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

    1 OF 18

    Renal Functional Reserve Revisited.
    Adv Chronic Kidney Dis 2018 May;25(3):e1-e8
    Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
    Kidney function, like the function of other organs, is dynamic and continuously adjusts to changes in the internal environment to maintain homeostasis. The glomerular filtration rate, which serves as the primary index of kidney function in clinical practice, increases in response to various physiological and pathological stressors including oral protein intake. The difference between the glomerular filtration rate in the resting state and at maximum capacity has been termed renal functional reserve (RFR). Read More

    Magnesium Balance in Chronic and End-Stage Kidney Disease.
    Adv Chronic Kidney Dis 2018 May;25(3):291-295
    Centre for Nephrology, Royal Free Hospital, London, UK.
    This article explores the effects of CKD and end-stage kidney disease on magnesium balance. In CKD, there is decreased glomerular filtration of magnesium. Decreased tubular reabsorption can compensate to a degree, but once CKD stage 4 is reached there is a tendency toward hypermagnesemia. Read More

    Magnesium as a Calcification Inhibitor.
    Adv Chronic Kidney Dis 2018 May;25(3):281-290
    INSERM U1088, CURS, Amiens, France; Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt/Paris, France; INSERM U1018, Team 5, CESP, UVSQ, Villejuif, France. Electronic address:
    Vascular calcification (VC) is associated with elevated cardiovascular mortality rates in patients with CKD. Recent clinical studies of patients with advanced CKD have observed an association between low serum magnesium (Mg) levels on one hand and elevated VC and cardiovascular mortality on the other. These findings have stimulated interest in understanding Mg's impact on CKD in general and the associated VC in particular. Read More

    Magnesium and Progression of Chronic Kidney Disease: Benefits Beyond Cardiovascular Protection?
    Adv Chronic Kidney Dis 2018 May;25(3):274-280
    Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Suita, Japan and Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
    Experimental and clinical studies have demonstrated that magnesium deficiency leads to hypertension, insulin resistance, and endothelial dysfunction, and is associated with an increased risk of cardiovascular events. Given that cardiovascular disease and CKD share similar risk factors, the low magnesium status may also contribute to CKD progression. In fact, lower serum magnesium levels and lower dietary magnesium intake are associated with an increased risk of incident CKD and progression to end-stage kidney disease. Read More

    Magnesium and Drugs Commonly Used in Chronic Kidney Disease.
    Adv Chronic Kidney Dis 2018 May;25(3):267-273
    Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; and Division of Transplantation, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:
    As with other electrolytes, magnesium homeostasis depends on the balance between gastrointestinal absorption and kidney excretion. Certain drugs used commonly in patients with CKD can decrease gastrointestinal ingestion and kidney reclamation, and potentially cause hypomagnesemia. Other magnesium-containing drugs such as laxatives and cathartics can induce hypermagnesemia, particularly in those with impaired glomerular filtration and magnesium excretion. Read More

    Oral Magnesium Supplementation and Metabolic Syndrome: A Randomized Double-Blind Placebo-Controlled Clinical Trial.
    Adv Chronic Kidney Dis 2018 May;25(3):261-266
    Biomedical Research Unit of the Mexican Social Security Institute, Durango, Durango, Mexico; and Research Group on Diabetes and Chronic Illnesses, Durango, Durango, Mexico. Electronic address:
    The objective of the study was to evaluate the efficacy of oral magnesium supplementation in the improvement of metabolic syndrome (MetS) and its components. This is a randomized double-blind, placebo-controlled clinical trial that enrolled 198 individuals with MetS and hypomagnesemia who were randomly allocated to receive either 30 mL of magnesium chloride 5% solution, equivalent to 382 mg of elemental magnesium (n = 100), or placebo solution (n = 98), daily for 16 weeks. Serum magnesium levels <1. Read More

    Magnesium and Cardiovascular Disease.
    Adv Chronic Kidney Dis 2018 May;25(3):251-260
    Department of Renal Medicine, Mahasarakham University Hospital, Mahasarakham, Thailand; and UCL Centre for Nephrology, Royal Free Hospital, University College London, Rowland Hill Street, London NW3 2PF, UK. Electronic address:
    Magnesium is the most abundant intracellular divalent cation and essential for maintaining normal cellular physiology and metabolism, acting as a cofactor of numerous enzymes, regulating ion channels and energy generation. In the heart, magnesium plays a key role in modulating neuronal excitation, intracardiac conduction, and myocardial contraction by regulating a number of ion transporters, including potassium and calcium channels. Magnesium also has a role in regulating vascular tone, atherogenesis and thrombosis, vascular calcification, and proliferation and migration of endothelial and vascular smooth muscle cells. Read More

    Magnesium and Blood Pressure: A Physiology-Based Approach.
    Adv Chronic Kidney Dis 2018 May;25(3):244-250
    Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Hypertension is an important public health challenge because of its high prevalence and strong association with cardiovascular disease and premature death. Hypertension is a major cause of CKD, is present in more than 80% of CKD patients, and contributes to CKD progression. Risk factors for hypertension include, but are not limited to, age, race, family history, obesity, physical inactivity, tobacco use, and inadequate intake of minerals such as calcium, potassium, and magnesium. Read More

    Magnesium Handling in the Kidney.
    Adv Chronic Kidney Dis 2018 May;25(3):236-243
    Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS; Kidney Institute, University of Kansas Medical Center, Kansas City, KS. Electronic address:
    Magnesium is a divalent cation that fills essential roles as regulator and cofactor in a variety of biological pathways, and maintenance of magnesium balance is vital to human health. The kidney, in concert with the intestine, has an important role in maintaining magnesium homeostasis. Although micropuncture and microperfusion studies in the mammalian nephron have shone a light on magnesium handling in the various nephron segments, much of what we know about the protein mediators of magnesium handling in the kidney have come from more recent genetic studies. Read More

    Dietary Magnesium and Chronic Disease.
    Adv Chronic Kidney Dis 2018 May;25(3):230-235
    Research Nutritionist Consultant, ORCID ID 0000-0001-9557-4792, Grand Forks, ND. Electronic address:
    Although official magnesium (Mg) dietary reference intakes are open to question, a significant number of adults likely have intakes that are in the range of 50%-99% of the requirement. This moderate or marginal (subclinical) deficient Mg intake generally is asymptomatic. Animal studies, however, indicate that moderate or subclinical Mg deficiency primes phagocytic cells for the release of proinflammatory cytokines leading to chronic inflammatory and oxidative stress. Read More

    Magnesium Balance and Measurement.
    Adv Chronic Kidney Dis 2018 May;25(3):224-229
    Henry Ford Hospital, Detroit, MI.
    Magnesium is an essential ion in the human body, playing an important role in practically every major metabolic and biochemical process, supporting and maintaining cellular processes critical for human life. Magnesium plays an important physiological role, particularly in the brain, heart, and skeletal muscles. As the second most abundant intracellular cation after potassium, it is involved in over 600 enzymatic reactions including energy metabolism and protein synthesis. Read More

    The Promise of Systems Biology for Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):202-213
    Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI; and the Department of Medicine, University of Arizona, Tucson, AZ.
    Diabetic kidney disease (DKD) has a complex and prolonged pathogenesis involving many cell types in the kidney as well as extrarenal factors. It is clinically silent for many years after the onset of diabetes and usually progresses over decades. Given this complexity, a comprehensive and unbiased molecular approach is best suited to help identify the most critical mechanisms responsible for progression of DKD and those most suited for targeted intervention. Read More

    Role of Kidney Biopsies for Biomarker Discovery in Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):192-201
    Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ; and the Department of Pediatrics and Medicine, University of Minnesota, Minneapolis, MN. Electronic address:
    Although estimated glomerular filtration rate and albuminuria are well-established biomarkers of diabetic kidney disease (DKD), additional biomarkers are needed, especially for the early stages of the disease when both albuminuria and estimated glomerular filtration rate may still be in the normal range and are less helpful for identifying those at risk of progression. Traditional biomarker studies for early DKD are challenging because of a lack of good early clinical end points, and most rely on changes in existing imprecise biomarkers to assess the value of new biomarkers. There are well-characterized changes in kidney structure, however, that are highly correlated with kidney function, always precede the clinical findings of DKD and, at preclinical stages, predict DKD progression. Read More

    Inflammatory Mechanisms as New Biomarkers and Therapeutic Targets for Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):181-191
    Providence Health Care, Spokane, WA; Kidney Research Institute and Division of Nephrology, Seattle, WA; Institute of Translational Health Sciences, Seattle, WA; and the University of Washington School of Medicine, Seattle, WA.
    Diabetic kidney disease (DKD) is the leading cause of CKD and end-stage kidney disease (ESKD) worldwide. Approximately 30-40% of people with diabetes develop this microvascular complication, placing them at high risk of losing kidney function as well as of cardiovascular events, infections, and death. Current therapies are ineffective for arresting kidney disease progression and mitigating risks of comorbidities and death among patients with DKD. Read More

    Acute Kidney Injury and Progression of Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):166-180
    Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY; and Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address:
    Diabetic kidney disease, commonly termed diabetic nephropathy (DN), is the most common cause of end-stage kidney disease (ESKD) worldwide. The characteristic histopathology of DN includes glomerular basement membrane thickening, mesangial expansion, nodular glomerular sclerosis, and tubulointerstitial fibrosis. Diabetes is associated with a number of metabolic derangements, such as reactive oxygen species overproduction, hypoxic state, mitochondrial dysfunction, and inflammation. Read More

    Treatment of Diabetic Kidney Disease With Hypertension Control and Renin Angiotensin System Inhibition.
    Adv Chronic Kidney Dis 2018 Mar;25(2):158-165
    Research Service, Harry S Truman Memorial Veterans' Hospital, Columbia, MO; and the Divisions of Nephrology and Hypertension and Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, Columbia, MO.
    The global incidence and prevalence of diabetes continues to expand due primarily to the influences of obesity and the contribution of obesity to the progression of type 2 diabetes mellitus. The rising prevalence of type 2 diabetes has driven an increase in rates of CKD in the past 3 decades in the United States. In turn, so have the rates for complications related to type 2 diabetes including CKD, eg, diabetic kidney disease (DKD). Read More

    New Glucose-Lowering Agents for Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):149-157
    Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia; and the Department of Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address:
    The prevalence of diabetes mellitus is increasing and is associated with a range of complications including nephropathy. New antidiabetic agents are sought which also have positive effects to diminish diabetic complications. Examples of promising new classes of such agents are glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter 2 inhibitors. Read More

    Glycemic Control as Primary Prevention for Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):141-148
    Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Australia; Department of Medicine, University of Melbourne, Victoria, Australia; and Endocrine Centre, Austin Health, Victoria, Australia.
    Improving strategies to prevent the development and progression of CKD is a highly desirable outcome for all involved in the care of patients with diabetes. This is because CKD is a major factor contributing to morbidly and mortality in patients with diabetes. Furthermore, diabetes is the leading cause of ESRD in most developed countries. Read More

    Competing Risk of Death With End-Stage Renal Disease in Diabetic Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):133-140
    Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, NC; and University of North Carolina Kidney Center, UNC School of Medicine, Chapel Hill, NC. Electronic address:
    The concept of competing risks is particularly relevant to survival analyses of diabetic ESRD given the high likelihood of death prior to ESRD. Approaches such as Kaplan-Meier curves and Cox regression models operate on the assumption that there are no competing risks for the event of interest, yielding uninterpretable and generally biased estimates in the presence of competing risks. The cumulative incidence function and Fine-Gray regression are more appropriate methodologies for survival analysis when competing risks are present. Read More

    The Global Epidemiology of Diabetes and Kidney Disease.
    Adv Chronic Kidney Dis 2018 Mar;25(2):121-132
    Department of Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; Chronic Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ; and Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address:
    The prevalence of diabetes is increasing worldwide, with the greatest increases occurring in low- and middle-income countries. In most developed countries, type 2 diabetes is presently the leading cause of end-stage renal disease and also contributes substantially to cardiovascular disease. In countries with weaker economies type 2 diabetes is rapidly replacing communicable diseases as a leading cause of kidney disease and is increasingly competing for scarce health care resources. Read More

    Measurement and Estimation of Residual Kidney Function in Patients on Dialysis.
    Adv Chronic Kidney Dis 2018 Jan;25(1):93-104
    Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
    Residual kidney function (RKF) in patients on dialysis is strongly associated with survival and better quality of life. Assessment of kidney function underlies the management of patients with chronic kidney disease before dialysis initiation. However, methods to assess RKF after dialysis initiation are just now being refined. Read More

    Challenges in Measuring Glomerular Filtration Rate: A Clinical Laboratory Perspective.
    Adv Chronic Kidney Dis 2018 Jan;25(1):84-92
    Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN; Department of Laboratory Medicine and Pathology; and Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
    The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration. Read More

    Measured GFR in Routine Clinical Practice-The Promise of Dried Blood Spots.
    Adv Chronic Kidney Dis 2018 Jan;25(1):76-83
    Department of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado, Denver, Aurora, CO; Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN; and Department of Pediatric Endocrinology, Stanford University School of Medicine, Palo Alto, CA.
    Accurate determination of glomerular filtration rate (GFR) is crucial for the diagnosis of kidney disease. Estimated GFR (eGFR) calculated by serum creatinine and/or cystatin C is a mainstay in clinical practice and epidemiologic research but lacks precision and accuracy until GFR <60 mL/min/1.73 m. Read More

    Estimated Glomerular Filtration Rate; Laboratory Implementation and Current Global Status.
    Adv Chronic Kidney Dis 2018 Jan;25(1):7-13
    Department of Pathology, Virginia Commonwealth University, Richmond, VA; SydPath, St. Vincent's Hospital, Sydney, Australia; and University of New South Wales, Kensington, NSW, Australia.
    In 2002, the Kidney Disease Outcomes Quality Initiative guidelines for identifying and treating CKD recommended that clinical laboratories report estimated glomerular filtration rate (eGFR) with every creatinine result to assist clinical practitioners to identify people with early-stage CKD. At that time, the original Modification of Diet in Renal Disease (MDRD) Study equation based on serum creatinine measurements was recommended for calculating eGFR. Because the MDRD Study equation was developed using a nonstandardized creatinine method, a Laboratory Working Group of the National Kidney Disease Education program was formed and implemented standardized calibration traceability for all creatinine methods from global manufacturers by approximately 2010. Read More

    Estimated Glomerular Filtration Rate From a Panel of Filtration Markers-Hope for Increased Accuracy Beyond Measured Glomerular Filtration Rate?
    Adv Chronic Kidney Dis 2018 Jan;25(1):67-75
    Tufts Medical Center, Boston, MA; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD.
    The recent Kidney Disease Improving Global Outcomes 2012 CKD guidelines recommend estimating GFR from serum creatinine (eGFR) as a first-line test to assess kidney function and using cystatin C or measured glomerular filtration rate (GFR) as confirmatory tests. eGFR may be inaccurate in people with variation in muscle mass or diet, and eGFR is not more accurate than eGFR eGFR is more accurate than either, but it is not independent of eGFR. Measured GFR is not practical and is susceptible to error due to variation in clearance methods and in the behavior of exogenous filtration markers. Read More

    Alternatives for the Bedside Schwartz Equation to Estimate Glomerular Filtration Rate in Children.
    Adv Chronic Kidney Dis 2018 Jan;25(1):57-66
    Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium; Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Department of Nuclear Medicine & Molecular Imaging, University Hospital Leuven, Leuven, Belgium; and Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium.
    The bedside Schwartz equation has long been and still is the recommended equation to estimate glomerular filtration rate (GFR) in children. However, this equation is probably best suited to estimate GFR in children with chronic kidney disease (reduced GFR) but is not optimal for children with GFR >75 mL/min/1.73 m. Read More

    Assessment of Kidney Function in Patients With Cancer.
    Adv Chronic Kidney Dis 2018 Jan;25(1):49-56
    Nephrology Division, Sao Paulo State Cancer Institute, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil and LIM 12, Division of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
    Cancer patients are living longer. The sequelae of cancer treatment and the role of comorbid conditions present before the diagnosis, such as CKD, have been increasingly recognized. The interface between CKD and cancer is multifaceted. Read More

    Glomerular Filtration Rates in Asians.
    Adv Chronic Kidney Dis 2018 Jan;25(1):41-48
    Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Nephrology, Department of Medicine, University of Hong Kong, Hong Kong, China; George Institute for Global Health, New Delhi, India; Division of Nephrology, Ewha Women's University School of Medicine, Korea; Ateneo School of Medicine and Public Health, Pasig, Philippines; Hospital Sultanah Aminah, Johor Bahru, Malaysia; Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Qianfoshan Hospital, Shandong University, Jinan, China; and the Department of Medicine, National University Health System, Singapore, Singapore.
    The National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines recommended the Modification of Diet in Renal Disease study equation for estimating glomerular filtration rate (GFR) for the classification of CKD, but its accuracy was limited to North American patients with estimated GFR <60 mL/min per 1.73 m body surface area of European (White) or African (Black) descent. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed another equation for estimating GFR, derived from a population that included both participants without kidney disease and with CKD. Read More

    Kidney Function in Obesity-Challenges in Indexing and Estimation.
    Adv Chronic Kidney Dis 2018 Jan;25(1):31-40
    Kidney Health Research Institute, Geisinger Health System, Danville, PA; Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; and Divison of Nephrology, Johns Hopkins University, Baltimore, MA.
    As the prevalence of obesity continues to increase worldwide, an increasing number of people are at risk for kidney disease. Thus, there is a critical need to understand how best to assess kidney function in this population, and several challenges exist. The convention of indexing glomerular filtration rate (GFR) to body surface area (BSA) attempts to normalize exposure to metabolic wastes across populations of differing body size. Read More

    Assessment of Glomerular Filtration Rate and End-Stage Kidney Disease Risk in Living Kidney Donor Candidates: A Paradigm for Evaluation, Selection, and Counseling.
    Adv Chronic Kidney Dis 2018 Jan;25(1):21-30
    Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA; Renal Section, St. Louis VA Medical Center, St. Louis, MO; Saint Louis University Center for Abdominal Transplantation, St. Louis, MO; and Division of Nephrology, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO. Electronic address:
    Living donor kidney transplantation is the preferred treatment option for ESRD. However, recent data suggest a small increase in the long-term risk of kidney failure in living kidney donors when compared to healthy nondonors. These data have led to a need for reconsideration of how donor candidates are evaluated and selected for donation. Read More

    Pragmatic Use of Kidney Function Estimates for Drug Dosing: The Tide Is Turning.
    Adv Chronic Kidney Dis 2018 Jan;25(1):14-20
    Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center, Memphis, TN; Department of Medicine (Division of Nephrology), The University of Tennessee Health Science Center, Memphis, TN; Department of Pharmacy and Therapeutics, Center for Clinical Pharmaceutical Sciences, University of Pittsburgh Schools of Pharmacy and Medicine, Pittsburgh, PA; and Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh Schools of Pharmacy and Medicine, Pittsburgh, PA. Electronic address:
    Creatinine clearance has been the most common method of estimating kidney function for the purpose of drug dosing for decades. The availability and extensive clinical use of estimated glomerular filtration rate (eGFR) now provides clinicians a potential alternative. Currently, data demonstrating the validity of eGFR-based drug dosing is limited, but proof of principle has been established and the tide related to use of eGFR for drug dosing appears to be turning. Read More

    Kinetic Glomerular Filtration Rate in Routine Clinical Practice-Applications and Possibilities.
    Adv Chronic Kidney Dis 2018 Jan;25(1):105-114
    MD Anderson Cancer Center, Houston, TX. Electronic address:
    When the [creatinine] is changing, the kidney function can still be tracked with a quantitative technique called kinetic glomerular filtration rate (GFR). The equation yields useful information on the severity of acute kidney injury, the clinical course of kidney and dialysis clearances, and the timing of kidney recovery. It has been validated in at least 3 independent studies, where it performed sufficiently well in intensive care unit and kidney transplant settings, and in head-to-head comparisons with biomarkers. Read More

    Self-Management and Health Care Transition Among Adolescents and Young Adults With Chronic Kidney Disease: Medical and Psychosocial Considerations.
    Adv Chronic Kidney Dis 2017 Nov;24(6):405-409
    Department of Pediatrics, University of North Carolina School of Medicine at Chapel Hill, NC; Hospital Pediátrico del Estado de México, Secretaría de Salubridad y Asistencia Pública, Toluca, Estado de Mexico, México; Hospital de Los Angeles, CDMx, México; Departamento de Enseñanza, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMx, México; Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMx, México; Unidad de Investigación y Diagnóstico en Nefrología, Hospital Infantil de México Federico Gómez, CDMx, México; Department of Rehabilitation, University of North Carolina School of Medicine, NC; Departmento de Ética, Universidad Panamericana de Mexico, CDMx, Mexico; Department of Pediatric Nephrology, Akron Children's Hospital, Akron, OH; Department of Nephrology, Cleveland Clinic Akron General, Akron, OH; SickKids, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
    Health care transition (HCT) is a process that requires preparation as a continuum from pediatric- to adult-focused services. For adolescents and young adults with chronic or ESRD, this process can be prolonged due to their physical, psychological, family, or ecological factors. HCT preparation is a matter of patient safety and patient rights as the consequences of poor preparation at the time of transfer to adult-focused services are great, including rejection of organs, disease relapse, or even death. Read More

    Special Considerations in Pediatric Kidney Transplantation.
    Adv Chronic Kidney Dis 2017 Nov;24(6):398-404
    Division of Pediatric Nephrology and Hypertension, Department of Internal Medicine and Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Children's Memorial Hermann Hospital, Houston, TX; Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Children's Memorial Hermann Hospital, Houston, TX; Division of Immunology and Organ Transplantation, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Children's Memorial Hermann Hospital, Houston, TX; and Department of Pediatric Urology, Children's Memorial Hermann Hospital, Houston, TX.
    Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Read More

    Care of the Pediatric Patient on Chronic Dialysis.
    Adv Chronic Kidney Dis 2017 Nov;24(6):388-397
    Division of Nephrology, Department of Pediatrics, Duke University School of Medicine, Duke Children's Hospital, Durham, NC and Division of Nephrology, Dialysis and Transplantation, University of Missouri-Kansas City School of Medicine; Division of Nephrology, Children's Mercy Kansas City, Kansas City, MO.
    Optimal care of the pediatric end-stage renal disease (ESRD) patient on chronic dialysis is complex and requires multidisciplinary care as well as patient/caregiver involvement. The dialysis team, along with the family and patient, should all play a role in choosing the dialysis modality which best meets the patient's needs, taking into account special considerations and management issues that may be particularly pertinent to children who receive peritoneal dialysis or hemodialysis. Meticulous attention to dialysis adequacy in terms of solute and fluid removal, as well as to a variety of clinical manifestations of ESRD, including anemia, growth and nutrition, chronic kidney disease-mineral bone disorder, cardiovascular health, and neurocognitive development, is essential. Read More

    Acute Kidney Injury in Children.
    Adv Chronic Kidney Dis 2017 Nov;24(6):380-387
    Division of Nephrology, Department of Pediatrics, Stanford University, Palo Alto, CA; and Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, CA.
    Acute kidney injury (AKI) has become one of the more common complications seen among hospitalized children. The development of a consensus definition has helped refine the epidemiology of pediatric AKI, and we now have a far better understanding of its incidence, risk factors, and outcomes. Strategies for diagnosing AKI have extended beyond serum creatinine, and the most current data underscore the diagnostic importance of oliguria as well as introduce the concept of urinary biomarkers of kidney injury. Read More

    Monogenic Hypertension in Children: A Review With Emphasis on Genetics.
    Adv Chronic Kidney Dis 2017 Nov;24(6):372-379
    Division of Medical Genetics, Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX. Electronic address:
    Hypertension (HT) is a public health problem in children particularly related to the epidemic of overweight and obesity. Monogenic forms of HT are important in the differential diagnosis in children presenting with severe or refractory HT, who have a family history of early-onset HT, unusual physical examination findings, and/or characteristic hormonal and biochemical abnormalities. Most genetic defects in these disorders ultimately result in increased sodium transport in the distal nephron resulting in volume expansion and HT. Read More

    Glomerular Diseases in Children.
    Adv Chronic Kidney Dis 2017 Nov;24(6):364-371
    From Baylor College of Medicine, Department of Pediatrics, and Texas Children's Hospital, Renal Section, Houston, TX; and Washington University School of Medicine, Department of Pathology and Immunology, and Department of Medicine, St. Louis, MO.
    Unique challenges exist in the diagnosis and treatment of glomerular diseases with their onset during childhood. Mounting evidence supports the notion that earlier onset cases occur due to larger numbers of genetic risk alleles. Nearly all causes of adult-onset glomerulonephritis, nephrotic syndrome, and thrombotic microangiopathy have also been described in children, although the prevalence of specific causes differs. Read More

    Holding Water: Congenital Anomalies of the Kidney and Urinary Tract, CKD, and the Ongoing Role of Excellence in Plumbing.
    Adv Chronic Kidney Dis 2017 Nov;24(6):357-363
    Division of Pediatric Urology, Department of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, TX. Electronic address:
    Congenital anomalies of the kidneys and urinary tracts can result in diminished natal kidney function, possibly through common embryologic pathway disruption or as a result of development taking place in the face of disordered 'post-renal' drainage. Impaired conduit and reservoir function present potential for an ongoing assault leading to further deterioration and progression of chronic kidney disease, a risk that extends to adults with these conditions, even after "correction". The drainage and storage aspects of the urinary system that can impact kidney function are reviewed with attention to correctable or manageable problems including: Bladder dysfunction wherein the low pressure storage of urine is compromised requiring the kidney to work against a pressure gradient, the classic post renal failure problem. Read More

    Measurement and Estimation of Glomerular Filtration Rate in Children.
    Adv Chronic Kidney Dis 2017 Nov;24(6):348-356
    University of Rochester School of Medicine, Rochester, NY.
    Rapid, accurate, and precise measures of kidney function are essential for daily management of patients. While plasma and urinary clearances provide the greatest accuracy for assessing glomerular filtration rate (GFR), these are often impractical particularly for the care of children. Serum creatinine, the most commonly used endogenous marker, is simple, convenient, and practical but less accurate because of the influence of non-GFR determinants such as muscle mass, which increases with age in children. Read More

    Treatment of Disorders of Sodium Balance in Chronic Kidney Disease.
    Adv Chronic Kidney Dis 2017 09;24(5):332-341
    Department of Medicine, Oregon Health & Science University, Portland, Oregon; Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, Oregon; and Renal Section, VA Portland Health Care System, Portland, Oregon. Electronic address:
    Extracellular fluid volume expansion is nearly universal in patients with CKD. Such volume expansion has features similar to the syndrome of heart failure with preserved ejection fraction, which not only leads to symptoms but can also lead to further organ damage. Unique treatment challenges are present in this patient population, including low glomerular filtration, which limits sodium chloride filtration, intrinsic tubule predisposition to sodium chloride retention, and proteinuria. Read More

    Sodium Homeostasis in Chronic Kidney Disease.
    Adv Chronic Kidney Dis 2017 09;24(5):325-331
    Henry Ford Hospital, Detroit, MI. Electronic address:
    The pathologic consequences of sodium retention in the CKD population can lead to hypertension, edema, and progressive disease. Sodium excess is responsible for increases in oxidative stress, which alters kidney vasculature. As progression of CKD occurs, hyperfiltration by remaining nephrons compensates for an overall decrease in the filtered load of sodium. Read More

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