References of "Clinical Journal of the American Society of Nephrology"
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See detailAre the creatinine-based equations accurate to estimate glomerular filtration rate in african american populations ?
DELANAYE, Pierre ULg; MARIAT, Christophe; MAILLARD, Nicolas et al

in Clinical Journal of the American Society of Nephrology (2011), 6

Regarding the high prevalence of African American patients with ESRD, it is important to estimate the prevalence of early stages of chronic kidney disease in this specific population. Because serum ... [more ▼]

Regarding the high prevalence of African American patients with ESRD, it is important to estimate the prevalence of early stages of chronic kidney disease in this specific population. Because serum creatinine concentration is dependent on muscular mass, an ethnic factor has to be applied to creatinine-based equations. Such ethnic factors have been proposed in the Modification of Diet in Renal Disease (MDRD) study equation and in the more recent Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. This review analyzes how these correction factors have been developed and how they have, or have not, been validated in external populations. It will be demonstrated that the African American factor in the MDRD study equation is accurate in African American chronic kidney disease (CKD) patients. However, it will be shown that this factor is probably too high for subjects with a GFR of >60 ml/min per 1.73 m2, leading to an underestimation of the prevalence of CKD in the global African American population. It will also be confirmed that this ethnic factor is not accurate in African (non-American) subjects. Lastly, the lack of true external validation of the new CKD-EPI equations will be discussed. Additional trials seem necessary in American African and African populations to better estimate GFR and apprehend the true prevalence of CKD in this population with a high renal risk. [less ▲]

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See detailPrognostic Value of Aortic Stiffness and Calcification for Cardiovascular Events and Mortality in Dialysis Patients: Outcome of the Calcification Outcome in Renal Disease (CORD) Study
Verbeke, Francis; Van Biesen, Wim; Honkanen, Eero et al

in Clinical Journal of the American Society of Nephrology (2011), 6

Background and objectives: Radiographic calcification and arterial stiffness each individually are predictive of outcome in dialysis patients. However, it is unknown whether combined assessment of these ... [more ▼]

Background and objectives: Radiographic calcification and arterial stiffness each individually are predictive of outcome in dialysis patients. However, it is unknown whether combined assessment of these intermediate endpoints also provides additional predictive value: Design, setting, participants & measurements: Scoring of abdominal aortic calcification (AAC) using plain lateral abdominal x-ray and measurement of carotid-femoral pulse wave velocity (PWV) were performed in a cohort of 1084 prevalent dialysis patients recruited from 47 European dialysis centers. Results: During a follow-up of 2 years, 234 deaths and 91 nonfatal cardiovascular (CV) events occured. Compared with the lowest tertile of AAC, the risk of an event was increased by a factor 3.7 in patients wih a score of 5 to 15 (middle tertile), and by a factor 8.6 in patients with scores of 16 to 24. Additionally, each 1-m/s increase in PWV was associated with a 15% higer risk. At higher AAC (scores >= 5), the effect of PWV was attenuated because of a negative PWV X AAC interaction (hazard ratio [HR]:0.895 and 0.865 for middle and upper AAC tertiles). After accounting for age, diabetes, and serum albumin, AAC and PWV remained independent predictors of outcome. Conclusions: AAC and central arterial stiffness are independent predictors of mortality and nonfatal CV events in dialysis patients. The risk associated with an increased PWV is less pronounced at higher levels of calcification. Assessment of AAC and PWV is feasible in a clinical setting and both may be used or an accurate CV risk estimation in this heterogeneous population. [less ▲]

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See detailPositron-emission computed tomography in cyst infection diagnosis in patients with autosomal dominant polycystic kidney disease.
JOURET, François ULg; Lhommel, Renaud; Beguin, Claire et al

in Clinical Journal of the American Society of Nephrology (2011), 6(7), 1644-50

BACKGROUND: Cyst infection remains a challenging issue in patients with autosomal dominant polycystic kidney disease (ADPKD). In most patients, conventional imaging techniques are inconclusive. Isolated ... [more ▼]

BACKGROUND: Cyst infection remains a challenging issue in patients with autosomal dominant polycystic kidney disease (ADPKD). In most patients, conventional imaging techniques are inconclusive. Isolated observations suggest that (18)fluorodeoxyglucose ((1)(8)FDG) positron-emission computed tomography (PET/CT) might help detect cyst infection in ADPKD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Comparative assessment of administrative databases from January 2005 to December 2009 identified 27 PET/CT scans performed in 24 ADPKD patients for suspicion of abdominal infection. Cyst infection was definite if confirmed by cyst fluid analysis. Cyst infection was probable if all four of the following criteria were met: temperature of >38 degrees C for >3 days, loin or liver tenderness, C-reactive protein plasma level of >5 mg/dl, and no CT evidence for intracystic bleeding. Episodes with only two or three criteria were grouped as "fever of unknown origin". RESULTS: Thirteen infectious events in 11 patients met all criteria for kidney (n = 3) or liver (n = 10) cyst infection. CT was contributive in only one patient, whereas PET/CT proved cyst infection in 11 patients (84.6%). In addition, 14 episodes of "fever of unknown origin" in 13 patients were recorded. PET/CT identified the source of infection in nine patients (64.3%), including 2 renal cyst infections. Conversely, PET/CT showed no abnormal (1)(8)FDG uptake in 5 patients, including 2 intracystic bleeding. The median delay between the onset of symptoms and PET/CT procedure was 9 days. CONCLUSIONS: This retrospective series underscores the usefulness of PET/CT to confirm and locate cyst infection and identify alternative sources of abdominal infection in ADPKD patients. [less ▲]

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See detailEstimation of the Stability of Parathyroid Hormone when Stored at -80°C for a Long Period
Cavalier, Etienne ULg; Delanaye, Pierre ULg; Hubert, Philippe ULg et al

in Clinical Journal of the American Society of Nephrology (2009), 4(12), 1988-92

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See detailMycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis
Appel, Gerald B; Contreras, Gabriel; Dooley, Mary Anne et al

in Clinical Journal of the American Society of Nephrology (2009), 20(5), 1103-1112

Recent studies have suggested that mycophenolate mofetil (MMF) may offer advantages over intravenous cyclophosphamide (IVC) for the treatment of lupus nephritis, but these therapies have not been compared ... [more ▼]

Recent studies have suggested that mycophenolate mofetil (MMF) may offer advantages over intravenous cyclophosphamide (IVC) for the treatment of lupus nephritis, but these therapies have not been compared in an international randomized, controlled trial. Here, we report the comparison of MMF and IVC as induction treatment for active lupus nephritis in a multinational, two-phase (induction and maintenance) study. We randomly assigned 370 patients with classes III through V lupus nephritis to open-label MMF (target dosage 3 g/d) or IVC (0.5 to 1.0 g/m(2) in monthly pulses) in a 24-wk induction study. Both groups received prednisone, tapered from a maximum starting dosage of 60 mg/d. The primary end point was a prespecified decrease in urine protein/creatinine ratio and stabilization or improvement in serum creatinine. Secondary end points included complete renal remission, systemic disease activity and damage, and safety. Overall, we did not detect a significantly different response rate between the two groups: 104 (56.2%) of 185 patients responded to MMF compared with 98 (53.0%) of 185 to IVC. Secondary end points were also similar between treatment groups. There were nine deaths in the MMF group and five in the IVC group. We did not detect significant differences between the MMF and IVC groups with regard to rates of adverse events, serious adverse events, or infections. Although most patients in both treatment groups experienced clinical improvement, the study did not meet its primary objective of showing that MMF was superior to IVC as induction treatment for lupus nephritis. [less ▲]

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