Increased Microalbuminuria Risk in Male Cigarette Smokers: Results from the “Olivetti Heart Study” after 8 Years Follow-Up

Background/Aims: Association between cigarette smoke and albuminuria (UA) was already demonstrated in cross-sectional studies and in selected population samples (i.e diabetic patients). This study aims to evaluate, prospectively, the relationship between cigarette smoke and UA in a male adult population sample, with basal normal kidney function, participating in the Olivetti Heart Study (OHS). Methods: Among 994 participants, examined in both 1994-95 and 2002-04, were selected those resulted in both visits smokers (n=221) and non-smokers (n=416) and with basal normal kidney function (GFR> 60 mL/min) and basal albumin/creatinine ratio (ACR< 30 mg/g). Results: At baseline, the prevalence of hypertension was 41%, diabetes affected 6.3% and obesity 17% of the whole sample. Smokers showed statistically significant lower levels of systolic (SBP) and diastolic blood pressure (DBP) and BMI (p< 0.001) compared to non-smokers. There were not basal differences in UA, GFR and metabolic profile. However, at follow-up examination, smokers showed a statistically significant increase in SBP and DBP (p< 0.05), but not in GFR and BMI. Moreover, smokers showed a higher risk compared to non-smokers to be in the higher median levels group of UA (OR: 2.17, C.I.95%: 1.51-3.13; p < 0.001), even after correction for major confounding factors. Further adjustment for basal antihypertensive and hypoglycemic treatment did not change these patterns of association. Conclusion: In a selected male adult population sample, cigarette smoke was independently associated with the development of higher levels of albuminuria over time.

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Mesangial C4d Deposits in Early IgA Nephropathy

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.02530317 ◽

2017 ◽

Vol 13 (2) ◽

pp. 258-264 ◽

Cited By ~ 13

Author(s):

Alfons Segarra ◽

Katheryne Romero ◽

Irene Agraz ◽

Natalia Ramos ◽

Alvaro Madrid ◽

...

Keyword(s):

Iga Nephropathy ◽

Kidney Function ◽

Prognostic Value ◽

Kidney Biopsy ◽

Interquartile Range ◽

Repeated Treatment ◽

Creatinine Ratio ◽

Normal Kidney ◽

Normal Kidney Function

Background and objectivesThe prognostic value of mesangial C4d deposits in IgA nephropathy has been analyzed in patients with reduced GFR but has not been analyzed in those with normal kidney function. The main objective of the study was to analyze the prognostic value of C4d deposits and association with response to treatment in patients with IgA nephropathy and normal GFR.Design, setting, participants, & measurementsThis retrospective cohort study included 190 patients with idiopathic IgA nephropathy diagnosed by kidney biopsy between 1988 and 2005. The patients had GFR≥80 ml/min per 1.73 m2 at the time of diagnosis, and they had a paraffin-embedded kidney biopsy with eight glomeruli available.ResultsIn total, 170 (89%) and 20 (11%) patients were >18 and <18 years old, respectively; median (interquartile range) follow-up was 15 (12–22) years. Mesangial C4d deposit prevalence was 20% (38 of 190). At diagnosis, C4d-positive versus -negative patients had higher protein-to-creatinine ratio (median [interquartile range]: 1.94 g/g [0.9–3.1] versus 1.45 g/g [0.9–2.2]; P=0.04). During follow-up, C4d-positive patients showed a higher number of nephritic flares (median [range]: 1.4 [0–5] versus 0.9 [0–2]; P=0.04), had a higher protein-to-creatinine ratio (median [interquartile range]: 1.32 g/g [0.7–1.7] versus 0.89 g/g [0.1–1.3]; P<0.01), were more prone to receive repeated treatment with corticosteroids (45% versus 24%; P<0.01), and showed a larger reduction in eGFR (−1.6 versus −0.8 ml/min per 1.73 m2 per year; P=0.04). Furthermore, the presence of mesangial C4d deposits was an independent predictor of long-term kidney survival.ConclusionsC4d deposits may be one of the earliest poor prognostic variables available for patients with idiopathic IgA nephropathy and normal kidney function at the time of diagnosis. However, Cd4 deposits alone are not associated with the response to angiotensin blockers or corticosteroid treatment.

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Anemia in Diabetic Patients without Underlying Nephropathy. a Retrospective Cohort Study

Blood ◽

10.1182/blood.v128.22.4809.4809 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4809-4809

Author(s):

Ali R. Mahjoub ◽

Eshan Patel ◽

Sami Ali ◽

Kendal Webb ◽

Alan Astrow ◽

...

Keyword(s):

Cohort Study ◽

Kidney Function ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Deficiency Anemia ◽

Diabetic Patients ◽

Normal Kidney ◽

Normal Kidney Function ◽

Patients With Diabetes ◽

Prevalence Of Anemia

Background: Anemia (defined by the World Health Organization as a hemoglobin level of less than 13 mg/dl in men and less than 12 mg/dl in women) is common in diabetic patients, particularly in those with reduced renal function. Most studies attribute anemia in diabetic patients to kidney function impairment. There are no controlled systematic studies of the prevalence and predictors of anemia in patients with diabetes in the absence of overt nephropathy. Objective: This retrospective cohort study was designed to measure the prevalence of anemia in diabetic patients with normal kidney function (estimated glomerular filtration rate (EGFR) greater than 90 ml/min/1.73 m2 and negative micro albuminuria) and compare it to a control group of non-diabetic patients. The study was designed to investigate diabetes as an independent risk for causing anemia. Methods: We undertook a retrospective review of medical records of 400 patients (older than 18 years old) visiting the outpatient clinic in our institution between January and June 2015. 200 patients with diabetes (glycosylated hemoglobin (HgA1C) greater than 7) were compared to 200 non-diabetic patients (HgA1C level below 5.6), to identify the prevalence of anemia, with and without kidney disease and any other associated factors. Results:The prevalence of anemia in all diabetic patients was 22% vs. 9% in non-diabetic group (OR: 2.69, 95% CI; 1.49 to 4.86, P = 0.001). Out of the 22% (n = 44) anemic patients, 18 patients had anemia with normal kidney function, out of those; 5 had iron deficiency anemia and one had autoimmune disease, while the remaining 12 patients (6%) did not have any obvious cause of anemia other than diabetes vs. 2 patients (1%) in non-diabetic patients who we did not find any explanation for the their anemia (OR: 6.6, 95% CI; 1.45 to 30, P < 0.015). Conclusion: Most studies have highlighted an association between anemia and nephropathy in diabetic patients. This retrospective cohort study suggests a high incidence of anemia with unidentified pathology in the diabetic population. The mechanism of this anemia is not well understood, although direct glucose toxicity to erythrocyte precursors in the bone marrow or oxidative stress to mature erythrocytes are both possibilities. Prospective study of hemoglobin levels in patients with diabetes may help elucidate the precise mechanism of anemia in this group. Disclosures No relevant conflicts of interest to declare.

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Serum uric acid and blood pressure in an European rural population with normal kidney function. Data from the Brisighella heart study (Italy) and ENAH study (Croatia)

Cardiologia Croatica ◽

10.15836/ccar2017.49 ◽

2017 ◽

Vol 12 (3) ◽

pp. 49-49

Author(s):

Sandra Karanović ◽

Vanja Ivković ◽

Angelo Parini ◽

Ana Jelaković ◽

Mirta Abramović Barić ◽

...

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Serum Uric Acid ◽

Kidney Function ◽

Rural Population ◽

Normal Kidney ◽

Normal Kidney Function ◽

Function Data ◽

Heart Study

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Cinacalcet-Associated Resolution of Primary Hyperparathyroidism in a Patient With Normal Kidney Function

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620936836 ◽

2020 ◽

Vol 8 ◽

pp. 232470962093683 ◽

Cited By ~ 1

Author(s):

Son Nguyen ◽

Elvira O. Gosmanova ◽

Aidar R. Gosmanov

Keyword(s):

Bone Mineral Density ◽

Chronic Kidney Disease ◽

Primary Hyperparathyroidism ◽

Kidney Function ◽

Calcium Supplementation ◽

Normal Kidney ◽

Mineral Density ◽

Calcium Supplements ◽

Normal Kidney Function

Cinacalcet use is associated with risk of hypocalcemia; however, this risk has been mostly demonstrated in patients with chronic kidney disease. In this article, we describe a case of a 59-year-old male with primary hyperparathyroidism (PHPT), hypercalciuria, osteopenia, and normal kidney function who was started on cinacalcet for the management of recurrent hypercalcemia following prior unsuccessful parathyroidectomy. Within 6 months following cinacalcet commencement, he developed symptomatic and biochemical hypocalcemia requiring discontinuation of the medication and initiation of calcium supplementation. Over more than 3 years of follow-up, his calcium supplementation was gradually tapered off and then discontinued. He is presently eucalcemic and euparathyroid off calcium supplements while also demonstrating normalization of hypercalciuria and bone mineral density. These data indicate that our patient has experienced resolution of PHPT after brief exposure to cinacalcet. We recommend that low starting cinacalcet doses should be considered for treatment of hypercalcemia in patients with PHPT who underwent unsuccessful parathyroidectomy along with close clinical and biochemical follow-up.

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[OP.1B.02] SERUM URIC ACID AND BLOOD PRESSURE IN EUROPEAN RURAL POPULATION WITH NORMAL KIDNEY FUNCTION. DATA FROM BRISGHELLA HEART STUDY (ITALY) AND ENAH STUDY (CROATIA)

Journal of Hypertension ◽

10.1097/01.hjh.0000491337.66462.ab ◽

2016 ◽

Vol 34 ◽

pp. e5

Author(s):

S. Karanovic ◽

V. Ivkovic ◽

A. Parini ◽

A. Vrdoljak ◽

M. Abramovic-Baric ◽

...

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Serum Uric Acid ◽

Kidney Function ◽

Rural Population ◽

Normal Kidney ◽

Normal Kidney Function ◽

Function Data ◽

Heart Study

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Early relapse rate determines further relapse risk: results of a 5-year follow-up study on pediatric CFH-Ab HUS

Pediatric Nephrology ◽

10.1007/s00467-020-04751-9 ◽

2020 ◽

Author(s):

Johannes Hofer ◽

Magdalena Riedl Khursigara ◽

Markus Perl ◽

Thomas Giner ◽

Alejandra Rosales ◽

...

Keyword(s):

Kidney Function ◽

Disease Onset ◽

Factor H ◽

Complement Factor ◽

Normal Kidney ◽

Term Outcome ◽

Long Term Outcome ◽

Normal Kidney Function

Abstract Background The complement factor H antibody (CFH-Ab)–associated hemolytic uremic syndrome (HUS) forms a distinct subgroup within the complement-mediated HUS disease spectrum. The autoimmune nature of this HUS subgroup implies the potential benefit of a targeted immunosuppressive therapy. Data on long-term outcome are scarce. Methods This observational study evaluates the clinical outcome of 19 pediatric CFH-Ab HUS patients from disease onset until their 5-year follow-up. Results All but one relapse occurred during the first 2 years, and patients who had no relapse within the first 6 months were relapse-free until the end of the observation period. Kidney function at disease onset determines long-term kidney function: all individuals with normal kidney function at disease onset had normal kidney function after 5 years, and all patients with reduced kidney function at onset had impaired kidney function at the last follow-up. Level of CFH-Ab titer at disease onset was not correlated with a higher risk of recurrences or worse long-term outcome after 5 years. Resolution of CFH-Ab titers after 5 years was common. Conclusions CFH-Ab HUS patients have a varied overall long-term course. Early relapses are common, making close surveillance during the first years essential, regardless of the initial CFH-Ab titer.

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