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3. The relationship between uremic toxins and symptoms in older men and women with advanced chronic kidney disease

Author

Massy Z. A., Chesnaye N. C., Larabi I. A., Dekker F. W., Evans M., Caskey F. J., Torino C., Porto G., Szymczak M., Drechsler C., Wanner C., Jager K. J., Alvarez J. C., Schneider A., Torp A., Iwig B., Perras B., Marx C., Blaser C., Emde C., Krieter D., Fuchs D., Irmler E., Platen E., Schmidt-Gurtler H., Schlee H., Naujoks H., Schlee I., Casar S., Beige J., Rothele J., Mazur J., Hahn K., Blouin K., Neumeier K., Anding-Rost K., Schramm L., Hopf M., Wuttke N., Frischmuth N., Ichtiaris P., Kirste P., Schulz P., Aign S., Biribauer S., Manan S., Roser S., Heidenreich S., Palm S., Schwedler S., Delrieux S., Renker S., Schattel S., Stephan T., Schmiedeke T., Weinreich T., Leimbach T., Stovesand T., Bahner U., Seeger W., Cupisti A., Sagliocca A., Ferraro A., Mele A., Naticchia A., Cosaro A., Ranghino A., Stucchi A., Pignataro A., De Blasio A., Pani A., Tsalouichos A., Bellasi A., Raffaele Di Iorio B., Butti A., Abaterusso C., Somma C., D'Alessandro C., Zullo C., Pozzi C., Bergamo D., Ciurlino D., Motta D., Russo D., Favaro E., Vigotti F., Ansali F., Conte F., Cianciotta F., Giacchino F., Cappellaio F., Pizzarelli F., Greco G., Bigatti G., Marinangeli G., Cabiddu G., Fumagalli G., Caloro G., Piccoli G., Capasso G., Gambaro G., Tognarelli G., Bonforte G., Conte G., Toscano G., Del Rosso G., Capizzi I., Baragetti I., Oldrizzi L., Gesualdo L., Biancone L., Magnano M., Ricardi M., Di Bari M., Laudato M., Luisa Sirico M., Ferraresi M., Provenzano M., Malaguti M., Palmieri N., Murrone P., Cirillo P., Dattolo P., Acampora P., Nigro R., Boero R., Scarpioni R., Sicoli R., Malandra R., Savoldi S., Bertoli S., Borrelli S., Maxia S., Maffei S., Mangano S., Cicchetti T., Rappa T., Palazzo V., De Simone W., Schrander A., Van Dam B., Siegert C., Gaillard C., Beerenhout C., Verburgh C., Janmaat C., Hoogeveen E., Hoorn E., Boots J., Boom H., Eijgenraam J. -W., Kooman J., Rotmans J., Vogt L., Raasveld M., Vervloet M., Van Buren M., Van Diepen M., Leurs P., Voskamp P., Blankestijn P., Van Esch S., Boorsma S., Berger S., Konings C., Aydin Z., Musiala A., Szymczak A., Olczyk E., Augustyniak-Bartosik H., Miskowiec-Wisniewska I., Manitius J., Pondel J., Jedrzejak K., Nowanska K., Nowak L., Durlik M., Dorota S., Nieszporek T., Heleniak Z., Jonsson A., Blom A. -L., Rogland B., Wallquist C., Vargas D., Dimeny E., Sundelin F., Uhlin F., Welander G., Bascaran Hernandez I., Grontoft K. -C., Stendahl M., Svensson M., Heimburger O., Kashioulis P., Melander S., Almquist T., Jensen U., Woodman A., McKeever A., Ullah A., McLaren B., Harron C., Barrett C., O'Toole C., Summersgill C., Geddes C., Glowski D., McGlynn D., Sands D., Roy G., Hirst G., King H., McNally H., Masri-Senghor H., Murtagh H., Rayner H., Turner J., Wilcox J., Berdeprado J., Wong J., Banda J., Jones K., Haydock L., Wilkinson L., Carmody M., Weetman M., Joinson M., Dutton M., Matthews M., Morgan N., Bleakley N., Cockwell P., Roderick P., Mason P., Kalra P., Sajith R., Chapman S., Navjee S., Crosbie S., Brown S., Tickle S., Mathavakkannan S., Kuan Y., Massy, Z. A., Chesnaye, N. C., Larabi, I. A., Dekker, F. W., Evans, M., Caskey, F. J., Torino, C., Porto, G., Szymczak, M., Drechsler, C., Wanner, C., Jager, K. J., Alvarez, J. C., Schneider, A., Torp, A., Iwig, B., Perras, B., Marx, C., Blaser, C., Emde, C., Krieter, D., Fuchs, D., Irmler, E., Platen, E., Schmidt-Gurtler, H., Schlee, H., Naujoks, H., Schlee, I., Casar, S., Beige, J., Rothele, J., Mazur, J., Hahn, K., Blouin, K., Neumeier, K., Anding-Rost, K., Schramm, L., Hopf, M., Wuttke, N., Frischmuth, N., Ichtiaris, P., Kirste, P., Schulz, P., Aign, S., Biribauer, S., Manan, S., Roser, S., Heidenreich, S., Palm, S., Schwedler, S., Delrieux, S., Renker, S., Schattel, S., Stephan, T., Schmiedeke, T., Weinreich, T., Leimbach, T., Stovesand, T., Bahner, U., Seeger, W., Cupisti, A., Sagliocca, A., Ferraro, A., Mele, A., Naticchia, A., Cosaro, A., Ranghino, A., Stucchi, A., Pignataro, A., De Blasio, A., Pani, A., Tsalouichos, A., Bellasi, A., Raffaele Di Iorio, B., Butti, A., Abaterusso, C., Somma, C., D'Alessandro, C., Zullo, C., Pozzi, C., Bergamo, D., Ciurlino, D., Motta, D., Russo, D., Favaro, E., Vigotti, F., Ansali, F., Conte, F., Cianciotta, F., Giacchino, F., Cappellaio, F., Pizzarelli, F., Greco, G., Bigatti, G., Marinangeli, G., Cabiddu, G., Fumagalli, G., Caloro, G., Piccoli, G., Capasso, G., Gambaro, G., Tognarelli, G., Bonforte, G., Conte, G., Toscano, G., Del Rosso, G., Capizzi, I., Baragetti, I., Oldrizzi, L., Gesualdo, L., Biancone, L., Magnano, M., Ricardi, M., Di Bari, M., Laudato, M., Luisa Sirico, M., Ferraresi, M., Provenzano, M., Malaguti, M., Palmieri, N., Murrone, P., Cirillo, P., Dattolo, P., Acampora, P., Nigro, R., Boero, R., Scarpioni, R., Sicoli, R., Malandra, R., Savoldi, S., Bertoli, S., Borrelli, S., Maxia, S., Maffei, S., Mangano, S., Cicchetti, T., Rappa, T., Palazzo, V., De Simone, W., Schrander, A., Van Dam, B., Siegert, C., Gaillard, C., Beerenhout, C., Verburgh, C., Janmaat, C., Hoogeveen, E., Hoorn, E., Boots, J., Boom, H., Eijgenraam, J. -W., Kooman, J., Rotmans, J., Vogt, L., Raasveld, M., Vervloet, M., Van Buren, M., Van Diepen, M., Leurs, P., Voskamp, P., Blankestijn, P., Van Esch, S., Boorsma, S., Berger, S., Konings, C., Aydin, Z., Musiala, A., Szymczak, A., Olczyk, E., Augustyniak-Bartosik, H., Miskowiec-Wisniewska, I., Manitius, J., Pondel, J., Jedrzejak, K., Nowanska, K., Nowak, L., Durlik, M., Dorota, S., Nieszporek, T., Heleniak, Z., Jonsson, A., Blom, A. -L., Rogland, B., Wallquist, C., Vargas, D., Dimeny, E., Sundelin, F., Uhlin, F., Welander, G., Bascaran Hernandez, I., Grontoft, K. -C., Stendahl, M., Svensson, M., Heimburger, O., Kashioulis, P., Melander, S., Almquist, T., Jensen, U., Woodman, A., Mckeever, A., Ullah, A., Mclaren, B., Harron, C., Barrett, C., O'Toole, C., Summersgill, C., Geddes, C., Glowski, D., Mcglynn, D., Sands, D., Roy, G., Hirst, G., King, H., Mcnally, H., Masri-Senghor, H., Murtagh, H., Rayner, H., Turner, J., Wilcox, J., Berdeprado, J., Wong, J., Banda, J., Jones, K., Haydock, L., Wilkinson, L., Carmody, M., Weetman, M., Joinson, M., Dutton, M., Matthews, M., Morgan, N., Bleakley, N., Cockwell, P., Roderick, P., Mason, P., Kalra, P., Sajith, R., Chapman, S., Navjee, S., Crosbie, S., Brown, S., Tickle, S., Mathavakkannan, S., Kuan, Y., Nephrology, ACS - Diabetes & metabolism, Medical Informatics, APH - Methodology, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, APH - Health Behaviors & Chronic Diseases, and ACS - Pulmonary hypertension & thrombosis

Subjects
Transplantation, Nephrology, uremic toxins, CKD, symptoms, symptom, elderly
Abstract

Background Patients with stage 4/5 chronic kidney disease (CKD) suffer from various symptoms. The retention of uremic solutes is thought to be associated with those symptoms. However, there are relatively few rigorous studies on the potential links between uremic toxins and symptoms in patients with CKD. Methods The EQUAL study is an ongoing observational cohort study of non-dialyzed patients with stage 4/5 CKD. EQUAL patients from Germany, Poland, Sweden and the UK were included in the present study (n = 795). Data and symptom self-report questionnaires were collected between April 2012 and September 2020. Baseline uric acid and parathyroid hormone and 10 uremic toxins were quantified. We tested the association between uremic toxins and symptoms and adjusted P-values for multiple testing. Results Symptoms were more frequent in women than in men with stage 4/5 CKD, while levels of various uremic toxins were higher in men. Only trimethylamine N-oxide (TMAO; positive association with fatigue), p-cresyl sulfate (PCS) with constipation and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (negative association with shortness of breath) demonstrated moderately strong associations with symptoms in adjusted analyses. The association of phenylacetylglutamine with shortness of breath was consistent in both sexes, although it only reached statistical significance in the full population. In contrast, TMAO (fatigue) and PCS and phenylacetylglutamine (constipation) were only associated with symptoms in men, who presented higher serum levels than women. Conclusion Only a limited number of toxins were associated with symptoms in persons with stage 4/5 CKD. Other uremic toxins, uremia-related factors or psychosocial factors not yet explored might contribute to symptom burden.

Published
2022

4. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease.

Author

Fouque, D, Kalantar-Zadeh, K, Kopple, J, Cano, N, Chauveau, P, Cuppari, L, Franch, H, Guarnieri, G, Ikizler, TA, Kaysen, G, Lindholm, B, Massy, Z, Mitch, W, Pineda, E, Stenvinkel, P, Treviño-Becerra, A, and Wanner, C

Subjects
Humans, Kidney Diseases, Wasting Syndrome, Malnutrition, Syndrome, Acute Disease, Chronic Disease, Inflammation, Cachexia, Proteins, Energy Metabolism, Terminology as Topic, malnutrition, inflammation, protein-energy wasting, cachexia, kidney disease wasting, anorexia, Urology & Nephrology, Clinical Sciences
Abstract

The recent research findings concerning syndromes of muscle wasting, malnutrition, and inflammation in individuals with chronic kidney disease (CKD) or acute kidney injury (AKI) have led to a need for new terminology. To address this need, the International Society of Renal Nutrition and Metabolism (ISRNM) convened an expert panel to review and develop standard terminologies and definitions related to wasting, cachexia, malnutrition, and inflammation in CKD and AKI. The ISRNM expert panel recommends the term 'protein-energy wasting' for loss of body protein mass and fuel reserves. 'Kidney disease wasting' refers to the occurrence of protein-energy wasting in CKD or AKI regardless of the cause. Cachexia is a severe form of protein-energy wasting that occurs infrequently in kidney disease. Protein-energy wasting is diagnosed if three characteristics are present (low serum levels of albumin, transthyretin, or cholesterol), reduced body mass (low or reduced body or fat mass or weight loss with reduced intake of protein and energy), and reduced muscle mass (muscle wasting or sarcopenia, reduced mid-arm muscle circumference). The kidney disease wasting is divided into two main categories of CKD- and AKI-associated protein-energy wasting. Measures of chronic inflammation or other developing tests can be useful clues for the existence of protein-energy wasting but do not define protein-energy wasting. Clinical staging and potential treatment strategies for protein-energy wasting are to be developed in the future.

Published
2008

5. Kidney Versus Combined Kidney and Liver Transplantation in Young People With Autosomal Recessive Polycystic Kidney Disease: Data From the European Society for Pediatric Nephrology/European Renal Association−European Dialysis and Transplant (ESPN/ERA-EDTA) Registry

Author

Levtchenko, E., Haffner, D., Bjerre, A., Massy, Z., Shtiza, D., Kramar, R., Oberbauer, R., Baiko, S., Sukalo, A., van Hoeck, K., Collart, F., des Grottes, J.M., Pokrajac, D., Roussinov, D., Batinić, D., Lemac, M., Slavicek, J., Seeman, T., Vondrak, K., Heaf, J.G., Toots, U., Finne, P., Grönhagen-Riska, C., Couchoud, C., Lasalle, M, Sahpazova, E, Abazi, N, Ristoka Bojkovska, N, von Gersdorff, G, Scholz, C, Tönshoff, B, Krupka, K, Höcker, B, Pape, L, Afentakis, N, Kapogiannis, A, Printza, N, Reusz, G, Berecki, Cs, Szabó, A, Szabó, T, Györke, Z.S., Kis, E., Palsson, R., Edvardsson, V., Gianoglio, B., Maringhini, S., Pecoraro, C., Picca, S., Testa, S., Vidal, E., Verrina, E., Jankauskiene, A., Pundziene, B., Said-Conti, V., Gatcan, S., Berbeca, O., Zaikova, N., Pavićević, S., Leivestad, T., Zurowska, A., Zagozdzon, I., Mota, C., Almeida, M., Afonso, C., Mircescu, G., Garneata, L., Molchanova, E.A., Tomilina, N.A., Bikbov, B.T., Kostic, M., Peco-Antic, A., Spasojevic-Dimitrijeva, B., Milosevski-Lomic, G., Paripovic, D., Puric, S., Kruscic, D., Podracka, L., Kolvek, G., Buturovic-Ponikvar, J., Novljan, G., Battelino, N., Alonso Melgar, A., Schön, S., Prütz, K.G., Backmän, L., Stendahl, M., Evans, M., Rippe, B., Kuenhi, C.E., Maurer, E., Laube, G.F., Tschumi, S., Parvex, P., Hoitsma, A., Hemke, A., Topaloglu, R., Duzova, A., Ivanov, D., Pruthi, R., Braddon, F., Mannings, S., Cassula, A., Sinha, M.D., Mekahli, Djalila, van Stralen, Karlijn J., Bonthuis, Marjolein, Jager, Kitty J., Balat, Ayşe, Benetti, Elisa, Godefroid, Nathalie, Edvardsson, Vidar O., Heaf, James G., Jankauskiene, Augustina, Kerecuk, Larissa, Marinova, Svetlana, Puteo, Flora, Seeman, Tomas, Zurowska, Aleksandra, Pirenne, Jacques, Schaefer, Franz, and Groothoff, Jaap W.

Published
2016
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6. NT-proBNP and stem cell factor plasma concentrations are independently associated with cardiovascular outcomes in end-stage renal disease hemodialysis patients

Author

Rossignol, P, primary, Duarte, K, additional, Bresso, E, additional, A, Åsberg, additional, Devignes, M D, additional, Eriksson, N, additional, Girerd, N, additional, Glerup, R, additional, Jardine, A G, additional, Holdaas, H, additional, Lamiral, Z, additional, Leroy, C, additional, Massy, Z, additional, März, W, additional, Krämer, B, additional, Wu, P H, additional, Schmieder, R, additional, Soveri, I, additional, Christensen, J H, additional, Svensson, M, additional, Zannad, F, additional, and Fellström, B, additional

Published
2022
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10. NT-proBNP and stem cell factor plasma concentrations are independently associated with cardiovascular outcomes in end-stage renal disease hemodialysis patients

Author

Rossignol, P, Duarte, K, Bresso, E, A, Åsberg, Devignes, M D, Eriksson, N, Girerd, N, Glerup, R, Jardine, A G, Holdaas, H, Lamiral, Z, Leroy, C, Massy, Z, März, W, Krämer, B, Wu, Ping-Hsun, Schmieder, R, Soveri, Inga, Christensen, J H, Svensson, M, Zannad, F, Fellström, Bengt, Rossignol, P, Duarte, K, Bresso, E, A, Åsberg, Devignes, M D, Eriksson, N, Girerd, N, Glerup, R, Jardine, A G, Holdaas, H, Lamiral, Z, Leroy, C, Massy, Z, März, W, Krämer, B, Wu, Ping-Hsun, Schmieder, R, Soveri, Inga, Christensen, J H, Svensson, M, Zannad, F, and Fellström, Bengt

Abstract

Aimas: End-stage renal disease (ESRD) treated by chronic hemodialysis (HD) is associated with poor cardiovascular (CV) outcomes, with no available evidence-based therapeutics. A multiplexed proteomic approach may identify new pathophysiological pathways associated with CV outcomes, potentially actionable for precision medicine. Methods and Results: The AURORA trial was an international, multicentre, randomized, double-blind trial involving 2776 patients undergoing maintenance HD. Rosuvastatin vs. placebo had no significant effect on the composite primary endpoint of death from CV causes, nonfatal myocardial infarction or nonfatal stroke. We first compared CV risk-matched cases and controls (n = 410) to identify novel biomarkers using a multiplex proximity extension immunoassay (276 proteomic biomarkers assessed with OlinkTM). We replicated our findings in 200 unmatched cases and 200 controls. External validation was conducted from a multicentre real-life Danish cohort [Aarhus-Aalborg (AA), n = 331 patients] in which 92 OlinkTM biomarkers were assessed. In AURORA, only N-terminal pro-brain natriuretic peptide (NT-proBNP, positive association) and stem cell factor (SCF) (negative association) were found consistently associated with the trial's primary outcome across exploration and replication phases, independently from the baseline characteristics. Stem cell factor displayed a lower added predictive ability compared with NT-ProBNP. In the AA cohort, in multivariable analyses, BNP was found significantly associated with major CV events, while higher SCF was associated with less frequent CV deaths. Conclusions: Our findings suggest that NT-proBNP and SCF may help identify ESRD patients with respectively high and low CV risk, beyond classical clinical predictors and also point at novel pathways for prevention and treatment.

Published
2022
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17. A multivariable model for improved prediction of kidney failure requiring kidney replacement therapy based on routine laboratory parameters

Author

Zacharias, H, Altenbuchinger, M, Schultheiß, U, Raffler, J, Kotsis, F, Ghasemi, S, Ali, I, Metzger, M, Steinbrenner, I, Sekula, P, Massy, Z, Combe, C, Kalra, P, Kronenberg, F, Stengel, B, Eckardt, KU, Köttgen, A, Schmid, M, Gronwald, W, Oefner, P, Zacharias, H, Altenbuchinger, M, Schultheiß, U, Raffler, J, Kotsis, F, Ghasemi, S, Ali, I, Metzger, M, Steinbrenner, I, Sekula, P, Massy, Z, Combe, C, Kalra, P, Kronenberg, F, Stengel, B, Eckardt, KU, Köttgen, A, Schmid, M, Gronwald, W, and Oefner, P

Published
2021

21. COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration

Author

Hilbrands, L. B., Duivenvoorden, R., Vart, P., Franssen, C. F. M., Hemmelder, M. H., Jager, K. J., Kieneker, L. M., Noordzij, M., Pena, M. J., de Vries, H., Arroyo, D., Covic, A., Crespo, M., Goffin, E., Islam, M., Massy, Z. A., Montero, N., Oliveira, J. P., Munoz, A. R., Sanchez, J. E., Sridharan, S., Winzeler, R., Gansevoort, R. T., van der Net, Jeroen B., Marie, Essig, Peggy W, G du Buf-Vereijken, Betty van Ginneken, Nanda, Maas, Liffert, Vogt, van Jaarsveld, Birgit C., Bemelman, Frederike J., Farah, Klingenberg-Salahova, Frederiek, Heenan-Vos, Vervloet, Marc G., Azam, Nurmohamed, Daniel, Abramowicz, Sabine, Verhofstede, Omar, Maoujoud, Jana, Fialova, Edoardo, Melilli, Alex, Favà, Cruzado, Josep M., Joy, Lips, Maaike, Hengst, Ryszard, Gellert, Andrzej, Rydzewski, Alferes, Daniela G., Ivan, Rychlik, Zakharova, Elena V., Patrice Max Ambuehl, Fanny, Lepeytre, Clémentine, Rabaté, Guy, Rostoker, Sofia, Marques, Tijana, Azasevac, Dajana, Katicic, Marc ten Dam, Thilo, Krüger, Susan J, J Logtenberg, Lutz, Fricke, L van Zanen, A, Jeroen J, P Slebe, Delphine, Kemlin, Jacqueline van de Wetering, Jaromir, Eiselt, Lukas, Kielberger, El-Wakil, Hala S., Samar Abd ElHafeez, Christina, Canal, Carme, Facundo, Ramos, Ana M., Alicja, Debska-Slizien, Nicoline M, H Veldhuizen, Stylianos, Panagoutsos, Irina, Matceac, Ionut, Nistor, Monica, Cordos, J H, M Groeneveld, Marjolijn van Buren, Fritz, Diekmann, Ferreira, Ana C., Augusto Cesar, S. Santos Jr., Carlos, Arias-Cabrales, Laura, Llinàs-Mallol, Anna, Buxeda, Carla Burballa Tàrrega, Dolores, Redondo-Pachon, Maria Dolores Arenas Jimenez, Hofstra, Julia M., Antonio, Franco, Rodríguez-Ferrero, María L., Sagrario Balda Manzanos, Gabriel de Arriba, Haridian Sosa Barrios, R., Karlijn, Bartelet, Erol, Demir, Daan A M, J Hollander, Angele, Kerckhoffs, Stefan, Büttner, Aiko P, J de Vries, Soufian, Meziyerh, Danny van der Helm, Marlies, Reinders, Hanneke, Bouwsma, Kristina, Petruliene, Sharon, Maloney, Iris, Verberk, Marina Di Luca, Tuğlular, Serhan Z., Charles, Beerenhout, Luik, Peter T., Julia, Kerschbaum, Martin, Tiefenthaler, Bruno, Watschinger, Adema, Aaltje Y., Stepanov, Vadim A., Zulkarnaev, Alexey B., Kultigin, Turkmen, Bonucchi, Decenzio, Anselm, Fliedner, Hitoshi, Miyasato, Anders, Åsberg, Geir, Mjoen, Stefano, Pini, Consuelo de Biase, Anne Els van de Logt, Rutger, Maas, Olga, Lebedeva, Veronica, Lopez, Louis J, M Reichert, Jacobien, Verhave, Denis, Titov, Parshina, Ekaterina V., Liesbeth E, A van Gils-Verrij, Charlotte J, R de Bruin, Harty, John C., Marleen, Meurs, Marek, Myslak, Yuri, Battaglia, Paolo, Lentini, Edwin den Deurwaarder, Hormat, Rahimzadeh, Marcel, Schouten, Cabezas-Reina, Carlos J., Anabel, Diaz-Mareque, Armando, Coca, Björn K, I Meijers, Maarten, Naesens, Dirk, Kuypers, Bruno, Desschans, Annelies, Tonnerlier, Wissing, Karl M., Ivana, Dedinska, Giuseppina, Pessolano, van der Sande, Frank M., Maarten H, L Christiaans, Ilaria, Gandolfini, Umberto, Maggiore, Nada, Kanaan, Laura, Labriola, Arnaud, Devresse, Shafi, Malik, Berger, Stefan P., Esther, Meijer, Sanders, Jan Stephan F., Jadranka Buturović Ponikvar, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., S C, A Meijvis, Helma, Dolmans, Luca, Zanoli, Carmelita, Marcantoni, Esposito, Pasquale, Jean-Marie, Krzesinski, Jean Damacène Barahira, Maurizio, Gallieni, Gianmarco, Sabiu, Paloma Leticia Martin-Moreno, Gabriele, Guglielmetti, Gabriella, Guzzo, Luik, Antinus J., Willi H, M van Kuijk, Lonneke W, H Stikkelbroeck, Hermans, Marc M. H., Laurynas, Rimsevicius, Marco, Righetti, Nicole Heitink-ter Braak, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Clinical sciences, Nephrology, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Global Health, and APH - Quality of Care

Subjects
Male, Databases, Factual, Kidney Failure, Chronic/mortality, medicine.medical_treatment, 030232 urology & nephrology, Waiting Lists/mortality, Kidney Failure, 0302 clinical medicine, Risk Factors, Epidemiology, Kidney Transplantation/mortality, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Chronic, Prospective cohort study, Kidney transplantation, Aged, 80 and over, Renal Dialysis/mortality, SARS-CoV-2/isolation & purification, Hazard ratio, Age Factors, Middle Aged, Prognosis, Europe, Survival Rate, Nephrology, COVID-19, Dialysis, Kidney, Mortality, Transplantation, Adult, Aged, Female, Humans, Kidney Failure, Chronic, Kidney Transplantation, Renal Dialysis, SARS-CoV-2, Waiting Lists, Hemodialysis, medicine.medical_specialty, kidney, Europe/epidemiology, 03 medical and health sciences, Databases, All institutes and research themes of the Radboud University Medical Center, Internal medicine, AcademicSubjects/MED00340, Survival rate, Factual, COVID-19/chemically induced, business.industry, Original Articles, medicine.disease, mortality, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], dialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, transplantation
Abstract

Background. Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. Methods. We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. Results. Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 ± 13 and 67 ± 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3–30.2%] in kidney transplant and 25.0% (95% CI 20.2–30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59–1.10, P = 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n = 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation Conclusions. The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.

Published
2020
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23. Longitudinal Serum Bicarbonate Measurements and Risk of Chronic Kidney Disease Progression and Mortality: Insights from the Ckd-Rein Cohort

Author

Prezelin-Reydit, Mathilde, Combe, C., HARAMBAT, Jerome, Massy, Z., Metzger, M., Lange, C., Lambert, O., Stengel, B., Leffondre, Karen, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, urologic and male genital diseases, female genital diseases and pregnancy complications, LEHA
Abstract

Background and AimsMetabolic acidosis is a common complication of CKD and may contribute to CKD progression. However, the association between serum bicarbonate and CKD progression has not yet been investigated using longitudinal measurements.MethodWe used data from CKD-REIN, a prospective cohort study conducted in 40 representative French nephrology clinics which included 3033 patients with CKD stages 3 to 5 between 2013 and 2016. Patients who had no serum bicarbonate or no creatinine measure at within 6 months of their inclusion date in the CKD-REIN study were excluded. All serum bicarbonate measurements were taken into account, from inclusion to the occurrence of renal replacement therapy (RRT), death, or end of follow-up, whichever came first. We used a shared random-effect model for the joint analysis of individual trajectories of serum bicarbonate and the hazard of the composite outcome (RRT or death before RRT) and each specific event separately. Hazard ratio were adjusted (aHR) for age, sex, primary kidney disease, metabolic syndrome, cardiovascular disease, proteinuria (< 30, 30-300, > 300 mg/day), and the CKD-EPI estimated glomerular filtration rate (eGFR) at baseline.ResultsA total of 2977 patients (65.4% men, median age 69 years) were included. At baseline, the median eGFR was 31.8 mL/min/1.73m2 and the median bicarbonate concentration was 25 mmol/L. During a median follow-up of 4.5 years, 615 patients received RRT and 378 died before RRT. At any time of follow-up, a decrease of 1 mmol/l of the current level of serum bicarbonate was associated with a significantly increased hazard of RRT or death before RRT (aHR 1.05, 95%CI 1.02-1.08). The estimated effect was stronger on death before RRT (aHR 1.05, 95% CI 1.00-1.09) than on RRT (aHR 1.02, 95% CI 0.99-1.06).ConclusionA lower current level of serum bicarbonate is associated with an increased mortality in patients with CKD stage 3 to 5.

Published
2020

24. AMPK activation alleviates stroke severity in mice with chronic kidney disease

Author

Grissi, M., Boudot, Cédric, Assem, Maryam, Poirot-Leclercq, S., Lando, M., Boullier, Agnès, Lenglet, G., Avondo, Carine, Candellier, Alexandre, Lalau, Jean-Daniel, Choukroun, Gabriel, Massy, Z. A., Kamel, Saïd, Chillon, Jean-Marc, Henaut, L., DESSAIVRE, Louise, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université de Picardie Jules Verne (UPJV), Hématopoïèse normale et pathologique (U1170 Inserm), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Génie Enzymatique et Cellulaire (GEC), Université de Technologie de Compiègne (UTC)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Amiens-Picardie, Épidémiologie et recherches translationnelles sur les maladies rénales et cardiovasculaires (EPREC) (U1018 (Équipe 5)), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Ambroise Paré [AP-HP], Département Intelligence Ambiante et Systèmes Interactifs (DIASI), Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio]
Abstract

e-Poster, World Stroke Congress Abstracts, 2020 -; International audience; Background and aims: Ischemic stroke is highly prevalent in patients with chronic kidney disease(CKD) and has been associated with poor outcomes. In experimental studies, CKD mice display widerand more inflammatory ischemic lesions as well as poorer functional outcomes than mice with normalrenal function. Our group recently showed that adenosine-monophosphate-activated protein kinase(AMPK) activation is impaired within ischemic lesions of CKD mice. In rodents with normal renalfunction, AMPK activation by metformin, an anti-diabetic drug, improved stroke outcomes. This workaimed to investigate whether a 5-week pre-conditioning with metformin can restore AMPK activity andimprove functional recovery in mice with CKD.Methods: . Eight-week old female C57BL/6J mice were assigned to CKD or SHAM groups. CKD wasinduced through right kidney cortical electrocautery followed by left total nephrectomy. Mice receivedmetformin (200 mg/kg/day) or vehicle in drinking water. The treatment began 1 week after CKDinduction and was given for 5 weeks until stroke induction by transient middle cerebral artery occlusion (tMCAO).Results: . Exposure to metformin rescued AMPK activation, decreased ischemic lesion size andimproved neurological score, grip strength and prehensile abilities in CKD mice. Ischemic hemisphereof CKD mice exposed to metformin displayed decreased microglia/macrophages pro-inflammatory M1signature genes’ expression (i.e. CD32, CD16, CD86, IL-1b and iNOS) as well as reduced activation ofthe canonical NF-KB pathway.Conclusions: . These data demonstrate that the AMPK could be a promising therapeutic target todecrease brain inflammation and improve stroke recovery in CKD

Published
2020

25. Mild cognitive impairment and kidney disease: clinical aspects

Author

Viggiano, D. (Davide), Wagner, C.A. (Carsten), Blankestijn, P.J. (Peter), Bruchfeld, A. (Annette), Fliser, D. (Danilo), Fouque, D. (Denis), Frische, S. (Sebastian), Gesualdo, L. (Loreto), Gutiérrez, E. (Eugenio), Goumenos, D. (Dimitrios), Hoorn, E.J. (Ewout), Eckardt, K.-U. (Kai-Uwe), Knauß, S. (Samuel), König, M. (Maximilian), Malyszko, J. (Jolanta), Massy, Z. (Ziad), Nitsch, R. (Robert), Pesce, F. (Francesco), Rychlík, I. (Ivan), Soler, M.J. (Maria Jose), Spasovski, G. (Goce), Stevens, K.I. (Kathryn I.), Trepiccione, F. (Francesco), Wanner, C. (Christoph), Wiecek, A. (Andrzej), Zoccali, C. (Carmine), Unwin, R.J. (Robert John), Capasso, G. (Giovambattista), Viggiano, D. (Davide), Wagner, C.A. (Carsten), Blankestijn, P.J. (Peter), Bruchfeld, A. (Annette), Fliser, D. (Danilo), Fouque, D. (Denis), Frische, S. (Sebastian), Gesualdo, L. (Loreto), Gutiérrez, E. (Eugenio), Goumenos, D. (Dimitrios), Hoorn, E.J. (Ewout), Eckardt, K.-U. (Kai-Uwe), Knauß, S. (Samuel), König, M. (Maximilian), Malyszko, J. (Jolanta), Massy, Z. (Ziad), Nitsch, R. (Robert), Pesce, F. (Francesco), Rychlík, I. (Ivan), Soler, M.J. (Maria Jose), Spasovski, G. (Goce), Stevens, K.I. (Kathryn I.), Trepiccione, F. (Francesco), Wanner, C. (Christoph), Wiecek, A. (Andrzej), Zoccali, C. (Carmine), Unwin, R.J. (Robert John), and Capasso, G. (Giovambattista)

Published
2020
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26. Mild cognitive impairment and kidney disease: clinical aspects

Author

Viggiano, D, Wagner, CA, Blankestijn, PJ, Bruchfeld, A, Fliser, D, Fouque, D, Frische, S, Gesualdo, L, Gutierrez, E, Goumenos, D, Hoorn, Ewout, Eckardt, KU, Knauss, S, Konig, M, Malyszko, J, Massy, Z, Nitsch, D, Pesce, F, Rychlik, I, Soler, MJ, Spasovski, G, Stevens, KI, Trepiccione, F, Wanner, C, Wiecek, A, Zoccali, C, Unwin, R, Capasso, G, Viggiano, D, Wagner, CA, Blankestijn, PJ, Bruchfeld, A, Fliser, D, Fouque, D, Frische, S, Gesualdo, L, Gutierrez, E, Goumenos, D, Hoorn, Ewout, Eckardt, KU, Knauss, S, Konig, M, Malyszko, J, Massy, Z, Nitsch, D, Pesce, F, Rychlik, I, Soler, MJ, Spasovski, G, Stevens, KI, Trepiccione, F, Wanner, C, Wiecek, A, Zoccali, C, Unwin, R, and Capasso, G

Published
2020

27. Place des nouveaux traitements de l'ostéodystrophie rénale : dérivés 1α-hydroxylés de la vitamine D « non hypercalcémiants », complexants non calciques, non magnésiens et non aluminiques des phosphates, et calcimimétiques

Author

Harbouche, L., Shahapuni, I., Monge, M., Araar, B., Rahmouni, K., Oprisiu, R., Mansour, J., Presne, C., El Esper, I., Boitte, F., El Esper, N., Morinière, P., Brazier, M, Massy, Z., Choukroun, G., and Fournier, A.

Published
2006
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39. Evaluation of the adequacy of drug prescriptions in patients with chronic kidney disease: results from the CKD-REIN cohort

Author

Laville, S. M., Metzger, M., Stengel, B., Jacquelinet, C., Combe, C., Fouque, Denis, Laville, M., Frimat, L., Ayav, C., Speyer, E., Robinson, B. M., Massy, Z. A., Liabeuf, S., Chronic Kidney Dis Renal, Epidemiol, Information Network, C. K. D. Rein Stud, Université de Picardie Jules Verne (UPJV), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Agence de la biomédecine [Saint-Denis la Plaine], Service de Néphrologie-Transplantation-Dialyse, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Réseau Lorrain de prise en charge de l’insuffisance rénale chronique : Réseau NEPHROLOR (Nephrolor), Service Néphrologie/Dialyse [AP-HP Ambroise-Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre de Recherche Clinique, CHU Amiens-Picardie, CKD REIN, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie [Ambroise Paré], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de Néphrologie Transplantation, Dialyse et Aphérèse [CHU Bordeaux], CHU Bordeaux [Bordeaux], INSERM U1026 (INSERM, U1026), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Service de Néphrologie [CHRU Nancy], Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Arbor Research Collaborative for Health, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), DIPI (DIPI), ENISE, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, and Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
pharmacoepidemiology, adjustment, [SDV]Life Sciences [q-bio], cockcroft-gault, prescribing, urologic and male genital diseases, female genital diseases and pregnancy complications, information, medications, equations, residents, community, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, guidelines, Pharmacology & Pharmacy, drug utilization, ComputingMilieux_MISCELLANEOUS, chronic kidney disease
Abstract

International audience; Aims Drug prescription is difficult to manage in patients with chronic kidney disease (CKD). We assessed the prevalence and determinants of inappropriate drug prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD under nephrology care. We also assessed the impact of the equation used to estimate GFR on the prevalence estimates. Methods Results The CKD-REIN cohort includes 3033 outpatients with CKD (eGFR between 15 and 60 ml min(-1) 1.73 m(-2)). We examined the daily doses of pharmacological agents prescribed at study entry. Inappropriate prescription was defined as the reported prescription of either a contraindicated drug or an indicated drug at an inappropriately high dose level with regard to the patient's GFR, as estimated with the CKD-EPI equation, the de-indexed CKD-EPI equation, or the Cockcroft-Gault (CG) equation. Multivariate logistic regression was used to assess the determinants of inappropriate prescription risk. At baseline, patients' median [interquartile range] number of drugs prescribed per patient was 8 [5-10]. Half of the patients had been prescribed at least one inappropriate drug. Anti-gout, cardiovascular agents and antidiabetic agents accounted for most of the inappropriate prescriptions. The percentage of inappropriate prescriptions varied from one GFR equation to another: 52% when using the CKD-EPI equation, 47% when using the de-indexed CKD-EPI equation and 41% with the CG equation. A multiple logistic regression analysis showed significantly higher odds ratios [95% confidence interval] for inappropriate prescriptions in male patients (1.28 [1.07; 1.53]), patients with diabetes (1.34 [1.06; 1.70]), those with a high BMI (1.58 [1.25; 1.99]), and those with a low GFR (10.2 [6.02; 17.3]). The risk of having at least one inappropriate prescription increased with the number of drugs per patient (P for trend \textless 0.0001) and therefore the odds ratio was 5.88 [4.17; 8.28] for those who received at least 11 prescribed medications compared to those who received fewer than 5. Conclusion Appendix Our results emphasize the complexity of drug management for CKD patients, for whom inappropriate prescription appears to be common.

Published
2018

44. Clinical management of the uraemic syndrome in chronic kidney disease

Author

Vanholder, R., Fouque, Denis, Glorieux, G., Heine, G. H., Kanbay, M., Mallamaci, F., Massy, Z. A., Ortiz, A., Rossignol, P., Wiecek, A., Zoccali, C., London, G. M., European Renal Association European, Dialysis, Transplant Association European, Renal, Cardiovascular Medicine working, group, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL)

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, 030232 urology & nephrology, Placebo-controlled study, Renal function, Disease, 030204 cardiovascular system & hematology, Metabolic bone disease, law.invention, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Randomized controlled trial, law, Internal Medicine, medicine, Humans, Renal Insufficiency, Chronic, Disease management (health), Intensive care medicine, Uremia, business.industry, Organ dysfunction, Disease Management, Syndrome, medicine.disease, 3. Good health, medicine.symptom, business, Kidney disease
Abstract

International audience; The clinical picture of the uraemic syndrome is a complex amalgam of accelerated ageing and organ dysfunction, which progress in parallel to chronic kidney disease. The uraemic syndrome is associated with cardiovascular disease, metabolic bone disease, inflammation, protein energy wasting, intestinal dysbiosis, anaemia, and neurological and endocrine dysfunction. In this Review, we summarise specific, modern management options for the uraemic syndrome in chronic kidney disease. Although large randomised controlled trials are scarce, based on data from randomised controlled trials and observational studies, as well as pathophysiological reasoning, a therapeutic algorithm can be developed for this complex and multifactorial condition, with interventions targeting several modifiable factors simultaneously.

Published
2016

49. Mortality due to bleeding, myocardial infarction and stroke in dialysis patients

Author

Ocak, G, Noordzij, M, Rookmaaker, M B, Cases, A, Couchoud, C, Heaf, J G, Jarraya, F, De Meester, J, Groothoff, J W, Waldum-Grevbo, B E, Palsson, R, Resic, H, Remón, C, Finne, P, Stendahl, M, Verhaar, M C, Massy, Z A, Dekker, F W, Jager, K J, Ocak, G, Noordzij, M, Rookmaaker, M B, Cases, A, Couchoud, C, Heaf, J G, Jarraya, F, De Meester, J, Groothoff, J W, Waldum-Grevbo, B E, Palsson, R, Resic, H, Remón, C, Finne, P, Stendahl, M, Verhaar, M C, Massy, Z A, Dekker, F W, and Jager, K J

Abstract

Essentials Mortality due to bleeding vs. arterial thrombosis in dialysis patients is unknown. We compared death causes of 201 918 dialysis patients with the general population. Dialysis was associated with increased mortality risks of bleeding and arterial thrombosis. Clinicians should be aware of the increased bleeding and thrombosis risks.SUMMARY: Background Dialysis has been associated with both bleeding and thrombotic events. However, there is limited information on bleeding as a cause of death versus arterial thrombosis as a cause of death. Objectives To investigate the occurrence of bleeding, myocardial infarction and stroke as causes of death in the dialysis population as compared with the general population. Methods We included 201 918 patients from 11 countries providing data to the ERA-EDTA Registry who started dialysis treatment between 1994 and 2011, and followed them for 3 years. Age-standardized and sex-standardized mortality rate ratios for bleeding, myocardial infarction and stroke as causes of death were calculated in dialysis patients as compared with the European general population. Associations between potential risk factors and these causes of death in dialysis patients were investigated by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) by the use of Cox proportional-hazards regression. Results As compared with the general population, the age-standardized and sex-standardized mortality rate ratios in dialysis patients were 12.8 (95% CI 11.9-13.7) for bleeding as a cause of death (6.2 per 1000 person-years among dialysis patients versus 0.3 per 1000 person-years in the general population), 13.4 (95% CI 13.0-13.9) for myocardial infarction (22.5 versus 0.9 per 1000 person-years), and 12.4 (95% CI 11.9-12.9) for stroke (14.3 versus 0.7 per 1000 person-years). Conclusion Dialysis patients have highly increased risks of death caused by bleeding and arterial thrombosis as compared with the general population. Clinicians

Published
2018

50. Circulating markers of bone turnover

Author

Vervloet, M. G., Brandenburg, V. M., Bover, J., Brandenburg, V., Covic, A., Cozzolino, M., Evenepoel, P., Goldsmith, D., Massy, Z., Mazzaferro, S., Urena-Torres, P., and Vervloet, M.

Subjects
Nephrology, medicine.medical_specialty, Bone turnover, Bone disease, 030232 urology & nephrology, Physiology, Parathyroid hormone, 030209 endocrinology & metabolism, Review, urologic and male genital diseases, Collagen Type I, Bone remodeling, 03 medical and health sciences, 0302 clinical medicine, Chronic kidney disease-mineral and bone disorder, Internal medicine, Chronic kidney disease, Bone cell, medicine, CKD-MBD, Humans, Renal osteodystrophy, ddc:610, Renal Insufficiency, Renal Insufficiency, Chronic, Chronic, Chronic Kidney Disease-Mineral and Bone Disorder, business.industry, Tartrate-Resistant Acid Phosphatase, medicine.disease, Alkaline Phosphatase, Peptide Fragments, Endocrinology, Parathyroid Hormone, Bone Remodeling, business, Peptides, Biomarkers, Procollagen, Kidney disease
Abstract

Symposium on Bone in Chronic Kidney Disease (CKD), CKD 2016, Amsterdam, Netherlands, 13 Sep 2016 - 13 Sep 2016; Journal of nephrology 30(5), 663-670 (2017). doi:10.1007/s40620-017-0408-8 special issue: "Special issue on “Bone in Chronic Kidney Disease” an activity of the ERA-EDTA WG on CKD-MBD", Published by Springer, Milano

Published
2017

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