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1. Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Author

Hemmelder, M. H., Noordzij, M., Vart, P., Hilbrands, L. B., Jager, K. J., Abrahams, A. C., Arroyo, D., Battaglia, Y., Ekart, R., Mallamaci, F., Malloney, S. -R., Oliveira, J., Rydzewski, A., Sridharan, S., Vogt, L., Duivenvoorden, R., Gansevoort, R. T., Franssen, C. F. M., van der Net, J. B., Essig, M., du Buf-Vereijken, P. W. G., van Ginneken, B., Maas, N., van Jaarsveld, B. C., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Konings, C. J. A. M., Braconnier, P., Weis, D., Gellert, R., Alferes, D. G., Radulescu, D., Zakharova, E. V., Ambuehl, P. M., Guidotti, R., Walker, A., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Majstorovic, G. S., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Liakopoulos, V., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Kuryata, O., Slebe, J. J. P., Abd ElHafeez, S., Kemlin, D., van de Wetering, J., Reinders, M. E. J., Hesselink, D. A., van Gestel, J. K., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Logan, I., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Polyzou Konsta, M. A., Panagoutsos, S., Postorino, A., Cambareri, F., Matceac, I., Nistor, I., Covic, A., Groeneveld, J. H. M., Jousma, J., Diekmann, F., Oppenheimer, F., Blasco, M., Pereira, T. A., dos Santos Junior, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Arenas Jimenez, M. D., Mendoza-Valderrey, A., Martins, A. C., Mateus, C., Alvila, G., Laranjinha, I., Hofstra, J. M., Siezenga, M. A., Franco, A., Castellano, S., Rodriguez-Ferrero, M. L., Manzanos, S. B., Haridian Sosa Barrios, R., Lemahieu, W., Bartelet, K., Dirim, A. B., Demir, E., Sever, M. S., Turkmen, A., Safak, S., Hollander, D. A. M. J., Kerckhoffs, A., Buttner, S., de Vries, A. P. J., Meziyerh, S., van der Helm, D., Mallat, M., Bouwsma, H., Petruliene, K., Verberk, I., van der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Luca, M. D., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Gandolfini, I., Maggiore, U., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., de Fijter, C. W. H., Mongera, N., Pini, S., de Biase, C., van de Logt, A. E., Maas, R., Lebedeva, O., Lopez, V., Reichert, L. J. M., Verhave, J., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., van Kempen, G., van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Lentini, P., den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Sahin, I., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Coca, A., de Arriba, G., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnerlier, A., Wissing, K. M., Dedinska, I., Pessolano, G., Malik, S., Dounousi, E., Papachristou, E., Berger, S. P., Meijer, E., Sanders, J. S. F., Ozyilmaz, A., Ponikvar, J. B., Pernat, A. M., Kovac, D., Arnol, M., Molenaar, F. M., van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Gallieni, M., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Heitink-Ter Braak, N., Nephrology, ACS - Microcirculation, ACS - Diabetes & metabolism, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Clinical sciences, Faculteit Medische Wetenschappen/UMCG, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, APH - Health Behaviors & Chronic Diseases, and Internal Medicine

Subjects
Male, Outcome Assessment, survival, mental health status, COVID-19 Testing, SDG 3 - Good Health and Well-being, Renal Dialysis, functional health status, Outcome Assessment, Health Care, 80 and over, Humans, KIDNEY-TRANSPLANT, AcademicSubjects/MED00340, Aged, Aged, 80 and over, Transplantation, SARS-CoV-2, MORTALITY, COVID-19, Middle Aged, Health Care, Intensive Care Units, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, dialysis, Original Article, Female, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
Abstract

Background Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8–6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.

Published
2022

2. Clinical triage of patients on kidney replacement therapy presenting with COVID-19: An ERACODA registry analysis

Author

Mitra, S., Jayanti, A., Vart, P., Coca, A., Gallieni, M., Ovrehus, M. A., Midtvedt, K., Abd Elhafeez, S., Gandolfini, I., Buttner, S., Franssen, C. F. M., Hemmelder, M. H., Van Der Net, J. B., Essig, M., Du Buf-Vereijken, P. W. G., Van Ginneken, B., Maas, N., Vogt, L., Van Jaarsveld, B. C., Jager, K. J., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Rydzewski, A., Gellert, R., Oliveira, J., Alferes, D. G., Zakharova, E. V., Ambuehl, P. M., Walker, A., Winzeler, R., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Slebe, J. J. P., Kemlin, D., Van De Wetering, J., Reinders, M. E. J., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Konsta, M. A. P., Panagoutsos, S., Mallamaci, F., Postorino, A., Cambareri, F., Covic, A., Matceac, I., Nistor, I., Cordos, M., Groeneveld, J. H. M., Jousma, J., Marjolijn Van Buren, Diekmann, F., Tiago Assis Pereira, Santos, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Jimenez, M. D. A., Hofstra, J. M., Franco, A., Arroyo, D., Rodriguez-Ferrero, M. L., Manzanos, S. B., Barrios, R. H. S., Avila, G., Laranjinha, I., Mateus, C., Lemahieu, W., Bartelet, K., Dirim, A. B., Sever, M. S., Demir, E., Safak, S., Turkmen, A., Hollander, D. A. M. J., De Vries, A. P. J., Meziyerh, S., Van Der Helm, D., Mallat, M., Bouwsma, H., Sridharan, S., Petruliene, K., Maloney, S. -R., Verberk, I., Van Der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Di Luca, M., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., De Fijter, C. W. H., Mongera, N., Pini, S., De Biase, C., Duivenvoorden, R., Hilbrands, L., Kerckhoffs, A., Van De Logt, A. -E., Maas, R., Lebedeva, O., Lopez, V., Verhave, J., Reichert, L. J. M., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., Van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Battaglia, Y., Lentini, P., Den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnelier, A., Wissing, K. M., De Arriba, G., Dedinska, I., Pessolano, G., Maggiore, U., Malik, S., Papachristou, E., Gansevoort, R. T., Noordzij, M., Berger, S. P., Meijer, E., Ozyilmaz, A., Sanders, J. S. F., Ponikvar, J. B., Arnol, M., Pernat, A. M., Kovac, D., Ekart, R., Abrahams, A. C., Molenaar, F. M., Van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Sabiu, G., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., Van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Braak, N. H. -T., Nephrology, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Groningen Kidney Center (GKC), ACS - Diabetes & metabolism, AII - Inflammatory diseases, AII - Infectious diseases, Internal Medicine, and Clinical sciences

Subjects
kidney, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Pulmonary insufficiency, infectious diseases, Kidney, Second presentation, Interquartile range, Internal medicine, medicine, Humans, Registries, Mortality, AcademicSubjects/MED00340, Dialysis, Aged, Transplantation, second presentation, business.industry, SARS-CoV-2, COVID-19, medicine.disease, mortality, Triage, Hospitalization, Renal Replacement Therapy, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, Oxygen Saturation, dialysis, Original Article, Hemodialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], Presentation (obstetrics), business, transplantation
Abstract

Background Patients on kidney replacement therapy (KRT) are at very high risk of coronavirus disease 2019 (COVID-19). The triage pathway for KRT patients presenting to hospitals with varying severity of COVID-19 illness remains ill-defined. We studied the clinical characteristics of patients at initial and subsequent hospital presentations and the impact on patient outcomes. Methods The European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized at initial triage and those re-presenting a second time. Predictors of outcomes (hospitalization, 28-day mortality) were then determined for all those not hospitalized at initial triage. Results Among 1423 KRT patients with COVID-19 [haemodialysis (HD), n = 1017; transplant, n = 406), 25% (n = 355) were not hospitalized at first presentation due to mild illness (30% HD, 13% transplant). Of the non-hospitalized patients, only 10% (n = 36) re-presented a second time, with a 5-day median interval between the two presentations (interquartile range 2–7 days). Patients who re-presented had worsening respiratory symptoms, a decrease in oxygen saturation (97% versus 90%) and an increase in C-reactive protein (26 versus 73 mg/L) and were older (72 vs 63 years) compared with those who did not return a second time. The 28-day mortality between early admission (at first presentation) and deferred admission (at second presentation) was not significantly different (29% versus 25%; P = 0.6). Older age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation were identified as risk predictors of mortality when re-presenting after discharge at initial triage. Conclusions This study provides evidence that KRT patients with COVID-19 and mild illness can be managed effectively with supported outpatient care and with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19 to aid clinical triage and optimize resource utilization during the ongoing pandemic.

Published
2021

4. Influence of exogenous growth hormone administration on circulating concentrations of α-klotho in healthy and chronic kidney disease subjects: A prospective, single-center open case-control pilot study 11 Medical and Health Sciences 1103 Clinical Sciences

Author

Adema, Aaltje Y., de Roij van Zuijdewijn, Camiel L. M., Hoenderop, Joost G., de Borst, Martin H., ter Wee, Piet M., Heijboer, Annemieke C., Vervloet, Marc G., Bindels, R., Hoenderop, J. G., de Borst, M. H., Hillebrands, J. L., Navis, G. J., ter Wee, P. M., Vervloet, M. G., Laboratory for Endocrinology, Amsterdam Gastroenterology Endocrinology Metabolism, AMS - Musculoskeletal Health, Nephrology, AII - Inflammatory diseases, ACS - Diabetes & metabolism, VU University medical center, Clinical chemistry, AGEM - Endocrinology, metabolism and nutrition, Amsterdam Movement Sciences - Rehabilitation & Development, and NCA - Brain mechanisms in health and disease

Subjects
urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Background: The CKD-associated decline in soluble α-Klotho (α-Klotho) levels is considered detrimental. Some studies suggest a direct induction of α-Klotho concentrations by growth hormone (GH). In the present study, the effect of exogenous GH administration on α-Klotho concentrations in a clinical cohort with mild chronic kidney disease (CKD) and healthy subjects was studied. Methods: A prospective, single-center open case-control pilot study was performed involving 8 patients with mild CKD and 8 healthy controls matched for age and sex. All participants received subcutaneous GH injections (Genotropin®, 20 mcg/kg/day) for 7 consecutive days. α-Klotho concentrations were measured at baseline, after 7 days of therapy and 1 week after the intervention was stopped. Results: α-Klotho concentrations were not different between CKD-patients and healthy controls at baseline (554 (388-659) vs. 547 (421-711) pg/mL, P = 0.38). Overall, GH therapy increased α-Klotho concentrations from 554 (405-659) to 645 (516-754) pg/mL, P < 0.05). This was accompanied by an increase of IGF-1 concentrations from 26.8 ± 5.0 nmol/L to 61.7 ± 17.7 nmol/L (P < 0.05). GH therapy induced a trend toward increased α-Klotho concentrations both in the CKD group (554 (388-659) to 591 (358-742) pg/mL (P = 0.19)) and the healthy controls (547 (421-711) pg/mL to 654 (538-754) pg/mL (P = 0.13)). The change in α-Klotho concentration was not different for both groups (P for interaction = 0.71). α-Klotho concentrations returned to baseline levels within one week after the treatment (P < 0.05). Conclusions: GH therapy increases α-Klotho concentrations in subjects with normal renal function or stage 3 CKD. A larger follow-up study is needed to determine whether the effect size is different between both groups or in patients with more severe CKD. Trial registration: This trial is registered in EudraCT (2013-003354-24).

Published
2018

5. Mortality reduction by post-dilution online-haemodiafiltration: a cause-specific analysis

Author

Nubé, Menso J., Peters, Sanne A E, Blankestijn, Peter J., Canaud, Bernard, Davenport, Andrew, Grooteman, Muriel P C, Asci, Gulay, Locatelli, Francesco, Maduell, Francisco, Morena, Marion, Ok, Ercan, Torres, Ferran, Bots, Michiel L., Moreso, Francesc, Pons, Mercedes, Ramos, Rosa, Mora-Macià, Josep, Carreras, Jordi, Soler, Jordi, Campistol, Josep M., Martinez-Castelao, Alberto, Insensé, B., Perez, C., Feliz, T., Barbetta, M., Soto, C., Mora, J., Juan, A., Ibrik, O., Foraster, A., Nin, J., Fernández, A., Arruche, M., Sánchez, C., Vidiella, J., Barbosa, F., Chiné, M., Hurtado, S., Llibre, J., Ruiz, A., Serra, M., Salvó, M., Poyuelo, T., Maduell, F., Carrera, M., Fontseré, N., Arias, M., Merín, A., Ribera, L., Galceran, J. M., Mòdol, J., Moliner, E., Ramirez, A., Aguilera, J., Alvarez, M., De La Torre, B., Molera, M., Casellas, J., Martín, G., Andres, E., Coll, E., Valles, M., Martínez, C., Castellote, E., Casals, J. M., Gabàs, J., Romero, M., Martinez-Castelao, A., Fulladosa, X., Ramirez-Arellano, M., Fulquet, M., Pelegrí, A., El Manouari, M., Ramos, N., Bartolomé, J., Sans, R., Fernández, E., Sarró, F., Compte, T., Marco, F., Mauri, R., Bronsoms, J., Arnaiz, J. A., Beleta, H., Pejenaute, A., Ríos, J., Lara, J., Ter Wee, P. M., Van Den Dorpel, M. A., Dorval, M., Lévesque, R., Koopman, M. G., Konings, C. J A M, Haanstra, W. P., Kooistra, M., Van Jaarsveld, B., Noordzij, T., Feith, G. W., Peltenburg, H. G., Van Buren, M., Offerman, J. J G, Hoogeveen, E. K., De Heer, F., Van De Ven, P. J., Kremer Hovinga, T. K., Bax, W. A., Groeneveld, J. O., Lavrijssen, A. T J, Schrander-Van Der Meer, A. M., Reichert, L. J M, Huussen, J., Rensma, P. L., Schrama, Y., Van Hamersvelt, H. W., Boer, W. H., Van Kuijk, W. H., Vervloet, M. G., Wauters, I. M P M J, Sekse, I., Toz, Huseyin, Ok, Ebru Sevinc, Kircelli, Fatih, Yilmaz, Mumtaz, Hur, Ender, Demirci, Meltem Sezis, Demirci, Cenk, Duman, Soner, Basci, Ali, Adam, Siddig Momin, Isik, Ismet Onder, Zengin, Murat, Suleymanlar, Gultekin, Yilmaz, Mehmet Emin, Ergin, Mehmet Ozkahya Pinar, Sagdic, Alfert, Kayali, Erkan, Boydak, Can, Colak, Taskin, Caliskan, Sihli, Kaplan, Hakan, Ulas, Hasibe, Kirbiyik, Sait, Berktas, Hakan, Dilbaz, Necati, Cristol, Jean Paul, Leray-Moragues, Hélène, Chenine, Leïla, Picot, Marie Christine, Jaussent, Audrey, Belloc, Claire, Lagarrigue, Mélodie, Chalabi, Lotfi, Debure, Alain, Ouziala, Messaoud, Lefevre, Jean Jacques, Thibaudin, Damien, Mohey, Hesham, Broyet, Christian, Afiani, Aida, Serveaux, Marie Odile, Patrier, Laure, Maurice, François, Rivory, Jean Pierre, Nicoud, Philippe, Durand, Claude, Normand, Michel, Seigneuric, Bruno, Magnant, Eric, Azzouz, Lynda, Islam, Mohamed Shariful, Vido, Sandor, Nzeyimana, Hilaire, Simonin, Danièle, Azymah, Yamina, Farah, Ibrahim, Coindre, Jean Philippe, Puyoo, Olivier, Chabannier, Marie Hélène, Ibos, Richard, Rouleau, Fabienne, Vela, Carlos, Joule, Josiane, Combarnous, François, Turc-Baron, Cécile, Ducret, Francis, Pointet, Philippe, Rey, Isabelle, Potier, Jacky, Bendini, Jean Christophe, Perrin, Franck, Kunz, Kristian, Lefrancois, Gaëlle, Colin, Angélique, Parahy, Sophie, Dancea, Irima, Coupel, Stéphanie, Testa, Angelo, Brunet, Philippe, Lebrun, Gaétan, Jaubert, Dominique, Delcroix, Catherine, Lavainne, Frédéric, Lefebvre, Anne, Guillodo, Marie Paule, Le Grignou, Dominique, Djema, Assia, Maaz, Mehadji, Chiron, Sylvie, Hoffmann, Maxime, Depraetre, Pascale, Haddj-Elmrabet, Atman, Joyeux, Véronique, Fleury, Dominique, Vrigneaud, Laurence, Lemaitre, Vincent, Aguilera, Didier, Guerraoui, Abdallah, Cremault, Alain, Laradi, Achour, Babinet, Francois, VU University Medical Center [Amsterdam], University of Oxford [Oxford], University Medical Center [Utrecht], Fresenius Medical Care Deutschland, University College of London [London] (UCL), Ege university, Alessandro Manzoni Hospital, Hospital Clinic Barcelona, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Universitat Autònoma de Barcelona (UAB), Ege Üniversitesi, Nephrology, ICaR - Circulation and metabolism, Herrada, Anthony, and University of Oxford

Subjects
Male, medicine.medical_specialty, 030232 urology & nephrology, Hemodiafiltration, 030204 cardiovascular system & hematology, haemodiafiltration, Convection, Lower risk, Sudden death, convection volume, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, haemo-diafiltration, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, cardiovascular disease, Cause of Death, Internal medicine, Journal Article, medicine, Humans, Intensive care medicine, Aged, Proportional Hazards Models, Randomized Controlled Trials as Topic, Transplantation, integumentary system, business.industry, Mortality rate, Hazard ratio, Middle Aged, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, mortality, Confidence interval, 3. Good health, meta-analysis, Cardiovascular Diseases, Nephrology, Meta-analysis, Cardiology, Number needed to treat, Kidney Failure, Chronic, Female, business
Abstract

WOS: 000398117600023, PubMed ID: 28025382, Background. From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and fatal cardiovascular disease (CVD) by 23% (39; 3). Significant differences were not found for fatal infections and sudden death. So far, it is unclear, however, whether the reduced mortality risk of HDF is only due to a decrease in CVD events and if so, which CVD in particular is prevented, if compared with HD. Methods. The IPD base was used for the present study. Hazard ratios and 95% confidence intervals for cause-specific mortality overall and in thirds of the convection volume were calculated using the Cox proportional hazard regression models. Annualized mortality and numbers needed to treat (NNT) were calculated as well. Results. Besides 554 patients dying from CVD, fatal infections and sudden death, 215 participants died from 'other causes', such as withdrawal from treatment and malignancies. In this group, the mortality risk was comparable between HD and ol-HDF patients, both overall and in thirds of the convection volume. Subdivision of CVD mortality in fatal cardiac, non-cardiac and unclassified CVD showed that ol-HDF was only associated with a lower risk of cardiac casualties [0.64 (0.61; 0.90)]. Annual mortality rates also suggest that the reduction in CVD death is mainly due to a decrease in cardiac fatalities, including both ischaemic heart disease and congestion. Overall, 32 and 75 patients, respectively, need to be treated by high-volume HDF (HV-HDF) to prevent one all-cause and one CVD death, respectively, per year. Conclusion. The beneficial effect of ol-HDF on all-cause and CVD mortality appears to be mainly due to a reduction in fatal cardiac events, including ischaemic heart disease as well as congestion. In HV-HDF, the NNT to prevent one CVD death is 75 per year., EuDial working group; European Nephrology and Dialysis Institute; Catalan Society of Nephrology; Fresenius Medical Care; Dutch Kidney Foundation [C02.2019]; Fresenius Medical Care, Netherlands; Gambro Lundia AB, Sweden; Dr E.E. Twiss Fund; International Society of Nephrology/Baxter Extramural Grant Program; Netherlands Organization for Health Research and DevelopmentNetherlands Organization for Health Research and Development [170882802]; national grant from the Health Ministry (Programme Hospitalier de Recherche Clinique, PHRC); Gambro through the Catalan Society of Nephrology; Roche Netherlands, The HDF Pooling project was designed, conducted and analysed independently of the financial contributors of the individual studies as listed below. Study data were collected and retained by the investigators and were not available for the financial contributors of the individual studies. S.A.E.P. and the meetings of the representatives of the combined authors of the four studies were financially supported by the EuDial working group. EuDial is an official working group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA, http://era-edta.org/eudial/European_Dialysis_Working_Group.html). No industry funding was received for any part of or activity related to the present analysis.; The Turkish HDF study was supported by European Nephrology and Dialysis Institute with an unrestricted grant. The study was performed in Fresenius Medical Care haemodialysis clinics in Turkey. ESHOL was supported by The Catalan Society of Nephrology and by grants from Fresenius Medical Care and Gambro through the Catalan Society of Nephrology. The CONTRAST study was supported by a grant from the Dutch Kidney Foundation (Nierstichting Nederland Grant C02.2019), and unrestricted grants from Fresenius Medical Care, Netherlands, and Gambro Lundia AB, Sweden. Additional support was received from the Dr E.E. Twiss Fund, Roche Netherlands, the International Society of Nephrology/Baxter Extramural Grant Program, and the Netherlands Organization for Health Research and Development (ZONMw Grant 170882802). The French HDF study was supported by a national grant from the Health Ministry (Programme Hospitalier de Recherche Clinique, PHRC) as a means to improve care and outcome of elderly chronic disease patients.

Published
2017

6. Circulating markers of bone turnover

Author

Vervloet, M. G., Brandenburg, V. M., Bover, J., Brandenburg, V., Covic, A., Cozzolino, M., Evenepoel, P., Goldsmith, D., Massy, Z., Mazzaferro, S., Urena-Torres, P., and Vervloet, M.

Subjects
Nephrology, medicine.medical_specialty, Bone turnover, Bone disease, 030232 urology & nephrology, Physiology, Parathyroid hormone, 030209 endocrinology & metabolism, Review, urologic and male genital diseases, Collagen Type I, Bone remodeling, 03 medical and health sciences, 0302 clinical medicine, Chronic kidney disease-mineral and bone disorder, Internal medicine, Chronic kidney disease, Bone cell, medicine, CKD-MBD, Humans, Renal osteodystrophy, ddc:610, Renal Insufficiency, Renal Insufficiency, Chronic, Chronic, Chronic Kidney Disease-Mineral and Bone Disorder, business.industry, Tartrate-Resistant Acid Phosphatase, medicine.disease, Alkaline Phosphatase, Peptide Fragments, Endocrinology, Parathyroid Hormone, Bone Remodeling, business, Peptides, Biomarkers, Procollagen, Kidney disease
Abstract

Symposium on Bone in Chronic Kidney Disease (CKD), CKD 2016, Amsterdam, Netherlands, 13 Sep 2016 - 13 Sep 2016; Journal of nephrology 30(5), 663-670 (2017). doi:10.1007/s40620-017-0408-8 special issue: "Special issue on “Bone in Chronic Kidney Disease” an activity of the ERA-EDTA WG on CKD-MBD", Published by Springer, Milano

Published
2017

8. Cardiovascular disease in CKD

Author

van den Broek, J. S., primary, Hoekstra, T., additional, Drechsler, C., additional, Brandenburg, V. M., additional, Dekker, F. W., additional, Vervloet, M. G., additional, Albrizio, P., additional, Sepe, V., additional, Gnecchi, M., additional, Cervio, E., additional, Mangione, F., additional, Fiorini, F., additional, Rampino, T., additional, Libetta, C., additional, Dal Canton, A., additional, Di Marco, G., additional, Reuter, S., additional, Kentrup, D., additional, Tiemann, K., additional, Fobker, M., additional, Engelbertz, C., additional, Breithardt, G., additional, Reinecke, H., additional, Brand, E., additional, Pavenstadt, H., additional, Brand, M., additional, De Mauri, A., additional, Conti, N., additional, Chiarinotti, D., additional, David, P., additional, Capurro, F., additional, De Leo, M., additional, Delanaye, P., additional, Krzesinski, J.-M., additional, Warling, X., additional, Smelten, N., additional, Cavalier, E., additional, Hayashi, M., additional, Kanno, Y., additional, Iwai, M., additional, Yoshida, T., additional, and Abe, T., additional

Published
2013
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13. Feasibility of long-term continuous subcutaneous magnesium supplementation in a patient with irreversible magnesium wasting due to cisplatin.

Author

Vermeulen EA, Vervloet MG, Lubach CH, Nurmohamed SA, and Penne EL

Subjects
Adult, Feasibility Studies, Female, Humans, Infusions, Subcutaneous, Renal Tubular Transport, Inborn Errors chemically induced, Time Factors, Treatment Outcome, Cisplatin adverse effects, Dietary Supplements, Magnesium administration & dosage, Renal Tubular Transport, Inborn Errors therapy
Abstract

A 39-year-old woman presented with severe, uncontrolled and irreversible hypomagnesaemia, following cisplatin treatment in her childhood. Because high-dose oral magnesium supplementation therapy was insufficient and not tolerated, continuous subcutaneous magnesium supplementation was successfully instituted and continued in the outpatient setting. This case demonstrates that continuous subcutaneous magnesium supplementation is effective in maintaining magnesium levels within the normal range, is well tolerated and may provide a long-term solution for chronic hypomagnesaemia due to intractable renal losses.

Published
2017

14. Cinacalcet for secondary hyperparathyroidism: from improved mineral levels to improved mortality?

Author

Vervloet MG, du Buf-Vereijken PW, Potter van Loon BJ, Manamley N, Reichert LJ, and Smak Gregoor PJ

Subjects
Bone Density drug effects, Calcinosis drug therapy, Calcium blood, Cinacalcet, Heart Valve Diseases drug therapy, Humans, Hyperparathyroidism, Secondary blood, Parathyroid Hormone blood, Calcimimetic Agents therapeutic use, Hyperparathyroidism, Secondary drug therapy, Naphthalenes therapeutic use
Abstract

Secondary hyperparathyroidism is an almost inevitable complication of advanced kidney failure. The introduction of the calcimimetic cinacalcet for the treatment of secondary hyperparathyroidism in patients on dialysis was based on its ability to reduce elevated levels of parathyroid hormone (PTH). Subsequent clinical studies confirmed the beneficial effects of cinacalcet on biochemical parameters reflecting mineral disturbances and bone disease. In this review we summarise the impact of cinacalcet on biochemical, intermediate and clinical outcomes. We also present previously unpublished mineral metabolism data from 144 Dutch dialysis patients treated with cinacalcet who participated in the pan-European ECHO observational study. Although secondary hyperparathyroidism tended to be more severe in our Dutch cohort, compared with the entire ECHO cohort, cinacalcet was nevertheless effective in reducing PTH in these patients. Two recent clinical studies evaluated, respectively, the efficacy of cinacalcet in improving the intermediate endpoint of cardiovascular calcifications (ADVANCE trial), and its impact on clinical outcomes, including all-cause mortality and cardiovascular events (EVOLVE trial). The ADVANCE trial provided evidence that cinacalcet may indeed improve calcification in both large arteries and cardiac valves. The EVOLVE trial, however, did not meet its clinical primary endpoint (time to all-cause mortality, myocardial infarction, hospitalisation for unstable angina, heart failure or a peripheral vascular event), although secondary and sensitivity analysis suggested a beneficial effect. The clinical implications of these important studies are also addressed in this review.

Published
2013

15. Dutch guidelines for diagnosis and therapy of proliferative lupus nephritis.

Author

van Tellingen A, Voskuyl AE, Vervloet MG, Bijl M, de Sévaux RG, Berger SP, Derksen RH, and Berden JH

Subjects
Antirheumatic Agents therapeutic use, Azathioprine therapeutic use, Biopsy, Cyclophosphamide therapeutic use, Disease Progression, Humans, Immunosuppressive Agents therapeutic use, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic pathology, Lupus Nephritis diagnosis, Lupus Nephritis pathology, Mycophenolic Acid analogs & derivatives, Mycophenolic Acid therapeutic use, Netherlands, Prognosis, Treatment Outcome, Lupus Nephritis drug therapy, Practice Guidelines as Topic
Abstract

Proliferative lupus nephritis is a strong predictor of morbidity and mortality in patients with systemic lupus erythematosus. Despite improvements in the management of lupus nephritis, a significant number of the patients do not respond to immunosuppressive therapy and progress to end-stage renal failure. In order to optimise the diagnostic strategy and treatment of patients with proliferative lupus nephritis, guidelines are needed. In this review, the Dutch Working Party on Systemic Lupus Erythematosus provides recommendations regarding four important areas in patients with proliferative lupus nephritis: I) indications for a first renal biopsy, II ) definitions of treatment response, III ) selection of treatment options, and IV) indications for a repeat biopsy.

Published
2012

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