Our faculty research broadens the knowledge of kidney disease.

Prediction of cardiovascular outcomes with machine learning techniques: application to the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study

Chen T, Brewster P, Tuttle KR, Dworkin LD, Henrich W, Greco BA, Steffes M, Tobe S, Jamerson K, Pencina K, Massaro JM, D'Agostino RB Sr, Cutlip DE, Murphy TP, Cooper CJ, Shapiro JI.

Data derived from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study were analyzed in an effort to employ machine learning methods to predict the composite endpoint described in the original study.

Association of Acute Kidney Injury with Cardiovascular Events and Death in Systolic Blood Pressure Intervention Trial

Dieter BP, Daratha KB, McPherson SM, Short R, Alicic RZ, Tuttle KR

Abstract - RATIONALE AND OBJECTIVE: In the Systolic Blood Pressure Intervention Trial, the possible relationships between acute kidney injury (AKI) and risk of major cardiovascular events and death are not known. STUDY DESIGN: Post hoc analysis of a multicenter, randomized, controlled, open-label clinical trial. SETTING AND PARTICIPANTS: Hypertensive adults without diabetes who were ≥50 years of age with prior cardiovascular disease, chronic kidney disease (CKD), 10-year Framingham risk score > 15%, or age > 75 years were assigned to a systolic blood pressure target of < 120 mm Hg (intensive) or < 140 mm Hg (standard). PREDICTOR: AKI episodes.

A Prediction Model for Severe AKI in Critically Ill Adults That Incorporates Clinical and Biomarker Data.

Bhatraju PK, Zelnick LR, Katz R, Mikacenic C, Kosamo S, Hahn WO, Dmyterko V, Kestenbaum B, Christiani DC, Liles WC, Himmelfarb J, Wurfel MM.

Critically ill patients with worsening AKI are at high risk for poor outcomes. Predicting which patients will experience progression of AKI remains elusive. We sought to develop and validate a risk model for predicting severe AKI within 72 hours after intensive care unit admission.

Blood pressure, antihypertensive medication use, and risk of erectile dysfunction in men with type I diabetes

Sarma AV, Hotaling JM, de Boer IH, Dunn RL, Oerline MK, Singh K, Goldberg J, Jacobson A, Braffett B, Herman WH, Pop-Busui R, Wessells H; DCCT/EDIC Research Group.

To gain insight into the effect of blood pressure on the pathophysiology of diabetic erectile dysfunction, we determined the onset, severity and treatment of hypertension and risk of incident erectile dysfunction in men with type I diabetes. This prospective cohort study included 692 men without prevalent erectile dysfunction in the Epidemiology of Diabetes Interventions and Complications study. Erectile dysfunction was assessed yearly for 16 years with a single question querying presence of impotence. Multivariable cox proportional hazards models examined associations of hypertension variables with risk for incident erectile dysfunction.

Serum Calcification Propensity and Coronary Artery Calcification Among Patients With CKD: The CRIC (Chronic Renal Insufficiency Cohort) Study

Bundy JD, Cai X, Scialla JJ, Dobre MA, Chen J, Hsu CY, Leonard MB, Go AS, Rao PS, Lash JP, Townsend RR, Feldman HI, de Boer IH, Block GA, Wolf M, Smith ER, Pasch A, Isakova T; CRIC Study Investigators.

Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and increases risks for cardiovascular disease events and mortality. We hypothesized that a novel serum measure of calcification propensity is associated with CAC among patients with CKD stages 2 to 4.

Updates in the management of heart failure for the chronic kidney disease patient

Hsu S, Bansal N

Heart failure is highly prevalent in patients with chronic kidney disease (CKD) and a leading cause of morbidity and mortality in this population. Heart failure therapies proven to benefit the general population may have different risk–benefit profiles in patients with concurrent CKD, plausibly because of the unique pathophysiology of heart failure in this population. The present review highlights recent advances in heart failure treatment as they apply to patients with CKD.

Association of serum uromodulin with mortality and cardiovascular disease in the elderly-the Cardiovascular Health Study

Steubl D, Buzkova P, Garimella PS, Ix JH, Devarajan P, Bennett MR, Chaves PHM, Shlipak MG, Bansal N, Sarnak MJ.

Uromodulin (UMOD) is released by renal tubular cells into the serum (sUMOD) and urine. Lower urine UMOD has been linked to mortality and cardiovascular disease but much less is known about sUMOD. We evaluated the association of sUMOD with these outcomes in community-dwelling older adults.

Urinary Concentration Ability: Time to Bring the Tubules to the Table

Ke Wang, Bryan Kestenbaum

As a central homeostatic organ, the kidneys perform diverse physiologic functions beyond glomerular filtration, including synthesis of vital hormones, secretion of protein-bound organic solutes, and maintenance of salt and water balance. The “intact nephron hypothesis” postulates a progressive and proportionate decline in kidney functions across the spectrum of chronic kidney disease (CKD). However, several lines of evidence suggest contrasts between tubular and glomerular functions in the diseased state. For example...

Health-related quality of life in glomerular disease

Canetta, P.A.,  Troost, J.P.,  Mahoney, S.,  Kogon, A.J.,  Carlozzi, N.,  Bartosh, S.M.,  Cai, Y.,,  Davis, T.K.,  Fernandez, H.,,  Fornoni, A.,  Gbadegesin, R.A.,  Herreshoff, E.,,  Mahan, J.D.,  Nachman, P.H.,  Selewski, D.T.,,  Sethna, C.B.,,  Srivastava, T.,  Tuttle, K.R.,,  Wang, C.-S.,  Falk, R.J.,  Gharavi, A.G.,  Gillespie, B.W.,  Greenbaum, L.A.,  Holzman, L.B.,  Kretzler, M.,  Robinson, B.M.,Smoyer, W.E.,  Guay-Woodford, L.M.,  Reeve, B., Gipson, D.S, GN Consortium.........Hasely, L.,  Hendren, E.,  Hingorani, S.,  Hladunewich, M.,  Hogan, J.,  Hou, J.,  Jefferson, J.A.,  Jhaveri, K.,  Johnstone, D.B.,  Kaskel, F.,  Kogan, A.,  Kopp, J.,  Lafayette, R.,  Lemley, K.V.,........GN Consortium

There is scant literature describing the effect of glomerular disease on health-related quality of life (HRQOL). The Cure Glomerulonephropathy study (CureGN) is an international longitudinal cohort study of children and adults with four primary glomerular diseases (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy). HRQOL is systematically assessed using items from the Patient-Reported Outcomes Measurement Informative System (PROMIS).

Building Scaffolds to Rebuild Kidneys

Benjamin S. Freedman, Buddy Ratner

The ability to promote a regenerative, rather than fibrotic, response to injury in the kidney could open up an important therapeutic possibility in patients with CKD. The paper by Lih et al. makes an important contribution to this topic by optimizing artificial scaffolds for kidney regeneration.The rationale behind this study is the observation that artificial scaffolds of porous materials have been widely studied for their ability to enhance tissue regeneration, but commonly used polyester scaffolds such as poly(lactic-co-glycolic acid) (PLGA) release acidic byproducts as they degrade, which can have the opposite effect. The authors therefore seek to optimize these scaffolds, drawing inspiration from two examples of well-studied biology: the ability of magnesium hydroxide to moderate stomach acidity in antacid formulations, and the ability of extracellular matrix preparations to suppress immune responses and promote healing.