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American journal of kidney diseases [journal]
- Visit-to-Visit Variability in Blood Pressure and Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Nephropathy: A Post Hoc Analysis From the RENAAL Study and the Irbesartan Diabetic Nephropathy Trial. [JOURNAL ARTICLE]
- Am J Kidney Dis 2014 Jul 24.
Increased systolic blood pressure variability between outpatient visits is associated with increased incidence of cardiovascular end points. However, few studies have examined the association of visit-to-visit variability in systolic blood pressure with clinically relevant kidney disease outcomes. We analyzed the association of systolic blood pressure visit-to-visit variability with renal and cardiovascular morbidity and mortality among individuals with diabetes and nephropathy.Observational analysis of IDNT (Irbesartan Diabetic Nephropathy Trial) and the RENAAL (Reduction of End Points in Non-Insulin-Dependent Diabetes With the Angiotensin II Antagonist Losartan) Study.2,739 participants with type 2 diabetes and nephropathy with at least 1 year of blood pressure measurements available.Systolic blood pressure visit-to-visit variability was calculated from the SD of the systolic blood pressure from 4 visits occurring 3-12 months postrandomization.The kidney disease outcome was defined as time to confirmed doubling of serum creatinine level, end-stage renal disease, or death; the cardiovascular outcome was defined as time to cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, or revascularization.Mean visit-to-visit variability in systolic blood pressure from 3 to 12 months postrandomization was 12.0±6.8(SD)mmHg. Following this ascertainment period, there were 954 kidney disease and 542 cardiovascular events. Greater systolic blood pressure visit-to-visit variability was associated independently with increased risk of the composite kidney disease end point (HR per 1-SD increment, 1.08 [95%CI, 1.01-1.16]; P=0.02) and end-stage renal disease, but not with the cardiovascular outcome.Observational study with the potential for confounding.In diabetic individuals with nephropathy, systolic blood pressure visit-to-visit variability is associated independently with hard kidney disease outcomes.
- Renal Leukocyte Chemotactic Factor 2 (LECT2) Amyloidosis in First Nations People in Northern British Columbia, Canada: A Report of 4 Cases. [JOURNAL ARTICLE]
- Am J Kidney Dis 2014 Jul 24.
Leukocyte chemotactic factor 2 (LECT2) amyloidosis is a recently identified type of amyloidosis that may represent an underdiagnosed cause of chronic kidney disease. LECT2 amyloidosis typically is reported as being renal limited and, in the United States, more prevalent in Hispanic patients. We add to the epidemiologic data of this condition by describing 4 First Nations people from Northern British Columbia, Canada, who presented with slowly progressive chronic kidney disease that was found to be due to LECT2 amyloidosis.
- Quiz page august 2014: pruritus in a dialysis patient. [Journal Article]
- Am J Kidney Dis 2014 Aug; 64(2):A18-22.
- Dialysis in limbo land. [Editorial]
- Am J Kidney Dis 2014 Aug; 64(2):A15-7.
- A Perspective From the Baltics Regarding the Canadian Society of Nephrology Commentary on the KDIGO Glomerulonephritis Guideline. [Letter]
- Am J Kidney Dis 2014 Aug; 64(2):315.
- Revisiting frontiers of tolerability and efficacy in renal replacement therapy. [Editorial]
- Am J Kidney Dis 2014 Aug; 64(2):171-3.
- Breaking Down the Vitamin D-GFR Relationship. [Editorial]
- Am J Kidney Dis 2014 Aug; 64(2):168-70.
- Is starting hemodialysis on a twice-weekly regimen a valid option? [Editorial]
- Am J Kidney Dis 2014 Aug; 64(2):165-7.
- Serum Albumin and Kidney Function Decline in HIV-Infected Women. [JOURNAL ARTICLE]
- Am J Kidney Dis 2014 Jul 21.
Serum albumin concentrations are a strong predictor of mortality and cardiovascular disease in human immunodeficiency virus (HIV)-infected individuals. We studied the longitudinal associations between serum albumin levels and kidney function decline in a population of HIV-infected women.Retrospective cohort analysis.Study participants were recruited from the Women's Interagency HIV Study (WIHS), a large observational study designed to understand risk factors for the progression of HIV infection in women living in urban communities. 908 participants had baseline assessment of kidney function and 2 follow-up measurements over an average of 8 years.The primary predictor was serum albumin concentration.We examined annual change in kidney function. Secondary outcomes included rapid kidney function decline and incident reduced estimated glomerular filtration rate (eGFR).Kidney function decline was determined by cystatin C-based (eGFRcys) and creatinine-based eGFR (eGFRcr) at baseline and follow-up. Each model was adjusted for kidney disease and HIV-related risk factors using linear and relative risk regression.After multivariate adjustment, each 0.5-g/dL decrement in baseline serum albumin concentration was associated with a 0.56-mL/min faster annual decline in eGFRcys (P < 0.001), which was attenuated only slightly to 0.55mL/min/1.73m(2) after adjustment for albuminuria. Results were similar whether using eGFRcys or eGFRcr. In adjusted analyses, each 0.5-g/dL lower baseline serum albumin level was associated with a 1.71-fold greater risk of rapid kidney function decline (P<0.001) and a 1.72-fold greater risk of incident reduced eGFR (P<0.001).The cohort is composed of only female participants from urban communities within the United States.Lower serum albumin levels were associated strongly with kidney function decline and incident reduced eGFRs in HIV-infected women independent of HIV disease status, body mass index, and albuminuria.