المؤلفون: Sevag Demirjian, Anne Huml, Faisal Bakaeen, Emilio Poggio, Mariya Geube, Andrew Shaw, A. Marc Gillinov, Crystal A. Gadegbeku

المصدر: BMC Nephrology, Vol 25, Iss 1, Pp 1-11 (2024)

مصطلحات موضوعية: Acute kidney injury, Cardiac surgery, Patient sex, Body surface area, Estimated glomerular filtration rate, Diseases of the genitourinary system. Urology, RC870-923

الوصف: Abstract Background Female sex has been recognized as a risk factor for cardiac surgery associated acute kidney injury (CS-AKI). The current study sought to evaluate whether female sex is a risk factor for CS-AKI, or modifies the association of peri-operative change in serum creatinine with CS-AKI. Methods Observational study of adult patients undergoing cardiac surgery between 2000 and 2019 in a single U.S. center. The main variable of interest was registered patient sex, identified from electronic medical records. The main outcome was CS-AKI within 2 weeks of surgery. Results Of 58526 patients, 19353 (33%) were female; 12934 (22%) incurred AKI based on ≥ 0.3 mg/dL or ≥ 50% rise in serum creatinine (any AKI), 3320 (5.7%) had moderate to severe AKI, and 1018 (1.7%) required dialysis within 2 weeks of surgery. Female sex was associated with higher risk for AKI in models that were based on preoperative serum creatinine (OR, 1.35; 95% CI, 1.29–1.42), and lower risk with the use of estimated glomerular filtration, (OR, 0.90; 95% CI, 0.86–0.95). The risk for moderate to severe CS-AKI for a given immediate peri-operative change in serum creatinine was higher in female compared to male patients (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2369Test

الوصول الحر: https://doaj.org/article/af1d7d5049e04d8eb73d0547b46fa163Test

المؤلفون: Sevag Demirjian, MD, Faisal Bakaeen, MD, W.H. Wilson Tang, MD, Chase Donaldson, MD, Jon Taliercio, DO, Anne Huml, MD, Crystal A. Gadegbeku, MD, A. Marc Gillinov, MD, Steven Insler, DO

المصدر: Critical Care Explorations, Vol 6, Iss 4, p e1063 (2024)

مصطلحات موضوعية: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

الوصف: OBJECTIVES:. Examine the: 1) relative role of hemodynamic determinants of acute kidney injury (AKI) obtained in the immediate postcardiac surgery setting compared with established risk factors, 2) their predictive value, and 3) extent mediation via central venous pressure (CVP) and mean arterial pressure (MAP). DESIGN:. Retrospective observational study. The main outcome of the study was moderate to severe AKI, per kidney disease: improving global outcomes, within 14 days of surgery. SETTING:. U.S. academic medical center. PATIENTS:. Adult patients undergoing cardiac surgery between January 2000 and December 2019 (n = 40,426) in a single U.S.-based medical center. Pulmonary artery catheter measurements were performed at a median of 102 minutes (11, 132) following cardiopulmonary bypass discontinuation. INTERVENTIONS:. None. MEASUREMENTS AND RESULTS:. The median age of the cohort was 67 years (58, 75), and 33% were female; 70% had chronic hypertension, 29% had congestive heart failure, and 3% had chronic kidney disease. In a multivariable model, which included comorbidities and traditional intraoperative risk factors, CVP (p < 0.0001), heart rate (p < 0.0001), cardiac index (p < 0.0001), and MAP (p < 0.0001), were strong predictors of AKI, and superseded factors such as surgery type and cardiopulmonary bypass duration. The cardiac index had a significant interaction with heart rate (p = 0.026); a faster heart rate had a differentiating effect on the relationship of cardiac index with AKI, where a higher heart rate heightened the risk of AKI primarily in patients with low cardiac output. There was also significant interaction observed between CVP and MAP (p = 0.009); where the combination of elevated CVP and low MAP had a synergistic effect on AKI incidence. CONCLUSIONS:. Hemodynamic factors measured within a few hours of surgery showed a strong association with AKI. Furthermore, determinants of kidney perfusion, namely CVP and arterial pressure are interdependent; as are constituents of stroke volume, that is, cardiac output and heart rate.

وصف الملف: electronic resource

العلاقة: http://journals.lww.com/10.1097/CCE.0000000000001063Test; https://doaj.org/toc/2639-8028Test

الوصول الحر: https://doaj.org/article/f551223eb9c745f8813620ec5b8fe72cTest

المؤلفون: Avrum Gillespie, Jonathan Daw, Riley Brown, Jamie Cappiello, Briana Eugene Lee, Edward L. Fink, Heather M. Gardiner, Peter P. Reese, Crystal A. Gadegbeku, Zoran Obradovic

المصدر: Kidney Medicine, Vol 5, Iss 6, Pp 100640- (2023)

مصطلحات موضوعية: Constraint, density, ESKD, hemodialysis, kidney transplant, living donation, Diseases of the genitourinary system. Urology, RC870-923

الوصف: Rationale & Objective: Most living kidney donors are members of a hemodialysis patient’s social network. Network members are divided into core members, those strongly connected to the patient and other members; and peripheral members, those weakly connected to the patient and other members. We identify how many hemodialysis patients’ network members offered to become kidney donors, whether these offers were from core or peripheral network members, and whose offers the patients accepted. Study Design: A cross-sectional interviewer-administered hemodialysis patient social network survey. Setting & Participants: Prevalent hemodialysis patients in 2 facilities. Predictors: Network size and constraint, a donation from a peripheral network member. Outcomes: Number of living donor offers, accepting an offer. Analytical Approach: We performed egocentric network analyses for all participants. Poisson regression models evaluated associations between network measures and number of offers. Logistic regression models determined the associations between network factors and accepting a donation offer. Results: The mean age of the 106 participants was 60 years. Forty-five percent were female, and 75% self-identified as Black. Fifty-two percent of participants received at least one living donor offer (range 1-6); 42% of the offers were from peripheral members. Participants with larger networks received more offers (incident rate ratio [IRR], 1.26; 95% CI, 1.12-1.42; P = 0.001), including networks with more peripheral members (constraint, IRR, 0.97; 95% CI, 0.96-0.98; P

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S259005952300050XTest; https://doaj.org/toc/2590-0595Test

الوصول الحر: https://doaj.org/article/5eacfac6a8034aeba5cd12e66cc12c9bTest

المؤلفون: Mingyue He, Rui Song, Zakir Shaik, Crystal A. Gadegbeku, Louise Enderle, Christina Petyo, Sally B. Quinn, Zoe Pfeffer, Kathleen Murphy, Steven Kelsen, Aaron D. Mishkin, Jean Lee, Avrum Gillespie

المصدر: Vaccines, Vol 11, Iss 7, p 1252 (2023)

مصطلحات موضوعية: COVID-19, mRNA vaccines, antibody response, hemodialysis, COVID-19 naïve, COVID-19 recovered, Medicine

الوصف: Background: The longitudinal response to the COVID-19 vaccines among patients on hemodialysis with and without prior SARS-CoV-2 infection has not been well characterized. Methods: To guide vaccination strategies in patients on hemodialysis, it is critical to characterize the longevity and efficacy of the vaccine; therefore, we conducted a prospective single-center monthly antibody surveillance study between March 2021 and March 2022 to investigate the dynamic humoral response to a series of COVID-19 mRNA vaccines in patients on hemodialysis with and without prior SARS-CoV-2 infection. Monthly quantitative antibody testing was performed using the Beckman Coulter Access SARS-CoV-2 IgG Antibody Test©, which detects IgG antibodies targeting the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. Results: This cohort of 30 participants (mean age: 61 ± 3 years) predominantly self-identified as African American (97%) and male (53%). Eight participants (27%) had recovered from COVID-19 (recovered) before the vaccine initiation. All participants received two vaccine doses, and 86.6% received a 6-month booster dose. Among patients naïve to COVID-19, the antibody positivity rate (APR) was 55% post-first-dose, 91% post-second-dose, 50% pre-booster at 6 months, 100% post-booster, and 89% at 6 months post-booster. Recovered patients sustained a consistent 100% APR throughout the year. The naïve patients demonstrated lower peak antibody levels post-second-dose than the recovered patients (17.9 ± 3.2 vs. 44.7 ± 5.6, p < 0.001). The peak antibody levels post-booster showed no significant difference between both groups (27.1 ± 3.9 vs. 37.9 ± 8.2, p = 0.20). Two naïve patients contracted COVID-19 during the follow-up period. Conclusions: The patients naïve to COVID-19 exhibited an attenuated and foreshortened antibody response following two doses of the mRNA vaccines compared with the recovered patients, who maintained 100% APR before the booster dose. The 6-month booster dose counteracted declining immunity and stimulated antibody responses in the naïve patients, even in previously non-responsive patients. This observation implies that different booster vaccination strategies might be required for COVID-19-naïve and -recovered patients. Post-vaccination antibody testing may serve as a valuable tool for guiding vaccination strategies.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2076-393X/11/7/1252Test; https://doaj.org/toc/2076-393XTest

الوصول الحر: https://doaj.org/article/b0d00971f26247bd972fd55b09591135Test

المؤلفون: Mariam L. Alam, Ronit Katz, Keith A. Bellovich, Zeenat Y. Bhat, Frank C. Brosius, Ian H. de Boer, Crystal A. Gadegbeku, Debbie S. Gipson, Jennifer J. Hawkins, Jonathan Himmelfarb, Bryan R. Kestenbaum, Matthias Kretzler, Cassianne Robinson-Cohen, Susan P. Steigerwalt, Courtney Tuegel, Nisha Bansal

المصدر: Kidney International Reports, Vol 4, Iss 1, Pp 103-111 (2019)

مصطلحات موضوعية: Diseases of the genitourinary system. Urology, RC870-923

الوصف: Introduction: Cardiac biomarkers soluble ST2 (sST2) and galectin-3 may reflect cardiac inflammation and fibrosis. It is plausible that these mechanisms may also contribute to the progression of kidney disease. We examined associations of sST2 and galectin-3 with kidney function decline in participants with chronic kidney disease (CKD). Methods: This was a pooled analysis of 2 longitudinal cohorts of participants with CKD: the Clinical Phenotyping and Resource Biobank (C-PROBE) study and the Seattle Kidney Study (SKS). We measured circulating concentrations of sST2 and galectin-3 at baseline. Our primary outcome was progression to estimated glomerular filtration rate (eGFR)

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2468024918302134Test; https://doaj.org/toc/2468-0249Test

الوصول الحر: https://doaj.org/article/b5fe64b74fc74f7f914e8978d19e3ca0Test

المؤلفون: Minsun Lee, Danielle Hu, Gabrielle Bunney, Crystal A. Gadegbeku, Daniel Edmundowicz, Steve R. Houser, Hong Wang, Grace X. Ma

المصدر: Preventive Medicine Reports, Vol 11, Iss , Pp 240-246 (2018)

مصطلحات موضوعية: Medicine

الوصف: Lifestyle modification and health behavior practice among the individuals with cardiometabolic diseases (CMD) are important for secondary prevention and disease control. This study was designed to investigate and compare health behavior practices among Chinese and Filipino Americans with CMD. Three hundred seventy-four Asian Americans (211 Chinese and 163 Filipino) who reside in the greater Philadelphia region and had either CMD or no identified disease were included in the study. Information on smoking, alcohol intake, physical activity, and salt and sweets consumption was collected, as well as demographic and acculturative characteristics. Of the 374 participants, 241 (64.4%) had CMD and 133 (35.6%) had no identified disease. The majority of Chinese and Filipino Americans with CMD failed to meet the dietary and physical activity guidelines, and only a small percentage of them restricted their amount of salt added to food and amount of sweets consumption. Compared to participants with no disease, Chinese participants with CMD were more likely to “never” add salt to food (AOR 4.42 compared to “frequently”). Filipino Americans with CMD were less likely to be those who “never” consume sweets than those who frequently consume sweets (AOR = 0.12). Among the participants with CMD, Chinese participants with CMD were less likely to restrict drinking (AOR 0.11) than Filipinos with CMD. The findings suggest that tailored interventions for Chinese and Filipino Americans with CMD should be developed to enhance their compliance to behavioral guidelines to prevent further disease progression and complications. Keywords: Cardiometabolic diseases, Chinese, Filipinos, Health behaviors, Secondary prevention

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2211335518301001Test; https://doaj.org/toc/2211-3355Test

الوصول الحر: https://doaj.org/article/be22b1b75f3c46a29e806a97422ea174Test

المؤلفون: Claudia S. Walker, Crystal A. Gadegbeku

المصدر: Cardiovascular Diagnosis and Therapy. 13:115-121

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::b142aa7dcf8d3a9a31188269095cae9cTest
https://doi.org/10.21037/cdt-22-566Test

المؤلفون: Sean D, Pokorney, Glenn M, Chertow, Hussein R, Al-Khalidi, Dianne, Gallup, Pat, Dignacco, Kurt, Mussina, Nisha, Bansal, Crystal A, Gadegbeku, David A, Garcia, Samira, Garonzik, Renato D, Lopes, Kenneth W, Mahaffey, Kelly, Matsuda, John P, Middleton, Jennifer A, Rymer, George H, Sands, Ravi, Thadhani, Kevin L, Thomas, Jeffrey B, Washam, Wolfgang C, Winkelmayer, Christopher B, Granger

المصدر: Circulation. 146:1735-1745

مصطلحات موضوعية: Stroke, Treatment Outcome, Renal Dialysis, Physiology (medical), Atrial Fibrillation, Embolism, Humans, Anticoagulants, Kidney Failure, Chronic, Hemorrhage, Warfarin, Prospective Studies, Cardiology and Cardiovascular Medicine

الوصف: Background: There are no randomized data evaluating the safety or efficacy of apixaban for stroke prevention in patients with end-stage kidney disease on hemodialysis and with atrial fibrillation (AF). Methods: The RENAL-AF trial (Renal Hemodialysis Patients Allocated Apixaban Versus Warfarin in Atrial Fibrillation) was a prospective, randomized, open-label, blinded-outcome evaluation (PROBE) of apixaban versus warfarin in patients receiving hemodialysis with AF and a CHA 2 DS 2 -VASc score ≥2. Patients were randomly assigned 1:1 to 5 mg of apixaban twice daily (2.5 mg twice daily for patients ≥80 years of age, weight ≤60 kg, or both) or dose-adjusted warfarin. The primary outcome was time to major or clinically relevant nonmajor bleeding. Secondary outcomes included stroke, mortality, and apixaban pharmacokinetics. Pharmacokinetic sampling was day 1, day 3, and month 1. Results: From January 2017 through January 2019, 154 patients were randomly assigned to apixaban (n=82) or warfarin (n=72). The trial stopped prematurely because of enrollment challenges. Time in therapeutic range (international normalized ratio, 2.0–3.0) for warfarin-treated patients was 44% (interquartile range, 23%–59%). The 1-year rates for major or clinically relevant nonmajor bleeding were 32% and 26% in apixaban and warfarin groups, respectively (hazard ratio, 1.20 [95% CI, 0.63–2.30]), whereas 1-year rates for stroke or systemic embolism were 3.0% and 3.3% in apixaban and warfarin groups, respectively. Death was the most common major event in the apixaban (21 patients [26%]) and warfarin (13 patients [18%]) arms. The pharmacokinetic substudy enrolled the target 50 patients. Median steady-state 12-hour area under the curve was 2475 ng/mL×h (10th to 90th percentiles, 1342–3285) for 5 mg of apixaban twice daily and 1269 ng/mL×h (10th to 90th percentiles, 615–1946) for 2.5 mg of apixaban twice daily. There was substantial overlap between minimum apixaban blood concentration, 12-hour area under the curve, and maximum apixaban blood concentration for patients with and without a major or clinically relevant nonmajor bleeding event. Conclusions: There was inadequate power to draw any conclusion regarding rates of major or clinically relevant nonmajor bleeding comparing apixaban and warfarin in patients with AF and end-stage kidney disease on hemodialysis. Clinically relevant bleeding events were ≈10-fold more frequent than stroke or systemic embolism among this population on anticoagulation, highlighting the need for future randomized studies evaluating the risks versus benefits of anticoagulation among patients with AF and end-stage kidney disease on hemodialysis. Registration: URL: https://www.clinicaltrials.govTest ; Unique identifier: NCT02942407.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a9c0b7759c9aa8239926cc0bf362ad92Test
https://doi.org/10.1161/circulationaha.121.054990Test

المؤلفون: Crystal A. Gadegbeku

المصدر: Journal of the American Society of Nephrology.

مصطلحات موضوعية: Nephrology, General Medicine

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::3dd56fefbc4b2c5f72d8b2df3c81eebaTest
https://doi.org/10.1681/asn.0000000000000151Test

المؤلفون: Markus Bitzer, Wenjun Ju, Lalita Subramanian, Jonathan P. Troost, Joseph Tychewicz, Becky Steck, Roger C. Wiggins, Debbie S. Gipson, Crystal A. Gadegbeku, Frank C. Brosius, Matthias Kretzler, Subramaniam Pennathur

المصدر: American Journal of Physiology-Renal Physiology. 323:F401-F410

مصطلحات موضوعية: Translational Research, Biomedical, Michigan, Physiology, Systems Biology, Humans, Kidney Diseases, Kidney

الوصف: Research on kidney diseases is being transformed by the rapid expansion and innovations in omics technologies. The analysis, integration, and interpretation of big data, however, have been an impediment to the growing interest in applying these technologies to understand kidney function and failure. Targeting this urgent need, the University of Michigan O’Brien Kidney Translational Core Center (MKTC) and its Administrative Core established the Applied Systems Biology Core. The Core provides need-based support for the global kidney community centered on enabling incorporation of systems biology approaches by creating web-based, user-friendly analytic and visualization tools, like Nephroseq and Nephrocell, guiding with experimental design, and processing, analysis, and integration of large data sets. The enrichment core supports systems biology education and dissemination through workshops, seminars, and individualized training sessions. Meanwhile, the Pilot and Feasibility Program of the MKTC provides pilot funding to both early-career and established investigators new to the field, to integrate a systems biology approach into their research projects. The relevance and value of the portfolio of training and services offered by MKTC are reflected in the expanding community of young investigators, collaborators, and users accessing resources and engaging in systems biology-based kidney research, thereby motivating MKTC to persevere in its mission to serve the kidney research community by enabling access to state-of-the-art data sets, tools, technologies, expertise, and learning opportunities for transformative basic, translational, and clinical studies that will usher in solutions to improve the lives of people impacted by kidney disease.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::95ca435a66e6bcf076b69f40c3cea9faTest
https://doi.org/10.1152/ajprenal.00091.2022Test