497 results on '"Rosas, Sylvia E"'
Search Results
2. Combination therapy for kidney disease in people with diabetes mellitus
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van Raalte, Daniël H., Bjornstad, Petter, Cherney, David Z. I., de Boer, Ian H., Fioretto, Paola, Gordin, Daniel, Persson, Frederik, Rosas, Sylvia E., Rossing, Peter, Schaub, Jennifer A., Tuttle, Katherine, Waikar, Sushrut S., and Heerspink, Hiddo J. L.
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- 2024
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3. Proceedings of a Workshop to Promote Community Health Worker Interventions in Nephrology
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Novick, Tessa K, Cervantes, Lilia, Golestaneh, Ladan, Osuna, Michelle, Cruz, Evelyn, Baqueiro, Luz, Argentina, Marissa, Sandoval, Andrea, Brown, Arleen, Reyna, Franco, Rosas, Sylvia E, Camacho, Claudia, and Shen, Jenny
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Kidney Disease ,Renal and urogenital ,Good Health and Well Being ,Humans ,Community Health Workers ,Nephrology ,Kidney Diseases ,community engagement and health ,health equity ,diversity ,and inclusion ,Urology & Nephrology ,Clinical sciences - Abstract
AbstractLatinx populations face a higher burden of kidney failure and associated negative outcomes compared with non-Latinx White populations, despite sharing a similar prevalence of CKD. Community health worker (CHW) interventions have been shown to improve outcomes for Latinx individuals, but they are largely underutilized in kidney disease. We convened a workshop of four ongoing kidney disease CHW programs to identify successes, challenges, potential solutions, and needed research to promote CHW programs for Latinx individuals with kidney disease. Key points from the workshop and recommendations for intervention and research are highlighted. Facilitators of program success included prioritizing trust-building with participants, enabling participants to determine what aspects of the intervention were needed, providing participants with tools to help themselves and others after the intervention, and taking a trauma-informed approach to relationships. Challenges included persistent systemic barriers despite successful care navigation and low recruitment and retention. Research is needed to capture the effect of CHW interventions on outcomes and to determine how to implement CHW interventions for people with kidney disease nationwide.
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- 2023
4. Plasma proteomics of acute tubular injury
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Schmidt, Insa M., Surapaneni, Aditya L., Zhao, Runqi, Upadhyay, Dhairya, Yeo, Wan-Jin, Schlosser, Pascal, Huynh, Courtney, Srivastava, Anand, Palsson, Ragnar, Kim, Taesoo, Stillman, Isaac E., Barwinska, Daria, Barasch, Jonathan, Eadon, Michael T., El-Achkar, Tarek M., Henderson, Joel, Moledina, Dennis G., Rosas, Sylvia E., Claudel, Sophie E., Verma, Ashish, Wen, Yumeng, Lindenmayer, Maja, Huber, Tobias B., Parikh, Samir V., Shapiro, John P., Rovin, Brad H., Stanaway, Ian B., Sathe, Neha A., Bhatraju, Pavan K., Coresh, Josef, Rhee, Eugene P., Grams, Morgan E., and Waikar, Sushrut S.
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- 2024
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5. The chromatin landscape of healthy and injured cell types in the human kidney
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Gisch, Debora L., Brennan, Michelle, Lake, Blue B., Basta, Jeannine, Keller, Mark S., Melo Ferreira, Ricardo, Akilesh, Shreeram, Ghag, Reetika, Lu, Charles, Cheng, Ying-Hua, Collins, Kimberly S., Parikh, Samir V., Rovin, Brad H., Robbins, Lynn, Stout, Lisa, Conklin, Kimberly Y., Diep, Dinh, Zhang, Bo, Knoten, Amanda, Barwinska, Daria, Asghari, Mahla, Sabo, Angela R., Ferkowicz, Michael J., Sutton, Timothy A., Kelly, Katherine J., De Boer, Ian H., Rosas, Sylvia E., Kiryluk, Krzysztof, Hodgin, Jeffrey B., Alakwaa, Fadhl, Winfree, Seth, Jefferson, Nichole, Türkmen, Aydın, Gaut, Joseph P., Gehlenborg, Nils, Phillips, Carrie L., El-Achkar, Tarek M., Dagher, Pierre C., Hato, Takashi, Zhang, Kun, Himmelfarb, Jonathan, Kretzler, Matthias, Mollah, Shamim, Jain, Sanjay, Rauchman, Michael, and Eadon, Michael T.
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- 2024
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6. Inference and Prediction Using Functional Principal Components Analysis: Application to Diabetic Kidney Disease Progression in the Chronic Renal Insufficiency Cohort (CRIC) Study
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Kwan, Brian, Yang, Wei, Montemayor, Daniel, Zhang, Jing, Fuhrer, Tobias, Anderson, Amanda H., Anderson, Cheryl A. M., Chen, Jing, Ricardo, Ana C., Rosas, Sylvia E., Natarajan, Loki, and Investigators, the CRIC Study
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Statistics - Applications - Abstract
Repeated longitudinal measurements are commonly used to model long-term disease progression, and timing and number of assessments per patient may vary, leading to irregularly spaced and sparse data. Longitudinal trajectories may exhibit curvilinear patterns, in which mixed linear regression methods may fail to capture true trends in the data. We applied functional principal components analysis to model kidney disease progression via estimated glomerular filtration rate (eGFR) trajectories. In a cohort of 2641 participants with diabetes and up to 15 years of annual follow-up from the Chronic Renal Insufficiency Cohort (CRIC) study, we detected novel dominant modes of variation and patterns of diabetic kidney disease (DKD) progression among subgroups defined by the presence of albuminuria. We conducted inferential permutation tests to assess differences in longitudinal eGFR patterns between groups. To determine whether fitting a full cohort model or separate group-specific models is more optimal for modeling long-term trajectories, we evaluated model fit, using our goodness-of-fit procedure, and future prediction accuracy. Our findings indicated advantages for both modeling approaches in accomplishing different objectives. Beyond DKD, the methods described are applicable to other settings with longitudinally assessed biomarkers as indicators of disease progression. Supplementary materials for this article are available online.
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- 2022
7. Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO).
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de Boer, Ian H, Khunti, Kamlesh, Sadusky, Tami, Tuttle, Katherine R, Neumiller, Joshua J, Rhee, Connie M, Rosas, Sylvia E, Rossing, Peter, and Bakris, George
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Kidney ,Humans ,Diabetes Mellitus ,Type 2 ,Consensus ,Renal Insufficiency ,Chronic ,Clinical Research ,Kidney Disease ,Health Services ,Nutrition ,Diabetes ,Cardiovascular ,5.1 Pharmaceuticals ,Development of treatments and therapeutic interventions ,Renal and urogenital ,Metabolic and endocrine ,Good Health and Well Being ,United States ,Sodium-Glucose Transporter 2 Inhibitors ,Mineralocorticoid Receptor Antagonists ,Metformin ,Glucagon-Like Peptide 1 ,Glucose ,Sodium ,Medical and Health Sciences ,Endocrinology & Metabolism - Abstract
People with diabetes and chronic kidney disease (CKD) are at high risk for kidney failure, atherosclerotic cardiovascular disease, heart failure, and premature mortality. Recent clinical trials support new approaches to treat diabetes and CKD. The 2022 American Diabetes Association (ADA) Standards of Medical Care in Diabetes and the Kidney Disease: Improving Global Outcomes (KDIGO) 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease each provide evidence-based recommendations for management. A joint group of ADA and KDIGO representatives reviewed and developed a series of consensus statements to guide clinical care from the ADA and KDIGO guidelines. The published guidelines are aligned in the areas of CKD screening and diagnosis, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management. Recommendations include comprehensive care in which pharmacotherapy that is proven to improve kidney and cardiovascular outcomes is layered on a foundation of healthy lifestyle. Consensus statements provide specific guidance on use of renin-angiotensin system inhibitors, metformin, sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD.
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- 2022
8. A Holistic Framework for the Evaluation of Kidney Function in a Gender-Diverse Landscape
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Turino Miranda, Keila, Greene, Dina N., Collister, David, Krasowski, Matthew D., Ahmed, Sofia B., Cirrincione, Lauren R., Rosas, Sylvia E., Saad, Nathalie, and Pierre, Christina C.
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- 2024
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9. An atlas of healthy and injured cell states and niches in the human kidney
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Lake, Blue B., Menon, Rajasree, Winfree, Seth, Hu, Qiwen, Melo Ferreira, Ricardo, Kalhor, Kian, Barwinska, Daria, Otto, Edgar A., Ferkowicz, Michael, Diep, Dinh, Plongthongkum, Nongluk, Knoten, Amanda, Urata, Sarah, Mariani, Laura H., Naik, Abhijit S., Eddy, Sean, Zhang, Bo, Wu, Yan, Salamon, Diane, Williams, James C., Wang, Xin, Balderrama, Karol S., Hoover, Paul J., Murray, Evan, Marshall, Jamie L., Noel, Teia, Vijayan, Anitha, Hartman, Austin, Chen, Fei, Waikar, Sushrut S., Rosas, Sylvia E., Wilson, Francis P., Palevsky, Paul M., Kiryluk, Krzysztof, Sedor, John R., Toto, Robert D., Parikh, Chirag R., Kim, Eric H., Satija, Rahul, Greka, Anna, Macosko, Evan Z., Kharchenko, Peter V., Gaut, Joseph P., Hodgin, Jeffrey B., Eadon, Michael T., Dagher, Pierre C., El-Achkar, Tarek M., Zhang, Kun, Kretzler, Matthias, and Jain, Sanjay
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- 2023
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10. Multi-Ethnic Study of Atherosclerosis Early Heart Failure Study: Rationale, Design, and Baseline Characteristics
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Beussink-Nelson, Lauren, Freed, Benjamin H., Chirinos, Julio A., Brubaker, Peter H., Kitzman, Dalane W., Yeboah, Joseph, Rosas, Sylvia E., Hu, Mo, Lima, João A.C., Pandit, Jay, Bertoni, Alain G., and Shah, Sanjiv J.
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- 2024
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11. Participant Experience with Protocol Research Kidney Biopsies in the Kidney Precision Medicine Project
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Victoria-Castro, Angela M., Corona-Villalobos, Celia P., Xu, Alan Y., Onul, Ingrid, Huynh, Courtney, Chen, Sarah W., Ugwuowo, Ugochukwu, Sarkisova, Natalya, Dighe, Ashveena L., Blank, Kristina N., Blanc, Victoria M., Rose, Michael P., Himmelfarb, Jonathan, de Boer, Ian H., Tuttle, Katherine R., Roberts, Glenda V., Alexandrov, Theodore, Alloway, Rita R., Alpers, Charles E., Amodu, Afolarin A., Anderton, Christopher R., Anjani, Kavya, Appelbaum, Paul, Ardayfio, Joseph, Arora, Tanima, Ascani, Heather, El-Achkar, Tarek M., Aulisio, Mark, Azeloglu, Evren U., Balderes, Olivia, Balis, Ulysses G.J., Bansal, Shweta, Barasch, Jonathan M., Bansal, Shweta, Barkell, Alex, Barwinska, Daria, Basit, Mujeeb, Basta, Jeanine, Bebiak, Jack, Beck, Laurence H., Bender, Filitsa, Berglund, Ashley, Bernard, Lauren, Berrouet, Cecilia, Berry, Brooke, Bjornstad, Petter M., Blanc, Victoria M., Blank, Kristina N., Bledsoe, Sharon, Boada, Patrick, Bogen, Steve, Bomback, Andrew S., Bonevich, Nikole, Borner, Katy, Brown, Keith, Bueckle, Andreas, Burg, Ashley R., Burgess, Adam, Bush, Lakeshia, Bush, William S., Campbell, Catherine E., Campbell, Taneisha, Canetta, Pietro A., Cantley, Lloyd G., Caprioli, Richard M., Carson, Jonas, Chen, Sarah, Chen, Yijiang M., Cheng, Yinghua, Cimino, Jim, Colona, Mia R., Conser, Ninive C., Cooperman, Leslie, Crawford, Dana C., DʼAgati, Vivette D., Dagher, Pierre C., Daniel, Stephen, Daratha, Kenn, de Boer, Ian H., Diettman, Sabine M., Dighe, Ashveena L., Donohoe, Isabel, Dowd, Frederick, Dunn, Kenneth W., Eadon, Michael T., Eddy, Sean, Elder, Michele M., Ferkowicz, Michael J., Frey, Renee, Gadegbeku, Crystal A., Gaut, Joseph P., Gilliam, Matthew, Ginley, Brandon, Gisch, Debora, Goltsev, Yury, Gonzalez-Vicente, Agustin, Greka, Anna, Grewenow, Stephanie M., Hacohen, Nir, Hall, Daniel E., Hansen, Jens, Hayashi, Lynda, He, Cijang, He, Yougqun, Hedayati, S. Susan, Henderson, Joel M., Hendricks, Allen H., Herlitz, Leal, Herr, Bruce W., Himmelfarb, Jonathan, Hodgin, Jeffrey B., Hoofnagle, Andrew N., Hoover, Paul J., Ilori, Titlayo, Iyengar, Ravi, Jain, Sanjay, Jain, Yashvardhan, Janowczyk, Andrew, Jefferson, Nichole, Johansen, Camille, Jolly, Stacey, Kakade, Vijaykumar R., Kellum, John A., Kelly, Katherine J., Kermani, Asra, Kiryluk, Krzysztof, Knight, Richard, Koewler, Robert, Kretzler, Matthias, Kudose, Satoru, Lake, Blue B., Larson, Brandon, Laszik, Zoltan G., Lecker, Stewart H., Lee, Paul J., Lee, Simon C., Lienczewski, Chrysta, Limonte, Christine, Lu, Christopher Y., Lucarelli, Nicholas, Lukowski, Jessica, Luo, Jinghui, Lutnick, Brendon, Ma, Shihong, Madabhushi, Anant, Madhavan, Sethu M., Maikhor, Shana, Mariani, Laura H., Marshall, Jamie L., McClelland, Robyn L., McMahon, Gearoid M., Mehl, Karla, Ferreira, Ricardo Melo, Menez, Steven, Menon, Rajasree, Miller, R. Tyler, Moe, Orson W., Moledina, Dennis, Montellano, Richard, Mooney, Sean D., Morales, Martha Catalina, Mukatash, Tariq, Murugan, Raghavan, Nam, Yunbi, Nguyen, Jane, Nolan, Garry, Oʼtoole, John, Oliver, George (Holt), Onul, Ingrid, Otto, Edgar, Palevsky, Paul M., Palmer, Ellen, Pamreddy, Annapurna, Parikh, Chirag R., Parikh, Samir, Park, Christopher, Park, Harold, Pasa-Tolic, Ljiljana, Patel, Jiten, Patterson, Nathan, Phuong, Jim, Pillai, Anil, Pinkeney, Roy, Poggio, Emilio, Pollack, Ari, Prasad, Pottumarthi, Pyle, Laura, Quardokus, Ellen M., Randhawa, Parmjeet, Rauchman, Michael I., Record, Elizabeth, Rennke, Helmut, Rezaei, Kasra, Rike, Adele, Rivera, Marcelino, Roberts, Glenda V., Rosas, Sylvia E., Rosenberg, Avi, Rosengart, Matthew, Rovin, Brad, Roy, Neil, Sabatello, Maya, Sambandam, Kamalanathan, Sarder, Pinaki, Sarkisova, Natalya, Sarwal, Minnie, Saul, John, Schaub, Jennifer, Schmidt, Insa, Sealfon, Rachel, Sedor, John, Sendrey, Dianna, Shang, Ning, Shankland, Stuart, Shapiro, John P., Sharma, Kumar, Sharman, Kavya, Shaw, Melissa M., Shi, Tiffany, Shpigel, Anna, Sigdel, Tara, Slade, Austen, Snyder, Jamie, Spates-Harden, Kassandra, Spraggins, Jeffrey M., Srivastava, Anand, Steck, Becky, Stillman, Isaac, Stutzke, Christy, Su, Jing, Sun, Jennifer, Sutton, Timothy A., Taliercio, Jonathan, Tan, Roderick, Torrealba, Jose, Toto, Robert D., Troyanskaya, Olga, Tublin, Mitchell, Tuttle, Katherine R., Ugwuowo, Ugochukwu, Valerius, M. Todd, Van de Plas, Raf, Varela, German, Vazquez, Miguel, Velickovic, Dusan, Venkatachalam, Manjeri, Verma, Ashish, Victoria-Castro, Angela M., Vijayan, Anitha, Corona-Villalobos, Celia P., Vinovskis, Carissa, Viswanathan, Vidya S., Vita, Tina, Waikar, Sushrut, Wang, Ashley, Wang, Ruikang, Wang, Nancy, Weins, Astrid, Wen, Natasha, Wen, Yumeng, Wilcox, Adam, Williams, James C., Jr., Kayleen Williams, Williams, Mark, Wilson, Francis P., Winfree, Seth, Winters, James, Wofford, Stephanie, Wong, Aaron, Woodle, E. Steve, Xiong, Yuguang, Xu, Alan, Yadati, Pranav, Ye, Hongping, Yu, Guanghao, Zhang, Dianbo, Zhang, Guanshi, and Zhang, Kun
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- 2024
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12. Clinical events and patient-reported outcome measures during CKD progression: findings from the Chronic Renal Insufficiency Cohort Study.
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Grams, Morgan E, Surapaneni, Aditya, Appel, Lawrence J, Lash, James P, Hsu, Jesse, Diamantidis, Clarissa J, Rosas, Sylvia E, Fink, Jeffrey C, Scialla, Julia J, Sondheimer, James, Hsu, Chi-Yuan, Cheung, Alfred K, Jaar, Bernard G, Navaneethan, Sankar, Cohen, Debbie L, Schrauben, Sarah, Xie, Dawei, Rao, Pandu, Feldman, Harold I, Go, Alan S, He, Jiang, Rahman, Mahboob, and Townsend, Raymond R
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Clinical Research ,Clinical Trials and Supportive Activities ,Kidney Disease ,Aging ,Heart Disease ,Cardiovascular ,Management of diseases and conditions ,7.1 Individual care needs ,Renal and urogenital ,Good Health and Well Being ,Cohort Studies ,Disease Progression ,Female ,Glomerular Filtration Rate ,Humans ,Kidney Failure ,Chronic ,Male ,Middle Aged ,Patient Reported Outcome Measures ,Quality of Life ,Renal Insufficiency ,Chronic ,albuminuria ,cardiovascular ,CKD ,ESKD ,patient-centered outcome ,CRIC study investigators ,Clinical Sciences ,Urology & Nephrology - Abstract
BackgroundPatients with chronic kidney disease (CKD) face risks of not only end-stage kidney disease (ESKD), cardiovascular disease (CVD) and death, but also decline in kidney function, quality of life (QOL) and mental and physical well-being. This study describes the multidimensional trajectories of CKD using clinical events, kidney function and patient-reported outcome measures (PROMs). We hypothesized that more advanced CKD stages would associate with more rapid decline in each outcome.MethodsAmong 3939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, we evaluated multidimensional disease trajectories by G- and A-stages of enrollment estimated glomerular filtration rate (eGFR) and albuminuria, respectively. These trajectories included clinical events (ESKD, CVD, heart failure and death), eGFR decline and PROMs [kidney disease QOL (KDQOL) burden, effects and symptoms questionnaires, as well as the 12-item short form mental and physical component summaries]. We also evaluated a group-based multitrajectory model to group participants on the basis of longitudinal PROMs and compared group assignments by enrollment G- and A-stage.ResultsThe mean participant age was 58 years, 45% were women, mean baseline eGFR was 44 mL/min/1.73 m2 and median urine albumin:creatinine ratio was 52 mg/g. The incidence of all clinical events was greater and eGFR decline was faster with more advanced G- and A-stages. While baseline KDQOL and physical component measures were lower with more advanced G- and A-stage of CKD, changes in PROMs were inconsistently related to the baseline CKD stage. Groups formed on PROM trajectories were fairly distinct from existing CKD staging (observed agreement 60.6%) and were associated with the risk of ESKD, CVD, heart failure and death.ConclusionsMore advanced baseline CKD stage was associated with a higher risk of clinical events and faster eGFR decline, and was only weakly related to changes in patient-reported metrics over time.
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- 2021
13. Increasing diversity and inclusion in nephrology clinical trials
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Young, Bessie A. and Rosas, Sylvia E.
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- 2023
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14. Finerenone in Hispanic Patients With CKD and Type 2 Diabetes: A Post Hoc FIDELITY Analysis
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Rosas, Sylvia E., Ruilope, Luis M., Anker, Stefan D., Pitt, Bertram, Rossing, Peter, Bonfanti, Andres Angelo Cadena, Correa-Rotter, Ricardo, González, Fernando, Munoz, Carlos Francisco Jaramillo, Pergola, Pablo, Umpierrez, Guillermo E., Scalise, Andrea, Scott, Charlie, Lawatscheck, Robert, Joseph, Amer, and Bakris, George L.
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- 2023
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15. Rationale and design of a randomised phase III registration trial investigating finerenone in participants with type 1 diabetes and chronic kidney disease: The FINE-ONE trial
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Heerspink, Hiddo J.L., Birkenfeld, Andreas L., Cherney, David Z.I., Colhoun, Helen M., Ji, Linong, Mathieu, Chantal, Groop, Per-Henrik, Pratley, Richard E., Rosas, Sylvia E., Rossing, Peter, Skyler, Jay S., Tuttle, Katherine R., Lawatscheck, Robert, Scott, Charlie, Edfors, Robert, Scheerer, Markus F., Kolkhof, Peter, and McGill, Janet B.
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- 2023
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16. Rationale and design of the Kidney Precision Medicine Project
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de Boer, Ian H, Alpers, Charles E, Azeloglu, Evren U, Balis, Ulysses GJ, Barasch, Jonathan M, Barisoni, Laura, Blank, Kristina N, Bomback, Andrew S, Brown, Keith, Dagher, Pierre C, Dighe, Ashveena L, Eadon, Michael T, El-Achkar, Tarek M, Gaut, Joseph P, Hacohen, Nir, He, Yongqun, Hodgin, Jeffrey B, Jain, Sanjay, Kellum, John A, Kiryluk, Krzysztof, Knight, Richard, Laszik, Zoltan G, Lienczewski, Chrysta, Mariani, Laura H, McClelland, Robyn L, Menez, Steven, Moledina, Dennis G, Mooney, Sean D, O’Toole, John F, Palevsky, Paul M, Parikh, Chirag R, Poggio, Emilio D, Rosas, Sylvia E, Rosengart, Matthew R, Sarwal, Minnie M, Schaub, Jennifer A, Sedor, John R, Sharma, Kumar, Steck, Becky, Toto, Robert D, Troyanskaya, Olga G, Tuttle, Katherine R, Vazquez, Miguel A, Waikar, Sushrut S, Williams, Kayleen, Wilson, Francis Perry, Zhang, Kun, Iyengar, Ravi, Kretzler, Matthias, Himmelfarb, Jonathan, Project, Kidney Precision Medicine, Lecker, Stewart, Stillman, Isaac, Waikar, Sushrut, Mcmahon, Gearoid, Weins, Astrid, Short, Samuel, Hoover, Paul, Aulisio, Mark, Cooperman, Leslie, Herlitz, Leal, O’Toole, John, Poggio, Emilio, Sedor, John, Jolly, Stacey, Appelbaum, Paul, Balderes, Olivia, Barasch, Jonathan, Bomback, Andrew, Canetta, Pietro A, d’Agati, Vivette D, Kudose, Satoru, Mehl, Karla, Radhakrishnan, Jai, Weng, Chenhua, Alexandrov, Theodore, Ashkar, Tarek, Barwinska, Daria, Dagher, Pierre, Dunn, Kenneth, Eadon, Michael, Ferkowicz, Michael, Kelly, Katherine, Sutton, Timothy, Winfree, Seth, Parikh, Chirag, Rosenberg, Avi, Villalobos, Pam, Malik, Rubab, Fine, Derek, Atta, Mohammed, Trujillo, Jose Manuel Monroy, Slack, Alison, Rosas, Sylvia, and Williams, Mark
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Clinical Research ,Transplantation ,Kidney Disease ,Prevention ,Renal and urogenital ,Good Health and Well Being ,Acute Kidney Injury ,Adult ,Humans ,Kidney ,Precision Medicine ,Prospective Studies ,Proteomics ,Renal Insufficiency ,Chronic ,acute kidney injury ,chronic kidney disease ,diabetes ,hypertension ,precision medicine ,Kidney Precision Medicine Project ,Clinical Sciences ,Urology & Nephrology - Abstract
Chronic kidney disease (CKD) and acute kidney injury (AKI) are common, heterogeneous, and morbid diseases. Mechanistic characterization of CKD and AKI in patients may facilitate a precision-medicine approach to prevention, diagnosis, and treatment. The Kidney Precision Medicine Project aims to ethically and safely obtain kidney biopsies from participants with CKD or AKI, create a reference kidney atlas, and characterize disease subgroups to stratify patients based on molecular features of disease, clinical characteristics, and associated outcomes. An additional aim is to identify critical cells, pathways, and targets for novel therapies and preventive strategies. This project is a multicenter prospective cohort study of adults with CKD or AKI who undergo a protocol kidney biopsy for research purposes. This investigation focuses on kidney diseases that are most prevalent and therefore substantially burden the public health, including CKD attributed to diabetes or hypertension and AKI attributed to ischemic and toxic injuries. Reference kidney tissues (for example, living-donor kidney biopsies) will also be evaluated. Traditional and digital pathology will be combined with transcriptomic, proteomic, and metabolomic analysis of the kidney tissue as well as deep clinical phenotyping for supervised and unsupervised subgroup analysis and systems biology analysis. Participants will be followed prospectively for 10 years to ascertain clinical outcomes. Cell types, locations, and functions will be characterized in health and disease in an open, searchable, online kidney tissue atlas. All data from the Kidney Precision Medicine Project will be made readily available for broad use by scientists, clinicians, and patients.
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- 2021
17. Association of Recipient APOL1 Kidney Risk Alleles With Kidney Transplant Outcomes
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Roy, Neil, Morales-Alvarez, M. Catalina, Anis, Karim H., Goral, Simin, Doria, Cataldo, Kopp, Jeffrey B., Winkler, Cheryl A., Feng, Rui, and Rosas, Sylvia E.
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- 2023
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18. Diabetic Kidney Disease: Increasing Hope with Transformative Therapies
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Rosas, Sylvia E., primary and Nasser, Samer, additional
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- 2023
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19. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
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Davies, Melanie J., Aroda, Vanita R., Collins, Billy S., Gabbay, Robert A., Green, Jennifer, Maruthur, Nisa M., Rosas, Sylvia E., Del Prato, Stefano, Mathieu, Chantal, Mingrone, Geltrude, Rossing, Peter, Tankova, Tsvetalina, Tsapas, Apostolos, and Buse, John B.
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- 2022
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20. Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
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Harhay, Meera Nair, Yang, Wei, Sha, Daohang, Roy, Jason, Chai, Boyang, Fischer, Michael J, Hamm, L Lee, Hart, Peter D, Hsu, Chi-yuan, Huan, Yonghong, Huml, Anne M, Kallem, Radhakrishna Reddy, Tamura, Manjula Kurella, Porter, Anna C, Ricardo, Ana C, Slaven, Anne, Rosas, Sylvia E, Townsend, Raymond R, Reese, Peter P, Lash, James P, Akkina, Sanjeev, Investigators, CRIC Study, Appel, Lawrence J, Feldman, Harold I, Go, Alan S, He, Jiang, Kusek, John W, Rao, Panduranga, and Rahman, Mahboob
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Biomedical and Clinical Sciences ,Clinical Sciences ,Kidney Disease ,Clinical Research ,Depression ,Transplantation ,Mental Health ,Organ Transplantation ,Behavioral and Social Science ,Renal and urogenital ,Good Health and Well Being ,CRIC Study Investigators ,Kidney Transplant ,depression ,quality-of-life ,wait-listing ,Clinical sciences - Abstract
Rationale & objectiveAmong individuals with chronic kidney disease (CKD), poor self-reported health is associated with adverse outcomes including hospitalization and death. We sought to examine the association between health-related quality-of-life (HRQoL) and depressive symptoms in advanced CKD and subsequent access to the kidney transplant waiting list.Study designProspective cohort study.Setting & population1,676 Chronic Renal Insufficiency Cohort (CRIC) study participants with estimated glomerular filtration rates ≤ 30 mL/min/1.73 m2 at study entry or during follow-up.ExposuresHRQoL ascertained by 5 scales of the Kidney Disease Quality of Life-36 Survey (Physical Component Summary [PCS], Mental Component Summary, Symptoms, Burdens, and Effects), with higher scores indicating better HRQoL, and depressive symptoms ascertained using the Beck Depression Inventory.OutcomesTime to kidney transplant wait-listing and time to pre-emptive wait-listing.Analytic approachTime-to-event analysis using Cox proportional hazards regression.ResultsDuring a median follow-up of 5.1 years, 652 (39%) participants were wait-listed, of whom 304 were preemptively wait-listed. Adjusted for demographics, comorbid conditions, estimated glomerular filtration rate slope, and cognitive function, participants with the highest scores on the Burden and Effects scales, respectively, had lower rates of wait-listing than those with the lowest scores on the Burden (wait-listing adjusted hazard ratio [aHR], 0.70; 95% CI, 0.57-0.85; P
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- 2020
21. APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO): Design and Rationale
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Freedman, Barry I, Moxey-Mims, Marva M, Alexander, Amir A, Astor, Brad C, Birdwell, Kelly A, Bowden, Donald W, Bowen, Gordon, Bromberg, Jonathan, Craven, Timothy E, Dadhania, Darshana M, Divers, Jasmin, Doshi, Mona D, Eidbo, Elling, Fornoni, Alessia, Gautreaux, Michael D, Gbadegesin, Rasheed A, Gee, Patrick O, Guerra, Giselle, Hsu, Chi-yuan, Iltis, Ana S, Jefferson, Nichole, Julian, Bruce A, Klassen, David K, Koty, Patrick P, Langefeld, Carl D, Lentine, Krista L, Ma, Lijun, Mannon, Roslyn B, Menon, Madhav C, Mohan, Sumit, Moore, J Brian, Murphy, Barbara, Newell, Kenneth A, Odim, Jonah, Ortigosa-Goggins, Mariella, Palmer, Nicholette D, Park, Meyeon, Parsa, Afshin, Pastan, Stephen O, Poggio, Emilio D, Rajapakse, Nishadi, Reeves-Daniel, Amber M, Rosas, Sylvia E, Russell, Laurie P, Sawinski, Deirdre, Smith, S Carrie, Spainhour, Mitzie, Stratta, Robert J, Weir, Matthew R, Reboussin, David M, Kimmel, Paul L, and Brennan, Daniel C
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Clinical Research ,Organ Transplantation ,Transplantation ,Kidney Disease ,Renal and urogenital ,Good Health and Well Being ,African Americans ,APOL1 ,chronic kidney disease ,graft failure ,kidney transplantation ,outcomes - Abstract
IntroductionMuch of the higher risk for end-stage kidney disease (ESKD) in African American individuals relates to ancestry-specific variation in the apolipoprotein L1 gene (APOL1). Relative to kidneys from European American deceased-donors, kidneys from African American deceased-donors have shorter allograft survival and African American living-kidney donors more often develop ESKD. The National Institutes of Health (NIH)-sponsored APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) is prospectively assessing kidney allograft survival from donors with recent African ancestry based on donor and recipient APOL1 genotypes.MethodsAPOLLO will evaluate outcomes from 2614 deceased kidney donor-recipient pairs, as well as additional living-kidney donor-recipient pairs and unpaired deceased-donor kidneys.ResultsThe United Network for Organ Sharing (UNOS), Association of Organ Procurement Organizations, American Society of Transplantation, American Society for Histocompatibility and Immunogenetics, and nearly all U.S. kidney transplant programs, organ procurement organizations (OPOs), and histocompatibility laboratories are participating in this observational study. APOLLO employs a central institutional review board (cIRB) and maintains voluntary partnerships with OPOs and histocompatibility laboratories. A Community Advisory Council composed of African American individuals with a personal or family history of kidney disease has advised the NIH Project Office and Steering Committee since inception. UNOS is providing data for outcome analyses.ConclusionThis article describes unique aspects of the protocol, design, and performance of APOLLO. Results will guide use of APOL1 genotypic data to improve the assessment of quality in deceased-donor kidneys and could increase numbers of transplanted kidneys, reduce rates of discard, and improve the safety of living-kidney donation.
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- 2020
22. Association of Vitamin K Status with Arterial Calcification and Stiffness in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort
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Shea, M. Kyla, Wang, Jifan, Barger, Kathryn, Weiner, Daniel E., Townsend, Raymond R., Feldman, Harold I., Rosas, Sylvia E., Chen, Jing, He, Jiang, Flack, John, Jaar, Bernard G., Kansal, Mayank, and Booth, Sarah L.
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- 2023
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23. Adipokines and coronary artery calcification in incident dialysis participants
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Roy, Neil, Haddad, Danny, Yang, Wei, and Rosas, Sylvia E.
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- 2022
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24. Baseline risk markers and visit-to-visit variability in relation to kidney outcomes – A post-hoc analysis of the PERL study
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Rotbain Curovic, Viktor, Roy, Neil, Hansen, Tine W., Luiza Caramori, M., Cherney, David Z., De Boer, Ian H., Emanuele, Mary Ann, Hirsch, Irl B., Lingvay, Ildiko, Mcgill, Janet B., Polsky, Sarit, Pop-Busui, Rodica, Sigal, Ronald J., Tuttle, Katherine R., Umpierrez, Guillermo E., Wallia, Amisha, Rosas, Sylvia E., and Rossing, Peter
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- 2022
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25. Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)
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de Boer, Ian H., Khunti, Kamlesh, Sadusky, Tami, Tuttle, Katherine R., Neumiller, Joshua J., Rhee, Connie M., Rosas, Sylvia E., Rossing, Peter, and Bakris, George
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- 2022
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26. Incident heart failure in chronic kidney disease: proteomics informs biology and risk stratification.
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Dubin, Ruth F, Deo, Rajat, Ren, Yue, Wang, Jianqiao, Pico, Alexander R, Mychaleckyj, Josyf C, Kozlitina, Julia, Arthur, Victoria, Lee, Hongzhe, Shah, Amil, Feldman, Harold, Bansal, Nisha, Zelnick, Leila, Rao, Panduranga, Sukul, Nidhi, Raj, Dominic S, Mehta, Rupal, Rosas, Sylvia E, Bhat, Zeenat, and Weir, Matthew R
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BRAIN natriuretic factor ,CHRONIC kidney failure ,DISEASE risk factors ,HEART failure ,GLOMERULAR filtration rate - Abstract
Background and Aims Incident heart failure (HF) among individuals with chronic kidney disease (CKD) incurs hospitalizations that burden patients and health care systems. There are few preventative therapies, and the Pooled Cohort equations to Prevent Heart Failure (PCP-HF) perform poorly in the setting of CKD. New drug targets and better risk stratification are urgently needed. Methods In this analysis of incident HF, SomaScan V4.0 (4638 proteins) was analysed in 2906 participants of the Chronic Renal Insufficiency Cohort (CRIC) with validation in the Atherosclerosis Risk in Communities (ARIC) study. The primary outcome was 14-year incident HF (390 events); secondary outcomes included 4-year HF (183 events), HF with reduced ejection fraction (137 events), and HF with preserved ejection fraction (165 events). Mendelian randomization and Gene Ontology were applied to examine causality and pathways. The performance of novel multi-protein risk models was compared to the PCP-HF risk score. Results Over 200 proteins were associated with incident HF after adjustment for estimated glomerular filtration rate at P < 1 × 10
−5 . After adjustment for covariates including N-terminal pro-B-type natriuretic peptide, 17 proteins remained associated at P < 1 × 10−5 . Mendelian randomization associations were found for six proteins, of which four are druggable targets: FCG2B, IGFBP3, CAH6, and ASGR1. For the primary outcome, the C -statistic (95% confidence interval [CI]) for the 48-protein model in CRIC was 0.790 (0.735, 0.844) vs. 0.703 (0.644, 0.762) for the PCP-HF model (P =.001). C -statistic (95% CI) for the protein model in ARIC was 0.747 (0.707, 0.787). Conclusions Large-scale proteomics reveal novel circulating protein biomarkers and potential mediators of HF in CKD. Proteomic risk models improve upon the PCP-HF risk score in this population. [ABSTRACT FROM AUTHOR]- Published
- 2024
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27. Risk factors for progression of coronary artery calcification in patients with chronic kidney disease: The CRIC study
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Bundy, Joshua D, Chen, Jing, Yang, Wei, Budoff, Matthew, Go, Alan S, Grunwald, Juan E, Kallem, Radhakrishna R, Post, Wendy S, Reilly, Muredach P, Ricardo, Ana C, Rosas, Sylvia E, Zhang, Xiaoming, He, Jiang, and Investigators, the CRIC Study
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Prevention ,Heart Disease - Coronary Heart Disease ,Kidney Disease ,Heart Disease ,Cardiovascular ,Atherosclerosis ,Renal and urogenital ,Good Health and Well Being ,Adult ,Aged ,Biomarkers ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Disease Progression ,Female ,Glomerular Filtration Rate ,Humans ,Incidence ,Kidney ,Male ,Middle Aged ,Multidetector Computed Tomography ,Prospective Studies ,Renal Insufficiency ,Chronic ,Risk Assessment ,Risk Factors ,Time Factors ,United States ,Vascular Calcification ,Young Adult ,Coronary artery disease ,Chronic kidney disease ,Risk factors ,Epidemiology ,CRIC Study Investigators ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
BACKGROUND AND AIMS:Coronary artery calcification (CAC) is common among patients with chronic kidney disease (CKD) and predicts the risk for cardiovascular disease (CVD). We examined the associations of novel risk factors with CAC progression among patients with CKD. METHODS:Among 1123 CKD patients in the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured in Agatston units at baseline and a follow-up visit using electron beam computed tomography or multidetector computed tomography. RESULTS:Over an average 3.3-year follow-up, 109 (25.1%) participants without CAC at baseline had incident CAC and 124 (18.0%) participants with CAC at baseline had CAC progression, defined as an annual increase of ≥100 Agatston units. After adjustment for established atherosclerotic risk factors, several novel risk factors were associated with changes in CAC over follow-up. Changes in square root transformed CAC score associated with 1 SD greater level of risk factors were -0.20 (95% confidence interval, -0.31 to -0.10; p < 0.001) for estimated glomerular filtration rate, 0.14 (0.02-0.25; p = 0.02) for 24-h urine albumin, 0.25 (0.15-0.34; p < 0.001) for cystatin C, -0.17 (-0.27 to -0.07; p < 0.001) for serum calcium, 0.14 (0.03-0.24; p = 0.009) for serum phosphate, 0.24 (0.14-0.33; p < 0.001) for fibroblast growth factor-23, 0.13 (0.04-0.23; p = 0.007) for total parathyroid hormone, 0.17 (0.07-0.27; p < 0.001) for interleukin-6, and 0.12 (0.02-0.22; p = 0.02) for tumor necrosis factor-α. CONCLUSIONS:Reduced kidney function, calcium and phosphate metabolism disorders, and inflammation, independent of established CVD risk factors, may progress CAC among CKD patients.
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- 2018
28. Cadherin-11, Sparc-related modular calcium binding protein-2, and Pigment epithelium-derived factor are promising non-invasive biomarkers of kidney fibrosis
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Knight, Richard, Lecker, Stewart H., Stillman, Isaac, Bogen, Steve, Amodu, Afolarin A., Ilori, Titlayo, Maikhor, Shana, Schmidt, Insa M., Beck, Laurence H., Henderson, Joel M., Onul, Ingrid, Verma, Ashish, McMahon, Gearoid M., Valerius, M. Todd, Waikar, Sushrut, Weins, Astrid, Colona, Mia R., Greka, Anna, Hacohen, Nir, Hoover, Paul J., Marshall, Jamie L., Aulisio, Mark, Chen, Yijiang M., Janowczyk, Andrew, Jayapandian, Catherine, Viswanathan, Vidya S., Bush, William S., Crawford, Dana C., Madabhushi, Anant, Bush, Lakeshia, Cooperman, Leslie, Gonzalez-Vicente, Agustin, Herlitz, Leal, Jolly, Stacey, Nguyen, Jane, O’toole, John, Palmer, Ellen, Poggio, Emilio, Sedor, John, Sendrey, Dianna, Spates-Harden, Kassandra, Taliercio, Jonathan, Bjornstad, Petter M., Pyle, Laura, Vinovskis, Carissa, Appelbaum, Paul, Balderes, Olivia, Barasch, Jonathan M., Bomback, Andrew S., Canetta, Pietro A., D’Agati, Vivette D., Kiryluk, Krzysztof, Kudose, Satoru, Mehl, Karla, Shang, Ning, Bansal, Shweta, Alexandrov, Theodore, Rennke, Helmut, El-Achkar, Tarek M., Barwinska, Daria, Bledso, Sharon, Borner, Katy, Bueckle, Andreas, Cheng, Yinghua, Dagher, Pierre C., Dunn, Kenneth W., Eadon, Michael T., Ferkowicz, Michael J., Herr, Bruce W., Kelly, Katherine J., Ferreira, Ricardo Melo, Quardokus, Ellen M., Record, Elizabeth, Rivera, Marcelino, Su, Jing, Sutton, Timothy A., Williams, James C., Jr., Winfree, Seth, Jain, Yashvardhan, Menez, Steven, Parikh, Chirag R., Rosenberg, Avi, Corona-Villalobos, Celia P., Wen, Yumeng, Johansen, Camille, Rosas, Sylvia E., Roy, Neil, Sun, Jennifer, Williams, Mark, Azeloglu, Evren U., Hansen, Jens, He, Cijang, Iyengar, Ravi, Xiong, Yuguang, Prasad, Pottumarthi, Srivastava, Anand, Madhavan, Sethu M., Parikh, Samir, Rovin, Brad, Shapiro, John P., Anderton, Christopher R., Lukowski, Jessica, Pasa-Tolic, Ljiljana, Velickovic, Dusan, Oliver, George (Holt), Ardayfio, Joseph, Bebiak, Jack, Brown, Keith, Campbell, Taneisha, Campbell, Catherine E., Hayashi, Lynda, Jefferson, Nichole, Roberts, Glenda V., Saul, John, Shpigel, Anna, Stutzke, Christy, Koewler, Robert, Pinkeney, Roy, Sealfon, Rachel, Troyanskaya, Olga, Wong, Aaron, Tuttle, Katherine R., Pollack, Ari, Goltsev, Yury, Ginley, Brandon, Lucarelli, Nicholas, Lutnick, Brendon, Sarder, Pinaki, Lake, Blue B., Zhang, Kun, Boada, Patrick, Laszik, Zoltan G., Nolan, Garry, Anjani, Kavya, Sarwal, Minnie, Mukatash, Tariq, Sigdel, Tara, Alloway, Rita R., Burg, Ashley R., Lee, Paul J., Rike, Adele, Shi, Tiffany, Woodle, E. Steve, Ascani, Heather, Balis, Ulysses G.J., Blanc, Victoria M., Conser, Ninive C., Eddy, Sean, Frey, Renee, He, Yougqun, Hodgin, Jeffrey B., Kretzler, Matthias, Lienczewski, Chrysta, Luo, Jinghui, Mariani, Laura H., Menon, Rajasree, Otto, Edgar, Schaub, Jennifer, Steck, Becky, Elder, Michele M., Gilliam, Matthew, Hall, Daniel E., Murugan, Raghavan, Palevsky, Paul M., Randhawa, Parmjeet, Rosengart, Matthew, Tublin, Mitchell, Vita, Tina, Winters, James, Kellum, John A., Alpers, Charles E., Berglund, Ashley, Berry, Brooke, Blank, Kristina N., Carson, Jonas, Daniel, Stephen, De Boer, Ian H., Dighe, Ashveena L., Dowd, Frederick, Grewenow, Stephanie M., Himmelfarb, Jonathan, Hoofnagle, Andrew N., Limonte, Christine, McClelland, Robyn L., Mooney, Sean D., Rezaei, Kasra, Shankland, Stuart, Snyder, Jamie, Wang, Ruikang, Wilcox, Adam, Williams, Kayleen, Park, Christopher, Montellano, Richard, Pamreddy, Annapurna, Sharma, Kumar, Venkatachalam, Manjeri, Ye, Hongping, Zhang, Guanshi, Basit, Mujeeb, Hedayati, S. Susan, Kermani, Asra, Lee, Simon C., Lu, Christopher Y., Miller, R. Tyler, Moe, Orson W., Patel, Jiten, Pillai, Anil, Sambandam, Kamalanathan, Torrealba, Jose, Toto, Robert D., Vazquez, Miguel, Wang, Nancy, Wen, Natasha, Zhang, Dianbo, Park, Harold, Caprioli, Richard M., Patterson, Nathan, Sharman, Kavya, Spraggins, Jeffrey M., Van de Plas, Raf, Basta, Jeanine, Diettman, Sabine M., Gaut, Joseph P., Jain, Sanjay, Rauchman, Michael I., Vijayan, Anitha, Cantley, Lloyd G., Kakade, Vijaykumar R., Moledina, Dennis, Shaw, Melissa M., Ugwuowo, Ugochukwu, Wilson, Francis P., Arora, Tanima, Kestenbaum, Bryan R., Alexopoulos, Leonidas G., Palsson, Ragnar, Liu, Jing, Stillman, Isaac E., Rennke, Helmut G., Vaidya, Vishal S., Wu, Haojia, Humphreys, Benjamin D., and Waikar, Sushrut S.
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- 2021
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29. Coronary Artery Calcification and Risk of Cardiovascular Disease and Death Among Patients With Chronic Kidney Disease
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Chen, Jing, Budoff, Matthew J, Reilly, Muredach P, Yang, Wei, Rosas, Sylvia E, Rahman, Mahboob, Zhang, Xiaoming, Roy, Jason A, Lustigova, Eva, Nessel, Lisa, Ford, Virginia, Raj, Dominic, Porter, Anna C, Soliman, Elsayed Z, Wright, Jackson T, Wolf, Myles, and He, Jiang
- Subjects
Heart Disease ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Prevention ,Kidney Disease ,Aging ,Cardiovascular ,Atherosclerosis ,Renal and urogenital ,Good Health and Well Being ,Adult ,Aged ,Cardiovascular Diseases ,Cause of Death ,Cohort Studies ,Comorbidity ,Coronary Artery Disease ,Female ,Heart Failure ,Humans ,Incidence ,Male ,Middle Aged ,Mortality ,Myocardial Infarction ,Proportional Hazards Models ,Prospective Studies ,Renal Insufficiency ,Chronic ,Risk Assessment ,Risk Factors ,Tomography ,X-Ray Computed ,Vascular Calcification ,Young Adult ,CRIC Investigators - Abstract
ImportanceCoronary artery calcification (CAC) is highly prevalent in dialysis-naive patients with chronic kidney disease (CKD). However, there are sparse data on the association of CAC with subsequent risk of cardiovascular disease and all-cause mortality in this population.ObjectiveTo study the prospective association of CAC with risk of cardiovascular disease and all-cause mortality among dialysis-naive patients with CKD.Design, setting, and participantsThe prospective Chronic Renal Insufficiency Cohort study recruited adults with an estimated glomerular filtration rate of 20 to 70 mL/min/1.73 m2 from 7 clinical centers in the United States. There were 1541 participants without cardiovascular disease at baseline who had CAC scores.ExposuresCoronary artery calcification was assessed using electron-beam or multidetector computed tomography.Main outcomes and measuresIncidence of cardiovascular disease (including myocardial infarction, heart failure, and stroke) and all-cause mortality were reported every 6 months and confirmed by medical record adjudication.ResultsDuring an average follow-up of 5.9 years in 1541 participants aged 21 to 74 years, there were 188 cardiovascular disease events (60 cases of myocardial infarction, 120 heart failures, and 27 strokes; patients may have had >1 event) and 137 all-cause deaths. In Cox proportional hazards models adjusted for age, sex, race, clinical site, education level, physical activity, total cholesterol level, high-density lipoprotein cholesterol level, systolic blood pressure, use of antihypertensive treatment, current cigarette smoking, diabetes status, body mass index, C-reactive protein level, hemoglobin A1c level, phosphorus level, troponin T level, log N-terminal pro-B-type natriuretic peptide level, fibroblast growth factor 23 level, estimated glomerular filtration rate, and proteinuria, the hazard ratios associated with per 1 SD log of CAC were 1.40 (95% CI, 1.16-1.69; P
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- 2017
30. Inflammatory Markers and Risk for Cognitive Decline in Chronic Kidney Disease: The CRIC Study.
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Kurella Tamura, Manjula, Tam, Karman, Vittinghoff, Eric, Raj, Dominic, Sozio, Stephen M, Rosas, Sylvia E, Makos, Gail, Lora, Claudia, He, Jiang, Go, Alan S, Hsu, Chi-Yuan, Yaffe, Kristine, and CRIC Study Investigators
- Subjects
CRIC Study Investigators ,aging ,chronic kidney disease ,cognitive decline ,dementia ,epidemiology ,inflammation - Abstract
IntroductionChronic kidney disease (CKD) is associated with an increased risk of cognitive decline, but the mechanisms remain poorly defined. We sought to determine the relation between serum inflammatory markers and risk of cognitive decline among adults with CKD.MethodsWe studied 757 adults aged ≥55 years with CKD participating in the Chronic Renal Insufficiency Cohort Cognitive study. We measured interleukin (IL)-1β, IL-1 receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP), and fibrinogen in baseline plasma samples. We assessed cognitive function at regular intervals in 4 domains and defined incident impairment as a follow-up score more than 1 SD poorer than the group mean.ResultsThe mean age of the sample was 64.3 ± 5.6 years, and the mean follow-up was 6.2 ± 2.5 years. At baseline, higher levels of each inflammatory marker were associated with poorer age-adjusted performance. In analyses adjusted for baseline cognition, demographics, comorbid conditions, and kidney function, participants in the highest tertile of hs-CRP, the highest tertile of fibrinogen, and the highest tertile of IL-1β had an increased risk of impairment in attention compared to participants in the lowest tertile of each marker. Participants in the highest versus lowest tertile of TNF-α had a lower adjusted risk of impairment in executive function. There was no association between other inflammatory markers and change in cognitive function.DiscussionAmong adults with CKD, higher levels of hs-CRP, fibrinogen, and IL-1β were associated with a higher risk of impairment in attention. Higher levels of TNF-α were associated with a lower risk of impaired executive function.
- Published
- 2017
31. How Would You Manage This Patient With Type 2 Diabetes and Chronic Kidney Disease? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
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Smetana, Gerald W., Romeo, Giulio R., Rosas, Sylvia E., and Burns, Risa B.
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ENDOCRINOLOGISTS ,CHRONIC kidney failure ,NEPHROLOGISTS ,TYPE 2 diabetes ,GLUCAGON-like peptide 1 ,ACE inhibitors ,DIABETIC nephropathies ,MEDICAL centers - Abstract
Most patients with type 2 diabetes receive their care from primary care physicians. The recent emergence of novel agents that reduce chronic kidney disease progression or mortality creates new challenges in type 2 diabetes care. Here, an endocrinologist and a nephrologist discuss and debate current approaches to screening and management, including the use of new drugs and the roles of primary care and subspecialty physicians in management of type 2 diabetes. Nearly 15% of U.S. adults have diabetes; type 2 diabetes (T2D) accounts for more than 90% of cases. Approximately one third of all patients with diabetes will develop chronic kidney disease (CKD). All patients with T2D should be screened annually for CKD with both a urine albumin–creatinine ratio and an estimated glomerular filtration rate. Research into strategies to slow the worsening of CKD and reduce renal and cardiovascular morbidity in patients with T2D and CKD has evolved substantially. In 2022, a consensus statement from the American Diabetes Association and the Kidney Disease: Improving Global Outcomes recommended prioritizing the use of sodium–glucose cotransporter-2 inhibitors and metformin and included guidance for add-on therapy with glucagon-like peptide 1 receptors agonists for most patients whose first-line therapy failed. It also recommended nonsteroidal mineralocorticoid receptor antagonists for patients with hypertension that is not adequately controlled with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Here, an endocrinologist and a nephrologist discuss the care of patients with T2D and CKD and how they would apply the consensus statement to the care of an individual patient with T2D who is unaware that he has CKD. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
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Appel, Lawrence J., Feldman, Harold I., Go, Alan S., He, Jiang, Kusek, John W., Rao, Panduranga, Rahman, Mahboob, Harhay, Meera Nair, Yang, Wei, Sha, Daohang, Roy, Jason, Chai, Boyang, Fischer, Michael J., Hamm, L. Lee, Hart, Peter D., Hsu, Chi-yuan, Huan, Yonghong, Huml, Anne M., Kallem, Radhakrishna Reddy, Tamura, Manjula Kurella, Porter, Anna C., Ricardo, Ana C., Slaven, Anne, Rosas, Sylvia E., Townsend, Raymond R., Reese, Peter P., Lash, James P., and Akkina, Sanjeev
- Published
- 2020
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33. Vitamin D Analogues and Coronary Calcification in CKD Stages 3 and 4: A Randomized Controlled Trial of Calcitriol Versus Paricalcitol
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Anis, Karim H., Pober, David, and Rosas, Sylvia E.
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- 2020
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34. Prevalence, Awareness, and Treatment of Hypertension in Hispanics/Latinos With CKD in the Hispanic Community Health Study/Study of Latinos
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Lora, Claudia M., Ricardo, Ana C., Chen, Jinsong, Franceschini, Nora, Kramer, Holly J., Melamed, Michal L., Raij, Leopoldo, Rosas, Sylvia E., Schneiderman, Neil, Daviglus, Martha, and Lash, James P.
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- 2020
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35. Meta-analyses identify DNA methylation associated with kidney function and damage
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Schlosser, Pascal, Tin, Adrienne, Matias-Garcia, Pamela R., Thio, Chris H. L., Joehanes, Roby, Liu, Hongbo, Weihs, Antoine, Yu, Zhi, Hoppmann, Anselm, Grundner-Culemann, Franziska, Min, Josine L., Adeyemo, Adebowale A., Agyemang, Charles, Ärnlöv, Johan, Aziz, Nasir A., Baccarelli, Andrea, Bochud, Murielle, Brenner, Hermann, Breteler, Monique M. B., Carmeli, Cristian, Chaker, Layal, Chambers, John C., Cole, Shelley A., Coresh, Josef, Corre, Tanguy, Correa, Adolfo, Cox, Simon R., de Klein, Niek, Delgado, Graciela E., Domingo-Relloso, Arce, Eckardt, Kai-Uwe, Ekici, Arif B., Endlich, Karlhans, Evans, Kathryn L., Floyd, James S., Fornage, Myriam, Franke, Lude, Fraszczyk, Eliza, Gao, Xu, Gào, Xīn, Ghanbari, Mohsen, Ghasemi, Sahar, Gieger, Christian, Greenland, Philip, Grove, Megan L., Harris, Sarah E., Hemani, Gibran, Henneman, Peter, Herder, Christian, Horvath, Steve, Hou, Lifang, Hurme, Mikko A., Hwang, Shih-Jen, Jarvelin, Marjo-Riitta, Kardia, Sharon L. R., Kasela, Silva, Kleber, Marcus E., Koenig, Wolfgang, Kooner, Jaspal S., Kramer, Holly, Kronenberg, Florian, Kühnel, Brigitte, Lehtimäki, Terho, Lind, Lars, Liu, Dan, Liu, Yongmei, Lloyd-Jones, Donald M., Lohman, Kurt, Lorkowski, Stefan, Lu, Ake T., Marioni, Riccardo E., März, Winfried, McCartney, Daniel L., Meeks, Karlijn A. C., Milani, Lili, Mishra, Pashupati P., Nauck, Matthias, Navas-Acien, Ana, Nowak, Christoph, Peters, Annette, Prokisch, Holger, Psaty, Bruce M., Raitakari, Olli T., Ratliff, Scott M., Reiner, Alex P., Rosas, Sylvia E., Schöttker, Ben, Schwartz, Joel, Sedaghat, Sanaz, Smith, Jennifer A., Sotoodehnia, Nona, Stocker, Hannah R., Stringhini, Silvia, Sundström, Johan, Swenson, Brenton R., Tellez-Plaza, Maria, van Meurs, Joyce B. J., van Vliet-Ostaptchouk, Jana V., Venema, Andrea, Verweij, Niek, Walker, Rosie M., Wielscher, Matthias, Winkelmann, Juliane, Wolffenbuttel, Bruce H. R., Zhao, Wei, Zheng, Yinan, Loh, Marie, Snieder, Harold, Levy, Daniel, Waldenberger, Melanie, Susztak, Katalin, Köttgen, Anna, and Teumer, Alexander
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- 2021
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36. Association of elevated serum aminotransferase levels with chronic kidney disease measures: hispanic community health study/study of latinos
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Missikpode, Celestin, Kramer, Holly, Cotler, Scott J., Durazo-Arvizu, Ramon, Lash, James P., Kallwitz, Eric, Cai, Jianwen, Kuniholm, Mark H., Rosas, Sylvia E., Ricardo, Ana C., Talavera, Gregory A., Raij, Leopoldo, Pirzada, Amber, and Daviglus, Martha L.
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- 2021
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37. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure
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Mishra, Rakesh K, Yang, Wei, Roy, Jason, Anderson, Amanda H, Bansal, Nisha, Chen, Jing, DeFilippi, Christopher, Delafontaine, Patrice, Feldman, Harold I, Kallem, Radhakrishna, Kusek, John W, Lora, Claudia M, Rosas, Sylvia E, Go, Alan S, and Shlipak, Michael G
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Biomedical and Clinical Sciences ,Clinical Sciences ,Kidney Disease ,Heart Disease ,Clinical Research ,Cardiovascular ,2.1 Biological and endogenous factors ,Aetiology ,Renal and urogenital ,Adult ,Aged ,Biomarkers ,Cardiomyopathies ,Chi-Square Distribution ,Disease Progression ,Female ,Heart Failure ,Hospitalization ,Humans ,Hypertrophy ,Left Ventricular ,Incidence ,Logistic Models ,Male ,Middle Aged ,Multivariate Analysis ,Myocardial Contraction ,Natriuretic Peptide ,Brain ,Odds Ratio ,Peptide Fragments ,Proportional Hazards Models ,Prospective Studies ,Renal Insufficiency ,Chronic ,Risk Assessment ,Risk Factors ,Surveys and Questionnaires ,Time Factors ,United States ,Ventricular Dysfunction ,Left ,Ventricular Function ,Left ,Young Adult ,heart failure ,hospitalization ,renal insufficiency ,chronic ,CRIC Study Investigators ,Biochemistry and Cell Biology ,Cardiorespiratory Medicine and Haematology ,Medical Physiology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Medical physiology - Abstract
BackgroundChronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF.Methods and resultsWe studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4).ConclusionsSymptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors.
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- 2015
38. Urine Neutrophil Gelatinase-Associated Lipocalin and Risk of Cardiovascular Disease and Death in CKD: Results From the Chronic Renal Insufficiency Cohort (CRIC) Study
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Liu, Kathleen D, Yang, Wei, Go, Alan S, Anderson, Amanda H, Feldman, Harold I, Fischer, Michael J, He, Jiang, Kallem, Radhakrishna R, Kusek, John W, Master, Stephen R, Miller, Edgar R, Rosas, Sylvia E, Steigerwalt, Susan, Tao, Kaixiang, Weir, Matthew R, Hsu, Chi-yuan, and Investigators, CRIC Study
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Biomedical and Clinical Sciences ,Clinical Sciences ,Cardiovascular ,Atherosclerosis ,Prevention ,Heart Disease ,Clinical Research ,Kidney Disease ,Renal and urogenital ,Good Health and Well Being ,Acute-Phase Proteins ,Adult ,Aged ,Biomarkers ,Cardiovascular Diseases ,Cohort Studies ,Female ,Follow-Up Studies ,Humans ,Lipocalin-2 ,Lipocalins ,Male ,Middle Aged ,Mortality ,Proto-Oncogene Proteins ,Renal Insufficiency ,Chronic ,Risk Factors ,Neutrophil gelatinase-associated lipocalin ,renal tubular injury ,renal tubular dysfunction ,biomarker ,chronic kidney disease ,Chronic Renal Insufficiency Cohort (CRIC) Study ,cardiovascular disease ,ischemic atherosclerotic event ,CRIC Study Investigators ,Public Health and Health Services ,Urology & Nephrology ,Clinical sciences - Abstract
BackgroundChronic kidney disease is common and is associated with increased cardiovascular disease risk. Currently, markers of renal tubular injury are not used routinely to describe kidney health and little is known about the risk of cardiovascular events and death associated with these biomarkers independent of glomerular filtration-based markers (such as serum creatinine or albuminuria).Study designCohort study, CRIC (Chronic Renal Insufficiency Cohort) Study.Setting & participants3,386 participants with estimated glomerular filtration rate of 20 to 70mL/min/1.73m(2) enrolled from June 2003 through August 2008.PredictorUrine neutrophil gelatinase-associated lipocalin (NGAL) concentration.OutcomesAdjudicated heart failure event, ischemic atherosclerotic event (myocardial infarction, ischemic stroke, or peripheral artery disease), and death through March 2011.MeasurementsUrine NGAL measured at baseline with a 2-step assay using chemiluminescent microparticle immunoassay technology on an ARCHITECT i2000SR (Abbott Laboratories).ResultsThere were 428 heart failure events (during 16,383 person-years of follow-up), 361 ischemic atherosclerotic events (during 16,584 person-years of follow-up), and 522 deaths (during 18,214 person-years of follow-up). In Cox regression models adjusted for estimated glomerular filtration rate, albuminuria, demographics, traditional cardiovascular disease risk factors, and cardiac medications, higher urine NGAL levels remained associated independently with ischemic atherosclerotic events (adjusted HR for the highest [>49.5ng/mL] vs lowest [≤6.9ng/mL] quintile, 1.83 [95% CI, 1.20-2.81]; HR per 0.1-unit increase in log urine NGAL, 1.012 [95% CI, 1.001-1.023]), but not heart failure events or deaths.LimitationsUrine NGAL was measured only once.ConclusionsAmong patients with chronic kidney disease, urine levels of NGAL, a marker of renal tubular injury, were associated independently with future ischemic atherosclerotic events, but not with heart failure events or deaths.
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- 2015
39. Subclinical atherosclerosis measures for cardiovascular prediction in CKD.
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Matsushita, Kunihiro, Sang, Yingying, Ballew, Shoshana H, Shlipak, Michael, Katz, Ronit, Rosas, Sylvia E, Peralta, Carmen A, Woodward, Mark, Kramer, Holly J, Jacobs, David R, Sarnak, Mark J, and Coresh, Josef
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Coronary Vessels ,Humans ,Cardiovascular Diseases ,Coronary Disease ,Calcium ,Incidence ,Proportional Hazards Models ,Risk Factors ,Case-Control Studies ,Retrospective Studies ,Follow-Up Studies ,Predictive Value of Tests ,Aged ,Aged ,80 and over ,Middle Aged ,Female ,Male ,Renal Insufficiency ,Chronic ,Coronary Artery Disease ,Heart Failure ,Stroke ,Ankle Brachial Index ,Peripheral Arterial Disease ,Carotid Intima-Media Thickness ,CKD ,arteriosclerosis ,cardiovascular disease ,coronary calcification ,and over ,Renal Insufficiency ,Chronic ,Urology & Nephrology ,Clinical Sciences - Abstract
Whether inclusion of the coronary artery calcium score improves cardiovascular risk prediction in individuals with CKD, a population with unique calcium-phosphate homeostasis, is unknown. Among 6553 participants ages 45-84 years without prior cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis, coronary artery calcium score was assessed for cardiovascular risk prediction beyond the Framingham predictors in those with (n=1284) and without CKD and contrasted with carotid intima-media thickness and ankle-brachial index (two other measures of subclinical atherosclerosis). During a median follow-up of 8.4 years, 650 cardiovascular events (coronary heart disease, stroke, heart failure, and peripheral artery disease) occurred (236 events in subjects with CKD). In Cox proportional hazards models adjusted for Framingham predictors, each subclinical measure was independently associated with cardiovascular outcomes, with larger adjusted hazard ratios (HRs; per 1 SD) for coronary artery calcium score than carotid intima-media thickness or ankle-brachial index in subjects without and with CKD (HR, 1.69; 95% confidence interval [95% CI], 1.45 to 1.97 versus HR, 1.12; 95% CI, 1.00 to 1.25 and HR, 1.20; 95% CI, 1.08 to 1.32, respectively). Compared with inclusion of carotid intima-media thickness or ankle-brachial index, inclusion of the coronary artery calcium score led to greater increases in C statistic for predicting cardiovascular disease and net reclassification improvement. Coronary artery calcium score performed best for the prediction of coronary heart disease and heart failure, regardless of CKD status. In conclusion, each measure improved cardiovascular risk prediction in subjects with CKD, with the greatest improvement observed with coronary artery calcium score.
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- 2015
40. Hepatitis C infection and chronic kidney disease among Hispanics/Latinos
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Wong, Eugenia, Ricardo, Ana C., Rosas, Sylvia E., Lash, James P., and Franceschini, Nora
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- 2021
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41. Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)
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Dubin, Ruth F, Li, Yongmei, He, Jiang, Jaar, Bernard G, Kallem, Radhakrishna, Lash, James P, Makos, Gail, Rosas, Sylvia E, Soliman, Elsayed Z, Townsend, Ray R, Yang, Wei, Go, Alan S, Keane, Martin, deFilippi, Christopher, Mishra, Rakesh, Wolf, Myles, and Shlipak, Michael G
- Abstract
Abstract Background Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD). Methods We studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio. Results Hs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT. Conclusions Knowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.
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- 2013
42. Acculturation and chronic kidney disease in the Hispanic community health study/study of Latinos (HCHS/SOL)
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Lora, Claudia M., Ricardo, Ana C., Chen, Jinsong, Cai, Jianwen, Flessner, Michael, Moncrieft, Ashley, Peralta, Carmen, Raij, Leopoldo, Rosas, Sylvia E., Talavera, Gregory A., Daviglus, Martha L., and Lash, James P.
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- 2018
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43. Risk factors for progression of coronary artery calcification in patients with chronic kidney disease: The CRIC study
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Bundy, Joshua D., Chen, Jing, Yang, Wei, Budoff, Matthew, Go, Alan S., Grunwald, Juan E., Kallem, Radhakrishna R., Post, Wendy S., Reilly, Muredach P., Ricardo, Ana C., Rosas, Sylvia E., Zhang, Xiaoming, and He, Jiang
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- 2018
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44. AACC/NKF Guidance Document on Improving Equity in Chronic Kidney Disease Care
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Pierre, Christina C, primary, Marzinke, Mark A, additional, Ahmed, Sofia B, additional, Collister, David, additional, Colón-Franco, Jessica M, additional, Hoenig, Melanie P, additional, Lorey, Thomas, additional, Palevsky, Paul M, additional, Palmer, Octavia Peck, additional, Rosas, Sylvia E, additional, Vassalotti, Joseph, additional, Whitley, Cameron T, additional, and Greene, Dina N, additional
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- 2023
- Full Text
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45. Perspectives on Chronic Kidney Disease With Type 2 Diabetes and Risk Management: Practical Viewpoints and a Paradigm Shift Using a Pillar Approach
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Morales, Javier, primary, Dagogo-Jack, Sam, additional, Fonseca, Vivian, additional, Neumiller, Joshua J., additional, and Rosas, Sylvia E., additional
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- 2023
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46. A Call for a National Policy of Scheduled Dialysis and Transplantation for All People With Kidney Failure Living in the United States
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Morales Alvarez, M. Catalina, primary and Rosas, Sylvia E., additional
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- 2023
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47. Kidney Disease in Obesity and Metabolic Syndrome
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William, Jeffrey H., Kramer, Holly, Rosas, Sylvia E., and Ahima, Rexford S., editor
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- 2016
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48. Defining the molecular correlate of arteriolar hyalinosis in kidney disease progression by integration of single cell transcriptomic analysis and pathology scoring
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Menon, Rajasree, Otto, Edgar A., Barisoni, Laura, Ferreira, Ricardo Melo, Limonte, Christine P., Godfrey, Bradley, Eichinger, Felix, Nair, Viji, Naik, Abhijit S., Subramanian, Lalita, D’Agati, Vivette, Henderson, Joel M., Herlitz, Leal, Kiryluk, Krzysztof, Moledina, Dennis G., Moeckel, Gilbert W., Palevsky, Paul M., Parikh, Chirag R., Randhawa, Parmjeet, Rosas, Sylvia E., Rosenberg, Avi Z., Stillman, Isaac, Toto, Robert, Torrealba, Jose, Vazquez, Miguel A., Waikar, Sushrut, Alpers, Charles E., Nelson, Robert G., Eadon, Michael T., Kretzler, Matthias, and Hodgin, Jeffrey B.
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Article - Abstract
Arteriolar hyalinosis in kidneys is an independent predictor of cardiovascular disease, the main cause of mortality in chronic kidney disease (CKD). The underlying molecular mechanisms of protein accumulation in the subendothelial space are not well understood. Using single cell transcriptomic data and whole slide images from kidney biopsies of patients with CKD and acute kidney injury in the Kidney Precision Medicine Project, the molecular signals associated with arteriolar hyalinosis were evaluated. Co-expression network analysis of the endothelial genes yielded three gene set modules as significantly associated with arteriolar hyalinosis. Pathway analysis of these modules showed enrichment of transforming growth factor beta / Bone morphogenetic protein (TGFβ / BMP) and vascular endothelial growth factor (VEGF) signaling pathways in the endothelial cell signatures. Ligand-receptor analysis identified multiple integrins and cell adhesion receptors as over-expressed in arteriolar hyalinosis, suggesting a potential role of integrin-mediated TGFβ signaling in arteriolar hyalinosis. Further analysis of arteriolar hyalinosis associated endothelial module genes identified focal segmental glomerular sclerosis as an enriched term. On validation in gene expression profiles from the Nephrotic Syndrome Study Network cohort, one of the three modules was significantly associated with the composite endpoint (> 40% reduction in estimated glomerular filtration rate (eGFR) or kidney failure) independent of age, sex, race, and baseline eGFR, suggesting poor prognosis with elevated expression of genes in this module. Thus, integration of structural and single cell molecular features yielded biologically relevant gene sets, signaling pathways and ligand-receptor interactions, underlying arteriolar hyalinosis and putative targets for therapeutic intervention.
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- 2023
49. Abstract P387: Effects of Reduced Dietary Sodium and the Dash Diet on Glomerular Filtration Rate: Results From the Dash-Sodium Trial
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Morales-Alvarez, M. Catalina, primary, Nissaisorakarn, Voravech, additional, Appel, Lawrence J, additional, Miller, Edgar R, additional, Christenson, Robert H, additional, Rebuck, Heather, additional, Rosas, Sylvia E, additional, William, Jeffrey H, additional, and Juraschek, Stephen P, additional
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- 2023
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50. Front Cover
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Rossing, Peter, primary, Garweg, Justus G., additional, Anker, Stefan D., additional, Osonoi, Takeshi, additional, Pitt, Bertram, additional, Rosas, Sylvia E., additional, Ruilope, Luis Miguel, additional, Zhu, Dalong, additional, Brinker, Meike, additional, Finis, David, additional, Leal, Sergio, additional, Schmelter, Thomas, additional, and Bakris, George, additional
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- 2023
- Full Text
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