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Spectrum and Dosing of Urate-lowering Drugs in a Large Cohort of Chronic Kidney Disease Patients and Their Effect on Serum Urate Levels: a Cross-sectional Analysis from the German Chronic Kidney Disease Study
Abstract: Background Despite a plethora of studies on the effect of urate-lowering therapy (ULT) in patients with chronic kidney disease (CKD), current guidelines on the treatment of hyperuricaemia and gout vary, especially concerning the need for dose adjustment of allopurinol, whose main metabolite is accumulating with declining renal function. Data on allopurinol dosing and its relationship to renal function, co-medication and sex and the resulting urate level in large cohorts are missing. Methods We studied a subgroup of 2378 patients of the German Chronic Kidney Disease (GCKD) study to determine prescription patterns of ULT among CKD patients under nephrological care and the relationshi...
KLKB1 and CLSTN2 are Associated with HDL-mediated Cholesterol Efflux Capacity in a Genome-wide Association Study
Abstract: Background and aims HDL-mediated cholesterol efflux capacity (CEC) may protect from cardiovascular disease. Thus, we aimed to identify its genetic and non-genetic determinants. Methods We measured CEC to 2% apolipoprotein B-depleted serum using BODIPY-cholesterol and cAMP-stimulated J774A.1 macrophages using serum samples from 4,981 participants in the German Chronic Kidney Disease (GCKD) study. Variance of CEC explained by clinical and biochemical parameters in a multivariable linear regression model was calculated by proportional marginal variance decomposition. A genome-wide association study with 7,746,917 variants was performed based on an additive genetic model. The main mode...
Genetic Studies of Paired Metabolomes Reveal Enzymatic and Transport Processes at the Interface of Plasma and Urine
Abstract: The kidneys operate at the interface of plasma and urine by clearing molecular waste products while retaining valuable solutes. Genetic studies of paired plasma and urine metabolomes may identify underlying processes. We conducted genome-wide studies of 1,916 plasma and urine metabolites and detected 1,299 significant associations. Associations with 40% of implicated metabolites would have been missed by studying plasma alone. We detected urine-specific findings that provide information about metabolite reabsorption in the kidney, such as aquaporin (AQP)-7-mediated glycerol transport, and different metabolomic footprints of kidney-expressed proteins in plasma and urine that are consistent with their localization and function, including the transporters NaDC3 (SLC13A3) and ASBT (SLC10A2). Shared genetic determinants of 7,073 metabolite-disease combinations represent a resource to better understand metabolic diseases and revealed connections of dipeptidase 1 with circulating digestive enzymes and with hypertension. Extending genetic studies of the metabolome beyond plasma yields unique insights into processes at the interface of body compartments
Approaches to Chronic Kidney Disease
Chronic kidney disease (CKD) is a major global public health problem, affecting nearly one in seven adults in the United States alone. It is a disease that integrates chronic illness at several levels, and the progressive condition is associated with high rates of co-morbidity. This text provides a comprehensive, current state-of-the art review of this field, serving as a valuable resource for primary care providers and non-nephrology clinicians that treat patients with CKD. It is comprised of 24 chapters focused on specific aspects of the disease. The first 2 chapters provide a bit of background on the disease, describing the anatomy and physiology of the kidney as well as the definition an...
Psychosocial Aspects of Chronic Kidney Disease
Psychosocial Aspects of Chronic Kidney Disease: Exploring the Impact of CKD, Dialysis, and Transplantation on Patients provides an overview of the emotional and psychological challenges faced by people with renal disease. This book outlines the epidemiology and treatment of the psychosocial factors affecting them. The sections in the book cover psychiatric illness in the earlier and middle stages of chronic kidney disease, end-stage renal disease treated with dialysis, and renal transplantation. The book concludes with a section on special considerations, delving into topics such as treating children and adolescents, quality of life, caregiver burden, challenges in psychosocial research in kidney disease, and future directions for intervention. Includes chapters that are written by a leading group of international researchers Emphasizes practical approaches to patient care and treatment issues Explores psychosocial issues related to hemodialysis and peritoneal dialysis Discusses available treatment for anxiety, depression, sleep disturbances, pain, nonadherence, cognitive dysfunction, palliative care, and other psychosocial concerns
Nutrition in Kidney Disease
This third edition of this text is organized into seven sections that address the educational needs of dietitians around the world who seek current information about nutritional management of chronic kidney disease (CKD). Part I addresses the differences in the epidemiology of CKD and renal replacement therapy worldwide, such as environmental, ethnic, cultural, political and macroeconomic factors. Part II includes a thorough review of the components of the nutrition assessment, which includes information about psychosocial issues affecting nutritional status in kidney disease and drug-nutrient interactions, and parts III and IV review preventative strategies for common disorders associated w...
Chronic Renal Disease
Chronic Renal Disease, Second Edition, comprehensively investigates the physiology, pathophysiology, treatment and management of chronic kidney disease (CKD). This translational reference takes an in-depth look at CKD with no coverage of dialysis or transplantation. Chapters are devoted to the scientific investigation of chronic kidney disease, the most common problems faced by nephrologists in the management of chronic kidney disease, specific illnesses in the CKD framework, and how the management of CKD in a polycystic kidney disease patient differs from other CKD patients. This award-winning reference features a series of case studies, covering both clinical aspects and pathophysiology. Q...
Clinical Investigations at a Glance
Clinical Investigations at a Glance provides an up-to-date, evidence-based overview of diagnostic investigations, looking at their choice, importance and interpretation for commonly presenting symptoms and conditions. Designed to help develop the evidence-based use of investigations and interpret results properly, the book provides a unique perspective on many critical issues in medical testing, with the aim of improving diagnostic accuracy and reducing unnecessary tests or harm. Clinical Investigations at a Glance is structured in three parts: an overview of tests; common presentations (such as chest pain, nausea and vomiting, weight loss and anaemia,); and conditions organized by body system, such as cardiovascular disease, respiratory disease and nephrology. Key features include: • How to interpret investigations, using high quality illustrations to compare ‘normal’ and ‘diseased’ results • Evidence-based, including references • How to select the most appropriate investigation, the accuracy of tests and how to manage incidental findings
Chronic Kidney Disease in Disadvantaged Populations
Chronic Kidney Disease in Disadvantaged Populations investigates the increased incidence and prevalence of kidney disease in vulnerable populations world-wide. The volume explores the complex interactions of genetic, biologic, cultural and socioeconomic factors such as the environment, and specific health behaviors that seem to be responsible for a significant proportion of the health disparities in these communities. Each chapter is written by leading experts in the field and analyzes the prevalence and incidence of pre-dialysis kidney disease in disadvantaged populations across both developed and developing countries. In addition, each contribution analyzes differentiated risk factors and ...
