Publications by authors named "Glenn Chertow"
Background: Contemporary population-based data examining the rates of cardiac surgery and the relationship between non-dialysis-requiring chronic kidney disease (CKD) and postoperative outcomes in cardiac surgery are limited.
Methods: We identified hospital admissions for cardiac surgical procedures in adults from 2010-2019 in the United States. The primary exposure was kidney disease, categorized as CKD stage G3, CKD stages G4 or G5, and end-stage kidney disease (ESKD).
Background: This real-world evidence study compared risks of cardiovascular events in hospital settings among patients with chronic kidney disease (CKD) with and without hyperkalemia.
Methods And Results: Adults with CKD stages 3b/4 with and without hyperkalemia were identified from Optum's deidentified Market Clarity Data (January 2016-August 2022). Patients with hyperkalemia were exact and propensity score matched to patients without hyperkalemia.
Background: Sedentary behavior is highly prevalent and associated with morbidity and mortality in chronic kidney disease (CKD). A Sit Less, Interact and Move More (SLIMM) sedentary activity coaching intervention can reduce sedentary duration among persons with CKD, but preliminary data suggest that effects may not persist. Prior studies have suggested that moderate/vigorous intensity physical activities are not sustainable in persons with CKD.
View Article and Find Full Text PDFTwo potassium (K) binders-patiromer sorbitex calcium and sodium zirconium cyclosilicate-are recommended by international guidelines for the management of hyperkalemia. There is, however, no universally accepted best practice for how to appropriately utilize K binders in the long-term clinical management of CKD. A panel of eight US-based nephrologists convened in October 2022 to develop a consensus statement regarding utilizing K binders in clinical practice to help manage patients with nonemergent, persistent/recurrent hyperkalemia in CKD.
View Article and Find Full Text PDFBackground: Prevention is a cornerstone for management of recurrent urinary stone disease. Current guidelines recommend metabolic evaluation, lifestyle modification, and medical treatment for patients with urinary stone disease. Nephrologists are uniquely qualified to evaluate stone risk and formulate treatment strategies to reduce that risk.
View Article and Find Full Text PDFImportance: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have changed clinical management of chronic kidney disease (CKD) and made populationwide screening for CKD a viable strategy. Optimal age of screening initiation has yet to be evaluated.
Objective: To compare the clinical benefits, costs, and cost-effectiveness of population-wide CKD screening at different initiation ages and screening frequencies.
Article Synopsis
- Prostate cancer is the most prevalent cancer among men in the U.S., and this study explores the link between pesticide exposure and its incidence and mortality.
- Researchers analyzed the relationship between the use of 295 pesticides and prostate cancer rates using county-level data from two different cohorts spanning multiple years.
- They found consistent associations for 22 pesticides with prostate cancer incidence, with four also linked to mortality, suggesting a need for further investigation into these pesticides' potential health impacts.
Effects of dialysate potassium concentration of 3.0 mmol/l with sodium zirconium cyclosilicate on dialysis-free days versus dialysate potassium concentration of 2.0 mmol/l alone on rates of cardiac arrhythmias in hemodialysis patients with hyperkalemia.
Kidney Int
January 2025
The optimal approach towards managing serum potassium (sK) and hemodialysate potassium concentrations is uncertain. To study this, adults receiving hemodialysis for three months or more with hyperkalemia (pre-dialysis sK 5.1-6.
View Article and Find Full Text PDFKidney disease and its comorbidities disproportionately affect older persons. Kidney disease modifying therapy is underutilized in older adults, as guidelines lack consensus on approaching diagnosis and treatment in older adults. This review aims to highlight the challenges presented by, and opportunities for, identifying and treating CKD in older adults.
View Article and Find Full Text PDFContemporary epidemiology of hospitalised heart failure with reduced versus preserved ejection fraction in England: a retrospective, cohort study of whole-population electronic health records.
Lancet Public Health
November 2024
Background: Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.
Methods: In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital.
Article Synopsis
- Albuminuria is a significant marker for kidney and cardiovascular problems in chronic kidney disease (CKD), and this study analyzed its impact on health outcomes in CKD patients receiving dapagliflozin or placebo.
- A post-hoc analysis of the DAPA-CKD trial involved 4,304 patients and found that dapagliflozin significantly decreased urinary albumin-to-creatinine ratio (UACR) after four months, with a 36% reduction in those with diabetes and 21% in those without.
- The study concluded that greater reductions in albuminuria were linked to lower risks of serious kidney and cardiovascular events, providing evidence for the benefits of dapagliflozin in managing CKD.
Objective: To determine rates of urology follow-up and implementation of stone prevention measures after stone surgery and to assess variation in care delivery within a large, integrated healthcare system.
Materials And Methods: We used nationwide data from the United States Veterans Health Administration to identify patients who had stone surgery between 2016 and 2018 and who were at higher risk for recurrence. Our cohort included 13,444 Veterans across 90 facilities.
Importance: Integrating routine SARS-CoV-2 testing in dialysis facilities may benefit patients receiving dialysis by mitigating risks of serious illness and reducing transmission. Patient acceptance of nonmandatory testing is unknown.
Objective: To evaluate the acceptance of 2 SARS-CoV-2 testing strategies among patients in hemodialysis facilities nationwide.
Article Synopsis
- The study explores the prevalence of Mendelian kidney diseases among high-risk genotype individuals who underwent genetic testing in the U.S., revealing a lifetime kidney failure risk of about 15% for these patients.
- In a sample of 15,181 individuals, 20.5% were diagnosed with Mendelian kidney disease, and only 6.8% had high-risk genotypes, suggesting that other factors may influence disease progression.
- Among those of recent genomic African ancestry, the study found differing prevalence rates of pathogenic variants linked to high-risk and low-risk genotypes, indicating variability in genetic influence on kidney disease.
Article Synopsis
- The CALCIPHYX trial tested hexasodium fytate, a potential treatment for calciphylaxis, a rare condition causing painful skin lesions, in a double-blind, placebo-controlled setting.
- Out of the randomised patients, both those receiving hexasodium fytate and the placebo group showed similar improvements in wound assessment and pain scores after 12 weeks, indicating no significant benefit from the treatment over placebo.
- Serious adverse events were lower in the fytate group compared to the placebo group, suggesting that hexasodium fytate may be safer, but there was no substantial difference in healing or pain reduction between the two groups.
Introduction: Associations between markers of impaired kidney function and adverse outcomes among South Asians is understudied and could differ from existing data derived mostly from North American or European cohorts.
Methods: We conducted a prospective analysis of 9797 participants from the ongoing cardiometabolic risk reduction study in South Asia, India. We examined the associations between baseline spot urine albumin-to-creatinine (UACR) ratio and creatinine-based estimated glomerular filtration rate (eGFR) estimating equations with all-cause mortality using Cox proportional hazards regression, adjusting for baseline age, sex, diabetes, systolic blood pressure, tobacco, history of cardiovascular disease, and cholesterol.
Introduction: Despite the provision of renin-angiotensin-aldosterone-system inhibitors and immunosuppressive therapies, membranous nephropathy often progresses to end-stage kidney disease (ESKD). The objective of this prespecified analysis was to assess the safety and efficacy of dapagliflozin in patients with membranous nephropathy enrolled in the DAPA-CKD trial.
Methods: Patients with an estimated glomerular filtration rate (eGFR) of 25-75 mL/min/1.
Introduction: There remains an unmet need to reduce kidney and cardiovascular risk in patients with chronic kidney disease (CKD). This report is therefore intended to provide real-world clinical guidance to primary care providers on sodium-glucose co-transporter-2 (SGLT2) inhibitor use in patients with CKD, focusing on practical considerations. Initially developed as glucose-lowering drugs, SGLT2 inhibitors preserve kidney function and reduce risks of cardiovascular events and mortality.
View Article and Find Full Text PDFKey Points: Hyperkalemia is a known complication of CKD; however, it is not known whether hyperkalemia directly contributes to CKD progression and risk of death. We found that patients with stages 3b/4 CKD and hyperkalemia had higher risk of CKD progression and death than matched patients without hyperkalemia.
Background: Hyperkalemia is a known complication of CKD; however, it is not known whether hyperkalemia directly contributes to CKD progression and the risk of death.
Article Synopsis
- In the Systolic Blood Pressure Intervention Trial (SPRINT), long-term kidney failure rates were low, primarily linked to patients' initial kidney function.
- Intensive blood pressure treatment resulted in higher but not statistically significant rates of dialysis or transplantation compared to standard treatment.
- The study analyzed 9,279 participants over roughly 8.6 years, finding that most kidney failure cases occurred in patients with poor baseline kidney function, and intensive treatment did not notably raise the overall risk of kidney failure.