Our research broadens the knowledge of kidney disease.

The Effect of Extended Release Niacin on Markers of Mineral Metabolism in CKD

Malhotra R, Katz R, Hoofnagle A, Bostom A, Rifkin DE, Mcbride R, Probstfield J, Block G, Ix JH

Chronic kidney disease is common and strongly linked with risk of fractures, cardiovascular disease, and end stage renal disease. Kidney disease patients have higher serum phosphate levels, and higher phosphate may be causing the higher risk of these outcomes. We identified that the lipid drug niacin lowers serum phosphate through a unique mechanism.

Stuck in a Bind With Phosphate Binders

Kestenbaum B, Psaty BM

Associations and Presumed Mechanisms Are Inadequate for Predicting Drug Effects. Scores of observational studies demonstrate that lower high-density lipoprotein cholesterol (HDL-C) concentrations are associated with cardiovascular risk.

Commentary on Lessons from CKD-Related Genetic Association Studies-Moving Forward

Kestenbaum B, Seliger SL

KEYWORDS: Genetic Association Studies; Renal Insufficiency, Chronic

Impact of Obesity on Modality Longevity, Residual Kidney Function, Peritonitis, and Survival Among Incident Peritoneal Dialysis Patients

Obi Y, Streja E, Mehrotra RRivara MB, Rhee CM, Soohoo M, Gillen DL, Lau WL, Kovesdy CP, Kalantar-Zadeh K

The association between obesity and clinical outcomes among patients ESRD undergoing peritoneal dialysis (PD) remains unclear in the current era. This observational study analyzed 15,573 PD patients in the US and found that higher body mass index was associated with greater risk for peritonitis-related hospitalizations, rapid decline in residual kidney function, and more frequent transfers to in-center hemodialysis. There was no difference in risk for death among obese patients undergoing PD compared to those treated with hemodialysis.

Charting the transcriptional landscape of cells of renin lineage following podocyte depletion

McClelland AD, Lichtnekert J, Eng DG, Pippin JW, Gross KW, Gharib SA, Shankland SJ

Renin producing cells of the juxtaglomerulus, herein called cells of renin lineage (CoRL), have garnered recent interest for their propensity to act as a progenitor source for various kidney cell types including podocytes. Despite recent advances, the process of transdifferentiation of CoRL to podocytes is poorly understood.

Perioperative THR-184 and AKI after Cardiac Surgery

Jonathan Himmelfarb, Glenn M. Chertow, Peter A. McCullough, Thierry Mesana, Andrew D. Shaw, Thoralf M. Sundt, Craig Brown, David Cortville, François Dagenais, Benoit de Varennes, Manuel Fontes, Jerome Rossert, Jean-Claude Tardif

AKI after cardiac surgery is associated with mortality, prolonged hospital length of stay, use of dialysis, and subsequent CKD. We evaluated the effects of THR-184, a bone morphogenetic protein-7 agonist, in patients at high risk for AKI after cardiac surgery.

Acute Kidney Injury and Risk of Incident Heart Failure Among US Veterans

Bansal N, Matheny ME, Greevy RA Jr, Eden SK, Perkins AM, Parr SK, Fly J, Abdel-Kader K, Himmelfarb J, Hung AM, Speroff T, Ikizler TA, Siew ED

In this study of over 300,000 hospitalized U.S. Veterans, we found that acute kidney injury was associated with a 23% greater risk of developing incident heart failure within 2 years from hospital discharge.

Risk profiles for acute health events after incident atrial fibrillation in patients with end-stage renal disease on hemodialysis

Airy M, Chang TI, Ding VY, Goldstein BA, Bansal N, Niu J, Navaneethan SD, Turakhia MP, Winkelmayer WC

Among 85,000 older incident hemodialysis patients in the U.S., atrial fibrillation was diagnosed in 14% of this population. Atrial fibrillation was associated with up to 9-fold increased risk of mortality, particularly in the first 90 days after diagnosis of atrial fibrillation.

Longitudinal FGF23 Trajectories and Mortality in Patients with CKD

Tamara Isakova, Xuan Cai, Jungwha Lee, Dawei Xie, Xue Wang, Rupal Mehta, Norrina B. Allen, Julia J. Scialla, Michael J. Pencina, Amanda H. Anderson, John Talierco, Jing Chen, Michael J. Fischer, Susan P. Steigerwalt, Mary B. Leonard, Chi-yuan Hsu, Ian H. de Boer, John W. Kusek, Harold I. Feldman, Myles Wolf, Chronic Renal Insufficiency Cohort (CRIC) Study Investigators

FGF-23 is a phosphaturic hormone that may promote cardiovascular disease. People with CKD enrolled in the CRIC study, and those whose blood FGF-23 concentrations rose during follow-up had markedly higher mortality rates than those whose FGF-23 concentrations remained stable or decreased. This provides new evidence that interventions to prevent rising FGF-23 may improve health outcomes in CKD.

Mortality Associated with Metformin Versus Sulfonylurea Initiation: A Cohort Study of Veterans with Diabetes and Chronic Kidney Disease

Marcum ZA, Forsberg CW, Moore KP, de Boer IH, Smith NL, Boyko EJ, Floyd JS

Metformin is the preferred first-line drug used to lower blood glucose for people with diabetes. However, metformin is cleared by the kidneys, and its use has been restricted among patients with CKD. In this observational cohort study of more than 175,000 veterans with diabetes, metformin was associated with better outcomes than a comparator glucose-lowering drug (glipizide) at all evaluated levels of estimated GFR. This supports more widespread use of metformin among people with diabetes and moderate (stage 3) CKD.