Matthew R. Weir's research while affiliated with University of Maryland, Baltimore and other places
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Publications (718)
Background: Mineralocorticoid receptor (MR) antagonists (MRA) benefit patients with diabetic chronic kidney disease (CKD) and heart failure, and may act upstream on multiple cardioprotective pathways. The NHLBI-sponsored MAGMA trial, a 12-month, randomized, double-blind, placebo-controlled trial compared Spironolactone vs. placebo in Type 2 diabeti...
Background and Aims
Incident heart failure (HF) among individuals with chronic kidney disease (CKD) incurs hospitalizations that burden patients and health care systems. There are few preventative therapies, and the Pooled Cohort equations to Prevent Heart Failure (PCP-HF) perform poorly in the setting of CKD. New drug targets and better risk strat...
A stable, minimum physiological health status is required for patients to qualify for transplant or artificial organ support eligibility to ensure the recipient has enough reserve to survive the perioperative transplant period. Herein, we present a novel strategy to stabilize and improve patient clinical status through extracorporeal immunomodulati...
Pulse pressure (PP) is associated with cardiovascular events and the progression of chronic kidney disease (CKD) to end stage kidney disease (ESKD). While PP is known to widen with age, it is less clear what other clinical factors affect PP and whether the risks associated with wide PP are the same across all ages. We used Cox proportional hazards...
Background
Use of eGFR to determine preemptive waitlisting eligibility may contribute to racial/ethnic disparities in access to waitlisting, which can only occur when the eGFR falls to < 20 mL/min1.73m ² . Use of an alternate risk-based strategy for waitlisting (e.g.,a Kidney Failure Risk Equation [KFRE] estimated two-year risk of kidney failure) r...
Background
Orthostatic changes in blood pressure (BP), either orthostatic hypotension or orthostatic hypertension (OHTN), are common among patients with chronic kidney disease. Whether they are associated with unique out-of-office BP phenotypes is unknown.
Methods
CRIC is a prospective, multicenter, observational cohort study of participants with...
There is controversy regarding the optimal renal-replacement therapy (RRT) modality for critically ill patients with acute kidney injury (AKI).
We conducted a secondary analysis of the STandard versus Accelerated Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial to compare outcomes among patients who initiated RRT with either cont...
Progression of chronic kidney disease (CKD) portends myriad complications, including kidney failure. In this study, we analyze associations of 4638 plasma proteins among 3235 participants of the Chronic Renal Insufficiency Cohort Study with the primary outcome of 50% decline in estimated glomerular filtration rate or kidney failure over 10 years. W...
Importance:
Excess aldosterone production contributes to hypertension in both classical hyperaldosteronism and obesity-associated hypertension. Therapies that reduce aldosterone synthesis may lower blood pressure.
Objective:
To compare the safety and efficacy of lorundrostat, an aldosterone synthase inhibitor, with placebo, and characterize dose...
Importance: Excess aldosterone production contributes to hypertension in both classical hyperaldosteronism and obesity-associated hypertension.
Objective: To compare the safety and efficacy of lorundrostat, an aldosterone synthase inhibitor, with placebo, and characterize dose-dependent safety and efficacy.
Design, Setting, and Participants: Random...
Introduction
Hyperkalaemia is common, life-threatening and often requires emergency department (ED) management; however, no standardised ED treatment protocol exists. Common treatments transiently reducing serum potassium (K ⁺ ) (including albuterol, glucose and insulin) may cause hypoglycaemia. We outline the design and rationale of the Patiromer...
Introduction:
Nephrotoxin exposure is significantly associated with acute kidney injury (AKI) development. A standardized list of nephrotoxic medications to surveil and their perceived nephrotoxic potential (NxP) does not exist for non-critically ill patients.
Objective:
This study generated consensus on the nephrotoxic effect of 195 medications...
Anemia is common in patients with chronic kidney disease (CKD) and is associated with a high burden of morbidity and adverse clinical outcomes. In 2012, Kidney Disease: Improving Global Outcomes (KDIGO) published a guideline for the diagnosis and management of anemia in CKD. Since then, new data from studies assessing established and emerging thera...
In patients with chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM), slowing kidney disease progression is an important therapeutic goal. Many patients with T2DM and CKD also have cardiovascular (CV) comorbidities. Renin-angiotensin-aldosterone system inhibitors (RAASis), which include angiotensin-converting enzyme inhibit...
Rationale and objective:
Hypertension is a known risk factor for dementia and cognitive impairment. There are limited data on the relation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with incident cognitive impairment in adults with chronic kidney disease. We sought to identify and characterize the relationship among blood...
Background:
Patients hospitalized with AKI have higher subsequent risks of heart failure, atherosclerotic cardiovascular events, and mortality than their counterparts without AKI, but these higher risks may be due to differences in pre-hospitalization patient characteristics, including the baseline level of kidney function, the rate of prior kidne...
Background Diabetes mellitus and hypertension are the leading causes of cardiovascular disease in renal transplant recipients. This review looks at the potential role of sodium-glucose co-transporter 2 inhibitors (SGLT2is) and reviews the management strategies for hypertension in this population. Summary Large-scale clinical trials are needed to st...
Hyperkalemia is a frequent complication in patients with chronic kidney disease (CKD) or heart failure (HF) and associated with neuromuscular manifestations, changes in the electrocardiogram, and increased risk of mortality. While data on the prevalence and management of hyperkalemia in the gulf region are scarce, risk factors such as preference fo...
Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease (CVD). However, traditional CVD risk factors cannot completely explain the increased risk. Altered HDL proteome is linked with incident CVD in CKD patients, but it is unclear whether other HDL metrics are associated with incident CVD in this population. In the cu...
IntroductionThe healthcare resource utilization (HRU) and costs of oral anticoagulant-naïve patients with non-valvular atrial fibrillation (NVAF) and diabetes initiated on rivaroxaban or warfarin in the United States (US) has not been previously evaluated.Methods
This retrospective study used data from the Optum’s de-identified Clinformatics® Data...
INTRODUCTION
Optimal blood pressure (BP) control has been debated between two schools of thought: standard BP control to a goal of systolic BP (SBP) <140 mmHg and intensive BP control with a goal of <120 mmHg. Currently only three randomized controlled trials (RCTs) have been performed to address this question, which will be included in this review...
Introduction: Chronic kidney disease (CKD) is associated with arrhythmias such as atrial fibrillation (AF) and sudden cardiac death, but limited rigorous data exist on the prevalence of AF, ventricular tachycardia (VT), nonsustained VT (NSVT), and high-degree atrioventricular (AV) block in a CKD cohort.
Hypothesis: In participants with CKD, worse k...
PurposeTo assess whether pre-existing chronic kidney disease (CKD) modified the relationship between the strategy for renal-replacement theraphy (RRT) initiation and clinical outcomes in the STARRT-AKI trial.Methods
This was a secondary analysis of a multi-national randomized trial. We included patients who had documented pre-existing estimated glo...
Background
People with type 2 diabetes mellitus (T2DM) have elevated cardiovascular (CV) risk, including for hospitalization for heart failure (HHF). Canagliflozin reduced CV and kidney events in patients with T2DM and high CV risk or nephropathy in the CANVAS (CANagliflozin cardioVascular Assessment Study) Program and the CREDENCE (Canagliflozin a...
Rationale and Objective
Chronic Kidney Disease is a risk-enhancing factor for cardiovascular disease (CVD) and mortality and the role of aspirin use is unclear in this population. We investigated the risk and benefits of aspirin use in primary and secondary prevention of CVD in the Chronic Renal Insufficiency Cohort (CRIC) Study.
Study Design
Pros...
![Fig. 1 A Theoretical priors based on [3] and B data-derived priors...](publication/362930555/figure/fig1/AS:11431281080960611@1661456489287/A-Theoretical-priors-based-on-3-and-B-data-derived-priors-based-on-STARRT-AKI-pilot_Q320.jpg)
Background
Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney i...
Background
Hyperkalemia is a common electrolyte abnormality in patients with CKD, which is associated with worse outcomes and limits use of renin–angiotensin–aldosterone system inhibitors (RAASi). This post hoc subgroup analysis of three clinical trials evaluated the efficacy and safety of the sodium-free, potassium-binding polymer, patiromer, for...
Patients with chronic kidney disease are at risk of developing cardiovascular disease. To facilitate out-of-clinic evaluation, we piloted wearable device-based analysis of heart rate variability and behavioral readouts in patients with chronic kidney disease from the Chronic Renal Insufficiency Cohort and controls (n = 49). Time-specific partitioni...
There are limited data on the degree of variability in practices surrounding prioritization of referrals for transplant evaluation and criteria for transplant candidacy and their association with transplantation rates. We surveyed transplant programs across the US between January 2020‐May 2020 to determine current pre‐transplantation practices. We...
Background
Heart failure (HF) is common in chronic kidney disease (CKD); identifying CKD patients at high risk for HF may guide clinical care. We assessed the prognostic value of cardiac biomarkers and echocardiographic variables for 10-year HF prediction compared to a published clinical HF prediction equation in a cohort of participants with CKD....
Rationale & Objective
Having a usual source of care increases use of preventive services and is associated with improved survival in the general population. We evaluated this association in adults with chronic kidney disease (CKD).
Study Design
Prospective, observational cohort
Setting & Participants
Adults with CKD enrolled in the Chronic Renal...
The Kidney Disease Outcomes Quality Initiative (KDOQI) convened a work group to review the 2021 KDIGO (Kidney Disease: Improving Global Outcomes) guideline for the management of blood pressure in chronic kidney disease (CKD). This commentary is the product of that work group and presents the recommendations and practice points from the KDIGO guidel...
Patients with chronic kidney disease (CKD) are at risk of developing cardiovascular disease. To facilitate out-of-clinic evaluation, we piloted wearable device-based analysis of heart rate variability and behavioral readouts in patients with CKD participating in the Chronic Renal Insufficiency Cohort and (n=49) controls. Time-specific partitioning...
The use of routine monitoring of donor-derived cell-free DNA (dd-cfDNA) after kidney transplant may allow clinicians to identify subclinical allograft injury and intervene prior to development of clinically evident graft injury. To evaluate this, data from 1092 kidney transplant recipients monitored for dd-cfDNA over a three year period was analyze...
Background
Patients receiving dialysis face a high risk of cardiovascular disease, arrhythmia and sudden cardiac death. Few patients, however, are aware of this risk. Implantable cardiac monitors are currently available for clinical use and can continuously monitor cardiac rhythms without the need for transvenous leads. Our goal was to gauge patien...
Aims
In patients with current or a history of hyperkalaemia, treatment with renin–angiotensin–aldosterone system inhibitors (RAASi) is often compromised. Patiromer, a novel potassium (K⁺) binder, may improve serum K⁺ levels and adherence to RAASi.
Methods
The DIAMOND trial will enrol ~820 patients with heart failure with reduced ejection fraction...
Introduction:
Nonvalvular atrial fibrillation (NVAF) is associated with a substantial economic burden, particularly in patients with comorbid conditions. This study compared healthcare resource utilization (HRU) and costs of rivaroxaban and warfarin in patients with NVAF, obesity, and diabetes.
Methods:
A de-identified healthcare claims database...
Hyperkalemia is a common electrolyte abnormality identified in the emergency department (ED) and potentially fatal. However, there is no consensus over the potassium threshold that warrants intervention or its treatment algorithm. Commonly used medications are at best temporizing measures, and the roles of binders are unclear in the emergent settin...
Background:
Despite advances in immune suppression, kidney allograft rejection and other injuries remain a significant clinical concern, particularly with regards to long-term allograft survival. Evaluation of immune activity can provide information about rejection status and help guide interventions to extend allograft life. Here, we describe the...
Aims
To compare clinical outcomes of rivaroxaban and warfarin in patients with nonvalvular atrial fibrillation (NVAF) and concurrent obesity and diabetes.
Methods
Patients aged ≥18 years were identified from a healthcare claims database with the following criteria: newly initiating rivaroxaban or warfarin, ≥1 medical claim with a diagnosis of AF,...
Background: We recently demonstrated how orthostatic hypotension might be used to identify out-of-office blood pressure phenotypes, including white coat effects and nocturnal non-dipping patterns. However, these findings have not been replicated in a population with chronic kidney disease (CKD).
Objective: To examine the association between orthost...
Aims:
People with type 2 diabetes mellitus (T2DM) have a greater risk of cardiovascular disease and major adverse cardiovascular events (MACE), which become more common as kidney function declines. Canagliflozin reduced the risk of MACE (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) in patients with T2DM and high cardi...
Background:
Patients with CKD frequently have anemia that results from iron-restricted erythropoiesis and inflammation. Anemia of CKD is currently managed with iron supplements and erythropoiesis-stimulating agents (ESAs) to promote erythropoiesis and with RBC transfusion in severe cases. Hyporesponse to ESAs, or the need for larger than usual dos...
IntroductionPeople with type 2 diabetes mellitus (T2DM) and diabetic kidney disease (DKD) have increased morbidity and mortality risk. Angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) are recommended to slow kidney function decline in DKD. This representative, real-world data analysis of patients with T2DM w...
Use of granulocyte colony-stimulating factor (G-CSF) has been associated with side effects including reports of acute glomerulonephritis (GN), almost all of which have been immune complex associated. There is one prior report of pauci-immune GN in a child, but was negative for ANCA (anti-neutrophilic cytoplasmic antibodies). We describe the first c...
Background and Aims
In patients with CKD and/or heart failure (HF), hyperkalaemia (HK) is a major problem which limits the use of guideline-recommended renin–angiotensin–aldosterone inhibitors (RAASi). Dose reduction or cessation of RAASi therapy results in increased morbidity and mortality. Improved strategies to mitigate HK are required to improv...
Background and Aims
People with type 2 diabetes mellitus (T2DM) have a greater risk of cardiovascular (CV) disease and major adverse CV events (MACE) that is more common as renal function declines. The sodium glucose co-transporter 2 (SGLT2) inhibitor canagliflozin reduced the risk of MACE (CV death, nonfatal myocardial infarction [MI], and nonfata...
IntroductionThe availability of the sodium-free potassium binder patiromer opens new opportunities for hyperkalemia management.Objective
Our objective was to compare data from a 4-year global pharmacovigilance database of adverse events (AEs) reported in patients prescribed patiromer in clinical practice compared with data obtained from the clinica...
Background:
A Minimal Clinically Meaningful Difference (MCMD) has not been defined for Estimated glomerular filtration rate (eGFR). Our goal: define the MCMD for eGFR anchored to kidney graft failure.
Methods:
A systematic review of studies with 12-month eGFR and subsequent renal graft failure was conducted. For observational studies we calculat...
Background:
Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive biomarker for the early detection of organ transplant rejection and other causes of graft injury. For nonrejection renal injuries, there is little information about the performance characteristics of this biomarker. We highlight some of the possible causes of kidney injury that ma...
IntroductionChronic kidney disease (CKD) may be associated with overt or subclinical hypothyroidism [SCH; defined as elevated serum thyroid-stimulating hormone (TSH) despite normal free thyroxine levels). Although some studies have demonstrated that thyroid replacement therapy may improve renal function in overt hypothyroidism, there is no consensu...
Background
Exposure to high doses or a high cumulative dose of erythropoiesis-stimulating agents (ESAs) may contribute to cardiovascular events in patients with CKD and anemia. Whether using a low fixed ESA dose versus dosing based on a hemoglobin-based, titration-dose algorithm in such patients might reduce risks associated with high ESA doses and...
Background
Protein carbamylation is a posttranslational protein modification caused, in part, by exposure to urea’s dissociation product cyanate. Carbamylation is linked to cardiovascular outcomes and mortality in dialysis dependent end stage kidney disease (ESKD), but its effects in earlier pre-dialysis stages of chronic kidney disease (CKD) are n...
Significance
Diabetic kidney disease (DKD) is the most common cause of chronic and end-stage renal failure in the world. In a genetically susceptible host, poor metabolic control contributes to DKD development. The epigenome integrates signals from sequence variations and environmental alterations. We performed genome-wide DNA methylation associati...
The Chronic Renal Insufficiency Cohort (CRIC) Study is an ongoing, multicenter, longitudinal study of nearly 5500 adults with CKD in the United States. Over the past 10 years, the CRIC Study has made significant contributions to the understanding of factors associated with CKD progression. This review summarizes findings from longitudinal studies e...
Refractory hypertension (RfH) is a severe phenotype of antihypertension treatment failure. Treatment-resistant hypertension (TRH), a less severe form of difficult-to-treat hypertension, has been associated with significantly worse health outcomes. However, no studies currently show how health outcomes may worsen upon progression to RfH. RfH and TRH...
Treatment with sodium-glucose co-transporter-2 inhibitors induces an initial 3-5 ml/min/1.73 m2 decline in estimated glomerular filtration rate (eGFR). Although considered to be of hemodynamic origin and largely reversible, this 'eGFR dip' may cause concern in clinical practice, which highlights the need to better understand its incidence and clini...
Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Despite various guidelines, no universally accepted consensus exists on best practices for hyperkalemia monitoring, with variations in precise potassium (K⁺) concentration thresholds or for the management of acute or chronic hyperkalemia. Based on the availab...
To the Editor: In their article on the results of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial, Bagshaw et al. (July 16 issue)¹ report that the accelerated initiation of dialysis, as compared with a standard strategy, resulted in similar mortality among patients with acute kidney...
Background
Whether ambulatory BP monitoring is of value in evaluating risk for outcomes in patients with CKD is not clear.
Methods
We followed 1502 participants of the Chronic Renal Insufficiency Cohort (CRIC) Study for a mean of 6.72 years. We evaluated, as exposures, ambulatory BP monitoring profiles (masked uncontrolled hypertension, white-coat...
Background
The sodium-glucose cotransporter 2 inhibitor canagliflozin has been shown to reduce the risk of cardiovascular and renal events in patients with Type 2 diabetes mellitus and high risk. Pooled analyses of data from early studies and interim data from the CANagliflozin cardioVascular Assessment Study (CANVAS) suggested that canagliflozin m...
Rationale & Objective
Current dietary guidelines recommend that chronic kidney disease (CKD) patients restrict individual nutrients, such as sodium, potassium, phosphorus and protein. This approach can be difficult for patients to implement and ignores important nutrient interactions. Dietary patterns are an alternative method to intervene on diet....
: Hypertension is a major risk factor for cardiovascular disease and all-cause mortality. Numerous antihypertensive medications and lifestyle changes have proven effective for the reduction of blood pressure (BP). Over the past few decades, the emergence of complementary and alternative medicine (CAM)-based strategies to lower BP have broadened the...
Nearly seven decades have elapsed since the clinical and biochemical features of primary hyperaldosteronism (PA) were described by Conn. PA is now widely recognized as the most common form of secondary hypertension. PA has a strong correlation with cardiovascular disease and failure to recognize and/or properly diagnose this condition has profound...
Background
Acute kidney injury is common in critically ill patients, many of whom receive renal-replacement therapy. However, the most effective timing for the initiation of such therapy remains uncertain.
Methods
We conducted a multinational, randomized, controlled trial involving critically ill patients with severe acute kidney injury. Patients...
Background. Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications.
Methods. Retrospective review of all renal transplant recipients who underwent...
Background
Apparent treatment-resistant hypertension is common in patients with CKD. Whether measurement of 24-hour ambulatory BP monitoring is valuable for risk-stratifying patients with resistant hypertension and CKD is unclear.
Methods
We analyzed data from the Chronic Renal Insufficiency Cohort study, a prospective study of participants ( n =1...
In EMPA-REG OUTCOME, empagliflozin (EMPA) reduced the risk of CV death by 38% in T2D patients (pts) with CV disease. EMPA induces an initial, reversible dip in estimated glomerular filtration rate (eGFR). We investigated whether this transient initial renal hemodynamic effect was influenced by baseline characteristics or had an impact on the EMPA-i...
Potassium (K⁺) is the most abundant cation in humans and is essential for normal cellular function. Alterations in K⁺ regulation can lead to neuromuscular, gastrointestinal, and cardiac abnormalities. Dyskalemia (i.e., hypokalemia and hyperkalemia) in heart failure is common because of heart failure itself, related comorbidities, and medications. D...
Objectives
Current dietary guidelines recommend that chronic kidney disease (CKD) patients reduce intake of individual nutrients, such as sodium, potassium, phosphorus, and protein. This approach can be difficult for patients to implement and ignores important nutrient interactions. Our objective was to define the association of healthy dietary pat...
Background and Aims
Empagliflozin (EMPA) reduces cardiovascular and renal risk in patients with type 2 diabetes (T2D) and established cardiovascular disease (CVD). EMPA induces an initial ‘dip’ in estimated glomerular filtration rate (eGFR). Although considered to be of haemodynamic origin and largely reversible, this needs to be better understood....
Purpose of program
This paper will provide guidance on how to best manage patients with end-stage kidney disease who will be or are being treated with home dialysis during the COVID-19 pandemic.
Sources of information
Program-specific documents, pre-existing, and related to COVID-19; documents from national and international kidney agencies; natio...
Background:
Chronic kidney disease (CKD) progression can be a cause and potentially a consequence of anemia. Previous studies suggesting that anemia is associated with CKD progression have not utilized methodologic approaches to address time-dependent confounding.
Methods:
We evaluated the association of anemia (defined using World Health Organi...
Citations
... CRRT had a lower rate of dialysis dependence and greater ICU and hospital-free days at 90 days; however, these patients also had better kidney function at baseline limiting the impact of these results. 17 Alternatively, pooled analysis of patients undergoing initial CCRT in the AKIKI and IDEAL-ICU trials was associated with higher mortality at 60 days and no difference in dialysis dependence. 18 Once the optimal modality is determined for the patient, an RRT dose must be prescribed. ...
... Before investigating dedicated animal models or randomized trials, the MR method with quantitative trait locus (QTLs) as IVs can add evidence for causal inference in CKD proteomics research [8]. For example, some recent studies have explored proteomics for CKD progression and estimated glomerular filtration rate regulation (eGFR) regulation by specific cohorts or Mendelian randomization-based methods [9][10][11]. Schlosser et al. nominated determinants of kidney filtration (eGFR, blood urea nitrogen) and kidney damage (albuminuria) by transcriptome and proteome-wide association studies [12]. ...
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... 104 Lorundrostat lowered blood pressure effectively in a small RCT in patients with uncontrolled hypertension. 105 Systolic blood pressure fell by 10.1 mm Hg and 13.8 mm Hg with lorundrostat twice daily doses of 12.5 mg and 2 mg, respectively. The mean difference in systolic blood pressure between placebo and treatment was -9.6 (90% CI −15.8 to −3.4) mm Hg) (P=0.01) with a 50 mg once daily dose and −7.8 (−14.1 to −1.5) mm Hg (P=0.04) with 100 mg daily. ...
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... RAS is the basic hormonal system responsible for the maintenance of cardiovascular homeostasis and hydroelectrolyte balance [33]. Two classes of drugs are highly effective as RAS blockers: ACE inhibitors (ACEi) act through the degradation of the RAS cascade [34], and angiotensin renin blockers-ARBs act through the blockade of AT1 receptors [35]. Blockage of the RAS with ACE inhibitors or ARBs has become one of the most successful therapeutic strategies in many cardiovascular diseases, including arterial hypertension, left ventricular systolic dysfunction, chronic heart failure, myocardial infarction, and diabetic and nondiabetic chronic kidney disease [36]. ...
... La producción reducida de eritropoyetina (EPO) endógena, la deficiencia de hierro (absoluta o funcional), la pérdida sanguínea, las deficiencias nutricionales y el estrés oxidativo acompañado de inflamación con niveles elevados de hepcidina son identificados como los principales factores contribuyentes a la anemia en la ERC 11 . La EPO una hormona glucoproteica (30.4 kDa) que se produce principalmente en las células intersticiales peritubulares renales y en menor proporción en las células perisinusoidales del hígado, y que se incrementa en respuesta a los cambios de tensión del oxígeno tisular 12 , está regulada por la transcripción del gen ...
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... the multiple lists which are used in inpatient and critical care medicine [32,33]. Considering this, healthcare providers and their patients frequently lack awareness of the potential nephrotoxic effects, which may lead to inadequate monitoring and delayed care. ...
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... Reduced HDL size is another biomarker of metabolism associated with chronic disease risk [16] as HDL cholesterol is primarily carried by large, buoyant, lipid-rich HDL particles [46]. Studies have found concentrations of smaller HDL particles to typically reveal positive correlations with cardiovascular risk [15,[46][47][48][49]. Results from this study also suggest a relationship between higher FSAm-NPS scores and increased large VLDL concentrations. ...
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... Hyperkalemia is defined as serum K þ levels 5.0 mEq/L, and it is common in patients with HFrEF, Diabetes, and CKD [51,52]. Hyperkalemia is divided into mild (5.0 -< 5.5 mEq/L), moderate (5.5-< 6.0 mEq/L), and severe hyperkalemia 6 mEq/L that requires emergency department visits [5]. ...
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... The secondary analysis of the STARRT-AKI trial suggest that an accelerated strategy of RRT initiation conferred a higher risk of 90-day RRT dependence among critically ill patients with AKI who have pre-existing chronic kidney disease [61]. It is plausible that exposure to RRT may contribute to a higher relative risk of disrupted and maladaptive kidney repair to which patients with pre-existing chronic kidney disease are particularly vulnerable. ...
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... The consistently increasing prevalence of diabetes has caused diabetic nephropathy to become the leading reason for end-stage renal disease or chronic kidney disease [9]. Urine albumin/creatinine ratio (UACR), which is reported as a milligram of albumin in a gram of urinary creatinine, is a simple method that can estimate 24-hour albumin excretion and is used in monitoring and diagnosing kidney disease [10,11]. Microalbuminuria is de ned as the excretion of 30-300 mg of albumin in 24-hour urine or a urinary albumin/creatinine ratio (UACR) ranging between 2 and 20 mg/g [12]. ...
