Abstract:
UNLABELLED:Although it is anticipated that most patients with renal insufficiency will progress towards end-stage renal disease (ESRD) there have been few population-based studies to validate this assumption. We examined serial creatinines from 3,874 anonymous patients at an urban VA medical center who had a baseline creatinine of 1.4 mg/dl or greater to estimate the frequency of deterioration in renal function (DRF). DRF was defined as the first Cr (1stCr) value being lower than the last Cr (LCr) for each patient. The median follow-up was 48.3 +/- 0.5 months with 18 +/- 0.5 creatinine values per patient. The median 1stCr was 1.6 +/- 0.1 mg/dl with 32.2% of the patients having a 1stCr greater than or equal to 1.7 mg/dl. In the study group, 1,723 (44.4%) had DRF including 1,089 (41.4%) of those patients with a 1stCr of 1.4-1.7 mg/dl. However, 45 (36.6%) of those with a 1stCr value 3.0-5.0 mg/dl did not have DRF, the percent with stable creatinine in this group did not vary with length of follow-up. Over the study period, 299 (7.7%) of all the patients had a creatinine rise to 7.0 mg/dl, with 104 (4%) of those with a 1stCr of 1.4-1.7 mg/dl reaching this endpoint. CONCLUSION:A majority, but not all, patients with renal insufficiency lose renal function over time and those with even mild hypercreatinemia are at risk for deterioration in renal function. Hypercreatinemia, however, does not accurately discriminate between those renal insufficiency patients who are stable versus those at high risk for ESRD.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Fink JC,Salmanullah M,Blahut SA,Weir MR,Sawyer R,Henrich WL,Hise MKdoi
10.1159/000046280subject
Has Abstractpub_date
2001-09-01 00:00:00pages
386-9issue
5eissn
0250-8095issn
1421-9670pii
46280journal_volume
21pub_type
杂志文章abstract:BACKGROUND/AIMS:The long-term renal outcomes of patients with IgA nephropathy (IgAN) who present with recurrent macroscopic hematuria (RMH) have not been described in previous studies. METHODS:Patients with biopsy-proven primary IgAN in Jinling Hospital were divided into three groups according to different patterns of...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000364954
更新日期:2014-01-01 00:00:00
abstract::Berengario da Carpi was magister of anatomy and surgery at the University of Bologna from 1502 to 1527. Eustachio and Falloppia defined him as 'the restaurator of anatomy'. He was a great surgeon, anatomist and physician of illustrious patients including Lorenzo II dei Medici, Giovanni dalle Bande Nere, Galeazzo Palla...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013452
更新日期:1999-01-01 00:00:00
abstract::Atherosclerotic diseases (ASD) are the major cause of mortality and morbidity in patients on hemodialysis (HD). To evaluate the significance and usefulness of atherogenic indices, we examined lipoprotein(a) (Lp(a)), remnant-like particles cholesterol (RLP.C), homocysteine (Hcy), cardiac troponin T (TnT), and ankle-arm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013566
更新日期:2000-03-01 00:00:00
abstract::A patient with renal failure due to myeloma kidney and coincident digitalis intoxication due to prescribed daily digoxin administration was treated with digoxin-specific antibody fragments and plasmapheresis. Rapid response to therapy was noted, removal of digoxin-antidigoxin antibody complexes was confirmed, and prev...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168179
更新日期:1990-01-01 00:00:00
abstract::To define the incidence of non-A, non-B (NANB) hepatitis and evaluate possible risk factors, we reviewed records of 163 patients on chronic dialysis during a 3-year period. 23 cases of NANB hepatitis occurred, 13 (27%) in 49 center dialysis, 8 (10%) in 77 home hemodialysis (p less than 0.02) and 2 (5%) in 37 peritonea...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166815
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Oxidative stress (OS) and asymmetric dimethylarginine (ADMA) are accepted as nonclassical cardiovascular risk factors in end-stage renal disease patients. To clarify the role of these factors in the atherosclerotic process, we investigated if OS and ADMA are associated with common carotid artery intima media...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000109397
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Dietary acid load (DAL) contributes to the risk of CKD and CKD progression. We sought to determine the relation of DAL to racial/ethnic differences in the risk of end-stage renal disease (ESRD) among persons with CKD. METHODS:Among 1,123 non-Hispanic black (NHB) and non-Hispanic white (NHW) National Health ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487715
更新日期:2018-01-01 00:00:00
abstract::Obese Zucker rats spontaneously develop lipoprotein abnormalities, proteinuria, mesangial expansion and glomerulosclerosis. Previous studies have implicated these lipoprotein abnormalities in the pathogenesis of the progressive renal injury which these rats develop. The present study was designed to examine the chrono...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168588
更新日期:1993-01-01 00:00:00
abstract::Collapsing glomerulopathy is a pattern of renal injury that is seen in association with human immunodeficiency virus (HIV) infection. Patients with this HIV-associated nephropathy (HIVAN) present nephrotic syndrome and rapid deterioration of the renal function. There is no proven effective therapy for HIVAN, and the m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065229
更新日期:2002-07-01 00:00:00
abstract::Administration of a single dose of 1,25-OH(2)D(3) can lower PTH levels for up to 4 days in chronic hemodialysis patients. Our purpose was to verify the effects of the same weekly dose of calcitriol per os given in one, two or three administrations, to patients on dialysis with secondary hyperparathyroidism. Thirty pat...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000046197
更新日期:2000-11-01 00:00:00
abstract:PURPOSE:To explore the association between CYP3A4 and CYP3A5 gene polymorphisms and blood pressure response to amlodipine among participants from the African-American Study of Kidney Disease and Hypertension Trial randomized to amlodipine (n = 164). METHODS:Cox proportional hazards models were used to determine the ri...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000258688
更新日期:2010-01-01 00:00:00
abstract::The number of patients with end-stage renal disease undergoing kidney transplantation - both cadaveric and living-donor - continues to rise. With long-term graft survival relatively fixed, this trend means that increasing numbers of patients are returning to dialysis after graft loss. Most will never be retransplanted...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000342626
更新日期:2012-01-01 00:00:00
abstract::A patient with advanced chronic renal failure secondary to polycystic kidney disease suffered an episode of volume contraction during which his urinary sodium concentration fell to less than 5 mEq daily. Urine sodium excretion remained at this level when later in his course he became clinically volume expanded. The pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166535
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Serum phosphorus concentrations reflect a dynamic balance between generation, exchanges, and removal. Time-averaged phosphorus concentrations (TAC(phos)) reflect the overall exposure better than single time-point concentrations, especially in dialysis patients treated with an intermittent modality. The prese...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000336308
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Aldosterone plays an important role in fibrosis. Recent studies showed that Na(+)-H(+) exchanger isoform 1 (NHE1) is involved in mineralocorticoid-induced organ fibrosis. In this study, we examined the role of NHE1 in aldosterone-induced fibronectin accumulation in rat mesangial cells and the signaling pathw...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000256665
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The objective of this study was to investigate the role of bone morphogenetic protein (BMP) signal transduction in the pathogenesis of calciphylaxis. METHODS:Skin biopsy specimens were obtained from 18 patients with, and 12 patients without, calciphylaxis. Tissue sections were stained with antibodies direct...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000484418
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Elevated osteoprotegerin (OPG) levels are inversely correlated with creatinine clearance and end-stage renal disease in patients with diabetes, however its role in predicting decline in renal function and progression to a more advanced stage disease in the elderly general population is unknown. METHODS:This...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000357787
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Increased mortality and morbidity are reported in association with high ultrafiltration rate (UFR) and with long dialysis recovery time (DRT). We studied the association between UFR and DRT. METHODS:This is a cross-sectional, observational study was conducted. Patients on thrice-weekly hemodialysis (HD) wit...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000476076
更新日期:2017-01-01 00:00:00
abstract::In hypoaldosteronemic patients with chronic renal insufficiency, administration of a mineralocorticoid steroid such as fludrocortisone can ameliorate hyperkalemia and metabolic acidosis, but this therapy is not always safe owing to the deleterious consequences of extracellular fluid volume expansion resulting from min...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166827
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND/AIMS:Thiazolidinediones (TZD) are ligands known to bind to and activate the nuclear peroxisome proliferator-activated receptor gamma (PPARgamma), and are currently used as insulin sensitizers in type 2 diabetes. Recently, several studies have shown that TZD may have a role in renal protection in various expe...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000105125
更新日期:2007-01-01 00:00:00
abstract::Left ventricular hypertrophy (LVH) is a common finding in hypertensive autosomal dominant polycystic kidney disease (ADPKD) patients. There are few studies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relationship between BP, hum...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013583
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Telomere attrition is a novel risk factor for cardiovascular disease. Studies of telomere length in relation to kidney function are limited. We explored the association of kidney function with telomere length and telomere shortening. METHODS:The Heart and Soul Study is a longitudinal study of patients with ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000343495
更新日期:2012-01-01 00:00:00
abstract::An 18-year-old woman complained of fever and edema and was admitted to Showa University Hospital for treatment of thrombocytopenia and deteriorating renal function. Laboratory studies demonstrated the presence of lupus anticoagulant (LA), prolongation of prothrombin time, hemolytic anemia, a negative Coombs' test, the...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013526
更新日期:1999-01-01 00:00:00
abstract::Skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046263
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Health-related quality of life (HRQOL) reflects a patient's perceived disease burden, treatment effectiveness, and health status. Given the time burden and physiologic effects of hemodialysis, patients who spend dialysis time (9-15 h/week) physically or intellectually engaged may have better HRQOL. We charac...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000492623
更新日期:2018-01-01 00:00:00
abstract::Glomerulosclerosis frequently complicates most renal diseases and is characterized by mesangial matrix accumulation. Oxidized low-density lipoprotein (Ox-LDL) could induce oxidative stress and profibrotic gene expression in mesangial cells. This article will review our current understanding of the pathogenetic mechani...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000151277
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Nephrology research is expanding, and harnessing the much-needed information and data for the practice of evidence-based medicine is becoming more challenging. In this study, we used the natural language processing and text mining approach to mitigate some of these challenges. METHODS:We analyzed 17,412 abs...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000504871
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:It is uncertain whether kidneys from marginal donors are suitable for live kidney transplantation. In deceased donor kidneys, tubular cell senescence affects allograft function. However, the degree of cell senescence in a living donor kidney with marginal factors has not been reported. In this study, we asse...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000485845
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Renal insufficiency is a well-described risk factor for perioperative morbidity and shortened survival after major vascular procedures. Due to the potential inaccuracy of serum creatinine levels alone in measuring kidney function, our aim was to determine whether estimated creatinine clearance more consisten...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000098150
更新日期:2006-01-01 00:00:00
abstract::To elucidate the relationship between the renal regulation of sodium and calcium excretion at extremes of sodium intake, we studied 6 normal men ingesting a fixed, 400 mg/day calcium intake and four levels of sodium intake from 10 to 1,500 mEq/day. Serum ionized calcium was not influenced by sodium intake. Blood press...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166496
更新日期:1981-01-01 00:00:00