Clinical journal of the American Society of Nephrology : CJASN
-
Clin J Am Soc Nephrol · Dec 2013
Editorial CommentOpportunities to improve end-of-life care in ESRD.
-
Clin J Am Soc Nephrol · Dec 2013
Multicenter StudyAssociation of elevated urinary concentration of renin-angiotensin system components and severe AKI.
Prognostic biomarkers that predict the severity of AKI at an early time point are needed. Urinary angiotensinogen was recently identified as a prognostic AKI biomarker. The study hypothesis is that urinary renin could also predict AKI severity and that in combination angiotensinogen and renin would be a strong predictor of prognosis at the time of AKI diagnosis. ⋯ The combination of urinary angiotensinogen and renin predicts progression to very severe disease in patients with early AKI after cardiac surgery.
-
Clin J Am Soc Nephrol · Dec 2013
Comparative StudyMetabolic subtypes and risk of mortality in normal weight, overweight, and obese individuals with CKD.
Higher body mass index (BMI) is paradoxically associated with lower mortality in persons with CKD, but whether cardiometabolic abnormalities modulate this association is unclear. ⋯ Metabolic abnormalities may attenuate the magnitude and strength of survival benefits associated with higher BMI in individuals with CKD.
-
Clin J Am Soc Nephrol · Dec 2013
Plasma NGAL for the diagnosis of AKI in patients admitted from the emergency department setting.
The purpose of this study was to determine the accuracy of plasma neutrophil gelatinase-associated lipocalin as a marker of AKI in patients admitted from the emergency department. ⋯ Plasma neutrophil gelatinase-associated lipocalin is an accurate biomarker for prediction of AKI in patients admitted from the emergency department. This work proposes a three-grade classification of AKI risk based on plasma neutrophil gelatinase-associated lipocalin levels.
-
Clin J Am Soc Nephrol · Dec 2013
Comparative StudyDifferences in access to kidney transplantation between Hispanic and non-Hispanic whites by geographic location in the United States.
Hispanic patients undergoing chronic dialysis are less likely to receive a kidney transplant compared with non-Hispanic whites. This study sought to elucidate disparities in the path to receipt of a deceased donor transplant between Hispanic and non-Hispanic whites. ⋯ After accounting for geographic location and controlling for competing risks (e.g., Hispanic survival advantage), the disparity in access to deceased donor transplantation was markedly attenuated among Hispanics compared with non-Hispanic whites. To overcome the geographic disparities that Hispanics encounter in the path to transplantation, organ allocation policy revisions are needed to improve donor organ equity.