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Using Administrative Health Care Databases to Identify Patients With End-Stage Kidney Disease With No Recorded Contraindication to Receiving a Kidney Transplant.

BackgroundAdministrative health care databases can be efficiently analyzed to describe the degree to which patients with end-stage kidney disease (ESKD) have access to kidney transplantation. Measures of access to transplantation are better represented when restricting to only those patients eligible to receive a kidney transplant. The way administrative data can be used to assess kidney transplant eligibility in the absence of clinical data has not been well described.ObjectiveTo demonstrate a method that uses administrative health care databases to identify patients with ESKD who have no rec

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… New creatinine- and cystatin C–based equations to estimate GFR without race . N Engl J Med . 2021 ; 385 : 1737 - 1749 . 34554658 10.1056/NEJMoa2102953 PMC8822996 …

The salivary proteome in relation to oral mucositis in autologous hematopoietic stem cell transplantation recipients: a labelled and label-free proteomics approach.

BACKGROUND: Oral mucositis is a frequently seen complication in the first weeks after hematopoietic stem cell transplantation recipients which can severely affects patients quality of life. In this study, a labelled and label-free proteomics approach were used to identify differences between the salivary proteomes of autologous hematopoietic stem cell transplantation (ASCT) recipients developing ulcerative oral mucositis (ULC-OM; WHO score ≥ 2) or not (NON-OM). METHODS: In the TMT-labelled analysis we pooled saliva samples from 5 ULC-OM patients at each of 5 timepoints: baseline, 1, 2, 3 week

Variation in Kidney Transplant Referral, Living Donor Contacts, Waitlisting, and Kidney Transplant Across Regional Renal Programs in Ontario, Canada: A Population-Based Cohort Study.

BackgroundPrevious studies conducted in publicly and privately funded health care systems suggest that access to kidney transplants may vary depending on where a patient receives their kidney care. It is poorly understood whether variability exists across the key steps required to receive a kidney transplant in a publicly funded health care system.ObjectiveTo determine whether there is variation across Ontario's regional renal programs (RRPs) in key steps completed toward receiving a kidney transplant.DesignPopulation-based cohort study from November 1, 2017, to December 31, 2021, using linked

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… New creatinine- and cystatin C–based equations to estimate GFR without race. N Engl J Med. 2021;385(19):1737-1749. doi: 10.1056/NEJMoa2102953. 22. The Kidney Failure Risk Equation. https://kidneyfailurerisk.com . Accessed January 3, 2025. 23. Wang C, Naylor KL, Luo B, et al. …

Defining Referral for a Kidney Transplant Evaluation as a Quality Indicator: A Population-Based Cohort Study.

BackgroundQuality indicators are required to identify gaps in care and to improve equitable access to kidney transplants. Referral to a transplant center for an evaluation is the first step toward receiving a kidney transplant, yet widespread reporting on this metric is lacking.ObjectiveThe objective was to use administrative health care databases to examine multiple ways to define referral for a kidney transplant evaluation by varying clinical inclusion criteria, definitions for end of follow-up, and statistical methodologies.DesignThis is a population-based cohort study.SettingThis study lin

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… New creatinine- and cystatin C–based equations to estimate GFR without race. N Engl J Med. 2021;385(19):1737-1749. doi: 10.1056/NEJMoa2102953. 23. The Kidney Failure Risk Equation. https://kidneyfailurerisk.com . Accessed June 1, 2024. 24. …

Association Between Sex and Kidney Transplant Referral, Living Donor Contacts, Waitlisting and Kidney Transplant: A Population-Based Cohort Study.

BackgroundStudies from several jurisdictions suggest that compared to male individuals, female individuals are less likely to get placed on the waiting list for kidney transplantation and less likely to receive a transplant. However, we poorly understand where sex disparities arise within four key steps in the pathway to kidney transplant.ObjectiveTo measure how sex influences key steps to kidney transplantation.DesignWe conducted a population-based cohort study using linked administrative healthcare databases.SettingOntario, Canada.PatientsThe study included people with kidney failure. This g

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… New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race. N Engl J Med. 2021;385:1737-1749. 24. The Kidney Failure Risk Equation. https://kidneyfailurerisk.com/ 25. Wang C, Naylor KL, Luo B, et al. …

Exploration of the Use of Natural Compounds in Combination with Chemotherapy Drugs for Tumor Treatment.

Currently, chemotherapy is the main treatment for tumors, but there are still problems such as unsatisfactory chemotherapy results, susceptibility to drug resistance, and serious adverse effects. Natural compounds have numerous pharmacological activities which are important sources of drug discovery for tumor treatment. The combination of chemotherapeutic drugs and natural compounds is gradually becoming an important strategy and development direction for tumor treatment. In this paper, we described the role of natural compounds in combination with chemotherapeutic drugs in synergizing, reduci

Recent Advances of Acute Kidney Injury in Hematopoietic Cell Transplantation.

Acute kidney injury (AKI) is a common complication of allogeneic hematopoietic cell transplantation (allo-HCT) and is associated with non-relapse mortality (NRM) and quality of life (QOL). Multiple factors may contribute to AKI during allo-HCT and are often present at the same time making it difficult to determine the cause of AKI in each patient. Nephrotoxic drugs, infections, thrombotic microangiopathy (TMA), and sinusoidal obstruction syndrome (SOS) are well described causes of AKI during allo-HCT. Acute graft-versus-host disease (aGVHD) is a major complication of allo-HCT that mainly targe

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… How to Use… Serum Creatinine, Cystatin C and GFR . Arch Dis Child Educ Pract Ed ( 2017 ) 102 ( 1 ): 37 – 43 . doi: 10.1136/archdischild-2016-311062 27647862 109 Amin R He R Gupta D Zheng W Burmakin M Mohammad DK . …

Preventive strategies for acute kidney injury in cancer patients.

Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregatio

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… Several proteins, mainly of urinary origin (e.g. beta-2-microglobulin, N -acetyl- d -glucosaminidase, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and cystatin C) have been proposed as biomarkers for CDDP-induced AKI. …

Kidney Disease and Hematopoietic Stem Cell Transplantation.

Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for patients with hematologic malignancies and certain solid tumors and nonmalignant hematologic conditions. Both AKI and CKD occur commonly after HSCT and are associated with significant morbidity and mortality. AKI and CKD in this setting may result from direct effects of the transplant or be caused by pretransplant bone marrow conditioning regimens and/or nephrotoxic agents administered in the post-transplant period. In this article, we review the epidemiology, risk factors, etiologies, pathophysiology, diagnos

Association of metformin exposure with low risks of frailty and adverse outcomes in patients with diabetes.

BackgroundDiabetes is an independent risk factor of frailty, which increases adverse outcomes in patients with diabetes. Metformin is a common antidiabetic drug in clinical practice. Insulin resistance and chronic inflammation are the two common mechanisms of diabetes and frailty, as well as the main targets of metformin. Research suggested that metformin has anti-aging potential. However, few studies focus on the relationship between metformin and frailty. Thus, we aimed to explore whether metformin was associated with a low risk of frailty and other adverse outcomes in diabetic patients.Meth

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… The Targeting Aging with Metformin (TAME) clinical trial reported eight serum biomarkers associated with geoscience, including interleukin-6, CRP, tumor necrosis factor receptor II, growth differentiation factor -15, insulin, IGF-1, cystatin C, NT-proBNP, and hemoglobin A1c [ 31 ]. …

Clinical approaches to osteoporosis in patients with chronic kidney disease: A comprehensive review.

Chronic kidney disease (CKD) induces secondary osteoporosis, characterized by an imbalance between bone formation and resorption due to kidney dysfunction; the result is a reduction in both bone mineral density and quality. This condition is compounded by disruption of bone metabolic turnover, abnormalities in bone microstructure and collagen cross-linking, and compromised bone quality, all of which contribute to increased bone fragility. Reduced kidney function is complicated by secondary hyperparathyroidism, which exacerbates bone fragility. Managing osteoporosis in patients with CKD is chal

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… A study from the United States showed that elevated cystatin C levels correlate significantly with proximal femur fractures in women but not in men, suggesting sex-specific differences in fracture risk associated with CKD [ 35 ]. …

An explainable predictive machine learning model of osteopenia for perimenopausal women based on clinical data: a retrospective single-center study.

BACKGROUND: Osteoporosis is increasingly prevalent, yet early detection remains difficult. This study aimed to develop a machine learning (ML)-based model for identifying individuals at risk of osteopenia using clinical data. METHODS: Female participants who were aged 45 years and above with complete femoral neck BMD data were included. A total of 1,108 participants were divided into training (70%) and test (30%) datasets. Various ML-based algorithms (random forest (RF), least absolute shrinkage and selection operator (LASSO), gradient boosting decision tree (GBDT) were used to identify key p

Навигатор биомаркеров человека.

Биомаркеры играют ключевую роль в современных исследованиях медицины, особенно в ранней диагностике заболеваний и персонализированном лечении. Несмотря на то, что предыдущие исследования систематически обзоры маркеров в различных областях заболеваний, интегрированная система, которая связывает основные физиологические системы, охватывает множество органов и охватывает широкий спектр заболеваний, все еще отсутствует. В контексте современных вызовов здоровья, характеризующихся высокой распространенностью хронических заболеваний и широкими сопутствующими заболеваниями, создание панорамной системы

RESEARCH COMMUNICATIONS OF THE 34th ECVIM-CA CONGRESS.

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Recent Advances in the Treatment and Supportive Care of POEMS Syndrome.

POEMS is a rare clonal plasma cell disorder characterized by multi-systemic features that include demyelinating peripheral neuropathy, organomegaly, endocrinopathy, presence of monoclonal proteins (M-protein), and skin changes. Even though the pathophysiology is poorly understood, recent studies suggest that both clonal and polyclonal plasmacytosis leading to the production of pro-inflammatory cytokines and angiogenic mediators play the central role. These mediators including vascular endothelial growth factor (VEGF) are the driving forces of the syndrome. The diagnosis of POEMS is not always

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… Yet, cystatin C, a surrogate renal marker is high in 71% of the patients [ 95 ] It is worth noting that some ethnic differences come into play as a study from China addressed the same issue and found that approximately 37% of patients had a creatinine clearance of less than 60 mL/min, 9% less than 30 …

New insight into adiponectin role in obesity and obesity-related diseases.

Obesity is a major health problem strongly increasing the risk for various severe related complications such as metabolic syndrome, cardiovascular diseases, respiratory disorders, diabetic retinopathy, and cancer. Adipose tissue is an endocrine organ that produces biologically active molecules defined "adipocytokines," protein hormones with pleiotropic functions involved in the regulation of energy metabolism as well as in appetite, insulin sensitivity, inflammation, atherosclerosis, cell proliferation, and so forth. In obesity, fat accumulation causes dysregulation of adipokine production tha

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… However, the mechanism by which adiponectin increases in renal failure has not been clarified and the clinical significance of plasma adiponectin level in patients with moderate renal dysfunction is controversial: in vitro studies indicated that adiponectin binds to cystatin C, an inhibitor of the cathepsin …

Effects of Expanded Hemodialysis with Medium Cut-Off Membranes on Maintenance Hemodialysis Patients: A Review.

Kidney failure is associated with high morbidity and mortality. Hemodialysis, the most prevalent modality of renal replacement therapy, uses the principle of semipermeable membranes to remove solutes and water in the plasma of patients with kidney failure. With the evolution of hemodialysis technology over the last half century, the clearance of small water-soluble molecules in such patients is adequate. However, middle molecules uremic toxins are still retained in the plasma and cause cardiovascular events, anemia, and malnutrition, which significantly contribute to poor quality of life and h

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… Uremic Toxin Class | Molecular Weight (kDa) | Representative Biomarkers Small water-soluble molecules | <0.5 | Urea (60 Da), creatinine (113 Da), uric acid (168 Da) Small-middle molecules | 0.5–15 | PTH (9.5 kDa), β2-MG (11.8 kDa), cystatin C(13.3 kDa) Medium-middle molecules | 15–25 | Myoglobin (17 …

The role of the PD-1/PD-L1 immune checkpoint pathway in myocardial infarction: a review from pathophysiological mechanisms to therapeutic strategies.

Programmed cell death protein 1 (PD-1) and its ligand, programmed death-ligand 1 (PD-L1), are vital molecules in immune checkpoints, significantly impacting cancer treatment. Recent studies have increasingly highlighted the complex roles of the PD-1/PD-L1 pathway in cardiovascular diseases, particularly in myocardial infarction (MI). In addition to being involved in immune modulation and the inflammatory response post-myocardial ischemia, this pathway is also crucial for myocardial repair and regeneration. Additionally, the clinical application of PD-1/PD-L1 immune checkpoint inhibitors has le

Soluble Biomarkers of Osteoporosis and Osteoarthritis, from Pathway Mapping to Clinical Trials: An Update.

Serum biomarkers of osteoarticular diseases have been in the limelight of current clinical research trends. Laboratory validation of defined and candidate biomarkers for both osteoarthritis and osteoporosis is of key importance for future decisional algorithms in the diagnosis, monitoring, and prognosis of these diseases. The current guidelines recommend the use of collagen degradation remnants, eg, CTX-I and CTX-II, in the complementary diagnosis of both osteoporosis and osteoarthritis. Besides the collagen degradation markers, enzymes that regulate bone and articular metabolism are useful in

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… In the study of Riegger et al, 100 conducted on 754 subjects who underwent total joint replacement, serum COMP levels positively correlated with markers of renal (cystatin C, creatinine, estimated glomerular filtration rate-eGFR) and cardiac (N-terminal propeptide of brain natriuretic peptide) function …

Safety of solid oncology drugs in older patients: a narrative review.

The older population represents ∼50%-60% of the population of newly diagnosed patients with cancer. Due to physiological and pathological aging and the increased presence of comorbidities and frailty factors, this population is at higher risk of serious toxicity from anticancer drugs and, consequently, often under-treated. Despite the complexity of these treatments, a good knowledge of the pharmacology of anticancer drugs and potentially risky situations can limit the emergence of potentially lethal toxicities in this population. This review focuses on optimizing systemic oncology treatments f