107 research outputs found
a global network of chronic kidney disease cohorts
Background Chronic kidney disease (CKD) is a global health burden, yet it is
still underrepresented within public health agendas in many countries. Studies
focusing on the natural history of CKD are challenging to design and conduct,
because of the long time-course of disease progression, a wide variation in
etiologies, and a large amount of clinical variability among individuals with
CKD. With the difference in health-related behaviors, healthcare delivery,
genetics, and environmental exposures, this variability is greater across
countries than within one locale and may not be captured effectively in a
single study. Methods Studies were invited to join the network. Prerequisites
for membership included: 1) observational designs with a priori hypotheses and
defined study objectives, patient-level information, prospective data
acquisition and collection of bio-samples, all focused on predialysis CKD
patients; 2) target sample sizes of 1,000 patients for adult cohorts and 300
for pediatric cohorts; and 3) minimum follow-up of three years. Participating
studies were surveyed regarding design, data, and biosample resources. Results
Twelve prospective cohort studies and two registries covering 21 countries
were included. Participants age ranges from >2 to >70 years at inclusion, CKD
severity ranges from stage 2 to stage 5. Patient data and biosamples (not
available in the registry studies) are measured yearly or biennially. Many
studies included multiple ethnicities; cohort size ranges from 400 to more
than 13,000 participants. Studies’ areas of emphasis all include but are not
limited to renal outcomes, such as progression to ESRD and death. Conclusions
iNET-CKD (International Network of CKD cohort studies) was established, to
promote collaborative research, foster exchange of expertise, and create
opportunities for research training. Participating studies have many
commonalities that will facilitate comparative research; however, we also
observed substantial differences. The diversity we observed across studies
within this network will be able to be leveraged to identify genetic,
behavioral, and health services factors associated with the course of CKD.
With an emerging infrastructure to facilitate interactions among the
investigators of iNET-CKD and a broadly defined research agenda, we are
confident that there will be great opportunity for productive collaborative
investigations involving cohorts of individuals with CKD
Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients
Separate assessment of mineral bone disorder (MBD) parameters including calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D (1,25D) predict renal outcomes in kidney transplant recipients (KTRs), with conflicting results. To date, data simultaneously evaluating these parameters and interwoven relations on renal outcomes are scarce. We conducted a prospective long-term follow-up cohort study included 263 KTRs with grafts functioning at least 1 year after transplantation. The outcome was a composite of estimated GFR halving and graft loss. Cox regression analyses were employed to evaluate associations between a panel of six MBD parameters and renal outcomes. The outcome occurred in 98 KTRs during a median follow-up of 10.7 years. In a multivariate Cox analysis, intact PTH (iPTH), phosphate, and 1,25D levels were associated with the outcome (hazard ratio, 1.60 per log scale; 95% confidence interval, 1.19–2.14, 1.60 per mg/dL; 1.14–2.23 and 0.82 per 10 pg/mL; 0.68–0.99, respectively). Competing risk analysis with death as a competing event yielded a similar result. After stratification into four groups by iPTH and phosphate medians, high risks associated with high iPTH was not observed in KTRs with low phosphate levels (P-interaction < 0.1). Only KTRs not receiving active vitamin D, poor 1,25D status predicted the worse outcome (P-interaction < 0.1). High iPTH, phosphate, and low 1,25D, but not FGF23, levels predicted poor renal outcomes. Simultaneous evaluation of PTH and phosphate levels may provide additional information regarding renal allograft prognosis.Doi Y., Hamano T., Ichimaru N., et al. Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients. Scientific Reports 10, 13766 (2020); https://doi.org/10.1038/s41598-020-70709-4
An Analysis of the Characteristics and Improved Use of Newly Developed CT-based Navigation System in Total Hip Arthroplasty
We developed a surface matching-type computed tomography (CT)-based navigation system for total hip arthroplasty (the N-navi; TEIJIN NAKASHIMA MEDICAL, Okayama, Japan). In the registration step, surface matching was performed with digitizing points on the pelvic bone surface after coarse paired matching. In the present study, we made model bones from the CT data of patients whose acetabular shapes had various deformities. We measured the distances and angles after surface matching from the fiducial points and evaluated the ability to correct surface-matching registration on each pelvic form, using several areas and numbers of points. When the surface-matching points were taken on the superior area of the acetabulum, the correction was easy for the external direction, but it was difficult to correct for the anterior and proximal directions. The correction was difficult for external and proximal directions on the posterior area. Each area of surface-matching points has particular directions that are easily corrected and other directions that are difficult to correct. The shape of the pelvis also affected the correction ability. Our present findings suggest that checking the position after coarse paired matching and choosing the surface-matching area and points that are optimal to correct will improve the accuracy of total hip arthroplasty and reduce surgical times
Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis.
Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 ± 16 years, average eGFR was 83 ± 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 ± 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts. Conclusions: Outpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria
COMPLETE INFRARED SPECTROSCOPIC CHARACTERIZATION OF PHENOL-BORANE-TRIMETHYLAMINE DIHYDROGEN-BONDED COMPLEX IN THE GAS PHASE
Author Institution: Department of Chemistry, Indian Institute of Technology Bombay, Mumbai, India 400076; Department of Chemistry, Graduate School of Science, Tohoku University, Sendai, Japan 980-8578The gas phase vibrational spectrum in the B-H and the O-H stretching regions is presented for the (di)hydrogen-bonded complex between phenol and borane-trimethylamine. Appearance of three transitions for the B-H stretching region indicates the lowering of the local symmetry of the BH group in borane-trimethylamine due to its interaction with phenol. Further, the shift in the O-H stretching frequency indicates that phenol is hydrogen bonded to borane-trimethylamine. The two sets of data unequivocally establish the formation of OH-HB dihydrogen-bonded complex between phenol and borane-trimethylamine
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