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Search Results for all work with filters:

  • Medicine: Nephrology
Authors 1-46 of 46
Janet D Klein PhD
SOM: Medicine: Nephrology
School Of Medicine
Russ Price PhD
SOM: Medicine: Nephrology
School Of Medicine
James T Someren MD
SOM: Medicine: Nephrology
School Of Medicine
Tahsin Masud MD
SOM: Medicine: Nephrology
School Of Medicine
Edwin Macon
SOM: Medicine: Nephrology
School Of Medicine
Janice Lea MD
SOM: Medicine: Nephrology
School Of Medicine
Tuncer Someren
SOM: Medicine: Nephrology
School Of Medicine
Robert Hoover Jr
SOM: Medicine: Nephrology
School Of Medicine
W Charles O'Neill MD
SOM: Medicine: Nephrology
School Of Medicine
Antonio Guasch MD
SOM: Medicine: Nephrology
School Of Medicine
Jose E Navarrete MD
SOM: Medicine: Nephrology
School Of Medicine
Xiaonan Wang MD
SOM: Medicine: Nephrology
School Of Medicine
Stephen Pastan MD
SOM: Medicine: Nephrology
School Of Medicine
James L Bailey MD
SOM: Medicine: Nephrology
School Of Medicine
Jason Cobb
SOM: Medicine: Nephrology
School Of Medicine
Titilayo Ilori
SOM: Medicine: Nephrology
School Of Medicine
Kum Han
SOM: Medicine: Nephrology
School Of Medicine
Sharon Graves MD
SOM: Medicine: Nephrology
School Of Medicine
Jack Work MD
SOM: Medicine: Nephrology
School Of Medicine
Sudha Tata MD
SOM: Medicine: Nephrology
School Of Medicine
Jeanie Park
SOM: Medicine: Nephrology
School Of Medicine
Clintoria Williams
SOM: Medicine: Nephrology
School Of Medicine
Laura Plantinga
SOM: Medicine: Nephrology
School Of Medicine
Ibironke Apata
SOM: Medicine: Nephrology
School Of Medicine
Mitsi A. Blount PhD
SOM: Medicine: Nephrology
School Of Medicine
Xiuyan Feng MD, PhD
SOM: Medicine: Nephrology
School Of Medicine
Brandi M. Wynne PhD
SOM: Medicine: Nephrology
School Of Medicine
Fuying Ma
SOM: Medicine: Nephrology
School Of Medicine
Koba A Lomashvili MD
SOM: Medicine: Nephrology
School Of Medicine
Ali Kashkouli
SOM: Medicine: Nephrology
School Of Medicine
Anju Oommen
SOM: Medicine: Nephrology
School Of Medicine
Jennifer Gooch PhD
SOM: Medicine: Nephrology
School Of Medicine
Abinash Mistry MD
SOM: Medicine: Nephrology
School Of Medicine
Hui Cai MD
SOM: Medicine: Nephrology
School Of Medicine
Steven Gorbatkin
SOM: Medicine: Nephrology
School Of Medicine
Vandana Dua Niyyar MD, FASN, FNKF
SOM: Medicine: Nephrology
School Of Medicine
Shalini Bumb
SOM: Medicine: Nephrology
School Of Medicine
Payaswini Vasanth
SOM: Medicine: Nephrology
School Of Medicine
Dona Wu
SOM: Medicine: Nephrology
School Of Medicine
Harold A Franch MD
SOM: Medicine: Nephrology
School Of Medicine
Susan M Wall MD
SOM: Medicine: Nephrology
School Of Medicine
Arlene B Chapman MD
SOM: Medicine: Nephrology
School Of Medicine
Frederic Rahbari Oskoui MD
SOM: Medicine: Nephrology
School Of Medicine
Anees Quyyumi MD
SOM: Medicine: Nephrology
School Of Medicine
Mazen Abdalla
SOM: Medicine: Nephrology
School Of Medicine
Robert Jansen
SOM: Medicine: Nephrology
School Of Medicine

Work 1-10 of 395

Sorted by relevance
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  8. ...
>

Article

Docosahexaenoic acid prevents palmitate-induced activation of proteolytic systems in C2C12 myotubes

by Myra Woodworth-Hobbs; Matthew B. Hudson; Jill A. Rahnert; Bin Zheng; Harold Franch; Stephen Price

2014

Subjects
  • Chemistry, Biochemistry
  • File Download
  • View Abstract

Abstract:Close

Saturated fatty acids like palmitate contribute to muscle atrophy in a number of conditions (e.g., type II diabetes) by altering insulin signaling. Akt is a key modulator of protein balance that inhibits the FoxO transcription factors (e.g., FoxO3) which selectively induce the expression of atrophy-inducing genes (atrogenes) in the ubiquitin-proteasome and autophagy-lysosome systems. Conversely, omega-3 polyunsaturated fatty acids have beneficial effects on insulin signaling and may preserve muscle mass. In an earlier report, the omega-3 fatty acid docosahexaenoic acid (DHA) protected myotubes from palmitate-induced atrophy; the mechanisms underlying the alterations in protein metabolism were not identified. This study investigated whether DHA prevents a palmitate-induced increase in proteolysis by restoring Akt/FoxO signaling. Palmitate increased the rate of protein degradation, while cotreatment with DHA prevented the response. Palmitate reduced the activation state of Akt and increased nuclear FoxO3 protein while decreasing its cytosolic level. Palmitate also increased the messenger RNAs (mRNAs) of two FoxO3 atrogene targets, the E3 ubiquitin ligase atrogin-1/MAFbx and the autophagy mediator Bnip3. DHA attenuated the effects of palmitate on Akt activation, FoxO3 localization and atrogene mRNAs. DHA, alone or in combination with palmitate and decreased the ratio of LC3B-II:LC3B-I protein as well as the rate of autophagosome formation, as indicated by reduced LC3B-II protein in the presence of 10 mmol/L methylamine, suggesting an independent effect of DHA on the macroautophagy pathway. These data indicate that palmitate induces myotube atrophy, at least in part, by activating multiple proteolytic systems and that DHA counters the catabolic effects of palmitate by restoring Akt/FoxO signaling.

Article

Dialysis Facility and Network Factors Associated With Low Kidney Transplantation Rates Among United States Dialysis Facilities

by Rachel Patzer; Laura Plantinga; J Krisher; Stephen Pastan

2014

Subjects
  • Health Sciences, Public Health
  • Sociology, Public and Social Welfare
  • Health Sciences, Medicine and Surgery
  • File Download
  • View Abstract

Abstract:Close

Variability in transplant rates between different dialysis units has been noted, yet little is known about facility-level factors associated with low standardized transplant ratios (STRs) across the United States End-stage Renal Disease (ESRD) Network regions. We analyzed Centers for Medicare & Medicaid Services Dialysis Facility Report data from 2007 to 2010 to examine facility-level factors associated with low STRs using multivariable mixed models. Among 4098 dialysis facilities treating 305 698 patients, there was wide variability in facility-level STRs across the 18 ESRD Networks. Four-year average STRs ranged from 0.69 (95% confidence interval [CI]: 0.64-0.73) in Network 6 (Southeastern Kidney Council) to 1.61 (95% CI: 1.47-1.76) in Network 1 (New England). Factors significantly associated with a lower STR (p-<-0.0001) included for-profit status, facilities with higher percentage black patients, patients with no health insurance and patients with diabetes. A greater number of facility staff, more transplant centers per 10 000 ESRD patients and a higher percentage of patients who were employed or utilized peritoneal dialysis were associated with higher STRs. The lowest performing dialysis facilities were in the Southeastern United States. Understanding the modifiable facility-level factors associated with low transplant rates may inform interventions to improve access to transplantation. Standardized transplant ratios vary widely among the more than 4,000 dialysis facilities in the United States, and facilities with the lowest rates are located in the Southeast. Also see viewpoint by Patzer and Pastan (page 1499) and counterpoint by Srinivas (page 1506).

Article

Apolipoprotein L1 Gene Variants in Deceased Organ Donors Are Associated With Renal Allograft Failure

by Stephen Pastan; Howard Gebel; Allan Kirk; Robert Bray; BI Freedman; BA Julian; AK Israni; D Schladt; MD Gautreaux; V Hauptfeld; RS Gaston; J Rogers; AC Farney; G Orlando; RJ Stratta; S Mohan; L Ma; CD Langefeld; PJ Hicks; ND Palmer; PL Adams; A Palanisamy; AM Reeves-Daniel; J Divers

2015

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, Pathology
  • File Download
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Apolipoprotein L1 gene (APOL1) nephropathy variants in African American deceased kidney donors were associated with shorter renal allograft survival in a prior single-center report. APOL1 G1 and G2 variants were genotyped in newly accrued DNA samples from African American deceased donors of kidneys recovered and/or transplanted in Alabama and North Carolina. APOL1 genotypes and allograft outcomes in subsequent transplants from 55 U.S. centers were linked, adjusting for age, sex and race/ethnicity of recipients, HLA match, cold ischemia time, panel reactive antibody levels, and donor type. For 221 transplantations from kidneys recovered in Alabama, there was a statistical trend toward shorter allograft survival in recipients of two-APOL1-nephropathy-variant kidneys (hazard ratio [HR] 2.71; p = 0.06). For all 675 kidneys transplanted from donors at both centers, APOL1 genotype (HR 2.26; p = 0.001) and African American recipient race/ethnicity (HR 1.60; p = 0.03) were associated with allograft failure. Kidneys from African American deceased donors with two APOL1 nephropathy variants reproducibly associate with higher risk for allograft failure after transplantation. These findings warrant consideration of rapidly genotyping deceased African American kidney donors for APOL1 risk variants at organ recovery and incorporation of results into allocation and informed-consent processes.

Article

Organizational Readiness to Implement the Chronic Disease Self-Management Program in Dialysis Facilities.

by Tiffany R. Washington; Tandrea S. Hilliard; Chivon A. Mingo; Rasheeda K. Hall; Matthew Lee Smith; Janice Lea

2018

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, Health Care Management
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A gap exists between the development and uptake of evidence-based health promotion programs in health care settings. One reason for this gap is lack of attention to organizational readiness. The objective of this study was to assess organizational readiness to implement the Chronic Disease Self-Management Program in dialysis facilities. Survey data were collected from dialysis staff using a semi-structured Organizational Readiness for Implementing Change questionnaire. Change efficacy and change commitment scale ratings were all above 3.0, indicating a moderate level of readiness among staff. Profession and level of education were significantly associated with mean change efficacy scale ratings. Textual data revealed benefits to patients, implementation barriers and facilitators, and the influence of facility environment and culture. The findings of the current study suggest that additional efforts to advance the implementation of evidence-based health promotion programs in dialysis facilities are needed.

Article

Increased Peripheral Arterial Calcification in Patients Receiving Warfarin

by Kum Han; William O'Neill

2016

Subjects
  • Health Sciences, General
  • Health Sciences, Pharmacology
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BACKGROUND: Matrix Gla protein is a vitamin K-dependent inhibitor of vascular calcification. Warfarin use is associated with increased breast arterial calcification, but whether this is reflective of other arteries or occurs in men is unclear. In this study, the prevalence of calcification in peripheral arteries was compared in patients with and without warfarin therapy. METHODS AND RESULTS: This retrospective matched cohort study assessed 430 patients with radiographs performed during or after warfarin therapy who were identified by a computerized search of medical records. Each patient was matched to a patient without warfarin exposure based on age, sex, and diabetes status. Patients with warfarin exposure <1 month, history of end-stage renal disease, or serum creatinine >2.0 mg/dl were excluded. Radiographs were reviewed visually for arterial calcification. The prevalence of arterial calcification was 44% greater in patients with versus without warfarin use (30.2% versus 20.9%, P=0.0023) but not on radiographs performed before warfarin therapy (26.4% versus 22.4%, n=156) or prior to 5 years of warfarin therapy. The increase was noted only in the ankle and foot, was limited to a medial pattern of calcification, and was similar in men and women. CONCLUSIONS: Warfarin use is associated with lower extremity arterial calcification in both men and women independent of age, sex, diabetes status, and other patient characteristics. This may have implications for the choice of therapies for long-term anticoagulation.

Article

Insulin increases the functional activity of the renal NaCl cotransporter

by Maria Chavez-Canales; Juan Pablo Arroyo; Benjamin Ko; Norma Vazquez; Rocio Bautista; Maria Castaneda-Bueno; Norma A. Bobadilla; Robert S. Hoover Jr; Gerardo Gamba

2013

Subjects
  • Health Sciences, Medicine and Surgery
  • Biology, Physiology
  • Biology, Molecular
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Objectives: Insulin is recognized to increase renal salt reabsorption in the distal nephron and hyperinsulinemic states have been shown to be associated with increased expression of the renal NaCl cotransporter (NCC). However, the effect of insulin on NCC functional activity has not been reported. Methods: Using a heterologous expression system of Xenopus laevis oocytes, a mouse distal convoluted cell line, mDCT15 cells, endogenously expressing NCC, and an ex-vivo kidney perfusion technique, we assessed the effect of insulin on the activity and phosphorylation of NCC. The signaling pathway involved was analyzed. Results: In Xenopus oocytes insulin increases the activity of NCC together with its phosphorylation at threonine residue 58. Activation of NCC by insulin was also observed in mDCT15 cells. Additionally, insulin increased the NCC phosphorylation in kidney under the ex-vivo perfusion technique. In oocytes and mDCT15 cells, insulin effect on NCC was prevented with inhibitors of phosphatidylinositol 3-kinase (PI3K), mTORC2, and AKT1 kinases, but not by inhibitors of MAP or mTORC1 kinases, suggesting that PI3K-mTORC2-AKT1 is the intracellular pathway required. Additionally, activation of NCC by insulin was not affected by wild-type or mutant versions of with no lysine kinase 1, with no lysine kinase 4, or serum glucocorticoid kinase 1, but it was no longer observed in the presence of wild-type or the dominant negative, catalytically inactive with no lysine kinase 3, implicating this kinase in the process. Conclusion: Insulin induces activation and phosphorylation of NCC. This effect could play an important role in arterial hypertension associated with hyperinsulinemic states, such as obesity, metabolic syndrome, or type 2 diabetes mellitus.

Article

Association of Initial Hemodialysis Vascular Access with Patient-Reported Health Status and Quality of Life

by Haimanot Wasse; Nancy Kutner; Rebecca Zhang; Yijian Huang

2007

Subjects
  • Health Sciences, Rehabilitation and Therapy
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Background Although the arteriovenous fistula (AVF) is the recommended form of vascular access for patients with ESRD, its impact on patient perception of health status, quality of life (QOL), or satisfaction is unknown. Design, setting, participants, and measurements This study compared patient-reported health status and QOL scores and vascular access type among a national random sample of 1563 patients at dialysis initiation and day 60 of ESRD during 1996 to 1997. Patients were stratified into five categories: AVF at first dialysis and day 60 of ESRD, arteriovenous graft (AVG) at first dialysis and day 60, central venous catheter (CVC) at first dialysis and AVF at day 60, CVC at first dialysis and AVG at day 60, and CVC at first dialysis and day 60. Results Ten percent (n = 154) of patients had an AVF, 21% (n = 326) had an AVG, and 69% (n = 1083) had a CVC at dialysis initiation; those who were most likely to use an AVF were white and male. After statistical adjustment, patients with persistent AVF use reported greater physical activity and energy, better emotional and social well-being, fewer symptoms, less effect of dialysis and burden of kidney disease, and better sleep compared with patients with persistent CVC use, whereas measures such as cognitive and sexual function did not differ by access type. Conclusions Compared with persistent CVC use, early persistent AVF use is associated with the perception of improved health status and QOL among patients with ESRD. Future longitudinal studies may help to clarify further the association between QOL and vascular access.

Article

Vasopressin Increases Urea Permeability in the Initial IMCD from Diabetic Rats

by Vladimir Pech; Janet D Klein; Shelley D. Kozlowski; Susan M Wall; Jeff M Sands

2005

Subjects
  • Health Sciences, General
  • Biology, Physiology
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In normal rats, vasopressin and hyperosmolality enhance urea permeability (Purea) in the terminal, but not in the initial IMCD, a process thought to occur through the UT-A1 urea transporter. In the terminal IMCD, UT-A1 is detected as 97 and 117 kDa glycoproteins. However, in the initial IMCD, only the 97 kDa form is detected. During streptozotocin induced diabetes mellitus, UT-A1 protein abundance is increased and the 117 kDa UT-A1 glycoprotein appears in the initial IMCD. We hypothesize that the 117 kDa glycoprotein mediates the vasopressin- and osmolality-induced changes in Purea. Thus in the present study, we measured Purea in in vitro perfused initial IMCDs from diabetic rats by imposing a 5 mM bath-to-lumen urea gradient without any osmotic gradient. Basal Purea was similar in control vs. diabetic rats (3±1 vs. 5±1 x10−5 cm/sec, n=4, p=NS). Vasopressin (10 nM) significantly increased Purea to 16±5 x10−5 cm/sec, n=4, p<0.05 in diabetic, but not in control rats. Forskolin (10 μM, adenylyl cyclase activator) also significantly increased Purea in diabetic rats. In contrast, increasing osmolality to 690 mOsm/kg H2O did not change Purea in diabetic rats. We conclude that initial IMCDs from diabetic rats have vasopressin- and forskolin-, but not hyperosmolality-stimulated Purea. The appearance of vasopressin-stimulated Purea in initial IMCDs correlates with an increase in UT-A1 protein abundance and the appearance of the 117 kDa UT-A1 glycoprotein in this region during diabetes. This suggests that the 117 kDa UT-A1 glycoprotein is necessary for vasopressin-stimulated urea transport.

Article

Candesartan augments compensatory changes in medullary transport proteins in the diabetic rat kidney

by Mitsi A. Blount; Jeff M Sands; Kimilia J. Kent; Tekla D. Smith; Russ Price; Janet D Klein

2008

Subjects
  • Biology, Physiology
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Volume depletion due to persistent glucosuria-induced osmotic diuresis is a significant problem in uncontrolled diabetes mellitus (DM). Angiotensin II receptor blockers (ARBs), such as candesartan, slow the progression of chronic kidney disease in patients with DM. However, mice with genetic knockout of components of the renin-angiotensin system have urine concentrating defects, suggesting that ARBs may exacerbate the volume depletion. Therefore, the effect of candesartan on UT-A1, UT-A3, NKCC2, and aquaporin-2 (AQP2) protein abundances was determined in control and 3-wk DM rats. Aldosterone levels in control rats (0.36 ± 0.06 nM) and candesartan-treated rats (0.34 ± 0.14 nM) were the same. DM rats had higher aldosterone levels (1.48 ± 0.37 nM) that were decreased by candesartan (0.97 ± 0.26 nM). Western analysis showed that UT-A1 expression was increased in DM rats compared with controls in inner medullary (IM) tip (158 ± 13%) and base (120 ± 25%). UT-A3 abundance was increased in IM tip (123 ± 11%) and base (146 ± 17%) of DM rats vs. controls. UT-A3 was unchanged in candesartan-treated control rats. In candesartan-treated DM rats, UT-A3 increased in IM tip (160 ± 14%) and base (210 ± 19%). Candesartan-treated DM rats had slightly higher AQP2 in IM (46%, P < 0.05) vs. control rats. NKCC2/BSC1 was increased 145 ± 10% in outer medulla of DM vs. control rats. We conclude that candesartan augments compensatory changes in medullary transport proteins, reducing the losses of solute and water during uncontrolled DM. These changes may represent a previously unrecognized beneficial effect of type 1 ARBs in DM.

Article

Atypical Presentation of Perforated Sigmoid Diverticulitis in a Kidney Transplant Recipient with Autosomal Dominant Polycystic Kidney Disease

by Ekamol Tantisattamo; Antonio Guasch

2013

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, Public Health
  • View on PubMed Central
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Perforated sigmoid diverticulitis, a complication of colonic diverticulosis commonly associated with autosomal dominant polycystic kidney disease (ADPKD), can be life-threatening in allogeneic kidney transplant recipients in the postoperative period. Immunosuppressive medications not only place the patient at risk for intestinal perforation, but also mask classic clinical symptoms and signs of acute abdomen, and subsequently lead to delayed diagnosis and treatment. We report a case of an ADPKD patient post kidney transplantation presenting with nausea, vomiting, and abdominal pain without signs of peritonitis. Chest x-ray revealed free air under the diaphragm consistent with intestinal perforation. Post kidney transplant recipients with ADPKD presenting with abdominal pain should prompt a search for possible perforated colonic diverticulitis in order to diagnose and treat this life-threatening condition early.
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