Association of Borderline Pulmonary Hypertension With Mortality and Hospitalization in a Large Patient Cohort: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Background: Pulmonary hypertension (PH) is associated with increased morbidity across the cardiopulmonary disease spectrum. Based primarily on expert consensus opinion, PH is defined by a mean pulmonary artery pressure (mPAP) ≥25 mm Hg. Although mPAP levels below this threshold are common among populations at risk for PH, the relevance of mPAP <25 mm Hg to clinical outcome is unknown.

Assessment and management of hypertension in patients on dialysis.

Hypertension is common, difficult to diagnose, and poorly controlled among patients with ESRD. However, controversy surrounds the diagnosis and treatment of hypertension. Here, we describe the diagnosis, epidemiology, and management of hypertension in dialysis patients, and examine the data sparking debate over appropriate methods for diagnosing and treating hypertension.

Multiple comparisons, interaction effects, and statistical inference: lessons from chronic kidney disease progression among blacks.

A post hoc analysis of a randomized trial comparing progression of chronic kidney disease among blacks and non-blacks provides an opportunity to explore statistical inference. Multiple comparisons without penalizing the P-value can lead to false positive results; this is illustrated using simulation. Tests of statistical interaction are then applied and interpreted to understand effect modification (or lack thereof) in the context of this trial.

Are vitamin D receptor agonists like angiotensin-converting enzyme inhibitors without side effects?

Vitamin D receptor agonists (VDRAs) inhibit the renin-angiotensin system (RAS) and reduce podocyte loss and fibrosis over and above RAS blockade. Several studies in humans show that VDRAs are antiproteinuric and have the potential to delay the progression of renal disease. Whether VDRAs will accomplish this goal among proteinuric patients with chronic kidney disease needs to be tested in randomized controlled trials.

Permissive role of calcium on regulatory volume decrease in freshly isolated mouse cholangiocytes.

Calcium (Ca2+) pathways are important in cell volume regulation in many cells, but its role in volume regulatory processes in cholangiocytes is unclear. Thus, we have investigated the role of Ca2+ in regulatory volume decrease (RVD) in cholangiocytes using freshly isolated bile duct cell clusters (BDCCs) from normal mouse. No significant increase in [Ca2+]i was observed during RVD, while ionomycin and ATP showed significant increases.

Etiology and management of hypertension in chronic kidney disease.

The kidneys are vital in the pathogenesis of hypertension and are also pathologically affected by the presence of hypertension. The prevalence of hypertension in chronic kidney disease (CKD) depends on age, the severity of renal failure, and proteinuria. The intricate and inextricable relationship between CKD and hypertension seems to cause cardiovascular disease that has assumed epidemic proportions.

Proinflammatory effects of oxidative stress in chronic kidney disease: role of additional angiotensin II blockade.

Oxidative stress plays an important role in causing progressive chronic kidney disease (CKD). We examined the influence of add-on ANG II receptor blockade administered as losartan (50 mg/day for 1 mo) on oxidative stress and proinflammatory state of the kidney in patients with CKD. All subjects were taking an angiotensin-converting enzyme inhibitor plus other antihypertensive agents.

Epithelioid angiomyolipoma of the kidney: a report of five cases with a prominent and diagnostically confusing epithelioid smooth muscle component.

We report five angiomyolipomas with a prominent component of epithelioid smooth muscle cells that occurred in patients from 20 to 48 (mean, 36) years of age. The tumors often posed problems in diagnosis, particularly with regard to distinction from renal cell carcinoma. Two patients had tuberous sclerosis.