Publications by authors named "Alexander Rosenkranz"

Article Synopsis
  • * The main issue resulting from vitamin D toxicity is hypercalcemia, which can be difficult to treat and can stem from various causes, including genetic mutations and excessive intake.
  • * The manuscript discusses possible treatments for vitamin D toxicity, highlighting the use of systemic corticosteroids as effective after traditional methods fail, as well as alternative options that could limit steroid side effects.
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Background: The impact of peritoneal filling on hepato-splanchnic perfusion during peritoneal dialysis has not been fully elucidated yet.

Methods: Measurements were done in 20 prevalent peritoneal dialysis patients during a peritoneal equilibration test (PET) with 2L of standard dialysate. Data were obtained in the drained state at baseline (), after instillation (), and after 2 h of dwell time ().

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Introduction: The global health burden of chronic kidney disease (CKD) results from both the disease itself and the numerous health problems associated with it. The aim of this study was to estimate the prevalence of previously undetected CKD in middle-aged patients with risk factors for CKD. Identified patients were included in the Styrian nephrology awareness program "kidney.

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  • * A study showed that rabbits lacking B vitamins experienced significant vascular damage when given Hcy, despite low cholesterol levels, including issues like collagen disorganization and impaired vascular reactivity.
  • * Findings indicate that Hcy promotes atherogenic changes in the aorta, suggesting its harmful effects extend beyond just high cholesterol conditions.
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Vancomycin is a widely used glycopeptide antibiotic with the need for therapeutic drug monitoring to avoid renal toxicity. We report a case of severe vancomycin-associated anuric acute kidney injury managed with successful drug-removal by hemodialysis (HD) using different types of dialyzers. Medium cut-off (MCO) and high-flux dialyzers were effective in drug removal.

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  • Cytomegalovirus (CMV) infection negatively impacts kidney transplant success, with risks influenced by the serostatus of both the donor and recipient.
  • CD8 T cells are essential for controlling CMV, and this study examined changes in these cells and CMV occurrence in 65 kidney transplant patients over one year.
  • Findings showed that intermediate risk recipients were more likely to develop CMV, and pre-transplant levels of a specific CD8 T cell subset (FoxP3CD25) could help predict who might get infected after the transplant.
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The concept of structural kidney damage and renal dysfunction as a result of jaundice attracted attention in the medical community in the early and mid-20th century. The postulated doctrine of the time was that the excretion of elevated concentrations of bile results in bile-stained casts occupying collecting and distal convoluted tubules, degeneration of tubular epithelium, and decreased renal function. Compared to the hepatorenal syndrome, the poster child of hepatology and nephrology collaboration, the notion of structural kidney damage and renal dysfunction as a result of cholemia lost its traction and has almost disappeared from modern textbooks.

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Objectives: Secondary hemophagocytic lymphohistiocytosis (sHLH) is a cytokine-driven inflammatory syndrome that is associated with substantial morbidity and mortality and frequently leads to ICU admission. Overall survival in adults with sHLH remains poor, especially in those requiring intensive care. Classical chemotherapeutic treatment exhibits myelosuppression and toxicity.

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  • Vaccination hesitancy among patients on chronic hemodialysis has increased during the COVID-19 pandemic, highlighting the need for strategies to address concerns and improve vaccination rates.
  • A study involving 347 hemodialysis patients in Austria found that older patients preferred information from dialysis physicians, while younger patients were more likely to rely on online sources for vaccine information.
  • Although 86% of patients expressed a desire to complete vaccinations, only 39% felt adequately informed about the vaccination plan, indicating a significant gap in knowledge that needs to be addressed.
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Introduction: We reported increased spleen tyrosine kinase (SYK) expression in kidney biopsies of patients with IgA nephropathy (IgAN) and that inhibition of SYK reduces inflammatory cytokines production from IgA stimulated mesangial cells.

Methods: This study was a double-blind, randomized, placebo-controlled phase 2 trial of fostamatinib (an oral SYK inhibitor) in 76 patients with IgAN. Patients were randomized to receive placebo, fostamatinib at 100 mg or 150 mg twice daily for 24 weeks on top of maximum tolerated dose of renin-angiotensin system inhibitors.

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Background: Whenever the kidney standard allocation (SA) algorithms according to the Eurotransplant (ET) Kidney Allocation System or the Eurotransplant Senior Program fail, rescue allocation (RA) is initiated. There are 2 procedurally different modes of RA: recipient oriented extended allocation (REAL) and competitive rescue allocation (CRA). The objective of this study was to evaluate the association of patient survival and graft failure with RA mode and whether or not it varied across the different ET countries.

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  • Carbohydrate-deficient transferrin (CDT) and the Anttila-Index are biomarkers that may indicate heavy alcohol use and could predict delirium and mortality in critically ill patients.
  • In a study of 343 ICU patients, 35% experienced delirium, with those affected showing significantly higher levels of CDT and Anttila-Index upon admission.
  • Higher CDT and Anttila-Index levels were linked to both the occurrence of delirium and longer duration of delirium, as well as increased hospital mortality risk.
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In recent decades, insights into the molecular pathways involved in disease have revolutionized the treatment of autoimmune diseases. A plethora of targeted therapies have been identified and are at varying stages of clinical development in renal autoimmunity. Some of these agents, such as rituximab or avacopan, have been approved for the treatment of immune-mediated kidney disease, but kidney disease lags behind more common autoimmune disorders in new drug development.

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Background: Hyperphosphatemia is associated with increased mortality and cardiovascular morbidity of end-stage kidney failure (ESKF) patients. Managing serum phosphate in ESKF patients is challenging and mostly based on limiting intestinal phosphate absorption with low phosphate diets and phosphate binders (PB). In a multi-centric, double-blinded, placebo-controlled study cohort of maintenance hemodialysis patients with hyperphosphatemia, we demonstrated the efficacy of nicotinamide modified release (NAMR) formulation treatment in addition to standard PB therapy in decreasing serum phosphate.

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  • Hemodialysis (HD) patients are particularly vulnerable to COVID-19 due to their compromised health, prompting a study to analyze the pandemic's impact on this group over time and identify severe risks.
  • The study reviewed data from 274 HD patients in Austria from May 2020 to August 2022, examining factors like hospitalization, ICU admission, and mortality rates correlated with different COVID-19 waves.
  • Findings revealed a significant decline in severe outcomes during the Omicron variant wave compared to earlier waves, with vaccination and prior infection offering some degree of protection, though only Omicron infection was a consistent predictor of reduced hospitalization and mortality.
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Health-related quality of life (HRQOL) improves after kidney transplantation (KT) but declines over time. Studies on the effect of early postoperative basal insulin therapy on HRQOL after KT, especially KTRs at high risk of developing post-transplant diabetes mellitus (PTDM) are missing. Data from a randomized controlled trial on 148 non-diabetic KTRs were analyzed.

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Epidemiological investigations have shown that approximately 2-3% of all Austrians have diabetes mellitus with renal involvement, leaving 250,000 people in Austria affected. The risk of occurrence and progression of this disease can be attenuated by lifestyle interventions as well as optimization of blood pressure, blood glucose control and special drug classes. The present article represents the joint recommendations of the Austrian Diabetes Association and the Austrian Society of Nephrology for the diagnostic and treatment strategies of diabetic kidney disease.

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Introduction: Although adherence to immunosuppressive medication is the key factor for long-term graft survival today, 20-70% of transplant recipients are non-adherent to their immunosuppressive medication.

Objective: A prospective, randomized, controlled single-center feasibility study was designed to evaluate the impact of a step guided multicomponent interprofessional intervention program for patients after kidney or liver transplantation on adherence to their immunosuppressive medication in daily clinical practice.

Materials And Methods: The intervention consisted of group therapy and daily training as well as individual sessions in a step guided approach.

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  • This study explores the risk factors for severe infections in patients with antineutrophil cytoplasm antibody-associated vasculitis (AAV) participating in the RAVE trial, focusing on those receiving rituximab or cyclophosphamide.
  • Most severe infections occurred within the first six months, particularly respiratory infections, with lower levels of certain B cells linked to a higher risk of severe infections.
  • The use of low-dose trimethoprim-sulfamethoxazole (TMP/SMX) was found to significantly reduce the risk of severe infections, highlighting the importance of immunoglobulin M levels and B cell numbers as potential indicators of immune function.
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Coronavirus disease 2019 (COVID-19)-induced metabolic alterations have been proposed as a source for prognostic biomarkers and may harbor potential for therapeutic exploitation. However, the metabolic impact of COVID-19 in hemodialysis (HD), a setting of profound a priori alterations, remains unstudied. To evaluate potential COVID-19 biomarkers in end-stage kidney disease (CKD G5), we analyzed the plasma metabolites in different COVID-19 stages in patients with or without HD.

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Rapid progressive glomerulonephritis (GN) often leads to end-stage kidney disease, driving the need for renal replacement therapy and posing a global health burden. Low-dose cytokine-based immunotherapies provide a new strategy to treat GN. IL-15 is a strong candidate for the therapy of immune-mediated kidney disease since it has proven to be tubular-protective before.

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Chronic kidney disease (CKD) drastically increases the risk for cardiovascular morbidity and mortality and its worldwide prevalence is still rising. Effective treatment slows CKD progression, prevents development of end-stage kidney disease and cardiovascular disease thereby prolonging survival of patients. Recently, several large-scale studies with sodium-glucose cotransport‑2 inhibitors (SGLT-2i) have demonstrated profound nephroprotective and cardioprotective properties in patients with type 2 diabetes mellitus with both CKD and heart failure.

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We report a case of a patient double-seropositive for anti-glomerular basement membrane (anti-GBM) and anti-neutrophil cytoplasmic antibodies (ANCA) who reported retrosternal chest pain during a regular hemodialysis session associated with ST-segment depression in electrocardiogram and an increase of serum high-sensitivity troponin T. Urgent coronary angiography excluded obstructive coronary artery disease, suggesting the diagnosis of ischemia with non-obstructive coronary arteries. This case illustrates an unusual presentation of cardiovascular involvement in a patient with double-positive ANCA/anti-GBM disease, emphasizing the possible relevance of coronary microvascular dysfunction and the need for close cardiovascular follow-up in this patient population.

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