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    3558 results match your criteria Clinical Journal of the American Society of Nephrology CJASN[Journal]

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    Employment among Patients Starting Dialysis in the United States.
    Clin J Am Soc Nephrol 2018 Jan 18. Epub 2018 Jan 18.
    Section of Nephrology and Selzman Institute for Kidney Health, Baylor College of Medicine, Houston, Texas; and.
    Background And Objectives: Patients with ESRD face significant challenges to remaining employed. It is unknown when in the course of kidney disease patients stop working.

    Design, Setting, Participants, & Measurements: We examined employment trends over time among patients ages 18-54 years old who initiated dialysis in the United States between 1996 and 2013 from a national ESRD registry. Read More

    Kidney Biomarkers and Decline in eGFR in Patients with Type 2 Diabetes.
    Clin J Am Soc Nephrol 2018 Jan 16. Epub 2018 Jan 16.
    Division of Cardiometabolic Trials, Baim Institute for Clinical Research, Boston, Massachusetts.
    Background And Objectives: Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling.

    Design, Setting, Participants, & Measurements: We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial. Read More

    Re-Evaluation of the Normal Range of Serum Total CO2 Concentration.
    Clin J Am Soc Nephrol 2018 Jan 16. Epub 2018 Jan 16.
    Division of Nephrology, Department of Medicine, St. Elizabeth's Medical Center, Boston, Massachusetts; and
    A reliable determination of blood pH, PCO2, and [HCO3-] is necessary for assessing the acid-base status of a patient. However, most acid-base disorders are first recognized through abnormalities in serum total CO2 concentration ([TCO2]) in venous blood, a surrogate for [HCO3-]. In screening patients on the basis of serum [TCO2], we have been concerned about the wide limits of normal for serum [TCO2], 10-13 mEq/L, reported by many clinical laboratories. Read More

    Effectiveness and Cost of Weekly Recombinant Tissue Plasminogen Activator Hemodialysis Catheter Locking Solution.
    Clin J Am Soc Nephrol 2018 Jan 15. Epub 2018 Jan 15.
    Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
    Background And Objectives: Evidence to guide hemodialysis catheter locking solutions is limited. We aimed to assess effectiveness and cost of recombinant tissue plasminogen activator (rt-PA) once per week as a locking solution, compared with thrice weekly citrate or heparin, in patients at high risk of complications.

    Design, Setting, Participants, & Measurements: We used a prospective design and pre-post comparison in three sites across Canada. Read More

    Mycophenolate Mofetil in Combination with Steroids for Treatment of C3 Glomerulopathy: A Case Series.
    Clin J Am Soc Nephrol 2018 Jan 11. Epub 2018 Jan 11.
    Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York; and.
    Background And Objectives: C3 glomerulopathy is a form of complement-mediated GN. Immunosuppressive therapy may be beneficial in the treatment of C3 glomerulopathy. Mycophenolate mofetil is an attractive treatment option given its role in the treatment of other complement-mediated diseases and the results of the Spanish Group for the Study of Glomerular Diseases C3 Study. Read More

    Weekly Standard Kt/Vurea and Clinical Outcomes in Home and In-Center Hemodialysis.
    Clin J Am Soc Nephrol 2018 Jan 11. Epub 2018 Jan 11.
    Kidney Research Institute, Harborview Medical Center, Division of Nephrology, University of Washington, Seattle, Washington.
    Background And Objectives: Patients undergoing hemodialysis with a frequency other than thrice weekly are not included in current clinical performance metrics for dialysis adequacy. The weekly standard Kt/Vurea incorporates treatment frequency, but there are limited data on its association with clinical outcomes.

    Design, Setting, Participants, & Measurements: We used multivariable regression to examine the association of dialysis standard Kt/Vurea with BP and metabolic control (serum potassium, calcium, bicarbonate, and phosphorus) in patients incidental to dialysis treated with home (n=2373) or in-center hemodialysis (n=109,273). Read More

    Nondepressive Psychosocial Factors and CKD Outcomes in Black Americans.
    Clin J Am Soc Nephrol 2018 Jan 3. Epub 2018 Jan 3.
    Divisions of General Internal Medicine and
    Background And Objectives: Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD in the Jackson Heart Study.

    Design, Setting, Participants, & Measurements: We used principal component analysis to identify underlying constructs from 12 psychosocial baseline variables (perceived daily, lifetime, and burden of lifetime discrimination; stress; anger in; anger out; hostility; pessimism; John Henryism; spirituality; perceived social status; and social support). Read More

    Treatment of Severe Hyponatremia.
    Clin J Am Soc Nephrol 2018 Jan 2. Epub 2018 Jan 2.
    University of Rochester School of Medicine and Dentistry, Rochester General Hospital, Rochester, New York
    Patients with severe (serum sodium ≤120 mEq/L), symptomatic hyponatremia can develop life-threatening or fatal complications from cerebral edema if treatment is inadequate and permanent neurologic disability from osmotic demyelination if treatment is excessive. Unfortunately, as is true of all electrolyte disturbances, there are no randomized trials to guide the treatment of this challenging disorder. Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports. Read More

    Medication Therapy Management after Hospitalization in CKD: A Randomized Clinical Trial.
    Clin J Am Soc Nephrol 2018 Jan 2. Epub 2018 Jan 2.
    College of Nursing, University of South Carolina.
    Background And Objectives: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization.

    Design, Setting, Participants, & Measurements: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Read More

    Changes in Excess Mortality from End Stage Renal Disease in the United States from 1995 to 2013.
    Clin J Am Soc Nephrol 2018 Jan 14;13(1):91-99. Epub 2017 Dec 14.
    Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
    Background And Objectives: Individuals with ESRD have a very high risk of death. Although mortality rates have decreased over time in ESRD, it is unknown if improvements merely reflect parallel increases in general population survival. We, therefore, examined changes in the excess risk of all-cause mortality-over and above the risk in the general population-among people treated for ESRD in the United States from 1995 to 2013. Read More

    Lessons from CKD-Related Genetic Association Studies-Moving Forward.
    Clin J Am Soc Nephrol 2018 Jan 14;13(1):140-152. Epub 2017 Dec 14.
    Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland; and
    Over the past decade, genetic association studies have uncovered numerous determinants of kidney function in the general, diabetic, hypertensive, CKD, ESRD, and GN-based study populations (e.g., IgA nephropathy, membranous nephropathy, FSGS). Read More

    Characteristics and Performance of Unilateral Kidney Transplants from Deceased Donors.
    Clin J Am Soc Nephrol 2018 Jan 7;13(1):118-127. Epub 2017 Dec 7.
    Division of Nephrology, Department of Medicine and
    Background And Objectives: The fraction of kidneys procured for transplant that are discarded is rising in the United States. Identifying donors from whom only one kidney was discarded allows us to control for donor traits and better assess reasons for organ discard.

    Design, Setting, Participants, & Measurements: We conducted a retrospective cohort study using United Network for Organ Sharing Standard Transplant Analysis and Research file data to identify deceased donors from whom two kidneys were procured and at least one was transplanted. Read More

    The Effect of Extended Release Niacin on Markers of Mineral Metabolism in CKD.
    Clin J Am Soc Nephrol 2018 Jan 5;13(1):36-44. Epub 2017 Dec 5.
    Division of Nephrology-Hypertension, Department of Medicine and
    Background And Objectives: Niacin downregulates intestinal sodium-dependent phosphate transporter 2b expression and reduces intestinal phosphate transport. Short-term studies have suggested that niacin lowers serum phosphate concentrations in patients with CKD and ESRD. However, the long-term effects of niacin on serum phosphate and other mineral markers are unknown. Read More

    Lowering Expectations with Niacin Treatment for CKD-MBD.
    Clin J Am Soc Nephrol 2018 Jan 5;13(1):6-8. Epub 2017 Dec 5.
    Institut National de la Santé et de la Recherche Médicale U-1018, Team 5, Centre de Recherche en Epidémiologie et Santé des Populations, Versailles Saint-Quentin-en-Yvelines University (Paris-Ile-de-France-Ouest University), Paris-Sud University and Paris Saclay University, Villejuif, France; and.

    Anion Gap as a Determinant of Ionized Fraction of Divalent Cations in Hemodialysis Patients.
    Clin J Am Soc Nephrol 2017 Nov 27. Epub 2017 Nov 27.
    Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan; and.
    Background And Objectives: Circulating levels of anions that bind to magnesium and calcium are often altered in patients with CKD. However, it is unknown how these alterations affect the ionized fraction of magnesium and calcium.

    Design, Setting, Participants, & Measurements: This cross-sectional study involved patients on maintenance hemodialysis and patients not on dialysis who visited the outpatient department of nephrology. Read More

    An Outcomes-Based Definition of Proteinuria Remission in Focal Segmental Glomerulosclerosis.
    Clin J Am Soc Nephrol 2017 Nov 22. Epub 2017 Nov 22.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Proteinuria is used as an indicator of FSGS disease activity, but its use as a clinical trial end point is not universally accepted. The goal of this study was to refine proteinuria definitions associated with long-term kidney survival.

    Design, Setting, Participants, & Measurements: Data on 466 patients with primary FSGS with proteinuria (urine protein-to-creatinine ratio >1 g/g) were analyzed from five independent cohorts. Read More

    Predicting Outcome in Patients with Anti-GBM Glomerulonephritis.
    Clin J Am Soc Nephrol 2018 Jan 21;13(1):63-72. Epub 2017 Nov 21.
    Departments of Pathology and.
    Background And Objectives: Large studies on long-term kidney outcome in patients with anti-glomerular basement membrane (anti-GBM) GN are lacking. This study aimed to identify clinical and histopathologic parameters that predict kidney outcome in these patients.

    Design, Setting, Participants, & Measurements: This retrospective analysis included a total of 123 patients with anti-GBM GN between 1986 and 2015 from six centers worldwide. Read More

    Prospective Evaluation of Kidney Disease in Joubert Syndrome.
    Clin J Am Soc Nephrol 2017 Dec 16;12(12):1962-1973. Epub 2017 Nov 16.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Joubert syndrome is a genetically heterogeneous ciliopathy associated with >30 genes. The characteristics of kidney disease and genotype-phenotype correlations have not been evaluated in a large cohort at a single center.

    Design, Setting, Participants, & Measurements: We evaluated 97 individuals with Joubert syndrome at the National Institutes of Health Clinical Center using abdominal ultrasonography, blood and urine chemistries, and DNA sequencing. Read More

    Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome.
    Clin J Am Soc Nephrol 2017 Nov 16. Epub 2017 Nov 16.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome.

    Design, Setting, Participants, & Measurements: The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Read More

    Mesangial C4d Deposits in Early IgA Nephropathy.
    Clin J Am Soc Nephrol 2017 Nov 16. Epub 2017 Nov 16.
    Vall d'Hebron Institut de Recerca, Barcelona, Spain.
    Background And Objectives: The prognostic value of mesangial C4d deposits in IgA nephropathy has been analyzed in patients with reduced GFR but has not been analyzed in those with normal kidney function. The main objective of the study was to analyze the prognostic value of C4d deposits and association with response to treatment in patients with IgA nephropathy and normal GFR.

    Design, Setting, Participants, & Measurements: This retrospective cohort study included 190 patients with idiopathic IgA nephropathy diagnosed by kidney biopsy between 1988 and 2005. Read More

    Phenotypic Spectrum of Children with Nephronophthisis and Related Ciliopathies.
    Clin J Am Soc Nephrol 2017 Dec 16;12(12):1974-1983. Epub 2017 Nov 16.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Genetic heterogeneity and phenotypic variability are major challenges in familial nephronophthisis and related ciliopathies. To date, mutations in 20 different genes (NPHP1 to -20) have been identified causing either isolated kidney disease or complex multiorgan disorders. In this study, we provide a comprehensive and detailed characterization of 152 children with a special focus on extrarenal organ involvement and the long-term development of ESRD. Read More

    Association between Urine Ammonium and Urine TGF-β1 in CKD.
    Clin J Am Soc Nephrol 2017 Nov 16. Epub 2017 Nov 16.
    Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah.
    Background And Objectives: Urinary ammonium excretion increases in response to nonvolatile acids to maintain normal systemic bicarbonate and pH. However, enhanced ammonia production promotes tubulointerstitial fibrosis in animal models. Therefore, a subset of individuals with CKD and normal bicarbonate may have acid-mediated kidney fibrosis that might be better linked with ammonium excretion than bicarbonate. Read More

    Whole Exome Sequencing of Patients with Steroid-Resistant Nephrotic Syndrome.
    Clin J Am Soc Nephrol 2018 Jan 10;13(1):53-62. Epub 2017 Nov 10.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Steroid-resistant nephrotic syndrome overwhelmingly progresses to ESRD. More than 30 monogenic genes have been identified to cause steroid-resistant nephrotic syndrome. We previously detected causative mutations using targeted panel sequencing in 30% of patients with steroid-resistant nephrotic syndrome. Read More

    Prognosis of Patients with Cirrhosis and AKI Who Initiate RRT.
    Clin J Am Soc Nephrol 2018 Jan 9;13(1):16-25. Epub 2017 Nov 9.
    Division of Nephrology and.
    Background And Objectives: Literature on the prognosis of patients with cirrhosis who require RRT for AKI is sparse and is confounded by liver transplant eligibility. An update on outcomes in the nonlisted subgroup is needed. Our objective was to compare outcomes in this group between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. Read More

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