Our faculty research broadens the knowledge of kidney disease.

Patient and Caregiver Priorities for Outcomes in Peritoneal Dialysis: Multinational Nominal Group Technique Study

Manera KE, Johnson DW, Craig JC, Shen JI, Ruiz L, Wang AY, Yip T, Fung SKS, Tong M, Lee A, Cho Y, Viecelli AK, Sautenet B, Teixeira-Pinto A, Brown EA, Brunier G, Dong J, Dunning T, Mehrotra R, Naicker S, Pecoits-Filho R, Perl J, Wilkie M, Tong A

The absence of accepted patient-centered outcomes in research can limit shared decision-making in peritoneal dialysis (PD), particularly because PD-related treatments can be associated with mortality, technique failure, and complications that can impair quality of life. We aimed to identify patient and caregiver priorities for outcomes in PD, and to describe the reasons for their choices.

Body Weight and eGFR during Body Weight and eGFR during Dulaglutide Treatment in Type 2 Diabetes and Moderate-to-Severe Chronic Kidney Disease (AWARD-7). Treatment in Type 2 Diabetes and Moderate-to-Severe Chronic Kidney Disease (AWARD-7)

Tuttle KR, Lakshmanan MC, Rayner B, Zimmermann AG, Woodward DB, Botros FT

In patients with T2D and moderate‐to‐severe CKD, dulaglutide treatment led to body weight (BW) loss and lesser eGFR decline compared to insulin glargine. Since BW may affect muscle mass, creatinine‐based eGFR can be altered independent of kidney function. Cystatin C‐based eGFR is not affected by muscle mass. The objective of this post‐hoc analysis was to evaluate if lesser eGFR decline with dulaglutide was related to BW loss.

Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease: A Report of the International Consortium for Health Outcomes Measurement (ICHOM) CKD Working Group

Verberne WR, Das-Gupta Z, Allegretti AS, Bart HAJ, van Biesen W, García-García G, Gibbons E, Parra E, Hemmelder MH, Jager KJ, Ketteler M, Roberts C, Al Rohani M, Salt MJ, Stopper A, Terkivatan T, Tuttle KR, Yang CW, Wheeler DC, Bos WJW

Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use.

Calcimimetics and Bundled Reimbursement

Lin E, Watnick S

Since 2011, the Centers for Medicare & Medicaid Services has provided reimbursement for renal dialysis services furnished to Medicare beneficiaries through a bundled payment system known as the Prospective Payment System. Medications that have no injectable equivalent, known as “oral-only medications,” are currently excluded from the bundle and are paid separately through Medicare Part D. Thus, before the development of etelcalcetide, the first injectable calcimimetic, calcimimetics were reimbursed outside the bundle. Etelcalcetide’s introduction and approval for use in Medicare triggered a transition payment for a minimum of 2 years that will eventually result in the incorporation of calcimimetics into the dialysis bundle. Consequently, providers may face incentives to reduce calcimimetic use when the transition period has expired.

The association of glycated hemoglobin with mortality and ESKD among persons with diabetes and chronic kidney disease

Limkunakul C, de Boer IH, Kestenbaum BR, Himmelfarb J, Ikizler TA, Robinson-Cohen C

Diabetic kidney disease (DKD) is the leading cause of end stage kidney disease (ESKD) and is associated with a considerably shortened lifespan. While glucose-lowering therapy targeting glycated hemoglobin (HbA1c) <7% is proven to reduce the risk of developing DKD, its effects on complications of DKD are unclear. We examined the associations of HbA1c with risks of progression to ESKD and death within a clinic-based study of CKD. We hypothesized that higher HbA1c concentrations would be associated with increased risks of ESKD and death.

Relationship of acid-base status with arterial stiffness in community-living elders: the Health ABC Study

Wei Chen, Anne B Newman, Linda F Fried, Dena E Rifkin, Michael G Shlipak, Mark J Sarnak, Ronit Katz, Magdalena Madero, Kalani L Raphael, David A Bushinsky, Joachim H Ix

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

Rajiv Saran, Bruce Robinson, Kevin C. Abbott, Lawrence Y.C. Agodoa, Jennifer Bragg-Gresham, Rajesh Balkrishnan, Nicole Bhave, Xue Dietrich, Zhechen Ding, Paul W.Eggers, Abduzhappar Gaipov, Daniel Gillen, Debbie Gipson, Haoyu Gu, Paula Guro, Diana Haggerty, Yun Han, Kevin He….Ann M. O'Hare, VahaknShahinian

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

Dieter, B.P., Meek, R.L., Anderberg, R.J., Cooney, S.K., Bergin, J.L., Zhang, H., Nair, V., Kretzler, M., Brosius, F.C., Tuttle, K.R.

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

Rajnish Mehrotra, Daniel Cukor, Mark Unruh, Tessa Rue, Patrick Heagerty, Scott D. Cohen, Laura M. Dember, Yaminette Diaz-Linhart, Amelia Dubovsky, Tom Greene, Nancy Grote, Nancy Kutner,  Madhukar H. Trivedi, Davin K. Quinn, Nisha ver Halen, Steven D. Weisbord, Bessie A. Young, Paul L. Kimmel, S. Susan Hedayati

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

Karsten B. Sieber, Anna Batorsky, Kyle Siebenthall, Kelly L. Hudkins, Jeff D. Vierstra, Shawn Sullivan, Aakash Sur, Michelle McNulty, Richard Sandstrom, Alex Reynolds, Daniel Bates, Morgan Diegel, Douglass Dunn, Jemma Nelson, Michael Buckley, Rajinder Kaul, Matthew G. Sampson, Jonathan Himmelfarb, Charles E. Alpers, Dawn Waterworth and Shreeram Akilesh

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.