Our faculty research broadens the knowledge of kidney disease.
Relationship of acid-base status with arterial stiffness in community-living elders: the Health ABC Study
Animal studies suggest that acidosis protects against arterial calcification, which contributes to arterial stiffness. The goal of this study was to investigate the associations of serum bicarbonate and pH with arterial stiffness in community-living older adults.
US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States
Trends in the prevalence of CKD and ESRD are important for health care policy and planning. According to data from the National Health and Nutrition Examination Survey (NHANES), the prevalence of CKD among US adults is estimated at just under 15%, indicating that over 30 million American adults may have CKD. This is likely due to the high prevalence of risk factors for the disease, including an aging population, diabetes, hypertension, obesity, cardiovascular disease, and other conditions.
Serum amyloid A and Janus kinase 2 in a mouse model of diabetic kidney disease
Serum amyloid A (SAA), a potent inflammatory mediator, and Janus kinase 2 (JAK2), an intracellular signaling kinase, are increased by diabetes. The aims were to elucidate: 1) a JAK2-mediated pathway for increased SAA in the kidneys of diabetic mice; 2) a JAK2-SAA pathway for inflammation in podocytes.
Comparative Efficacy of Therapies for Treatment of Depression for Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial
Although depression is common among patients receiving maintenance hemodialysis, data on their acceptance of treatment and on the comparative efficacy of various therapies are limited.To determine the effect of an engagement interview on treatment acceptance (phase 1) and to compare the efficacy of cognitive behavioral therapy (CBT) versus sertraline (phase 2) for treating depression in patients receiving hemodialysis.
Integrated Functional Genomic Analysis Enables Annotation of Kidney Genome-Wide Association Study Loci
Linking genetic risk loci identified by genome-wide association studies (GWAS) to their causal genes remains a major challenge. Disease-associated genetic variants are concentrated in regions containing regulatory DNA elements, such as promoters and enhancers. Although researchers have previously published DNA maps of these regulatory regions for kidney tubule cells and glomerular endothelial cells, maps for podocytes and mesangial cells have not been available.
Lower Extremity Amputation and Health Care Utilization in the Last Year of Life among Medicare Beneficiaries with ESRD
Although lower extremity amputation is common among patients with ESRD and often portends a poor prognosis, little is known about end-of-life care among these patients. The authors’ analysis of a national cohort of Medicare beneficiaries finds that patients with ESRD are far more likely than those without ESRD to undergo amputation during their final year of life.
Burden of excess mortality after implementation of the new kidney allocation system may be borne disproportionately by middle-aged recipients
Under the new kidney allocation system (KAS), implemented in 2014, the distribution of the best quality donor kidney grafts shifted between age groups, but it is unclear whether this change translates to meaningful differences in post-transplant outcomes. We conducted a retrospective cohort study of 20,345 deceased donor kidney transplant recipients before and 4,605 recipients after implementation of the KAS using data from the United Network of Organ Sharing
Commentary on "Demystifying the Benefits and Harms of Anticoagulation for Atrial Fibrillation in CKD"
Given the high incidence of both ischemic stroke and major hemorrhage among patients with CKD and atrial fibrillation, treatment decisions regarding oral anaticoagulation can be challenging. The authors note that there is no evidence from randomized trials on the safety or efficacy of these medications in patients with CKD stages 4 and 5.
Patterns of Beverages Consumed and Risk of Incident Kidney Disease
Selected beverages, such as sugar-sweetened beverages, have been reported to influence kidney disease risk, although previous studies have been inconsistent. Further research is necessary to comprehensively evaluate all types of beverages in association with CKD risk to better inform dietary guidelines. We conducted a prospective analysis in the Jackson Heart Study, a cohort of black men and women in Jackson, Mississippi. Beverage intake was assessed using a food frequency questionnaire administered at baseline (2000–2004). Incident CKD was defined as onset of eGFR<60 ml/min per 1.73 m2 and ≥30% eGFR decline at follow-up (2009–13) relative to baseline among those with baseline eGFR ≥60 ml/min per 1.73 m2.
Sodium-Glucose Cotransporter 2 Inhibition and Diabetic Kidney Disease
Preclinical studies and clinical trials of SGLT2 inhibitors have consistently demonstrated reduction of albuminuria and preservation of kidney function. In particular, SGLT2 inhibitors lower risk of congestive heart failure, a major cardiovascular complication in DKD. This Perspective summarizes proposed mechanisms of action for SGLT2 inhibitors, integrates these data with results of recent cardiovascular outcomes trials, and discusses clinical applications for patients with DKD.