Anemia, Author Interviews, Kidney Disease, Transfusions / 28.05.2014

MedicalResearch.com Interview with: David T. Gilbertson, Ph.D. Chronic Disease Research Group Center for Observational Research, Amgen, Inc, Thousand Oaks, CA MedicalResearch: What were the main findings of the study? Dr. Gilbertson: Since transfusion avoidance is important in patients receiving maintenance hemodialysis, development of a measure of red blood cell transfusion use to assess dialysis facility anemia management is reasonable. Because dialysis facility size varies widely, calculation of a standardized transfusion ratio (STfR) using standard methods is possible, but these methods result in significant instability in estimates for small dialysis facilities. Use of more advanced statistical methods results in standardized transfusion ratio estimates that are considerably more stable and more consistently precise across dialysis facilities of all sizes. (more…)
Author Interviews, Kidney Disease, Mayo Clinic, Rheumatology / 11.04.2014

Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com Interview with: Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com: What are the main findings of the study? Dr. Matteson: “The main points are that kidney disease is more common in patients with rheumatoid arthritis than in the general population and that moderate reduction in kidney function was more likely to be associated with cardiovascular disease in these patients as well. Patients with more active disease week are also at higher risk for kidney disease. “ (more…)
Author Interviews, Heart Disease, Kidney Disease / 06.04.2014

Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The NetherlandsMedicalResearch.com Interview with: Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The Netherlands   MedicalResearch.com: What are the main findings of the study? Dr. Kooiman: The main finding of our study is that trans radial PCI (TRI) is associated with a significantly lower risk of AKI compared with trans femoral PCI (TFI), after adjustment for confounding factors. (more…)
Author Interviews, Diabetes, Kidney Disease / 30.03.2014

Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical School and Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston. Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston.   MedicalResearch.com: What are the main findings of the study? Dr. Fiorina: It is common knowledge that type 2 diabetes is a worldwide epidemic and that diabetic nephropathy has become the leading cause of renal failure in the western world. One of the main drivers and worsening factors for the diabetic kidney disease is proteinuria associated with various degrees of tubular damage, and unfortunately, therapies to halt or prevent this complication are not available so far. Our findings show that B7-1 when expressed on podocytes (a specific subset of renal cells) determines alterations in podocytes function and morphology, predisposing individuals with T2D to the loss of proteins into the urine. We also demonstrate that Abatacept, an immunomodulatory drug currently employed for the treatment of a variety of autoimmune diseases, is able to specifically target this malignant pathway, preventing podocytes cellular alterations in vitro and proteinuria development in two murine models of diabetic nephropathy in vivo. (more…)
Author Interviews, Heart Disease, Kidney Disease, McGill / 27.03.2014

Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill UniversityMedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22). (more…)
Author Interviews, Biomarkers, Diabetes, Diabetologia, Kidney Disease / 14.03.2014

Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, FranceMedicalResearch.com Interview with: Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, France MedicalResearch.com: What are the main findings of the study? Prof: Hadjadj: The study helps to establish sTNFR1 as a valid biomarker not only for renal outcomes in type 2 diabetes but also for all cause death. Interestingly the addition of sTNFR1 concentration to the UKPDS model outcome equation showed to add some clinical prognostic value to this model for all-cause death. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute, Kidney Disease / 04.03.2014

Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.MedicalResearch.com Interview with: Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.   MedicalResearch.com: Why did you choose to study this particular question? Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Kidney Disease / 25.02.2014

Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical CenterMedicalResearch.com Interview with: Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Kovesdy: We describe significantly lower all-cause mortality rates in 141,413 non-dialysis dependent CKD (chronic kidney disease) patients who were de-novo users of ACEI/ARB. (more…)
Author Interviews, Diabetes, Diabetes Care, General Medicine, Kidney Disease / 25.02.2014

MedicalResearch.com Interview with: Eiji Ishimura, MD, PhD, FASN, FACP Osaka City University Hospital Professor,Department of Nephrology Osaka, JAPAN MedicalResearch.com: What are the main findings of the study? Dr. Ishimura: Poor glycemic control is a major factor in the overestimation of glomerular filtration rate (GFR) in diabetic patients. We found this simple conclusion by directly measuring GFR by use of inulin clearance. We have created new formulae to accurately assess the GFR in diabetic patients, with the correction of hemoglobin A1C (HbA1C) or glycated albumin (GA) as followings; 1)      eGFRcr corrected by HbA1c=eGFRcr / (0.428 + 0.085 × HbA1c) 2)      eGFRcr corrected by GA=eGFRcr / (0.525 + 0.028 × GA) (more…)
Author Interviews, Heart Disease, Kidney Disease / 31.12.2013

Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com Interview with: Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com: What are the main findings of the study? This was the first long-term study in individuals with atrial fibrillation to consider the impact of renal function, as measured by eGFR, on stroke/thromboembolism, mortality and bleeding in the same population concurrently. Answer: There were three main findings of our study.
  • First, patients with worsening renal function had more severe risk factor profiles and had higher rates of stroke/thromboembolism, mortality and bleeding.
  • Second, individuals receiving oral anticoagulation had lower rates of stroke/thromboembolism and mortality than those not receiving anticoagulation at all levels of renal function measured by eGFR, suggesting that anticoagulation has benefit in even patients with low eGFR.
  • Third, renal function was not an independent predictor of stroke/thromboembolism at 1 year after adjustment for baseline characteristics. (more…)
Author Interviews, Blood Clots, Kidney Disease / 24.11.2013

Frits R. Rosendaal PhD Department of Clinical Epidemiology Leiden University Medical Center, Leiden, The NetherlandsMedicalResearch.com Interview with: Frits R. Rosendaal PhD Department of Clinical Epidemiology Leiden University Medical Center, Leiden, The Netherlands MedicalResearch.com: What are the main findings of the study? Answer: In our study, we  found that moderately to severely decreased kidney function was associated with a 2.6-fold (95%CI 2.0-3.5) increased risk of venous thrombosis as compared with normal kidney function. Several hemostatic factors showed a procoagulant shift with decreasing kidney function, most notably factor VIII and von Willebrand factor. We showed that the increased risk of venous thrombosis in chronic kidney disease could not be explained by confounding factors such as body mass index, diabetes, hospitalization, or corticosteroid use. However, we found that factor VIII and von Willebrand factor fully explained the increased risk of venous thrombosis associated with impaired kidney function. (more…)
Author Interviews, Kidney Disease / 25.09.2013

Renée L. Mulder, PhD Department of Pediatric Oncology Emma Children's Hospital / Academic Medical Center 1100 DD Amsterdam The NetherlandsMedicalResearch.com Interview with: Renée L. Mulder, PhD Department of Pediatric Oncology Emma Children's Hospital / Academic Medical Center 1100 DD Amsterdam The Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Mulder: The glomerular function of childhood cancer survivors treated with nephrotoxic therapy declines very soon after treatment and does not recover. The glomerular function declines over time. This decline is comparable to survivors treated without nephrotoxic therapy. (more…)
Author Interviews, HIV, Kidney Disease / 11.09.2013

MedicalResearch.com Interview with: Magnus G. Rasch MD Faculty of Health Sciences, University of Copenhagen 1455 København K, Denmark Department of Infectious Diseases Copenhagen University Hospital, Rigshospitalet, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population. The risk of aRRT was highest the first year after HIV diagnosis. Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate. (more…)
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Medical Research Centers / 05.09.2013

MedicalResearch.com Interview with: Gearoid M. McMahon, MB, BCh Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Framingham Heart Study, National Heart, Lung, and Blood Institute, and Center for Population Studies, Framingham, Massachusetts MedicalResearch.com: What are the main findings of the study? Answer: This study examined the incidence, causes and outcomes of rhabdomyolysis in two large University Teaching hospitals. Rhabdomyolysis is a characterized by an increase in serum creatine phosphokinase (CPK) and results from muscle damage from a variety of causes. The most important complication of rhabdomyolysis is acute kidney injury which can result in a need for dialysis. Using a series of laboratory and clinical variables that are readily available on admission, we constructed a risk score that can predict with some accuracy the likelihood that a patient with rhabdomyolysis might die or need dialysis during an admission. The final variables included in the model were age, gender, the cause of rhabdomyolysis and the admission CPK, creatinine, phosphate, bicarbonate and calcium. One of the advantages of this study was, because we had access to data from two institutions, we were able to derive the risk score in one hospital and confirm its accuracy in the second institution. (more…)
Author Interviews, Kidney Disease, University of Michigan / 03.09.2013

Afshinnia, Farsad, M.D., M.S. Research Fellow and Clinical Lecturer Department of Nephrology University of Michigan Health System MedicalResearch.com: What are the main findings of the study? Answer: Spontaneous Renal Artery Dissection (SRAD) is most commonly observed in middle aged individuals. Although SRAD can have no association with other comorbidities at the time of presentation, we have noticed association with a number of systemic disorders such as hypertension, cancer, congestive heart failure, and rheumatologic diseases. In particular clustering of Fibromascular dysplasia (FMD), Ehlers-Danlos syndrome, poly arteritis nodosa, Poland syndrome, and nail patella syndrome in our patients has been striking. The most commonly observed presenting symptom is sudden onset severe flank pain which may be spontaneous or following physical stress. Other presenting features may include uncontrolled hypertension, groin and/or testicular pain, headache, nausea, vomiting, fever, dysuria, hematuria and blurry vision. (more…)
Author Interviews, JACC, Kidney Disease, Vitamin C / 30.08.2013

MedicalResearch.com Interview with: Umar Sadat, MD, PhD Addenbrooke’s Hospital Cambridge, United Kingdom MedicalResearch.com: What are the main findings of the study? Dr. Sadat: Vitamin C offers significant nephroprotection against contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography. Patients receiving Vitamin C were observed to have 33% less risk of CI-AKI compared to those receiving placebo or other treatment. (more…)
Author Interviews, Blood Pressure - Hypertension, Kidney Disease, Nature / 20.08.2013

MedicalResearch.com Interview with: Hemodialysis.com Author Interview: Csaba P. Kovesdy MD FASN. Csaba P. Kovesdy MD FASN.The Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program in Nephrology University of Tennessee Health Science Center Chief of Nephrology Division of Nephrology, Memphis VA Medical CenterDr.Csaba P. Kovesdy MD FASN. The Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program in Nephrology University of Tennessee Health Science Center Chief of Nephrology Division of Nephrology, Memphis VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Kovesdy: In this study of >650,000 US veterans with CKD we found that categories of lower SBP/DBP combinations are associated with lower mortality only as long as the DBP component remains above a threshold of approximately 70 mmHg, and that patients with BP values in the range of 130-159/70-89 mmHg had the lowest mortality.  Patients who might be considered to have “ideal” blood pressure (<130/80) actually had increased mortality due to the inclusion of individuals with low systolic and diastolic blood pressures. (more…)
Author Interviews, Genetic Research, Kidney Disease, Nature, University of Pennsylvania / 12.08.2013

MedicalResearch.com Interview with: Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper  Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145 Dr. Sarah Tishkoff, Ph.D., Senior author of the paper  David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of PennsylvaniaDr. Sarah Tishkoff, Ph.D., Senior author of the paper David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of Pennsylvania MedicalResearch.com: What are the main findings of the study?

 Answer: In humans the APOL1 gene codes for Apolipoprotein L1, a major component of the trypanolytic factor in serum.  The APOL1 gene harbors two risk alleles (G1 and G2) associated with chronic kidney disease (CKD) among individuals of recent African ancestry. We studied APOL1 across genetically and geographically diverse ethnic groups in Africa. We have discovered a number of novel variants at the APOL1 functional domains that are required to lyse trypanosome parasites inside human blood vessels. We further identified signatures of natural selection influencing the pattern of variation on chromosomes carrying some of these variants. In particular, we have identified a haplotype (a cluster of genetic variants linked along a short region of a chromosome), termed G3, that has evolved adaptively in the Fulani population who have been practicing cattle herding which has been historically documented as early as in the medieval ages (but which could have begun thousands of years earlier).  Many of the novel variants discovered in this study are candidates to play a role conferring protection against trypanosomiasis and/or to play a role in susceptibility of CKD in humans. (more…)
Diabetes, Kidney Disease / 04.07.2013

MedicalResearch.com Interview with: C Raina Elley C Raina Elley  Associate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New ZealandAssociate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Answer: Type 2 Diabetes is the leading cause of end-stage renal failure and dialysis in many countries. Early identification of those who are at risk within primary care could prompt more intensive intervention to control glycaemia and blood pressure and use of ACE inhibitors or angiotensin receptor blockers to slow progression. Traditionally estimated glomerular filtration rate and/or urine albumin creatinine ratio have been used to alert clinicians of deteriorating renal function in people with diabetes. However, a far more accurate renal risk score has been developed that combines serum creatinine, demographic characteristics, albuminuria, glycaemia, blood pressure, cardiovascular co-morbidity and duration of diabetes. The 5-year renal risk score was developed by following more than 25,000 people with type 2 diabetes in New Zealand for a median of 7.3 years (equivalent to 180,497 person-years). The study identified those who commenced dialysis for end-stage renal disease, received a renal transplant or died from renal failure to derive the risk score. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Kidney Disease, Medical Research Centers, Mediterranean Diet, Nutrition / 29.05.2013

MedicalResearch.com eInterview with Iris Shai, RD, PhD PI of the DIRECT trial Ben Gurion University of the Negev, Israel MedicalResearch.com: What are the main findings of the study? Dr. Shai: Low-carbohydrate is as effective as Mediterranean or low-fat diets in improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine<176µmol/L (not sever renal stage).  The effect is likely to be mediated by weight-loss induced improvements in insulin sensitivity and blood pressure. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Kidney Disease, Pediatrics / 28.05.2013

MedicalResearch.com eInterview with: Dr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San AntonioDr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San Antonio MedicalResearch.com: What are the main findings of the study? Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes. MedicalResearch.com: Were any of the findings unexpected? Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control. (more…)