Genomic testing in patients with renal disease.

Inherited kidney disease accounts for a significant proportion of chronic kidney disease and end-stage renal failure. There is increasing evidence that genetic testing for inherited kidney disease should be integrated into clinical care pathways at the earliest opportunity so that patients and their families can maximally benefit from carefully tailored care. Despite increased availability of genetic testing, the proportion of patients with renal disease undergoing genetic investigations remains low.

Nesting Ecology and Colony Survival of Two Invasive Polistes Wasps (Hymenoptera: Vespidae) in New Zealand.

We examined the abundance, nesting ecology, and colony survival of two invasive species of paper wasp, Polistes dominula Christ (Hymenoptera: Vespidae) and Polistes chinensis Pérez (Hymenoptera: Vespidae), within their invaded range in New Zealand. The more recent invader, P. dominula, exhibited a strong habitat preference, reaching the highest abundances within suburban areas with an average of 87.

Bioclimatic Modelling Identifies Suitable Habitat for the Establishment of the Invasive European Paper Wasp (Hymenoptera: Vespidae) across the Southern Hemisphere.

Species distribution models (SDMs) are tools used by ecologists to help predict the spread of invasive species. Information provided by these models can help direct conservation and biosecurity efforts by highlighting areas likely to contain species of interest. In this study, two models were created to investigate the potential range expansion of Christ (Hymenoptera: Vespidae) in the southern hemisphere.

Investigating the relationship between class I HLA-specific immunoglobulin-G subclasses, Pan-IgG single antigen bead assays and complement mediated interference in sera from renal transplant recipients.

Introduction: Antibody mediated rejection is the leading cause of kidney transplant failure. Not all antibodies are harmful and some may be protective. Immunoglulin Gs, of which there are four subtypes, are detected by single antigen bead testing.

Investigating complement mediated interference in class I HLA-specific antibodies following renal transplantation.

Introduction: Single antigen bead testing (SAB) for HLA-specific antibody enables efficient organ allocation and aids in the diagnosis of antibody mediated rejection. In this retrospective cohort study, a population of kidney transplant recipients possessing HLA Class I antibodies was used to evaluate the best method for resolving complement interference, the so called "prozone" effect. The aim was to compare the use of EDTA versus a Biotin-Streptavidin Complex as methodological approaches for abating the prozone effect using a fixed 1 in 10 dilution as validation.

Social behaviour of domestic dogs (Canis familiaris) in a public off-leash dog park.

This study examines the activity budgets and social behaviours initiated and received by 69 focal dogs in an off-leash dog park for 400 s after entry, a time of high activity about which little is known. Using motivationally-neutral labels for social behaviour categories, we describe the frequency of behaviours, and correlations among them. We then examine these relationships in the context of proposed functions for some behaviours in dogs, in terms of information gathering and communication, including visual and tactile signalling.

A study to describe the health trajectory of patients with advanced renal disease who choose not to receive dialysis.

Background: Some patients with end-stage renal failure (ESRF) are unlikely to benefit from dialysis and conservative management (CM) is offered as a positive alternative. Understanding the trajectory of illness by health care professionals may improve end-of-life care.

Methods: We aimed to describe the trajectory of functional status within our CM population through a prospective, observational study using the objective Timed Up and Go (TUG) test and subjective Barthel Index (BI) and health-related quality of life (HRQoL) [EuroQol 5D-5L (EQ-5D-5L)] measurements and correlating them with demographic and laboratory data and with sentinel events.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.

Background: Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time.

Methods: Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.

Adiponectin gene expression in human primary adipocyte culture treated with uremic serum.

End-stage renal disease (ESRD) is accompanied by an increased rate of morbidity and mortality due to cardiovascular disease (CVD). Although renal replacement therapy is required at this stage, it is associated with additional complications such as inflammation and dyslipidemia. It has been suggested that adiponectin has anti-inflammatory properties.

Pregnancies complicated by preeclampsia and non-preeclampsia-related nephrotic range proteinuria.

Objective: To examine the impact of nephrotic range proteinuria during pregnancy on renal, maternal and fetal outcomes.

Methods: A retrospective study of pregnant women with proteinuria greater than 3 g/24 h. Outcome measures included: gestation and mode of delivery, maternal high dependency unit admission, birth weight, maternal blood pressure and proteinuria at time of last follow-up, renal biopsy.

Is blood ammonia influenced by kidney function? A prospective study.

Background: We have investigated whether blood ammonia is increased with worsening CKD.

Methods: Fifty eight subjects with a range of CKD were recruited for analysis of plasma ammonia and other electrolytes.

Results: The concentrations of plasma ammonia were all within the normal reference range and there was no correlation between ammonia and CKD without any effect of dialysis.

The severity of pseudohyperkalaemia is not dependent upon the stage of chronic kidney disease: a prospective study.

Background: Pseudohyperkalaemia may result from delay in centrifugation and storage at 4°C. We investigated whether the stage of chronic kidney disease (CKD), its aetiology or medications influence this.

Methods: Seventy-seven patients with CKD were recruited.

'Septrin psychosis' among renal transplant patients with Pneumocystis jirovecii pneumonia.

Objectives: To report on the temporal relationship between administration of trimethoprim/sulfamethoxazole to medically immunosuppressed HIV-negative renal patients with Pneumocystis jirovecii pneumonia (PCP) and the development of an acute psychosis.

Methods: We investigated a retrospective case series of renal transplant and immunosuppressed patients with PCP within an ongoing outbreak in the northwest of England since 2009. Four patients with PCP developed psychosis following treatment with trimethoprim/sulfamethoxazole.

Successful management of recurrent pregnancy-related thrombotic thrombocytopaenia purpura in a renal transplant recipient.

Thrombotic thrombocytopaenic purpura (TTP) is a rare but potentially devastating complication of pregnancy. We report the first documented case of a successful treatment of recurrent TTP complicating pregnancy in a renal transplant patient.

Symptom management for the adult patient dying with advanced chronic kidney disease: a review of the literature and development of evidence-based guidelines by a United Kingdom Expert Consensus Group.

Improvement in end-of-life-care is required for patients dying with chronic kidney disease (CKD). The UK government now recommends that tools such as the Liverpool Care Pathway for the Dying Patient (LCP) be used to enhance the care of those patients dying with CKD. The LCP was originally developed for patients dying with terminal cancer, however has been shown to be transferable to patients dying with heart failure or stroke.

Factors affecting survival in advanced chronic kidney disease patients who choose not to receive dialysis.

Introduction: Non-dialytic treatment (NDT) has become a recognized and important modality of treatment in end stage renal disease (ESRD) in certain groups of chronic kidney disease (CKD) patients. However, little is known about the prognosis of these NDT patients in terms of hospitalization rates and survival. We analyzed our experience in managing these NDT with a multidisciplinary team (MDT) approach over a three-year period.

Regulation of neutrophil apoptosis by Mcl-1.

Neutrophils rapidly undergo spontaneous apoptosis, but this process can be considerably delayed by exposure to a variety of agents such as pro-inflammatory cytokines. The anti-apoptotic protein of the Bcl-2 family, Mcl-1, plays a key role in the regulation of neutrophil apoptosis. The protein has some unusual properties compared with other family members, including an extremely high turnover rate.

Late-onset mitochondrial disorder with electromyographic evidence of myotonia.

We describe a patient with chronic progressive external ophthalmoplegia (CPEO) due to a deletion of mitochondrial DNA (mtDNA) who had electromyographic evidence of myotonic discharges. Myotonia has not previously been described in association with mitochondrial disease and this report extends the known phenotypic expression of these disorders.

The antiproteinuric effect of losartan is systemic blood pressure dependent.

Background: It has been suggested that high doses of angiotensin II receptor antagonists (AIIAs) may reduce proteinuria by a non-haemodynamic action additional to their effect on systemic blood pressure.

Methods: We tested this for the AIIA losartan using a prospective single-blind randomized design in patients with proteinuria (>1 g/24 h) due to non-diabetic chronic renal failure (stable creatinine clearance >20 ml/min) and mild to moderate hypertension (130/80 < blood pressure < 160/110 mmHg). Twenty-one patients were randomized into two groups: group A received losartan 50 mg daily for 4 weeks, then 100 mg daily for 4 weeks; group B received losartan 50 mg daily for 8 weeks.

Land contamination and urinary abnormalities: cause for concern?

Aims: To determine the prevalence of proteinuira and enzymuria among a cohort of subjects exposed to hexachlorobutadiene (HCBD) in their homes and to determine whether there was a change in observed effects when exposure ceased.

Methods: Residents underwent a health check, which included a panel of urinary markers of both glomerular and tubular origin, within two months of cessation of long term exposure to HCBD and again at least 10 months after exposure ceased. Analysis of the results was performed to determine if there was any early evidence of renal effects, and to ascertain whether changes in these parameters occurred after exposure to HCBD ceased.

Changes in the corrected QT interval and corrected QT dispersion during haemodialysis.

The link between increased QT dispersion and cardiac death in subjects with diabetes and arterial disease is well recognised. Corrected QT dispersion was studied in subjects with end stage renal failure on haemodialysis. Thirty one stable, chronic subjects on haemodialysis had 12-lead electrocardiograms (ECGs) taken before and after a single haemodialysis session.