Our research broadens the knowledge of kidney disease.

Symptom Prioritization among Adults Receiving In-Center Hemodialysis: A Mixed Methods Study

Flythe JE, Hilliard T, Castillo G, Ikeler K, Orazi J, Abdel-Rahman E, Pai AB, Rivara MB, St Peter WL, Weisbord SD, Wilkie C, Mehrotra R

Individuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for symptom relief in this population. To stimulate innovation in symptom management, data on patient symptom prioritization and treatment preferences are needed. We undertook this study to (1) identify patient-prioritized symptoms for the development of symptom relief therapies and (2) elicit preferences for treatments among individuals receiving hemodialysis.

Proximal Tubular Secretory Clearance: A Neglected Partner of Kidney Function

Wang K, Kestenbaum B

The secretion of small molecules by the proximal tubules of the kidneys represents a vital homeostatic function for rapidly clearing endogenous solutes and medications from the circulation. After filtration at the glomerulus, renal blood flow is directed through a network of peritubular capillaries, where transporters of the proximal tubules actively secrete putative uremic toxins and hundreds of commonly prescribed drugs into the urine, including protein-bound substances that cannot readily cross the glomerular basement membrane. Despite its central physiologic importance, tubular secretory clearance is rarely measured or even estimated in clinical or research settings.

Genome-wide association study in 79,366 European-ancestry individuals informs the genetic architecture of 25-hydroxyvitamin D levels.

Kestenbaum B, et al

Vitamin D is a steroid hormone precursor that is associated with a range of human traits and diseases. Previous GWAS of serum 25-hydroxyvitamin D concentrations have identified four genome-wide significant loci (GC, NADSYN1/DHCR7, CYP2R1, CYP24A1). In this study, we expand the previous SUNLIGHT Consortium GWAS discovery sample size from 16,125 to 79,366 (all European descent).

Fibroblast Growth Factor 23: A Biomarker of Kidney Function Decline

Drew DA, Katz R, Kritchevsky S, Ix JH, Shlipak MG, Newman AB, Hoofnagle A, Fried L, Sarnak MJ, Gutierrez OM

Fibroblast growth factor 23 (FGF-23) is a hormone that regulates phosphorus levels and vitamin D metabolism. Previous studies have shown FGF-23 to be a risk factor for incident end-stage renal disease; however, there are less data on the association of FGF-23 with earlier kidney-related outcomes.

Urinary Biomarkers of Kidney Tubular Damage and Risk of Cardiovascular Disease and Mortality in Elders

Jotwani V, Katz R, Ix JH, Gutiérrez OM, Bennett M, Parikh CR, Cummings SR, Sarnak MJ, Shlipak MG

Novel urinary biomarkers have enabled earlier detection of kidney tubular damage, but their prognostic value for adverse cardiovascular outcomes is uncertain. We hypothesized that tubular damage, measured by urine α1-microglobulin (A1M), amino-terminal propeptide of type III procollagen (PIIINP), and neutrophil gelatinase-associated lipocalin (NGAL), would be associated with higher risks for cardiovascular events and mortality among elders.

Masked hypertension and kidney function decline: the Jackson Heart Study

Mwasongwe S, Min YI, Booth JN 3rd, Katz R, Sims M, Correa A, Young B, Muntner P

Hypertension diagnosed by blood pressure (BP) measured in the clinic is associated with rapid kidney function decline (RKFD) and incident chronic kidney disease (CKD). The extent to which hypertension defined using out-of-clinic BP measurements is associated with these outcomes is unclear.

The Dietary Fructose:Vitamin C Intake Ratio Is Associated with Hyperuricemia in African-American Adults

Zheng Z, Harman JL, Coresh J, Köttgen A, McAdams-DeMarco MA, Correa A, Young BA, Katz R, Rebholz CM.

A high fructose intake has been shown to be associated with increased serum urate concentration, whereas ascorbate (vitamin C) may lower serum urate by competing with urate for renal reabsorption.

Race and stroke in an atrial fibrillation inception cohort: Findings from the Penn Atrial Fibrillation Free study

Patel PJ, Katz R, Borovskiy Y, Killian A, Levine JM, McNaughton NW, Callans D, Supple G, Dixit S, Epstein AE, Marchlinski FE, Deo R

Stroke may be the initial manifestation of atrial fibrillation (AF). Limited studies, however, have evaluated racial differences in stroke before the diagnosis of AF. We assessed racial differences in strokes that occurred before and after AF diagnosis in the Penn Atrial Fibrillation Free study.

Social Determinants of Health: Addressing Unmet Needs in Nephrology

There is ongoing recognition that a wide array of social, economic, and environmental factors influence individuals' opportunities to engage in health care and healthy behaviors. Despite spending $34 billion annually on the care of patients with end-stage renal disease, the American public and nephrology community remain remarkably complacent about addressing "upstream" factors that influence the prevention, progression, and treatment of chronic kidney diseases.

US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States

Hall YNO'Hare AM, et al

The US Renal Data System (USRDS) is the largest and most comprehensive national end-stage renal disease (ESRD) and chronic kidney disease (CKD) surveillance system in the world. Trends in the prevalence of CKD and ESRD are important for health care policy and planning.