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4. Quantification and classification of potassium and calcium disorders with the electrocardiogram: What do clinical studies, modeling, and reconstruction tell us?

Author

Pilia, N, Severi, S, Raimann, J, Genovesi, S, Dossel, O, Kotanko, P, Corsi, C, Loewe, A, Pilia N., Severi S., Raimann J. G., Genovesi S., Dossel O., Kotanko P., Corsi C., Loewe A., Pilia, N, Severi, S, Raimann, J, Genovesi, S, Dossel, O, Kotanko, P, Corsi, C, Loewe, A, Pilia N., Severi S., Raimann J. G., Genovesi S., Dossel O., Kotanko P., Corsi C., and Loewe A.

Abstract

Diseases caused by alterations of ionic concentrations are frequently observed challenges and play an important role in clinical practice. The clinically established method for the diagnosis of electrolyte concentration imbalance is blood tests. A rapid and non-invasive point-of-care method is yet needed. The electrocardiogram (ECG) could meet this need and becomes an established diagnostic tool allowing home monitoring of the electrolyte concentration also by wearable devices. In this review, we present the current state of potassium and calcium concentration monitoring using the ECG and summarize results from previous work. Selected clinical studies are presented, supporting or questioning the use of the ECG for the monitoring of electrolyte concentration imbalances. Differences in the findings from automatic monitoring studies are discussed, and current studies utilizing machine learning are presented demonstrating the potential of the deep learning approach. Furthermore, we demonstrate the potential of computational modeling approaches to gain insight into the mechanisms of relevant clinical findings and as a tool to obtain synthetic data for methodical improvements in monitoring approaches.

Published
2020

7. Hypocalcemia-Induced Slowing of Human Sinus Node Pacemaking

Author

Loewe, A, Lutz, Y, Nairn, D, Fabbri, A, Nagy, N, Toth, N, Ye, X, Fuertinger, D, Genovesi, S, Kotanko, P, Raimann, J, Severi, S, Loewe A., Lutz Y., Nairn D., Fabbri A., Nagy N., Toth N., Ye X., Fuertinger D. H., Genovesi S., Kotanko P., Raimann J. G., Severi S., Loewe, A, Lutz, Y, Nairn, D, Fabbri, A, Nagy, N, Toth, N, Ye, X, Fuertinger, D, Genovesi, S, Kotanko, P, Raimann, J, Severi, S, Loewe A., Lutz Y., Nairn D., Fabbri A., Nagy N., Toth N., Ye X., Fuertinger D. H., Genovesi S., Kotanko P., Raimann J. G., and Severi S.

Abstract

Each heartbeat is initiated by cyclic spontaneous depolarization of cardiomyocytes in the sinus node forming the primary natural pacemaker. In patients with end-stage renal disease undergoing hemodialysis, it was recently shown that the heart rate drops to very low values before they suffer from sudden cardiac death with an unexplained high incidence. We hypothesize that the electrolyte changes commonly occurring in these patients affect sinus node beating rate and could be responsible for severe bradycardia. To test this hypothesis, we extended the Fabbri et al. computational model of human sinus node cells to account for the dynamic intracellular balance of ion concentrations. Using this model, we systematically tested the effect of altered extracellular potassium, calcium, and sodium concentrations. Although sodium changes had negligible (0.15 bpm/mM) and potassium changes mild effects (8 bpm/mM), calcium changes markedly affected the beating rate (46 bpm/mM ionized calcium without autonomic control). This pronounced bradycardic effect of hypocalcemia was mediated primarily by ICaL attenuation due to reduced driving force, particularly during late depolarization. This, in turn, caused secondary reduction of calcium concentration in the intracellular compartments and subsequent attenuation of inward INaCa and reduction of intracellular sodium. Our in silico findings are complemented and substantiated by an empirical database study comprising 22,501 pairs of blood samples and in vivo heart rate measurements in hemodialysis patients and healthy individuals. A reduction of extracellular calcium was correlated with a decrease of heartrate by 9.9 bpm/mM total serum calcium (p < 0.001) with intact autonomic control in the cross-sectional population. In conclusion, we present mechanistic in silico and empirical in vivo data supporting the so far neglected but experimentally testable and potentially important mechanism of hypocalcemia-induced bradycardia and asystole, pot

Published
2019

9. POS-534 TRAJECTORIES OF CLINICAL AND LABORATORY CHARACTERISTICS ASSOCIATED WITH COVID-19 IN HEMODIALYSIS PATIENTS BY SURVIVAL

Author

Lasky, R., primary, Chaudhuri, S., additional, Jiao, Y., additional, Larkin MS, J., additional, Monaghan, C., additional, Winter, A., additional, Raimann, J., additional, Neri, L., additional, Kotanko, P., additional, Hymes, J., additional, Lee, S., additional, Usvyat, L., additional, Kooman, J., additional, and Maddux, F., additional

Published
2021
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17. CLINICAL ACUTE KIDNEY INJURY 2

Author

Gonzalez Sanchidrian, S., primary, Cebrian Andrada, C. J., additional, Jimenez Herrero, M. C., additional, Deira Lorenzo, J. L., additional, Labrador Gomez, P. J., additional, Marin Alvarez, J. P., additional, Garcia-Bernalt Funes, V., additional, Gallego Dominguez, S., additional, Castellano Cervino, I., additional, Gomez-Martino Arroyo, J. R., additional, Parapiboon, W., additional, Boonsom, P., additional, Stadler, T., additional, Raddatz, A., additional, Poppleton, A., additional, Hubner, W., additional, Fliser, D., additional, Klingele, M., additional, Rosa, J., additional, Sydor, A., additional, Krzanowski, M., additional, Chowaniec, E., additional, Sulowicz, W., additional, Vidal, E., additional, Mergulhao, C., additional, Pinheiro, H., additional, Sette, L., additional, Amorim, G., additional, Fernandes, G., additional, Valente, L., additional, Ouaddi, F., additional, Tazi, I., additional, Mabrouk, K., additional, Zamd, M., additional, El Khayat, S., additional, Medkouri, G., additional, Benghanem, M., additional, Ramdani, B., additional, Dabo, G., additional, Badaoui, L., additional, Ouled Lahcen, A., additional, Sosqi, M., additional, Marih, L., additional, Chakib, A., additional, Marhoum El Filali, K., additional, Oliveira, M. J. C., additional, Silva Junior, G., additional, Sampaio, A. M., additional, Montenegro, B., additional, Alves, M. P., additional, Henn, G. A. L., additional, Rocha, H. A. L., additional, Meneses, G. C., additional, Martins, A. M. C., additional, Sanches, T. R., additional, Andrade, L. C., additional, Seguro, A. C., additional, Liborio, A. B., additional, Daher, E. F., additional, Haase, M., additional, Robra, B.-P., additional, Hoffmann, J., additional, Isermann, B., additional, Henkel, W., additional, Bellomo, R., additional, Ronco, C., additional, Haase-Fielitz, A., additional, Kee, Y. K., additional, Kim, Y. L., additional, Kim, E. J., additional, Park, J. T., additional, Han, S. H., additional, Yoo, T.-H., additional, Kang, S.-W., additional, Choi, K. H., additional, Oh, H. J., additional, Dharmendra, P., additional, Vinay, M., additional, Mohit, M., additional, Rajesh, G., additional, Dhananjai, A., additional, Pankaj, B., additional, Campos, P., additional, Pires, A., additional, Inchaustegui, L., additional, Avdoshina, S., additional, Villevalde, S., additional, Kobalava, Z., additional, Mukhopadhyay, P., additional, Das, B., additional, Mukherjee, D., additional, Mishra, R., additional, Kar, M., additional, Biswas, N. M., additional, Onuigbo, M., additional, Agbasi, N., additional, Ponce, D., additional, Albino, B. B., additional, Balbi, A. L., additional, Klin, P., additional, Zambrano, C., additional, Gutierrez, L. M., additional, Varela Falcon, L., additional, Zeppa, F., additional, Bilbao, A., additional, Klein, F., additional, Raffaele, P., additional, Chang, K. Y., additional, Park, H. S., additional, Kim, H. W., additional, Choi, B. S., additional, Park, C. W., additional, Yang, C. W., additional, Jin, D. C., additional, Checherita, I.-A., additional, Peride, I., additional, David, C., additional, Radulescu, D., additional, Ciocalteu, A., additional, Niculae, A., additional, Balbi, A., additional, Goes, C., additional, Buffarah, M., additional, Xavier, P., additional, Karimi, S. M., additional, Cserep, G., additional, Gannon, D., additional, Sinnamon, K., additional, Saudan, P., additional, Alves, C., additional, De La Fuente, V., additional, Ponte, B., additional, Carballo, S., additional, Rutschmann, O., additional, Martin, P.-Y., additional, Stucker, F., additional, Saurina, A., additional, Pardo, V., additional, Barba, N., additional, Jovell, E., additional, Pou, M., additional, Esteve, V., additional, Fulquet, M., additional, Duarte, V., additional, Ramirez De Arellano, M., additional, Sun, I. O., additional, Yoon, H. J., additional, Kim, J. G., additional, Lee, K. Y., additional, Tiranathanagul, K., additional, Sallapant, S., additional, Eiam-Ong, S., additional, Treeprasertsuk, S., additional, Checherita, I. A., additional, Geavlete, B., additional, Ando, M., additional, Shingai, N., additional, Morito, T., additional, Ohashi, K., additional, Nitta, K., additional, Duarte, D. B., additional, Vanderlei, L. A., additional, Bispo, R. K. A., additional, Pinheiro, M. E., additional, Si Nga, H., additional, Paes, A., additional, Medeiros, P., additional, Gentil, T. M. S., additional, Assis, L. S., additional, Amaral, A. P., additional, Alvares, V. R. C. A., additional, Scaranello, K. L. R. S., additional, Soeiro, E. M. D., additional, Castanho, V., additional, Castro, I., additional, Laranja, S. M., additional, Barreto, S., additional, Molina, M., additional, Silvisk, M., additional, Pereira, B. J., additional, Izem, A., additional, Amer Mhamed, D., additional, El Khayat, S. S., additional, Donadio, C., additional, Klimenko, A., additional, Andreoli, M. C., additional, Souza, N. K., additional, Ammirati, A. L., additional, Matsui, T. N., additional, Naka, E. L., additional, Carneiro, F. D., additional, Ramos, A. C., additional, Lopes, R. K., additional, Dias, E. S., additional, Coelho, M. P., additional, Afonso, R. C., additional, Ferraz-Neto, B.-H., additional, Almeida, M. D., additional, Durao, M., additional, Batista, M. C., additional, Monte, J. C., additional, Pereira, V. G., additional, Santos, O. P., additional, Santos, B. C., additional, Silva, V. C., additional, Raimann, J. G., additional, Nerbass, F. B., additional, Vieira, M. A., additional, Dabel, P., additional, Richter, A., additional, Callegari, J., additional, Carter, M., additional, Levin, N. W., additional, Winchester, J. F., additional, Kotanko, P., additional, Pecoits-Filho, R., additional, Gjyzari, A., additional, Thereska, N., additional, Barbullushi, M., additional, Koroshi, A., additional, Petrela, E., additional, Mumajesi, S., additional, Han, J. S., additional, Simone, S., additional, Scrascia, G., additional, Montemurno, E., additional, Rotunno, C., additional, Mastro, F., additional, Gesualdo, L., additional, Paparella, D., additional, Pertosa, G., additional, Lopes, D., additional, Santos, C., additional, Cunha, C., additional, Gomes, A. M., additional, Coelho, H., additional, Seabra, J., additional, Qasem, A., additional, Farag, S., additional, Hamed, E., additional, Emara, M., additional, Bihery, A., additional, Pasha, H., additional, Chhaya, S., additional, Mukhopadhyay, G., additional, Das, C., additional, Vieira, A. P. F., additional, Lima, L. L. L., additional, Nascimento, L. S., additional, Zawiasa, A., additional, Ko Odziejska, M., additional, Bia Asiewicz, P., additional, Nowak, D., additional, and Nowicki, M., additional

Published
2014
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18. Pathophysiology and clinical studies in CKD 5D

Author

Raimann, J. G., primary, Gotch, F., additional, Keen, M., additional, Kotanko, P., additional, Levin, N. W., additional, Pierratos, A., additional, Lindsay, R., additional, Severova-Andreevska, G., additional, Trajceska, L., additional, Gelev, S., additional, Selim, G., additional, Sikole, A., additional, Yoon, S. Y., additional, Hwang, S. D., additional, Cho, D. K., additional, Cho, Y. H., additional, Moon, S. J., additional, Ribitsch, W., additional, Schreiner, P. J., additional, Uhlmann, M., additional, Schilcher, G., additional, Stadlbauer, V., additional, Horina, J. H., additional, Rosenkranz, A. R., additional, Schneditz, D., additional, Kiss, I., additional, Kerkovits, L., additional, Ambrus, C., additional, Kulcsar, I., additional, Szegedi, J., additional, Benke, A., additional, Borbas, B., additional, Ferenczi, S., additional, Hengsperger, M., additional, Kazup, S., additional, Nagy, L., additional, Nemeth, J., additional, Rozinka, A., additional, Szabo, T., additional, Szelestei, T., additional, Toth, E., additional, Varga, G., additional, Wagner, G., additional, Zakar, G., additional, Gergely, L., additional, Tisler, A., additional, Kiss, Z., additional, Sasaki, S., additional, Miyamato, M., additional, Nomura, A., additional, Koitabashi, K., additional, Nishiwaki, H., additional, Suzuki, T., additional, Uchida, D., additional, Kawarazaki, H., additional, Shibagaki, Y., additional, Kimura, K., additional, Libetta, C., additional, Martinelli, C., additional, Margiotta, E., additional, Borettaz, I., additional, Canevari, M., additional, Esposito, P., additional, Sepe, V., additional, Dal Canton, A., additional, Pateinakis, P., additional, Dimitriadis, C., additional, Papagianni, A., additional, Douma, S., additional, Efstratiadis, G., additional, Memmos, D., additional, Nelson, C. L., additional, Dunstan, P. J., additional, Zwiech, R., additional, Hasuike, Y., additional, Yanase, K., additional, Hamahata, S., additional, Nagai, T., additional, Yahiro, M., additional, Kaibe, S., additional, Kida, A., additional, Nagasawa, Y., additional, Kuragano, T., additional, Nakanishi, T., additional, Kim, J. S., additional, Yang, J. W., additional, Choi, S. O., additional, Han, B. G., additional, Chang, J. H., additional, Kim, A. J., additional, Kim, H. S., additional, Ro, H., additional, Jung, J. Y., additional, Lee, H. H., additional, Chung, W., additional, Tanaka, H., additional, Kita, T., additional, Okamoto, K., additional, Mikami, M., additional, Sakai, R., additional, Lojacono, E., additional, Votta, B., additional, Rampino, T., additional, Gregorini, M., additional, Amore, A., additional, Coppo, R., additional, ElSharkawy, M. M. S., additional, Kamel, M., additional, Elhamamsy, M., additional, Allam, S., additional, Ryu, J.-H., additional, Lee, S., additional, Hong, S. C., additional, Kim, S.-J., additional, Kang, D.-H., additional, Ryu, D.-R., additional, Choi, K. B., additional, Kiraz, T., additional, Yalcin, A., additional, Akay, M., additional, Sahin, G., additional, Musmul, A., additional, Kamijo, Y., additional, Horiuchi, H., additional, Iida, H., additional, Saito, K., additional, Furutera, R., additional, Ishibashi, Y., additional, Sidiropoulou, M., additional, Patsialas, S., additional, Angelopoulos, M., additional, Torreggiani, M., additional, Serpieri, N., additional, Arazzi, M., additional, Esposito, V., additional, Calatroni, M., additional, La Porta, E., additional, Catucci, D., additional, Montagna, G., additional, Semeraro, L., additional, Efficace, E., additional, Piazza, V., additional, Picardi, L., additional, Villa, G., additional, Esposito, C., additional, Kim, J. C., additional, Hwang, E., additional, Park, K., additional, Karakizlis, H., additional, Bohl, K., additional, Kortus-Goetze, B., additional, Dodel, R., additional, Hoyer, J., additional, Cinar, A., additional, Kazancioglu, R., additional, Isik, A. T., additional, Aydemir, E., additional, Gorcin, B., additional, Radic, J., additional, Ljutic, D., additional, Radic, M., additional, Kovacic, V., additional, Sain, M., additional, Dodig Curkovic, K., additional, Grzegorzewska, A. E., additional, Niepolski, L., additional, Sikora, J., additional, Jagodzinski, P., additional, Sowinska, A., additional, Sirolli, V., additional, Rossi, C., additional, Di Castelnuovo, A., additional, Felaco, P., additional, Amoroso, L., additional, Zucchelli, M., additional, Ciavardelli, D., additional, Sacchetta, P., additional, Urbani, A., additional, Arduini, A., additional, Bonomini, M., additional, Inoue, T., additional, Okano, K., additional, Tsuruta, Y., additional, Tsuchiya, K., additional, Akiba, T., additional, Nitta, K., additional, and Pajzderski, D., additional

Published
2013
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20. Epidemiology and outcome research in CKD 5D

Author

Coentrao, L., primary, Ribeiro, C., additional, Santos-Araujo, C., additional, Neto, R., additional, Pestana, M., additional, Kleophas, W., additional, Karaboyas, A., additional, LI, Y., additional, Bommer, J., additional, Pisoni, R., additional, Robinson, B., additional, Port, F., additional, Celik, G., additional, Burcak Annagur, B., additional, Yilmaz, M., additional, Demir, T., additional, Kara, F., additional, Trigka, K., additional, Dousdampanis, P., additional, Vaitsis, N., additional, Aggelakou-Vaitsi, S., additional, Turkmen, K., additional, Guney, I., additional, Turgut, F., additional, Altintepe, L., additional, Tonbul, H. Z., additional, Abdel-Rahman, E., additional, Sclauzero, P., additional, Galli, G., additional, Barbati, G., additional, Carraro, M., additional, Panzetta, G. O., additional, Van Diepen, M., additional, Schroijen, M., additional, Dekkers, O., additional, Dekker, F., additional, Sikole, A., additional, Severova- Andreevska, G., additional, Trajceska, L., additional, Gelev, S., additional, Amitov, V., additional, Pavleska- Kuzmanovska, S., additional, Rayner, H., additional, Vanholder, R., additional, Hecking, M., additional, Jung, B., additional, Leung, M., additional, Huynh, F., additional, Chung, T., additional, Marchuk, S., additional, Kiaii, M., additional, Er, L., additional, Werb, R., additional, Chan-Yan, C., additional, Beaulieu, M., additional, Malindretos, P., additional, Makri, P., additional, Zagkotsis, G., additional, Koutroumbas, G., additional, Loukas, G., additional, Nikolaou, E., additional, Pavlou, M., additional, Gourgoulianni, E., additional, Paparizou, M., additional, Markou, M., additional, Syrgani, E., additional, Syrganis, C., additional, Raimann, J., additional, Usvyat, L. A., additional, Bhalani, V., additional, Levin, N. W., additional, Kotanko, P., additional, Huang, X., additional, Stenvinkel, P., additional, Qureshi, A. R., additional, Riserus, U., additional, Cederholm, T., additional, Barany, P., additional, Heimburger, O., additional, Lindholm, B., additional, Carrero, J. J., additional, Chang, J. H., additional, Sung, J. Y., additional, Jung, J. Y., additional, Lee, H. H., additional, Chung, W., additional, Kim, S., additional, Han, J. S., additional, Na, K. Y., additional, Fragoso, A., additional, Pinho, A., additional, Malho, A., additional, Silva, A. P., additional, Morgado, E., additional, Leao Neves, P., additional, Joki, N., additional, Tanaka, Y., additional, Iwasaki, M., additional, Kubo, S., additional, Hayashi, T., additional, Takahashi, Y., additional, Hirahata, K., additional, Imamura, Y., additional, Hase, H., additional, Castledine, C., additional, Gilg, J., additional, Rogers, C., additional, Ben-Shlomo, Y., additional, Caskey, F., additional, Sandhu, J. S., additional, Bajwa, G. S., additional, Kansal, S., additional, Sandhu, J., additional, Jayanti, A., additional, Nikam, M., additional, Ebah, L., additional, Summers, A., additional, Mitra, S., additional, Agar, J., additional, Perkins, A., additional, Simmonds, R., additional, Tjipto, A., additional, Amet, S., additional, Launay-Vacher, V., additional, Laville, M., additional, Tricotel, A., additional, Frances, C., additional, Stengel, B., additional, Gauvrit, J.-Y., additional, Grenier, N., additional, Reinhardt, G., additional, Clement, O., additional, Janus, N., additional, Rouillon, L., additional, Choukroun, G., additional, Deray, G., additional, Bernasconi, A., additional, Waisman, R., additional, Montoya, A. P., additional, Liste, A. A., additional, Hermes, R., additional, Muguerza, G., additional, Heguilen, R., additional, Iliescu, E. L., additional, Martina, V., additional, Rizzo, M. A., additional, Magenta, P., additional, Lubatti, L., additional, Rombola, G., additional, Gallieni, M., additional, Loirat, C., additional, Mellerio, H., additional, Labeguerie, M., additional, Andriss, B., additional, Savoye, E., additional, Lassale, M., additional, Jacquelinet, C., additional, Alberti, C., additional, Aggarwal, Y., additional, Baharani, J., additional, Tabrizian, S., additional, Ossareh, S., additional, Zebarjadi, M., additional, Azevedo, P., additional, Travassos, F., additional, Frade, I., additional, Almeida, M., additional, Queiros, J., additional, Silva, F., additional, Cabrita, A., additional, Rodrigues, R., additional, Couchoud, C., additional, Kitty, J., additional, Benedicte, S., additional, Fergus, C., additional, Cecile, C., additional, Sahar, B., additional, Emmanuel, V., additional, Christian, J., additional, Rene, E., additional, Barahimi, H., additional, Mahdavi-Mazdeh, M., additional, Nafar, M., additional, Petruzzi, M., additional, De Benedittis, M., additional, Sciancalepore, M., additional, Gargano, L., additional, Natale, P., additional, Vecchio, M. C., additional, Saglimbene, V., additional, Pellegrini, F., additional, Gentile, G., additional, Stroumza, P., additional, Frantzen, L., additional, Leal, M., additional, Torok, M., additional, Bednarek, A., additional, Dulawa, J., additional, Celia, E., additional, Gelfman, R., additional, Hegbrant, J., additional, Wollheim, C., additional, Palmer, S., additional, Johnson, D. W., additional, Ford, P. J., additional, Craig, J. C., additional, Strippoli, G. F., additional, Ruospo, M., additional, El Hayek, B., additional, Hayek, B., additional, Baamonde, E., additional, Bosch, E., additional, Ramirez, J. I., additional, Perez, G., additional, Ramirez, A., additional, Toledo, A., additional, Lago, M. M., additional, Garcia-Canton, C., additional, Checa, M. D., additional, Canaud, B., additional, Lantz, B., additional, Granger-Vallee, A., additional, Lertdumrongluk, P., additional, Molinari, N., additional, Ethier, J., additional, Jadoul, M., additional, Gillespie, B., additional, Bond, C., additional, Wang, S., additional, Alfieri, T., additional, Braunhofer, P., additional, Newsome, B., additional, Wang, M., additional, Bieber, B., additional, Guidinger, M., additional, Zuo, L., additional, Yu, X., additional, Yang, X., additional, Qian, J., additional, Chen, N., additional, Albert, J., additional, Yan, Y., additional, Ramirez, S., additional, Beresan, M., additional, Lapidus, A., additional, Canteli, M., additional, Tong, A., additional, Manns, B., additional, Craig, J., additional, Strippoli, G., additional, Mortazavi, M., additional, Vahdatpour, B., additional, Shahidi, S., additional, Ghasempour, A., additional, Taheri, D., additional, Dolatkhah, S., additional, Emami Naieni, A., additional, Ghassami, M., additional, Khan, M., additional, Abdulnabi, K., additional, Pai, P., additional, Vecchio, M., additional, Muqueet, M. A., additional, Hasan, M. J., additional, Kashem, M. A., additional, Dutta, P. K., additional, Liu, F. X., additional, Noe, L., additional, Quock, T., additional, Neil, N., additional, Inglese, G., additional, Motamed Najjar, M., additional, Bahmani, B., additional, Shafiabadi, A., additional, Helve, J., additional, Haapio, M., additional, Groop, P.-H., additional, Gronhagen-Riska, C., additional, Finne, P., additional, Sund, R., additional, Cai, M., additional, Baweja, S., additional, Clements, A., additional, Kent, A., additional, Reilly, R., additional, Taylor, N., additional, Holt, S., additional, Mcmahon, L., additional, Carter, M., additional, Van der Sande, F. M., additional, Kooman, J., additional, Malhotra, R., additional, Ouellet, G., additional, Penne, E. L., additional, Thijssen, S., additional, Etter, M., additional, Tashman, A., additional, Guinsburg, A., additional, Grassmann, A., additional, Barth, C., additional, Marelli, C., additional, Marcelli, D., additional, Von Gersdorff, G., additional, Bayh, I., additional, Scatizzi, L., additional, Lam, M., additional, Schaller, M., additional, Toffelmire, T., additional, Wang, Y., additional, Sheppard, P., additional, Neri, L., additional, Andreucci, V. A., additional, Rocca-Rey, L. A., additional, Bertoli, S. V., additional, Brancaccio, D., additional, De Berardis, G., additional, Lucisano, G., additional, Johnson, D., additional, Nicolucci, A., additional, Bonifati, C., additional, Navaneethan, S. D., additional, Montinaro, V., additional, Zsom, M., additional, Bednarek-Skublewska, A., additional, Graziano, G., additional, Ferrari, J. N., additional, Santoro, A., additional, Zucchelli, A., additional, Triolo, G., additional, Maffei, S., additional, De Cosmo, S., additional, Manfreda, V. M., additional, Juillard, L., additional, Rousset, A., additional, Butel, F., additional, Girardot-Seguin, S., additional, Hannedouche, T., additional, Isnard, M., additional, Berland, Y., additional, Vanhille, P., additional, Ortiz, J.-P., additional, Janin, G., additional, Nicoud, P., additional, Touam, M., additional, Bruce, E., additional, Grace, B., additional, Clayton, P., additional, Cass, A., additional, Mcdonald, S., additional, Furumatsu, Y., additional, Kitamura, T., additional, Fujii, N., additional, Ogata, S., additional, Nakamoto, H., additional, Iseki, K., additional, Tsubakihara, Y., additional, Chien, C.-C., additional, Wang, J.-J., additional, Hwang, J.-C., additional, Wang, H.-Y., additional, Kan, W.-C., additional, Kuster, N., additional, Patrier, L., additional, Bargnoux, A.-S., additional, Morena, M., additional, Dupuy, A.-M., additional, Badiou, S., additional, Cristol, J.-P., additional, Desmet, J.-M., additional, Fernandes, V., additional, Collart, F., additional, Spinogatti, N., additional, Pochet, J.-M., additional, Dratwa, M., additional, Goffin, E., additional, Nortier, J., additional, Zilisteanu, D. S., additional, Voiculescu, M., additional, Rusu, E., additional, Achim, C., additional, Bobeica, R., additional, Balanica, S., additional, Atasie, T., additional, Florence, S., additional, Anne-Marie, S., additional, Michel, L., additional, Cyrille, C., additional, Strakosha, A., additional, Pasko, N., additional, Kodra, S., additional, Thereska, N., additional, Lowney, A., additional, Lowney, E., additional, Grant, R., additional, Murphy, M., additional, Casserly, L., additional, O' Brien, T., additional, Plant, W. D., additional, Radic, J., additional, Ljutic, D., additional, Kovacic, V., additional, Radic, M., additional, Dodig-Curkovic, K., additional, Sain, M., additional, Jelicic, I., additional, Hamano, T., additional, Nakano, C., additional, Yonemoto, S., additional, Okuno, A., additional, Katayama, M., additional, Isaka, Y., additional, Nordio, M., additional, Limido, A., additional, Postorino, M., additional, Nichelatti, M., additional, Khil, M., additional, Dudar, I., additional, Khil, V., additional, Shifris, I., additional, Momtaz, M., additional, Soliman, A. R., additional, El Lawindi, M. I., additional, Dzekova-Vidimliski, P., additional, Pavleska-Kuzmanovska, S., additional, Nikolov, I., additional, Selim, G., additional, Shoji, T., additional, Kakiya, R., additional, Tatsumi-Shimomura, N., additional, Tsujimoto, Y., additional, Tabata, T., additional, Shima, H., additional, Mori, K., additional, Fukumoto, S., additional, Tahara, H., additional, Koyama, H., additional, Emoto, M., additional, Ishimura, E., additional, Nishizawa, Y., additional, and Inaba, M., additional

Published
2012
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21. Cardiovascular complications in CKD 5D

Author

Fusaro, M., primary, Fusaro, M., additional, Noale, M., additional, Tripepi, G., additional, D'angelo, A., additional, Miozzo, D., additional, Gallieni, M., additional, Study Group, P.-V., additional, Tsamelesvili, M., additional, Dimitriadis, C., additional, Papagianni, A., additional, Raidis, C., additional, Efstratiadis, G., additional, Memmos, D., additional, Mutluay, R., additional, Konca Degertekin, C., additional, Derici, U., additional, Deger, S. M., additional, Akkiyal, F., additional, Gultekin, S., additional, Gonen, S., additional, Tacoy, G., additional, Arinsoy, T., additional, Sindel, S., additional, Sanchez-Perales, C., additional, Vazquez, E., additional, Merino, E., additional, Perez Del Barrio, P., additional, Borrego, F. J., additional, Borrego, M. J., additional, Liebana, A., additional, Krzanowski, M., additional, Janda, K., additional, Dumnicka, P., additional, Krasniak, A., additional, Sulowicz, W., additional, Kim, Y.-O., additional, Yoon, S.-A., additional, Yun, Y.-S., additional, Song, H.-C., additional, Kim, B.-S., additional, Cheong, M. A., additional, Pasch, A., additional, Farese, S., additional, Floege, J., additional, Jahnen-Dechent, W., additional, Ohtake, T., additional, Furuya, R., additional, Iwagami, M., additional, Tsutsumi, D., additional, Mochida, Y., additional, Ishioka, K., additional, Oka, M., additional, Maesato, K., additional, Moriya, H., additional, Hidaka, S., additional, Kobayashi, S., additional, Guedes, A., additional, Malho Guedes, A., additional, Pinho, A., additional, Fragoso, A., additional, Cruz, A., additional, Mendes, P., additional, Morgado, E., additional, Bexiga, I., additional, Silva, A. P., additional, Neves, P., additional, Oyake, N., additional, Suzuki, K., additional, Itoh, S., additional, Yano, S., additional, Turkmen, K., additional, Kayikcioglu, H., additional, Ozbek, O., additional, Saglam, M., additional, Toker, A., additional, Tonbul, H. Z., additional, Gelev, S., additional, Trajceska, L., additional, Srbinovska, E., additional, Pavleska, S., additional, Amitov, V., additional, Selim, G., additional, Dzekova, P., additional, Sikole, A., additional, Bouarich, H., additional, Lopez, S., additional, Alvarez, C., additional, Arribas, I., additional, DE Sequera, P., additional, Rodriguez, D., additional, Tanaka, S., additional, Kanemitsu, T., additional, Sugahara, M., additional, Kobayashi, M., additional, Uchida, L., additional, Ishimoto, Y., additional, Kotera, N., additional, Tanimoto, S., additional, Tanabe, K., additional, Hara, K., additional, Sugimoto, T., additional, Mise, N., additional, Goldstein, B., additional, Turakhia, M., additional, Arce, C., additional, Winkelmayer, W., additional, Zayed, B. E.-D., additional, Said, K., additional, Nishimura, M., additional, Okamoto, Y., additional, Tokoro, T., additional, Nishida, M., additional, Hashimoto, T., additional, Iwamoto, N., additional, Takahashi, H., additional, Ono, T., additional, Sato, N., additional, Raimann, J., additional, Usvyat, L. A., additional, Sands, J., additional, Levin, N. W., additional, Kotanko, P., additional, Iwasaki, M., additional, Joki, N., additional, Tanaka, Y., additional, Ikeda, N., additional, Hayashi, T., additional, Kubo, S., additional, Imamura, T.-A., additional, Takahashi, Y., additional, Hirahata, K., additional, Imamura, Y., additional, Hase, H., additional, Claes, K., additional, Meijers, B., additional, Bammens, B., additional, Kuypers, D., additional, Naesens, M., additional, Vanrenterghem, Y., additional, Evenepoel, P., additional, Boscutti, G., additional, Calabresi, L., additional, Bosco, M., additional, Simonelli, S., additional, Boer, E., additional, Vitali, C., additional, Martone, M., additional, Mattei, P. L., additional, Franceschini, G., additional, Baligh, E., additional, El-Shafey, E., additional, Ezaat, A., additional, Zawada, A., additional, Rogacev, K., additional, Hummel, B., additional, Grun, O., additional, Friedrich, A., additional, Rotter, B., additional, Winter, P., additional, Geisel, J., additional, Fliser, D., additional, Heine, G. H., additional, Makino, J.-I., additional, Makino, K.-S., additional, Ito, T., additional, Genovesi, S., additional, Santoro, A., additional, Fabbrini, P., additional, Rossi, E., additional, Pogliani, D., additional, Stella, A., additional, Bonforte, G., additional, Remuzzi, G., additional, Bertoli, S., additional, Pozzi, C., additional, Pasquali, S., additional, Cagnoli, L., additional, Conte, F., additional, Buzadzic, I., additional, Tosic, J., additional, Dimkovic, N., additional, Djuric, Z., additional, Popovic, J., additional, Pejin Grubisa, I., additional, Barjaktarevic, N., additional, DI Napoli, A., additional, DI Lallo, D., additional, Salvatori, M. F., additional, Franco, F., additional, Chicca, S., additional, Guasticchi, G., additional, Onofriescu, M., additional, Hogas, S., additional, Luminita, V., additional, Mugurel, A., additional, Gabriel, V., additional, Laura, F., additional, Irina, M., additional, Adrian, C., additional, Bosch, E., additional, Baamonde, E., additional, Culebras, C., additional, Perez, G., additional, El Hayek, B., additional, Ramirez, J. I., additional, Ramirez, A., additional, Garcia, C., additional, Lago, M., additional, Toledo, A., additional, Checa, M. D., additional, Taira, T., additional, Hirano, T., additional, Nohtomi, K., additional, Hyodo, T., additional, Chiba, T., additional, Saito, A., additional, Kim, Y. K., additional, Choi, E. J., additional, Yang, C. W., additional, Kim, Y.-S., additional, Lim, P. S., additional, Ming Ying, W., additional, Ya-Chung, J., additional, Zaripova, I., additional, Kayukov, I., additional, Essaian, A., additional, Nimgirova, A., additional, Young, H., additional, Dungey, M., additional, Watson, E. L., additional, Baines, R., additional, Burton, J. O., additional, Smith, A. C., additional, Yamazaki, K., additional, Bossola, M., additional, Colacicco, L., additional, Scribano, D., additional, Vulpio, C., additional, Tazza, L., additional, Okada, T., additional, Okada, N., additional, Michibata, I., additional, Yura, T., additional, Montero, N., additional, Soler, M., additional, Pascual, M., additional, Barrios, C., additional, Marquez, E., additional, Rodriguez, E., additional, Orfila, M. A., additional, Cao, H., additional, Arcos, E., additional, Comas, J., additional, Pascual, J., additional, Ferrario, M., additional, Garzotto, F., additional, Sironi, T., additional, Monacizzo, S., additional, Basso, F., additional, Cruz, D. N., additional, Moissl, U., additional, Tetta, C., additional, Signorini, M. G., additional, Cerutti, S., additional, Ronco, C., additional, Mostovaya, I., additional, Grooteman, M., additional, Van den Dorpel, M., additional, Penne, L., additional, Van der Weerd, N., additional, Mazairac, A., additional, Den Hoedt, C., additional, Levesque, R., additional, Nube, M., additional, Ter Wee, P., additional, Bots, M., additional, Blankestijn, P., additional, Liu, J., additional, MA, K. L., additional, Zhang, X., additional, Liu, B. C., additional, Vladu, I.-D., additional, Mustafa, R., additional, Cana-Ruiu, D., additional, Vaduva, C., additional, Grauntanu, C., additional, Mota, E., additional, Singh, R., additional, Abbasian, N., additional, Stover, C., additional, Brunskill, N., additional, Burton, J., additional, Herbert, K., additional, Bevington, A., additional, Wu, M., additional, Tang, R.-N., additional, Gao, M., additional, Liu, H., additional, Chen, L., additional, LV, L.-L., additional, Liu, B.-C., additional, Nikodimopoulou, M., additional, Liakos, S., additional, Kapoulas, S., additional, Karvounis, C., additional, Fedak, D., additional, Kuzniewski, M., additional, Paulina, D., additional, Kusnierz-Cabala, B., additional, Kapusta, M., additional, Solnica, B., additional, Junque, A., additional, Vicent, E. S., additional, Moreno, L., additional, Fulquet, M., additional, Duarte, V., additional, Saurina, A., additional, Pou, M., additional, Macias, J., additional, Lavado, M., additional, Ramirez de Arellano, M., additional, Ryuzaki, M., additional, Nakamoto, H., additional, Kinoshita, S., additional, Kobayashi, E., additional, Takimoto, C., additional, Shishido, T., additional, Enia, G., additional, Torino, C., additional, Tripepi, R., additional, Panuccio, V., additional, Postorino, M., additional, Clementi, A., additional, Garozzo, M., additional, Bonanno, G., additional, Boito, R., additional, Natale, G., additional, Cicchetti, T., additional, Chippari, A., additional, Logozzo, D., additional, Alati, G., additional, Cassani, S., additional, Sellaro, A., additional, Zoccali, C., additional, Quiroga, B., additional, Verde, E., additional, Abad, S., additional, Vega, A., additional, Goicoechea, M., additional, Reque, J., additional, Lopez-Gomez, J. M., additional, Luno, J., additional, Cabre Menendez, C., additional, Moles, V., additional, Vives, J. P., additional, Villa, D., additional, Vinas, J., additional, Compte, T., additional, Arruche, M., additional, Diaz, C., additional, Soler, J., additional, Aguilera, J., additional, Martinez Vea, A., additional, De Mauri, A., additional, David, P., additional, Conte, M. M., additional, Chiarinotti, D., additional, Ruva, C. E., additional, De Leo, M., additional, Bargnoux, A.-S., additional, Morena, M., additional, Jaussent, I., additional, Chalabi, L., additional, Bories, P., additional, Dion, J.-J., additional, Henri, P., additional, Delage, M., additional, Dupuy, A.-M., additional, Badiou, S., additional, Canaud, B., additional, Cristol, J.-P., additional, Sironi, E., additional, Pieruzzi, F., additional, Galbiati, E., additional, Vigano, M. R., additional, Anpalakhan, S., additional, Rocha, S., additional, Chitalia, N., additional, Sharma, R., additional, Kaski, J. C., additional, Chambers, J., additional, Goldsmith, D., additional, Banerjee, D., additional, Cernaro, V., additional, Lacquaniti, A., additional, Lupica, R., additional, Lucisano, S., additional, Fazio, M. R., additional, Donato, V., additional, Buemi, M., additional, Segalen, I., additional, Vinsonneau, U., additional, Tanquerel, T., additional, Quiniou, G., additional, Le Meur, Y., additional, Seibert, E., additional, Girndt, M., additional, Zohles, K., additional, Ulrich, C., additional, Kluttig, A., additional, Nuding, S., additional, Swenne, C., additional, Kors, J., additional, Werdan, K., additional, Fiedler, R., additional, Van der Weerd, N. C., additional, Grooteman, M. P., additional, Van den Dorpel, M. A., additional, Nube, M. J., additional, Wetzels, J., additional, Swinkels, D. W., additional, Ter Wee, P. M., additional, Khandekar, A., additional, Khandge, J., additional, Lee, J. E., additional, Moon, S. J., additional, Choi, K. H., additional, Lee, H. Y., additional, Kim, B. S., additional, Tuaillon, E., additional, Rodriguez, A., additional, Chenine, L., additional, Vendrell, J.-P., additional, Sue, Y.-M., additional, Tang, C.-H., additional, Chen, Y.-C., additional, Segura, P., additional, Garcia Cortes, M. J., additional, Gil, J. M., additional, Biechy, M. M., additional, Poulikakos, D., additional, Shah, A., additional, Persson, M., additional, Dattolo, P., additional, Amidone, M., additional, Michelassi, S., additional, Moriconi, L., additional, Betti, G., additional, Conti, P., additional, Rosati, A., additional, Mannarino, A., additional, Panichi, V., additional, Pizzarelli, F., additional, Klejna, K., additional, Naumnik, B., additional, Koc-Zorawska, E., additional, Mysliwiec, M., additional, Dimitrie, S., additional, Simona, H., additional, Mihaela, O., additional, Gabriela, O., additional, Radu, S., additional, Octavian, P., additional, Akdam, H., additional, Akar, H., additional, Yenicerioglu, Y., additional, Kucuk, O., additional, Kurt Omurlu, I., additional, Thambiah, S., additional, Roplekar, R., additional, Manghat, P., additional, Fogelman, I., additional, Fraser, W., additional, Hampson, G., additional, Likaj, E., additional, Caco, G., additional, Seferi, S., additional, Rroji, M., additional, Barbullushi, M., additional, Thereska, N., additional, Serban, A., additional, Carmen, V., additional, Cristian, S., additional, Silvia, L., additional, and Covic, A., additional

Published
2012
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22. Nutrition, inflammation and oxidative stress - CKD 5D

Author

Usvyat, L. A., primary, Raimann, J., additional, Thijssen, S., additional, van der Sande, F. M., additional, Kooman, J., additional, Levin, N. W., additional, Kotanko, P., additional, Von Gersdorff, G., additional, Schaller, M., additional, Bayh, I., additional, Etter, M., additional, Grassmann, A., additional, Guinsburg, A., additional, Lam, M., additional, Marcelli, D., additional, Marelli, C., additional, Scatizzi, L., additional, Tashman, A., additional, Toffelmire, T., additional, Usvyat, L., additional, Van der Sande, F., additional, Wang, Y., additional, Barth, C., additional, Moffitt, T., additional, Hariton, F., additional, Devlin, M., additional, Garrett, P., additional, Hannon-Fletcher, M., additional, Ekramzadeh, M., additional, Sohrabi, Z., additional, Salehi, M., additional, Fallahzadeh, M. K., additional, Ayatollahi, M., additional, Geramizadeh, B., additional, Hassanzadeh, J., additional, Sagheb, M. M., additional, Beberashvili, I., additional, Sinuani, I., additional, Azar, A., additional, Kadoshi, H., additional, Shapiro, G., additional, Feldman, L., additional, Averbukh, Z., additional, Weissgarten, J., additional, Abe, Y., additional, Watanabe, M., additional, Ito, K., additional, Sasatomi, Y., additional, Ogahara, S., additional, Nakashima, H., additional, Saito, T., additional, Witt, S., additional, Kunze, R., additional, Guth, H. J., additional, Skarabis, H., additional, Vienken, J., additional, Nowak, P., additional, Wilk, R., additional, Mamelka, B., additional, Prymont-Przyminska, A., additional, Zwolinska, A., additional, Sarniak, A., additional, Wlodarczyk, A., additional, Rysz, J., additional, Nowak, D., additional, Trajceska, L., additional, Dzekova-Vidimliski, P., additional, Gelev, S., additional, Arsov, S., additional, Sikole, A., additional, Sonikian, M., additional, Dona, A., additional, Skarakis, I., additional, Metaxaki, P., additional, Chiotis, C., additional, Papoutsis, I., additional, Karaitianou, A., additional, Spiliopoulou, C., additional, Van der Sande, F. M., additional, Usvyat, L. A., additional, Teta, D., additional, Tappy, L., additional, Theumann, N., additional, Halabi, G., additional, Gauthier, T., additional, Mathieu, C., additional, Tremblay, S., additional, Coti, P., additional, Burnier, M., additional, Zanchi, A., additional, Martinez Vea, A., additional, Cabre, C., additional, Villa, D., additional, Munoz, M., additional, Vives, J. P., additional, Arruche, M., additional, Soler, J., additional, Compte, M. T., additional, Aguilera, J., additional, Romeu, M., additional, Giralt, M., additional, Barril, G., additional, Anaya, S., additional, Vozmediano, C., additional, Celayeta, A., additional, Novillo, R., additional, Bernal, V., additional, Beiret, I., additional, Huarte, E., additional, Martin, J., additional, Santana, H., additional, Torres, G., additional, Sousa, F., additional, Sanchez, R., additional, Lopez-Montes, A., additional, Tornero, F., additional, Uson, J., additional, Pousa, M., additional, Giorgi, M., additional, Rdez Cubillo, B., additional, Malhotra, R., additional, Abbas, S. R., additional, Thjissen, S., additional, Carter, M., additional, von Gersdorff, G., additional, Levin, N., additional, Jens, R., additional, Tepel, M., additional, Katharina, E., additional, Andrea, H., additional, Simone, F., additional, Florian, S., additional, Slusanschi, O., additional, Garneata, L., additional, Moraru, R., additional, Preoteasa, E., additional, Barbulescu, C., additional, Santimbrean, C., additional, Klein, C., additional, Dragomir, D., additional, Mircescu, G., additional, Idorn, T., additional, Knop, F., additional, Holst, J. J., additional, Hornum, M., additional, Feldt-Rasmussen, B., additional, Son, Y. K., additional, An, W. S., additional, Kim, S. E., additional, Kim, K. H., additional, Borrelli, S., additional, Minutolo, R., additional, De Nicola, L., additional, Conte, G., additional, De Simone, W., additional, Zito, B., additional, Guastaferro, P., additional, Nigro, F., additional, Bassi, A., additional, Leone, L., additional, Credendino, O., additional, Genualdo, R., additional, Capuano, M., additional, Iulianiello, G., additional, Auricchio, M. R., additional, Sezer, S., additional, Bal, Z., additional, Tutal, E., additional, Erkmen Uyar, M., additional, Ozdemir Acar, F. N., additional, Ribeiro, S., additional, Faria, M. S., additional, Melo, F., additional, Sereno, J., additional, Freitas, I., additional, Mendonca, M., additional, Nascimento, H., additional, Fernandes, J., additional, Rocha-Pereira, P., additional, Miranda, V., additional, Mendonca, D., additional, Quintanilha, A., additional, Belo, L., additional, Costa, E., additional, Reis, F., additional, Santos-Silva, A., additional, Valtuille, R., additional, Casos, M. E., additional, and Fernandez, E. A., additional

Published
2012
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24. Cardiovascular complications in CKD 5D (1)

Author

Kuo, K.-L., primary, Hung, S.-C., additional, Tarng, D.-C., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Gelev, S., additional, Stojcev, N., additional, Dzekova, P., additional, Trajcevska, L., additional, Severova, G., additional, Pavleska, S., additional, Sikole, A., additional, Combe, C., additional, Thumma, J., additional, Gillespie, B., additional, De Sequera, P., additional, Yamamoto, H., additional, Robinson, B., additional, Matsushita, Y., additional, Tasaki, H., additional, Tohara, Y., additional, Yamauchi, E., additional, Matsuoka, K., additional, Arizono, K., additional, Bellasi, A., additional, Ferramosca, E., additional, Ratti, C., additional, Block, G., additional, Raggi, P., additional, Drozdz, M., additional, Krasniak, A., additional, Chmiel, G., additional, Podolec, P., additional, Pasowicz, M., additional, Tracz, W., additional, Kowalczyk-Michalek, M., additional, Sulowicz, W., additional, Kalantzi, K., additional, Korantzopoulos, P., additional, Bechlioulis, A., additional, Vlachopanou, A., additional, Foulidis, V., additional, Pagiati, E., additional, Nikolopoulos, P., additional, Gouva, C., additional, Arroyave, I., additional, Rodelo, J., additional, Cardona, M., additional, Garcia, A., additional, Henao, J., additional, Mejia, G., additional, Rico, J., additional, Arbelaez, M., additional, Fujimori, A., additional, Okada, S., additional, Yamamoto, K., additional, Okamoto, S., additional, Kamiura, N., additional, Sakai, M., additional, Tanikake, M., additional, Kutlay, S., additional, Sengul, S., additional, Keven, K., additional, Nergizoglu, G., additional, Erturk, S., additional, Ates, K., additional, Duman, N., additional, Karatan, O., additional, Erbay, B., additional, Sameiro-Faria, M., additional, Costa, E., additional, Rocha-Pereira, P., additional, Borges, A., additional, Nascimento, H., additional, Mendonca, D., additional, Amado, L., additional, Reis, F., additional, Miranda, V., additional, Quintanilha, A., additional, Belo, L., additional, Santos-Silva, A., additional, Oh, J. S., additional, Kim, S. M., additional, Sin, Y. H., additional, Kim, J. K., additional, Ishihara, M., additional, Otsubo, S., additional, Kimata, N., additional, Akiba, T., additional, Nitta, K., additional, Kim, K. M., additional, Baek, C. H., additional, Kim, S. B., additional, Testa, A., additional, Sanguedolce, M. C., additional, Spoto, B., additional, Mallamaci, F., additional, Malatino, L., additional, Tripepi, G., additional, Zoccali, C., additional, Lee, J. E., additional, Moon, S. J., additional, Kim, J.-K., additional, An, H. R., additional, Ha, S. K., additional, Pakr, H. C., additional, Bahlmann, F. H., additional, Becker, E., additional, Sperber, V., additional, Triem, S., additional, Noll, C., additional, Zewinger, S., additional, Fliser, D., additional, Laufs, U., additional, Thijssen, S., additional, Usvyat, L. A., additional, Raimann, J. G., additional, Balter, P., additional, Kotanko, P., additional, Levin, N. W., additional, Hornum, M., additional, Bay, J. T., additional, Clausen, P., additional, Melchior Hansen, J., additional, Mathiesen, E. R., additional, Feldt-Rasmussen, B., additional, Garred, P., additional, Sural, S., additional, Panja, C. S., additional, Bhattacharya, S. K., additional, Cernaro, V., additional, Lacquaniti, A., additional, Lorenzano, G., additional, Romeo, A., additional, Donato, V., additional, Buemi, M., additional, Usvyat, L., additional, Rogus, J., additional, Lacson, E., additional, Robinson, B. M., additional, Karaboyas, A., additional, Sen, A., additional, Hecking, M., additional, Mendelssohn, D., additional, Jadoul, M., additional, Kawanishi, H., additional, Saran, R., additional, Kolarz, M., additional, Undas, A., additional, Wyroslak, J., additional, Malyszko, J., additional, Klejna, K., additional, Naumnik, B., additional, Koc-Zurawska, E., additional, Mysliwiec, M., additional, Piecha, G., additional, Kuczera, P., additional, Adamczak, M., additional, Fedorova, O. V., additional, Bagrov, A. Y., additional, Wiecek, A., additional, Gungor, O., additional, Kircelli, F., additional, Asci, G., additional, Carrero, J. J., additional, Tatar, E., additional, Demirci, M., additional, Toz, H., additional, Ozkahya, M., additional, Ok, E., additional, Bansal, V., additional, Shareain, K., additional, Hoppensteadt, D., additional, Litinas, E., additional, Fareed, J., additional, Kim, M.-J., additional, Lee, S. W., additional, Song, J. H., additional, Kweon, J., additional, Kim, W. H., additional, Sasaki, K., additional, Yasuda, K., additional, Hatanaka, M., additional, Hayashi, T., additional, Katsipi, I., additional, Tatsiopoulos, A., additional, Papanikolaou, P., additional, Doulgerakis, C., additional, Kollia, K., additional, Kardouli, E., additional, Asmanis, E., additional, Gennadiou, M., additional, Kyriazis, J., additional, Panizo, S., additional, Barrio-Vazquez, S., additional, Carrillo-Lopez, N., additional, Fernandez-Vazquez, A., additional, Braga, S., additional, Rodriguez-Rebollar, A., additional, Naves-Diaz, M., additional, Cannata-Andia, J. B., additional, Nikodimopoulou, M., additional, Liakos, S., additional, and Kapoulas, S., additional

Published
2011
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25. Dialysis / Cardiovascular complications

Author

Ocak, G., primary, van Stralen, K., additional, Verduijn, M., additional, Dekker, F., additional, Jager, K., additional, Liabeuf, S., additional, Schiffer, E., additional, Lacroix, C., additional, Temmar, M., additional, Renard, C., additional, Monsarrat, B., additional, Choukroun, G., additional, Lemke, H.-D., additional, Vanholder, R., additional, Mischak, H., additional, Massy, Z., additional, Fenske, W., additional, Wanner, C., additional, Allolio, B., additional, Drechsler, C., additional, Blouin, K., additional, Lilienthal, J., additional, Krane, V., additional, Usvyat, L., additional, Raimann, J. G., additional, Thijssen, S., additional, Kotanko, P., additional, Levin, N. W., additional, Roman-Garcia, P., additional, Carrillo-Lopez, N., additional, Panizo, S., additional, Rodriguez-Garcia, I., additional, Fernandez-Martin, J. L., additional, Naves-Diaz, M., additional, Cannata-Andia, J. B., additional, Speer, T., additional, Rohrer, L., additional, Krankel, N., additional, Shi, Y., additional, Akhmedov, A., additional, Kuschnerus, K., additional, Wernicke, G., additional, Jung, A., additional, von Eckardstein, A., additional, Luscher, T., additional, Fliser, D., additional, Landmesser, U., additional, and Bahlmann, F., additional

Published
2011
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34. Fungal Peritonitis in Children Undergoing Chronic Peritoneal Dialysis: Experiences from a Single Center in Khartoum, Sudan.

Author

Hussein, R., Topping, A., Ahmed, A., Abdelraheem, M. B., Ali, E.-T. M. A., Ellidir, R. A., Bakhiet, Y., Abdelkarim, A., Abu-Aisha, H., Raimann, J., and Kotanko, P.

Subjects
PERITONITIS, PERITONEAL dialysis, CHILDREN'S health, DEATH rate
Abstract

Background: Fungal Peritonitis (FP) is an uncommon but potentially serious and fatal complications of Chronic Peritoneal Dialysis (CPD), it accounts for 1-15% of all peritonitis episodes. The morbidity and mortality rates are very high varies from 20% to 30% ((Matuszkiewicz-Rowinska 2009). Methods: We retrospectively analyzed all pediatric PD patients treated at Soba University Hospital (SUH) from June 2005 to June 2015. Descriptive statistics of patient demographics, primary causes of ESRD leading to dialysis and clinical outcomes including episodes of fungal peritonitis with particular attention to identify risk factors for causes like antibiotic usage preceded the fungal infection, specific type of fungus causing peritonitis, treatment guidelines, and patient outcome data. FP was diagnosed based on effluent cell count and positive fungal culture. Results: Data from 120 pediatric patients who received treatment during the study period were included in this analysis (44% male, median age 10 years [1-17 years], median length of PD 350 days). Fifty-two cases of peritonitis were recorded, 46 first episodes and 6 secondary episodes. The rate of first peritonitis episode was one episode per 3.35 years of follow-up. The rate of second peritonitis episode was one episode per 18.5 years of follow up. Of the total 52 episodes of peritonitis in these patients occurring over 2,096 patient-months of follow-up, FP accounted for 5 (2.9%) of the episodes. The patients on PD who developed FP were similar to those who did not develop FP with regard to dialysis modality, dialysis access characteristics, and primary cause of ESRD. Two of them were males and three were females. The overall peritonitis rate in patients who developed FP was 0.05 episodes per patient-year compared with 0.02 episodes per patient-year in the patients who did not develop this infection (P = 0.095). In 2 cases, the FP was the patient's initial episode of peritonitis. Whereas recent antibiotic usage was present in 3 of patients with FP. Candida species were cultured from 4 patients accounting 80% (three of them had C. Albicans and one had C. Parapsilosis) and Aspergillus Fumigatus from one patient 20%. Successful management of FP consists of a combination of prompt removal of the PD catheter and intravenous administration of anti-fungal for 4-6 weeks. Four patients transferred to Hemodialysis (HD) after catheter removal, one travelled abroad. Only one patient was put back on CAPD after 8 weeks (failure to resume PD occurs in 4 patients). Conclusions: FP is rarer than BP in our CPD population but has worse prognosis with a significant CPD drop-out rate. FP can be managed in many patients with a combination of antifungal therapy, prompt catheter removal, and temporary hemodialysis. The role of FP in CAPD peritonitis has received relatively little attention. Further studies are required. [ABSTRACT FROM AUTHOR]

Published
2017
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36. Dialyzer Membrane Effects on Intradialytic Hypotension.

Author

Patel, S. D., Raimann, J. G., and Kotanko, P.

Subjects
*HEMODIALYZERS, *HYPOTENSION, *BIOCOMPATIBILITY, *HEMODIALYSIS, *POLYACRYLONITRILES
Abstract

Background: Factors such as membrane biocompatibility have been reported to affect intradialytic hypotension (IDH) [Daugirdas, AJKD 2001; Cheung, JASN 1999]. To investigate the association between dialyzer membrane and IDH, we conducted a review of trials exploring the relationship between membrane types and IDH incidence. Methods: We conducted a literature search in Pubmed on November 1, 2016. We included relevant randomized controlled trials, randomized cross-over trials, prospective and retrospective cohort studies published in English in the final selection. Search strings used were 'intradialytic hypotension + membrane', 'intradialytic hypotension + cuprophan', and 'intradialytic hypotension + polysulfone'. Results: Out of 64 publications, 54 were duplicates or not pertinent to our topic, with a final 8 selected reports. A randomized prospective crossover of 40 chronic hemodialysis patients (pts) comparing cuprophan (CU) and polyacrylonitrile found no statistical difference between either dialyzer membranes. In this study the per pt incidence of symptomatic IDH requiring saline administration over a 3 months (mo) period was 10 ± 1 for CU and 11 ± 2 for PAN69 (P = NS) [Collins, JASN 1993]. One RCT compared the IDH rate in pts with acute kidney injury comparing CU (N = 76 pts) and polymethlmethacrylate (N = 84 pts) membranes. Average treatment (Tx) number in either group was 5.1 per pt. 21 IDH episodes were in the CU group (5.4%) versus 37 in the polymethacrylate group (14.5%; P < 0.0001) [Jorres, Lancet 1999]. An open-label randomized cross over trial of 25 pts over a 3 mo period compared the IDH incidence with 4 different polysulfone (PSU) membranes, Revaclear® high flux (HF) (70 IDH episodes), Helixone® high flux (HF) (87 IDH episodes), Xevonta® high flux (HF) (73 IDH episodes), and Helixone® low flux (LF) (70 IDH episodes). IDH incidence was significantly higher with Helixone® HF dialyzers compared to Revaclear® HF dialyzers (P < 0.01) and Xevonta® HF dialyzers (P = 0.05), but not different from Helixone® LF dialyzers [Bianchi, HDI 2014]. In a RCT 20 HD pts were randomly assigned to either HF PSU or LF cellulose acetate over 12 mo. The fraction of sessions with saline use > 100 mL for IDH was 18 ± 4% for cellulose acetate, 17 ± 3% for PSU (P=NS) [Hartmann, AJKD 1997]. A cross-over study compared 3 mo of PSU with a preceding and subsequent 3 mo each period of AN 69. The authors found a significantly (P < 0.05) decreased frequency of saline administration for IDH with AN 69 [Furuta, ASAIO J 2011]. Conclusions: Our review does not indicate a benefit of synthetic versus non-synthetic dialyzer membranes with respect to IDH. [ABSTRACT FROM AUTHOR]

Published
2017
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37. Association of intradialytic hypotension and convective volume in hemodiafiltration: results from a retrospective cohort study

Author

Mora-Bravo Franklin G, De-La-Cruz Guadalupe, Rivera Sonia, Ramírez Alfonso, Raimann Jochen G, and Pérez-Grovas Héctor

Subjects
Intradialytic hypotension, Hemodiafiltration, Convective volume, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Hemodiafiltration (HDF), as a convective blood purification technique, has been associated with favorable outcomes improved phosphate control, removal of middle-molecules such as Beta2-microglobulin and the occurrence of intradialytic hypotension (IDH) as compared to diffusive techniques. The aim of this retrospective cohort study in dialysis patients receiving HDF in one urban dialysis facility in Mexico City was to investigate the occurrence of IDH during HDF treatments with varying convective volume prescriptions. Methods Subjects were stratified into equal groups of percentiles of convective volume prescription: Group 1 of 0 to 7.53 liters, group 2 of 7.54 to 14.8 liters, group 3 of 14.9 to 16.96 liters, group 4 of 16.97 to 18.9 liters, group 5 of 21 to 19.9 liters and group 6 of 21.1 to 30 liters. Logistic Regression with and without adjustment for confounding factors was used to evaluate factors associated with the occurrence of IDH. Results 2276 treatments of 154 patients were analyzed. IDH occurred during 239 HDF treatments (10.5% of all treatments). Group 1 showed 31 treatments (8.2%) with IDH whereas group 6 showed IDH in only 15 sessions (4% of all treatments). Odds Ratio of IDH for Group 6 was 0.47 (95% CI 0.25 to 0.88) as compared to Group 1 after adjustment. Conclusions In summary the data of this retrospective cohort study shows an inverse correlation between the occurrence of IDH and convective volume prescription. Further research in prospective settings is needed to confirm these findings.

Published
2012
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38. Quantification and classification of potassium and calcium disorders with the electrocardiogram: What do clinical studies, modeling, and reconstruction tell us?

Author

Nicolas Pilia, Jochen G. Raimann, Peter Kotanko, Axel Loewe, Cristiana Corsi, Simonetta Genovesi, Olaf Dössel, Stefano Severi, Pilia, N, Severi, S, Raimann, J, Genovesi, S, Dossel, O, Kotanko, P, Corsi, C, Loewe, A, Pilia N., Severi S., Raimann J.G., Genovesi S., Dossel O., Kotanko P., Corsi C., and Loewe A.

Subjects
CHRONIC KIDNEY-DISEASE, lcsh:Medical technology, BIG DATA, Computer science, lcsh:Biotechnology, Biomedical Engineering, Biophysics, Reviews, Bioengineering, electrocardiogram, Machine learning, computer.software_genre, HYPERKALEMIA, End stage renal disease, Biomaterials, lcsh:TP248.13-248.65, end stage renal disease, Wearable technology, Engineering & allied operations, HEART-RATE-VARIABILITY, business.industry, ECG, potassium, QT INTERVAL, IN-VIVOHEMODIALYSIS, electrolyte concentration, Clinical Practice, lcsh:R855-855.5, Calcium concentration, Artificial intelligence, ddc:620, VENTRICULAR REPOLARIZATION, Calcium disorder, business, computer, SUDDEN CARDIAC DEATH
Abstract

Diseases caused by alterations of ionic concentrations are frequently observed challenges and play an important role in clinical practice. The clinically established method for the diagnosis of electrolyte concentration imbalance is blood tests. A rapid and non-invasive point-of-care method is yet needed. The electrocardiogram (ECG) could meet this need and becomes an established diagnostic tool allowing home monitoring of the electrolyte concentration also by wearable devices. In this review, we present the current state of potassium and calcium concentration monitoring using the ECG and summarize results from previous work. Selected clinical studies are presented, supporting or questioning the use of the ECG for the monitoring of electrolyte concentration imbalances. Differences in the findings from automatic monitoring studies are discussed, and current studies utilizing machine learning are presented demonstrating the potential of the deep learning approach. Furthermore, we demonstrate the potential of computational modeling approaches to gain insight into the mechanisms of relevant clinical findings and as a tool to obtain synthetic data for methodical improvements in monitoring approaches.

Published
2020

39. Hypocalcemia-Induced Slowing of Human Sinus Node Pacemaking

Author

Yannick Lutz, Doris H. Fuertinger, Deborah Nairn, Jochen G. Raimann, Noémi Tóth, Norbert Nagy, Xiaoling Ye, Simonetta Genovesi, Peter Kotanko, Alan Fabbri, Stefano Severi, Axel Loewe, Loewe, A, Lutz, Y, Nairn, D, Fabbri, A, Nagy, N, Toth, N, Ye, X, Fuertinger, D, Genovesi, S, Kotanko, P, Raimann, J, Severi, S, Loewe, Axel, Lutz, Yannick, Nairn, Deborah, Fabbri, Alan, Nagy, Norbert, Toth, Noemi, Ye, Xiaoling, Fuertinger, Doris H., Genovesi, Simonetta, Kotanko, Peter, Raimann, Jochen G., and Severi, Stefano

Subjects
Bradycardia, Male, medicine.medical_specialty, Sodium, Biophysics, chemistry.chemical_element, Action Potentials, Calcium, sinus node, calcium, hemodialysis, cardiac arrest, electrolytes, 03 medical and health sciences, Electrolytes, 0302 clinical medicine, Biological Clocks, Diastole, Heart Rate, Renal Dialysis, Internal medicine, Heart rate, medicine, Extracellular, Humans, Computer Simulation, 030304 developmental biology, Aged, Sinoatrial Node, Calcium metabolism, 0303 health sciences, Hypocalcemia, Chemistry, Models, Cardiovascular, Depolarization, Articles, Middle Aged, CELL PHYSIOLOGY & BIOPHYSICS/4G - Cardiac, Smooth & Skeletal Muscle Electrophysiology, CHANNELS/5G - Ion Channels, Pharmacology & Disease, NEW DEVELOPMENTS IN BIOPHYSICAL TECHNIQUES /10E - Computational Methods & Bioinformatics, Kinetics, Cross-Sectional Studies, Cardiology, Female, medicine.symptom, 030217 neurology & neurosurgery, Intracellular
Abstract

Each heartbeat is initiated by cyclic spontaneous depolarization of cardiomyocytes in the sinus node forming the primary natural pacemaker. In patients with end-stage renal disease undergoing hemodialysis, it was recently shown that the heart rate drops to very low values before they suffer from sudden cardiac death with an unexplained high incidence. We hypothesize that the electrolyte changes commonly occurring in these patients affect sinus node beating rate and could be responsible for severe bradycardia. To test this hypothesis, we extended the Fabbri et al. computational model of human sinus node cells to account for the dynamic intracellular balance of ion concentrations. Using this model, we systematically tested the effect of altered extracellular potassium, calcium, and sodium concentrations. Although sodium changes had negligible (0.15 bpm/mM) and potassium changes mild effects (8 bpm/mM), calcium changes markedly affected the beating rate (46 bpm/mM ionized calcium without autonomic control). This pronounced bradycardic effect of hypocalcemia was mediated primarily by I(CaL) attenuation due to reduced driving force, particularly during late depolarization. This, in turn, caused secondary reduction of calcium concentration in the intracellular compartments and subsequent attenuation of inward I(NaCa) and reduction of intracellular sodium. Our in silico findings are complemented and substantiated by an empirical database study comprising 22,501 pairs of blood samples and in vivo heart rate measurements in hemodialysis patients and healthy individuals. A reduction of extracellular calcium was correlated with a decrease of heartrate by 9.9 bpm/mM total serum calcium (p < 0.001) with intact autonomic control in the cross-sectional population. In conclusion, we present mechanistic in silico and empirical in vivo data supporting the so far neglected but experimentally testable and potentially important mechanism of hypocalcemia-induced bradycardia and asystole, potentially responsible for the highly increased and so far unexplained risk of sudden cardiac death in the hemodialysis patient population.

Published
2019

40. Editor's Choice - Challenges of Predicting Arteriovenous Access Survival Prior to Conversion from Catheter.

Author

Hofmann AG, Lama S, Zhang H, Assadian A, Sor M, Hymes J, Kotanko P, and Raimann J

Subjects
Humans, Retrospective Studies, Male, Female, Middle Aged, Aged, Machine Learning, Risk Assessment, Risk Factors, Clinical Decision-Making, Time Factors, Arteriovenous Shunt, Surgical adverse effects, Renal Dialysis
Abstract

Objective: The decision to convert from catheter to arteriovenous access is difficult yet very important. The ability to accurately predict fistula survival prior to surgery would significantly improve the decision making process. Many previously investigated demographic and clinical features have been associated with fistula failure. However, it is not conclusively understood how reliable predictions based on these parameters are at an individual level. The aim of this study was to investigate the probability of arteriovenous fistula maturation and survival after conversion using machine learning workflows., Methods: A retrospective cohort study on multicentre data from a large North American dialysis organisation was conducted. The study population comprised 73 031 chronic in centre haemodialysis patients. The dataset included 49 variables including demographic and clinical features. Two distinct feature selection and prediction pipelines were used: LASSO regression and Boruta followed by a random forest classifier. Predictions were facilitated for re-conversion to catheter within one year. Additionally, all cause mortality predictions were conducted to serve as a comparator., Results: In total, 38 151 patients (52.2%) had complete data and made up the main cohort. Sensitivity analyses were conducted in 67 421 patients (92.3%) after eliminating variables with a high proportion of missing data points. Selected features diverged between datasets and workflows. A previously failed arteriovenous access appeared to be the most stable predictor for subsequent failure. Prediction of re-conversion based on the demographic and clinical information resulted in an area under the receiver operating characteristic curve (ROCAUC) between 0.541 and 0.571, whereas models predicting all cause mortality performed considerably better (ROCAUC 0.662 - 0.683)., Conclusion: While group level depiction of major adverse outcomes after catheter to arteriovenous fistula or graft conversion is possible using the included variables, patient level predictions are associated with limited performance. Factors during and after fistula creation as well as biomolecular and genetic biomarkers might be more relevant predictors of fistula survival than baseline clinical conditions., (Copyright © 2024 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)

Published
2024
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41. The Role of Kt/V and Creatinine clearance on Assisting Optimization of Serum Phosphorus Levels among Patients on PD.

Author

Uribarri J, Guedes M, Diaz Bessone MI, Chan L, De La Torre A, Mermelstein A, Garcia-Garcia G, Raimann J, Moraes T, Peters V, Konings S, Farrell D, Sharma S, Guinsburg A, and Kotanko P

Abstract

Background: Hyperphosphatemia is associated with poor outcome and is still very common in peritoneal dialysis (PD) patients. Since peritoneal phosphate clearance is closer to peritoneal creatinine clearance than urea clearance, we hypothesized that weekly creatinine clearance (CrCl) could be a better marker of serum phosphate in PD., Methods: In a retrospective observational study, data from adult PD patients were collected across five institutions in North and South America: LATAM, RRI, Mount Sinai Hospital, Hospital Civil de Guadalajara, and the BRAZPD cohort. All centers analyzed routinely available laboratory data, with exclusions for missing data on serum phosphate, CrCl, or urea Kt/V. A unified statistical protocol was employed across centers. Linear mixed-effect models examined associations between longitudinal serum phosphate levels, CrCl, and Kt/V. Adjustments were made for age, gender, and baseline phosphate binder usage. Mixed-effects meta-analysis determined the pooled effect size of CrCl and Kt/V on serum phosphate trajectories, adjusted for confounders., Results: There were 16,796 incident PD patients analyzed. Age, BMI, gender, PD modality, Kt/V and CrCl as well as serum phosphate varied significantly across the different cohorts, but >70% had residual renal function. For most cohorts, both CrCltotal and urea Kt/V associated negatively with serum phosphorus levels, and log-likelihood ratio tests demonstrate that models including CrCltotal have more predictive information than those including only urea Kt/V for the largest cohorts. Models including CrCltotal increase information predicting longitudinal serum phosphate levels irrespective of baseline urea Kt/V, age, use of phosphorus binder, and gender., Conclusions: CrCl was not more accurate in predicting serum phosphate than urea Kt/V, but its inclusion in multivariable models predicting serum phosphate added accuracy. In conclusion, both creatinine clearance and Kt/V are associated with phosphate levels, and using both biomarkers, instead of just one, may better assist in the optimization of serum phosphate levels., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.)

Published
2024
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42. Virtually isolated: social identity threat predicts social approach motivation via sense of belonging in computer-supported collaborative learning.

Author

Bick N, Froehlich L, Voltmer JB, Raimann J, Reich-Stiebert N, Seidel N, Burchart M, Martiny SE, Nikitin J, Stürmer S, and Martin A

Abstract

Collaboration improves multiple academic and social outcomes. Accordingly, computer-supported collaborative learning (CSCL) can be beneficial in distance education contexts to overcome the issues specific to online learning (e.g., underperformance, low identification with university). Distance universities often attract a substantial number of non-traditional students (e.g., students with disability, students with migration background). Despite their representation, non-traditional students face negative stereotypes and associated social consequences, including social identity threat, diminished sense of belonging, and less motivation for social interactions. In the context of online learning, where there is little individuating information, social categories like socio-demographic group memberships become salient, activating stereotypes. Consequently, socio-demographic group memberships can have detrimental consequences for the integration of non-traditional students. The purpose of the present study was to (a) determine the extent of social identity threat for students in higher distance education, (b) explore the social consequences of this threat in the same context, (c) validate these findings through longitudinal analyses embedded in a CSCL task, and (d) use learning analytics to test behavioral outcomes. In a longitudinal study with three measurement occasions over 8 weeks ( N  = 1,210), we conducted path analyses for cross-sectional associations and Random Intercept Cross-Lagged Panel Models for longitudinal predictions. The results showed that non-traditional students mostly reported higher social identity threat than traditional students. While the expected longitudinal within-person effects could not be demonstrated, we found stable between-person effects: students who reported higher levels of social identity threat also reported lower sense of belonging and lower social approach motivation. Exploratory analyses of actual online collaboration during CSCL offer potential avenues for future research. We conclude that social identity threat and its social consequences play an important role in higher distance education and should therefore be considered for successful CSCL., Competing Interests: MB was employed by Research Institute for Telecommunications and Cooperation e.V. This research institute is a legally independent organization at the FernUniversität that is connected to the FernUniversität regarding staff, place, and organizationally but is no part of the university. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bick, Froehlich, Voltmer, Raimann, Reich-Stiebert, Seidel, Burchart, Martiny, Nikitin, Stürmer and Martin.)

Published
2024
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44. Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes.

Author

Canaud B, Kooman J, Maierhofer A, Raimann J, Titze J, and Kotanko P

Abstract

New physiologic findings related to sodium homeostasis and pathophysiologic associations require a new vision for sodium, fluid and blood pressure management in dialysis-dependent chronic kidney disease patients. The traditional dry weight probing approach that has prevailed for many years must be reviewed in light of these findings and enriched by availability of new tools for monitoring and handling sodium and water imbalances. A comprehensive and integrated approach is needed to improve further cardiac health in hemodialysis (HD) patients. Adequate management of sodium, water, volume and hemodynamic control of HD patients relies on a stepwise approach: the first entails assessment and monitoring of fluid status and relies on clinical judgement supported by specific tools that are online embedded in the HD machine or devices used offline; the second consists of acting on correcting fluid imbalance mainly through dialysis prescription (treatment time, active tools embedded on HD machine) but also on guidance related to diet and thirst management; the third consist of fine tuning treatment prescription to patient responses and tolerance with the support of innovative tools such as artificial intelligence and remote pervasive health trackers. It is time to come back to sodium and water imbalance as the root cause of the problem and not to act primarily on their consequences (fluid overload, hypertension) or organ damage (heart; atherosclerosis, brain). We know the problem and have the tools to assess and manage in a more precise way sodium and fluid in HD patients. We strongly call for a sodium first approach to reduce disease burden and improve cardiac health in dialysis-dependent chronic kidney disease patients., Competing Interests: Authors AM and BC were employed by company Fresenius Medical Care (FMC). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Canaud, Kooman, Maierhofer, Raimann, Titze and Kotanko.)

Published
2022
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45. Clinical and predictive value of simplified creatinine index used as muscle mass surrogate in end-stage kidney disease haemodialysis patients-results from the international MONitoring Dialysis Outcome initiative.

Author

Canaud B, Ye X, Usvyat L, Kooman J, van der Sande F, Raimann J, Wang Y, and Kotanko P

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Body Composition, Europe epidemiology, Female, Humans, Kidney Failure, Chronic epidemiology, Male, Middle Aged, Prognosis, Reproducibility of Results, Retrospective Studies, Sarcopenia blood, Sarcopenia etiology, Young Adult, Creatinine blood, Kidney Failure, Chronic therapy, Renal Dialysis adverse effects, Sarcopenia diagnosis
Abstract

Background: Protein-energy wasting, muscle mass (MM) loss and sarcopenia are highly prevalent and associated with poor outcome in haemodialysis (HD) patients. Monitoring of MM and/or muscle metabolism in HD patients is of paramount importance for timely detection of muscle loss and to intervene adequately. In this study we assessed the reliability and reproducibility of a simplified creatinine index (SCI) as a surrogate marker of MM and explored its predictive value on outcome., Method: We included all in-centre HD patients from 16 European countries with at least one SCI. The baseline period was defined as 30 days before and after the first multifrequency bioimpedance spectroscopy measurement; the subsequent 7 years constituted the follow-up. SCI was calculated by the Canaud equation. Multivariate Cox proportional hazards models were applied to assess the association of SCI with all-cause mortality. Using backward analysis, we explored the trends of SCI before death. Bland-Altman analysis was performed to analyse the agreement between estimated and measured MM., Results: We included 23 495 HD patients; 3662 were incident. Females and older patients have lower baseline SCI. Higher SCI was associated with a lower risk of mortality [hazard ratio 0.81 (95% confidence interval 0.79-0.82)]. SCI decline accelerated ∼5-7 months before death. Lean tissue index (LTI) estimated by SCI was correlated with measured LTI in both sexes (males: R2 = 0.94; females: R2 = 0.92; both P < 0.001). Bland-Altman analysis showed that measured LTI was 4.71 kg/m2 (±2 SD: -12.54-3.12) lower than estimated LTI., Conclusion: SCI is a simple, easily obtainable and clinically relevant surrogate marker of MM in HD patients., (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2020
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46. SARS-CoV-2 in Spent Dialysate from Chronic Peritoneal Dialysis Patients with COVID-19.

Author

Wang X, Patel A, Tisdale L, Haq Z, Ye X, Lasky R, Preciado P, Tao X, Dias GF, Chao JE, Hakim M, Han M, Thwin O, Raimann J, Chatoth D, Kotanko P, and Grobe N

Subjects
Dialysis Solutions, Humans, SARS-CoV-2 genetics, COVID-19, Peritoneal Dialysis adverse effects
Abstract

Background: To date, it is unclear whether SARS-CoV-2 is present in spent dialysate from patients with COVID-19 on peritoneal dialysis (PD). Our aim was to assess the presence or absence of SARS-CoV-2 in spent dialysate from patients on chronic PD who had a confirmed diagnosis of COVID-19., Methods: Spent PD dialysate samples from patients on PD who were positive for COVID-19 were collected between March and August 2020. The multiplexed, real-time RT-PCR assay contained primer/probe sets specific to different SARS-CoV-2 genomic regions and to bacteriophage MS2 as an internal process control for nucleic acid extraction. Demographic and clinical data were obtained from patients' electronic health records., Results: A total of 26 spent PD dialysate samples were collected from 11 patients from ten dialysis centers. Spent PD dialysate samples were collected, on average, 25±13 days (median, 20; range, 10-45) after the onset of symptoms. The temporal distance of PD effluent collection relative to the closest positive nasal-swab RT-PCR result was 15±11 days (median, 14; range, 1-41). All 26 PD effluent samples tested negative at three SARS-CoV-2 genomic regions., Conclusions: Our findings indicate the absence of SARS-CoV-2 in spent PD dialysate collected at ≥10 days after the onset of COVID-19 symptoms. We cannot rule out the presence of SARS-CoV-2 in spent PD dialysate in the early stage of COVID-19., Competing Interests: J.E. Chao, G.F. Dias, N. Grobe, M. Hakim, M. Han, O. Thwin, Z. Haq, P. Kotanko, A. Patel, P. Preciado, J. Raimann, X. Tao, L. Tisdale, X. Wang, and X. Ye are employees of the Renal Research Institute, a wholly owned subsidiary of FMCNA. D. Chatoth and R. Lasky are employees of FMCNA. D. Chatoth and P. Kotanko hold stock in Fresenius Medical Care. All remaining authors have nothing to disclose., (Copyright © 2021 by the American Society of Nephrology.)

Published
2020
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47. Increased early acute cellular rejection events in hepatitis C-positive heart transplantation.

Author

Gidea CG, Narula N, Reyentovich A, Fargnoli A, Smith D, Pavone J, Lewis T, Karpe H, Stachel M, Rao S, Moreira A, Saraon T, Raimann J, Kon Z, and Moazami N

Subjects
Acute Disease, Adult, Aged, Female, Follow-Up Studies, Graft Rejection etiology, Graft Rejection immunology, Hepatitis C, Chronic complications, Hepatitis C, Chronic immunology, Humans, Male, Middle Aged, Prospective Studies, Time Factors, Graft Rejection epidemiology, Heart Transplantation, Hepacivirus immunology, Hepatitis C Antigens immunology, Hepatitis C, Chronic virology, Tissue Donors
Abstract

Background: Increased utilization of hepatitis C virus (HCV)-positive donors has increased transplantation rates. However, high levels of viremia have been documented in recipients of viremic donors. There is a knowledge gap in how transient viremia may impact acute cellular rejections (ACRs)., Methods: In this study, 50 subjects received hearts from either viremic or non-viremic donors. The recipients of viremic donors were classified as nucleic acid amplification testing (NAT)+ group, and the remaining were classified as NAT-. All patients were monitored for viremia levels. Endomyocardial biopsies were performed through 180 days, evaluating the incidence of ACRs., Results: A total of 50 HCV-naive recipients received hearts between 2018 and 2019. A total of 22 patients (44%) who received transplants from viremic donors developed viremia at a mean period of 7.2 ± 0.2 days. At that time, glecaprevir/pibrentasvir was initiated. In the viremia period (<56 days), 14 of 22 NAT+ recipients (64%) had ACR vs 5 of 28 NAT- group (18%) (p = 0.001). Through 180 days, 17 of 22 NAT+ recipients (77%) had a repeat rejection biopsy vs 12 of 28 NAT- recipients (43%) (p = 0.02). NAT+ biopsies demonstrated disparity of ACR distribution: negative, low-grade, and high-grade ACR in 84%, 12%, and 4%, respectively, vs 96%, 3%, and 1%, respectively, in the NAT- group (p = 0.03). The median time to first event was 26 (interquartile range [IQR]: 8-45) in the NAT+ group vs 65 (IQR: 44-84) days in the NAT-. Time to first event risk model revealed that NAT+ recipients had a significantly higher rate of ACR occurrences, adjusting for demographics (p = 0.004)., Conclusions: Transient levels of viremia contributed to higher rates and severity of ACRs. Further investigation into the mechanisms of early immune activation in NAT+ recipients is required., (Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)

Published
2020
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48. Viral safety of APOSECTM: a novel peripheral blood mononuclear cell derived-biological for regenerative medicine.

Author

Gugerell A, Sorgenfrey D, Laggner M, Raimann J, Peterbauer A, Bormann D, Suessner S, Gabriel C, Moser B, Ostler T, Mildner M, and Ankersmit HJ

Subjects
Animals, Cattle, Cell Line, Chlorocebus aethiops, Diarrhea Viruses, Bovine Viral isolation & purification, Gamma Rays, HIV-1 isolation & purification, Hepatitis A virus isolation & purification, Herpesvirus 1, Suid isolation & purification, Humans, Leukocytes, Mononuclear drug effects, Leukocytes, Mononuclear radiation effects, Macaca mulatta, Methylene Blue pharmacology, Parvovirus, Porcine isolation & purification, Swine, Virus Inactivation, Leukocytes, Mononuclear virology, Regenerative Medicine methods
Abstract

Background: Viral reduction and inactivation of cell-derived biologicals is paramount for patients' safety and so viral reduction needs to be demonstrated to regulatory bodies in order to obtain marketing authorisation. Allogeneic human blood-derived biological medicinal products require special attention. APOSEC TM , the secretome harvested from selected human blood cells, is a new biological with promising regenerative capabilities. We evaluated the effectiveness of inactivation of model viruses by methylene blue/light treatment, lyophilisation, and gamma irradiation during the manufacturing process of APOSEC TM ., Materials and Methods: Samples of intermediates of APOSEC TM were acquired during the manufacturing process and spiked with bovine viral diarrhoea virus (BVDV), human immunodeficiency virus type 1 (HIV-1), pseudorabies virus (PRV), hepatitis A virus (HAV), and porcine parvovirus (PPV). Viral titres were assessed with suitable cell lines., Results: Methylene blue-assisted viral reduction is mainly effective against enveloped viruses: the minimum log 10 reduction factors for BVDV, HIV-1, and PRV were ≥6.42, ≥6.88, and ≥6.18, respectively, with no observed residual infectivity. Viral titres of both HAV and PPV were not significantly reduced, indicating minor inactivation of non-enveloped viruses. Lyophilisation had minor effects on the viability of several enveloped model viruses. Gamma irradiation contributes to the viral safety by reduction of enveloped viruses (BVDV: ≥2.42; HIV-1: 4.53; PRV: ≥4.61) and to some degree of non-enveloped viruses as seen for HAV with a minimum log10 reduction factor of 2.92. No significant reduction could be measured for the non-enveloped virus PPV (2.60)., Discussion: Three manufacturing steps of APOSEC TM were evaluated under Good Laboratory Practice conditions for their efficacy at reducing and inactivating potentially present viruses. It could be demonstrated that all three steps contribute to the viral safety of APOSEC TM .

Published
2020
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49. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease.

Author

Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, and Sapkota A

Subjects
Aged, Climate Change, Cross-Over Studies, Female, Humans, Kidney Failure, Chronic therapy, Male, Middle Aged, Poisson Distribution, Renal Dialysis statistics & numerical data, Risk Factors, Extreme Heat adverse effects, Hospitalization statistics & numerical data, Kidney Failure, Chronic mortality
Abstract

Importance: Extreme heat events (EHEs) are increasing in frequency, duration, and intensity, and this trend is projected to continue as part of ongoing climate change. There is a paucity of data regarding how EHEs may affect highly vulnerable populations, such as patients with end-stage renal disease (ESRD). Such data are needed to inform ESRD patient management guidelines in a changing climate., Objectives: To investigate the association between EHEs and the risk of hospital admission or mortality among patients with ESRD and further characterize how this risk may vary among races/ethnicities or patients with preexisting comorbidities., Design, Setting, and Participants: This study used hospital admission and mortality records of patients with ESRD who underwent hemodialysis treatment at Fresenius Kidney Care clinics in Boston, Massachusetts; Philadelphia, Pennsylvania; or New York, New York, from January 1, 2001, to December 31, 2012. Data were analyzed using a time-stratified case-crossover design with conditional Poisson regression to investigate associations between EHEs and risk of hospital admission or mortality among patients with ESRD. Data were analyzed from July 1, 2017, to March 31, 2019., Exposures: Calendar day- and location-specific 95th-percentile maximum temperature thresholds were calculated using daily meteorological data from 1960 to 1989. These thresholds were used to identify EHEs in each of the 3 cities during the study., Main Outcomes and Measures: Daily all-cause hospital admission and all-cause mortality among patients with ESRD., Results: The study included 7445 patients with ESRD (mean [SD] age, 61.1 [14.1] years; 4283 [57.5%] men), among whom 2953 deaths (39.7%) and 44 941 hospital admissions (mean [SD], 6.0 [7.5] per patient) were recorded. Extreme heat events were associated with increased risk of same-day hospital admission (rate ratio [RR], 1.27; 95% CI, 1.13-1.43) and same-day mortality (RR, 1.31; 95% CI, 1.01-1.70) among patients with ESRD. There was some heterogeneity in risk, with patients in Boston showing statistically significant increased risk for hospital admission (RR, 1.15; 95% CI, 1.00-1.31) and mortality (RR, 1.45; 95% CI, 1.04-2.02) associated with cumulative exposure to EHEs, while such risk was absent among patients with ESRD in Philadelphia. While increases in risks were similar among non-Hispanic black and non-Hispanic white patients, findings among Hispanic and Asian patients were less clear. After stratifying by preexisting comorbidities, cumulative lag exposure to EHEs was associated with increased risk of mortality among patients with ESRD living with congestive heart failure (RR, 1.55; 95% CI, 1.27-1.89), chronic obstructive pulmonary disease (RR, 1.60; 95% CI, 1.24-2.06), or diabetes (RR, 1.83; 95% CI, 1.51-2.21)., Conclusions and Relevance: In this study, extreme heat events were associated with increased risk of hospital admission or mortality among patients with ESRD, and the association was potentially affected by geographic region and race/ethnicity. Future studies with larger populations and broader geographic coverage are needed to better characterize this variability in risk and inform ESRD management guidelines and differential risk variables, given the projected increases in the frequency, duration, and intensity of EHEs.

Published
2019
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50. Pre-dialysis fluid status, pre-dialysis systolic blood pressure and outcome in prevalent haemodialysis patients: results of an international cohort study on behalf of the MONDO initiative.

Author

Dekker M, Konings C, Canaud B, Carioni P, Guinsburg A, Madero M, van der Net J, Raimann J, van der Sande F, Stuard S, Usvyat L, Wang Y, Xu X, Kotanko P, and Kooman J

Subjects
Adult, Aged, Aged, 80 and over, Biomarkers analysis, Cohort Studies, Dialysis Solutions, Female, Humans, Hypertension etiology, Inflammation etiology, Kidney Failure, Chronic mortality, Male, Middle Aged, Prevalence, Proportional Hazards Models, Water-Electrolyte Imbalance etiology, Blood Pressure physiology, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic therapy, Renal Dialysis adverse effects, Water-Electrolyte Imbalance prevention & control
Abstract

Background: Pre-dialysis fluid overload (FO) associates with mortality and causes elevated pre-dialysis systolic blood pressure (pre-SBP). However, low pre-SBP is associated with increased mortality in haemodialysis patients. The objective of this study was to investigate the interaction between pre-dialysis fluid status (FS) and pre-SBP in association with mortality., Methods: We included all patients from the international Monitoring Dialysis Outcome Initiative (MONDO) database with a pre-dialysis multifrequency bioimpedance spectroscopy measurement in the year 2011. We used all parameters available during a 90-day baseline period. All-cause mortality was recorded during 1-year follow-up. Associations with outcome were assessed with Cox models and a smoothing spline Cox analysis., Results: We included 8883 patients. In patients with pre-dialysis FO (>+1.1 to +2.5 L), pre-SBP <110 mmHg was associated with an increased risk of death {hazard ratio (HR) 1.52 [95% confidence interval (CI) 1.06-2.17]}. An increased risk of death was also associated with pre-dialysis fluid depletion (FD; <-1.1 L) combined with a pre-SBP <140 mmHg. In normovolemic (NV) patients, low pre-SBP <110 mmHg was associated with better survival [HR 0.46 (95% CI 0.23-0.91)]. Also, post-dialysis FD associated with a survival benefit. Results were similar when inflammation was present. Only high ultrafiltration rate could not explain the higher mortality rates observed., Conclusion: The relation between pre-SBP and outcome is dependent on pre-dialysis FS. Low pre-SBP appears to be disadvantageous in patients with FO or FD, but not in NV patients. Post-dialysis FD was found to associate with improved survival. Therefore, we suggest interpreting pre-SBP levels in the context of FS and not as an isolated marker.

Published
2018
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