The 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimation of glomerular filtration rate (GFR) lower values for Black individuals relative to previous equations, which may change medication eligibility or trigger the need to reevaluate dosing decisions. Major drug classes such as antibiotics, antidiabetic medications, cardiovascular agents, medications for the treatment of psychiatric illness, and chemotherapy drugs all have estimated GFR thresholds for prescribing eligibility. However, the use of strict thresholds for medication eligibility should be heavily scrutinized, and individualized comprehensive approaches should be used for patients on the cusps of these thresholds.
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http://dx.doi.org/10.1016/j.cll.2024.07.001 | DOI Listing |
Rheumatol Int
January 2025
Copenhagen Research Center for Autoimmune Connective Tissue Diseases (COPEACT), Copenhagen University Hospital, Rigshospitalet, Denmark.
To investigate if progression of coronary artery calcification (CAC) in patients with systemic lupus erythematosus (SLE) is associated with renal and traditional cardiovascular risk factors as well as incidence of myocardial infarctions. CAC progression was evaluated by cardiac computed tomography (CT) at baseline and after 5 years. Multivariable Poisson regression was applied to investigate associations between CAC progression and baseline values for traditional cardiovascular risk factors, CAC, SLE disease duration, lupus nephritis, and renal function.
View Article and Find Full Text PDFDiabetic kidney disease (DKD) progression is often marked by early glomerular endothelial cell (GEC) dysfunction, including alterations in the fenestration size and number linked to impaired glomerular filtration. However, the cellular mechanisms regulating GEC fenestrations remain poorly understood due to limitations in existing models, challenges in imaging small fenestrations , and inconsistencies between and findings. This study used a logic-based protein-protein interaction network model with normalized Hill functions for dynamics to explore how glucose-mediated signaling dysregulation impacts fenestration dynamics in GECs.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, University of Chicago Medicine AdventHealth La Grange, Chicago, USA.
Treatment-resistant hypertension (TRH) is defined by consistently elevated blood pressure readings unresponsive to medical management. In clinical practice, it poses a significant challenge due to the intertwining variables that may cause the issue to persist such as lifestyle, genetics, and other comorbidities, as opposed to simple medication non-adherence. This report describes the case of a 68-year-old female patient presenting for a routine follow-up with persistently elevated ambulatory blood pressure readings.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
Background: Limited studies have suggested an effect of dietary choline intake on uric acid levels. We aim to investigate the associations between choline intake and hyperuricemia (HUA), as well as the mediating role of kidney function in this relationship, among the Chinese population aged 6-17 years.
Methods: Participants were divided into quartiles according to residual energy-adjusted dietary choline intake in our cross-sectional study.
Circ Rep
January 2025
Department of Diabetes/Endocrinology and Metabolism, Minoh City Hospital Osaka Japan.
Background: The urinary albumin-to-creatinine ratio (UACR) or urinary protein-to-creatinine ratio (UPCR) has been reported as predictors of cardiovascular and renal events. We aimed to evaluate the impact of changes in proteinuria severity on the prognosis of hypertensive patients post-esaxerenone initiation.
Methods And Results: Hypertensive patients who commenced esaxerenone (n=164) were classified into 3 groups according to baseline UACR or UPCR, based on the modified proteinuria severity classification: A1 (normal; n=35); A2 (microalbuminuria/mild proteinuria; n=49); and A3 (macroalbuminuria/severe proteinuria; n=80).
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