6 research outputs found
Supplementary Material for: Addition of eGFR and Age Improves the Prognostic Absolute Renal Risk-Model in 1,134 Norwegian Patients with IgA Nephropathy
<p><b><i>Background:</i></b> Predicting outcome in individual patients
with IgA nephropathy (IgAN) is difficult but important. For this
purpose, the absolute renal risk (ARR) model has been developed in a
French cohort to calculate the risk of end-stage renal disease (ESRD)
and death. ARR (0-3) is scored in individual IgAN patients based on the
presence of proteinuria ≥1 g/24 h, hypertension, and severe
histopathological lesions (1 point per risk factor). We have validated
the ARR model in a Norwegian cohort of IgAN patients and tested whether
adding data on initial estimated glomerular filtration rate (eGFR) and
age improved prediction. <b><i>Methods:</i></b> IgAN patients diagnosed
between 1988 and 2012 were identified in the Norwegian Kidney Biopsy
Registry, and endpoints were identified by record linkage with the
Norwegian Renal Registry (ESRD) and the Population Registry (deaths). <b><i>Results:</i></b>
We identified 1,134 IgAN patients. The mean duration of follow-up was
10.2 years (range 0.0 to 25.7 years). Two hundred and fifty one patients
developed ESRD and there were 69 pre-ESRD deaths. The ARR model
significantly stratified the IgAN cohort according to risk of
ESRD/death. The inclusion of eGFR and age significantly improved the ARR
prognostic model; in the receiver operator characteristics (ROC)
analysis, area under the curve (AUC) at 10-years of follow-up increased
from 0.79 to 0.89, p < 0.001. <b><i>Conclusions:</i></b> ARR is a
suitable prognostic model for stratifying IgAN patients according to the
risk of ESRD or death. Including initial eGFR and age in the model
substantially improved its accuracy in our nationwide cohort.</p
Supplementary Material for: Proteomic Analysis of Minimally Damaged Renal Tubular Tissue from Two-Kidney-One-Clip Hypertensive Rats Demonstrates Extensive Changes Compared to Tissue from Controls
<p><b><i>Background:</i></b> Tubular atrophy and interstitial fibrosis mark the final stage in most forms of progressive kidney diseases. Little is known regarding changes in the tubular proteome. In this study, we investigated changes in the tubular proteome of normal or minimally damaged tubular tissue in the non-clipped kidney from rats with two-kidney one-clip (2K1C) hypertension. <b><i>Methods:</i></b> Formalin-fixed paraffin-embedded kidney sections from four 2K1C rats with hypertensive kidney damage and 6 sham rats were used. Tubulointerstitial tissue without discernable interstitial expansion or pronounced tubular alterations was microdissected and this was assumed to represent an early stage of chronic tubular damage in 2K1C. Samples were analyzed by mass spectrometry and relative protein abundances were compared between 2K1C and sham. <b><i>Results:</i></b> A total of 1,160 proteins were identified with at least 2 unique peptides, allowing for relative quantitation between samples. Among these, 151 proteins were more abundant, and 192 proteins were less abundant in 2K1C compared with sham. Transgelin, vimentin and creatine kinase B-type were among the proteins that were most increased in 2K1C. Ingenuity Pathway Analysis showed increased abundance of proteins related to Rho signaling and protein turnover (eIF2 signaling and protein ubiquitination), and decreased abundance of proteins related to fatty acid β-oxidation. <b><i>Conclusion:</i></b> Tubular tissue from normal or minimally damaged hypertensive kidney damage demonstrate extensive proteomic changes with upregulation of pathways associated with progressive kidney damage, such as Rho signaling and protein turnover. Thus, proteomics presents itself to be a promising tool for the discovery of early damage markers from not yet morphologically visible tubular damage.</p
Performance of an easy-to-use prediction model for renal patient survival: an external validation study using data from the ERA-EDTA Registry
Clinical epidemiolog
Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis
IMPORTANCE During the past decades, improvements in the prevention and management of myocardial infarction, stroke, and pulmonary embolism have led to a decline in cardiovascular mortality in the general population. However, it is unknown whether patients receiving dialysis have also benefited from these improvements.OBJECTIVE To assess the mortality rates for myocardial infarction, stroke, and pulmonary embolism in a large cohort of European patients receiving dialysis compared with the general population.DESIGN, SETTING, AND PARTICIPANTS In this cohort study, adult patients who started dialysis between 1998 and 2015 from 11 European countries providing data to the European Renal Association Registry were and followed up for 3 years. Data were analyzed from September 2020 to February 2022.EXPOSURES Start of dialysis.MAIN OUTCOMES AND MEASURES The age- and sex-standardized mortality rate ratios (SMRs) with 95% CIs were calculated by dividing the mortality rates in patients receiving dialysis by the mortality rates in the general population for 3 equal periods (1998-2003, 2004-2009, and 2010-2015).RESULTS In total, 220 467 patients receiving dialysis were included in the study. Their median (IQR) age was 68.2 (56.5-76.4) years, and 82 068 patients (37.2%) were female. During follow-up, 83 912 patients died, of whom 7662 (9.1%) died because of myocardial infarction, 5030 (6.0%) died because of stroke, and 435 (0.5%) died because of pulmonary embolism. Between the periods 1998 to 2003 and 2010 to 2015, the SMR of myocardial infarction decreased from 8.1 (95% CI, 7.8-8.3) to 6.8 (95% CI, 6.5-7.1), the SMR of stroke decreased from 7.3 (95% CI, 7.0-7.6) to 5.8 (95% CI, 5.5-6.2), and the SMR of pulmonary embolism decreased from 8.7 (95% CI, 7.6-10.1) to 5.5 (95% CI, 4.5-6.6).CONCLUSIONS AND RELEVANCE In this cohort study of patients receiving dialysis, mortality rates for myocardial infarction, stroke, and pulmonary embolism decreased more over time than in the general population.Nephrolog