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26 results on '"Champion de Crespigny P."'

1. The Challenges of Distinguishing Different Causes of TMA in a Pregnant Kidney Transplant Recipient.

Author

Krelle, A., Price, S., Law, M. M., Kranz, S., Shamdasani, P., Kane, S., Unterscheider, J., and Champion de Crespigny, P.

Subjects
KIDNEY transplantation, HEMOLYTIC-uremic syndrome, CHRONIC kidney failure, FETAL growth retardation, HELLP syndrome, THROMBOTIC thrombocytopenic purpura, ECTOPIC pregnancy
Abstract

Thrombotic microangiopathy (TMA) reflects a syndrome of endothelial injury characterised by microangiopathic haemolytic anaemia (nonimmune), thrombocytopenia, and often end-organ dysfunction. TMA disorders are well-recognised in kidney transplant recipients, often due to an underlying genetic predisposition related to complement dysregulation, or de novo due to infection, immunosuppression toxicity, or antibody-mediated rejection. In pregnancy, TMA disorders are most commonly due to severe pre-eclampsia or HELLP, but may also be due to thrombotic thrombocytopenic purpura (TTP) or complement-mediated (atypical) haemolytic uremic syndrome (aHUS). Complement dysregulation is being recognised as playing a role in the development of preeclampsia and HELLP syndrome in addition to aHUS. Due to overlapping clinical and laboratory features, diagnosis can be difficult and delays in treatment can be life-threatening for both mother and fetus. This report describes a 32 year-old female who had two successive wanted pregnancies. The first pregnancy was terminated at 22 weeks gestation due to presumed severe preeclampsia and fetal growth restriction in the context of known chronic kidney failure due to reflux nephropathy. A living-related kidney transplant was performed to improve the chances of pregnancy resulting in a live birth. A subsequent pregnancy was complicated by progressive kidney impairment and hypertension at 22 weeks gestation. Kidney biopsy showed TMA, but the etiology was unclear. This report highlights the diagnostic dilemma of TMA in a pregnant kidney transplant recipient and a role for the anti-C5 terminal complement blockade monoclonal antibody eculizumab, in pregnancy-associated TMA, especially at a peri-viable gestation. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Monitoring skin temperature at the wrist in hospitalised patients may assist in the detection of infection

Author

Holt, SG, Yo, JH, Karschimkus, C, Volpato, F, Christov, S, Smith, ER, Hewitson, TD, Worth, LJ, Champion De Crespigny, P, Holt, SG, Yo, JH, Karschimkus, C, Volpato, F, Christov, S, Smith, ER, Hewitson, TD, Worth, LJ, and Champion De Crespigny, P

Abstract

BACKGROUND: Measuring temperature has always been a key observation in the diagnosis of infection. No studies have examined the usefulness of measuring temperature at the wrist to detect infection. AIM: We sought to determine whether a watch measuring wrist temperature could accurately identify patients who are infected. METHODS: Prospective cross-sectional pilot study of temperature monitoring in an unselected patients in a tertiary referral adult nephrology unit. RESULTS: One hundred and four data recording sessions revealed 88 useful data sets, with recording failures in the others. Patients were retrospectively classified as having no infection (Group A, n = 60), clinically diagnosed infection with less than 24 h of treatment with antibiotics (Group B, n = 5), and clinically diagnosed infection with greater than 24 h on antibiotics (Group C, n = 23). There was a significantly higher average maximum temperature in Group B (mean (SEM)) 38°C (0.6) compared with Groups A (36.1°C (0.1)) and C (36.3°C (0.3)). Based on receiver operating characteristics (ROC) a cut-off temperature of ≥37.5°C gave sensitivity 80% and specificity 98%. Mean electrodermal activity was significantly higher in Groups B and C. CONCLUSIONS: ROC of peripheral skin temperature measurements suggest that such a device may identify many patients requiring treatment for infection. This proof of principle study showed value in using a wearable device in the detection of infection and its potential as an early warning or monitoring device.

Published
2020

11. Identifying and integrating patient and caregiver perspectives in clinical practice guidelines for percutaneous renal biopsy.

Author

Menahem S., Voss D., Saunders J., Jesudason S., Champion de Crespigny P., Tong A., Gutman T., Lopez-Vargas P., Manera K.E., Craig J.C., Howell M., Tunnicliffe D., James L.J., MacGinley R., See E., Wong J., Menahem S., Voss D., Saunders J., Jesudason S., Champion de Crespigny P., Tong A., Gutman T., Lopez-Vargas P., Manera K.E., Craig J.C., Howell M., Tunnicliffe D., James L.J., MacGinley R., See E., and Wong J.

Abstract

Aim: Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patient-relevance. Method(s): We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with 10 patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritized by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analyzed thematically to identify the reasons for participants' choices. Result(s): In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: alleviating anxiety and unnecessary distress, minimizing discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result. Conclusion(s): Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies.Copyright © 2018 Asian Pacific Society of Nephrology

Published
2019

12. Bardoxolone Methyl in Type 2 Diabetes and Stage 4 Chronic Kidney Disease

Author

De Zeeuw, Dick, Akizawa, Tadao, Audhya, Paul, Bakris, George L., Chin, Melanie, Christ-Schmidt, Heidi, Goldsberry, Angie, Houser, Mark, Krauth, Melissa, Lambers Heerspink, Hiddo J., McMurray, John J., Meyer, Colin J., Parving, Hans-Henrik, Remuzzi, Giuseppe, Toto, Robert D., Vaziri, Nosratola D., Wanner, Christoph, Wittes, Janet, Wrolstad, Danielle, Chertow, Glenn M., Toto, B., McCullough, P., Ivanovich, P., Ketteler, M., Lachin, J., McGill, J., Agarwal, R., Anker, S., Arenillas, J. F., Januzzi, J., Jardine, A., Kasner, S., Kissela, B., Kolansky, D., Mann, J., Thadhani, R., Champion de Crespigny, P., Chan, D. T., D'Almeida, E., Fraser, I., Gray, N., Holt, S., Irish, A., Isbel, N., Kerr, P., Packham, D., Phoon, R., Pollock, C., Roger, S., Suranyi, M., Walker, R., Wittert, G., Yue, D., Balcke, P., Prager, R., Schernthaner, G., Sunder-Plassmann, G., Jadoul, M., Krzesinski, J. M., Peeters, P., Van der Niepen, P., Van Gaal, L., Van Vlem, B., Warling, X., Chow, S., Cournoyer, S., Dumas, R., Jolly, S., Levin, A., McMahon, A., Mehta, H., Ooi, T. C., Perkins, D., Roy, L., Sapir, D., Tam, P., Bartaskova, D., Hemzsky, L., Kubina, D., Szabo, M., Tesar, V., Combe, C., Faller, B., Fauvel, J. P., Halimi, J. M., Hourmant, M., Le Meur, Y., Urena-Torres, P., Zaoui, P., Al-Sarraf, S., Burst, V., Degenhardt, S., Kempe, H. P., Kleophas, W., Kosch, C., Krumme, B., Kuhlmann, M., Pistrosch, F., Rambausek, M., Schmidt-Guertler, H., Segiet, T., Sommerer, C., Vielhauer, V., Wanner, C., Beberashvili, I., Benchetrit, S., Herskovits, T., Karnieli, E., Levin-Iaina, N., Mosenzon, O., Tsur, A., van Dijk, D. J., Wainstein, J., Yagil, Y., Yerushalmi, Y., Colussi, G., Conte, G., Di Luca, M., Giovambatista, C., Messa, P., Pani, A., Pisani, A., Rapana, M. R., Ruggenenti, P., Villa, G., Zoccali, C., Correa-Rotter, R., Diaz-Escobedo, S. L., Garcia, P., Gonzalez Galvez, G., Obrador Vera, G. T., Rico, R., Calero, F., Cigarran, S., de Alvaro, F., de Francisco, A. L., Egido, J., Fernandez, E., Fernandez Vega, F., Fort, J., Galan Serrano, A., Gorriz Teruel, J. L., Martinez, I., Martinez Castelao, A., Munar, M. A., Navarro, J., Nieto, J., Osuna, A., Pascual, J., Portoles, J., Praga, M., Vallés, M., Fellstrom, B., Frisenette-Fich, C., Hadimeri, H., Stenvinkel, P., Svensson, M., Weiss, L., Adamson, K., Dornhorst, A., El Kossi, M., Gnudi, L., Hendry, B., Johnson, A., Joseph, F., Kalra, P., Marshall, S., Mikhail, A., Myint, K. S., Soran, H., Taal, M., Zehnder, D., Abbott, L., Acharya, A., Ahmed, Z., Aiello, J., Akom, M., Ali, S., Alzohaili, O., Anderson, L., Anderson, S., Anger, M., Appel, G., Arakaki, R. F., Arif, A., Assefi, A. R., Atray, N., Awad, A., Barranco, E., Belledonne, M. O., Belo, D., Bernardo, M., Bernstein, R., Bhalla, V., Bhatia, D., Black, R. M., Block, G., Blondin, J., Blumenthal, S. S., Bononi, P., Brantley, R. R., Bresssler, P., Broumand, V., Brusco, O., Buerkert, J., Burgos-Calderon, R., Campbell, R., Canas, G., Cangiano, J., Cherlin, R., Chilakapati, V., Comunale, R., Coyne, D., Crawford, P. W., Darwish, R., Deeb, W., Denker, P. S., Desai, S., Desouza, C., Diamond, S., Dixon, B. S., Durham, J. H., Eisner, G., Elder, J. G., El-Shahawy, M., Fadda, G., Fitz-Patrick, D., Fonseca, V., Fraser, N. J., Frei, G., Fried, L., Galindo-Ramos, E., Germain, M., Ghantous, W., Gilbert, J. M., Gillum, D., Godwin, J., Goel, A., Goldfarb, DS., Graf, R. J., Greenwood, T., Guasch, A., Hanna, A., Harper, K., Herman, T., Hilton, T., Hines, T., Hoggard, J., Hootkins, R., Huseman, R., Israelit, A., Jamal, A., Kant, K., Kaptein, E., Kathresal, A., Kaupke, J., Kaveh, K., Kaye, W., Keightley, G. E., Keith, K., Khairullah, Q., Kondle, V., Kopyt, N., Krishna, G., Lawrence, M. K., LeBeau, M., Leehey, D. J., Levine, M. M., Levinson, D., Lew, S. Q., Lewis, D., Linfert, D., Liss, K., Lund, R., Madeleine, P., Mahmood, K., Martin, E. R., Martinez, C., Mayeda, S. O., Mendez, R., Middleton, J., Molitch, M. E., Moncrief, J., Moustafa, M., Muoneke, R., Murray, A. V., Murugan, T. S., Nammour, T. M., Nassar, G., Navaneethan, S., Newman, J., Nossuli, A., Nwakoby, I., Osama, S., Ouseph, R., Parker, J., Parnes, E., Patel, N., Pergola, P., Perlman, A., Perry, R. G., Petrillo, R., Prabhakar, S., Purighalla, R. S., Quesada-Suarez, L., Rabiei, A., Raskin, P., Rastogi, A., Reisin, E., Rekhi, A., Rivera-Colon, L., Rizk, D., Rodelas, R., Roer, D., Rosas, S., Ross, D. L., Rovner, S., Sackel, H., Sader, S., Santos, P., Schmidt, R., Shafik, S., Shakeel, M., Sharon, Z., Silva, A. L., Silva, A., Singh, B., Smith, M., Solomon, R., Soman, S., Spinowitz, B., Sprague, S. M., Spry, L., Stonesifer, L., Streja, D., Suchinda, P., Sun, C., Thakar, C. V., Trespalacios, F., Tumlin, J. A., Van Buren, P., Vernace, M., Vicks, S., Warren, M., Weiss, D., Welker, J., Winston, J. A., Wombolt, D. G., Wood, M., Wu, M., Wynne, A., Yu, H., Zabaneh, R. I., Groningen Kidney Center (GKC), Methods in Medicines evaluation & Outcomes research (M2O), De Zeeuw, Dick, Akizawa, Tadao, Audhya, Paul, Bakris, George L., Chin, Melanie, Christ-Schmidt, Heidi, Goldsberry, Angie, Houser, Mark, Krauth, Melissa, Lambers Heerspink, Hiddo J., Mcmurray, John J., Meyer, Colin J., Parving, Hans-Henrik, Remuzzi, Giuseppe, Toto, Robert D., Vaziri, Nosratola D., Wanner, Christoph, Wittes, Janet, Wrolstad, Danielle, Chertow, Glenn M., Toto, B., Mccullough, P., Ivanovich, P., Ketteler, M., Lachin, J., Mcgill, J., Agarwal, R., Anker, S., Arenillas, J. F., Januzzi, J., Jardine, A., Kasner, S., Kissela, B., Kolansky, D., Mann, J., Thadhani, R., Champion de Crespigny, P., Chan, D. T., D'Almeida, E., Fraser, I., Gray, N., Holt, S., Irish, A., Isbel, N., Kerr, P., Packham, D., Phoon, R., Pollock, C., Roger, S., Suranyi, M., Walker, R., Wittert, G., Yue, D., Balcke, P., Prager, R., Schernthaner, G., Sunder-Plassmann, G., Jadoul, M., Krzesinski, J. M., Peeters, P., Van der Niepen, P., Van Gaal, L., Van Vlem, B., Warling, X., Chow, S., Cournoyer, S., Dumas, R., Jolly, S., Levin, A., Mcmahon, A., Mehta, H., Ooi, T. C., Perkins, D., Roy, L., Sapir, D., Tam, P., Bartaskova, D., Hemzsky, L., Kubina, D., Szabo, M., Tesar, V., Combe, C., Faller, B., Fauvel, J. P., Halimi, J. M., Hourmant, M., Le Meur, Y., Urena-Torres, P., Zaoui, P., Al-Sarraf, S., Burst, V., Degenhardt, S., Kempe, H. P., Kleophas, W., Kosch, C., Krumme, B., Kuhlmann, M., Pistrosch, F., Rambausek, M., Schmidt-Guertler, H., Segiet, T., Sommerer, C., Vielhauer, V., Wanner, C., Beberashvili, I., Benchetrit, S., Herskovits, T., Karnieli, E., Levin-Iaina, N., Mosenzon, O., Tsur, A., van Dijk, D. J., Wainstein, J., Yagil, Y., Yerushalmi, Y., Colussi, G., Conte, G., Di Luca, M., Giovambatista, C., Messa, P., Pani, A., Pisani, A., Rapana, M. R., Ruggenenti, P., Villa, G., Zoccali, C., Correa-Rotter, R., Diaz-Escobedo, S. L., Garcia, P., Gonzalez Galvez, G., Obrador Vera, G. T., Rico, R., Calero, F., Cigarran, S., de Alvaro, F., de Francisco, A. L., Egido, J., Fernandez, E., Fernandez Vega, F., Fort, J., Galan Serrano, A., Gorriz Teruel, J. L., Martinez, I., Martinez Castelao, A., Munar, M. A., Navarro, J., Nieto, J., Osuna, A., Pascual, J., Portoles, J., Praga, M., Vallés, M., Fellstrom, B., Frisenette-Fich, C., Hadimeri, H., Stenvinkel, P., Svensson, M., Weiss, L., Adamson, K., Dornhorst, A., El Kossi, M., Gnudi, L., Hendry, B., Johnson, A., Joseph, F., Kalra, P., Marshall, S., Mikhail, A., Myint, K. S., Soran, H., Taal, M., Zehnder, D., Abbott, L., Acharya, A., Ahmed, Z., Aiello, J., Akom, M., Ali, S., Alzohaili, O., Anderson, L., Anderson, S., Anger, M., Appel, G., Arakaki, R. F., Arif, A., Assefi, A. R., Atray, N., Awad, A., Barranco, E., Belledonne, M. O., Belo, D., Bernardo, M., Bernstein, R., Bhalla, V., Bhatia, D., Black, R. M., Block, G., Blondin, J., Blumenthal, S. S., Bononi, P., Brantley, R. R., Bresssler, P., Broumand, V., Brusco, O., Buerkert, J., Burgos-Calderon, R., Campbell, R., Canas, G., Cangiano, J., Cherlin, R., Chilakapati, V., Comunale, R., Coyne, D., Crawford, P. W., Darwish, R., Deeb, W., Denker, P. S., Desai, S., Desouza, C., Diamond, S., Dixon, B. S., Durham, J. H., Eisner, G., Elder, J. G., El-Shahawy, M., Fadda, G., Fitz-Patrick, D., Fonseca, V., Fraser, N. J., Frei, G., Fried, L., Galindo-Ramos, E., Germain, M., Ghantous, W., Gilbert, J. M., Gillum, D., Godwin, J., Goel, A., Goldfarb, Ds., Graf, R. J., Greenwood, T., Guasch, A., Hanna, A., Harper, K., Herman, T., Hilton, T., Hines, T., Hoggard, J., Hootkins, R., Huseman, R., Israelit, A., Jamal, A., Kant, K., Kaptein, E., Kathresal, A., Kaupke, J., Kaveh, K., Kaye, W., Keightley, G. E., Keith, K., Khairullah, Q., Kondle, V., Kopyt, N., Krishna, G., Lawrence, M. K., Lebeau, M., Leehey, D. J., Levine, M. M., Levinson, D., Lew, S. Q., Lewis, D., Linfert, D., Liss, K., Lund, R., Madeleine, P., Mahmood, K., Martin, E. R., Martinez, C., Mayeda, S. O., Mendez, R., Middleton, J., Molitch, M. E., Moncrief, J., Moustafa, M., Muoneke, R., Murray, A. V., Murugan, T. S., Nammour, T. M., Nassar, G., Navaneethan, S., Newman, J., Nossuli, A., Nwakoby, I., Osama, S., Ouseph, R., Parker, J., Parnes, E., Patel, N., Pergola, P., Perlman, A., Perry, R. G., Petrillo, R., Prabhakar, S., Purighalla, R. S., Quesada-Suarez, L., Rabiei, A., Raskin, P., Rastogi, A., Reisin, E., Rekhi, A., Rivera-Colon, L., Rizk, D., Rodelas, R., Roer, D., Rosas, S., Ross, D. L., Rovner, S., Sackel, H., Sader, S., Santos, P., Schmidt, R., Shafik, S., Shakeel, M., Sharon, Z., Silva, A. L., Silva, A., Singh, B., Smith, M., Solomon, R., Soman, S., Spinowitz, B., Sprague, S. M., Spry, L., Stonesifer, L., Streja, D., Suchinda, P., Sun, C., Thakar, C. V., Trespalacios, F., Tumlin, J. A., Van Buren, P., Vernace, M., Vicks, S., Warren, M., Weiss, D., Welker, J., Winston, J. A., Wombolt, D. G., Wood, M., Wu, M., Wynne, A., Yu, H., Zabaneh, R. I., de Zeeuw, D, Akizawa, T, Audhya, P, Bakris, Gl, Chin, M, Christ Schmidt, H, Goldsberry, A, Houser, M, Krauth, M, Lambers Heerspink, Hj, Mcmurray, Jj, Meyer, Cj, Parving, Hh, Remuzzi, G, Toto, Rd, Vaziri, Nd, Wanner, C, Wittes, J, Wrolstad, D, Chertow, Gm, Pisani, Antonio, De Zeeuw, D, Bakris, G, Lambers Heerspink, H, Mcmurray, J, Meyer, C, Parving, H, Toto, R, Vaziri, N, and Chertow, G.

Subjects
Male, medicine.medical_specialty, Intention to Treat Analysi, NF-E2-Related Factor 2, NEPHROPATHY, Urology, Renal function, Kaplan-Meier Estimate, Type 2 diabetes, Placebo, Article, Nephropathy, NRF2, Double-Blind Method, Cardiovascular Disease, Diabetes mellitus, Internal medicine, medicine, CKD, Treatment Failure, Bardoxolone methyl, Oleanolic Acid, Renal Insufficiency, Chronic, Aged, OUTCOMES, IRBESARTAN, ANALOGS, business.industry, Medicine (all), Hazard ratio, General Medicine, Middle Aged, medicine.disease, Weight Lo, Endocrinology, Diabetes Mellitus, Type 2, Diabetic Nephropathie, Kidney Failure, Chronic, Female, TRIAL, Stage 4 chronic kidney disease, business, Glomerular Filtration Rate, Human, RENAL EVENTS BEACON
Abstract

Background: Although inhibitors of the renin–angiotensin–aldosterone system can slow the progression of diabetic kidney disease, the residual risk is high. Whether nuclear 1 factor (erythroid-derived 2)–related factor 2 activators further reduce this risk is unknown. Methods: We randomly assigned 2185 patients with type 2 diabetes mellitus and stage 4 chronic kidney disease (estimated glomerular filtration rate [GFR], 15 to < 30 ml per minute per 1.73 m2 of body-surface area) to bardoxolone methyl, at a daily dose of 20 mg, or placebo. The primary composite outcome was end-stage renal disease (ESRD) or death from cardiovascular causes. Results: The sponsor and the steering committee terminated the trial on the recommendation of the independent data and safety monitoring committee; the median follow-up was 9 months. A total of 69 of 1088 patients (6%) randomly assigned to bardoxolone methyl and 69 of 1097 (6%) randomly assigned to placebo had a primary composite outcome (hazard ratio in the bardoxolone methyl group vs. the placebo group, 0.98; 95% confidence interval [CI], 0.70 to 1.37; P=0.92). In the bardoxolone methyl group, ESRD developed in 43 patients, and 27 patients died from cardiovascular causes; in the placebo group, ESRD developed in 51 patients, and 19 patients died from cardiovascular causes. A total of 96 patients in the bardoxolone methyl group were hospitalized for heart failure or died from heart failure, as compared with 55 in the placebo group (hazard ratio, 1.83; 95% CI, 1.32 to 2.55; P < 0.001). Estimated GFR, blood pressure, and the urinary albumin-to-creatinine ratio increased significantly and body weight decreased significantly in the bardoxolone methyl group, as compared with the placebo group. Conclusions: Among patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, bardoxolone methyl did not reduce the risk of ESRD or death from cardiovascular causes. A higher rate of cardiovascular events with bardoxolone methyl than with placebo prompted termination of the trial. (Funded by Reata Pharmaceuticals; BEACON ClinicalTrials.gov number, NCT01351675.)

Published
2013

13. Bardoxolone methyl in type 2 diabetes and stage 4 chronic kidney disease

Author

De Zeeuw, D, Akizawa, T, Audhya, P, Bakris, GL, Chin, M, Christ-Schmidt, H, Goldsberry, A, Houser, M, Krauth, M, Lambers Heerspink, HJ, McMurray, JJ, Meyer, CJ, Parving, HH, Remuzzi, G, Toto, RD, Vaziri, ND, Wanner, C, Wittes, J, Wrolstad, D, Chertow, GM, Toto, B, McCullough, P, Ivanovich, P, Ketteler, M, Lachin, J, McGill, J, Agarwal, R, Anker, S, Arenillas, JF, Januzzi, J, Jardine, A, Kasner, S, Kissela, B, Kolansky, D, Mann, J, Thadhani, R, Champion de Crespigny, P, Chan, DT, D'Almeida, E, Fraser, I, Gray, N, Holt, S, Irish, A, Isbel, N, Kerr, P, Packham, D, Phoon, R, Pollock, C, Roger, S, Suranyi, M, Walker, R, Wittert, G, Yue, D, Balcke, P, Prager, R, Schernthaner, G, Sunder-Plassmann, G, Jadoul, M, Krzesinski, JM, Peeters, P, Van der Niepen, P, Van Gaal, L, Van Vlem, B, Warling, X, Chow, S, Cournoyer, S, Dumas, R, Jolly, S, Levin, A, McMahon, A, Mehta, H, Ooi, TC, Perkins, D, Roy, L, Sapir, D, Tam, P, Bartaskova, D, Hemzsky, L, Kubina, D, Szabo, M, Tesar, V, Combe, C, Faller, B, Fauvel, JP, Halimi, JM, Hourmant, M, Le Meur, Y, Urena-Torres, P, Zaoui, P, Al-Sarraf, S, Burst, V, Degenhardt, S, Kempe, HP, Kleophas, W, Kosch, C, Krumme, B, Kuhlmann, M, Pistrosch, F, and Rambausek, M

Abstract

BACKGROUND: Although inhibitors of the renin-angiotensin-aldosterone system can slow the progression of diabetic kidney disease, the residual risk is high. Whether nuclear 1 factor (erythroid-derived 2)-related factor 2 activators further reduce this risk is unknown. METHODS: We randomly assigned 2185 patients with type 2 diabetes mellitus and stage 4 chronic kidney disease (estimated glomerular filtration rate [GFR], 15 to

Published
2013
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14. Caffeine Potentiates the Nephrotoxicity of Mefenamic Acid on the Rat Renal Papilla

Author

Champion de Crespigny P, Priscilla Kincaid-Smith, Tim D. Hewitson, and Birchall I

Subjects
medicine.medical_specialty, Time Factors, Mefenamic acid, Pharmacology, Nephrotoxicity, Mefenamic Acid, chemistry.chemical_compound, Oral administration, Caffeine, Internal medicine, medicine, Animals, Kidney Medulla, Creatinine, Kidney, business.industry, Drug Synergism, Rats, Inbred Strains, Rats, medicine.anatomical_structure, Endocrinology, chemistry, Nephrology, Renal papilla, Toxicity, Female, Kidney Papillary Necrosis, business, medicine.drug
Abstract

The effect of caffeine given in combination with mefenamic acid on the renal papilla was studied. Sprague-Dawley rats were divided into four groups and gavage fed either control suspension, mefenamic acid, mefenamic acid and caffeine or caffeine alone for 4 months. Semiquantitative urinalysis was performed at 3 months and showed increased haematuria in the mefenamic acid and caffeine group. There were no significant differences in serum creatinine at sacrifice. Renal histology revealed more advanced papillary necrosis in rats gavage fed mefenamic acid and caffeine compared with all other groups (p less than 0.0001). Rats fed mefenamic acid alone showed more damage than control and caffeine-fed groups (p less than 0.0001, p less than 0.0002, respectively). This suggests that caffeine potentiates the nephrotoxicity of the non-steroidal anti-inflammatory drug, mefenamic acid, on the rat renal papilla. The mechanism of this potentiation by caffeine is yet to be defined.

Published
1990
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15. Progression & risk factors CKD 1-5 (2)

Author

Bouba, I., primary, Bountouri, C., additional, Dounousi, E., additional, Kiatou, V., additional, Georgiou, I., additional, Chatzidakis, S., additional, Kotzadamis, N., additional, Tsakiris, D., additional, Siamopoulos, K., additional, Dimas, G., additional, Iliadis, F., additional, Tegos, T., additional, Makedou, K., additional, Didangelos, T., additional, Pitsalidis, C., additional, Chatziapostolou, A., additional, Makedou, A., additional, Baloyannis, S., additional, Grekas, D., additional, Li, O., additional, Bobkova, I., additional, Tchebotareva, N., additional, Kozlovskaya, L., additional, Varshavskiy, V., additional, Mydlik, M., additional, Derzsiova, K., additional, Bohu , B., additional, Clapp, E., additional, Kosmadakis, G., additional, Smith, A., additional, Viana, J., additional, Shirreffs, S., additional, Maughan, R., additional, Feehally, J., additional, Bevington, A., additional, Ando, M., additional, Yanagisawa, N., additional, Hara, M., additional, Tsuchiya, K., additional, Nitta, K., additional, Chen, C.-H., additional, Wang, C.-L., additional, Huang, J.-W., additional, Hung, K.-Y., additional, Tsai, T.-J., additional, Gadalean, F., additional, Gluhovschi, G., additional, Kaycsa, A., additional, Trandafirescu, V., additional, Petrica, L., additional, Velciov, S., additional, Bozdog, G., additional, Gluhovschi, C., additional, Bob, F., additional, Solberg Eikrem, O., additional, Hope Jaeger-Hoie, E., additional, Hausken, T., additional, Svarstad, E., additional, de Goeij, M., additional, Liem, M., additional, de Jager, D., additional, Voormolen, N., additional, Sijpkens, Y., additional, Boeschoten, E., additional, Dekker, F., additional, Grootendorst, D., additional, Halbesma, N., additional, Moran, A.-M., additional, Kenny, E., additional, Ward, F., additional, Dunne, O. M., additional, Holian, J., additional, Watson, A. J., additional, Saginova, E., additional, Gallyamov, M., additional, Severova, M., additional, Surkova, O., additional, Fomin, V., additional, Topchii, I., additional, Kirienko, A., additional, Schenyavskaya, E., additional, Efimova, N., additional, Bondar, T., additional, Lesovaja, A., additional, Gama Axelsson, T., additional, Barany, P., additional, Heimburger, O., additional, Lindholm, B., additional, Stenvinkel, P., additional, Qureshi, A. R., additional, Bal, Z., additional, Erkmen Uyar, M., additional, Ahmed, N., additional, Tutal, E., additional, Sezer, S., additional, Labrador, P. J., additional, Gonzalez Castillo, P. M., additional, Silva Junior, G. B., additional, Liborio, A. B., additional, Lopes Filho, A. S., additional, Figueiredo Filho, A. C., additional, Vieira, A. P. F., additional, Couto Bem, A. X., additional, Guedes, A. L. M. O., additional, Costa, C. M. B. E., additional, Holanda de Souza, J., additional, Daher, E. F., additional, Donadio, C., additional, Kanaki, A., additional, Tognotti, D., additional, Donadio, E., additional, Reznik, E., additional, Guschina, V., additional, Volinkina, V., additional, Gendlin, G., additional, Storozhakov, G., additional, Capusa, C., additional, Stancu, S., additional, Badulescu, M., additional, Ilyes, A., additional, Anghel, C., additional, Mircescu, G., additional, Yonemoto, S., additional, Fujii, N., additional, Hamano, T., additional, Okuno, A., additional, Soda, T., additional, Yamanaka, K., additional, Hirai, T., additional, Nishimura, K., additional, Ichikawa, Y., additional, Boudville, N., additional, Kemp, A., additional, Champion de Crespigny, P., additional, Fassett, R., additional, Healy, H., additional, Mangos, G., additional, Moody, H., additional, Pedagogos, E., additional, Waugh, D., additional, Kirkland, G., additional, Kay, T., additional, Hoffman, D., additional, Abaterusso, C., additional, Branco, C., additional, Thomaseth, K., additional, Graziani, M. S., additional, Lupo, A., additional, Chaudhry, M., additional, Lok, C., additional, Kudo, K., additional, Konta, T., additional, Takasaki, S., additional, Degawa, N., additional, Kubota, I., additional, Nykula, T., additional, Moyseyenko, V., additional, Topchii, A., additional, Nanami, K., additional, Yoshiharu, T., additional, Hiroshi, Y., additional, Miyuki, M., additional, Masayuki, N., additional, Sotila, G. G., additional, Rugina, S., additional, Tuta, L., additional, Dumitru, I., additional, Cernat, R., additional, Rugina, C., additional, Kim, I. Y., additional, Lee, S. B., additional, Choi, B. K., additional, Son, J., additional, Lee, H. S., additional, Lee, N., additional, Rhee, H., additional, Song, S. H., additional, Seong, E. Y., additional, and Kwak, I. S., additional

Published
2011
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17. Factors Associated with Chronic Kidney Disease Progression in Australian Nephrology Practices

Author

Boudville, Neil, Kemp, Anna, Moody, Henry, Fassett, Robert G., Pedagogos, Eugenie, Nelson, Craig, Healy, Helen, Mangos, George, Kirkland, Geoff, Kay, Troy, Champion de Crespigny, Paul, Hoffman, David, and Waugh, David

Abstract

AbstractBackground/Aims:Chronic kidney disease (CKD) is a major health issue worldwide. The aim of this study was to explore factors associated with CKD progression in Australian nephrology practices. Methods:This was a retrospective study utilising an electronic medical record (EMR), Audit4 (Software for Specialists, Australia). The baseline visit was defined as the first entry into the EMR. The primary outcome was the rate of change in estimated glomerular filtration rate (eGFR). Results:1,328 patients were included with a mean eGFR at baseline of 37.4 ± 0.7 ml/min/1.73 m2, a mean follow-up of 17.7 months and a mean annual rate of change in eGFR of –0.84 ± 0.26 ml/min/1.73 m2. Univariate analysis demonstrated that women, smokers, and patients prescribed erythropoiesis-stimulating agents (ESA) had a significantly more rapid decline in eGFR (p = 0.007, 0.033, and 0.003, respectively). On multivariate analysis: gender, age, prescription of ESA and phosphate binders, and baseline eGFR were significantly associated with CKD progression (p = 0.003, 0.004, <0.001, 0.029, and <0.001, respectively). Conclusions:This study identifies potential factors associated with CKD progression in a population referred to nephrologists, but current data quality may result in bias. Implementation of changes in the format of data collection is required so that busy clinicians record essential information to enable this to become a more accurate and reliable research tool.Copyright © 2012 S. Karger AG, Basel

Published
2012
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19. Pregnancy outcomes post-kidney transplantation across 23 years.

Author

Han J, McCormick CA, Krelle A, Champion de Crespigny P, and Unterscheider J

Subjects
Humans, Female, Pregnancy, Retrospective Studies, Adult, Pregnancy Complications epidemiology, Pre-Eclampsia epidemiology, Hypertension, Pregnancy-Induced epidemiology, Victoria epidemiology, Infant, Newborn, Cesarean Section statistics & numerical data, Premature Birth epidemiology, Young Adult, Kidney Transplantation, Pregnancy Outcome
Abstract

Background: Pregnancy in kidney transplant recipients has become increasingly common. However, pregnancy carries higher risks to these patients compared to the general population., Aims: To describe pregnancy outcomes in kidney transplant recipients., Materials and Methods: We conducted a single-centre retrospective cohort study of kidney transplant recipients who delivered after 20 weeks gestation at a quaternary hospital in Victoria, Australia, between 2000 and 2022 inclusive., Results: The study included 37 pregnancies from 27 patients, accounting for 38 infants. Over half of recorded pregnancies occurred in the past five years (56.8%, n = 21). There were high rates of pre-existing hypertension (75.7%, n = 28). Pregnancy-induced hypertension and pre-eclampsia were common antenatal complications (21.6%, n = 8 and 48.6%, n = 18 respectively). Soluble fms-like tyrosine kinase-1 / placental growth factor ratios were elevated in all patients who developed severe pre-eclampsia (16.2%, n = 6). The median gestational age at birth was 36.4 weeks (range 20-40.4, Q 1 32.9, Q 3 37.6) and 59.5% (n = 22) of births were preterm. Unplanned caesarean without labour was the most common mode of birth (35.1%, n = 13). The overall caesarean rate was 62.1% (n = 23). Post-partum haemorrhage complicated over half of pregnancies (56.8%, n = 21). Fifty percent (n = 19) of infants were admitted for neonatal care, in particular neonatal intensive care, and had low birthweights under 2500 g. While there was a transient deterioration in kidney function, there was no graft rejection within one year of birth., Conclusions: Clinicians should consider the high rates of pre-existing hypertension, preterm birth, and caesarean birth when counselling and managing pregnant kidney transplant recipients., (© 2024 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Published
2024
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21. Monitoring skin temperature at the wrist in hospitalised patients may assist in the detection of infection.

Author

Holt SG, Yo JH, Karschimkus C, Volpato F, Christov S, Smith ER, Hewitson TD, Worth LJ, and Champion De Crespigny P

Subjects
Adult, Cross-Sectional Studies, Humans, Pilot Projects, Prospective Studies, ROC Curve, Retrospective Studies, Skin Temperature, Wrist
Abstract

Background: Measuring temperature has always been a key observation in the diagnosis of infection. No studies have examined the usefulness of measuring temperature at the wrist to detect infection., Aim: We sought to determine whether a watch measuring wrist temperature could accurately identify patients who are infected., Methods: Prospective cross-sectional pilot study of temperature monitoring in an unselected patients in a tertiary referral adult nephrology unit., Results: One hundred and four data recording sessions revealed 88 useful data sets, with recording failures in the others. Patients were retrospectively classified as having no infection (Group A, n = 60), clinically diagnosed infection with less than 24 h of treatment with antibiotics (Group B, n = 5), and clinically diagnosed infection with greater than 24 h on antibiotics (Group C, n = 23). There was a significantly higher average maximum temperature in Group B (mean (SEM)) 38°C (0.6) compared with Groups A (36.1°C (0.1)) and C (36.3°C (0.3)). Based on receiver operating characteristics (ROC) a cut-off temperature of ≥37.5°C gave sensitivity 80% and specificity 98%. Mean electrodermal activity was significantly higher in Groups B and C., Conclusions: ROC of peripheral skin temperature measurements suggest that such a device may identify many patients requiring treatment for infection. This proof of principle study showed value in using a wearable device in the detection of infection and its potential as an early warning or monitoring device., (© 2020 The Authors. Internal Medicine Journal by Wiley Publishing Asia Pty Ltd on behalf of Royal Australasian College of Physicians.)

Published
2020
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22. Identifying and integrating patient and caregiver perspectives in clinical practice guidelines for percutaneous renal biopsy.

Author

Gutman T, Lopez-Vargas P, Manera KE, Craig JC, Howell M, Tunnicliffe D, James LJ, MacGinley R, See E, Wong J, Voss D, Saunders J, Menahem S, Jesudason S, Tong A, and Champion de Crespigny P

Subjects
Adult, Aged, Caregivers education, Consensus, Female, Humans, Male, Middle Aged, Patient Education as Topic, Patient-Centered Care methods, Self Care standards, Social Support, Caregivers psychology, Health Knowledge, Attitudes, Practice, Kidney pathology, Kidney Diseases pathology, Patient-Centered Care standards, Patients psychology, Practice Guidelines as Topic standards
Abstract

Aim: Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patient-relevance., Methods: We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with 10 patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritized by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analyzed thematically to identify the reasons for participants' choices., Results: In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: alleviating anxiety and unnecessary distress, minimizing discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result., Conclusions: Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies., (© 2018 Asian Pacific Society of Nephrology.)

Published
2019
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23. Caffeine potentiation of mefenamic acid-induced lesions in the rat renal medulla.

Author

Hewitson TD, Champion de Crespigny PJ, and Kincaid-Smith P

Subjects
Animals, Drug Synergism, Female, Kidney Diseases pathology, Kidney Medulla ultrastructure, Microscopy, Electron, Rats, Rats, Inbred Strains, Caffeine toxicity, Kidney Diseases chemically induced, Kidney Medulla drug effects, Mefenamic Acid toxicity
Abstract

The effect of caffeine given in combination with mefenamic acid on the renal medulla was examined. Sprague-Dawley rats were divided into four groups and gavage fed either vehicle suspension (control), mefenamic acid, mefenamic acid+caffeine or caffeine only for 4 months. Renal tissue taken from the corticomedullary junction was processed for electron microscopy. Ultrathin sections were cut after identification of vasa rectae on survey sections. On subsequent morphometric analysis, percentage interstitial tissue was calculated from the total area of vasa recta less the non-interstitial tissue. The median percentage of interstitial tissue in the mefenamic acid and caffeine group was 41 (range 33-50; n = 15) compared with 34 (20-48; n = 20) in mefenamic acid (P less than 0.01), 29 (15-42; n = 15) in caffeine only (P less than 0.001) and 32 (20-46; n = 18) in vehicle-treated animals (P less than 0.001). There were no significant differences between mefenamic acid alone and vehicle or caffeine-only groups or between caffeine-only and vehicle-treated controls. This suggests that caffeine potentiates the effect of the non-steroidal anti-inflammatory drug, mefenamic acid, on the rat renal medulla, resulting in a quantitative increase in the interstitial tissue between adjacent afferent and efferent vasa recta.

Published
1991
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24. Effects of the angiotensin converting enzyme inhibitor, benazepril, on the sino-aortic baroreceptor heart rate reflex.

Author

West JN, Champion de Crespigny PC, Stallard TJ, and Littler WA

Subjects
Benzazepines blood, Double-Blind Method, Female, Heart Rate drug effects, Humans, Male, Middle Aged, Reflex drug effects, Angiotensin-Converting Enzyme Inhibitors pharmacology, Antihypertensive Agents pharmacology, Benzazepines pharmacology, Pressoreceptors drug effects
Abstract

The effects of monotherapy with the angiotensin converting enzyme inhibitor benazepril (10 mg once daily) on cardiovascular baroreceptor reflexes were determined in 10 patients with essential hypertension using a randomized, double-blind, placebo-controlled, cross-over protocol. Early sino-aortic baroreceptor/heart rate reflex resetting was apparent with acute treatment; this effect persisted throughout the active treatment period. Changes in baroreflex sensitivity did not appear to mediate the hypotensive effect of benazepril.

Published
1991
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25. Renal failure and nephrotic syndrome associated with sulindac.

Author

Champion de Crespigny PJ, Becker GJ, Ihle BU, Walter NM, Wright CA, and Kincaid-Smith P

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Sulindac therapeutic use, Acute Kidney Injury chemically induced, Indenes adverse effects, Nephrotic Syndrome chemically induced, Sulindac adverse effects
Abstract

Four elderly patients developed nephrotic syndrome while receiving sulindac. Sulindac treatment had commenced 4-12 months prior to presentation with the nephrotic syndrome. Two patients also developed oliguric renal failure. Renal biopsy in one showed minimal change nephropathy and in three cases membranous nephropathy. Interstitial nephritis was present on renal biopsy in all cases. The nephrotic syndrome and renal failure resolved in all cases after withdrawal of sulindac. Two patients received steroid therapy and improvement in renal function and disappearance of proteinuria seemed to be temporarily related to steroid therapy in both cases. Despite the fact that sulindac is less likely to cause renal failure due to inhibition of renal prostaglandin secretion this report shows that sulindac treatment can be associated with renal failure and the nephrotic syndrome.

Published
1988

26. A 75 year old man with sideroblastic anemia.

Author

Firkin BG, Champion de Crespigny PJ, and Clarke BE

Subjects
Aged, Anemia, Sideroblastic complications, Anemia, Sideroblastic therapy, Blood Transfusion, Cardiomyopathies complications, Cardiomyopathies pathology, Hemochromatosis complications, Hemochromatosis pathology, Humans, Liver Diseases complications, Liver Diseases pathology, Male, Pyridoxine therapeutic use, Anemia, Sideroblastic pathology
Published
1986
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