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  1. Article ; Online: Beyond Creatinine: Is Cystatin C the New Global Standard for Estimated Glomerular Filtration Rate Evaluation?

    Hundemer, Gregory L / Sood, Manish M / Akbari, Ayub

    Kidney medicine

    2024  Volume 6, Issue 4, Page(s) 100806

    Language English
    Publishing date 2024-02-19
    Publishing country United States
    Document type Editorial
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2024.100806
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Has the time come for age-adapted glomerular filtration rate criteria to define chronic kidney disease: how soon is now?

    Hundemer, Gregory L / Akbari, Ayub / Sood, Manish M

    Current opinion in nephrology and hypertension

    2024  Volume 33, Issue 3, Page(s) 318–324

    Abstract: ... a straightforward eGFR threshold of <60 ml/min/1.73 m 2 has been widely adopted as the standard for defining CKD ... The fixed eGFR threshold of <60 ml/min/1.73 m 2 for defining CKD misses crucial opportunities ...

    Abstract Purpose of review: The conventional definition of chronic kidney disease (CKD) primarily relies on the identification of albuminuria or a decline in estimated glomerular filtration rate (eGFR). For many years, a straightforward eGFR threshold of <60 ml/min/1.73 m 2 has been widely adopted as the standard for defining CKD. Nonetheless, this criterion fails to consider the natural aging process of the kidney, and this oversight may affect the accurate diagnosis of kidney disease particularly at the extremes of age.
    Recent findings: The fixed eGFR threshold of <60 ml/min/1.73 m 2 for defining CKD misses crucial opportunities for risk prevention. Studies have revealed that the eGFR threshold at which the risks for adverse long-term health outcomes such as mortality, cardiovascular events, and kidney failure begin to rise varies substantially by age. Specifically, this threshold is lower for the elderly and higher for young adults. Consequently, this results in the over-diagnosis of kidney disease in the elderly and the under-diagnosis of kidney disease in young adults.
    Summary: To address these limitations of the current CKD definition, we discuss a number of proposed age-adapted eGFR criteria and weigh their pros and cons against the current, simple, and universally accepted approach.
    MeSH term(s) Young Adult ; Humans ; Aged ; Glomerular Filtration Rate ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Kidney ; Albuminuria/diagnosis
    Language English
    Publishing date 2024-02-23
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000971
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    Zs.A 3686: Show issues Location:
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  3. Article ; Online: Growing Understanding of the Clinical and Serologic Effects of COVID-19 Vaccines in Patients Undergoing Long-Term Dialysis.

    Hundemer, Gregory L / Sood, Manish M

    Clinical journal of the American Society of Nephrology : CJASN

    2022  Volume 17, Issue 3, Page(s) 335–337

    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Humans ; Renal Dialysis ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-02-10
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.00320122
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    Zs.A 6584: Show issues Location:
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  4. Article ; Online: Is Warfarin Being Relegated to the Pharmaceutical Dustbin?

    Harel, Ziv / Sood, Manish M

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2021  Volume 78, Issue 2, Page(s) 174–176

    MeSH term(s) Humans ; Pharmaceutical Preparations ; Warfarin/adverse effects
    Chemical Substances Pharmaceutical Preparations ; Warfarin (5Q7ZVV76EI)
    Language English
    Publishing date 2021-05-28
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2021.02.329
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    Zs.A 1669: Show issues Location:
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    Zs.MO 468: Show issues

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  5. Article ; Online: Recent updates in kidney risk prediction modeling: novel approaches and earlier outcomes.

    Hundemer, Gregory L / Sood, Manish M / Canney, Mark

    Current opinion in nephrology and hypertension

    2023  Volume 32, Issue 3, Page(s) 257–262

    Abstract: Purpose of review: Recent years have witnessed the development of kidney risk prediction models which diverge from traditional model designs to incorporate novel approaches along with a focus on earlier outcomes. This review summarizes these recent ... ...

    Abstract Purpose of review: Recent years have witnessed the development of kidney risk prediction models which diverge from traditional model designs to incorporate novel approaches along with a focus on earlier outcomes. This review summarizes these recent advances, evaluates their pros and cons, and discusses their potential implications.
    Recent findings: Several kidney risk prediction models have recently been developed utilizing machine learning rather than traditional Cox regression. These models have demonstrated accurate prediction of kidney disease progression, often beyond that of traditional models, in both internal and external validation. On the opposite end of the spectrum, a simplified kidney risk prediction model was recently developed which minimized the need for laboratory data and instead relies primarily on self-reported data. While internal testing showed good overall predictive performance, the generalizability of this model remains uncertain. Finally, there is a growing trend toward prediction of earlier kidney outcomes (e.g., incident chronic kidney disease [CKD]) and away from a sole focus on kidney failure.
    Summary: Newer approaches and outcomes now being incorporated into kidney risk prediction modeling may enhance prediction and benefit a broader patient population. However, future work should address how best to implement these models into practice and assess their long-term clinical effectiveness.
    MeSH term(s) Humans ; Kidney ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency ; Treatment Outcome ; Forecasting
    Language English
    Publishing date 2023-02-22
    Publishing country England
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000879
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    Zs.A 3686: Show issues Location:
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  6. Article ; Online: Managing Hyperkalemia in the Modern Era: A Case-Based Approach.

    Massicotte-Azarniouch, David / Canney, Mark / Sood, Manish M / Hundemer, Gregory L

    Kidney international reports

    2023  Volume 8, Issue 7, Page(s) 1290–1300

    Abstract: The last decade has seen tremendous advances in the prevention and treatment of recurrent hyperkalemia. In this narrative review, we aim to highlight contemporary data on key areas in the epidemiology and management of hyperkalemia. Focusing on drug- ... ...

    Abstract The last decade has seen tremendous advances in the prevention and treatment of recurrent hyperkalemia. In this narrative review, we aim to highlight contemporary data on key areas in the epidemiology and management of hyperkalemia. Focusing on drug-induced hyperkalemia (the implications of renin-angiotensin-aldosterone system inhibitors [RAASi] discontinuation and the role of mineralocorticoid receptor antagonists), newer concurrent therapies that modify potassium handling (sodium-glucose transporter 2 inhibitors [SGLT2i]), the introduction of new treatment agents (oral potassium binding agents), and the controversial role of dietary potassium restriction, we apply recent research findings and review the evidence in a case-based format.
    Language English
    Publishing date 2023-04-24
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2023.04.016
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  7. Article ; Online: Hyperkalemia with RAAS inhibition: Mechanism, clinical significance, and management.

    Hundemer, Gregory L / Sood, Manish M

    Pharmacological research

    2021  Volume 172, Page(s) 105835

    Abstract: Renin-angiotensin-aldosterone system (RAAS) inhibitors are evidence-based treatments for a number of conditions including hypertension, diabetes mellitus, chronic kidney disease, and congestive heart failure. Among the most common adverse effects of RAAS ...

    Abstract Renin-angiotensin-aldosterone system (RAAS) inhibitors are evidence-based treatments for a number of conditions including hypertension, diabetes mellitus, chronic kidney disease, and congestive heart failure. Among the most common adverse effects of RAAS inhibitors is hyperkalemia which results from either reduced secretion of aldosterone or increased resistance to aldosterone. Many of the conditions for which RAAS inhibitors are recommended further amplify the risk for hyperkalemia in and of themselves. RAAS inhibitor-related hyperkalemia is associated with an increased risk for cardiovascular events, hospitalizations, and death. Yet discontinuation of RAAS inhibitors for patients with chronic kidney disease and congestive heart failure is also associated with an increased risk for cardiovascular events, hospitalizations, and death. Therefore, clinicians are often left to struggle with the dilemma of the best management approach to RAAS inhibitor-related hyperkalemia. The ideal solution involves pharmacotherapies that are safe and effective in mitigating hyperkalemia and allow patients to continue to receive the beneficial effects from RAAS inhibitors. In this regard, modern pharmacologic agents such as patiromer and zirconium cyclosilicate are providing a mechanism whereby physicians are better equipped to maintain their patients on RAAS inhibitors.
    MeSH term(s) Adrenergic beta-Antagonists/adverse effects ; Angiotensin Receptor Antagonists/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Calcium Channel Blockers/adverse effects ; Humans ; Hyperkalemia/chemically induced ; Hyperkalemia/drug therapy ; Mineralocorticoid Receptor Antagonists/adverse effects ; Renin-Angiotensin System
    Chemical Substances Adrenergic beta-Antagonists ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Calcium Channel Blockers ; Mineralocorticoid Receptor Antagonists
    Language English
    Publishing date 2021-08-23
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1003347-6
    ISSN 1096-1186 ; 0031-6989 ; 1043-6618
    ISSN (online) 1096-1186
    ISSN 0031-6989 ; 1043-6618
    DOI 10.1016/j.phrs.2021.105835
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    Zs.A 721: Show issues Location:
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  8. Article: The Intersection of SGLT2 Inhibitors, Cognitive Impairment, and CKD.

    Noel, J Ariana / Hougen, Ingrid / Sood, Manish M

    Frontiers in neurology

    2022  Volume 13, Page(s) 823569

    Abstract: Impairment in cognition and decline in kidney function often converge in the aging individual with chronic kidney disease (CKD). Cognitive impairment (CI) may be preventable through modification of health behaviors and risk factors that contribute to the ...

    Abstract Impairment in cognition and decline in kidney function often converge in the aging individual with chronic kidney disease (CKD). Cognitive impairment (CI) may be preventable through modification of health behaviors and risk factors that contribute to the vascular disease burden. CKD patients often have multiple coexisting comorbid conditions contributing to vascular risk. These comorbidities include hypertension, diabetes, cerebrovascular disease, and cardiovascular disease. Emerging evidence suggests that the management and prevention of vascular risk factors and cardiovascular diseases may indirectly contribute to the prevention of CI in CKD. Sodium glucose transport protein 2 inhibitors (SGLT2i) are emerging as the standard of care for selected individuals with CKD, type 2 diabetes (T2DM), and heart failure with rapidly expanding indications being actively investigated. In this narrative review, we examine the intriguing hypothesis that SGLT2i demonstrate potential disease modifying properties in CI among individuals with CKD.
    Language English
    Publishing date 2022-06-21
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2022.823569
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  9. Article ; Online: Contemporary risk prediction models in chronic kidney disease: when less is more.

    Canney, Mark / Sood, Manish M / Hundemer, Gregory L

    Current opinion in nephrology and hypertension

    2022  Volume 31, Issue 3, Page(s) 297–302

    Abstract: Purpose of review: Clinicians have an ever-increasing number of prediction tools at their disposal for estimating the risk of kidney failure in their patients. This review aims to summarize contemporary evidence for chronic kidney disease (CKD) risk ... ...

    Abstract Purpose of review: Clinicians have an ever-increasing number of prediction tools at their disposal for estimating the risk of kidney failure in their patients. This review aims to summarize contemporary evidence for chronic kidney disease (CKD) risk prediction models across the spectrum of kidney function, and explore nuances in the interpretation of risk estimates.
    Recent findings: A European study using predominantly laboratory data has extended kidney failure prediction to patients with more preserved estimated glomerular filtration rate. For older patients with advanced CKD, prediction tools that censor for death (such as the Kidney Failure Risk Equation) overestimate the risk of kidney failure, especially over time horizons longer than 2 years. This problem can be addressed by accounting for the competing risk of death, as shown in well designed validation studies. The clinical utility of kidney failure risk prediction tools is being increasingly tested at a population level to inform policy and referral guidelines.
    Summary: There is welcome trend to validate existing prediction tools in diverse clinical settings and identify their role in clinical practice. Clinicians should be cognizant of overestimating kidney failure risk in older patients with advanced CKD due to the competing risk of death. For moderate CKD and for short-term predictions, the Kidney Failure Risk Equation remains the most widely validated prediction tool.
    MeSH term(s) Aged ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic ; Male ; Renal Insufficiency ; Renal Insufficiency, Chronic/diagnosis ; Risk Assessment ; Risk Factors
    Language English
    Publishing date 2022-02-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000788
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    Zs.A 3686: Show issues Location:
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  10. Article ; Online: Elimination of race in estimates of kidney function to provide unbiased clinical management in Canada.

    Parekh, Rulan S / Perl, Jeffrey / Auguste, Bourne / Sood, Manish M

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2022  Volume 194, Issue 11, Page(s) E421–E423

    MeSH term(s) Canada/epidemiology ; Humans ; Kidney
    Language English
    Publishing date 2022-03-31
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.210838
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