Publications by authors named "Kelvin L Lynn"

Aims: Due to the paucity of studies focusing on primary glomerulonephritis, the second commonest cause of end-stage-kidney-disease in most of the developed world, we sought to review outcomes of these renal pathologies.

Methods: We reviewed renal outcomes and mortality for primary glomerulonephritis patients enrolled in the New Zealand Glomerulonephritis Study between 1972 and 1983.

Results: There were 765 patients with median follow-up of 30 years (range 0.

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Background: New Zealand (NZ) has a high prevalence of both peritoneal dialysis (PD) and home haemodialysis (HD) relative to other countries, and probably less selection bias. We aimed to determine if home dialysis associates with better survival than facility HD by simultaneous comparisons of the three modalities.

Methods: We analysed survival by time-varying dialysis modality in New Zealanders over a 15-year period to 31-Dec-2011, adjusting for patient co-morbidity by Cox proportional hazards multivariate regression.

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Background: Renal transplant recipients (RTRs) have an increased risk of developing nonmelanoma skin cancers (NMSCs). The aims of this study were to determine the incidence and subsequent history of NMSCs in RTRs, together with risk factors.

Methods: All patients transplanted between July 1972 and March 2007, and followed up at Christchurch Hospital, New Zealand, were studied.

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Maintenance haemodialysis (HD) was pioneered in Seattle and rapidly became home-based. When dialysis treatment began in Australia and New Zealand, home haemodialysis (HHD) became the predominant form of dialysis. When compared with in-centre conventional dialysis, HHD is associated with superior survival and quality of life and is cheaper.

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Focal and segmental glomerulosclerosis (FSGS) is a kidney disorder of unknown etiology, and up to 20% of patients on dialysis have been diagnosed with it. Here we show that a large family with hereditary FSGS carries a missense mutation in the TRPC6 gene on chromosome 11q, encoding the ion-channel protein transient receptor potential cation channel 6 (TRPC6). The proline-to-glutamine substitution at position 112, which occurs in a highly conserved region of the protein, enhances TRPC6-mediated calcium signals in response to agonists such as angiotensin II and appears to alter the intracellular distribution of TRPC6 protein.

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Hypertension is clearly an independent risk factor for cardiovascular (CV) events and death in the general population, but the relationship between blood pressure (BP) and survival in dialysis patients is less clear. In dialysis populations at lower risk of CV events, BP is directly related to survival, while in those with high risk, it has been difficult to show such an effect. The effects of cardiac disease complicate the relationship between BP and outcome.

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Background: We report the outcome of arteriovenous (AV) fistulas created and managed by a multidisciplinary team in patients on hemodialysis (HD) over 20 years.

Methods: We analyzed 432 AV fistulas in 301 home HD patients (12% diabetic; median age 47 years) followed for up to 161 months. Observed end points were spontaneous or surgical AV fistula closure, or construction of a new vascular anastomosis.

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Background: Endothelial dysfunction is common in end-stage renal disease and may contribute to the development of both hypertension and atherosclerosis. Long-slow hemodialysis (HD) has been associated with superior blood pressure control and fewer cardiovascular complications. We hypothesized that long dialysis times would improve endothelial function compared with shorter dialysis times.

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Background: Previous studies of the risks of hypertension for dialysis patients have yielded conflicting results. The aim of this study was to investigate, in a home dialysis population with low rates of diabetes and antihypertensive drug use, whether blood pressure (BP) was an independent risk factor for survival.

Methods: The outcome of 168 consecutive patients (94 male, 88% Caucasian), aged 48 years (SD 16), who began home hemodialysis (HD; N = 124) or home continuous ambulatory peritoneal dialysis (CAPD; N = 44) between January 1, 1985 and December 31, 1994 were analyzed retrospectively.

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