Search

Background Posterior urethral valves (PUV) is the most common cause of obstructive uropathy in boys; approximately 15% develop kidney failure by early adulthood. However, rates of kidney function decline are poorly defined in PUV children and adults, as is the impact of potentially modifiable chronic kidney disease (CKD) progression risk factors. Methods We conducted a retrospective review of all PUV patients followed at our institution from 1995 to 2018. Inclusion criteria were estimated glomerular filtration rate (eGFR) > 20 ml/min/1.73 m.sup.2 after 1 year of age, no dialysis or kidney transplant history, and [greater than or equal to] 2 yearly serum creatinine values after age 1 year. eGFRs were calculated using creatinine-based estimating formulas for children (CKID U25) or adults (CKD-EPI). The primary outcome was annualized change in eGFR, assessed with linear mixed effects models. We also examined the association of acute kidney injury (AKI), proteinuria, hypertension (HTN), and recurrent febrile urinary tract infections (UTIs) with eGFR decline. Results Fifty-two PUV patients met the inclusion criteria. Median (interquartile range) eGFR decline was 2.6 (2.1, 3.1) ml/min/1.73 m.sup.2/year. Children (n = 35) and adults (n = 17) demonstrated progressive decline. Proteinuria and recurrent UTIs were significantly associated with faster progression; AKI and HTN were also associated but did not reach significance. Conclusion PUV patients show progressive loss of kidney function well into adulthood. Proteinuria and recurrent UTIs are associated with faster progression, suggesting potential modifiable risk factors. This is the first study to report annualized eGFR decline rates in PUV patients, which could help inform the design of clinical trials of CKD therapies. Graphical abstract, Author(s): Victoria W. Huang [sup.1] , Mohga Behairy [sup.2] , Benjamin Abelson [sup.3] , Alice Crane [sup.3] , Wei Liu [sup.4] , Lu Wang [sup.4] , Katherine M. Dell [sup.1] [...]

Author(s): Nicholas J. A. Webb [sup.1] , Gary Lerner [sup.2] , Bradley A. Warady [sup.3] , Katherine M. Dell [sup.4] , Larry A. Greenbaum [sup.5] , Gema Ariceta [sup.6] , [...], Background Elevated intact parathyroid hormone (iPTH) levels can contribute to morbidity and mortality in children with chronic kidney disease (CKD). We evaluated the pharmacokinetics, efficacy, and safety of oral paricalcitol in reducing iPTH levels in children with stages 3-5 CKD. Methods Children aged 10-16 years with stages 3-5 CKD were enrolled in two phase 3 studies. The stage 3/4 CKD study characterized paricalcitol pharmacokinetics and compared the efficacy and safety of paricalcitol with placebo followed by an open-label period. The stage 5 CKD study evaluated the efficacy and safety of paricalcitol (no comparator) in children with stage 5 CKD undergoing dialysis. Results In the stage 3/4 CKD study, mean peak plasma concentration and area under the time curve from zero to infinity were 0.13 ng/mL and 2.87 ng*h/((or ngxh/))mL, respectively, for 12 children who received 3 [mu]g paricalcitol. Thirty-six children were randomized to paricalcitol or placebo; 27.8% of the paricalcitol group achieved two consecutive iPTH reductions of [greater than or equal to]30% from baseline versus none of the placebo group (P = 0.045). Adverse events were higher in children who received placebo than in those administered paricalcitol during the double-blind treatment (88.9 vs. 38.9%; P = 0.005). In the stage 5 CKD study, eight children (61.5%) had two consecutive iPTH reductions of [greater than or equal to]30% from baseline, and five (38.5%) had two consecutive iPTH values of between 150 and 300 pg/mL. Clinically meaningful hypercalcemia occurred in 21% of children. Conclusions Oral paricalcitol in children aged 10-16 years with stages 3-5 CKD reduced iPTH levels and the treatment was well tolerated. Results support an initiating dose of 1 [mu]g paricalcitol 3 times weekly in children aged 10-16 years.

Introduction Autosomal recessive polycystic kidney disease (ARPKD, OMIM 263200) is an important genetic cause of progressive chronic kidney disease (CKD), and occurs in an estimated 1 in 20,000 live births [...], Background Autosomal recessive polycystic kidney disease (ARPKD) is an inherited disorder characterized by enlarged, cystic kidneys with progressive chronic kidney disease (CKD), systemic hypertension, and congenital hepatic fibrosis. Children with ARPKD can have early onset CKD and severe hypertension, both of which are known to have adverse neurocognitive effects. The objectives of this study were (1) to determine whether ARPKD patients have greater neurocognitive deficits compared to that of children with other causes of CKD, and (2) to examine the relative prevalence of hypertension in ARPKD, a known risk factor for neurocognitive dysfunction. Methods We performed a cross-sectional, control-matched analysis of 22 ARPKD patients with mild-to-moderate CKD in the Chronic Kidney Disease in Children (CKiD) cohort study, compared with a control group of 44 children with other causes of CKD, matched based on glomerular filtration rate, age at study entry, and age at diagnosis. Results Children with ARPKD in this cohort had neurocognitive functioning comparable to children with other causes of CKD in domains of intellectual functioning, academic achievement, attention regulation, executive functioning, and behavior. Blood pressure parameters were similar between the two groups; however, ARPKD patients required a significantly greater number of antihypertensive medications to achieve similar BP levels. Conclusions ARPKD patients are potentially at risk for neurocognitive dysfunction due to early onset CKD and more severe hypertension. However, this study of children with mild-to-moderate CKD in the CKiD cohort did not demonstrate increased risk in children with ARPKD compared to children with other causes of CKD. Further studies are needed to determine if these findings are applicable to children with more severe manifestations of ARPKD. Keywords Autosomal recessive polycystic kidney disease * Behavior * Chronic kidney disease * Hypertension * Neurocognition * Neuropsychological

In this paper, the Poisson's ratio v of low-temperature plasma-enhanced chemical vapor deposited silicon nitride (Si[N.sub.x][H.sub.y]) thin films has been determined by a modified double-membrane bulge test. This test method utilizes a square membrane and a large-aspect-ratio rectangular membrane that is fabricated alongside from the same thin film. The Poisson's ratio is determined from the ratio of the bulge deflections of the two membranes under an applied pressure. The method is suitable for determining v of either stress-free thin films or those containing low tensile residual stresses. Poisson's ratio values of 0.23 [+ or -] 0.02 and 0.25 [+ or -] 0.01 were measured for Si[N.sub.x][H.sub.y] films that were deposited at 125 [degrees]C and 205 [degrees]C, respectively. [2006-0065] Index Terms--Amorphous materials, dielectric films, plasma chemical vapor deposition (CVD), thin films.

An interpretation of the physical mechanisms involved in the generation of laser beam-induced current (LBIC) in semiconductor p-n junction diodes is presented. LBIC is a nondestructive semiconductor characterization technique that is especially useful for examining individual photoiodides within large two-dimensional arrays of devices.

The use of laser beam-induced current (LBIC) is proposed as a nondestructive characterization technique, and quantitative aspects of its use in the study of electrically active defects in photodiode arrays are examined. The presence of a single electrically active leakage path within the p-n junction can produce a vertical shift of the LBIC profile depending on the location of the leakage along the p-n junction of the device structure and the severity of the leakage mechanism.

Plasma deposited silicon nitride thin films were deposited at temperatures between 150 [degrees]C and 300 [degrees]C. Diagnostic microstructures were fabricated from the thin films using bulk micromachining, and the strain was calculated from optical measurement of postbuckling deflection. The results indicate that the residual strain of the thin films is dominated by film-substrate thermal mismatch, with the coefficient of thermal expansion monotonically increasing with decreasing deposition temperature. Metal-insulator-metal devices of variable area were also fabricated to measure the dielectric constant, which was shown to be independent of deposition temperature. The importance of these results to microsystems technology (MST) was briefly discussed. [1441] Index Terms--Amorphous materials, dielectric films, electric field measurement, microelectromechanical devices, micromachining, plasma chemical vapor deposition (CVD), silicon compounds, strain measurement, thin films.

A technique is proposed for the extraction of precise values of field-dependent absorption coefficient [Alpha] and refractive index n from photocurrent and transmittance measurements of optical modulator structures. The technique uses approximate results of [Alpha] and n extracted from a simplified device as the initial input into an iterative procedure that utilizes the consistency between [Alpha] and n to obtain successively better estimates of these parameters. The technique was applied to results that were measured experimentally, and we verified the accuracy by using synthetic data. Errors caused by measurement inaccuracy are also investigated. It is shown that the absorption coefficient has a modest sensitivity whereas the refractive index is insensitive to these errors.

An examination is done of the optical quenching of photoconductivity in undoped n-type GaN which has been researched. In conclusion, to explain the observed experimental behavior, the conventional hole trap and recombination center model was extended to include an electron trap and the extended model was found to accurately predict the experimental results.

Tested theory that adherence to the traditional male gender role and help-seeking attitudes and behaviors are related. Ss were 401 undergraduate men who completed measures of help-seeking attitudes and behaviors, attitudes toward the stereotypic male role, and gender role conflict factors (i.e., success/power/competition, restrictive emotionality, and restrictive affectionate behavior between men). Canonical analysis and regression indicated that traditional attitudes about the male role, concern about expressing emotions, and concern about expressing affection toward other men were each significantly related to negative attitudes toward seeking professional psychological assistance. Restrictive emotionality also significantly predicted decreased past help-seeking behavior and decreased likelihood of future help seeking. The implications of these results for theory, research, and counseling practice are discussed.