1-year tolvaptan efficacy in ADPKD

Autosomal dominant polycystic kidney disease (ADPKD) develops into end-stage kidney disease by 65 years of age in an estimated 45%-70% of patients. Recent trials revealed that tolvaptan inhibits disease progression both in early-stage or late-stage ADPKD ; however, stratified analysis showed a difference of favorable factors correlated with tolvaptan efficacy between early-stage and late-stage ADPKD. Thus, we examined the efficacy of tolvaptan in ADPKD with a wide range of estimated glomerular filtration rates (eGFR). We enrolled 24 patients with eGFR 35.3 (28.0-65.5) ml / min / 1.73m2 and evaluated treatment effect as ΔΔeGFR (ml / min / 1.73m2 / year) or ΔΔtotal kidney volume (TKV) (% / year) that was calculated as post-treatment annual change - pre-treatment annual change. Pre ΔeGFR was significantly low in eGFR responders, defined as ΔΔeGFR > 0 ml / min / 1.73m2 / year. In eGFR responders, pre ΔeGFR, post ΔeGFR, eGFR, TKV, and proteinuria were significantly correlated with ΔΔeGFR. In TKV responders defined as ΔΔTKV > 5 % / year, we identified hypertension history, proteinuria, TKV, and post ΔTKV as significantly correlated factors with ΔΔTKV. In conclusion, pre ΔeGFR may be a predictive factor of therapeutic efficacy on kidney function. Tolvaptan may have greater efficacy in early-stage ADPKD with rapid GFR decline or with well-controlled blood pressure

A retrospective study of patients with Stenotrophomonas maltophilia peritonitis undergoing peritoneal dialysis

Abstract Background Stenotrophomonas maltophilia (S. maltophilia) is being increasingly recognized as an important cause of nosocomial infections, particularly in immunocompromised patients, such as patients undergoing dialysis. S. maltophilia peritonitis is strongly associated with the loss of peritoneal catheter among patients undergoing peritoneal dialysis (PD) owing to its resistance to different groups of antibiotics. Thus, the aim of this study was to investigate the characteristics of and risk factors for S. maltophilia peritonitis in patients undergoing PD. Methods This single-center, retrospective, case–control study was conducted between April 2013 and October 2022. Patients who were undergoing PD at Kawashima Hospital and were diagnosed with S. maltophilia peritonitis were included in this study. Controls were randomly selected from among patients who were undergoing PD and were diagnosed with peritonitis caused by microorganisms other than S. maltophilia. The demographic data, clinical characteristics, and initial treatment data of the patients were analyzed to determine the risk factors for PD-related S. maltophilia peritonitis. Results Five patients with S. maltophilia peritonitis and 15 controls (three controls to one case) were included in this study. The incidence of S. maltophilia peritonitis was significantly more frequent among patients with diabetes mellitus (80.0% vs. 20.0%; p = 0.031) and among patients with higher white blood cell counts in the dialysate after appropriate antibiotic therapy (2561/µL [349–4654/µL] vs. 20/µL [20–23/µL]; p = 0.0006) than among the control patients. Although all the patients were treated with appropriate antibiotics after the identification of S. maltophilia, they had a significantly higher rate of catheter removal than the controls (80.0% vs. 0.0%; p = 0.001). Conclusions Diabetes mellitus may be an important risk factor for S. maltophilia peritonitis in patients undergoing PD

Additional file 2 of Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study

Additional file2. Table S2. Hemodiafilters and mean estimated albumin leakage (EAL

Additional file 8 of Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study

Additional file8. Fig. S6. Relationship between albumin leakage in the range of 3.0 to <5.0 g/session and the removal amount of α1-microglobulin (α1MG). a Predilution online hemodiafiltration. b Postdilution online hemodiafiltratio

Additional file 3 of Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study

Additional file3. Fig. S1 Comparison of annual crude mortality rate in the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) versus our institution

Additional file 1 of Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study

Additional file1. Table S1. Dialyzers and mean estimated albumin leakage (EAL

Additional file 6 of Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study

Additional file6. Fig. S4. Relationships of removal amount of α1-microglobulin (α1MG) over 250 mg/session with albumin leakage and reduction rate of α1MG. a Removal amount of α1MG and albumin leakage. b Removal amount of α1MG and reduction rate of α1M

A new β-carbonic anhydrase from Brucella suis, its cloning, characterization, and inhibition with sulfonamides and sulfamates, leading to impaired pathogen growth

International audienceA β-carbonic anhydrase (CA, EC 4.2.1.1) from the bacterial pathogen Brucella suis, bsCA II, has been cloned, purified, and characterized kinetically. bsCA II showed high catalytic activity for the hydration of CO(2) to bicarbonate, with a k(cat) of 1.1×10(6), and k(cat)/K(m) of 8.9×10(7)M(-1)s(-1). A panel of sulfonamides and sulfamates have been investigated for inhibition of this enzyme. All types of activities, from the low nanomolar to the micromolar, have been detected for these derivatives, which showed inhibition constants in the range of 7.3nM-8.56μM. The best bsCA II inhibitors were some glycosylated sulfanilamides, aliphatic sulfamates, and halogenated sulfanilamides, with inhibition constants of 7.3-87nM. Some of these dual inhibitors of bsCA I and II, also inhibited bacterial growth in vitro, in liquid cultures. These promising data on live bacteria allow us to propose bacterial β-CA inhibition as an approach for obtaining anti-infective agents with a new mechanism of action compared to classical antibiotics