Abstract:
BACKGROUND:Patients with diabetic nephropathy are at high risk for further progressive renal function loss. Treatments that decrease albuminuria have been linked with renal and cardiovascular protection. However, even when taking optimal treatment, residual renal and cardiovascular risk remains high which correlates with the magnitude of residual albuminuria. Use of vitamin D receptor activators, such as calcitriol and paricalcitol, is associated with improved sur- vival. A small study with paricalcitol showed reductions in albuminuria. The VITAL study tests the hypothesis whether paricalcitol persistently reduces albuminuria in diabetic subjects already receiving angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB) therapy. METHODS:Randomization in this double-blind trial is equal allocation to paricalcitol 1 micro/day, 2 microg/day, or placebo. Inclusion criteria include: a diagnosis of type 2 diabetes, urinary albumin/creatinine ratio (UACR) between 100-3,000 mg/g, estimated glomerular filtration rate (eGFR) between 15-90 ml/min/1.73 m(2), serum calcium <9.8 mg/dl, and parathyroid hormone (PTH) between 35-500 pg/ml. RESULTS:Baseline characteristics of the 281 subjects are: 69% men, mean age 64.9 +/- 10.4 years, eGFR 40.7 +/- 16.7 ml/min, median UACR (interquartile range) 612.3 mg/g (281-1,181 mg/g) and PTH 98.4 +/- 63.8 pg/ml. CONCLUSION:This trial will be the first clinical test of the hypothesis that paricalcitol possesses pleiotropic effects and can modulate albuminuria in the setting of ACEI and/or ARB therapy. Results will have important clinical implications and are expected in November 2009.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Lambers Heerspink HJ,Agarwal R,Coyne DW,Parving HH,Ritz E,Remuzzi G,Audhya P,Amdahl MJ,Andress DL,de Zeeuw Ddoi
10.1159/000225903subject
Has Abstractpub_date
2009-01-01 00:00:00pages
280-6issue
3eissn
0250-8095issn
1421-9670pii
000225903journal_volume
30pub_type
杂志文章,随机对照试验abstract:BACKGROUND/AIMS:Serum phosphorus levels have been associated with adverse long-term outcome in several populations, however, no prior studies evaluated short-term postoperative outcome. The present study evaluated the predictive value of phosphorus levels on 30-day outcome after vascular surgery. METHODS:The study inc...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000315856
更新日期:2010-01-01 00:00:00
abstract::45 bone biopsies from patients with chronic uremia were reviewed to define which noninvasive investigations were of value in predicting the histological diagnosis and to quantify the spectrum of uremic bone disease at a center that has consistently used an aluminum-free dialysis bath. 17 biopsies were taken postmortem...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167465
更新日期:1987-01-01 00:00:00
abstract::The terminal complement-inhibitor eculizumab has dramatically changed the management of patients with atypical hemolytic uremic syndrome (aHUS), and has also shown promise for treating certain forms of secondary HUS (sHUS), including that caused by drugs and solid-organ/hematopoietic stem cell transplant. While effect...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000492033
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIM:Although clinical and immunological findings in steroid-sensitive nephrotic syndrome (SSNS) favor an immunopathogenesis, many issues remain unsolved. Comprehensive studies analyzing cellular and humoral immunity in SSNS are scarce, and few studies addressed the effect of steroids on immunological factors...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000085357
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND/AIMS:Gastrointestinal (GI) symptoms in renal transplant recipients may be caused due to mycophenolic acid (MPA) toxicity. Using small bowel capsule endoscopy (SBCE) we examined the impact of conversion from Mycophenolate Mofetil (MMF) to enteric-coated formulation of Mycophenolate Sodium (EC-MPS) given to tr...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000365360
更新日期:2014-01-01 00:00:00
abstract::Acute hyperammonemia is an emergent cause of central nervous system dysfunction for which renal replacement therapy is advocated. We report the successful use of continuous venovenous hemodiafiltration in this metabolic emergency, and report the calculated ammonia clearances for both continuous venovenous hemofiltrati...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013400
更新日期:1998-01-01 00:00:00
abstract::Dialysis patients have increased susceptibility to infection and this is, in part, due to impaired phagocytic and bactericidal activities of polymorphonuclear leukocytes (PMNL). The mechanisms responsible for the reduced phagocytosis are not known. Dialysis patients have elevated blood levels of parathyroid hormone (P...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168284
更新日期:1991-01-01 00:00:00
abstract::Thirty-one renal transplant recipients, submitted to treatment with cyclosporin in association with other immunosuppressive agents, were also treated for 9 months with two hydroxymethylglutaryl coenzyme A reductase inhibitors, simvastatin (10 mg/day) or pravastatin (20 mg/day), for concomitant hypercholesterolemia and...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000013487
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, has recently emerged as a predictor of survival and cardiovascular risk. Along with others, we have shown an independent association between PlGF and cardiovascular events in CKD patients, but not much is known ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000439187
更新日期:2015-01-01 00:00:00
abstract::The prejunctional beta-adrenoceptors present in the isolated perfused kidney of normotensive rats (NR) and spontaneously hypertensive rats (SHR) were compared and the effects of tertatolol on these receptors were investigated. Kidneys of NR (Wistar + Wistar-Kyoto [WKY]) and SHR, were continuously perfused with Tyrode ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167330
更新日期:1986-01-01 00:00:00
abstract::A dramatic response was noted in a patient at our hospital who received hemodialysis therapy for severe acidosis secondary to an unknown toxin, subsequently identified as cyanide. We were unable to find any information concerning the hemodialysis clearance and extraction ratio of cyanide; thus, we studied the effect o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166918
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:More than 50% of American adolescents and adults report having used illicit drugs in their lifetime. We examined the association of lifetime opiate and cocaine use with reduced kidney function, albuminuria and rapid kidney function decline among urban-dwelling adults. METHODS:Our prospective cohort included...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000452348
更新日期:2016-01-01 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/AIMS:Upregulation of transforming growth factor beta (TGF-beta)/Smad signaling has been implicated in the primary pathogenesis of renal fibrosis. The ubiquitin-proteasome pathway has an important influence on TGF-beta signaling through regulating Smad degradation. As E3 ubiquitin ligases, both Arkadia and Sm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000100518
更新日期:2007-01-01 00:00:00
abstract:AIM:The relation of ambient temperature (AMT) and relative humidity to systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight (BW), and body weight gain between dialysis sessions (DeltaBW) was examined in hemodialysis patients by Fourier analysis. METHODS AND RESULTS:The authors recruited 144 dialy...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013538
更新日期:1999-01-01 00:00:00
abstract::Tubulointerstitial disease is an invariant finding in proteinuric renal disease regardless of the underlying disease or the compartment in which the disease originates. Such histologic changes are functionally significant in that scores of such injury rather than glomerular histologic injury correlate with decrements ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168652
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is evidence that hereditary predisposition contributes to the development of diabetic nephropathy and hypertension. Polymorphisms in the genes for bradykinin receptors (B(1)R and B(2)R) were found to be associated with decreased risk of the development of end-stage renal disease. This study examin...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000068035
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000358496
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a critical need for more noninvasive biomarkers to identify nephritis in patients with systemic lupus erythematosus (SLE). Recent studies in a model mouse and an adult SLE patient cohort suggest that anti-basement membrane antibody levels correlate well with lupus activity and kidney injury. Th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000381965
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/AIMS:The association between chronic kidney disease (CKD) awareness and healthy behaviors is unknown. We examined whether CKD self-recognition is associated with healthy behaviors and achieving risk-reduction targets known to decrease risk of cardiovascular morbidity and CKD progression. METHODS:CKD awarene...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000346712
更新日期:2013-01-01 00:00:00
abstract::Serum levels of vitamin A (VA) were measured in 71 hemodialysis (HD) patients and in 30 normal controls. 65 of the 71 patients were taking multivitamin preparations (MP) containing VA. The HD patients had significantly greater values: 7.81 +/- 2.86 mumol/l (224 +/- 82 micrograms/dl) versus 3.97 +/- 0.97 mumol/l (114 +...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167486
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Published reports examining the efficacy and safety of glucocorticoids for preserving renal function in immunoglobulin A nephropathy (IgAN) have yielded conflicting results. To systematically evaluate the efficacy and safety of glucocorticoids agents for IgAN, we conducted a meta-analysis of the published ra...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000226129
更新日期:2009-01-01 00:00:00
abstract::We describe a female renal transplant recipient with cytomegalovirus and Epstein-Barr virus (EBV) infections who developed aggressive polymorphous polyclonal B cell proliferation. She received two courses of OKT3. We found a majority of transformed B cells bearing EBV membrane receptor CR2 and EBV nuclear antigen. Pos...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168818
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescr...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000486647
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Elderly patients with cardiovascular comorbidities are more likely to die before progressing to the need for undergoing hemodialysis; so deferring their predialysis vascular access (VA) surgery has been suggested. However, recent declines in cardiovascular mortality in the US population may have changed this...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000446159
更新日期:2016-01-01 00:00:00
abstract::The great Spanish military and orthopedic surgeon J. Trueta gained his field and clinical experience in the Spanish civil war (1936-1939) and in Britain during World War II. As part of his major contribution to traumatology, he searched for the causes of the characteristic oliguria of combat casualties. For this purpo...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013473
更新日期:1999-01-01 00:00:00
abstract::The treatment of the bleeding diathesis of renal failure remains unsatisfactory. 1-Deamino-8-D-arginine vasopressin (DDAVP) has recently been shown to shorten the prolonged bleeding time of renal failure and may as a result diminish the risk of clinical hemorrhage. We describe 2 cases where DDAVP was used successfully...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166773
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND/AIMS:The elderly are the fastest growing subpopulation with end-stage renal disease. The goal of our study was to define characteristics of elderly patients who were considered ineligible for transplantation compared to those who were listed. METHODS:984 patients were referred for evaluation during a 2-year...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000354483
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs frequently in the intensive care unit. A primary cause is renal ischemia/reperfusion (I/R) injury, during which excess reactive oxygen species (ROS) are produced. ROS subsequently damage renal cells, leading to the development of AKI. Here, we investigated whether renal I/R i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000327820
更新日期:2011-01-01 00:00:00
abstract::The treatment of peritonitis in continuous ambulatory peritoneal dialysis patients is empiric until the bacteriological results are available. The Lymulus amebocyte lysate assay (LAL) is a very sensitive method for the detection of endotoxin, a structural component of gram-negative bacteria. We performed the LAL assay...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168412
更新日期:1992-01-01 00:00:00