Abstract:
BACKGROUND:Hypertension often accompanies chronic kidney disease (CKD), and diuretics are widely prescribed to reduce blood pressure (BP). Chlorthalidone (CTD) is a thiazide-like diuretic and an effective antihypertensive drug, yet little data exist to support its use in treating hypertension in individuals with advanced CKD. METHODS:Chlorthalidone in Chronic Kidney Disease (CLICK) is a phase II, single-institution, multicenter, double-blind randomized control trial to test the hypothesis that CTD improves BP, through reduction of extracellular fluid volume, and results in target organ protection in patients with stage 4 CKD and poorly controlled hypertension. After a single-blind placebo run-in for 2 weeks and confirmation of hypertension by 24-h ambulatory blood pressure (ABP), patients are randomized to either placebo or CTD 12.5 mg once daily (QD) followed by dose escalation. Randomization is stratified by prior loop diuretic use, and the double-blind phase lasts 12 weeks. With a total of 160 patients, the study will have ≥80% power to detect a 6 mm Hg difference in systolic 24-h ABP between the 2 treatment groups. RESULTS:Between June 2016 and October 2019, 131 patients have been randomized. The baseline characteristics are as follows: average age 65.8 years, 79% men, 36% Black, 79% with diabetes, mean eGFR 23.2 mL/min/1.73 m2, median urine albumin/creatinine ratio 923 mg/g, average number of BP medications 3.4, 60% on loop diuretics, and 24-h ABP averaged 141.7/73.8 mm Hg. CONCLUSION:Among patients with stage 4 CKD and uncontrolled hypertension, CLICK should answer the question whether CTD is safe and effective.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Agarwal R,Cramer AE,Balmes-Fenwick M,Sinha AD,Ouyang F,Tu Wdoi
10.1159/000508700subject
Has Abstractpub_date
2020-01-01 00:00:00pages
542-552issue
7eissn
0250-8095issn
1421-9670pii
000508700journal_volume
51pub_type
杂志文章abstract:BACKGROUND:The optimal level of serum ferritin (s-ft) for anemia control and good survival in hemodialysis (HD) patients remains unclear. A 10-year survey was performed to clarify the appropriate quantities of s-ft and investigate the relationships among s-ft, transferrin saturation (TSAT), and mortality in HD patients...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000370317
更新日期:2014-01-01 00:00:00
abstract::Tuberculosis associated with dialysis was studied at the Artificial Kidney Unit (AKU) in Abha, Saudi Arabia. There were 13 tuberculosis patients out of 270 patients on maintenance hemodialysis from August 1986 to July 1993, a prevalence of 4.8%. Ten (77%) were female and 3 (23%) were male, mean age of 51.23 +/- 11.62 ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169068
更新日期:1997-01-01 00:00:00
abstract::Several medical inventors in Europe and North America brought the artificial kidney (hemodialysis) to practical usefulness in the late 1940s, but there were very few early successes. It was used at first for only desperate cases of acute renal failure. Renal authorities in the 'metabolic' tradition favored newly quant...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000169117
更新日期:1997-01-01 00:00:00
abstract::In 1828, Friedrich Wöhler, a German physician and chemist by training, published a paper that describes the formation of urea, known since 1773 to be a major component of mammalian urine, by combining cyanic acid and ammonium in vitro. In these experiments the synthesis of an organic compound from two inorganic molecu...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013463
更新日期:1999-01-01 00:00:00
abstract::Erythropoietin-stimulating agent (ESA) hyporesponsiveness is aggravated by chronic inflammation in maintenance hemodialysis (MHD) patients. Dyslipidemia is prevalent in MHD patients. Statin therapy has been demonstrated to not only be effective in lowering lipid levels, but also numerous pleiotropic effects including ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000169658
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Hypercholesterolemia is one of the major manifestations of nephrotic syndrome. We have previously shown that nephrotic hypercholesterolemia is associated with and, in part, due to dysregulation of hepatic HMG-CoA reductase, acyl-CoA:cholesterol acyltransferase (ACAT) and cholesterol 7alpha-hydroxylase, as we...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000082510
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Protein-energy wasting (PEW) is common and associated with poor outcome in hemodialysis patients. In hemodialysis patients, geriatric nutritional risk index (GNRI) and decoy receptor 3 (DcR3) have been shown as the nutritional and inflammatory markers, respectively. The present study aimed to assess the pred...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000366457
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The proinflammatory cytokine S100A12 (also known as EN-RAGE) is associated with cardiovascular morbidity and mortality in hemodialysis patients. In the current study, we tested the hypothesis that S100A12 expressed in vascular smooth muscle in nonatherosclerosis-prone C57BL/6J mice on normal rodent chow diet...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000324693
更新日期:2011-01-01 00:00:00
abstract::To determine the prevalence and type of glomerulonephritis (GN) associated with hepatitis C virus (HCV) cirrhosis, we prospectively evaluated 28 consecutive Saudi patients with HCV cirrhosis for liver transplantation. Six patients (21%) underwent kidney biopsies for proteinuria, unexplained elevated serum creatinine o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168874
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Older adults with advanced non-dialysis-dependent chronic kidney disease (NDD-CKD) face a high risk of hospitalization and related adverse events. METHODS:This prospective cohort study followed nephrology clinic patients ≥60 years old with NDD-CKD stages 4-5. After an eligible patient's office visit, study ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000509046
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:There is continued and significant debate regarding the salient etiologies associated with graft loss and racial disparities in kidney transplant recipients. METHODS:This was a longitudinal cohort study of all adult kidney transplant recipients, comparing patients with early graft loss (<5 years) to those w...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000363393
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Insufficient evidenced-based information is available for the treatment of osteoporosis in hemodialysis (HD) patients. METHODS:In 102 HD patients, bone mineral density (BMD) was measured twice 16 ± 3 months apart. In the second BMD measurement 66 of them had a femoral neck (FN) T-score <-2.5. Of these 66 pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341864
更新日期:2012-01-01 00:00:00
abstract::Most pretransplant malignancies require a tumor-free waiting period before transplantation. End-stage renal disease (ESRD) patients have an increased risk of renal cell carcinoma (RCC), which is mostly detected from routine screening during pre-kidney transplant evaluation. RCC must be quiescent prior to kidney transp...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000365201
更新日期:2014-01-01 00:00:00
abstract::Forty-eight chronic hemodialysis patients were divided comparably into two groups (24 patients in each). Two micrograms of 1 alpha(OH)D3 was administered to one group for 3 months and its placebo to the other group. In the 1 alpha(OH)D3-treated group, serum total calcium increased from 7.82 +/- 0.11 (mean +/- SEM) to ...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000167658
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Familial juvenile hyperuricemic nephropathy (FJHN) is an autosomal dominant disorder characterized by early onset of hyperuricemia, decreased fractional renal urate excretion and progressive interstitial nephropathy. Mutations in the uromodulin (UMOD) gene encoding uromodulin/Tamm-Horsfall, a glycosylphospha...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000339752
更新日期:2012-01-01 00:00:00
abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND/AIMS:Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. METHODS:In this retrospective cohort study, we used the US Renal Data System database to identify period-...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000380828
更新日期:2015-01-01 00:00:00
abstract::The development of new therapies for chronic diseases, such as diabetic kidney disease (DKD), will continue to be hampered by lack of sufficient biomarkers that will provide insights and will be responsive to treatment interventions. The recent application of metabolomic technologies, such as nuclear magnetic resonanc...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000447954
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The value of chronic kidney disease (CKD) screening in the general population remains unclear but may be beneficial in populations with high disease prevalence. We examined risk factors for albuminuria among participants in a state-wide CKD screening program in Hawaii. METHODS:The National Kidney Foundation...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000455389
更新日期:2017-01-01 00:00:00
abstract::Awareness that sphygmomanometry is encompassed with serious limitations has led to the development of techniques that allow blood pressure (BP) to be monitored intraarterially or noninvasively during the day or over a 24-hour period. Although intraarterial BP monitoring allows an accurate evaluation of 24-hour BP mean...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167335
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Henoch-Schönlein purpura (HSP) is a form of systemic vasculitis that can progress to Henoch-Schönlein purpura nephritis (HSPN), and the most effective treatment remains controversial. Our aim was to compare the effects of oral mycophenolate mofetil (MMF) with low-dose prednisone and the full-dose corticoster...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341914
更新日期:2012-01-01 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::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::We assessed blood volume (BV) in 20 edematous patients with nephrotic syndrome and in 32 subjects without renal or other disease liable to induce BV variation. Two methods were chosen, one using 131I-albumin and the other 51Cr red blood cells. Among the 20 patients, 11 presented minimal-change lesions, and 9 had histo...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167967
更新日期:1989-01-01 00:00:00
abstract::Bardoxolone methyl has been reported to cause detrimental cardiovascular events in the terminated BEACON Phase III human clinical trial via modulation of the renal endothelin pathway. However, the effects of bardoxolone methyl administration on the endothelin pathway in the heart are unknown. Our purpose in this persp...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000368563
更新日期:2014-01-01 00:00:00
abstract::A young woman presented with nephrotic syndrome due to membranous nephropathy and a localized form of giant lymph node hyperplasia (Castleman's disease) occurring as a large intra-abdominal mass. Five months after surgical removal of the mass, only mild proteinuria persisted. Twenty months later a second kidney biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168127
更新日期:1990-01-01 00:00:00
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:BACKGROUND/AIMS:Chronic kidney disease (CKD) and serious mental illness (SMI) are both associated with an increased risk for repeated hospitalization. The objective of this study was to determine if co-occurring SMI exacerbates the risk for subsequent hospitalization, particularly through the emergency department (ED),...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000360095
更新日期:2014-01-01 00:00:00
abstract::To evaluate the therapeutic effect of recombinant human alpha-interferon (alpha-IFN) on hepatitis B virus associated glomerulonephritis (HBV-GN) and the relationship between the seroconversion of viral antigens and the change of proteinuria, the hepatitis B viral markers and urinary protein were monitored during alpha...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169083
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus (HCV) infection is highly prevalent among patients on hemodialysis (HD) and is associated with poor prognosis. Treatment with interferon and ribavirin is poorly tolerated, and few data are available on the impact of new direct-acting antivirals (DAAs). This study was intended to analyze the...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.1159/000454819
更新日期:2017-01-01 00:00:00