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    3460 results match your criteria Clinical Journal of the American Society of Nephrology CJASN[Journal]

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    Is Chronic Dialysis the Right Hard Renal End Point To Evaluate Renoprotective Drug Effects?
    Clin J Am Soc Nephrol 2017 Sep 18. Epub 2017 Sep 18.
    Department of Clinical Pharmacy and Pharmacology and
    Background And Objectives: RRT and doubling of serum creatinine are considered the objective hard end points in nephrology intervention trials. Because both are assumed to reflect changes in the filtration capacity of the kidney, drug effects, if present, are attributed to kidney protection. However, decisions to start RRT are not only on the basis of filtration capacity of the kidney, but also on other factors. Read More

    Nephrology Provider Prognostic Perceptions and Care Delivered to Older Adults with Advanced Kidney Disease.
    Clin J Am Soc Nephrol 2017 Sep 18. Epub 2017 Sep 18.
    Divisions of Nephrology and Hypertension,
    Background And Objectives: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying.

    Design, Setting, Participants, & Measurements: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Read More

    International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis.
    Clin J Am Soc Nephrol 2017 Sep 18. Epub 2017 Sep 18.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Uremic pruritus in patients on hemodialysis is associated with depression, lower quality of life, and mortality. We studied the prevalence, awareness, and treatment of pruritus to assess how well this important condition is currently managed internationally.

    Design, Setting, Participants, & Measurements: Data from 35,452 patients on hemodialysis in up to 17 countries from the Dialysis Outcomes and Practice Patterns Study were analyzed to describe pruritus prevalence from 1996 to 2015. Read More

    Multi-Disciplinary Vascular Access Care and Access Outcomes in People Starting Hemodialysis Therapy.
    Clin J Am Soc Nephrol 2017 Sep 14. Epub 2017 Sep 14.
    Departments of Medicine and
    Background And Objectives: Fistulas, the preferred form of hemodialysis access, are difficult to establish and maintain. We examined the effect of a multidisciplinary vascular access team, including nurses, surgeons, and radiologists, on the probability of using a fistula catheter-free, and rates of access-related procedures in incident patients receiving hemodialysis.

    Design, Setting, Participants, & Measurements: We examined vascular access outcomes in the first year of hemodialysis treatment before (2004-2005, preteam period) and after the implementation of an access team (2006-2008, early-team period; 2009-2011, late-team period) in the Calgary Health Region, Canada. Read More

    Urinary Fibrinogen as a Predictor of Progression of CKD.
    Clin J Am Soc Nephrol 2017 Sep 13. Epub 2017 Sep 13.
    National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China; and
    Background And Objectives: Fibrinogen has been reported to be involved in kidney tubulointerstitial fibrosis and podocyte injury in mouse models. However, the relationship between urinary fibrinogen and kidney outcomes has not been clarified in patients with CKD.

    Design, Setting, Participants, & Measurements: We evaluated 402 patients with CKD and kidney biopsies, including 101 with diabetic nephropathy, 94 with idiopathic membranous nephropathy, 55 with idiopathic FSGS, and 152 with IgA nephropathy. Read More

    Changes in Albuminuria and Subsequent Risk of Incident Kidney Disease.
    Clin J Am Soc Nephrol 2017 Sep 11. Epub 2017 Sep 11.
    Division of Nephrology, Department of Medicine and
    Background And Objectives: Albuminuria is a robust predictor of CKD progression. However, little is known about the associations of changes in albuminuria with the risk of kidney events outside the settings of clinical trials.

    Design, Setting, Participants, & Measurements: In a nationwide cohort of 56,946 United States veterans with an eGFR≥60 ml/min per 1. Read More

    Randomized, Controlled Trial of the Effect of Dietary Potassium Restriction on Nerve Function in CKD.
    Clin J Am Soc Nephrol 2017 Sep 11. Epub 2017 Sep 11.
    Prince of Wales Clinical School, UNSW Sydney, Sydney, Australia;
    Background And Objectives: Neuromuscular complications are almost universal in CKD by the time that a patient commences dialysis. Recent studies have indicated that chronic hyperkalemia may contribute to the development of neuropathy in CKD. This study was undertaken to determine whether dietary restriction of potassium intake may be a neuroprotective factor in CKD. Read More

    Effect of Sofosbuvir-Based Hepatitis C Virus Therapy on Kidney Function in Patients with CKD.
    Clin J Am Soc Nephrol 2017 Sep 7. Epub 2017 Sep 7.
    Department of Medicine, Gastrointestinal Unit, and.
    Background And Objectives: Hepatitis C virus infection is common in patients with CKD and leads to accelerated progression to ESRD. Sofosbuvir is a potent direct-acting antiviral therapy against hepatitis C virus; however, there are concerns about its safety in patients with CKD. The objective of our study was to determine the safety and efficacy of sofosbuvir in patients with CKD. Read More

    Effectiveness of Quality Improvement Strategies for the Management of CKD: A Meta-Analysis.
    Clin J Am Soc Nephrol 2017 Sep 6. Epub 2017 Sep 6.
    Division of Nephrology and
    Background And Objectives: Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD.

    Design, Setting, Participants, & Measurements: We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015. Read More

    Magnetic Resonance Elastography to Assess Fibrosis in Kidney Allografts.
    Clin J Am Soc Nephrol 2017 Aug 30. Epub 2017 Aug 30.
    Division of Nephrology, Department of Medicine, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; and.
    Background And Objectives: Fibrosis is a major cause of kidney allograft injury. Currently, the only means of assessing allograft fibrosis is by biopsy, an invasive procedure that samples <1% of the kidney. We examined whether magnetic resonance elastography, an imaging-based measure of organ stiffness, could noninvasively estimate allograft fibrosis and predict progression of allograft dysfunction. Read More

    ANCA Glomerulonephritis and Vasculitis.
    Clin J Am Soc Nephrol 2017 Aug 25. Epub 2017 Aug 25.
    Department of Pathology and Laboratory Medicine, Department of Medicine, and Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
    ANCA vasculitis has an associated autoimmune response that produces ANCAs that induce distinct pathologic lesions. Pauci-immune necrotizing and crescentic GN is a frequent component of ANCA vasculitis. ANCA vasculitis is associated with ANCA specific for myeloperoxidase (MPO-ANCA) or proteinase 3 (PR3-ANCA). Read More

    Marijuana Use and Estimated Glomerular Filtration Rate in Young Adults.
    Clin J Am Soc Nephrol 2017 Aug 24. Epub 2017 Aug 24.
    Departments of Medicine and.
    Background And Objectives: Marijuana use has become more widely accepted in the United States and has been legalized in many areas. Although it is biologically plausible that marijuana could affect kidney function, epidemiologic data are lacking.

    Design, Setting, Participants, & Measurements: We conducted a cohort study among young adults with preserved eGFR (i. Read More

    Racial Differences in Home Dialysis Utilization and Outcomes in Canada.
    Clin J Am Soc Nephrol 2017 Aug 23. Epub 2017 Aug 23.
    Division of Nephrology, St. Michael's Hospital and the Keenan Research Center in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and
    Background And Objectives: Data on racial disparities in home dialysis utilization and outcomes are lacking in Canada, where health care is universally available.

    Design, Setting, Participants, & Measurements: We studied patients starting maintenance dialysis between 1996 and 2012 in the Canadian Organ Replacement Register, stratified by race: white, Asian, black, Aboriginal, Indian subcontinent, and other. The association between race and treatment with home dialysis was examined using generalized linear models. Read More

    Effectiveness of Treatment Modalities on Kidney Stone Recurrence.
    Clin J Am Soc Nephrol 2017 Aug 22. Epub 2017 Aug 22.
    Section of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois
    Nephrolithiasis is highly prevalent across all demographic groups in the Western world and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Across the majority of stone types, increased fluid intake and targeted dietary modifications are mainstays of therapy. Read More

    eGFR and the Risk of Community-Acquired Infections.
    Clin J Am Soc Nephrol 2017 Sep 17;12(9):1399-1408. Epub 2017 Aug 17.
    Departments of Medical Epidemiology and Biostatistics and
    Background And Objectives: Community-acquired infections are common, contributing to adverse outcomes and increased health care costs. We hypothesized that, with lower eGFR, the incidence of community-acquired infections increases, whereas the pattern of site-specific infections varies.

    Design, Setting, Participants, & Measurements: Among 1,139,470 health care users (mean age =52±18 years old, 53% women) from the Stockholm CREAtinine Measurements Project, we quantified the associations of eGFR with the risk of infections, overall and major types, over 12 months. Read More

    A French Cohort Study of Kidney Retransplantation after Post-Transplant Lymphoproliferative Disorders.
    Clin J Am Soc Nephrol 2017 Aug 17. Epub 2017 Aug 17.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder. Read More

    Statistical Methods for Modeling Time-Updated Exposures in Cohort Studies of Chronic Kidney Disease.
    Clin J Am Soc Nephrol 2017 Aug 17. Epub 2017 Aug 17.
    Department of Biostatistics, Epidemiology and Informatics, and.
    When estimating the effect of an exposure on a time-to-event type of outcome, one can focus on the baseline exposure or the time-updated exposures. Cox regression models can be used in both situations. When time-dependent confounding exists, the Cox model with time-updated covariates may produce biased effect estimates. Read More

    A Scoping Review for Strategies to Increase Living Kidney Donation.
    Clin J Am Soc Nephrol 2017 Sep 17;12(9):1518-1527. Epub 2017 Aug 17.
    Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada;
    Background And Objectives: The literature on strategies to increase the number of potential living kidney donors is extensive and has yet to be characterized. Scoping reviews are a novel methodology for systematically assessing a wide breadth of a given body of literature and may be done before conducting a more targeted systematic review.

    Design, Setting, Participants, & Measurements: We performed a scoping review and summarized the evidence for existing strategies to increase living kidney donation. Read More

    Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD.
    Clin J Am Soc Nephrol 2017 Aug 15. Epub 2017 Aug 15.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Avoiding nonsteroidal anti-inflammatory drugs is important for safe CKD care. This study examined nonsteroidal anti-inflammatory drug use patterns and their association with other analgesic use in CKD.

    Design, Setting, Participants, & Measurements: The Chronic Renal Insufficiency Cohort Study is an observational cohort study that enrolled 3939 adults ages 21-74 years old with CKD between 2003 and 2008 using age-based eGFR inclusion criteria. Read More

    Epidemiology and Natural History of the Cardiorenal Syndromes in a Cohort with Echocardiography.
    Clin J Am Soc Nephrol 2017 Aug 11. Epub 2017 Aug 11.
    Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
    Background And Objectives: It is unknown whether echocardiographic parameters are independently associated with the cardiorenal syndrome. No direct comparison of the natural history of various cardiorenal syndrome types has been conducted.

    Design, Setting, Participants, & Measurements: Our retrospective cohort study enrolled adult patients with at least one transthoracic echocardiography between 2004 and 2014 at a single health care system. Read More

    Circulating Antibodies against Thrombospondin Type-I Domain-Containing 7A in Chinese Patients with Idiopathic Membranous Nephropathy.
    Clin J Am Soc Nephrol 2017 Aug 11. Epub 2017 Aug 11.
    Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University.
    Background And Objectives: Thrombospondin type-I domain-containing 7A (THSD7A) was recently identified as the target antigen in about 10% of patients with M-type phospholipase A2 receptor (PLA2R)-negative membranous nephropathy in European and North American populations. The prevalence of THSD7A in other populations and their clinical associations deserve further clarification.

    Design, Setting, Participants, & Measurements: Immunofluorescence assay was performed to investigate anti-THSD7A antibodies in 578 consecutive patients with biopsy-proven idiopathic membranous nephropathy, 114 patients with secondary membranous nephropathy, 64 disease controls, and 20 healthy controls. Read More

    eGFR and Albuminuria in Relation to Risk of Incident Atrial Fibrillation: A Meta-Analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study.
    Clin J Am Soc Nephrol 2017 Sep 10;12(9):1386-1398. Epub 2017 Aug 10.
    Cardiovascular Health Research Unit, and.
    Background And Objectives: The incidence of atrial fibrillation is high in ESRD, but limited data are available on the incidence of atrial fibrillation across a broad range of kidney function. Thus, we examined the association of eGFR and urine albumin-to-creatinine ratio with risk of incident atrial fibrillation.

    Design, Setting, Participants, & Measurements: We meta-analyzed three prospective cohorts: the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Read More

    Vascular Access Type and Clinical Outcomes among Elderly Patients on Hemodialysis.
    Clin J Am Soc Nephrol 2017 Aug 10. Epub 2017 Aug 10.
    Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama.
    Background And Objectives: The optimal type of initial permanent access for hemodialysis among the elderly is controversial. Duration of central venous catheter dependence, patient comorbidities, and life expectancy are important considerations in whether to place an arteriovenous fistula or graft. We used an observational study design to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed. Read More

    The Making Dialysis Safer for Patients Coalition: A New Partnership to Prevent Hemodialysis-Related Infections.
    Clin J Am Soc Nephrol 2017 Aug 9. Epub 2017 Aug 9.
    Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
    The Making Dialysis Safer for Patients Coalition is a partnership of organizations and individual stakeholders that share the common goal to prevent bloodstream infections among patients receiving hemodialysis. Led by the Centers for Disease Control and Prevention (CDC), in collaboration with the CDC Foundation, this public-private partnership strives to improve adherence to evidence-based recommendations, share information and experiences, and engage patients in infection prevention efforts. Read More

    Association of QT-Prolonging Medication Use in CKD with Electrocardiographic Manifestations.
    Clin J Am Soc Nephrol 2017 Aug 9. Epub 2017 Aug 9.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Several drugs used in CKD can prolong electrocardiographic conduction. We examined the use of electrocardiogram QT-prolonging medications in predialysis CKD and their association with QT duration.

    Design, Setting, Participants, & Measurements: In total, 3252 Chronic Renal Insufficiency Cohort participants with at least one study electrocardiogram between 2003 and 2011 were included. Read More

    The Clinical and Mutational Spectrum of Turkish Patients with Cystinosis.
    Clin J Am Soc Nephrol 2017 Aug 9. Epub 2017 Aug 9.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Infantile nephropathic cystinosis is a severe disease that occurs due to mutations in the cystinosis gene, and it is characterized by progressive dysfunction of multiple organs; >100 cystinosis gene mutations have been identified in multiple populations. Our study aimed to identify the clinical characteristics and spectrum of cystinosis gene mutations in Turkish pediatric patients with cystinosis.

    Design, Setting, Participants, & Measurements: We identified the clinical characteristics and spectrum of cystinosis gene mutations in Turkish patients with cystinosis in a multicenter registry that was established for data collection. Read More

    Use of Proteomics To Investigate Kidney Function Decline over 5 Years.
    Clin J Am Soc Nephrol 2017 08 21;12(8):1226-1235. Epub 2017 Jul 21.
    Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Background And Objectives: Using a discovery/replication approach, we investigated associations between a multiplex panel of 80 circulating proteins associated with cardiovascular pathology or inflammation, and eGFR decline per year and CKD incidence.

    Design, Setting, Participants, & Measurements: We used two cohorts, the Prospective Investigation of the Vasculature in Uppsala Seniors Study (PIVUS; n=687, mean age of 70 years, 51% women) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n=360 men, mean age of 78 years), with 5-year follow-up data on eGFR. There were 231 and 206 incident cases of CKD during follow-up in the PIVUS and ULSAM studies, respectively. Read More

    Cholecalciferol, Calcitriol, and Vascular Function in CKD: A Randomized, Double-Blind Trial.
    Clin J Am Soc Nephrol 2017 Sep 7;12(9):1438-1446. Epub 2017 Aug 7.
    Divisions of Renal Diseases and Hypertension and.
    Background And Objectives: High circulating vitamin D levels are associated with lower cardiovascular mortality in CKD, possibly by modifying endothelial function. We examined the effect of calcitriol versus cholecalciferol supplementation on vascular endothelial function in patients with CKD.

    Design, Setting, Participants, & Measurements: We performed a prospective, double-blind, randomized trial of 128 adult patients with eGFR=15-44 ml/min per 1. Read More

    Fibroblast Growth Factor 23 and Anemia in the Chronic Renal Insufficiency Cohort Study.
    Clin J Am Soc Nephrol 2017 Aug 7. Epub 2017 Aug 7.
    Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
    Background And Objectives: Anemia is an early complication of CKD that is associated with increased morbidity and mortality. Prior data show associations between abnormal mineral metabolism markers and decreased erythropoiesis. However, few studies have investigated elevated fibroblast growth factor 23 as a risk factor for the development of anemia in patients with CKD. Read More

    Endothelium-Dependent and -Independent Vascular Function in Advanced Chronic Kidney Disease.
    Clin J Am Soc Nephrol 2017 Aug 7. Epub 2017 Aug 7.
    Renal, Electrolyte and Hypertension Division and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
    Background And Objectives: CKD is associated with increased cardiovascular risk not fully attributable to traditional risk factors. We compared endothelium-dependent and -independent vascular function among individuals with advanced CKD with function in those with vascular disease but preserved kidney function.

    Design, Setting, Participants, & Measurements: Matched cohort analysis randomly selected from 1259 participants at a single center with measurements of brachial artery flow-mediated dilation, an endothelium-dependent process, and nitroglycerin-mediated dilation, an endothelium-independent process. Read More

    Pragmatic Randomized, Controlled Trial of Patient Navigators and Enhanced Personal Health Records in CKD.
    Clin J Am Soc Nephrol 2017 Sep 4;12(9):1418-1427. Epub 2017 Aug 4.
    Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio; and.
    Background And Objectives: Patient navigators and enhanced personal health records improve the quality of health care delivered in other disease states. We aimed to develop a navigator program for patients with CKD and an electronic health record-based enhanced personal health record to disseminate CKD stage-specific goals of care and education. We also conducted a pragmatic randomized clinical trial to compare the effect of a navigator program for patients with CKD with enhanced personal health record and compare their combination compared with usual care among patients with CKD stage 3b/4. Read More

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