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  1. Article ; Online: An Engaged and Empowered Patient: A Critically Important Concept in Nephrology.

    Nigwekar, Sagar U / Thakar, Charuhas V

    Advances in kidney disease and health

    2024  Volume 31, Issue 1, Page(s) 1

    MeSH term(s) Nephrology ; Renal Dialysis
    Language English
    Publishing date 2024-02-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 3156601-7
    ISSN 2949-8139
    ISSN (online) 2949-8139
    DOI 10.1053/j.akdh.2024.01.004
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    Zs.A 4627: Show issues Location:
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  2. Article ; Online: Cardiovascular Calcifications Among Patients With Uremia: Answers to Hard Questions.

    Nigwekar, Sagar U

    Advances in chronic kidney disease

    2019  Volume 26, Issue 6, Page(s) 407–408

    MeSH term(s) Chronic Kidney Disease-Mineral and Bone Disorder/complications ; Heart Valve Diseases/diagnosis ; Heart Valve Diseases/etiology ; Humans ; Uremia/etiology ; Vascular Calcification/diagnosis ; Vascular Calcification/etiology
    Language English
    Publishing date 2019-12-09
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ISSN 1548-5609 ; 1548-5595
    ISSN (online) 1548-5609
    ISSN 1548-5595
    DOI 10.1053/j.ackd.2019.11.001
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  3. Article ; Online: Calciphylaxis.

    Nigwekar, Sagar U

    Current opinion in nephrology and hypertension

    2017  Volume 26, Issue 4, Page(s) 276–281

    Abstract: Purpose of review: Calciphylaxis remains a poorly understood vascular calcification disorder with predilection for patients with end-stage renal disease (ESRD). Recent data from large patient registries and databases have begun to provide information ... ...

    Abstract Purpose of review: Calciphylaxis remains a poorly understood vascular calcification disorder with predilection for patients with end-stage renal disease (ESRD). Recent data from large patient registries and databases have begun to provide information regarding incidence, risk factors, and outcomes in patients with calciphylaxis.
    Recent findings: The most recent estimate places the incidence of calciphylaxis at 3.5 new cases/1000 patient-years among the patients with ESRD on chronic hemodialysis. It is possible that misdiagnosis or subclinical disease may attribute to lower than the true incidence. There is a suggestion that the incidence is higher in peritoneal dialysis patients compared with patients with hemodialysis. Recent studies have identified a number of risk factors and point to the effects of vitamin K deficiency mediated impairment in Matrix Gla Protein carboxylation as one of the likely pathogenic mechanisms. The outcomes in calciphylaxis patients remain poor with mortality approaching 30% at 6 months and 50% at 12 months.
    Summary: The present review describes recent literature in the field of calciphylaxis. Calciphylaxis registries and specimen biorepositories promise to provide insights into the pathogenesis of calciphylaxis and will pave the way for much needed clinical trials.
    MeSH term(s) Calciphylaxis/diagnosis ; Calciphylaxis/epidemiology ; Calciphylaxis/etiology ; Calciphylaxis/therapy ; Humans ; Incidence ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/therapy ; Prognosis ; Registries ; Renal Dialysis/adverse effects ; Renal Dialysis/statistics & numerical data ; Risk Factors ; Vascular Calcification/diagnosis ; Vascular Calcification/epidemiology ; Vascular Calcification/etiology ; Vascular Calcification/therapy
    Language English
    Publishing date 2017
    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.0000000000000328
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Risks of Hip and Nonvertebral Fractures in Patients With CKD.

    Ayus, Juan Carlos / Nigwekar, Sagar U / Negri, Armando Luis

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

    2021  Volume 77, Issue 4, Page(s) 546

    MeSH term(s) Female ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Humans ; Osteoporosis, Postmenopausal ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology
    Language English
    Publishing date 2021-02-12
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2020.10.018
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  5. Article ; Online: Medication Prescription Patterns for Secondary Hyperparathyroidism: More Questions than Answers.

    Seethapathy, Harish / Nigwekar, Sagar U

    Clinical journal of the American Society of Nephrology : CJASN

    2019  Volume 14, Issue 2, Page(s) 178–179

    MeSH term(s) Cinacalcet ; Humans ; Hyperparathyroidism, Secondary ; Renal Dialysis
    Chemical Substances Cinacalcet (UAZ6V7728S)
    Language English
    Publishing date 2019-01-21
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.15081218
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Opioids in Hemodialysis Patients.

    Kalim, Sahir / Lyons, Karen S / Nigwekar, Sagar U

    Seminars in nephrology

    2021  Volume 41, Issue 1, Page(s) 24–32

    Abstract: Chronic pain and prescription opioid use are prevalent among patients with end-stage kidney disease treated with hemodialysis. Vulnerabilities to complications from opioid use are high in this patient population, as shown in many recent, well-conducted, ... ...

    Abstract Chronic pain and prescription opioid use are prevalent among patients with end-stage kidney disease treated with hemodialysis. Vulnerabilities to complications from opioid use are high in this patient population, as shown in many recent, well-conducted, patient-oriented studies. Such studies have highlighted the need for a balanced approach to pain management in hemodialysis patients that includes careful assessment of the risks and benefits of opioid prescriptions in this population. In this article, we review the available literature and experience regarding opioid prescriptions among hemodialysis patients, discuss clinical implications, and outline ongoing research.
    MeSH term(s) Analgesics, Opioid ; Chronic Pain/drug therapy ; Humans ; Pain Management ; Renal Dialysis
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2021-04-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 604652-6
    ISSN 1558-4488 ; 0270-9295
    ISSN (online) 1558-4488
    ISSN 0270-9295
    DOI 10.1016/j.semnephrol.2021.02.003
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    Se 784: Show issues Location:
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  7. Article ; Online: Physiopathology of Phosphate Disorders.

    Portales-Castillo, Ignacio / Rieg, Timo / Khalid, Sheikh B / Nigwekar, Sagar U / Neyra, Javier A

    Advances in kidney disease and health

    2023  Volume 30, Issue 2, Page(s) 177–188

    Abstract: Intracellular phosphate is critical for cellular processes such as signaling, nucleic acid synthesis, and membrane function. Extracellular phosphate (Pi) is an important component of the skeleton. Normal levels of serum phosphate are maintained by the ... ...

    Abstract Intracellular phosphate is critical for cellular processes such as signaling, nucleic acid synthesis, and membrane function. Extracellular phosphate (Pi) is an important component of the skeleton. Normal levels of serum phosphate are maintained by the coordinated actions of 1,25-dihydroxyvitamin D3, parathyroid hormone and fibroblast growth factor-23, which intersect in the proximal tubule to control the reabsorption of phosphate via the sodium-phosphate cotransporters Npt2a and Npt2c. Furthermore, 1,25-dihydroxyvitamin D3 participates in the regulation of dietary phosphate absorption in the small intestine. Clinical manifestations associated with abnormal serum phosphate levels are common and occur as a result of genetic or acquired conditions affecting phosphate homeostasis. For example, chronic hypophosphatemia leads to osteomalacia in adults and rickets in children. Acute severe hypophosphatemia can affect multiple organs leading to rhabdomyolysis, respiratory dysfunction, and hemolysis. Patients with impaired kidney function, such as those with advanced CKD, have high prevalence of hyperphosphatemia, with approximately two-thirds of patients on chronic hemodialysis in the United States having serum phosphate levels above the recommended goal of 5.5 mg/dL, a cutoff associated with excess risk of cardiovascular complications. Furthermore, patients with advanced kidney disease and hyperphosphatemia (>6.5 mg/dL) have almost one-third excess risk of death than those with phosphate levels between 2.4 and 6.5 mg/dL. Given the complex mechanisms that regulate phosphate levels, the interventions to treat the various diseases associated with hypophosphatemia or hyperphosphatemia rely on the understanding of the underlying pathobiological mechanisms governing each patient condition.
    MeSH term(s) Adult ; Child ; Humans ; Phosphates ; Hyperphosphatemia ; Calcitriol ; Hypophosphatemia ; Rickets
    Chemical Substances Phosphates ; Calcitriol (FXC9231JVH)
    Language English
    Publishing date 2023-02-27
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 3156601-7
    ISSN 2949-8139
    ISSN (online) 2949-8139
    DOI 10.1053/j.akdh.2022.12.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4627: Show issues Location:
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  8. Article ; Online: Revisiting therapeutic options for calciphylaxis.

    Seethapathy, Harish / Nigwekar, Sagar U

    Current opinion in nephrology and hypertension

    2019  Volume 28, Issue 5, Page(s) 448–454

    Abstract: Purpose of review: Calciphylaxis is a disorder of cutaneous microvascular calcification and thrombosis leading to chronic, excruciatingly painful, progressive wounds with a high risk of sepsis and death. The diagnosis and treatment of calciphylaxis ... ...

    Abstract Purpose of review: Calciphylaxis is a disorder of cutaneous microvascular calcification and thrombosis leading to chronic, excruciatingly painful, progressive wounds with a high risk of sepsis and death. The diagnosis and treatment of calciphylaxis presents significant challenges. A poorly understood disease, the management of calciphylaxis has mostly been restricted to wound management and a few novel therapies. Data from patient registries and new studies on causal pathways is stimulating the development of pathogenesis-based medical therapies.
    Recent findings: Much needed clinical trials are now underway to examine the safety and efficacy of sodium thiosulfate and other therapeutics for the indication of calciphylaxis. There is emerging data suggesting a potential role of therapeutic anticoagulation in these patients. There has also been a renewed emphasis on patient-oriented outcomes, such as improvement of pain scores and quality-of-life indices.
    Summary: This review highlights ongoing clinical trials studying therapeutic options in calciphylaxis and emphasizes the causal pathways that led to the development of such therapies.
    MeSH term(s) Anticoagulants/therapeutic use ; Calciphylaxis/diagnosis ; Calciphylaxis/etiology ; Calciphylaxis/therapy ; Cinacalcet/therapeutic use ; Clinical Trials as Topic ; Humans ; Pain Management ; Parathyroidectomy ; Thiosulfates/therapeutic use
    Chemical Substances Anticoagulants ; Thiosulfates ; sodium thiosulfate (HX1032V43M) ; Cinacalcet (UAZ6V7728S)
    Language English
    Publishing date 2019-06-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; 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.0000000000000520
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  9. Article ; Online: Long-Term Anticoagulation for Patients Receiving Dialysis.

    Nigwekar, Sagar U / Thadhani, Ravi

    Circulation

    2018  Volume 138, Issue 15, Page(s) 1530–1533

    MeSH term(s) Anticoagulants ; Atrial Fibrillation ; Humans ; Kidney Failure, Chronic ; Pyrazoles ; Pyridones ; Renal Dialysis ; United States
    Chemical Substances Anticoagulants ; Pyrazoles ; Pyridones ; apixaban (3Z9Y7UWC1J)
    Language English
    Publishing date 2018-10-24
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.118.037091
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  10. Article ; Online: Prevalence and risk factors for development of recurrent calciphylaxis.

    Xia, Joyce / Tan, Alice J / Gabel, Colleen K / Nguyen, Emily D / Chand, Sidharth / Rrapi, Renajd / Dobry, Allison S / Garza-Mayers, Anna Cristina / Ko, Lauren N / Shah, Radhika / St John, Jessica / Nigwekar, Sagar U / Kroshinsky, Daniela

    Journal of the American Academy of Dermatology

    2024  

    Language English
    Publishing date 2024-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603641-7
    ISSN 1097-6787 ; 0190-9622
    ISSN (online) 1097-6787
    ISSN 0190-9622
    DOI 10.1016/j.jaad.2024.02.019
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