 2019

Antiphospholipid Syndrome Nephropathy and Other Thrombotic Microangiopathies Among Patients With Systemic Lupus Erythematosus.

Adv Chronic Kidney Dis 2019 09;26(5):376-386

Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address:

Antiphospholipid syndrome (APS) and other causes of thrombotic microangiopathy (TMA) negatively impact the renal outcomes of patients with systemic lupus erythematosus (SLE) and lupus nephritis. Here we review the diagnosis and management of occlusive renal vascular lesions due to APS and other TMAs, with a focus on patients with SLE and lupus nephritis. The presence of a thrombotic event, unexplained hypertension, thrombocytopenia, or hemolytic anemia should prompt consideration for TMA syndromes. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.012DOI Listing
September 2019

Lupus Podocytopathy: An Overview.

Adv Chronic Kidney Dis 2019 09;26(5):369-375

Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, NY. Electronic address:

In systemic lupus erythematosus, nephrotic-range proteinuria typically signals the presence of a proliferative lupus nephritis (class III/IV) and/or membranous lupus nephritis (class V, with or without concomitant class III or IV lesions). However, in rare instances, systemic lupus erythematosus patients with nephrotic syndrome have kidney biopsy findings of normal glomeruli or focal segmental glomerulosclerosis lesions, with or without mesangial proliferation, on light microscopy; the absence of subepithelial or subendothelial deposits on immunofluorescence and electron microscopy; and diffuse foot process effacement on electron microscopy. This pattern, termed lupus podocytopathy, is a unique form of lupus nephritis that mimics minimal change disease or primary focal segmental glomerulosclerosis and represents approximately 1% of lupus nephritis biopsies. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.011DOI Listing
September 2019

The Kidney Biopsy in Systemic Lupus Erythematosus: A View of the Past and a Vision of the Future.

Adv Chronic Kidney Dis 2019 09;26(5):360-368

Department of Internal Medicine, Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, OH.

The kidney biopsy advanced our understanding of kidney disease in systemic lupus erythematosus. It allowed for better recognition and classification of lupus nephritis (LN). Several LN classifications have been devised in an effort to inform treatment decision and predict prognosis, and these are being further updated. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.015DOI Listing
September 2019

Utilization of Biomarkers in Lupus Nephritis.

Adv Chronic Kidney Dis 2019 09;26(5):351-359

Department of Medicine, University of Louisville School of Medicine, Louisville, KY.

Lupus nephritis (LN) occurs in up to 60% of SLE patients, and is a leading cause of disability and death. Current treatment of LN consists of a combination of high dose corticosteroids that non-specifically decrease inflammation and cytotoxic medications that reduce auto-antibody production. That combination of therapy is associated with significant side effects while remission rates remain inadequate. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001747PMC
September 2019

Moving Forward With Biologics in Lupus Nephritis.

Adv Chronic Kidney Dis 2019 09;26(5):338-350

Lewis Katz School of Medicine, Section of Nephrology, Hypertension and Kidney Transplantation, Temple University, Philadelphia, PA. Electronic address:

The majority of patients with systemic lupus erythematosus develop lupus nephritis (LN) which significantly contributes to increased risks of hospitalizations, ESRD, and death. Unfortunately, treatments for LN have not changed over the past 15 years. Despite continued efforts to elucidate the pathogenesis of LN, no new drugs have yet replaced the standard-of-care regimens of cyclophosphamide or mycophenolate mofetil plus high-dose corticosteroids. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.008DOI Listing
September 2019

Pregnancy in Women With Systemic Lupus and Lupus Nephritis.

Adv Chronic Kidney Dis 2019 09;26(5):330-337

Department of Medicine, Lehigh Valley Health Network, Allentown, PA.

Pregnancy is an altered immunologic state in which hormonal changes impact the immune system to enable maternal tolerance of the fetus. These hormonal and immunologic changes may affect disease activity in systemic lupus erythematosus. Conversely, lupus nephritis and its complications may adversely impact pregnancy. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.013DOI Listing
September 2019

Classification of Lupus Nephritis; Time for a Change?

Adv Chronic Kidney Dis 2019 09;26(5):323-329

Columbia University College of Physicians and Surgeons, New York, NY.

Renal biopsy plays a critical role in the diagnosis and management of kidney disease in patients with systemic lupus erythematosus. The current pathologic classification of lupus nephritis is widely accepted but remains a work in progress. We discuss the key challenges in lupus nephritis classification and review new approaches to improve clinical utility and prognostic value. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.06.002DOI Listing
September 2019

Lupus Nephritis and Kidney Transplantation: Where Are We Today?

Adv Chronic Kidney Dis 2019 09;26(5):313-322

Renal-Electrolyte and Hypertension Division, University of Pennsylvania Medical Center, Philadelphia, PA. Electronic address:

Lupus nephritis (LN) is the cause of end-stage kidney disease (ESKD) for 1.9% of the ESKD population in the United States. Although the incidence rates of ESKD from LN stopped rising in recent years, racial disparities in waiting time, pre-emptive kidney transplant, and transplant outcomes still exist. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.08.007DOI Listing
September 2019

Lupus Nephritis: How Far Have We Come, and Where Are We Headed?

Adv Chronic Kidney Dis 2019 09;26(5):311-312

Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, OH.

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http://dx.doi.org/10.1053/j.ackd.2019.09.003DOI Listing
September 2019

Lupus Nephritis: Breaking the Lull.

Adv Chronic Kidney Dis 2019 09;26(5):307-310

Henry Ford Hospital, Detroit, MI; Professor of Clinical Medicine, Wayne State University, Detroit, MI.

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http://dx.doi.org/10.1053/j.ackd.2019.05.005DOI Listing
September 2019

Hepcidin.

Adv Chronic Kidney Dis 2019 07;26(4):298-305

Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI.

Dysregulation of metabolism and utilization of iron can lead to the development and maintenance of anemia of CKD. Anemia is prevalent among patients with CKD. The markers of iron sufficiency or availability of iron are far from perfect which results in inaccurate diagnosis and treatment of anemia with poor outcomes. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.04.005DOI Listing
July 2019
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Long-Term Risks of Intravenous Iron in End-Stage Renal Disease Patients.

Adv Chronic Kidney Dis 2019 07;26(4):292-297

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.

Patients with end-stage renal disease on dialysis commonly receive intravenous iron to treat anemia along with erythropoiesis-stimulating agents. While studies of intravenous iron have demonstrated efficacy in raising hemoglobin, the quantity of administered intravenous iron has raised concerns about iron overload leading to long-term toxicities. The goal of this review is to understand recent trends in intravenous iron use, potential mechanisms of iron toxicity, and to evaluate the available evidence in the literature for potential long-term cardiovascular and infectious complications. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.05.001DOI Listing
July 2019
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Novel Oral Iron Therapies for Iron Deficiency Anemia in Chronic Kidney Disease.

Adv Chronic Kidney Dis 2019 07;26(4):272-291

David Geffen School of Medicine, UCLA, Los Angeles, CA.

Iron deficiency anemia (IDA) is a frequent complication of chronic kidney disease (CKD) and is associated with adverse outcomes in these patients. Patients with CKD and IDA remain largely undertreated. Conventional oral iron agents are insufficiently effective due to poor absorption and cause gastrointestinal side effects; thus, novel oral iron preparations are needed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15485595193011
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http://dx.doi.org/10.1053/j.ackd.2019.05.002DOI Listing
July 2019
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Biosimilar Erythropoiesis-Stimulating Agents in Chronic Kidney Disease.

Adv Chronic Kidney Dis 2019 07;26(4):267-271

Division of Nephrology, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY. Electronic address:

Anemia is a well-known complication of advanced CKD and treatment with erythropoietin analogues (epoetin) remains a key component of management. Although biologic agents, including epoetin, play an extremely important role in the treatment of various medical conditions, their cost can be prohibitive. As a result, several biosimilar agents have now been approved by the U. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.04.007DOI Listing

Hypoxia-Inducible Factor Activators in Renal Anemia: Current Clinical Experience.

Adv Chronic Kidney Dis 2019 07;26(4):253-266

Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; Department of Medical Cell Biology, Uppsala Universitet, Uppsala, Sweden; Department of Molecular Physiology & Biophysics and Program in Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN. Electronic address:

Prolyl hydroxylase domain oxygen sensors are dioxygenases that regulate the activity of hypoxia-inducible factor (HIF), which controls renal and hepatic erythropoietin production and coordinates erythropoiesis with iron metabolism. Small molecule inhibitors of prolyl hydroxylase domain dioxygenases (HIF-PHI [prolyl hydroxylase inhibitor]) stimulate the production of endogenous erythropoietin and improve iron metabolism resulting in efficacious anemia management in patients with CKD. Three oral HIF-PHIs-daprodustat, roxadustat, and vadadustat-have now advanced to global phase III clinical development culminating in the recent licensing of roxadustat for oral anemia therapy in China. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.04.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318915PMC
July 2019
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2.052 Impact Factor

The Impact of Anemia Treatment on Health-Related Quality of Life in Patients With Chronic Kidney Disease in the Contemporary Era.

Adv Chronic Kidney Dis 2019 07;26(4):250-252

Department of Psychiatry, Yale University, New Haven, CT.

The treatment of anemia with erythropoietic-stimulating agents is now part of the routine care of patients with CKD with guidelines for anemia management carefully outlined by Kidney Disease Improving Global Outcomes. The treatment of anemia impacts the health-related quality of life of CKD patients, primarily affecting the domains of energy/vitality and physical functioning. Improvements in these domains occur, in general, most noticeably when hemoglobin levels are raised from below 9 g/dL to the 10-12 range, with limited improvements occurring when hemoglobin levels are increased above 12 g/dL. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.04.003DOI Listing
July 2019
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Low Quality of International Classification of Diseases, 10th Revision, Procedural Coding System Data Undermines the Validity of the Standardized Transfusion Ratio: Time to Chart a New Course?

Adv Chronic Kidney Dis 2019 07;26(4):237-249

Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN; Division of Nephrology, Hennepin County Medical Center, Minneapolis, MN.

The validity of the standardized transfusion ratio, a quality measure for dialysis facilities, may have been affected by the transition from International Classification of Diseases, Ninth Revision (ICD-9) to International Classification of Diseases, Tenth Revision (ICD-10) procedure coding in October 2015. We analyzed Medicare Part A claims for inpatient care among dialysis patients in 2014-2017 and investigated billing patterns for blood transfusion during the last year of ICD-9 coding and the first and second years of ICD-10 coding. We identified 2205 hospitals with a steady volume of dialysis patient admissions. Read More

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http://dx.doi.org/10.1053/j.ackd.2019.04.006DOI Listing
July 2019
5 Reads